Comprehensive Stress Management fourteenth edition Jerrold S. Greenberg Professor Emeritus, University of Maryland COMPREHENSIVE STRESS MANAGEMENT, FOURTEENTH EDITION Published by McGraw-Hill Education, Penn Plaza, New York, NY 10121 Copyright © 2017 by McGraw-Hill Education All rights reserved Printed in the United States of America Previous editions © 2013, 2011, and 2009 No part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written consent of McGraw-Hill Education, including, but not limited to, in any network or other electronic storage or transmission, or broadcast for distance learning Some ancillaries, including electronic and print components, may not be available to customers outside the United States This book is printed on acid-free paper RMN 21 20 19 18 17 16 ISBN 978-0-07-802866-3 MHID 0-07-802866-3 Chief Product Officer, SVP Products & Markets: G Scott Virkler Vice President, General Manager, Products & Markets: Michael Ryan Managing Director: Gina Boedecker Brand Manager: Penina Braffman Director, Product Development: Meghan Campbell Product Developer: Anthony McHugh Marketing Manager: Meredith Leo Director, Content Design & Delivery: Terri Schiesl Program Manager: Jennifer Shekleton Content Project Managers: Jessica Portz, Katie Klochan, Sandra Schnee Buyer: Sandy Ludovissy Design: Studio Montage, St Louis, MO Content Licensing Specialist: Ann Marie Jannette Cover Image: Peter Zelei/Getty Images Compositor: MPS Limited Printer: R.R Donnelley All credits appearing on page or at the end of the book are considered to be an extension of the copyright page Library of Congress Cataloging-in-Publication Data Greenberg, Jerrold S., author Comprehensive stress management / Jerrold S Greenberg, Professor Emeritus, University of Maryland Fourteenth edition | New York, NY : McGraw-Hill Education, [2017] LCCN 2016013178 | ISBN 9780078028663 (alk paper) LCSH: Stress (Psychology) | Stress (Physiology) | Stress (Psychology)—Prevention | Stress management LCC BF575.S75 G66 2017 | DDC 155.9/042—dc23 LC record available at https://lccn.loc.gov/2016013178 The Internet addresses listed in the text were accurate at the time of publication The inclusion of a website does not indicate an endorsement by the authors or McGraw-Hill Education, and McGraw-Hill Education does not guarantee the accuracy of the information presented at these sites mheducation.com/highered brief table of contents brief table of contents part Scientific Foundations Chapter What Is Stress? Chapter Stress Psychophysiology 25 Chapter Stress and Illness/Disease 43 Chapter Stress and the College Student 75 part General Applications: Life-Situation and Perception Interventions 107 Chapter Intervention 108 Chapter Life-Situation Interventions: Intrapersonal 123 Chapter Life-Situation Interventions: Interpersonal 147 Chapter Perception Interventions 177 Chapter Spirituality and Stress 215 part General Applications: Relaxation Techniques 235 Chapter 10 Meditation 236 Chapter 11 Autogenic Training, Imagery, and Progressive Relaxation 249 Chapter 12 Other Relaxation Techniques 277 part General Applications: Physiological Arousal and Behavior Change Interventions 305 Chapter 13 Physiological Arousal Interventions 306 Chapter 14 Strategies for Decreasing Stressful Behaviors 331 Chapter 15 Diversity and Stress 351 part Specific Applications 377 Chapter 16 Occupational Stress 378 Chapter 17 Family Stress 417 table of contents table of contents Preface x part Scientific Foundations CHAPTER what is stress? What Can You Get Out of This Book and This Course? The Pioneers Stress Theory Life-Events Theory Hardiness Theory Social Support Theory The Stressor Stress Reactivity 11 Strain 11 Gender Differences in Reactivity 11 A Definition of Stress 12 Stress Management Goals 14 The Way to Use This Book 14 Your Personal Stress Profile and Activity Workbook 14 The Stress Portfolio 15 “Getting Involved in Your Community” Boxes 15 coping in today’s world 19 summary 19 internet resources 19 references 20 lab assessment 1.1 what causes you stress? 