Week 14 · Chapter

Chapter 14 — Stress, Health & Coping

Introduction to Psychology Free sample edition

The module's primary reading · ~40–50 minutes · Objective 8 (apply psychological science to social behavior, stress and health, and the classification and evidence-based treatment of psychological disorders, using accurate and non-stigmatizing language), Objective 6 (analyze higher mental processes (cognition, judgment and its biases, language, and intelligence) and the forces of motivation and emotion) · Read it first this week; the lecture, the slides, the tutorial, the quiz, and the Analysis Workshop all build on it.

In plain language

Everyone knows the feeling of too much at once: a deadline, a bill, a sick relative, a phone buzzing with bad news. Stress is the word psychologists use for how your body and mind respond to an event you see as threatening or challenging. This week you will learn why the same event can energize one person and flatten another, how a worry in your head reaches your heart and your immune system, and what happens when stress lasts for months. You will also compare two ways of coping, which means the things you think and do to manage a stressor and the feelings it brings. Finally, you will look at which stress-management habits the evidence actually supports, and how careful you need to be when you read that evidence.

Why you already care about this

Two students have the same exam at 9 a.m. on the same morning. The first one feels a jolt of energy the night before. She makes flash cards, texts her study group, and goes to bed at 11. The second one lies awake at 2 a.m. with a racing heart, rereading the same page. Same exam, same room, same clock. Two very different nights.

Now widen the lens. A cyclist swerves as a car door swings open in front of her, and in under a second her heart is pounding. A grandson spends months caring for his grandmother after a fall, and by the end he catches one cold after another. A laptop dies the night before a paper is due. None of these people is weak or doing anything wrong. Each one is having a stress response, and psychology can describe each response with surprising precision.

A landmark in the science of stress came in 1936, when Hans Selye described a three-stage pattern in how the body responds to long-lasting stress. Later, Richard Lazarus and Susan Folkman showed in 1984 how much depends on the way a person reads an event. You will meet both ideas this week, test them on concrete cases, and see where the evidence is strong and where it is only suggestive.

By the end of this chapter you will be able to:

define stress and tell a stressor from the stress response;
sort stressors into catastrophes, significant life changes, and daily hassles, and tell eustress from distress;
use primary and secondary appraisal to explain why one event stresses two people differently;
trace the fight-or-flight response through the sympathetic nervous system, adrenaline, and cortisol, and describe tend-and-befriend;
place a long-lasting stressor in the right stage of the general adaptation syndrome;
explain how long stress is associated with immune function and heart disease, and why the Type A finding narrowed to hostility;
sort a coping move as problem-focused or emotion-focused;
name the evidence-based stress-management practices and read a stress-related correlation as an association, not a cause.

Carry this sentence with you: the event is the stressor; your appraisal shapes the stress.

Where we are

Already covered: Week 2 taught you to ask what a design can claim. Week 3 mapped the nervous system, Week 5 covered sleep, Week 10 took emotion apart, and Week 13 showed how powerful situations are.
This week: what stress is, how you appraise it, how it travels through the body over seconds and over months, and how people cope.
How they connect: the sympathetic nervous system from Week 3 is the engine of the stress response, and cognitive appraisal from Week 10 is its first step. The sleep data from Weeks 2 and 5 return as a lesson in reading health claims.
Where we're going next: Week 15, Psychological Disorders & Treatment, is the last unit of the course, and stress returns there as one of the two parts of the diathesis–stress model.

Four earlier ideas matter most this week. In Week 3 you met the sympathetic nervous system, the division of the autonomic nervous system that mobilizes the body for action, speeding the heart and breathing in the fight-or-flight response. You also met the parasympathetic nervous system, which calms the body afterward. Week 3 also introduced the hypothalamus, a small structure that helps regulate the release of hormones. In Week 10 you learned that cognitive appraisal is your conscious reading of what a situation means for you. And in Weeks 2 and 5 you practiced reading a correlation coefficient, r, as an association and never as a cause. All four come back in the next seven sections.

1. Name the pressure: stress, stressors, and eustress

Think about the last week that felt heavy. Maybe a car repair, a new job, and a friend's move all landed at once. You can probably name the events. You can probably also name how they felt: tight shoulders, short temper, trouble sleeping. Psychologists keep those two things apart.

Stress is the response of body and mind to an event a person appraises as threatening or challenging; what counts is how the event is perceived, not only the event itself. A stressor is the event or condition that sets off a stress response, such as an exam, a move, or a long commute. The exam is the stressor. The racing heart and the sleepless night are the stress.

