Health Psychology : a Textbook

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1.Self-efficacy. In 1987, Lazarus and Folkman suggested that self-efficacy was a
powerful factor for mediating the stress response. Self-efficacy refers to an individual’s
feeling of confidence that they can perform a desired action. Research indicates that
self-efficacy may have a role in mediating stress-induced immunosuppression and
physiological changes such as blood pressure, heart rate and stress hormones (e.g.
Bandura et al. 1982, 1988; Wiedenfeld et al. 1990). For example, the belief ‘I am
confident that I can succeed in this exam’ may result in physiological changes that
reduce the stress response. Therefore, a belief in the ability to control one’s behaviour
may relate to whether or not a potentially stressful event results in a stress response
(see later for a discussion of PNI).


2 Hardiness. This shift towards emphasizing self-control is also illustrated by Kobasa’s
concept of ‘hardiness’ (Kobasa et al. 1982; Maddi and Kobasa 1984). Hardiness
was described as reflecting (a) personal feelings of control; (b) a desire to accept
challenges; and (c) commitment. It has been argued that the degree of hardiness
influences an individual’s appraisal of potential stressors and the resulting stress
response. Accordingly, a feeling of being in control may contribute to the process of
primary appraisal.


3 Mastery. Karasek and Theorell (1990) defined the term ‘feelings of mastery’, which
reflected an individual’s control over their stress response. They argued that the
degree of mastery may be related to the stress response.


In summary, most current stress researchers consider stress the result of a person
environment fit and emphasize the role of primary appraisal (‘is the event stressful?’)
and secondary appraisal (‘Can I cope?’). Psychological factors are seen as a central com-
ponent to the stress response. However, they are always regarded as co-occurring with
physiological changes.


STRESS AND CHANGES IN PHYSIOLOGY


The physiological consequences of stress have been studied extensively, mostly in the
laboratory using the acute stress paradigm which involves bringing individuals into
a controlled environment, putting them into a stressful situation such as counting
backwards, completing an intelligence task or given an unprepared speech and then
recording any changes. This research has highlighted two main groups of physiological
changes (see Figure 10.3):


(i)Sympathetic activation: When an event has been appraised as stressful it triggers
responses in the sympathetic nervous system. This results in the production of
catecholamines (adrenalin and noradrenalin, also known as epinephrine and
norepinephrine) which cause changes in factors such as blood pressure, heart rate,
sweating and pupil dilation and is experienced as a feeling of arousal. This process is
similar to the fight or flight response described by Cannon (1932). Catecholamines
also have an effect on a range of the bodies tissues and can lead to changes in
immune function.


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