23 lab assessment 1.2 why some of your stressors result in a stress response? 24 CHAPTER stress psychophysiology 25 The Brain 25 The Endocrine System 29 The Autonomic Nervous System 33 The Cardiovascular System 35 The Gastrointestinal System 36 The Muscles 37 The Skin 38 Symptoms, Stress, and You 38 coping in today’s world 38 summary 39 internet resources 39 references 39 lab assessment 2.1 how much you know about stress psychophysiology? 41 lab assessment 2.2 what are your physiological reactions to stress? 42 CHAPTER stress and illness/disease 43 Hot Reactors 43 Psychosomatic Disease 43 Stress and the Immunological System 44 Stress and Serum Cholesterol 47 Specific Conditions 49 Hypertension 49 Stroke 50 Coronary Heart Disease 51 Ulcers 53 Migraine Headaches 54 Tension Headaches 55 Cancer 56 Allergies, Asthma, and Hay Fever 56 Rheumatoid Arthritis 58 Backache 58 TMJ Syndrome 59 Obesity 60 Posttraumatic Stress Disorder 62 Symptoms of PTSD 62 Treatment of PTSD 62 Stress and Other Conditions 64 coping in today’s world 65 summary 66 internet resources 66 references 66 lab assessment 3.1 you know what to for posttraumatic stress disorder? 71 lab assessment 3.2 why did you get sick as a result of stress? 72 lab assessment 3.3 how are my health indices? 73 CHAPTER stress and the college student 75 The Younger College Student 76 Lifestyle Change 76 Grades 77 Course Overload 78 Finances 78 Friendship 83 Love 83 Sex 84 HIV/AIDS 86 Other Sexually Transmitted Infections 86 Prevention of Sexually Transmitted Infections 86 Acquaintance Rape 87 Shyness 89 Jealousy 90 Breakups 90 Eating Disorders 91 The Older College Student 93 Career and School 93 Family and School 94 Self-Doubt 94 The Minority College Student 95 Interventions 97 Life-Situation Interventions 97 Perception Interventions 99 Emotional Arousal Interventions 100 Physiological Arousal Interventions 101 coping in today’s world 101 summary 102 internet resources 102 references 102 lab assessment 4.1 budgeting while in school: using a worksheet to help manage your money 105 lab assessment 4.2 how intimate are your friendships? 106 part General Applications: Life-Situation and Perception Interventions 107 CHAPTER intervention 108 Coping with a Stressor 108 A Model of Stress 109 Feedback Loops in the Stress Model 111 Setting Up Roadblocks 111 Comprehensive Stress Management 112 Eustress and the Model 114 Taking Control 115 Making a Commitment 117 coping in today’s world 118 summary 119 internet resources 119 references 119 lab assessment 5.1 what eustressors have you experienced? 121 CHAPTER life-situation interventions: intrapersonal 123 Eliminating Unnecessary Stressors 123 Nutrition and Stress 125 Noise and Stress 137 Life Events and Stress 138 Hassles and Chronic Stress 140 Success Analysis 140 coping in today’s world 143 summary 143 internet resources 143 references 144 lab assessment 6.1 what is your resting metabolic rate (rmr)? 145 lab assessment 6.2 what hassles you encounter? 146 Table of Contents v CHAPTER life-situation interventions: interpersonal 147 Asserting Yourself 147 Nonverbal Assertiveness 148 Verbal Assertiveness 149 Conflict Resolution 150 Communication 153 Nonverbal Communication 154 Verbal Communication 154 Emotional Intelligence 156 The Importance of Emotional Intelligence 156 Ways to Develop Emotional Intelligence 157 Technostress 158 Time Management 159 Assessing How You Spend Time 159 Setting Goals 160 Prioritizing 160 Scheduling 160 Maximizing Your Rewards 160 Saying No 160 Delegating 161 Evaluating Tasks Once 161 Using the Circular File 161 Limiting Interruptions 161 Investing Time 161 Social Support Networking 162 coping in today’s world 165 summary 165 internet resources 165 references 166 lab assessment 7.1 how assertive are you? 169 lab assessment 7.2 how you resolve conflicts? 171 lab assessment 7.3 how is your social support? 172 lab assessment 7.4 what is your active listening style? 