That split matters because it puts the person in the middle. The same stressor does not produce the same stress in everyone, and the next section explains why.

Stressors come in three sizes:

A catastrophe is a large-scale, usually unpredictable event, such as a flood or an earthquake, that acts as a stressor for many people at once.
A significant life change is a major personal transition, such as moving, starting a new job, or losing someone close, that acts as a stressor even when the change is welcome.
A daily hassle is a small, everyday irritation, such as a slow line or a phone that will not charge, that can add up to a meaningful source of stress.

Worked example — sorting three stressors. A town's riverside neighborhood floods after a storm. A woman in the town starts her first nursing job the same month. Her bus is late three mornings in a row.

The flood. It is large-scale, it was not chosen, and it hits many people at once. It is a catastrophe.
The new job. It is a major personal transition, and she wanted it. Welcome changes still demand adjustment, so it is a significant life change.
The late bus. It is small and ordinary, but it repeats. It is a daily hassle.

In words: size and reach decide the category, not how bad the event feels on a given morning. Daily hassles are easy to dismiss, but they pile up, and a week of them can wear on a person as much as one big event.

Not all stress feels the same, either. Picture a job interview you really wanted. Your palms sweat and your heart speeds up, but you also feel sharp and ready. Now picture an interview you were pushed into, for a job you dread. The body's signals may be similar. The experience is not.

Eustress is stress a person experiences as energizing and motivating, such as the nerves before a job interview the person wanted.
Distress is stress a person experiences as overwhelming or harmful, the kind that drains energy rather than focusing it.

Selye, who coined the term eustress, argued that some stress is part of a full life. You saw the same idea in Week 10's Yerkes–Dodson law: a moderate level of arousal tends to help performance.

Misconception check. Students often think all stress is bad and the goal is a stress-free life. It is tempting because "stressed" is almost always used as a complaint. The cure is eustress. The nerves before a race you trained for, a wedding you planned, or an interview you wanted can sharpen you. What tends to harm health is distress that is intense or lasts a long time, not the existence of stress itself.

If stress ever feels like more than you can carry, you do not have to handle it alone: your campus counseling or health center, or a health professional you trust, is a good place to start.

2. Read the event: primary and secondary appraisal

Go back to the two students and the 9 a.m. exam. Nothing about the exam differs between them. What differs is what happens in each student's head in the first few moments of thinking about it.

Richard Lazarus built a model around those moments. In Lazarus's appraisal model, a person makes two judgments about an event, one after the other. Both are a kind of cognitive appraisal, your reading of what a situation means for you.

Primary appraisal is the first judgment a person makes about an event: whether it is a threat, a challenge, or nothing to worry about.
Secondary appraisal is the second judgment a person makes about an event: whether they have the resources, such as time, skills, or help, to cope with it.

In short, primary appraisal asks "Is this a threat?" and secondary appraisal asks "Can I cope with it?"

Worked example — the same exam, appraised two ways. Follow each student through both appraisals.

Student 1, primary appraisal. She reads the exam as a challenge: "This is a chance to show what I know."
Student 2, primary appraisal. He reads it as a threat: "If I fail, I lose my scholarship." Same event, 2 different primary appraisals.
Student 1, secondary appraisal. "I have a study plan and a group." Her answer to "Can I cope?" is yes. Her stress is eustress.
Student 2, secondary appraisal. "I have no time and no notes." His answer is no. His stress is distress.

In words: the event is the same, and the appraisal differs. That is why one student studies with focus and the other lies awake.

The model also points to where change is possible. Student 2 cannot cancel the exam. He can change his secondary appraisal by building resources: a two-hour block on his calendar, a borrowed set of notes, a question for his instructor. As his answer to "Can I cope?" shifts toward yes, the same exam can start to feel more like a challenge.

Pause and think. Choose one. Answer it in two or three sentences.

(a) Describe an event that felt like a threat to you at first and later felt manageable, and name what changed in your secondary appraisal.

(b) Imagine two coworkers told on the same day that their team is switching to new software, and describe how a challenge appraisal and a threat appraisal would play out for each of them.

Misconception check. Students often think stress is a property of the event, so a "stressful event" stresses everyone equally. It is tempting because some events, like a flood, really do stress almost everyone. The cure is the appraisal model: even with a flood, how much a person feels threatened and how many resources they have shape how much stress they feel. One caveat: appraisal is not a matter of "thinking positive." A person with no money for rent is reading the situation accurately, and the fix there is resources, not a new attitude.

