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First responders encounter a wide variety of scenarios, ranging in intensity from five-car pile-ups to soccer injuries. What determines how a first responder reacts in these situations? There are two types of variables to consider: those that reside within the individual and those that exist in the environment. We can see both of these variables at work in one of the most common stressors of everyday life: conflict.

LO 9 Identify different types of conflicts.

When people think of conflict, they may imagine arguments and fist fights, but conflict can also refer to the discomfort one feels when making tough choices. In an approach–approach conflict, two or more favorable alternatives are pitted against each other. Here, you must choose between two options you find attractive. Imagine this situation: You have to pick only one class this semester, and to fit your schedule, you must choose between two classes you would really like to take. An approach–avoidance conflict occurs when you face a choice or situation that has both favorable and unfavorable characteristics. For example, you are required to take a biology lab class, and although you like biology, you do not like working with other students in lab settings. A third type of conflict is the avoidance–avoidance conflict, which occurs when you are faced with two or more alternatives that are unattractive. In order to fulfill a requirement, you must choose between two courses that you really dread taking.

Let’s see how these types of conflict might arise in police work:

Conflicts can be even more complicated than this. A double approach–avoidance conflict occurs when you must decide between two choices, each possessing attractive and unattractive qualities. For example, you are trying to decide whether to purchase an e-book or a hardcover, so you consider the good and bad qualities of both types of books. On the one hand, the e-book allows for portability and quick access, but it is not a good option if the Internet fails or electricity is unavailable. The hardcover is long lasting and always accessible, but it is heavy and more expensive. You might even have to deal with multiple approach–avoidance conflicts, which occur when you are faced with a decision that has more than two possible choices. You are trying to decide where to live when you attend college in a new city. Should you apply for a dormitory room, look for an apartment, share a house, or live with a family member? Each of these choices has attractive and unattractive qualities.

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Sometimes conflicts and other stressors pile up so high they become difficult to tolerate. When we can no longer deal with stress in a constructive way, we experience what psychologists call burnout.

Police officers are also susceptible to burnout. The nature of the work they do, the size of the department they work in, and the amount of trust in their coworkers all play a role (McCarty, Schuck, Skogan, & Rosenbaum, 2011, January 7). To survive and thrive in this career, you must excel under pressure. Police departments need officers who are emotionally stable and capable of making split-second decisions with potentially serious ethical implications. If a tired, stressed-out officer makes one bad decision, the reputation of the entire police department could be tarnished. No wonder over 90% of city police departments in the United States require job applicants to take psychological tests, such as the Minnesota Multiphasic Personality Inventory–2 (MMPI–2; Butcher & Rouse, 1996; Cochrane, Tett, & Vandecreek, 2003). Psychological testing is just one hurdle facing the aspiring police officer; some departments also insist on full-length meetings with a psychologist. Most city agencies require criminal background checks, polygraph (lie detector) tests, and physical fitness assessments. And don’t forget the 1,000-or-so hours of training at the police academy (Cochrane et al., 2003). But even after overcoming all the hurdles of the hiring process, some police officers end up struggling with stress management. In this respect, police work is like any other field; there will always be people who have trouble coping with the stress of the job.

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LO 10 Illustrate how appraisal influences coping.

APPRAISAL AND COPING Needless to say, people respond to stress in their own unique ways. Psychologist Richard Lazarus (1922–2002) suggested that stress is the result of a person’s appraisal of a stressor, not necessarily the stressor itself (Folkman & Lazarus, 1985; Lazarus & Folkman, 1984). This viewpoint stands in contrast to Selye’s suggestion (noted earlier) that we all react to stressors in a similar manner. Coping refers to the cognitive, behavioral, and emotional abilities used to manage something that is perceived as difficult or challenging. In order to cope, we must determine if an event is harmful, threatening, or challenging (Infographic 11.3). A person making a primary appraisal of a situation determines how the event will affect him. He must decide if it is irrelevant, positive, challenging, or harmful. Next, the individual makes a secondary appraisal, or decides how to respond. If he believes he can cope with virtually any challenge that comes his way, the impact of stress remains low. If he thinks his coping abilities are poor, then the impact of stress will be high. These differences in appraisals help explain why two people can react to the same event in dramatically different ways.

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There are two basic types of coping. Problem-focused coping means taking a direct approach, confronting a problem head-on. Suppose you are having trouble in a relationship; an example of problem-focused coping might be reading self-help books or finding a counselor. Emotion-focused coping involves addressing the emotions that surround a problem, rather than trying to solve it. With a troubled relationship, you might think about your feelings, look to friends for support, or exercise to take your mind off it, instead of addressing the problem directly. Sometimes it’s better to use emotion-focused coping—when an emotional reaction might be too stressful or interferes with daily functioning, or when a problem cannot be solved (for example, the death of a loved one). In the long run, however, problem-focused coping is usually more productive.

LO 11 Describe Type A and Type B personalities and explain how they relate to stress.

