UNIT 5.1 · MENTAL AND PHYSICAL HEALTH
Health Psychology — AP Psychology Notes
Explore stress, coping, the biopsychosocial model, social support and health behavior with clear examples.
What is Health Psychology?
Health psychology is the study of how biological, psychological, and social factors interact to influence physical health, illness, and well-being. It examines the mind-body connection and how our thoughts, emotions, and behaviors affect our physical health.
Health psychologists investigate questions like: How does stress affect the immune system? Why do some people adopt healthy behaviors while others don't? How can psychological interventions help people manage chronic illness? What role does social support play in recovery?
This field connects mental and physical health. Psychological processes can influence health through behavior, stress physiology and access to support; illness also affects emotions and behavior. A psychological association is not proof that thoughts caused a disease.
Biopsychosocial Model
Health reflects interacting influences
- Biological ↔ psychological
Stress physiology, illness experience and behavior - Psychological ↔ social
Beliefs, relationships, expectations and resources - Social ↔ biological
Living conditions, access to care and exposure
The Three Interacting Factors
The biopsychosocial model proposes that health and illness result from the complex interaction of biological, psychological, and social factors. No single factor determines health — all three work together.
Biological Factors
- Genetics and heredity
- Brain chemistry and hormones
- Immune system functioning
- Physical injuries or infections
- Nutritional status
- Age and physical development
Psychological Factors
- Stress and coping strategies
- Emotions (anxiety, depression, anger)
- Beliefs and attitudes about health
- Personality traits (Type A, hardiness)
- Self-efficacy and locus of control
- Learned behaviors and habits
Social Factors
- Social support from family and friends
- Socioeconomic status and poverty
- Cultural beliefs and practices
- Access to healthcare
- Social relationships and isolation
- Community resources and environment
Example: Heart Disease
Biological: Genetic vulnerability and cholesterol. Psychological: Chronic stress, coping patterns and depression. Social: Support, poverty and access to care. These can interact; no single personality label diagnoses or inevitably causes heart disease.
Stress: Definition and Types
Appraisal and context: A stressor’s impact depends partly on how demands and coping resources are evaluated. Traumatic experiences and adverse childhood experiences can increase later risk without determining someone’s future. The same event can involve both motivating and distressing aspects.
What is Stress?
Stress is the physical and psychological response to challenging or threatening situations (stressors). It involves physiological arousal, emotional reactions, and behavioral responses.
Key Point:
Stress isn't just the event itself (stressor) — it's your body's and mind's reaction to the event. The same situation can be stressful for one person but not another, depending on how they perceive and appraise it.
Eustress vs. Distress
Eustress (Good Stress)
Positive stress that is motivating, exciting, and manageable
- Energizes and motivates
- Improves performance
- Feels exciting, not overwhelming
- Short-term
- Perceived as within coping abilities
Examples: Getting married, starting new job, riding roller coaster, competing in sports, graduation
Distress (Bad Stress)
Negative stress that is overwhelming, unpleasant, and harmful
- Decreases performance
- Causes anxiety and worry
- Feels unmanageable
- Can be short or long-term
- Exceeds coping abilities
Examples: Death of loved one, divorce, serious illness, job loss, ongoing financial problems, chronic pain
Types of Stressors
Acute Stressors
Short-term, immediate threats or challenges
Examples: Taking exam, giving speech, near-accident while driving
Chronic Stressors
Long-term, ongoing sources of stress
Examples: Chronic illness, poverty, ongoing marital problems, caring for disabled family member
Daily Hassles
Minor, everyday annoyances that accumulate
Examples: Traffic jams, losing keys, computer crashes, long lines, noisy neighbors
General Adaptation Syndrome (Selye)
GAS: a conceptual sequence under sustained demand
- 1 · Alarm
Mobilization: fight, flight or freeze responses - 2 · Resistance
Continued adaptation and demands on resources - 3 · Exhaustion
Resources may be strained; illness vulnerability can rise
Key concepts to understand
Hans Selye's General Adaptation Syndrome (GAS) describes the body's three-stage response to prolonged stress. Know all three stages and their characteristics — frequently tested!
Stage 1: Alarm Reaction (Fight-or-Flight)
The body's immediate reaction to a stressor. The sympathetic nervous system activates, preparing the body for action.
Physiological Changes:
- Adrenaline (epinephrine) and cortisol released
- Heart rate and blood pressure increase
- Breathing rate increases
- Pupils dilate
- Blood sugar increases (energy)
- Blood flows to muscles (away from digestion)
- Enhanced alertness and focus
Purpose:
Mobilizes body's resources for immediate action — either fight the threat or flee from it. This is an adaptive, survival response.
Stage 2: Resistance (Adaptation)
If the stressor continues, the body attempts to cope and adapt. Physiological responses can remain altered; there is no fixed arousal level for every person.
