Chapter6(2) 健康心理学

Chapter 6Moderators of the stress experiencesSocial supportWhat are some psychosocial protective factors?Buffers reduce the negative effects of a risk factor (i.e. stress).Social support as a bufferWhat is social support?•The perceived comfort, caring, esteem or help received from others.•The existence or quantity of social relationships•the amount of assistance individuals believe is available to them•the amount of assistance individuals receivePerceived Social Support•Assessed based on people’s perceptions of the different types of support various relationships provide•Types of Social Support•Emotional support – in one study 90% rated as most important•expression of empathy, caring, concern•Tangible or instrumental support•direct assistance, concrete assistance•Informational/appraisal support•advice, directions, suggestions, feedbackEmotional supportTangible assistanceInformational supportSocial Support•Most frequent forms of social support•Type of support received often depends on the circumstances.•Tend to receive more forms of support during stressful situations.•Emotional, informational, and esteem support occurred more frequently than tangible support.•Esteem support was associated with less depressionReceived social support•Perceptions of social support more important than actual availability of support •Assessed based on the amount of support received in a particular period of time – Inventory of Socially Supportive Behaviors – how often in the past 4 weeks received supportive behaviors – Barrera et al. (1981)•Problems•the amount of support received is correlated with negative health symptoms•the available support may have not been needed during the assessment period •there is often little or no association between actual and perceived supportWhat is the link between social support and health?•House et al. (1982) – 3000 participants ages 35 – 69 using interviews, measures of social activities and biomedical measures. Participants were followed for 10 to 12 years. Participants with more social involvement had longer lives.•Social support is related to a variety of positive health outcomesPsychological well-being and Social Support•More social support – higher psychological well-being•Depressed persons have lower social supportPhysical Well-Being and Social Support (SS)•Associated with lower coronary heart risks – study of 3809 Japanese-American males – Berkman (1985)•Associated with lower levels of PSA (a marker of prostate cancer) – Stone et al.(1999)•Impact on health of having low levels of SS is similar in magnitude to the effects of smoking – House et al. (1988)•With women, higher SS associated with fewer pregnancy complications, heavier and healthier babies, and lower rates of postpartum depressionWhen does social support lead to better healthDirect effects hypothesis posits that SS can help people at both low and high levels of stress, and hence having high levels of SS is always advantageous to health Social relationships could influence their attitudes and behaviors related to health – like wearing seatbelts•encourage others to exercise, stop smoking, eat balanced diet•Absence of social relationships leads to lonelinessBuffering hypothesis suggests that SS leads to better health by protecting people from the negative effects of high stress•SS is particularly beneficial during stressful times•numerous studies suggest SS is particularly beneficial in terms of health for people undergoing high levels of stress: military in combat, AIDS patients,persons experiencing natural disasters•SS allows people to think about difficult situations more positively•SS allows people to cope more effectively – Peirce et al. (1996)•more SS lower levels of drinkingPet benefits – Siegel (1990)Can having a pet lower your blood pressure? Karen Allen (State Universityof New York, USA) surveyed the evidence.Allen recalled studies dating from the 1980's that found pet ownership tobe a predictor of 1-yr survival after heart-attack; that pet-owning AIDSsufferers suffer less from depression than non-owners; and that people withpets have lower lipid levels (fats linked with risk of heart disease). Amore recent study by the author sought to remove the possible confound thatgood health might lead people to become pet owners. Allen recruited asample of pet-free, stress-suffering stock-brokers with high blood pressureand randomly allocated half of them to become an adopter of a cat or dog.When they were put in a stress-inducing situation, the blood pressure ofthe pet adopters rose by less than half that of the other, still pet-freestock-brokers.It sounds promising but Allen warned that "most researchers in this areaare pet enthusiasts" and that "researchers still do not know thephysiological consequences (to pet owners) when their pets die". Still, ifthe research can be believed, it brings a whole new meaning to theexpression "a pet is for life, not just for Christmas".Allen, K. (2003). Are pets a healthy pleasure? The influence of pets onblood pressure. Current Directions in Psychological Science, 12, 236-239.Who benefits from what support?•matching hypothesis•People in different situations benefit from having different types of support – matching hypothesis – depends on type of problem•in the case of controllable events (e.g., new parents, victims of natural disaster), people benefit from practical support•in the case of uncontrollable events (e.g., loss of spouse), people benefit from emotional supportHow does social support lead to better health?Does social support benefit men and women equally?•Women more likely to have a close confidant•Men have larger social networks but women use theirs more effectively.•Women receive more support than men – Flaherty & Richman (1989)•Women give more support than men•SS acts as a buffer against stress•Positive social support may encourage people to change health-related behaviour •Negative social support may undermine people’s attempts to change health-related behaviourStress ManagementA program for dealing with stress in which people learn how they appraise stressful events, develop skills for coping with stress, and practice putting these skills into effect. Stress Management – teaches coping techniques•Reduce harmful environmental conditions•Teaches techniques by which person can develop stress tolerance.•Helps client maintain a positive self-image.•Help maintain emotional equilibrium.•Help client maintain or develop satisfying relations with others.Cognitive Therapy – Albert Ellis, Aaron Beck•Assumes that stress arises or is augmented by faulty or irrational ways of thinking.•Catastrophizing – “It is awful if I get turned down when I ask for a date”.•Overgeneralizing – “I didn’t get a good grade on this test. I can’t get anything right”.•Selective abstraction – Only seeing specific details of the situation (e.g., Seeing the negatives but missing the positive details).•Often these irrational beliefs or faulty thinking errors stem from past “programming”.• E.g., Not receiving adequate love and nurturance as a child may lead to feelings that loved ones in the present don’t “quite love you enough”. •Hypothesis testing – client is encouraged to test out these irrational beliefs by collecting evidence for or against the belief.•Errors in Information Processing -•Irrational Thinking Errors include:•Emotional reasoning•Overgeneralization•Catastrophic thinking•Mind reading•Selective negative focus, etc.Relaxation Therapy•Aims to either reduce hyperarousal or curb emotional-physiological reactivity.•Progressive muscular relaxation•Mental imagery•Meditation•Autogenic trainingTime ManagementSkills for learning how to use one’s time more effectively to accomplish one’s goals. •Set short-term (e.g., daily) and long-term (e.g., yearly) goals.•Make daily to-do lists (prioritize each).•Make a daily schedule for when and where you will carry out your to-do list items (estimate time allocated for each to-do item).•Revise throughout the day as needed.。