Health psychologist – A psychologist who studies the interrelationships between psychological factors in physical illness.

Stress – A demand made on an organism to adapt or adjust.  Internal psychological or physiological response to a stressor.

The state of stress has two components:

Stressor – A source of stress.

–External event or situation that places a physical or psychological demand on a person

–Range from chronic irritation to acute an traumatic events

• Psychological sources of stress not only diminish our capacity for adjustment, but also may adversely affect our health.
• Stress is associated with an increased risk of various types of physical illness, ranging from digestive disorders to heart disease.
• The field of psychoneuroimmunology studies relationships between psychological factors, especially stress, and the workings of the immune system.

Five Leading Causes of Stress in America

Stress response – person’s reactions to the demands

• Influenced by how we judge both the events and our capacity to react to them effectively
• People who sense that they have the ability and resources to cope are more likely to take stressors in stride and respond well

When we view a stressor as threatening, the natural reaction is arousal and fear

• Fear is a “package” of responses that are physical, emotional, and cognitive
• Stress reactions, and the fear they produce, are often at play in psychological disorders
• People who experience a large number of stressful events are particularly vulnerable to the onset of anxiety and other psychological disorders

Stress also plays a more central role in certain psychological disorders, including:

• Acute stress disorder
• Posttraumatic stress disorder (PTSD)
• Technically, DSM-5 lists these patterns within a group called “trauma- and stressor-related disorders“
• These disorders are triggered by traumatic stressors and include symptoms such as heightened arousal, anxiety, and mood disturbance, and memory difficulties

• The physical disorders of stress are typically called psychophysiological disorders
• These disorders are listed in DSM-5 under “psychological factors affecting medical condition”
• Here significant stressors set in motion an interaction of biological, psychological, and sociocultural factors to help produce or worsen a physical illness or ailment

Psychological Factors That Moderate Stress

• Stress may be a fact of life, but the ways in which we handle stress help determine our ability to cope with it.
• Individuals react differently to stress depending on psychological factors such as the meaning they ascribe to stressful events.
• For example, whether a major life event, such as pregnancy, is a positive or negative stressor depends on a couple’s desire for a child and their confidence in their ability to care for one.

Psychological Stress Disorders

• During and immediately after trauma, we may temporarily experience levels of arousal, anxiety, and depression
• For some, symptoms persist well after the trauma
• These people may be suffering from:
• Acute stress disorder
• Posttraumatic stress disorder (PTSD)
• The precipitating event usually involves actual or threatened serious injury to self or others

The situations that cause these disorders would be traumatic to anyone (unlike the anxiety disorders)

• Acute stress disorder
• Symptoms begin within four weeks of event and last for less than one month
• Posttraumatic stress disorder (PTSD)
• Symptoms may begin either shortly after the event, or months or years afterward
• As many as 80% of all cases of acute stress disorder develop into PTSD
• Aside from the differences in onset and duration, the symptoms of acute stress disorders and PTSD are almost identical:
• Reexperiencing the traumatic event
• Avoidance
• Reduced responsiveness
• Increased arousal, anxiety, and guilt

Why Do People Develop a Psychological Stress Disorder?

To understand the development of these disorders, researchers have looked to the:

• Survivors’ biological processes
• Personalities
• Childhood experiences
• Social support systems
• Cultural backgrounds
• Severity of the traumas

Biological and genetic factors

• Traumatic events trigger physical changes in the brain and body that may lead to severe stress reactions and, in some cases, to stress disorders
• Some research suggests abnormal neurotransmitter and hormone activity (especially norepinephrine and cortisol)
• Evidence suggests that once a stress disorder sets in, further biochemical arousal and damage may also occur (especially in the hippocampus and amygdala)
• There may be a biological/genetic predisposition to such reactions

Personality factors

• Some studies suggest that people with certain personalities, attitudes, and coping styles are particularly likely to develop stress disorders
• Risk factors include:
• Preexisting high anxiety
• Negative worldview
• A set of positive attitudes (called resiliency or hardiness) is protective against developing stress disorders

Childhood experiences

• Researchers have found that certain childhood experiences increase risk for later stress disorders
• Risk factors include:
• An impoverished childhood
• Psychological disorders in the family
• The experience of assault, abuse, or catastrophe at an early age
• Being younger than 10 years old when parents separated or divorced

Styles of Coping

• Emotion-focused coping – A coping style that involves reducing the impact of a stressor by ignoring or escaping it rather than dealing with it directly.
• Problem-focused coping – A coping style that involves confronting a stressor directly.
• Self-efficacy expectancies – Beliefs in one’s ability to cope with challenges and to accomplish particular tasks.

Optimism

• Seeing the proverbial glass as half full rather than half empty is linked to better physical health and emotional well-being.
• One recent research study links greater optimism in women to lower rates of heart disease and greater longevity (Tindle et al., 2009).
• Pain patients who express more pessimistic thoughts during flare-ups tend to report more severe pain and distress (Gil et al., 1990).

• Positive psychology – A growing contemporary movement within psychology that focuses on the positive attributes of human behavior.
• The developers of this movement believe that psychology should focus more of its efforts on the positive aspects of the human experience, rather than just the deficit side of the human equation, such as problems of emotional disorders, drug abuse, and violence.

Social Support

• The role of social support as a buffer against stress is well documented.
• People with a broad network of social relationships not only show greater resistance to fending off the common cold but also tend to live longer.
• The investigators believe that having a wide range of social contacts may help protect the body’s immune system by serving as a buffer against stress.
• People whose social support systems are weak are more likely to develop a stress disorder after a traumatic event

References:
Bernstein, D.A. & Nash, P.W. (2008). Essentials of psychology (4th ed.) Boston: Houghton Mifflin Company.
Comer, R.J. (2013). Abnormal Psychology (8th ed).  Worth Publishers
Diagnostic and Statistical Manual of Mental Disorders, (DSM-5) American Psychiatric Publishing, 2013
Feldman, R. (2013). Essentials of understanding psychology (11th ed.). New York, NY: McGraw-Hill.
Friedman, H.S. & Schustack, M.W. (2012), Personality: classic theories and modern research (5th ed). Boston: Pearson Allyn & Bacon.
McGraw-Hill.McGraw Hill Higher Education (2013), The McGraw Hill Companies, Inc.
Ryckman, R. M. (2013). Theories of personality (10th ed.). Mason, OH: Cengage Learning.
Sue,Sue, and Sue (2014).  Understanding Abnormal Behavior (10th Ed), Cengage Learning