174 CHAPTER perception interventions 177 Selective Awareness 177 Stop to Smell the Roses 179 Perspective and Selective Awareness 179 An Attitude of Gratitude 180 Humor and Stress 182 Type A Behavior Pattern 183 vi Table of Contents Self-Esteem 186 Locus of Control 188 Anxiety Management 190 Test Anxiety 190 Trait and State Anxiety 190 Panic Disorder 190 Social Phobia (Social Anxiety Disorder) 191 Specific Phobias 192 Coping Techniques 192 Resiliency 197 Hardiness 198 coping in today’s world 199 summary 199 internet resources 200 references 200 lab assessment 8.1 what kind of sense of humor you have? 205 lab assessment 8.2 are you a type a? 207 lab assessment 8.3 how is your self–esteem? 208 lab assessment 8.4 how is your physical self–esteem? 209 lab assessment 8.5 what is your locus of control? 210 lab assessment 8.6 what is your level of test anxiety? 211 lab assessment 8.7 you have irrational beliefs? 213 CHAPTER spirituality and stress 215 Spiritual Health 215 Religion and Spirituality 216 Spirituality and Health 216 Spirituality and College Students 218 How Spirituality and Religion Affect Health 218 Control Theory 218 Social Support Theory 219 Spirituality, Social Support, and Terrorism 219 Placebo Theory 220 Forgiveness and Health 220 Volunteerism as a Spiritual and Healthy Activity 221 Service-Learning: A Spiritual and Academic Activity 222 Closing Thoughts on Spirituality, Health, and Managing Stress 224 coping in today’s world 226 summary 226 internet resources 227 references 227 lab assessment 9.1 how spiritual are you? 231 lab assessment 9.2 how forgiving are you? 233 part General Applications: Relaxation Techniques 235 CHAPTER 10 meditation 236 What Is Meditation? 236 Types of Meditation 236 Benefits of Meditation 237 Physiological Effects 238 Psychological Effects 239 How to Meditate 240 Other Types of Meditation 242 Making Time for Meditation 242 coping in today’s world 243 summary 244 internet resources 244 references 244 lab assessment 10.1 is meditation for you? 247 CHAPTER 11 autogenic training, imagery, and progressive relaxation 249 Autogenic Training 249 Benefits of Autogenic Training 250 Physiological Effects 250 Psychological Effects 250 How to Do Autogenic Training 251 Prerequisites 251 Body Position 251 Six Initial Stages of Autogenic Training 252 An Autogenic Training Experience 253 Imagery 255 Physiological Effects 256 Psychological Effects 257 Progressive Relaxation 257 Bracing 257 What Is Progressive Relaxation? 258 Benefits of Progressive Relaxation 259 How To Do Progressive Relaxation 259 coping in today’s world 267 summary 268 internet resources 268 references 268 lab assessment 11.1 is autogenic training for you? 273 lab assessment 11.2 is imagery for you? 274 lab assessment 11.3 is progressive relaxation for you? 275 CHAPTER 12 other relaxation techniques 277 Biofeedback 277 Benefits of Biofeedback 278 How to Relax Using Biofeedback 279 How to Arrange for Biofeedback Training 281 Diaphragmatic Breathing 281 Body Scanning 282 Body Scan Relaxation Exercise 283 Massage and Acupressure 284 Yoga and Stretching 284 Repetitive Prayer 287 Quieting Reflex 288 Instant Calming Sequence 288 Mindfulness 288 Music and Relaxation 290 Tai Chi 291 Pets and Stress 292 coping in today’s world 295 summary 296 internet resources 296 references 296 lab assessment 12.1 how you cause stress, and what will you about it? 303 lab assessment 12.2 pets: stress busters in spite of it all? 304 part General Applications: Physiological Arousal and Behavior Change Interventions 305 CHAPTER 13 physiological arousal interventions 306 Exercise and Health 307 Aerobic and Anaerobic Exercise 307 Physical Health 307 Table of Contents vii Psychological Health 309 Can Physical Fitness and Exercise Make You Smarter? 312 The Healthy Way to Exercise 312 Principles of Exercise 313 Intensity, Frequency, and Duration 313 Assessing Your Cardiorespiratory Fitness 314 Starting an Exercise Program 315 How to Exercise 315 Do’s and Don’ts 315 Competition and Enjoyment 316 Choosing an Exercise Program 317 Swimming 317 Rope Jumping 317 Bicycling 318 Walking 318 Jogging 319 Stretching 321 Weight Training 321 Exercise Guidelines 321 Exercise and the Elderly 323 Exercise—Keeping It Going 324 coping in today’s world 325 summary 326 internet resources 326 references 326 lab assessment 13.1 can you overcome roadblocks to exercise? 