Week 9 Summary - Brain and Behaviour PDF

Week 9: Health, stress and coping Weekly Objective 1: Define health psychology • Health psychology is the specialisation of psychology concerned with psychological influences on how people stay healthy, why they become ill, and how they cope and recover from illness. Weekly Objective 2: Distinguis...

Week 9: Health, stress and coping Weekly Objective 1: Define health psychology • Health psychology is the specialisation of psychology concerned with psychological influences on how people stay healthy, why they become ill, and how they cope and recover from illness. Weekly Objective 2: Distinguish between the various social-cognitive theories of health behaviour • The cognitive approach to health psychology is embodied in various health belief models. One of the most influential of these models was developed by Irwin Rosenstock (1974). This model is based on the assumption that people’s decisions about health-related behaviours (such as smoking) are guided by four main factors: 1. Perceiving a personal threat of, or susceptibility to, developing a specific health problem. (Do you believe that you will get lung cancer from smoking?) 2. Perceiving the seriousness of the illness and the consequences of having it. (How serious do you think lung cancer is, and what will happen if you get it? 3. Believing that changing a particular behaviour will reduce the threat. (Will giving up smoking prevent you from getting lung cancer?) 4. A comparison of the perceived costs of enacting a health-related behaviour change and the benefits expected from that change. (Will the reduced chance of getting cancer in the future be worth the discomfort and loss of pleasure associated with not smoking now?) • • • According to this health belief model, the people most likely to quit smoking would be those who believe that they are at risk of getting cancer from smoking, that cancer is serious and life-threatening, that quitting will reduce their chances of getting cancer, and that the benefits of preventing cancer clearly outweigh the difficulties associated with quitting. Other cognitive factors are emphasised in other health belief models. For example, people generally do not try to quit smoking unless they believe they can succeed. So self-efficacy, the belief that one is able to perform some behaviour, is an additional consideration in decisions about health behaviours. A related factor is the person’s intention to engage in a behaviour designed to improve health or protect against illness. Weekly Objective 3: Describe the barriers to health promotion and preventative health Changing health-related behaviours depends not only on a person’s health beliefs but also on that person’s readiness to change. According to James Prochaska and his colleagues, the process of successful change occurs in five stages: 1. Precontemplation: the person does not perceive a health-related problem and has no intention of changing in the foreseeable future. 2. Contemplation: the person is aware of a health-related behaviour that should be changed and is seriously thinking about changing it. 3. Preparation: the person has a strong intention to change and has made specific plans to do so. 4. Action: the person is engaging successfully in behaviour change. 5. Maintenance: The healthy behaviour has continued for at least six months, and the person is using newly learned skills to prevent relapse, or ‘backsliding’. • These stages may actually overlap somewhat; for example, some ‘precontemplators’ may actually be starting to contemplate change. In any case, the path from precontemplation through maintenance can be a bumpy one. • Usually, people relapse and go through the stages repeatedly before finally achieving stability in the healthy behaviour they desire. Smokers, for example, typically require three to four cycles through the stages over several years before they finally reach the maintenance stage. Weekly Objective 4: Describe the major sources of stress • • Stress is the internal processes that occur as people try to adjust to events and situations, especially those that they perceive to be beyond their coping capacity. Common sources of stress (stressors) include: 1. Catastrophic events - these are sudden, unexpected, potentially life-threatening experiences or traumas, such as physical or sexual assault, military combat, natural disasters, terrorist attacks and accidents. 2. Life changes and strains - these include divorce, illness in the family, difficulties at work and other circumstances that create demands to which people must adjust. 3. Chronic problems – those that continue over a long period of time – include circumstances such as living in a high-crime neighbourhood or under the threat of terrorism, having a serious illness, being unable to earn a decent living, being the victim of discrimination, and even enduring years of academic pressure. 4. Daily hassles - are irritations, pressures and annoyances that may not be significant stressors by themselves but whose cumulative effects can be significant. Weekly Objective 5: Discuss the nature of the relationship between stress and health • • • The immune system is the body’s first line of defence against invading substances and microorganisms. It is perhaps as complex as the nervous system and contains as many cells as the brain. If our immune system is impaired – by stressors, for example – we are left more vulnerable to colds, mononucleosis and many other infectious diseases. The activity of immune system cells can be either strengthened or weakened by a number of systems, including the endocrine system and the central and autonomic nervous systems. It is through these connections that stress-related psychological and emotional factors can affect the functioning of the immune system. Researchers have found that people under stress are more likely than less stressed people to develop infectious diseases and to experience flare-ups of • • • • latent