PS370 Unit 3 Stress and Health Paper Example

Weather, Quotas and a Boat Loan: A PS370 Unit 3 Stress and Health Paper

[Student Name]

Purdue University Global

PS370: Health Psychology

Unit 3 Stress and Health Paper

[Instructor Name]

[Date]

The captain, his boat, his crew and his family are composite; the theories and studies cited are real.

The Stressors

Paul, 51, owns and captains a scallop boat out of New Bedford, Massachusetts. He bought it seven years ago with a loan that still has a balance of about $640,000. A normal trip lasts ten to fourteen days, and he makes about fifteen trips a year. Scallop fishing is managed through a federal system of allowed days and access areas, and the rules can change from one season to the next. A storm can end a trip early. A broken winch can cost a week. Five crew members depend on his decisions for their pay, and two of them have young children.

More than a year ago, nine days into a trip, Paul had a heart attack and was flown to a Boston hospital for a stent. His cardiologist listed his risk factors as smoking, high cholesterol, high blood pressure and family history. Stress was not on the list. This paper argues that it belongs there, while being careful about how much weight it can bear.

Appraisal and Coping

Lazarus and Folkman (1984) treated stress as a transaction rather than an event: it arises when someone judges that demands strain or outrun what they can bring to bear and that something they value is at risk. The first judgment, primary appraisal, sorts an event as damage already suffered, danger ahead, or an opening with something to win. The second, secondary appraisal, weighs the options for responding.

Paul appraises his stressors differently from how an outsider might. Storms, which frighten his wife, he treats as challenges; he has fished through them for thirty years and believes in his boat and crew. A cut in allowed days, though, he appraises as a threat, because nothing he can do on the water changes it. His secondary appraisal for regulation is bleak: he cannot fish harder, only less. The loan sharpens every threat, since a short season and a broken winch in the same year could put the boat at risk.

For Paul, the most dangerous stressors are not the ones that frighten his wife, but the ones he can do nothing about.

His coping follows the same pattern. With challenges he uses problem-focused coping: he checks forecasts, changes routes and repairs gear. With threats he cannot control, he relies on emotion-focused coping, and much of it is unhealthy. He smokes more on the nights after a regulatory announcement, sleeps less, and, by his own account, stops talking to Ana for days. Lazarus and Folkman do not treat emotion-focused coping as bad in itself, but the forms Paul relies on add risk of their own.

From Appraisal to the Body

A threat appraisal starts two physiological systems. The sympathetic adrenal medullary system releases epinephrine and norepinephrine within seconds, raising heart rate and blood pressure. The hypothalamic-pituitary-adrenal axis releases cortisol more slowly, mobilizing energy and changing immune and metabolic function. These responses evolved to help an animal escape a predator and then recover.

McEwen (1998) argued that cortisol and the catecholamines, protective over minutes and hours, damage the body when they are called on too often, turned on too long or not turned off. He named the cumulative cost allostatic load. He described four routes to it: alarms that come too often, alarms the body never learns to discount, alarms that keep sounding after the danger passes, and a muted alarm that leaves other systems to overcompensate.

Paul's working life fits at least three. His stressors are frequent; every trip brings weather, breakdowns and decisions about crew pay. Some never end; the loan and regulatory uncertainty continue on land. His sleep, broken into four-hour watches for two weeks at a time, removes the nightly recovery period in which blood pressure and cortisol should fall. McEwen described sleep deprivation as both a product of stress and a cause of further load. On a long trip Paul may never fully turn off. When he comes home, the loan payment and the next season's rules are waiting, so the recovery that land should bring is often cut short as well.

Over years, allostatic load can show up as high blood pressure, abnormal cholesterol, abdominal fat and insulin resistance, which are among Paul's own risk factors. Stress also acts through behavior: Paul smokes more, eats from the galley at irregular hours and has not seen a doctor for a routine visit in nine years.

Weighing the Research

Support for a stress-illness link is firm in some areas and thin in others. Cohen et al. (1991) gave healthy volunteers nasal drops containing a cold virus and found that infection and clinical illness rose with each step up in the volunteers' stress scores, in a dose-response pattern that held after controlling for many health practices. That experiment shows that stress can change the body's response to a real pathogen.

For heart disease, a review of large cohort studies found that job strain, long working hours and other work stressors carried a modest added risk of coronary heart disease, and that stress may also trigger events in people who already have advanced disease (Kivimäki & Steptoe, 2018). The increases are smaller than those for smoking, and stress often works through behaviors such as smoking and poor sleep. Paul's case reflects that picture. Stress did not replace his other risk factors; it fed them.

Implications for Recovery

Paul cannot remove most of his stressors. He can change how often his stress response is called on and whether it switches off. Several steps follow from the analysis. First, his appraisals of regulatory threats could be shifted toward what he can control, such as planning a season around the most likely scenarios with his accountant and other captains. Second, coping that does not add risk, such as calling Ana from the boat or walking the deck during watch breaks instead of smoking, could replace some of what he does now. Third, protecting one block of six hours of sleep on each trip, by sharing the night watch with his most experienced crew member, would restore some recovery time. Cardiac rehabilitation programs often include stress management, and Paul's could be adapted to his schedule between trips.

Conclusion

Stress did not cause Paul's heart attack on its own, but it is part of the explanation that a list of risk factors leaves out. His appraisals explain which stressors matter, McEwen's model explains how repeated alarms became wear on his body, and research on work stress gives that wear its proper weight next to smoking. The most useful changes are the ones that let his body turn off between trips.

References

Cohen, S., Tyrrell, D. A. J., & Smith, A. P. (1991). Psychological stress and susceptibility to the common cold. New England Journal of Medicine, 325(9), 606-612. https://doi.org/10.1056/NEJM199108293250903

Kivimäki, M., & Steptoe, A. (2018). Effects of stress on the development and progression of cardiovascular disease. Nature Reviews Cardiology, 15(4), 215-229. https://doi.org/10.1038/nrcardio.2017.189

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer.

McEwen, B. S. (1998). Protective and damaging effects of stress mediators. New England Journal of Medicine, 338(3), 171-179. https://doi.org/10.1056/NEJM199801153380307