329 lab assessment 13.2 can you differentiate between exercise myths and facts? 330 CHAPTER 14 strategies for decreasing stressful behaviors 331 Health and Lifestyle Behaviors 331 Health-Behavior Assessment 331 Selected Lifestyle Behaviors 331 Barriers to Action 332 Locus of Control 332 Methods for Decreasing Stressful Behaviors 332 Self-Monitoring 333 Tailoring 333 Material Reinforcement 334 Social Reinforcement 334 Social Support 335 Self-Contracting 335 Contracting with a Significant Other 335 Shaping 335 Reminders 336 Self-Help Groups 336 viii Table of Contents Professional Help 336 Application of Behavior Change Techniques 337 Example: Exercise 338 Behavior Change Theories and Stress 338 Stages of Change Theory 339 Health Belief Model 340 Self-Efficacy Theory 341 Goal-Setting Theory 342 coping in today’s world 342 summary 343 internet resources 343 references 344 lab assessment 14.1 are your behaviors healthy? 345 lab assessment 14.2 are your lifestyle behaviors healthy? 347 lab assessment 14.3 decreasing stressful behaviors: a guide 348 lab assessment 14.4 can you use behavior change theory to change your behavior? 349 CHAPTER 15 diversity and stress 351 Diverse Populations 351 Positive Aspects of Minority Status 352 An Introduction to Problems Faced by Minorities 353 Stressors Challenging Minorities 354 Health Status 356 National Health Objectives and Diversity 356 Infant Mortality 358 Life Expectancy 359 Years of Potential Life Lost 359 High Blood Pressure 359 Acquired Immune Deficiency Syndrome (AIDS) 360 Cancer 361 Mental Health 361 Poverty and Educational Level 362 Family Life 362 Homelessness 362 Family Structure 363 Age and Physical Challenges 365 Elders 365 People with Physical and Mental Challenges 367 Sexual Orientation 367 coping in today’s world 368 summary 369 internet resources 369 references 370 lab assessment 15.1 how has prejudice affected your level of stress? 373 lab assessment 15.2 what biases you possess? 374 lab assessment 15.3 how well you know diverse groups and individuals? 375 lab assessment 16.1 you have occupational stress? 411 lab assessment 16.2 how stressful is your job? 412 lab assessment 16.3 you have burnout or brownout? 415 part CHAPTER 17 Specific Applications 377 CHAPTER 16 occupational stress 378 What Is Occupational Stress? 378 Occupational Stress Cycle 379 Why Is Occupational Stress of Concern? 381 Gender and Occupational Stress 385 Disease and Occupational Stress 386 Physiological Effects 386 Disease States 386 Psychological Effects 386 Occupational Stressors 387 Lack of Participation 387 Role Problems 387 Job Dissatisfaction 389 The Work Environment 389 The Workaholic 390 Burnout 392 Women and Work Outside the Home 393 Types of Jobs and Wages 394 Coping with Work Stress 394 Women and Retirement 395 Family-Friendly Work-Related Policies 396 Work-Family Balance 399 Working in the Home 400 Interventions 402 Life-Situation Interventions 402 Perception Interventions 402 Emotional Arousal Interventions 403 Physiological Arousal Interventions 404 Managing Occupational Stress 404 coping in today’s world 405 summary 405 internet resources 406 references 406 family stress 417 The Family 417 Needs Satisfied by the Family 417 The Changing Family 418 Marriage 420 Cohabitation 420 Divorce 421 Single-Parent Families 421 Gay and Lesbian Families 422 Family Stressors 423 The Dual-Career Family 423 Children 425 Family Planning 426 Adoption 428 Mobility 428 Violence: A Family Matter 429 Financial Stressors 431 Other Stressors 432 A Model of Family Stress 433 Interventions 433 Life-Situation Interventions 433 Financial Stress Interventions 435 Perception Interventions 436 Emotional Arousal Interventions 438 Physiological Arousal Interventions 438 coping in today’s world 439 summary 439 internet resources 439 references 440 lab assessment 17.1 are you ready for marriage? 