Studiegids met samenvattingen en studiehulp voor:

• Boektitel: Why Zebras Don’t Get Ulcers
• Subtitel: The Acclaimed Guide to Stress, Stress-Related Diseases, and Coping
• Auteur: Sapolsky
• Druk: 3e druk

Health psychology focuses on the influence of psychological and behavioral factors on health, often in combination with the environment. Stress is central to this.

What models of personality are there?

What is the interactional model?

The interactional model suggests that personality factors determine the impact of events, because they determine how someone deals with the situation. Personality would thus influence coping. How someone deals with an event determines the degree of stress caused by that event. However, a limitation of this model is that stable coping strategies have never been found.

What is the transactional model?

The transactional model does things differently. According to this model, personality has three potential effects:

1. Personality can influence coping.
2. Personality can affect how the person interprets an event.
3. Personality can influence the event itself.

It is not the event that causes stress here, but rather how it is dealt with. This model is called transactional because of the person's influence on the event and the person's appreciation. There is mutual influence.

What is the health and behavior model?

A third model is the health and behavior model. This assumes that personality does not directly influence the degree of stress or illness, but that it indirectly influences stress or illness through certain behaviors, such as unsafe sex or overeating. The less healthy someone is, the greater the chance of experiencing more stress.

What is the disease and behavior model?

Another model is the disease and behavior model. In this model, disease is explained as the presence of an objectively measurable abnormal physiological process, such as fever, high blood pressure, or a tumor. Abnormal or sick behavior is about the way people behave when they think they are sick. Personality determines the degree of sick behavior, whether or not in combination with a real illness.

According to the predispositional model, associations exist between personality and illness because of a third variable that affects both, namely predisposition. The predisposition can exist for stable individual personality differences and for specific illnesses.

What is stress?

Stress is a subjective feeling that is the result of uncontrollable and threatening events (stressors). These are often extreme situations with unpleasant consequences that cannot be influenced. Stress can be divided into low sources of stress in daily life (daily hassles) and important life events (major life events). Major life events are associated with intensity, conflict and uncontrollability. Positive things can also be very stressful, for example a marriage, a move or a promotion. People with a lot of stress in their lives have many psychological and physiological symptoms. Possible responses to stress

The clinical presentation of PTSD varies. It is not entirely clear what is seen as a traumatic event and what is not. A life-threatening illness or medical condition is not seen as trauma but medical incidents can qualify as traumatic events (e.g. waking up during surgery), same as a medical catastrophe in one’s child.

Intrusive recollection is not the same as depressive rumination. Intrusive recollection applies to involuntary and intrusive distressing memories. It can be short (e.g. flashback) but can lead to prolonged stress and heightened arousal.

In PTSD, there often is a heightened sensitivity to threats. Developmental regression (e.g. loss of language) may occur in children. PTSD can lead to difficulties in regulating emotions or maintaining stable interpersonal relationships.

The lifetime prevalence of PTSD is 8.7% in the United States and the twelve-month prevalence is 3.5%. These estimates are lower in many other countries (e.g. European countries). Different groups have different levels of exposure to traumatic events. The conditional probability of developing PTSD following a similar level of exposure may differ between groups.

Cultural syndromes (e.g. ataques de nervosia) may influence the expression of PTSD. The risk of onset of PTSD and severity may differ across cultural groups as a result of:

• Variation in the type of traumatic exposure (e.g. genocide).
• The meaning attributed to the traumatic event.
• The ongoing sociocultural context.
• Other cultural factors.

PTSD appears to be more severe if the traumatic event is interpersonal and intentional (e.g. torture). The highest PTSD rates are found among rape survivors (1), military combat and captivity survivors (2) and ethnically and politically-motivated internment and genocide survivors (3). Young children and older adults are less likely to show full-threshold PTSD.

The symptoms and relative predominance of symptoms may vary over time. Symptom recurrence and intensification may occur in response to reminders of the original trauma (1), ongoing life stressors (2) and newly experienced traumatic events (3). PTSD symptoms may exacerbate as result of declining health (1), worsening cognitive functioning (2) and social isolation (3).

Individuals who continue to experience PTSD into older adulthood may express fewer symptoms of hyperarousal (1), avoidance (2) and negative cognitions and moods (3) compared with younger adults. However, adults exposed to traumatic events during later life may display more avoidance (1), hyperarousal (2), sleep problems (3) and crying spells (4) than younger adults exposed to the same traumatic event.

There are several pre-trauma risk factors for the development of PTSD:

1. Temperamental
   This includes childhood emotional problems by age 6 and prior mental disorders.
2. Environmental
   This includes lower socioeconomic status (1), lower education (2), exposure to prior trauma (3), childhood adversity (4), cultural characteristics (5), lower intelligence (6), minority status (7) and family psychiatric history (8).
3. Genetic and physiological
   This includes being female and being younger at the time of trauma exposure.

There are several peritraumatic