the coping sequence stressor primary appraisal (harm, threat, challenge) external resources and...
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The Coping SequenceStressor
Primary Appraisal (Harm, Threat, Challenge)
External Resources and Impediments
Tangibles
Social Support
Other life stressors Internal Resources and Impediments
Typical coping style
Other personality factors
Secondary Appraisal
Coping Tasks/Goals
Coping Outcomes
Moderators
Moderators
Negative Affect (Watson, Clark, & Tellegen)
Defined: Pervasive negative mood marked by anxiety, depression, and hostility.
Find many situations difficult to manage
Resort to unhealthy coping behaviors (such as?)
Related to poor health: asthma, arthritis, ulcers, headaches, CHD
Related to excess complaining:
a. More symptomsb. Higher use of health servicesc. Higher rates of self-reported illnessd. These people may compromise validity of self-reported illness
1. Focus on Introduction and Discussion
2. Skim "Methods", know what was done.
3. Skip over "Results" section
About Reading Research Articles
Hardiness
Commitment: Get fully involved
Control: Strong internal Locus of Control (LOC)
Challenge: Seek out opportunities, meet challenges head on.
Why would these qualities moderate stress? Appraisal processes
Active, not avoidant
Hardiness and Executives Study Kobassa, 1979
Subjects: 160 execs. under high stress, per Holmes & Rahe scale
Group A (n = 86) experiences stress but no illnessGroup B (n = 75) experiences stress with illness
Illness measured by self report.
What distinguishes Group A from Group B?
Kobassa sends execs questionnaire:a. Internal/external LOCb. Commitment to life challengesc. Change as challenge rather than threat.
Responses confirm hardiness model: Control, commitment, challenge
Problems with this study?
Illness self reported (High NA?) Design is correlational
High Stress/Low Illness
High Stress/High Illness
CONTROL
Nihilism Hardy < Not Hardy
External LOC Hardy < Not Hardy
Powerlessness Hardy < Not Hardy
Commitment
Alienation from Self Hardy < Not Hardy
Challenge
Vegetativeness Hardy < Not Hardy
Adventurousness Hardy > Not Hardy
Relation Between Hardiness and CopingKobasa, 1979
Efficacy, Stress, and Immunocompetence
Background:Animals exposed to stressor (shock)
Group A: Believes has controlGroup B: Believes has NO control
Outcome: Opioids in system
Which animals produce MORE opioids? Group B--No Control
Efficacy, Stress, and Immunocompetence
Stress --> ______ path --> ______ stim --> _____ --> opiods
How do opioids affect immune system? ____________
Thus, less control --> ___more stress OR ___ less stress -->
___more opioids OR ___ less opioids --> ___ Immunocompetence OR
___ Immunocompromise
ACTH adrenal cortisol
depress it
X
X
X
1. SAM: Sympathetic-adrenomedullary
Event cortex hypothalamus SNS adrenal medulla catecholamines charged feeling increased BP, HR, etc.
SAM Corresponds to Cannon's stress model
2. HPA: Hypothlamic-pituitary-adreocortical
Event cortex hypothalamus coritcotrophin releasing factor (CRF) pituitary adrencorticotropic hormone (ACTH) adrenal cortex
corticosteriods conserves carbos reduces inflammation
HPA corresponds to Selye's stress model
Physiology of Stress
Predicted model:
Failure --> stress --> opioids --> less pain --> (immunocompromise)
Four groups:1. Success, pain, opioid blocker2. Success, pain, no opioid blocker3. Failure, pain, opioid blocker4. Failure, pain, no opioid blocker
Evidence that Efficacy ModeratesStress --> Illness Connection in Humans
Bandura, Cioffi, Taylor, & Brouillard, 1988
Efficacy Manipulation
High Efficacy Group
(2 X 7 + 15)
(9 X 8 - 12)
(73 - 15 X 3)
At own pace
Low Efficacy Group
(2 X 7 + 15)
(9 X 8 - 12)
(73 - 15 X 3)
At preset, and difficult, pace -70
-60-50-40-30-20-10
010203040
High Efficacy
Low Efficacy
Change in self-perceived math
efficacy
Psychological Effects of Math-Test Manipulation
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stress0
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Time Pressure
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Percieved Impairment Due toTime Pressure
High Efficacy ConditionLow Efficacy Condition
Opiate Blockage
Purpose: If stress increases opiates, and opiates reduce pain, then ___High efficacy OR ___ Low efficacy condition will have higher pain thresholds (i.e., be better able to withstand pain longer)?
