Chapter 3

Question 1

What does stress involve?

Answer 1

> perturbation of the system / movement away from homeostasis or resting state
in response to some perceived threat or demand.

Question 2

When did the study of the body’s reaction to stress begin?

Answer 2

> launched by Cannon’s (1929) work on the fight-or-flight response and by Selye’s idea of a General Adaptation Syndrome (Selye, 1976).

Question 3

What bodily system coordinates the body’s neuroendocrine response with respect to stress?

Answer 3

> the hypothalamic-adrenal-pituitary axis

Question 4

When is stress less funcitional?

Answer 4

> but is less functional in dealing with the vaguer psychological threats of modern life, which cannot often be resolved by either fighting or fleeing

Question 5

With respect to stress, what is the main negative outcome that has received the most research? What is this research based on?

Answer 5

> Heart disease.
Much research based on the “reactivity hypothesis” that repeated blood pressure spikes lead to hypertension and heart disease.

Question 6

What is stress actually meant to do?

Answer 6

> meant to give us the resources to deal with threats, rather than add to the negative experience of the situation.

Question 7

What distinction did Selye make with respect to stress?

Answer 7

> he also distinguished between distress, which has negative health consequences, and eustress, which is positive.

> This good stress generally comes from confronting challenges that one can adequately deal with and thus can provide a sense of meaning and well-being
On the other hand, distress comes from feeling that one’s resources are insufficient to meet the demands of a situation

Question 8

What notion is eustress associated with?

Answer 8

> it is connected to the notion of optimal arousal, and there is considerable evi-dence that people can perform better, if not live longer, when they reach an optimal level of arousal (i.e., with some pressure on them)

Question 9

One factor underlying the difference between positive and negative stress is what?

Answer 9

> Duration

Question 10

Stress researcher Robert Sapolsky (2004) has theorized that the physiological stress response was designed (in evolutionary terms) to address what?

Answer 10

> acute threats, such as being chased by a predator.

> It is when these short-term changes, such as increases in blood pressure, become long-term that stress can lead to disease.

Question 11

Chronic stress is not always a product of the actual stressor being extended or recurring; rather, what actually causes it? What is this process known as?

Answer 11

> dwelling on events that are themselves very brief (“You’re fired!” “I’m leaving you!”) can turn these acute stressors into chronic ones. This process is known as rumination.

Question 12

What have studies revealed about rumination?

Answer 12

> Research shows that ruminating on a stressor can extend elevated blood pressure response, or later recreate it

> People who tend to ruminate also have a higher incidence of cardiovascular disease, suggesting that this tendency to extend acute stressors into chronic ones can be damaging to one’s health.

Question 13

Overall then, what is the main difference between acute and chronic stress?

Answer 13

> Rumination

Question 14

Among the most studied sources of situational stress are what?

Answer 14

> Various occupations

Question 15

Timio et al. (1988) followed
for two decades a group with particularly low job stress: nuns living in a secluded order in Umbria. Compared to the nuns, what was found about the control group?

Answer 15

> Over the span of the study, blood pressure rose significantly—roughly 40 mmHg SBP—for people in the control group, while for the nuns it did not rise at all.

Question 16

The most simple, intuitive notion of job strain is what?

Answer 16

> that some professions intrinsically come with high levels of stress, while others are naturally more relaxing. However, it is not immediately clear what the most stressful jobs would be

Question 17

One key question about job stress (and stress in general) is the issue of control; namely, is it
more stressful to have control in a demanding situation or to have no control? What do the studies say?

Answer 17

This has been explored in animal studies with conflicting results.

> Studies with humans show that the effect of job stress on health seems to rely on multiple factors, though there is not complete agreement on what those factors are.

Question 18

The model of occupational stress developed by Karasek et al. (1988) suggests what about job stress?

Answer 18

> suggests that job stress is a function of job demands and “decision latitude,” or amount of autonomy.

> The argument is that jobs with high demands but little autonomy would be highly stressful and, consequently, damaging to health.

> moves away from a simple hierarchical view, since upper executives may have high demand, but this can be offset by high control, and those nearer the bottom of the pyramid may have fewer demands, but also less control.

