Health Psychology: Stress, Coping, and Psychoneuroimmunology

Health Psychology

Introduction

Health psychology explores how psychological, biological, and social factors influence health, illness, and healthcare. This field emphasizes the mind-body connection and the impact of stress, coping strategies, and personality on physical health.

Psychoneuroimmunology

Definition and Scope

Psychoneuroimmunology is the study of the relationship between the immune system and nervous system functioning. It highlights how psychological factors can influence physical health.

• Disease was initially seen as purely biological, but psychological factors are now recognized as influential.

• Stress impacts immunity, making individuals more susceptible to illness.

• Positive emotions boost health and immune function.

• Sleep and immunity are closely linked; poor sleep can weaken immune responses.

Stress and Its Impact

Stress during COVID-19

• Financial woes, social isolation, and increase in mental health disorders (anxiety, depression, PTSD) were major stressors during the pandemic.

Understanding Stress

• Stress is a response to events that threaten or challenge an individual.

• It is personal and depends on perception.

• Events are stressful when perceived as threatening and when resources to cope are lacking.

Lazarus & Folkman's Transactional Stress Model

This model explains that stress is subjective and depends on two types of appraisal:

1. Primary appraisal: Assessing the significance of an event ("Is this important to me? Could this be a problem?").

2. Secondary appraisal: Evaluating one's ability to cope ("Do I have what I need to deal with this?").

Example: Surprise Test

• Primary appraisal: Is the test a big deal? Does it affect grades?

• Secondary appraisal: Can I handle it? Do I understand the material? Do I have time to study?

• If resources are sufficient, stress is lower; if not, stress and anxiety increase.

Categorizing Stressors

• Cataclysmic events: Sudden, strong stressors affecting many (e.g., pandemics, natural disasters).

• Personal stressors: Major life events (e.g., death, job loss, marriage).

• Background stressors: Everyday annoyances (e.g., traffic, long lines) that can accumulate and have long-term effects.

Post-Traumatic Stress Disorder (PTSD)

• Triggered by major catastrophes or strong personal stressors.

• Symptoms: Re-experiencing events (flashbacks, dreams), emotional numbing, sleep difficulties, interpersonal issues, substance use, and suicide risk.

• Feelings of helplessness are common.

Personal Stressors

• Examples: Death of a loved one, job loss, personal failure, marriage.

• Categories: Life changes, internal conflicts, frustration, pressure.

Holmes-Rahe Life Stress Inventory

This scale assigns numerical values to 43 major life events to measure stress. Higher scores correlate with increased risk of physical and mental health issues.

Life Event	Stress Value
Death of spouse	100
Divorce	73
Marriage	50
Job loss	47
Major personal failure	45
Additional info: Other events included in original scale

Stress & Technology

Impact on Teens

• More time on technology correlates with increased mental health issues (Twenge et al., 2018).

• Non-screen activities are associated with fewer reported issues.

Screen Time, Mental Health & Well-being

• Reducing screen time to ≤2 hours daily improves stress, depressive symptoms, sleep quality, and well-being.

• Excessive screen time (>4 hours) linked to anxiety, depression, behavioral problems, and ADHD.

• Contributing factors: Lack of physical activity, irregular sleep.

Responding to Stress

Physiological and Psychological Responses

• Stressful events are appraised psychologically and physiologically.

• Responses include autonomic arousal (heart rate, sweating), emotional reactions, and changes in physical health.

The Science of Stress

• Stress triggers release of adrenaline and cortisol from the adrenal glands.

• These hormones prepare the body for "fight or flight".

Stress & Our Immune System

• The immune system defends against infection and cancer.

• Chronic stress impairs immune function, increasing frequency and severity of illness.

• Lymphocytes (white blood cells) are suppressed by stress hormones.

Short-Term vs. Long-Term Stress Response

• Short-term: Increased heart rate, blood pressure, sweating, fast breathing; prepares for emergencies.

• Long-term (chronic): Prolonged stress damages heart, blood vessels, and weakens immune system, leading to increased illness.

Stress Makes You Sick

• Heart & Body: High blood pressure, arterial buildup, heart attack risk.

• Stomach & Digestion: Changes in gut bacteria, heartburn, weight gain due to cortisol.

• Other Effects: Weaker immune system, acne, hair loss, headaches.

