Health, Stress, and Coping: Psychology Study Notes (Chapter 14)

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Behaviour and Health

Health Psychology

Health psychology examines how behavior, lifestyle choices, and environmental factors impact health, survival, and well-being.

Obesity is influenced by both genetic and environmental factors.
Public health interventions, such as taxes on unhealthy foods (e.g., sugary drinks), aim to reduce consumption and improve health outcomes.
Example: Berkeley's sugar tax led to a 21% reduction in sugar-sweetened beverage consumption and a 26% reduction in cola consumption.
Smoking-related cues can trigger cravings, and taxes on cigarettes aim to reduce smoking rates.
Behavioral choices (diet, exercise, smoking) significantly affect health.
Microbiota in the gut influence mental health, affecting nervous system functioning and serotonin production (about 90% of brain serotonin is produced by intestinal microbes).
Premature deaths are increasingly due to lifestyle factors (tobacco, alcohol, obesity, inactivity) rather than contagious diseases.

Smoking

Tobacco use is a major health concern, causing numerous life-shortening health problems.

Health risks: Lung, mouth, and throat cancer, heart disease, pulmonary diseases (e.g., emphysema).
Mortality: 21% of all deaths in Canada over the past decade were due to smoking-related illnesses.
Life expectancy: Smokers live 7–14 years less than non-smokers.
Quitting: Stopping smoking by age 30 greatly reduces risk of dying from smoking-related cancers.
Prevalence: 12.9% of Canadian adults smoke; higher rates in males (15.8%) than females (10.1%).
Global impact: Tobacco use causes about 7 million deaths worldwide annually.
Second-hand smoke: Over 800 Canadians die each year due to second-hand smoke.
More Canadians die from tobacco-related diseases than from traffic accidents.

Efforts to Prevent Smoking

Laws ban smoking in public places to reduce second-hand smoke exposure.
Steep taxes on tobacco products deter use and fund healthcare initiatives.
Warning labels: Graphic pictorial warnings on cigarette packages are more effective than text-only messages in educating about risks and motivating quitting.
E-cigarettes and vaping are not necessarily safer; advertising is less regulated, and adolescents who vape are more likely to try cigarettes.
Approaches include education about dangers and understanding cues that stimulate cravings.

Nicotine Addiction and Reinforcement

Nicotine is highly addictive, providing immediate pleasure and reducing withdrawal symptoms (positive and negative reinforcement).
Cues: External cues (images, odors) can trigger cravings and smoking behavior.
Brain circuitry: Nicotine stimulates reward circuitry, including the ventral striatum, amygdala, orbitofrontal cortex, and anterior cingulate cortex.
Functional MRI studies show nicotine-related images activate these brain regions, eliciting cravings.
Impulsivity can lead to dependence; cues specifically activate regions tied to nicotine addiction.
Understanding cue-craving interactions informs treatment plans for nicotine addiction.

Obesity

Obesity is a complex health issue influenced by genetics, lifestyle, and social factors.

The "freshman 15" is a myth; average weight gain in first year of university is about 6 pounds (2.7 kg).
Contributing factors: Increased food intake, decreased physical activity, higher alcohol consumption, stress, and lifestyle changes.
Habits formed during this period can be difficult to change.

Defining Healthy Weights and Obesity

Body Mass Index (BMI): Used to estimate healthy body weight relative to height.
Formula:
BMI categories:
- Underweight: BMI < 18.5
- Normal weight: BMI 18.5–24.9
- Overweight: BMI 25–29.9
- Obese: BMI ≥ 30
BMI is more useful for large groups than individuals due to variations like muscle mass.
27% of Canadian adults are obese; rates vary by province.
Obesity is linked to cardiovascular disease, diabetes, osteoarthritis, and some cancers.
Obesity rates have increased since the mid-1990s, with younger generations becoming obese earlier.
Causes include positive energy balance (calories consumed > calories expended), genetics, lifestyle, and social factors.

Genetics and Body Weight

Genes account for 50%–90% of variation in body weight.
The FTO gene is associated with obesity and elevated food intake.
Set point theory: Suggests a genetically programmed weight range (10%–20% of a person’s weight) the body tries to maintain.
Weight gain can shift the set point upward, making weight loss harder due to slowed metabolism.
Physical activity may be more important for weight loss and maintenance than set point alone.
Goal of 10,000 steps/day is popular; benefits may level off at about 7,500 steps.