443 lab assessment 17.2 who is your ideal mate? 444 Epilogue E-1 Glossary G-1 Photo Credits PC-1 Index I-1 Table of Contents ix muscular endurance, cardiorespiratory endurance, flexibility, body composition, and agility (p 308) Plaque: debris that clogs coronary arteries (p 50) Pons: part of the subcortex responsible for regulating sleep (p 26) Pranayama: a Hindu practice that involves breathing as the object of focus during meditation (pp 237, 285) Preattack: synonymous with prodrome (p 54) Primary Appraisal: judging how much of a threat is involved, and how important is the outcome (p 108) Primary Control: attempts to change a situation; similar to problemfocused coping (p 218) Problem-focused Coping: the use of activities specific to getting a task done (p 403) Prodrome: the constriction phase of a migraine headache; also called preattack (p 54) Progressive Relaxation: a relaxation technique involving contracting and relaxing muscle groups throughout the body; also called neuromuscular relaxation or Jacobsonian relaxation (pp 6, 258) Pseudostressors: food substances that produce a stresslike response; also called sympathomimetics (p 135) Psychogenic: a physical disease caused by emotional stress without a microorganism involved (p 44) Psychoneuroimmunology: the study of the illness-causing and healing effects of the mind on the body (p 44) Psychophysiological: synonymous with psychosomatic (p 44) Psychosomatic: conditions that have a mind and body component (p 44) Q Quieting Reflex (QR): a six-step relaxation technique that results in relaxation in seconds (p 287) S Saliva: substance in the mouth that starts to break down food (p 36) Secondary Appraisal: determining whether resources needed to meet the demand are available (p 109) Secondary Control: attempts to control oneself or one’s emotional reactions; similar to emotion-focused coping (p 218) Self-Contracting: making a contract with oneself to change a behavior (p 335) Self-Efficacy: confidence in the ability to manage a demand/threat (p 109) Self-Esteem: how highly one regards oneself (p 186) Self-Monitoring: the process of observing and recording behavior (p 333) Sexually Transmitted Infections (STIs): diseases such as syphilis, gonorrhea, chlamydia, and genital warts that are transmitted through sexual activity (p 85) Shaping: changing a behavior a little bit at a time (p 335) Shiatsu: acupressure massage (p 284) Shyness: to be afraid of people and being worried of what strangers and powerful others think of oneself (p 89) Significant Other: another person who is important to an individual (p 335) Single-Parent Families: families in which the father or the mother is absent because of divorce, marital separation, out-of-wedlock pregnancy, or death (p 421) Skeletal Muscles: muscles attached to bones (p 37) Small Intestine: part of the digestive system into which the esophagus empties (p 36) Smooth Muscles: muscles that control the contraction of internal organs (p 37) R Social Phobia: overwhelming fear and excessive self-consciousness in everyday situations; a chronic fear of being watched by others and not performing well Fear of public speaking is an example (p 191) Race: a group of people with similar physical traits, blood types, genetic patterns, and inherited characteristics (p 352) Social Reinforcement: rewarding a behavior with social approval by someone else (p 334) Reappraisal: evaluation of whether the response made to a demand/threat was effective (p 109) Social Support: the presence of significant others with whom to discuss stressors (p 139) Reflective Listening: paraphrasing the speaker’s words and feelings; also called active listening (p 152) Somatogenic: a psychosomatic disease that results from the mind increasing the body’s susceptibility to disease-causing microbes or natural degenerative processes (p 44) Reflexology: a massage technique that massages a “reflex zone” in the foot in which damage to body parts is thought to be manifested (p 284) Relaxation