Question 19

People holding high-demand/low-autonomy jobs, such as waiters and firefighters, are roughly four times as likely to suffer heart attacks as those with what?

Answer 19

> the greatest balance of autonomy and strain

Question 20

hose who put in high effort and receive few rewards are also at risk for what?

Answer 20

Job strain

Question 21

the imbalance of effort and reward can predict what, in large samples of blue-collar workers?

Answer 21

> negative health events such as coronary heart disease (CHD, or, colloquially, harden-ing of the heart’s arteries), myocardial infarction (MI, or, colloquially, a heart attack), and death (colloquially, kicking the bucket)

Question 22

Aside from Karasek’s model of stress, what do other models theorize?

Answer 22

> damage results from a misfit/incongruence between the person and the environment,

• or - the demands of the job and capabilities of the employee

Question 23

In general, what do job-strain models rely on?

Answer 23

> job strain models rely on some interactive aspect of the effort involved in the job and whether that job includes factors that make its successful completion viable.

Question 24

What scale measures stressful life events? How does it work? Lastly, what is one notable feature about this scale?

Answer 24

> the Social Readjustment Rating Scale (SRRS), more commonly known as the Holmes and Rahe Stress Scale (Holmes & Rahe, 1967).

> This scale includes numerous possible life events, and people obtain a score for each event they have experienced in some given interval, with more points assigned for the more major events

> One notable feature of this scale is that it does not distinguish between positive and negative events; both contribute to the total stress score.

Question 25

What are issues with the SRRS scale?

Answer 25

> One argument points out the somewhat arbitrary weighting of the various factors > Another issue has been the question of whether positive items produce the same sort of stress as negative ones.

Question 26

Another debate about the measurement of life stress is whether what occurs?

Answer 26

> is whether stress problems depend on rare major events, or whether they have a greater relationship to frequent and minor ones.

Question 27

Kanner, Coyne, Schaefer, and Lazarus (1981) developed a scale with questions about more than 100 life hassles. People indicate which events they have experienced in the past month and also rate the severity of the events. Following 100 people for 9 months what did Kanner and colleagues (1981) find?

Answer 27

> found a large and significant > correlation between reports of these daily hassles and psychological symptoms. In fact, these daily hassles were more associated with scores on a self-reported symptom checklist (including such symptoms as headaches and feeling lonely) than were the more major events.

Question 28

What is a negative outcome of caregiver stress (bodily)?

Answer 28

> This sort of stress has been shown actually to reduce telomere length, which is a marker of cellular aging (Epel et al., 2004). Chronically caring for others, it seems, even makes one’s cells feel old.

Question 29

Nolan, Grant, and Ellis (1990) suggested that caregiver stress is produced by what?

Answer 29

> the perceived nature of the demand ex-ceeding the perceived capabilities of the person.

Question 30

Besides the model proposed by Nolan et al., what do other caregiver stress models note?

Answer 30

> Other views of caregiver stress are more specific to this stressor and suggest that caregiving is stressful because it interferes with the caregiver taking care of himself or—more commonly—herself. > In addition to such objective burdens there is also the subjective burden, which includes the feelings experienced when providing care.

Question 31

Cause of death varies by occupation, race, and nationality, but also what unsuspecting factor? What is the most discussed example?

Answer 31

> by region! > New York City is a hot spot for heart-attack mortality and there is a “stroke buckle” in the southeastern area of the US.

Question 32

The stress of caregiving does not seem to impact all caregivers equally. What does this mean?

Answer 32

> With traumatic brain injury, partners seem particularly affected > perhaps because it represents a more profound or unexpected change to the prior relationship. > Women seem to report more caregiver-associated stress and depression than men

Question 33

Some forms of stress are thought to result not from the particulars of one’s employment, family responsibilities, or specific life events, but more generally from what?

Answer 33

> one’s status in society. (socioeconomic status)

Question 34

The SES positions thought to be associated with poor health outcomes are? How does this relate to the other models about strain so far?

