Health Psychology: Stress (College Board AP® Psychology): Revision Note

What is stress?

• Health psychology is the branch of psychology that examines how psychological factors influence physical health and wellbeing

  • It examines how behavior, thoughts, and feelings influence:

    • susceptibility to illness

    • recovery from illness

    • overall physical wellbeing

• Health psychologists apply psychological principles to:

  • promote healthy behaviors

  • manage stress

  • improve quality of life

• A central focus of health psychology is stress

  • Stress is one of the most significant psychological factors affecting physical health

• Stress is the experience of feeling challenged, threatened, or overwhelmed by demands that exceed a individual's perceived ability to cope

• The same situation can produce different levels of stress in different people

  • What matters is not the event itself, but how the individual appraises it

    • E.g. giving a presentation may be highly stressful for one person and energizing for another

• A key cognitive component of stress is primary appraisal, which refers to the individual’s initial evaluation of a situation as:

  • threatening

  • challenging

  • or irrelevant to their wellbeing

Eustress & distress

• Stressors can be experienced in two fundamentally different ways:

  • Eustress is stress that is positive and motivating:

    • It energizes the person and enhances performance

    • The stressor is perceived as a challenge that can be successfully managed

      • E.g. the pressure of a deadline that drives productive work

  • Distress is stress that is negative and debilitating:

    • It overwhelms the individual and impairs functioning

    • The stressor is perceived as a threat that exceeds the person's ability to cope

      • E.g. prolonged work overload; bereavement; serious illness

• The key distinction lies in appraisal

  • The same stressor may be experienced as eustress by one person and distress by another

Types of stressors

• Traumatic stressors:

  • Major, acute life events that create intense, sudden stress

  • They may be single-incident (e.g. a natural disaster, bereavement) or prolonged experiences (e.g. living through conflict, chronic illness)

  • These are typically clearly identifiable and often produce strong immediate stress responses

• Daily hassles:

  • Minor, recurring irritations and frustrations of everyday life (e.g. traffic, work conflicts, financial concerns)

  • Although individually small, their cumulative effect can lead to chronic stress, a persistent state that gradually undermines wellbeing

  • Research suggests they may have a stronger impact on health than major life events due to their frequency.

  • Research suggests that daily hassles may be more strongly linked to health outcomes than major life events, due to their frequency and persistence

• Adverse Childhood Experiences (ACEs):

  • Stressful or traumatic events in childhood, such as abuse, neglect, or household dysfunction

  • These experiences can have long-term effects, increasing vulnerability to both mental and physical health problems across the lifespan.

Physiological effects of stress

• Stress has clear biological consequences and can increase vulnerability to disorders and disease:

  • Hypertension: chronic activation of the sympathetic nervous system raises heart rate and blood pressure, increasing the risk of cardiovascular disease

  • Headaches: stress can trigger tension headaches through muscle contraction and may also contribute to migraines

  • Immune suppression: prolonged stress reduces immune functioning (e.g. fewer white blood cells), making individuals more susceptible to infections and slowing recovery

    • E.g. people experiencing sustained stress (such as during exams) are more likely to develop minor illnesses and show slower wound healing

• These effects highlight that stress is not only a psychological experience but also has measurable physiological impacts on health

General Adaptation Syndrome (GAS)

• Hans Selye (1956) proposed the General Adaptation Syndrome (GAS) to describe the body’s predictable response to prolonged stress

• The GAS model explains how:

  • the body initially adapts to a stressor to protect itself

  • sustained stress gradually depletes resources, leading to physical damage.

• Importantly, Selye argued that both physical and psychological stressors produce the same general pattern of response.

• The GAS model outlines three distinct stages:

Stage 1: Alarm reaction

• This is the body's initial response to encountering a stressor

• The fight-flight-freeze response is triggered:

  • the sympathetic nervous system activates

  • stress hormones (adrenaline/epinephrine, cortisol) are released

  • heart rate, blood pressure, and breathing rate increase

  • blood is diverted to muscles, while digestion slows

  • the body mobilizes energy resources to tackle or escape the threat

• At the very start (the shock phase), resistance to stress briefly drops before the body mobilizes its defenses

  • E.g. receiving sudden bad news may initially cause dizziness or faintness before full physiological activation occurs

• This stage is adaptive in the short term, as it prepares the body for rapid action

