Stress, Coping, and Health

The Relationship
Between Stress and Disease
• Contagious diseases
vs. chronic diseases
– Biopsychosocial model
– Health psychology
• Health promotion and
maintenance
– Discovery of
causation, prevention,
and treatment
 Stress: An Everyday Event

• Major stressors vs. routine hassles

– Cumulative nature of stress
– Cognitive appraisals
 Major Types of Stress
• Frustration: blocked goal
• Conflict: incompatible
motivations
– Approach-approach
– Approach-avoidance
– Avoidance-avoidance
• Change: having to adapt
– Social Readjustment
Rating Scale
– Life Change Units
• Pressure
– Perform/conform
Overview of the Stress Process
 Responding to Stress Emotionally
• Emotional
Responses
– Annoyance, anger,
rage
– Apprehension, anxiety,
fear
– Dejection, sadness,
grief
– Positive emotions
• Emotional response
and performance
– The inverted-U-
 Responding to Stress
Physiologically
• Physiological Responses
– Fight-or-flight response
– Selye’s General Adaptation Syndrome
• Alarm
• Resistance
• Exhaustion
Responding to Stress Behaviorally
• Behavioral Responses
– Frustration-aggression
hypothesis
– catharsis
– defense mechanisms
• Coping
– Reappraisal
– Confronting problems
– Using humor
– Expressing emotions
– Managing hostility
 Effects of Stress:
Behavioral and Psychological
• Impaired task
performance
• Burnout
• Psychological
problems and
disorders
• Positive effects
 Effects of Stress: Physical

• Psychosomatic diseases
• Heart disease
– Type A behavior - 3
elements
• strong competitiveness
• impatience and time
urgency
• anger and hostility
– Emotional reactions and
depression
• Stress and immune
functioning
– Reduced immune activity
Factors Moderating the Impact of
Stress

• Social support
– Increased immune functioning
• Optimism
– More adaptive coping
– Pessimistic explanatory style
• Conscientiousness
– Fostering better health habits
• Autonomic reactivity
– Cardiovascular reactivity to stress
 Firefighter Specific Stressors
• Reliance on teamwork
• Low job control
• Sleep disturbances/Shift work
• Boredom
• Coworker conflict
• Management-Labor conflict
• Second jobs
• Marital/Family spillover
 Firefighter Stress Reactions
• Apprehension/Dread
• Intrusive thoughts
• No hope
• Sleep difficulties
• Gastrointestinal symptoms
• Throat and mouth symptoms
 At-Risk Firefighters
• Research reveals 2 distinct profiles for at-risk
firefighters
– Profile 1 (somaticizers) Reported greater frequency
and intensity of physical symptoms
• Head/neck/facial tension
• Gastrointestinal distress
• Cardiopulmonary complaints
– Profile 2 (psychological stress) Reported higher levels
of
• Apprehension/dread
• Anger
• Generalized anxiety
• Agitated depression
 Implications for treatment
• Identify high-risk firefighters
– No penalty or stigmatization
• Potential interventions
– Psychoeducation
• Work redesign
• Coping skills training
• Relaxation training
• Conflict-resolution training
• Leadership training
• Sleep hygiene education
 Coping Skills
• Problem-focused coping • Emotion-focused coping
– Taking direct action – Focusing on and venting
– Planning emotions
– Suppression of competing – Behavioral disengagement
activities – Mental disengagement
– Restraint coping – Positive reappraisal
– Seeking social support – Denial
– Acceptance
– Turning to religion