The Sedentary Lifestyle

Strong correlation between hours spent watching TV and obesity rates.
Computer use does not significantly affect obesity rates in males; females who spend more than 11 hours/week on a computer have slightly higher obesity rates.
Active engagement in computer use may reduce snacking compared to passive TV watching.
Studies on video game play and obesity in children are inconclusive; more rigorous research is needed.

Social Factors

Family eating habits play a significant role in body weight similarities among family members.
Eating patterns developed in childhood are typically carried into adulthood.
Food advertisements can trigger eating behaviors; children exposed to food commercials consume 45% more snack food.
Corporations use marketing techniques to promote unhealthy foods, often targeting children.

Psychology and Weight Loss

Critical thinking about weight-loss options is important; avoid gimmicks and focus on healthy eating and exercise.
Positive self-reflection (writing about self-defining values) can promote healthy weight loss by reducing stress.
Mindfulness and awareness of emotional and physiological states help make healthier food choices.
Obese individuals are more attentive to food cues and find them more rewarding.
Dieting can lead to weight gain later due to increased reinforcement of avoided foods.
Cultural ideals and body image: Overweight individuals often face stigma and harmful assumptions.

Psychosocial Influences on Health

Environments and social interactions influence physical and mental health.
Children in wealthy, safe neighborhoods have different experiences than those in disadvantaged, high-crime areas.
Health and wealth are interconnected; affluent communities provide better access to health care and healthier lifestyles.
Poverty, discrimination, and social stressors increase rates of mental health issues and heart disease.
Discrimination increases blood pressure, heart rate, and stress hormone levels, leading to long-term health issues.
Experiencing discrimination increases likelihood of unhealthy behaviors (smoking, substance abuse).

Family and Social Environment

Close interpersonal relationships significantly impact health and life satisfaction.
Chronic social isolation poses a mortality risk comparable to smoking, obesity, and high blood pressure.
Social resilience helps maintain positive relationships and recover from isolation and stress.
Marriage generally provides long-term health benefits; same-sex marriages offer similar benefits.
Marital problems and divorce can be highly stressful, affecting both adults and children.
High-quality parenting can mitigate negative health effects on children during marital discord.

Social Contagion

Social groups influence health-related behaviors through social contagion (spread of behaviors via social interactions).
Framingham Heart Study documented clusters of similar health characteristics among friends.
Social contagion can spread both unhealthy and healthy behaviors.

Stress and Illness

Stress and Working Memory

Stress negatively impacts working memory, which is essential for tasks requiring short-term information manipulation.

Experiments show stress diverts cognitive resources, leading to poorer performance under pressure.
"Choking under pressure" occurs when stressful thoughts occupy working memory space.

Definition of Stress

Stress: A psychological and physiological reaction when perceived demands exceed available resources.
Includes both stressors (events) and the stress response (experiences).
Stressors can be acute (e.g., giving a speech) or chronic (e.g., illness, marital problems).

Cognitive Appraisal Theory of Stress

Primary appraisal: Assessing whether an event is a threat.
Secondary appraisal: Evaluating coping resources.
If coping resources are inadequate, stress reactions continue.
Common sources: Workplace demands, life changes, interpersonal relationships.
Social Readjustment Rating Scale (SRRS): Ranks stressful events by magnitude; higher scores indicate greater stress and increased risk of illness.

Stress and Performance

Moderate stress can be beneficial; optimal performance occurs under moderate stress (Yerkes-Dodson Law).
Task complexity affects stress impact: Stress improves performance on simple tasks but harms complex tasks.
Individual differences exist in optimal stress levels (individual zone of optimal functioning, IZOF).

Physiology of Stress

Stress involves mental appraisal and physiological responses throughout the body.
Fight-or-flight response: Physiological changes in response to threats (increased blood pressure, muscle tension, heart rate, adrenaline release).
General Adaptation Syndrome (GAS): Three stages:
- Alarm Reaction: Initial recognition and response.
- Resistance: Coping with the stressor.
- Exhaustion: Prolonged stress depletes resources.
Modern stress physiology involves the autonomic nervous system (ANS) and endocrine responses.

The Stress Pathways

ANS: Hypothalamus stimulates sympathetic nervous system, releasing epinephrine and norepinephrine from adrenal medulla.
Fight-or-flight: Epinephrine and norepinephrine trigger bodily changes for survival.
HPA Axis: Hypothalamus, pituitary gland, and adrenal glands communicate, resulting in cortisol release from adrenal cortex.
Cortisol: Increases access to energy stores and reduces inflammation.
Both sympathetic nervous system and HPA axis responses are adaptive.