Answer 34

> those subjected to discrimination, harassment, and limited opportunities. > Again consistent with some job-strain models and care-giver stress, people in positions of less power often experience demands that overwhelm their personal resources.

Question 35

How do negative health effects relate to SES?

Answer 35

> Some of these relationships seem to be due to the relatively poorer health behaviours of those in lower SES groups as compared to those of higher SES > People of lower SES and those who are marginalized, for example, are likely to have poorer nutrition and are more likely to smoke.

Question 36

With respect to SES and health outcomes, which interventions improve health?

Answer 36

> Evidence, however, indicates that education interventions improve health

Question 37

Stress relating to SES is different than other forms of stress, how?

Answer 37

> in that it is due to relative position, rather than to any absolute level of daily events, task demands, and the like

Question 38

How does gender affect health?

Answer 38

> Role conflict for women, for example, has been associated with increased psychosocial symptoms > Women have a longer lifespan than men > at least through menopause, women have significantly lower blood pressure levels

Question 39

Pascoe and Smart Richman (2009) found that per-ceived discrimination was associated with health outcomes? Also, what specific type of stress is caused because of racial discrimination?

Answer 39

> with poor physical health, as well as psychological distress. > Reports of racial discrimination were associated with red blood cell oxidative stress

Question 40

Oxidative stress involves free radicals - what are those?

Answer 40

> are molecules that, having a single unpaired electron in their outer shell, are highly chemically reactive since they seek to steal an electron from neighbouring molecules) damaging DNA and other cellular components.

Question 41

While African Americans clearly suffer worse health outcomes than Caucasians, the same appears not to be true of what persons?

Answer 41

> of Hispanic heritage, an effect at least partly attributable to health behaviour differences such as alcohol consumption and cigarette smoking

Question 42

What is Alexander's notion of a stressed person?

Answer 42

> suggested that people who channel their hostile anger inward activate the auto-nomic nervous system, and are therefore more likely to develop hypertension.

Question 43

What is the competing notion to Alexanders notion of the stressed person? How is it similar?

Answer 43

> The stress-prone personality developede by Friedman and Rosenman’s (1959) notion of a Type A personality > Irvine, Garner, Craig, and Logan (1991) found a significantly higher prevalence of Type A in persons with hypertension than in matched controls, but similar in that it was found that hostility seemed to be the key factor, rather than the more general Type A pattern, and more recently attention has moved to that dimension

Question 44

Another personality dimension that has received some attention is what?

Answer 44

negative affectivity (NA), a trait that characterizes people prone to negative emotions such as anger, fear, disgust, contempt, and the like.

Question 45

What does negative affectivity relate to?

Answer 45

his is related to other constructs such as neuroticism, having to do with anxiety, worry, envy, and such.

Question 46

What health outcomes are related to negative affectivity?

Answer 46

> Eysenck (1991) finding higher death rates (an outcome not so biased by self-report) in those high in NA > and others suggesting that NA can confound reporting

Question 47

The effort–distress model (Frankenhauser, 1983) suggests what? What does Dressier's contending model say in response?

Answer 47

> suggests that distress de-pends not only on effortful situations, but also on the individual seeing events as excessive or feel-ing out of control. > Another model (Dressier) has suggested that it is not being poor that is stressful, but rather living beyond one’s means—that is, the stressfulness of SES is a combination of available resources and the ways individuals use them.

Question 48

Another interaction showing that stress depends on the particular personality of a person and when a corresponding situation emerges - what specific occupation showcases this?

Answer 48

> work with New York City traffic enforcement agents (TEAs) > TEAs wore ambulatory blood pressure monitors, and their activities were tracked. > personality trait of high hostility + hostile interactions = high levels of ambulatory blood pressure

Question 49

What does the interactionist view of stress argue?

Answer 49

> he interactionist’s view suggests that some stressors are too much for some individuals and over-whelm their resources > involves appraisals

Question 50

Who coined the term appraisals with respect to stress?

Answer 50

> Richard Lazarus

Question 51

What is a primary appraisal? What follows a primary appraisal?