3. Sound the alarm: fight-or-flight, cortisol, and tend-and-befriend

A cyclist rides down a city street. A car door swings open a few feet ahead. Before she has a single word in her head, she swerves, her heart pounds, her breathing speeds up, and her hands grip the bars. A second later she thinks, "That was close."

That instant reaction has a name. The fight-or-flight response is the fast, body-wide reaction to a perceived danger in which the sympathetic nervous system speeds the heart and breathing and readies the body to act. Walter Cannon described it in 1915. It works through two systems, a fast one and a slower one.

Adrenaline is a hormone released by the adrenal glands within seconds of a perceived danger that helps speed the heart and raise energy for the fight-or-flight response.
Cortisol is a stress hormone released through the HPA axis that keeps energy available during a long challenge; when it stays high for long periods, it suppresses immune function.
The HPA axis is the hypothalamic-pituitary-adrenal axis: the hormone pathway in which the hypothalamus signals the pituitary gland, which signals the adrenal glands to release cortisol.

Worked example — the car door, second by second. Trace the cyclist's stress response in order.

The danger. She sees the door open in her path. Her brain reads it as a threat in a fraction of a second.
The fast system. Her sympathetic nervous system fires, and adrenaline is released within seconds. Her heart pounds and her breathing speeds up, sending fuel to her muscles so she can swerve.
The slower system. The hypothalamus signals the pituitary gland, and the pituitary signals the adrenal glands to release cortisol. Cortisol keeps energy available in case the challenge continues.
The recovery. The danger passes. Her parasympathetic nervous system calms her body, and over the next several minutes her heart rate settles.

In words: the sympathetic system and adrenaline are the sprint, cortisol is the follow-through, and the parasympathetic system is the cool-down. For a near-miss on a bike, that is a well-designed system.

Fight-or-flight is not the only way people respond to stress. Think of a parent who hears a fire alarm in an apartment building. The first move is often not to fight or to run alone, but to gather the children and knock on a neighbor's door.

Tend-and-befriend is a pattern of responding to stress by protecting and caring for others and reaching out to them for support, an alternative to fighting or fleeing.

Tend-and-befriend connects to Week 13. People are social, and under stress many of them turn toward others, not away. That turning-toward will matter again in section 7, where social support appears on the list of practices the evidence supports.

Misconception check. Students often swap the two divisions of the autonomic nervous system, saying the parasympathetic system revs the body up. It is tempting because both names are long and sound alike. The cure is the cyclist. The sympathetic system is the swerve: it mobilizes. The parasympathetic system is the cool-down: it calms. A second trap is calling cortisol "the stress chemical that causes anxiety." Cortisol helps keep energy available; as with any hormone, it is associated with many effects, and no single chemical is the cause of a feeling.

4. Follow stress over months: the general adaptation syndrome

The cyclist's stress lasted a few minutes. Some stressors last for months. A grandson moves in to care for his grandmother after she falls and breaks her hip. There are appointments to drive to, medications to track, and nights of broken sleep. No single moment is a car door, but the pressure never lets up.

Hans Selye studied what happens to the body under that kind of long-lasting stress. He found the same three-stage pattern again and again.

The general adaptation syndrome (GAS) is Selye's description of the body's response to long-lasting stress in three stages that always come in the same order: the alarm reaction, the resistance stage, and the exhaustion stage.

The alarm reaction is the first stage of the general adaptation syndrome, in which the body mobilizes quickly to meet a new stressor.
The resistance stage is the second stage of the general adaptation syndrome, in which the body stays mobilized and keeps coping with a stressor that has not gone away.
The exhaustion stage is the third stage of the general adaptation syndrome, in which the body's resources run low after long stress and a person becomes more open to illness.

The order is fixed: alarm → resistance → exhaustion.

Worked example — the caregiver. Place each stretch of the grandson's months in the right stage.

Alarm reaction. In the first week after the fall, he cannot eat or sleep and his heart races. His body has mobilized fast for a new stressor. This is stage 1 of 3.
Resistance stage. For months he manages the appointments and the medications, running on stress hormones. He is coping, and from the outside he looks fine. This is stage 2 of 3.
Exhaustion stage. After a long stretch with no break, he catches one cold after another and feels drained. His resources are running low. This is stage 3 of 3, and the colds fit the finding that long-lasting high cortisol suppresses immune function.