Oxytocin: To Tend and Befriend

Males typically have a larger cortisol response (fight-or-flight); females tend to seek social support (tend-and-befriend).
Oxytocin: Hormone involved in reproduction, childbirth, and social bonding; reduces stress responses.
Oxytocin lowers blood pressure and reduces activity in the sympathetic nervous system.
Women with higher oxytocin levels show lower stress responses; men given oxytocin also exhibit reduced stress.

Hormones, Relationships, and Health

Oxytocin and vasopressin are hormones involved in social behavior and bonding, with stress-reducing functions.
Oxytocin inhibits activity in the amygdala and may prevent cortisol release.
Vasopressin affects stress hormone levels and improves relationship quality.
Both hormones interact with the immune system to reduce inflammation.
Positive interactions between spouses correlate with higher hormone levels and faster wound healing.
Intranasal oxytocin leads to more positive behavior and lower cortisol during conflict.
High oxytocin levels can also be present in relationship distress, suggesting a nuanced role.
Benefits of positive social relationships extend beyond marriage to friendships and family.
Early adversity can inhibit the brain's ability to use oxytocin, increasing susceptibility to illness.

Stress, Immunity, and Illness

Stress increases susceptibility to illness; stress during exams reduces immune responses.
Immune system is linked to nervous system, explaining why stress affects immunity.
Psychoneuroimmunology: Studies the relationship between immune and nervous system functioning.
Acute stress can activate the immune system; chronic stress generally suppresses it.

Stress, Personality, and Heart Disease

High stress increases risk of coronary heart disease (CHD) by causing plaques in blood vessels.
Type A personality (impatience, anger, competitiveness) is linked to higher risk of heart attacks than Type B (laid-back).
Hostility, anger, anxiety, and depression are also linked to higher CHD risk.
High conscientiousness is associated with better self-care and reduced diabetes incidence.

Myths in Mind: Stress and Ulcers

Most ulcers are caused by the bacterium Helicobacter pylori, not stress.
Stress can worsen ulcer symptoms but does not cause them directly.
Smoking, alcohol, pain relievers, and poor diet can exacerbate ulcers.

Stress, Food, and Drugs

Stress influences heart functioning indirectly by affecting dietary choices.
People tend to consume more sweet and fatty foods when stressed.
Similar patterns observed in animals; subordinate monkeys eat more and self-administer more drugs when stressed.
Overeating or drug use is not a good long-term solution to stress.
Chronic stress may suppress the reward system, making stressed individuals find less joy in activities.

Stress, the Brain, and Disease

Stress negatively impacts the immune system, contributing to conditions like AIDS and cancer.
Stress impedes response to vaccinations and HIV treatments.
Norepinephrine and cortisol support cancer cell growth and proliferation.
Psychosocial factors (assertiveness training, anger management, optimism, humour) can improve disease outcomes.

Coping and Well-Being

Key Terminology and Concepts

Understanding coping mechanisms and well-being is crucial for managing stress.
Control over the environment influences coping strategies and outlook.
Positive coping styles are constructive; negative coping styles are destructive.
Optimism helps reframe stressful situations as opportunities.
Relaxation techniques and meditation are effective coping strategies.
Writing about emotions (emotional writing) can improve mental and physical health.

Coping Strategies

Coping: Processes used to manage demands, stress, and conflict.
Problem-focused coping: Addressing the problem directly (e.g., study schedule, dropping a course).
Emotion-focused coping: Managing emotional response to a stressor (e.g., grief).
Suitability depends on the nature of the problem; both strategies can be used together.
Not all coping techniques are helpful; some may replace one problem with another (e.g., substance use).

Positive Coping Strategies

Positive psychology studies human strengths and potential.
Positive emotions expand focus of attention and increase creativity.
Flexible thinking helps reframe stressors.
Positive emotions speed up recovery from negative emotional events.
Broaden-and-build theory: Positive emotions broaden thought processes and build new resources.
Recovery times from cardiovascular arousal are faster with positive emotions.

Optimism and Pessimism

Optimism: Positive outlook and expectation of favorable outcomes.
Pessimism: Negative outlook and expectation of unfavorable outcomes.
Pessimists attribute negative events to internal, stable factors (pessimistic explanatory style).
Optimism is correlated with better physical health and longevity.
Nun Study: Positive emotions in young adulthood predicted longer lifespans among nuns.