Answer 51

> primary appraisal, which involves a determination of the magnitude and nature of the threat that the situation pre-sents > Primary appraisal is then followed by secondary appraisal, a de-termination of the resources available to deal with that threat.

Question 52

According to Lazarus, when is something a challenge and when is something a threat?

Answer 52

> When resources are judged to be adequate, the situation can be seen as a challenge, > and when inadequate, as a threat. > These judgements have been shown to change physiological responses (

Question 53

In respect to primary and secondary appraisals, what does stress and coping align with?

Answer 53

While stress itself tends to spring from primary appraisal, the coping process is focused around secondary appraisal, or an assessment of one’s resources available for meeting stressful demands.

Question 54

Resources and the coping strategies that utilize them generally fall into two categories:

Answer 54

> problem-focused coping and emotion-focused coping. - In problem-focused coping, one copes with stress by directly addressing the demands of the situation, such as borrowing money to pay an unexpected bill. > In emotion-focused coping, one copes with stress by addressing the emotions that come with stressful situations, such as turning to friends for encouragement and support

Question 55

Some evidence suggests that problem-focused coping for health problems is associated with what kind of health outcomes?

Answer 55

> better health outcomes. * BUT - this statment could be causal. > Really, one type of coping is not necessarily better than the other; when facing a serious illness, for example, it is likely that an individual will have to engage in both problem-focused coping, such as seeking treatment options, and emotion-focused coping, such as learning to deal with uncertainty. > The most appropriate coping response will depend on the situation, and most situations will call for some combination

Question 56

Folkman and Lazarus (1980) have suggested that the most effective coping strategy is what type?

Answer 56

> a flexible one—that is, being able to switch coping strategies based on the demands of the situation.

Question 57

One type of coping, however, sometimes classified as a type of emotional coping, appears to be less effective than the others:

Answer 57

avoidant coping. > Rather than dealing with the situation or emotions about the stressor, the goal of avoidant coping is to ignore the problem and its resulting emotions. > This type of coping is quite robustly shown to lead to worse physical and mental health outcomes > maladaptive strategy.

Question 58

What negative health outcome (what disorder) is associated with avoidant coping?

Answer 58

> often associated with substance-abuse disorders.

Question 59

Much research on coping has involved which scale? What should be noted about other scales that are different from this one?

Answer 59

Ways of Coping Scale, a 66-item measure developed by Folkman, Lazarus, Dunkel-Schetter, DeLongis, and Gruen (1986). > The scale identifies distinct coping strategies within the categories mentioned above (problem-focused, emotion-focused, and avoidant). > Measures how coping changes over time, within or across stressful events > not as specific as other models.

Question 60

What were the 8 types of coping as identified by the ways of coping scales?

Answer 60

1. Confrontative coping (e.g., “I tried to get the person responsible to change his or her mind”). 2. Distancing (e.g., “I went on as if nothing had happened”). 3. Self-controlling (e.g., “I tried not to act too hastily or follow my first hunch”). 4. Seeking social support (e.g., “I talked to someone about how I was feeling”). 5. Accepting responsibility (e.g., “I realized I brought the problem on myself”). 6. Escape-avoidance (e.g., “I slept more than usual”). 7. Planful problem-solving (e.g., “I made a plan of action and followed it”). 8. Positive reappraisal (e.g., “I changed something about myself”)

Question 61

One of the most common ways of coping with stress— is what?

Answer 61

Social support

Question 62

Social support has many forms, but it can generally be described as:

Answer 62

a social network in which others care about one’s well-being and provide help and assistance.

Question 63

What are the four forms of help (Social support)?

Answer 63

1) emotional support, such as pro-viding encouragement and empathy; 2) instrumental support, which refers to providing tangible goods and services, like loaning someone money or offering them a ride; 3) informational support, in which one provides valuable information relevant to addressing the situation; 4) and appraisal support, or helping someone identify a stressor and potential coping options

Question 64

Is social support a good coping strategy?

Answer 64

> It turns out that our inclination to seek social support during stress is a good one, as support is one of the most effective ways of dealing with stress—not just emotionally, but also physiologically.

Question 65

What are the two different perspectives of social support?