HOWEVER, if opiates are blocked, which group should have higher pain thresholds, ____ High efficacy OR ___ Low efficacy?X
X
To show this, need to block opiates to some subjects
Naloxone: Opiate antagonist; 100% effective
Subs get Naloxone or saline. Why saline?
Experiment Design and Predictions
High Efficacy
Low Efficacy
Saline Naloxone (Placebo) (Opiate Blocker)
Pain Threshold (Ability to Tolerate Hand in Freezing Water)
Moderate Moderate
High Tolerance Low Tolerance
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High Efficacy Low Efficacy
Pain
Tol
eran
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PlaceboBlocker
Evidence that Efficacy ModeratesStress --> Illness Connection in Humans
Bandura, Cioffi, Taylor, & Brouillard, 1988
Health Outcomes Questions1. Compared to most other college students, what is your risk of an alcohol-
related injury?
2. Compared to most other college students, what is your risk of getting into a car accident?
Much Below
Average
Below Average
Slightly Below
Average
Average for
Rutgers students
SlightlyAbove
Average
Above Average
Much Above
Average
-3 -2 -1 0 +1 +2 +3
Much Below
Average
Below Average
Slightly Below
Average
Average for
Rutgers students
SlightlyAbove
Average
Above Average
Much Above
Average
-3 -2 -1 0 +1 +2 +3
Denial and Coping
Psychological defense: Minimize or deny existence of threat
Is denial good or bad? _______ Early in crisis
_______ Chronic (ongoing)
Good*
Bad
* Sometimes
On-going denial can stop people from taking necessary action.
NMAD = Near Miss Asthma Death
Who denies more: ___ Asthmatics who experienced NMAD
___ Regular Asthmatics
___ Non Asthmatics
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NMAD Regular Asthma Normals
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Denial Among NMAD Survivors, “Regular” Asthmatics, and Non-Asthmatics
Yellowlees & Ruffin, 1989
0123456789
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GHQ MHQ QOL HYPERVENT DENIAL
Rat
ing
Psych. Probs. Normals
Denial and Health Indices Among NMAD Survivors with or without Pre-existing Psychological Problems
Yellowlees & Ruffin, 1989
“He has been less violent since the attack. He plays
with me now by twisting my arm up my back as a joke
rather than by badly bruising me”.
Evidence of Improved Marital Relations Following NMAD
(????)
Optimists vs. Pessimists
Optimists
1. Expect positive outcomes2. Expect to cope with adversity
Pessimists
1. Expect negative outcomes2. Do not expect to cope with adversity
Joe Pessi Robert Optiheimer
I bombed the math test. I bombed the math test.
I just couldn't get myself to study. All the noise outside my apartment made it hard to study
A
I don't have good math ability, is what it is.
I didn't really try as hard as I could have.
B
Basically, I'm just not academically skilled.
Math is my one weak area. C
A. Internal vs. External CauseB. Stable vs. Transitory CauseC. Global vs. Specific Cause
Pessimistic vs. Optimistic Attribution Styles
Success Failure
Internal Cause
External Cause
Stable Cause
Optimist Pessimist
Optimist
OptimistPessimist
Pessimist
Transitory Cause Pessimist Optimist
Optimistic and Pessimistic Explanatory Styles
I won the tennis match because my opponent wasn’t trying hard.___Internal cause ___ External cause
I lost my keys because I'm such a flake.___Internal cause ___ External cause
I showed up late for my date because I didn’t plan far enough in advance..___ Stable Cause ___ Transitory Cause
I showed up late for my date because I am so bad at planning.___ Stable Cause ___ Transitory Cause
My cholesterol went up because I’m not exercising.___ Specific Cause ___ Global Cause
My cholesterol went up because I’m a lazy slob.___ Specific Cause ___ Global Cause
Explanatory Causes and Styles
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X
Optimism Measure Scheier, M.F., Carver, C.S., & Bridges, M.W. (1994)