In words: the body first sounds the alarm, then holds the line, and then, if the stressor never lets up, runs low. The resistance stage is the one people most often misread, because it can look like everything is fine.

The caregiver's story also shows where help fits. A sibling who takes over two nights a week, a respite program, or a friend who drives to one appointment does not end the stressor. It can, though, give his body a chance to recover before exhaustion sets in.

Misconception check. Students often scramble the stages, putting exhaustion before resistance or treating "alarm" as the last stage, when everything finally falls apart. It is tempting because "alarm" sounds like the most dramatic word. The cure is the caregiver's timeline. Alarm is the first week, resistance is the long middle, and exhaustion is what comes after months with no break. Alarm, resistance, exhaustion: always in that order.

5. Connect mind and body: immunity, the heart, and Type A

During the grandson's exhaustion stage, the colds were not a coincidence. Stress reaches the body through the same hormones you met in section 3, and when those hormones stay high for months, they leave marks.

Start with immunity. Cortisol that stays high for long periods suppresses immune function. That is one reason long-lasting stress is associated with getting sick more often. Notice the wording: associated with, not "causes." Stressed people may also sleep less, eat differently, and exercise less, and each of those can affect health too.

Stress is also associated with heart disease. Here the history of one idea is worth knowing, because it shows science correcting itself.

In 1959, Meyer Friedman and Ray Rosenman described what they called the Type A behavior pattern.

The Type A behavior pattern is a historical description of people who are competitive, rushed, and impatient, first linked to heart disease as a whole; later research narrowed the risk mainly to its hostility component.
The Type B behavior pattern is a historical description of people who are relaxed and easygoing, used as the comparison group for the Type A behavior pattern.
Hostility is a habit of anger, suspicion, and antagonism toward other people; it is the part of the Type A pattern that research has most consistently associated with heart disease.

Worked example — two drivers in the same traffic jam. Two commuters sit in the same 40-minute backup. Use the narrowed finding to decide which pattern carries the risk.

Driver 1. She is in a hurry and checks the clock every minute. She drums the wheel, impatient to get to work. She is rushed and competitive, but she is not angry at anyone.
Driver 2. He is also in a hurry, and he is furious. He leans on the horn, assumes the other drivers are idiots, and stays angry long after he parks.
Apply the narrowed finding. Both show parts of the Type A pattern. Only Driver 2 shows hostility, the component research has most consistently associated with heart disease.

In words: being busy and driven is not the risk factor the evidence supports. Chronic anger toward other people is. A limitation to keep in mind: these are associations from studies that measured people as they were. A hostile person may also sleep less or smoke more, so a third variable could carry part of the link.

Misconception check. Students often think the Type A finding means "ambitious, busy people get heart attacks." It is tempting because that was the original claim, and it still shows up in magazines. The cure is the update. Later research narrowed the risk mainly to hostility. Ambition and a full calendar are not the part the evidence flags; habitual anger is.

6. Choose a coping style: problem-focused and emotion-focused

It is 11 p.m., and your paper is due at 9 the next morning. You press the power button on your laptop. Nothing. You press it again. Nothing. Your stomach drops.

What do you do next? Whatever it is, it counts as coping, the thoughts and actions a person uses to manage a stressor and the feelings it brings. Lazarus and Folkman split coping into two styles.

Problem-focused coping is coping that tackles the stressor itself, such as making a plan, asking for an extension, or fixing what went wrong.
Emotion-focused coping is coping that manages the feelings a stressor produces, such as taking a walk or talking with a friend, without changing the stressor itself.

The test is one question: does this move change the stressor, or does it change how I feel about it?

Worked example — the dead laptop. Sort four possible moves.

Borrow a laptop from the library. This changes the stressor: you now have a working computer. Problem-focused.
Email your instructor. This changes the stressor too, by asking about an extension or another way to submit. Problem-focused.
Take a ten-minute walk. This calms your racing heart, but the laptop is still dead. Emotion-focused.
Call a friend to vent. This eases the panic, and the paper is still unsaved. Emotion-focused.

Tally: 2 + 2 = 4 coping moves, two of each style.

In words: problem-focused coping works on the problem, and emotion-focused coping works on you. Neither style is always better. When a stressor can be changed, problem-focused coping is often the best first move. When a stressor cannot be changed, such as a diagnosis in the family or a loss, emotion-focused coping is often the better fit. Most people use both, often in the same evening. The walk calms you enough to think, and then you head to the library.