viruses responsible for oral herpes (cold sores) or genital herpes. Other research has shown that a variety of stressors lead to suppression of the immune system. The effects are especially strong in the elderly but they occur in everyone. The relationship between stress and the immune system is especially important in people who are HIV-positive but do not yet have AIDS. As their immune systems are already seriously compromised, further stress-related impairments could be lifethreatening. Research indicates that psychological stressors are associated with the progression of HIV-related illnesses. The sympatho-adreno-medullary (SAM) system is linked to the cardiovascular system, its repeated activation in response to stressors, especially chronic ones, has been associated with the development of coronary heart disease (CHD), high blood pressure (hypertension) and stroke. The link between CHD and physical stress responses appears especially strong in people who show intense physiological reactivity to stressors. For example, among healthy young adult research participants, those whose blood pressure rose most dramatically in response to a mild stressor or a series of stressors were • the ones most likely to develop hypertension later in life. Physiological reactions to stressors – and the chances of suffering stress-related health problems – depend partly on personality, especially on how people tend to think about stressors and about life in general. For example, the trait of hostility – particularly when accompanied by irritability and impatience – has been associated with the appearance of coronary heart disease. Weekly Objective 6: Describe the major strategies for coping with stress Coping methods can be classified as either problem-focused or emotion-focused. • Problem-focused coping involves efforts to alter or eliminate a source of stress e.g. confronting, seeking social support and planned problem solving. • Emotion-focused techniques are aimed at regulating the negative emotional consequences of the stressor e.g. self-controlling, distancing, positive reappraisal, accepting responsibility and escape/avoidance (wishful thinking). • • • • • Some people use both kinds of coping. For example, you might deal with the problem of noise from a nearby airport by forming a community action group to push for tougher noise regulations and, at the same time, calm your anger when noise occurs by mentally focusing on the group’s efforts to improve the situation. However, coping efforts may not always be so adaptive. In the face of a financial crisis or impending exams, for example, some people rely on emotion-focused methods such as using alcohol or other drugs to ease anxiety but take no problemfocused steps to get out of debt or learn difficult material. These emotion-focused strategies may reduce distress in the short run, but the long-term result may be a financial or academic situation that is worse than it was before. Strategies for coping with stress can be cognitive, emotional, behavioural or physical. Cognitive coping strategies involve changing how we think about stressors. These changes include thinking more calmly, rationally and constructively in the face of stressors and may lead to a more hopeful emotional outlook. For example, students with heavy course loads may experience anxiety, confusion, • • • • discouragement, lack of motivation and the desire to run away from it all. Frightening, catastrophising thoughts about their tasks (for example, ‘What if I fail?’) magnify these stress responses. Cognitive coping strategies replace catastrophic thinking with thoughts in which stressors are viewed as challenges rather than threats. This substitution process is called cognitive restructuring which involves first identifying upsetting thoughts (such as ‘I’ll never figure this out!’) and then developing and practising more constructive thoughts to use when under stress (such as ‘All I can do is the best I can’). Cognitive coping does not eliminate stressors, but it can help people perceive them as less threatening and thus make them less disruptive. Finding social support is an effective emotional coping strategy. Feeling that you are cared about and valued by others can be a buffer against the ill effects of stressors. Research suggests that having enhanced social support is associated with improved immune function and more rapid recovery from illness. Behavioural coping strategies involve changing behaviour in ways that minimise the impact of stressors. Time management is one example. Time management can’t create more time, but it can help • • • • control catastrophising thoughts by providing reassurance that there is enough time for everything and a plan for handling all that you have to do. Physical coping strategies can be used to alter the undesirable physiological responses that occur before, during or after the appearance of stressors. The most common physical coping strategy is some form of drug use. Prescription medications are sometimes an appropriate coping aid, especially when stressors are severe and acute, such as the sudden death of one’s child. However, the drug effects that blunt stress responses may also interfere with the ability to apply other coping strategies. The resulting loss of perceived control over stressors may make those stressors even more threatening and disruptive. Non-chemical methods of reducing physical stress reactions and improving health and functioning include progressive muscle relaxation training physical exercise, biofeedback, yoga, meditation and tai chi. Progressive muscle relaxation training is one of the most popular physical methods for coping with stress. It involves tensing a group of muscles (such as the hand and arm) for a few seconds and then releasing the tension and focusing on the resulting feelings of relaxation. Once people develop some skill at relaxation, they can use it to calm themselves down anywhere and anytime, often without lying down.