+ Coping with Stigma & Other Stressors. Nicole Ennis Whitehead, Ph.D. Assistant Professor Clinical and Health Psychology
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1 Coping with Stigma & Other Stressors Nicole Ennis Whitehead, Ph.D. Assistant Professor Clinical and Health Psychology
2 Disclosure No Conflict of Interest to Report Acknowledgement: This work was supported in part by the National Institutes on Drug Abuse under award number (1K23DA ).
3 Learning Objectives Discuss Stigma and related stressors Describe the biobehavioral conceptualization of stress and coping in HIV Explain the coping process in the context of stigma Define Healthy Coping Strategies
4 What is Stigma? Stigma is characterized by associations with physical imperfection and membership in a negatively regarded social group. Enacted stigma refers to acts of discrimination such as social rejection Perceived stigma refers to the extent that one is aware of negative societal attitudes
5 How Does Stigma Show Up? Physical Social Behavioral Psychological Cognitive
6 Physical Fast heartbeat Stomach problems and indigestion Headaches Backaches Muscle pain and tension
7 Social Pulling away from others/social withdrawal Easily Irritable with others Social Isolation
8 Behavioral Problems sleeping Using alcohol or drugs Overeating and comfort foods
9 Psychological Get angry easily Feel fearful Feel blue and depressed Feel irritated or hostile Feel bad about yourself
10 Cognitive Feel worn out/unmotivated Feel overwhelmed Negative Thought Spirals
11 What can we do? Understand Identify Adjust
12 Biobehavioral Model
13 Stress Response When someone experiences a stressful event, the amygdala, an area of the brain that contributes to emotional processing, sends a distress signal to the hypothalamus. This area of the brain functions like a command center, communicating with the rest of the body through the nervous system so that the person has the energy to fight or flee.
14 Pieces of the Puzzle
15 Biological Resilience Determined (in any given moment) by the interaction of our genetic endowment and our environment
16 Cognitive/Psychological Processes Thoughts Feelings
17 Coping!
18 Biobehavioral Model
19 Coping!
20 Cognitive Appraisal Primary Appraisal: Perceiving the Threat Secondary Appraisal: Process of Bringing to Mind a Response to the Threat
21 I just coped with it!
22 Coping An individual's efforts to manage demands that are believed to exceed available resources - (Lazarus & Folkman, 1984) By changing the way he/she thinks about the situation (cognitive appraisal) By altering their behaviors in the situation or
23 Coping Processes Can Be: Emotional Behavioral Social Cognitive Create A: Physiological Response
24 Problem-Focused Coping Changing a problem, or aspect of a problem causing distress. Problem-focused coping may involve: decision making conflict resolution information or advice seeking goal setting problem solving
25 Emotion-Focus Coping regulating the emotional response connected to a stressful situation. Emotion-focused coping strategies could involve: cognitive reappraisal and reframing emotional expression behavioral changes (i.e., engaging in pleasant activities) physical stress reduction (i.e., exercising, relaxation, deep breathing)
26 Stressor is: Controllable Uncontrollable Use: Problem-Focused Emotion-Focused
27 Stressor is: Controllable Uncontrollable Use: Problem-Focused Emotion-Focused Active: Information Seeking Goal Setting Decision Making Conflict Resolution Requesting help Reappraisal of situation Reframing thoughts Exercise, Massage Relaxation exercises, meditation Accept Negative Emotions: self-soothing (softening) talk with friends
28 Stressor is: Controllable Uncontrollable Use: Problem-Focused Emotion-Focused Active: Information Seeking Goal Setting Decision Making Conflict Resolution Requesting help Reappraisal of situation Reframing thoughts Exercise, Massage Relaxation exercises, meditation Accept Negative Emotions: self-soothing (softening) talk with friends Passive: Cognitive and Behavioral Avoidance: denial not thinking about it procrastinating Smoking, eating, drinking alcohol, doing drugs Not taking medication Missing doctor s appointment Stuffing feelings, giving up
29 Pieces of the Puzzle
30 Focus: Quality of Life (QOL) QOL In Question: Medical Complications Co-morbidities Substance Use Poorer Mental Health Social Isolation
31 Lack of Social Support High levels of: Loneliness Depression Insufficient instrumental and emotional support
32 Depression Estimated Prevalence -50% Depression linked to: poor HAART adherence
33 The Aging Process Associated with: Increased Social Isolation Greater Depressive Symptoms Transition from informal to formal care settings
34 Active Coping Social Support an essential coping skill
35 Thank You! QUESTIONS?
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