Stage 2: Resistance

• If the stressor continues, the body enters a stage of sustained coping

  • physiological arousal remains elevated (e.g. heart rate, blood pressure, and stress hormone levels)

  • the body attempts to maintain functioning while dealing with the stressor

  • the parasympathetic nervous system attempts to restore balance, but is only partially successful

• During this stage, resistance to other stressors is reduced because resources are focused on the primary demand

  • E.g. a person under ongoing work pressure may cope with their workload but become more vulnerable to illness or emotional strain

Stage 3: Exhaustion

• Prolonged stress eventually depletes the body’s resources:

  • stress hormone reserves are exhausted

  • immune functioning declines significantly

  • symptoms similar to the alarm stage may reappear (e.g. increased heart rate, sweating)

• At this stage, the individual is at greatest risk of stress-related illness, including cardiovascular disease, depression, and other chronic conditions

  • E.g. long-term work stress may lead to burnout or serious physical illness

• This stage highlights that while the body can manage short-term stress, chronic stress overwhelms its capacity to cope

Reactions to stress: tend and befriend

• The fight-flight-freeze response describes a well-established reaction to acute stress

  • However, research suggests it is not the only pattern of response

• Tend-and-befriend theory (Taylor et al., 2000) proposes that some individuals respond to stress by:

  • tending: caring for and protecting others, particularly vulnerable individuals

  • befriending: seeking social support and forming alliances to reduce threat

    • E.g. instead of confronting or avoiding a stressor, a person may contact a friend, focus on caring for family, or seek comfort through social interaction

• This response appears to be more common in females, and has been explained in two ways:

  • Biological explanation:

    • Under stress, females produce higher levels of oxytocin, a hormone linked to bonding and nurturing

    • This hormone promotes affiliative behavior rather than fight-or-flight responses

  • Social explanation:

    • Gender socialization encourages females to value nurturing and relationships

    • This makes tending and befriending more likely as a learned response

• Tend-and-befriend is adaptive because:

  • social support reduces perceived threat and physiological stress

  • caring for others can provide distraction and a sense of purpose

  • strong social networks increase long-term resilience

Cultural context of stress reactions

• Stress responses are shaped by cultural norms:

  • In collectivist cultures, tending and befriending may be more common across genders due to an emphasis on group cohesion and mutual support

  • In individualistic cultures, independent coping and problem-solving are often prioritized, particularly among males

• Norms around help-seeking, emotional expression, and gender roles influence which stress responses are considered appropriate

Coping with stress

• Coping refers to the cognitive and behavioral strategies used to manage the demands of stressful situations and reduce their impact on wellbeing

• Lazarus & Folkman (1984) identified two main coping styles:

  • problem-focused coping

  • emotion-focused coping

• While research suggests males tend to favor problem-focused coping and females emotion-focused coping, both strategies are used by everyone depending on the situation

Problem-focused coping

• Problem-focused coping involves directly addressing the source of stress

  • The aim is to eliminate or reduce the stressor itself, making it most effective when the situation is controllable

• Common strategies include:

  • identifying and implementing solutions

  • planning and taking practical action

  • seeking information or support to address the problem

  • developing relevant skills (e.g. time management) to manage the demands more effectively

    • E.g. a student stressed about exams creates a revision plan, targets weak areas, and seeks help from a teacher

Emotion-focused coping

• Emotion-focused coping involves managing the emotional response to a stressor rather than changing it

  • The aim is to reduce distress, making it most effective when the stressor is uncontrollable

• Common strategies include:

  • Relaxation techniques, e.g. deep breathing to activate the parasympathetic nervous system

  • Meditation and mindfulness in order to turn attention to the present moment, reducing rumination about past or future stressors

  • Seeking social support to share the emotional burden with trusted others

  • Medication , e.g. prescribed anxiolytics or antidepressants that reduce the physiological and emotional stress response

  • Cognitive reframing, which involves restructuring how the stressor is thought about to reduce its perceived threat

    • E.g. someone who has been made redundant seeks support, practices mindfulness, and maintains a positive outlook

Choosing between coping styles

• Neither coping style is universally superior

  • For controllable stressors, problem-focused coping is generally more effective

    • This is because it addresses the root cause and may fully resolve the stress

  • For uncontrollable stressors, emotion-focused coping is generally more adaptive

    • Attempting to control the uncontrollable can increase helplessness and distress

• In practice, the most effective coping is flexible

  • Combining both approaches; changing what can be changed while managing emotional responses to what cannot