What Happens:
- Body tries to restore homeostasis while coping with stressor
- Continues to release stress hormones (cortisol)
- Maintains elevated heart rate and blood pressure
- Resources being used to cope with ongoing stress
- Outwardly may appear to be coping well
The Problem:
Prolonged resistance depletes the body's energy reserves. The body can't maintain this elevated state indefinitely. If demands persist without sufficient recovery, vulnerability to exhaustion may rise.
Stage 3: Exhaustion (Depletion)
In Selye’s model, prolonged demands can exceed adaptive resources. Fatigue and vulnerability to physical or psychological problems may increase; this is a conceptual model, not an inevitable collapse or a clinical staging test.
Consequences:
- Immune system weakens (increased illness)
- Physical health risks can rise, including hypertension and cardiovascular problems. Stress can worsen some digestive symptoms; peptic ulcers commonly involve H. pylori infection or NSAID use rather than stress alone.
- Mental health problems (depression, anxiety, burnout)
- Extreme fatigue and decreased functioning
- Increased vulnerability to stress-related diseases
- Severe, sustained adversity can carry serious health risks; the model does not predict an individual outcome.
Prevention:
Key is to reduce or eliminate stressor before reaching exhaustion stage. Use coping strategies, seek social support, practice stress management.
Stress Response Patterns
Two response pathways: Rapid sympathetic activation promotes adrenal-medulla release of epinephrine and norepinephrine. The hypothalamic–pituitary–adrenal pathway involves pituitary ACTH and adrenal-cortex cortisol, with a slower time course. Freezing can also occur; defensive behavior is not always fight or flight.
Fight-or-Flight Response
The fight-or-flight response is the body's automatic physiological reaction to perceived threats. Prepares you to either confront danger (fight) or escape from it (flight).
Triggered by:
- Sympathetic nervous system activation
- Hypothalamus signals adrenal glands
- Release of adrenaline and noradrenaline
- Rapid, automatic, and involuntary
Evolutionary advantage: Helped our ancestors survive immediate physical threats (predators, attacks). Today, activates for psychological stressors too (exams, public speaking).
Tend-and-Befriend Theory (Taylor)
Shelley Taylor’s tend-and-befriend theory describes responding to stress through care and social connection. Early work emphasized women, but this pattern can occur across genders and coexist with defensive responses.
The Pattern:
- Tend: Nurture and protect offspring and others
- Befriend: Form alliances and seek social support
- More common in women but men can also exhibit this response
- Oxytocin has been investigated in affiliation and stress; effects depend on context
- May be evolutionary adaptation to protect offspring
Why the Difference?
One evolutionary proposal concerns caregiving and social alliances. Treat it as an explanation to evaluate, rather than evidence that gender determines coping behavior.
Coping Strategies
What is Coping?
Coping is the cognitive and behavioral effort to manage demands and emotional responses. Its effects depend on the stressor, strategy, resources and context; coping alone does not determine whether someone becomes ill.
Two Types of Coping
Problem-Focused Coping
Directly addressing the stressor by taking action to change or eliminate it
- Change the situation causing stress
- Develop plan of action
- Solve the problem
- Seek information
- Learn new skills
Best when: Stressor is controllable
Examples: Studying for exam (stress from test), creating budget (financial stress), ending toxic relationship, getting medical treatment
Emotion-Focused Coping
Managing emotional reactions to the stressor rather than changing the situation
- Regulate emotional response
- Seek emotional support
- Reframe/reappraise situation
- Use relaxation techniques
- Distraction or avoidance
Best when: Stressor is uncontrollable
Examples: Deep breathing when anxious, talking to friend about feelings, meditation, exercising, journaling, accepting death of loved one
Key Point:
Both types are useful. Problem-focused works when you can change the situation. Emotion-focused helps when situation can't be changed (death, chronic illness). Often, people use both simultaneously.
Type A and Type B Personality
Personality and Heart Disease Risk
Friedman and Rosenman identified two personality patterns associated with different levels of coronary heart disease risk.
Type A Personality
Competitive, time-urgent, hostile
- Always rushing, impatient
- Highly competitive
- Workaholic tendencies
- Easily angered and hostile
- Multitasking constantly
- Perfectionistic
Research interpretation: Anger and hostility have been associated with cardiovascular risk. The broad Type A label is an imperfect predictor; relationships vary with measurement and other risk factors.
Type B Personality
Relaxed, easy-going, patient
- Relaxed and patient
- Less competitive
- Not easily angered
- Works steadily, not urgently
- Enjoys leisure time
- Flexible and adaptable
Research interpretation: A relaxed style is not protection against all disease. Biological and social risk factors still matter.
Important Note:
Hostility and chronic anger have received particular research attention. Avoid interpreting competitiveness, a busy schedule or a Type B description as an individual cardiovascular diagnosis.
Hardiness
Psychological Resilience to Stress
Hardiness (Kobasa) is a personality trait that helps people cope with stress and remain healthy. Hardy individuals are resilient and view stress as manageable.
Three Components (The Three C's):
1. Commitment
Deep involvement and engagement in life activities. Find meaning and purpose. Not easily giving up.