Answer 65

> These two perspectives (i.e., main effects vs buffering) represent two different prevailing theories about social support and health: that social support has a main effect on health, and that social support buffers—or protects us from—the negative effects that stress has on our health

Question 66

The main effects model suggests that social support is what?

Answer 66

> generally beneficial to health and well-being, whether we are carefree or stress-ridden. This has been shown for myriad measures of health; people with more social support tend to have lower blood pressure, are less likely to suffer from heart disease, have stronger immune systems, and live longer

Question 67

The buffering model suggests what about social support?

Answer 67

> one of the main ways that social support leads to better health is by reducing stress and, therefore, reducing the negative effects of stress on one’s health

Question 68

The notion of “allostatic load” captures the idea that:

Answer 68

> that not just the magnitude of the elevation but also the duration and frequency of the blood pressure response will contribute to disease outcomes.

Question 69

during stressful times, women are much more likely than men to do what? what are men also less likely to do?

Answer 69

> seek social support > go to the doctor

Question 70

Taylor and colleagues (2000) have argued what about the typical fight-or-flight response

Answer 70

> may actually be a more appropriate description of men’s response to stress, and that women’s much more social response could more accurately be classified as tend-and-befriend. > based on evolution

Question 71

Can social events be stressful?

Answer 71

> Yes - divorce is an example.

Question 72

Social networks can actually become a liability to health when what occurs?

Answer 72

> when they do not provide the sup-port that is needed or expected.

Question 73

How does spousal support affect health? Describe the Kulik and Mahler study:

Answer 73

> Kulik and Mahler (1989), in their study of male coronary bypass patients, examined recovery time in relation to how often the patients’ wives visited them in the hospital. > They found that those who recovered fastest and went home earliest, not surprisingly, were the ones whose wives visited most often. > The surprising finding, however, was that the group slowest to recover was not single men, but married men whose wives visited rarely or never. > In this case it appeared that having an unsupportive spouse was actually worse for health than having no spouse at all.

Question 74

Just like with social support, not everyone responds to social conflict equally, and in this case the division is again drawn along gender lines. Do men or women recieve more distress over social conflict?

Answer 74

> Women generally report more distress over social conflict than men, which is not surprising because women appear to rely more on social networks than men do.

Question 75

What is the one exception to the gender divide in social support?

Answer 75

> while men receive more health benefits from marriage, they appear to suffer just as many health consequences from divorce as women - thus, when men get married they receive a major boost to their social resources, but when they get divorced they may lose it all at once.

Question 76

Central to the tend-and-befriend hypothesis is the idea that women may have what?

Answer 76

> a modified stress response due to the hormone oxytocin

Question 77

While both men and women secrete oxytocin during stress, oxytocin may affect women more because what?

Answer 77

> its effects are modulated by estrogen and suppressed by androgens. > Women have especially elevated levels of oxytocin when pregnant and nursing; thus, if oxytocin suppresses the fight-or-flight response, this urge would be especially blunted when women have young offspring.

Question 78

Is the "tend-and-befriend" hypothesis universally accepted?

Answer 78

> no. > but there is some evidence for it. > i.e., researchers interviewed children about their parents’ behaviours after work and found that the days that children reported the most nurturing from their mothers were the days that women reported the most stress at work. Fathers’ stressful days, however, aligned with days children reported their fathers being distant and isolating themselves - or - - In rodents, group housing acts as a stressor for males but is calming for females

Question 79

A large study of Canadians explored gender differences in the use of social support and the severity and duration of depression- what was found about men specifically?

Answer 79

> Positive social interactions were found to be beneficial for both sexes, but men who used more emotional/informational sup-port actually did worse. It may be that men, with less of this sort of support available in reserve, were harmed by using up so much of it.

Question 80

People going through significant stressors may also report negative effects of support if the recieve what type of support?

Answer 80

> The wrong type of social support. > I.e., People going through treatment for cancer, for example, gener-ally benefit from social support, but report that receiving informational support and treatment suggestions from friends and family can actually be more distressing than helpful, and that they would rather receive such information only from their physicians

Question 81

Are support groups beneficial?