Resilience

Resilience: Ability to effectively recover from illness or adversity.
Contributing factors: Financial and social resources, rest, positive life circumstances, personality, and emotional characteristics.
Viktor Frankl: Survived concentration camps by helping others find meaning; "Despair = Suffering - Meaning".
Resilience of Indigenous Peoples is often expressed at the community level through cultural customs and practices.
Post-Traumatic Growth: Capacity to grow and experience positive effects in response to negative events.

Meditation and Relaxation

Relaxation and meditation techniques help manage stress by calming emotional and physiological responses.
Meditation: Shifting consciousness to a highly focused and aware state.
Focused Attention (FA) Meditation: Concentrates on a specific object or sensation.
Open Monitoring (OM) Meditation: Observes moment-by-moment sensations without focusing on any single object.
Meditation reduces self-focused thoughts and increases present-moment awareness.
Meditation is linked to decreased anxiety, lower blood pressure, and reduced risk of cardiovascular disease.
Mindfulness-Based Stress Reduction (MBSR): Uses mindfulness meditation to reduce stress and increase meaningfulness.
Body Scan Technique: Focuses on bodily sensations sequentially.
Integrated Mind-Body Training (IMBT): Combines relaxation, posture correction, and body awareness.
Yoga: Directed breathing and poses reduce emotional arousal and stress, enhance immune function.

Exercise

Relaxation training and physical exercise provide significant physical and psychological benefits.
Short bursts of intense exercise enhance cognitive performance.
Exercise increases dopamine, epinephrine, and brain-derived neurotrophic factor (BDNF).
Cardiovascular exercise improves cognitive processing speed and preserves cognitive function.
Exercise supports development of new nerve cells in the hippocampus (important for memory).

Perceived Control

Lack of control over stressful situations can lead to learned helplessness.
Learned helplessness: Individuals learn their actions cannot change circumstances, leading to suppressed avoidance or escape behaviors.
Brain mechanisms: Controllable stressors inhibit stress responses; uncontrollable stressors do not.
Learned helplessness is seen in depression and anxiety disorders.
Perception of control is crucial for coping with stress.

Compensatory Control and Health

When personal control is compromised, people use psychological strategies to maintain a sense of order (compensatory control).
Believing in the ability to predict and influence events is linked to better well-being.
Loss of control increases need for structure, belief in superstitions, and endorsement of conspiracy theories.
COVID-19 pandemic increased perceptions of lost control, leading to higher endorsement of conspiracy theories.
Clear information about medical procedures reduces anxiety, illustrating health benefits of perceived control.

Summary Tables

BMI Categories Table

BMI Category	BMI Range
Underweight	< 18.5
Normal weight	18.5–24.9
Overweight	25–29.9
Obese	≥ 30

General Adaptation Syndrome (GAS) Stages Table

Stage	Description
Alarm Reaction	Initial recognition and physiological response to threat
Resistance	Body uses resources to cope with stressor
Exhaustion	Prolonged stress depletes resources, leading to decline in coping ability

Type A vs. Type B Personality Table

Type	Traits	Health Risk
Type A	Impatience, time urgency, anger, competitiveness, high motivation	Higher risk of heart disease
Type B	Laid-back, relaxed	Lower risk of heart disease

Positive vs. Negative Coping Styles Table

Coping Style	Characteristics	Outcomes
Positive	Constructive, resilience, optimism, reframing	Recovery, post-traumatic growth, improved well-being
Negative	Destructive, pessimism, avoidance, substance use	Psychological and physiological disadvantages

Summary of Key Points

Genetic and environmental factors influence obesity; social contagion impacts weight gain.
Stereotypes and prejudicial attitudes are often directed at overweight individuals.
Environmental cues can trigger strong cravings for smoking, linked to brain circuitry.
Physiological reactions to stress involve the hypothalamus, sympathetic nervous system, and HPA axis.
Chronic cortisol release suppresses the immune system, increasing vulnerability to illness.
Ulcers are primarily caused by Helicobacter pylori; stress can exacerbate symptoms.
Control over the environment helps people cope; loss of control leads to compensatory responses.
Positive coping is associated with resilience and recovery; negative coping has disadvantages.
Optimism and reframing stressful situations improve outlook and emotional response.
Relaxation techniques, meditation, and exercise are effective in reducing stress.