2. Control
Belief that you can influence events and outcomes (internal locus of control). Not feeling helpless.
3. Challenge
View changes and stressors as opportunities for growth rather than threats. Embrace change.
Benefits:
- Associated with better adaptation in some research; not immunity to illness
- Better psychological adjustment
- More effective coping strategies
- Greater life satisfaction
Social Support
Interpreting health benefits: Support is associated with better outcomes in many settings, but network size alone is not a treatment. Relationship quality, practical help, resources and health can influence each other. Correlation alone does not establish direction of causation.
The Power of Connection
Social support is the perception or reality that one is cared for, valued, and part of a supportive social network. It's one of the most powerful buffers against stress.
Types of Social Support:
- Emotional support: Empathy, love, caring, trust
- Instrumental support: Tangible aid (money, help with tasks)
- Informational support: Advice, guidance, information
- Companionship support: Sense of belonging, shared activities
Health Benefits:
- Reduces physiological stress responses
- Lowers risk of heart disease and other illnesses
- May support recovery through practical assistance, coping and adherence
- Improves immune system functioning
- Strong social ties are associated with lower mortality in many studies; causal pathways are complex
- Protects against depression and anxiety
- Provides buffering effect against stress
Locus of Control and Health
Control Beliefs and Well-Being
Locus of control (Rotter — covered in 4.5) affects health behaviors and stress responses. (Review from Unit 4, but important here too)
Internal Locus of Control
Believe one’s actions can influence health outcomes; influence is different from complete control.
- Take responsibility for health
- More likely to adopt healthy behaviors
- Better stress management
- Feel empowered to change
Health interpretation: Realistic control beliefs may support action, but do not guarantee health or longevity. Illness is not evidence of insufficient effort.
External Locus of Control
Believe outside forces control health outcomes
- Attribute health to luck, fate, chance
- Less likely to engage in preventive care
- Feel helpless to change
- Some control beliefs may affect adherence; the direction depends on whether control is attributed to chance, clinicians or other sources.
Health interpretation: Recognizing external constraints can be accurate. Trusting knowledgeable clinicians or seeking support can help; an external-control belief does not automatically mean poor adherence or illness.
AP Exam Strategy
Multiple Choice Tips
- Know biopsychosocial model: Health influenced by biological, psychological, and social factors interacting
- Distinguish stress types: Eustress (positive, motivating) vs. distress (negative, harmful)
- Master GAS stages: Alarm (fight-or-flight), resistance (adaptation), exhaustion (depletion/illness)
- Understand tend-and-befriend: caregiving and connection can be stress responses across genders; avoid rigid stereotypes.
- Know coping types: Problem-focused (change stressor) vs. emotion-focused (manage feelings)
- Identify Type A traits: Competitive, hostile, time-urgent — heart disease risk
- Remember hardiness 3 C's: Commitment, control, challenge
- Recognize locus of control as a belief about influence, distinct from actual access to care and objective control.
Free Response Question (FRQ) Tips
- Apply biopsychosocial model: Given health scenario, identify biological, psychological, and social factors
- Explain GAS stages fully: Describe what happens in each stage and progression through them
- Distinguish coping strategies: Explain when problem-focused vs. emotion-focused is appropriate
- Use proper terminology: "General Adaptation Syndrome" not "stress stages"
- Connect personality to health: Explain mechanism linking Type A to heart disease (chronic arousal, hostility)
- Show understanding of process: Don't just list — explain how stress affects health through specific pathways
- Provide concrete examples: Illustrate theoretical concepts with specific situations
Quick Review Summary
The Big Picture
Health psychology studies interacting biological, psychological and social influences. Stress is a response to demands, shaped by appraisal and resources. GAS describes alarm, resistance and possible exhaustion; recovery can interrupt it. Defensive responses and care-seeking can coexist. Problem-focused coping addresses demands, while emotion-focused coping regulates reactions; both can help. Type A/B and hardiness are frameworks rather than diagnoses. Social support and realistic control beliefs may help people act, while objective constraints and illness biology still matter.
Essential Concepts
- Health psychology
- Biopsychosocial model
- Stress
- Stressors
- Eustress
- Distress
- Acute stressors
- Chronic stressors
- Daily hassles
- General Adaptation Syndrome (GAS)
- Hans Selye
- Alarm stage
- Resistance stage
- Exhaustion stage
- Fight-or-flight response
- Tend-and-befriend theory
- Shelley Taylor
- Coping
- Problem-focused coping
- Emotion-focused coping
- Type A personality
- Type B personality
- Friedman and Rosenman
- Hardiness
- Commitment, control, challenge
- Social support
- Locus of control
- Internal locus of control
- External locus of control
Quick FAQs
Is stress always harmful?
No. Demands can feel motivating or overwhelming depending on appraisal, duration and resources. Persistent strain can raise health risks without making illness inevitable.
Are problem-focused and emotion-focused coping mutually exclusive?
No. Someone can address a practical demand and manage their emotional response at the same time.