Psychophysiological Disorders

• Stress can cause physical conditions: headache, back pain, skin rashes, fatigue, stomach problems.

General Adaptation Syndrome (GAS) Model

Describes the body's response to stress in three stages:

1. Alarm: Initial reaction to stressor.

2. Resistance: Coping with stress and resistance to stressor.

3. Exhaustion: Negative consequences if stress persists.

Challenges with GAS

• Biological reactions may differ based on appraisal of stressor.

• Not all stressors produce the same response.

Psychoneuroimmunology & Stress Consequences

• Direct physiological effects

• Engagement in harmful behaviors

• Indirect consequences leading to health declines

Personality and Heart Disease

ABD's of Coronary Heart Disease

Personality Type	Characteristics	Chance of Coronary Heart Disease
Type A	Hostile, competitive, time urgent, achievement-oriented	High
Type B	Cooperative, patient, non-competitive, nonaggressive	Low
Type D	Distressed, insecure, anxious, negative outlook	Very High

• Type A men develop heart disease twice as often as Type B.

• Hostility increases physiological arousal, raising risk for heart disease.

Transactional Model of Hostility

• Hostile thoughts and behaviors reinforce each other in social interactions, perpetuating stress and negative health outcomes.

Psychological Aspects of Cancer

• Emotional responses may affect coping but not long-term survival.

• Emotional state influences immune system similarly to stress.

• Certain therapies may extend lives of cancer patients.

Coping & Stress Management

Little Good Things (Uplifts)

• Small positive experiences protect mental health and improve mood.

Exercise

• Increases dopamine, epinephrine, and BDNF (brain-derived neurotrophic factor).

• Improves cognitive processing and preserves brain function.

Meditation & Stress

• Reduces stress hormones and inflammatory responses.

• Improves sleep, memory, and attention span.

Coping Strategies

Emotion-Focused Coping	Problem-Focused Coping
Handle feelings about stress; doesn't fix the problem but improves mood (e.g., deep breaths, music, talking to a friend)	Try to solve the problem causing stress (e.g., study group, asking for help, taking a break)

Example: Low Grade on a Test

• Emotion-focused: Talk to a friend, watch a show, remind yourself one grade doesn't define you.

• Problem-focused: Ask for help, set a study schedule, review mistakes.

Building Resilience

• Resilience is the ability to bounce back after stress.

• Low resilience = higher perceived stress; high resilience = optimism and confidence.

• Key factors: support systems, growth mindset, learning from challenges.

Hardiness

• Commitment: Involvement and curiosity about life.

• Control: Belief in ability to influence events.

• Challenge: Viewing change as opportunity for growth.

Sense of Control

• Perceived control predicts stress response and well-being.

• Greater control = better health, confidence, and coping.

Locus of Control

Internal Locus of Control	External Locus of Control
Belief in personal influence over outcomes; more motivated, better coping, more action	Belief that outcomes are controlled by luck, fate, or others; can feel powerless, more likely to give up

Examples of Internal vs. External LOC

• School: Internal - "I'll try a new strategy." External - "Nothing I could have done."

• Sports: Internal - "I can practice more." External - "No point in trying."

• Social Life: Internal - "I'll try to listen more." External - "People are just mean."

• Work: Internal - "I'll plan better." External - "Can't do anything about it."

Learned Helplessness

• Occurs when individuals believe they cannot change a bad situation, even when they can.

• Results in passivity and lack of initiative.

• Seligman & Maier (1967): Dogs exposed to unavoidable shocks stopped trying to escape, even when escape was possible.

Learned Helplessness & Interrogations

• "Enhanced interrogation techniques" designed to induce learned helplessness in detainees.

• Subjects exposed to uncontrollable afflictions became passive and compliant.

Compensatory Control

• Randomness creates anxiety; people use psychological strategies to preserve a sense of order when control is compromised.

• Examples: Detecting patterns, belief in conspiracy theories, seeking structure.

Social Support

• Being part of a social network, receiving information/advice, and access to goods/services all provide support.

Talking About Trauma

• Confiding in others (talking or writing) benefits mind and body.

• Studies show improved health, reduced stress, and better coping after discussing traumatic events.

Unhealthy (Maladaptive) Coping

• Avoidance, substance use, excessive screen time, and social withdrawal are maladaptive strategies that worsen stress and health outcomes.