Pause and think. Choose one. Answer it in two or three sentences.

(a) Describe a stressor from your own life that you could change, and name one problem-focused move and one emotion-focused move you used or could use.

(b) Describe a stressor that a character in a film, show, or book could not change, and explain why emotion-focused coping fit that situation better.

Misconception check. Students often describe emotion-focused coping as if it changes the stressor, saying "the walk solved the laptop problem." It is tempting because after the walk you feel better, and feeling better can feel like solving. The cure is the test question. Did the laptop start working? No. The walk changed your feelings, so it is emotion-focused coping. Only borrowing a laptop or emailing your instructor changed the stressor, and that is problem-focused coping.

7. Check the evidence: stress management and the sleep data

You have probably heard a dozen stress tips: drink tea, take a bath, get a massage, buy a planner. Some may help you. Only a short list has steady research behind it.

Social support, regular exercise, enough sleep, relaxation, and mindfulness are associated with better stress outcomes.

Social support is the help, comfort, and sense of connection a person receives from family, friends, coworkers, or a community, one of the practices associated with better stress outcomes.
Relaxation is a deliberate practice, such as slow breathing or relaxing one muscle group at a time, that lowers the body's arousal and supports the calming role of the parasympathetic nervous system.
Mindfulness is the practice of paying attention to the present moment, including thoughts and feelings, on purpose and without judging them.

Each practice links back to a section of this chapter. Social support is tend-and-befriend put to work. Relaxation and mindfulness help the parasympathetic system do its cool-down. Exercise may help use up the energy that fight-or-flight mobilizes. And sleep, as you learned in Week 5, is when the brain does much of its recovery work, including memory consolidation.

Now read some evidence with care. In Week 5 you met a small dataset of ten students, illustrative and constructed for this course, not real data: hours of sleep the night before a 20-point quiz, paired with quiz scores. Here it is again.

Hours of sleep and next-day quiz score for 10 students, illustrative course dataset (score out of 20)
Hours of sleep	5	6	6.5	7	7	7.5	8	8	8.5	9
Quiz score	11	14	12	15	13	16	17	14	18	17

Worked example — the sleep data, read for stress. Read the dataset the way a careful health reader would.

The guideline. Most adults need about 7 to 9 hours of sleep a night. In the dataset, 3 of the 10 students slept fewer than 7 hours (5, 6, and 6.5 hours). So 3 ⁄ 10 = 0.30, or 30%, slept below the guideline.
The rest. That leaves 10 − 3 = 7 students who slept 7 to 9 hours.
Read r. Here r (the correlation coefficient) is 0.8457. The sign is positive, so sleep and score rise together, and 0.8457 is close to +1, so the linear association is strong. In this sample, students who slept more tended to score higher.
The stress check. Stress is a third variable. A student facing a heavy stressor that week, such as a double shift at work or a family emergency, might both sleep less and score lower. Stress could drive both numbers.
What it may claim. Nothing was manipulated, so this is a correlational study. It supports an association claim ("sleep is associated with higher scores") and not a causal claim.

In words: the data fit the idea that sleep is a recovery resource, but they cannot prove it, because stress could sit behind both columns. That is the same habit you built in Week 2, now applied to health advice. A headline that says "sleep raises grades" has turned an association into a cause. A careful reader asks what else could explain it, and stress is often the first answer.

The same honesty note applies to the whole list of practices. Its wording is deliberate: "associated with better stress outcomes" is the accurate summary, not "cures stress." That is still a good reason to try them, as long as you read each new claim about them with the same care.

Misconception check. Students often read "people who exercise report less stress" as "exercise cures stress." It is tempting because the advice sounds sensible and you may have felt it work. The cure is the third-variable question. People with more free time may both exercise more and feel less stressed. A single correlation cannot show that, however sensible the advice sounds, and a correlation is never a percentage or proof of a cause.

If stress ever feels like more than you can carry, you do not have to handle it alone: your campus counseling or health center, or a health professional you trust, is a good place to start.