TYPE A AND TYPE B PERSONALITIES Personality appears to have a profound effect on coping style and predispositions to stress-related illness. For example, people with certain personality types are more prone to developing cardiovascular disease. Cardiologists Meyer Friedman (1910–2001) and Ray Rosenman (1920–2013) were among the first to suspect a link between personality type and the cardiovascular problems they observed in their patients (Friedman & Rosenman, 1974). In particular, they noted that many of the people they treated were intensely focused on time and always in a hurry. This characteristic pattern of behaviors eventually was referred to as Type A personality. Someone with a Type A personality is competitive, aggressive, impatient, and often hostile (Diamond, 1982; Smith & Ruiz, 2002). Through numerous studies, Friedman and Rosenman discovered that people with Type A personalities were twice as likely to develop cardiovascular disease as those with Type B personality. People with Type B personality are often more relaxed, patient, and nonaggressive (Rosenman et al., 1975). There appear to be various reasons people with Type A personality suffer disproportionately from cardiovascular disease: they are more likely to have high blood pressure, heart rate, and stress hormone levels. Type A individuals are also prone to more interpersonal problems (for example, arguments, fights, or hostile interactions), which increase the time their bodies are prepared for fight or flight.

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Although many years of research confirmed the relationship between Type A behavior and coronary heart problems, some researchers began to report findings inconsistent with this (Smith & MacKenzie, 2006). Failure to reproduce the results led some to question the validity of this relationship, although one major factor was a lack of consistency in research methodology. For example, some studies used samples with high-risk participants, whereas others included healthy people. As researchers continued to probe the relationship between personality type and coronary heart disease, they found that the component of hostility in Type A personality was the strongest predictor of coronary heart disease.

TYPE D PERSONALITY More recently, researchers have suggested another personality type that may better predict how patients fare when they already have heart disease: Type D personality, where the “D” refers to distress (Denollet & Conraads, 2011). Someone with Type D personality is characterized by emotions like worry, tension, bad moods, and social inhibition (avoids confronting others, poor social skills). There is a clear link between Type D characteristics and a “poor prognosis” in patients with coronary heart disease (Denollet & Conraads, 2011). In other words, people who have heart problems and exhibit these Type D characteristics are more likely to struggle with their illness. It could be that people with Type D personality tend to avoid dealing with their problems directly and don’t take advantage of social support. Such an approach might lead to poor choices about coping with stressors over time (Martin et al., 2011).

THE THREE Cs OF HARDINESS Clearly, not everyone has the same tolerance for stress (Ganzel, Morris, & Wethington, 2010; Straub, 2012). Some people seem capable of handling intensely stressful situations, such as war and poverty. These individuals appear to have a personality characteristic referred to as hardiness, meaning that even when functioning under a great deal of stress, they are very resilient and tend to remain positive. Kehlen, who considers himself “a very optimistic person,” may fit into this category, and findings from one study of Scottish ambulance personnel suggest that EMS workers with this characteristic are less likely to experience burnout (Alexander & Klein, 2001).

Kobasa (1979) and others have studied how some executives seem to withstand the effects of extremely stressful jobs. Their hardiness appears to be associated with three characteristics: feeling a strong commitment to work and personal matters; believing they are in control of the events in their lives and not victims of circumstances; and not feeling threatened by challenges, but rather seeing them as opportunities for growth.

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The ability to manage stress is very much dependent on one’s perceived level of personal control. Psychologists have consistently found that people who believe they have control over their lives and circumstances are less likely to experience the negative impact of stressors than those who do not feel the same control. For example, Langer and Rodin (1976) conducted a series of studies using nursing home residents as participants. Residents in a “responsibility-induced” group were allowed to make a variety of choices about their daily activities and their environments. Members of the “comparison” group were not given these kinds of choices; instead, the nursing home staff made all of these decisions for them (the residents were told the staff were responsible for their happiness and care). After following the residents for 18 months, the researchers found that members of the responsibility-induced group were more lively, active in their social lives, and healthier than the residents in the comparison group. And twice as many of the residents in the comparison group died during this period (Rodin & Langer, 1977).

Researchers have examined how having a sense of personal control relates to a variety of health issues across all ages. Feelings of control are linked to how patients fare with some diseases. Cancer patients who exhibit a “helpless attitude” regarding their disease seem more likely to experience a recurrence of the cancer than those with perceptions of greater control. Why would this be? Women who have had breast cancer and believe they maintain control over their lifestyle, through diet and exercise, are more likely to make proactive changes related to their health, and perhaps reduce risk factors associated with recurrence (Costanzo, Lutgendorf, & Roeder, 2011). The same type of relationship is apparent in cardiovascular disease; the less control people feel they have, the greater their risk (Shapiro, Schwartz, & Astin, 1996). As we pointed out, having choices increases a perceived sense of control.