1. In uncertain times, I usually expect the best.
2. It's easy for me to relax. (Filler item)
3. If something can go wrong for me, it will. *
4. I'm always optimistic about my future.
5. I enjoy my friends a lot. (Filler item)
6. It's important for me to keep busy. (Filler item)
7. I hardly ever expect things to go my way. *
8. I don't get upset too easily. (Filler item)
9. I rarely count on good things happening to me.*
10. Overall, I expect more good things to happen to me than bad.
Kurt Lewin: Morale, Not Simply Optimism
Diagnosed with heart disease risk
I will improve heart health
Diagnosed with heart disease risk
I will improve heart health
I’ll sign up at a gym I’ll change diet
I’ll meet MD every 3 mos
Hope
Morale
C. Synder "Hope" Measure (Really a Measure of Morale)
P _____ 1. I can think of many ways to get out of a jam.A _____ 2. I energetically pursue my goals.F _____ 3. I feel tired most of the time.P _____ 4. There are lots of ways around any problem.F _____ 5. I am easily downed in an argument.P _____ 6. I can think of many ways to get the things in life that are most important to me.F _____ 7. I worry about my health.P _____ 8. Even when others get discouraged, I know I can find a way to solve my problem.A _____ 9. My past experiences have prepared me well for my future.A _____10. I've been pretty successful in life.F _____11. I usually find myself worrying about something.A _____12. I meet the goals that I set for myself.--------------------------A = Agency F = Filler P = Pathways
Prediction: Optimism and trait anxiety increased ambulatory BP
Subjects:100 volunteers, 50% female, ave. age = 3780% white, 10% black, 10% other
Procedure1. Pre-assessment
a. Resting BPb. Complete survey battery
1. Optimism (LOT)2. Trait anxiety3. Other background
2. Daily Monitoringa. Wear BP device, 3 days, activates every 30”b. Daily diary: Mood, Context (where, what doing,...)
Optimism, Pessimism, and Ambulatory BP Raikkonen, et al. (1999)
1. Optimism
Pessimists have higher BPMood affects only optimists
2. Trait AnxietyHigh anxious higher BPMood affects only low anxious
3. Conclusionsa. Results real, not due to posture, activity, etc.b. Chronic high BP is a health risk: can lead to
hypertensionc. Pessimists and high anxious may be at greater
long-term health riskd. NA is a real health risk, not just a “whining” artifact.
Results of Raikkonen, et al. (1999)
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Pessimists Optimists
Pos Mood
Neg Mood
Fabricated Data for Illustration
Defined: Belief that one is immune from bad events, or that one will not be injured or harmed even when taking risks.
Arises from:
1. Easier to think up things that reduce risk than things that increase risk.
2. Lack of info about others' risk prevention efforts.
3. Egocentric dismissal of other's efforts to reduce risk.
Illusion of Invulnerability
GROUP 1 COMPLETE INFO.: ABOUT ME AND ABOUT OTHERSYour Risk Factor for Heart Attack Me Others
1. Cigarettes smoked per week _____ ( 8 )2. # Family members with heart ailments _____ ( 2 )3. Hours of exercise per week _____ ( 3 )
GROUP 2PARTIAL INFO: ABOUT ME ONLY, NO COMPARISON TO OTHERSYour Risk Factor for Heart Attack Me Others
1. Cigarettes smoked per week _____ ? 2. # Family members with heart ailments _____ ?3. Hours of exercise per week _____ ?
GROUP 3NO INFO: NO TRACKING OF SELF, NO COMPARISON TO OTHERS ------------------------------------------------------------------------------------------
Weinstein Unrealistic Optimism Study
All subjects next answer the following question:
Compared to other Rutgers students of my sex, my chances of having a heart attack are:
Much Below Average
Below Average
Slightly Below
Average
Average for Rutgers students
SlightlyAbove
Average
Above Average
Much Above
Average
-3 -2 -1 0 +1 +2 +3
Weinstein Unrealistic Optimism Study
Health Outcomes Questions1. Compared to most other college students, what is your risk of an alcohol-
related injury?
2. Compared to most other college students, what is your risk of getting into a car accident?
Much Below
Average
Below Average
Slightly Below
Average
Average for
Rutgers students
SlightlyAbove
Average
Above Average
Much Above
Average
-3 -2 -1 0 +1 +2 +3
Much Below
Average
Below Average
Slightly Below
Average
Average for
Rutgers students
SlightlyAbove
Average
Above Average
Much Above
Average
-3 -2 -1 0 +1 +2 +3