Key terms

Stress — The response of body and mind to an event a person appraises as threatening or challenging; what counts is how the event is perceived, not only the event itself. (first used: 1. Name the pressure: stress, stressors, and eustress)
Stressor — The event or condition that sets off a stress response, such as an exam, a move, or a long commute. (first used: 1. Name the pressure: stress, stressors, and eustress)
Catastrophe — A large-scale, usually unpredictable event, such as a flood or an earthquake, that acts as a stressor for many people at once. (first used: 1. Name the pressure: stress, stressors, and eustress)
Significant life change — A major personal transition, such as moving, starting a new job, or losing someone close, that acts as a stressor even when the change is welcome. (first used: 1. Name the pressure: stress, stressors, and eustress)
Daily hassle — A small, everyday irritation, such as a slow line or a phone that will not charge, that can add up to a meaningful source of stress. (first used: 1. Name the pressure: stress, stressors, and eustress)
Eustress — Stress a person experiences as energizing and motivating, such as the nerves before a job interview the person wanted. (first used: 1. Name the pressure: stress, stressors, and eustress)
Distress — Stress a person experiences as overwhelming or harmful, the kind that drains energy rather than focusing it. (first used: 1. Name the pressure: stress, stressors, and eustress)
Primary appraisal — In Lazarus's appraisal model, the first judgment a person makes about an event: whether it is a threat, a challenge, or nothing to worry about. (first used: 2. Read the event: primary and secondary appraisal)
Secondary appraisal — In Lazarus's appraisal model, the second judgment a person makes about an event: whether they have the resources, such as time, skills, or help, to cope with it. (first used: 2. Read the event: primary and secondary appraisal)
Fight-or-flight response — The fast, body-wide reaction to a perceived danger in which the sympathetic nervous system speeds the heart and breathing and readies the body to act. (first used: 3. Sound the alarm: fight-or-flight, cortisol, and tend-and-befriend)
Adrenaline — A hormone released by the adrenal glands within seconds of a perceived danger that helps speed the heart and raise energy for the fight-or-flight response. (first used: 3. Sound the alarm: fight-or-flight, cortisol, and tend-and-befriend)
Cortisol — A stress hormone released through the HPA axis that keeps energy available during a long challenge; when it stays high for long periods, it suppresses immune function. (first used: 3. Sound the alarm: fight-or-flight, cortisol, and tend-and-befriend)
HPA axis — The hypothalamic-pituitary-adrenal axis: the hormone pathway in which the hypothalamus signals the pituitary gland, which signals the adrenal glands to release cortisol. (first used: 3. Sound the alarm: fight-or-flight, cortisol, and tend-and-befriend)
Tend-and-befriend — A pattern of responding to stress by protecting and caring for others and reaching out to them for support, an alternative to fighting or fleeing. (first used: 3. Sound the alarm: fight-or-flight, cortisol, and tend-and-befriend)
General adaptation syndrome (GAS) — Selye's description of the body's response to long-lasting stress in three stages that always come in the same order: the alarm reaction, the resistance stage, and the exhaustion stage. (first used: 4. Follow stress over months: the general adaptation syndrome)
Alarm reaction — The first stage of the general adaptation syndrome, in which the body mobilizes quickly to meet a new stressor. (first used: 4. Follow stress over months: the general adaptation syndrome)
Resistance stage — The second stage of the general adaptation syndrome, in which the body stays mobilized and keeps coping with a stressor that has not gone away. (first used: 4. Follow stress over months: the general adaptation syndrome)
Exhaustion stage — The third stage of the general adaptation syndrome, in which the body's resources run low after long stress and a person becomes more open to illness. (first used: 4. Follow stress over months: the general adaptation syndrome)
Type A behavior pattern — A historical description of people who are competitive, rushed, and impatient, first linked to heart disease as a whole; later research narrowed the risk mainly to its hostility component. (first used: 5. Connect mind and body: immunity, the heart, and Type A)
Type B behavior pattern — A historical description of people who are relaxed and easygoing, used as the comparison group for the Type A behavior pattern. (first used: 5. Connect mind and body: immunity, the heart, and Type A)
Hostility — A habit of anger, suspicion, and antagonism toward other people; it is the part of the Type A pattern that research has most consistently associated with heart disease. (first used: 5. Connect mind and body: immunity, the heart, and Type A)
Coping — The thoughts and actions a person uses to manage a stressor and the feelings it brings. (first used: 6. Choose a coping style: problem-focused and emotion-focused)
Problem-focused coping — Coping that tackles the stressor itself, such as making a plan, asking for an extension, or fixing what went wrong. (first used: 6. Choose a coping style: problem-focused and emotion-focused)
Emotion-focused coping — Coping that manages the feelings a stressor produces, such as taking a walk or talking with a friend, without changing the stressor itself. (first used: 6. Choose a coping style: problem-focused and emotion-focused)
Social support — The help, comfort, and sense of connection a person receives from family, friends, coworkers, or a community, one of the practices associated with better stress outcomes. (first used: 7. Check the evidence: stress management and the sleep data)
Relaxation — A deliberate practice, such as slow breathing or relaxing one muscle group at a time, that lowers the body's arousal and supports the calming role of the parasympathetic nervous system. (first used: 7. Check the evidence: stress management and the sleep data)
Mindfulness — The practice of paying attention to the present moment, including thoughts and feelings, on purpose and without judging them. (first used: 7. Check the evidence: stress management and the sleep data)