Feelings of control may also have a more direct effect on the body; for example, a sense of powerlessness is associated with increases in catecholamines and corticosteroids, both key players in a physiological response to stressors. Some have suggested a causal relationship between feelings of perceived control and immune system function; the greater the sense of control, the better the functioning of the immune system (Shapiro et al., 1996). But these are correlations, and the direction of causality should not be assumed. Could it be that better immune functioning, and thus better health, might increase a sense of control?

We must also consider cross-cultural differences. Individual control is emphasized and valued in individualist cultures like our own, but not necessarily in collectivistic cultures, where people look to “powerful others” and “chance factors” to explain events and guide decision making (Cheng, Cheung, Chio, & Chan, 2013).

LOCUS OF CONTROL Differences in perceived sense of control stem from beliefs about where control resides (Rotter, 1966). Someone with an internal locus of control generally feels she is in control of life and its circumstances; she probably believes it is important to take charge and make changes when problems occur. A person with an external locus of control generally feels as if chance, luck, or fate is responsible for her circumstances; there is no point in trying to change things or make them better. Imagine that a doctor tells a patient he needs to change his lifestyle and start exercising. If the patient has an internal locus of control, he will likely take charge and start walking to work or hitting the gym; he expects his actions will impact his health. If the patient has an external locus of control, he is more apt to think his actions won’t make a difference and may not attempt lifestyle changes. In the 1970 British Cohort Study, researchers examined over 11,000 children at age 10, and then assessed their health at age 30. Participants with an internal locus of control, measured at 10 years of age, were less likely as adults to be overweight or obese, and had lower levels of psychological problems. They were also less likely to smoke and more likely to exercise regularly than people with a more external locus of control (Gale, Batty, & Deary, 2008).

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LO 12 Discuss several tools for reducing stress and maintaining health.

Dealing with stressors can be challenging, but you don’t have to grin and bear it. There are many simple ways to manage and reduce stress. Let’s take a look at two powerful stress-fighting weapons: physical exercise and relaxation techniques.

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CONTROVERSIES

Many forms of meditation emphasize control and awareness of breathing. This may be one of the reasons people find meditation so relaxing. Taking slow, deep breaths is a fast and easy way to reduce the impact of stress.

BIOFEEDBACK A proven method for reducing physiological responses to stressors is biofeedback. This technique builds on learning principles to teach control of seemingly involuntary physiological activity (such as heart rate, blood pressure, and skin temperature). The biofeedback equipment monitors internal responses and provides visual or auditory signals to help a person identify those that are maladaptive (for example, tense shoulder muscles). The person begins by focusing on a signal (a light or tone, for example) that indicates when a desired response occurs. By learning to control this biofeedback indicator, the person learns to maintain the desired response (relaxed shoulders in this example). The goal is to be able to tap into this technique outside of the clinic or lab, and translate what has been learned into real-life practice.

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The use of biofeedback can decrease the frequency of headaches and chronic pain (Flor & Birbaumer, 1993; Sun-Edelstein & Mauskop, 2011). It appears to be useful for all age groups, including children, adolescents, and the elderly (Morone & Greco, 2007; Palermo, Eccleston, Lewandowski, Williams, & Morley, 2010).

SOCIAL SUPPORT Up until now, we have discussed ways to manage the body’s physiological response to stressors. There are also situational methods to deal with stressors, like maintaining a social support network. Researchers have found that proactively participating in positive enduring relationships with family, friends, and religious groups can generate a health benefit similar to exercise and not smoking (House, Landis, & Umberson, 1988). People who maintain positive, supportive relationships also have better overall health (Walsh, 2011).

You might expect that receiving support is the key to lowering stress, but research suggests that giving support also really matters. In a study of older married adults, researchers reported reduced mortality rates for participants who indicated that they helped or supported others, including friends, spouses, relatives, and neighbors. There were no reductions in mortality, however, associated with receiving support from others (Brown, Nesse, Vinokur, & Smith, 2003).

Helping others because it gives you pleasure, and expecting nothing in return, is known as altruism, and it appears to be an effective stress reducer and happiness booster (Schwartz, Keyl, Marcum, & Bode, 2009; Schwartz, Meisenhelder, Yunsheng, & Reed, 2003). When we care for others, we generally don’t have time to focus on our own problems; we also come to recognize that others may be dealing with more troubling circumstances than we are.

FAITH, RELIGION, AND PRAYER Psychologists are also discovering the health benefits of faith, religion, and prayer. Research suggests elderly people who actively participate in religious services or pray experience improved health and noticeably lower rates of depression than those who don’t participate in such activities (Lawler-Row & Elliott, 2009; Powell, Shahabi, & Thoresen, 2003). In fact, religious affiliation is associated with increased reports of happiness and physical health (Green & Elliott, 2010).

These various types of proactive, stress-reducing behaviors reflect a certain type of attitude. You might call it a positive psychology attitude.

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Question 1

Question 2

1. Emotion-focused coping

2. Positive psychology

3. Support seeking

4. Problem-focused coping

Question 3

1. Type A personality.

2. Type B personality.

3. Type C personality.

4. Type D personality.

Question 4