Answer 81

> It depends!! There are mixed results, but it depends on if that is the right support for someone.

Question 82

While many benefits are gained from discussing stressful events with others, it appears that there may be some benefits in simply “discussing” a problem with what?

Answer 82

> ourselves. > "emotional self-disclosure"

Question 83

Pennebaker and Seagal (1999), writing about traumatic events can help do what>

Answer 83

> can help place these events in a meaningful narrative. > or to find purpose in relation to the event, or to place it in the context of his or her life in a meaningful way.

Question 84

One common approach to coping with stress is to do what? What does the research say about it and which method is best?

Answer 84

> exercise. > but the research is limited on this as a coping strategy. > it is also unclear at which exercise is best. > In sum-mary, evidence supports exercise as an effective coping strategy but it remains unclear how much or what type is needed to prevent or reduce stress, or how and why exercise reduces stress.

Question 85

Extreme stress is a major risk factor for which disorders? (BUT- what is the most representative example? - which disorder)

Answer 85

> depression and anxiety disorders. > Post-traumatic stress disorder (PTSD) represents an extreme example of the connection between stress and mental health

Question 86

Thus, the effects of extreme stress can endure long after what?

Answer 86

> the initial stressor has subsided.

Question 87

Chronic ruminating and resulting activation of the stress response could partially explain why people with anxiety and mood disorders are at risk for what?

Answer 87

> at two to three times greater risk for stress-related diseases like cardiovascular disease

Question 88

What appears to mediate the relationship between job-stress and sleep disturbances?

Answer 88

> Rumination

Question 89

What type of relationship is apparent in stress and sleep?

Answer 89

> bi-directional > I.e., Improving sleep habits can decrease stress levels, though stress can also make maintaining healthy sleeping habits more difficult.

Question 90

Some environmental stressors have a direct effect on sleep and stress, whereas in other instan-ces how one copes with a stressor may be more important than whether a stressor is present. Describe what type of work affects sleep.

Answer 90

> Shift work, a schedule that requires working either earlier or later than the typical 9:00 a.m. to 5:00 p.m. work day, has a direct association with increased social stress and increased sleep complaints in a sample of police officers

Question 91

What is a popular therapy approach to stress management?

Answer 91

> One popular behavioural approach is cognitive behavioural therapy (CBT), a form of therapy focused on changing cognitions and beliefs in order to change behaviour and emotions

Question 92

Which stress management strategies have been implemented by Eastern practices and Buddhism?

Answer 92

> Biofeedback, relaxation, and mindfulness > Such strategies involve taking some con-trol over one’s own stress responses, both physical and mental.

Question 93

Biofeedback techniques allow people to do what?

Answer 93

to monitor, often with the use of devices, their physiological responses, such as heart rate, and so come to have more control over those bodily systems.

Question 94

Relaxation interventions can involve a variety of other techniques to promote what?

Answer 94

> calmness, including music, meditation, massage, and the like.

Question 95

Mindfulness aims to do what?

Answer 95

> reduce anxiety about future events and rumination about past ones by having people more focused on their experiences in the moment, and this has also been shown to be effective in reducing anxiety and stress

Question 96

Pharmacological treatments for stress are used how? How should they be used?

Answer 96

> widely—and some would say sometimes inappropriately—used. > should be used short-term and accompanied with behavioural interventions.

Question 97

What has research said about social media and stress?

Answer 97

> causes more stress than it reduces. > More time spent on, and more memberships in, online social networks correlated with higher stress levels and lower quality of life > Online social networks have also been shown to affect physical health by inducing stress: > The relationship between stress and infection increased in strength as one’s online network increased in size

Question 98

What aspect of social media can be beneficial for coping with stress?

Answer 98

> Online support groups. > may be particularly useful to those not willing or able to seek in-person social support regarding a condition or topic due to it being stigmatizing or when the condition pre-vents in-person attendance > Online social support groups may confer their benefits by facilitating a sense of self-empowerment that helps members cope with distress and by conveying emotional support > Both active and passive participation appears to confer the same benefits