Summary

Stress is your response to an event you appraise as threatening or challenging.
The stressor is the event; the stress is the response.
Stressors come as catastrophes, significant life changes, and daily hassles.
Eustress energizes and distress overwhelms; not all stress is bad.
Primary appraisal asks "Is this a threat?" and secondary appraisal asks "Can I cope?"
Fight-or-flight runs on the sympathetic nervous system and adrenaline, with cortisol from the HPA axis.
The parasympathetic nervous system calms the body after the danger passes.
Tend-and-befriend is an alternative pattern: protect others and reach out.
The general adaptation syndrome runs alarm, resistance, exhaustion, always in that order.
Long-lasting high cortisol suppresses immune function.
The Type A risk for heart disease narrowed mainly to hostility.
Problem-focused coping changes the stressor; emotion-focused coping manages the feelings.
Social support, exercise, sleep, relaxation, and mindfulness are associated with better stress outcomes.
In the sleep data, stress is a third variable, so the correlation supports association, not cause.

Check your understanding

Work these before looking at the answers — they are ungraded, and the answers (with reasoning) are at the bottom of the page.

A family has three things happen in one season: a wildfire forces their whole neighborhood to evacuate for a week, their oldest child leaves home for college, and the kitchen faucet drips every night. Sort each into a stressor category, and explain why the college move counts even though the family is proud of it.
Two line cooks hear that a well-known food critic will eat at their restaurant on Friday. Rafael thinks, "This is our chance, and we have practiced every dish." Mei thinks, "If we mess up, the restaurant could close, and we are short-staffed." Name each cook's primary and secondary appraisal, and say who is more likely to feel eustress.
A small-business owner's street is torn up for road construction that lasts 5 months. In the first days she cannot sleep. Through the next few months she works long hours and seems to manage. By month 5 she is sick every other week. Label each stretch with its stage of the general adaptation syndrome, in order.
A made-up survey of 12 warehouse workers finds a correlation of −0.42 between weekly minutes of exercise and a 1-to-10 tension rating. Describe the direction and strength, write one sentence about what it may claim, and name one third variable.

Answers (worked reasoning — read after attempting)

The wildfire evacuation is a catastrophe: it is large-scale, unpredictable, and hit the whole neighborhood at once. The college move is a significant life change: it is a major transition in the family's daily life. It counts even though they are proud, because welcome changes still demand adjustment. The dripping faucet is a daily hassle: small and ordinary, but repeated every night.
Rafael's primary appraisal is a challenge ("this is our chance"), and his secondary appraisal is yes, he can cope ("we have practiced every dish"). Mei's primary appraisal is a threat ("the restaurant could close"), and her secondary appraisal is no ("we are short-staffed"). Rafael is more likely to feel eustress. Same critic, same Friday, two appraisals.
The first sleepless days are the alarm reaction: her body mobilizes fast for a new stressor. The months of long hours are the resistance stage: she keeps coping while the stressor stays. Being sick every other week by month 5 is the exhaustion stage: her resources have run low, which fits long-lasting high cortisol suppressing immune function. Alarm, resistance, exhaustion, in that order.
The sign is negative, so as exercise minutes go up, tension ratings tend to go down. The size, 0.42, is a moderate linear association, not close to −1. What it may claim: in this sample, more exercise was associated with lower tension ratings. It cannot show that exercise lowered tension. One third variable is free time: workers with lighter schedules may both exercise more and feel less tense. (The directionality problem fits too: very tense workers may skip exercise.)

Next up in this module: the Readings & Resources page, the lecture tutorial, the practice set, and the quiz — and next week the diathesis–stress model shows how stress and an underlying vulnerability can interact in psychological disorders.

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