Response: the physiological state achieved when one is relaxed; the opposite of the stress reaction; also called the trophotropic response (p 6, 239) Religion: an organized entity in which people have common beliefs and engage in common practices relevant to spiritual matters (p 216) Reminder System: a means of reminding oneself to perform a particular behavior (p 336) Resiliency: the ability to identify and make use of strengths and assets to respond to challenges, thereby growing as an individual (p 197) Specific Phobia: an intense fear of a specific situation that poses little or no actual danger Fear of elevators is an example (p 192) Sphygmomanometer: an instrument used to measure blood pressure (p 49) Spiritual Disease: a condition in which people are not true to their spiritual selves and are living a “life story” that is inconsistent with their beliefs and values (p 225) Spiritual Health: adherence to religious doctrine; the ability to discover and express one’s purpose in life; to experience love, joy, peace, and fullfillment; or to achieve and help others to achieve full potential (p 215) Reticular Activating System (RAS): a network of nerves that connects the mind and the body (p 27) Spirituality: a person’s view of life’s meaning, direction, purpose, and connectedness to other things, other people, and the past and future (p 216) Rheumatoid Factor: a blood protein associated with rheumatoid arthritis (p 58) State Anxiety: anxiety that is either temporary in nature or specific to a particular stimulus (p 190) G-4 Glossary Storgic Love (Storge): a calm, companionate type of love conceiving of a long commitment (p 83) Thyrotropic Hormone (TTH): stimulates the thyroid gland to secrete thyroxin (p 28) Strain: the physical, psychological, and behavioral outcomes of stress reactivity (p 11) Thyrotropic Hormone Releasing Factor (TRF): released by hypothalamus and stimulates the pituitary gland to secrete thyrotropic hormone (p 28) Stress: the combination of a stressor, stress reactivity, and strain (pp 13, 108) Stressor: something with the potential to cause a stress reaction (p 3) Stroke: a lack of oxygen to the brain resulting from a blockage or rupture of a blood vessel; also called apoplexy (p 50) Subcortex: the lower part of the brain responsible for various physiological processes necessary to stay alive (p 26) Suppressor T Cells: cells whose purpose is to halt the immune response (p 45) Sympathetic Nervous System: part of the autonomic nervous system responsible for expending energy (p 33) Sympathomimetics: synonymous with pseudostressors (p 135) Systematic Desensitization: either imagining or encountering an anxiety-provoking stimulus while practicing relaxation (p 193) Systolic Blood Pressure: the pressure of the blood as it leaves the heart (p 49) T T Cells: a type of lymphocyte whose purpose is to destroy substances foreign to the body by puncturing invaded body cells and killing the cells and foreign substances (p 45) T-Lymphocytes: a part of the immune system that destroys mutant cells (p 56) Tai Chi: an exercise and relaxation technique developed in China that involves focused, slow, rhythmic movement (p 291) Trait Anxiety: a general sense of anxiety not specific to a particular stimulus (p 190) Transcendental Meditation (TM): a relaxation technique involving the use of a Sanskrit word as the object of focus (p 236) Trophotropic Response: the physiological state achieved when one is relaxed; also called the relaxation response (p 239) Type A Behavior Pattern: a cluster of behaviors associated with the development of coronary heart disease that includes excessive competitiveness, free-floating hostility, and a sense of time urgency and is associated with the development of coronary heart disease (pp 51, 183) Type B Behavior Pattern: behavior pattern that is not excessively competitive, no free-floating hostility and no sense of time urgency Also develops coronary heart disease (p 184) Type C: a personality type proposed to be associated with the development of cancer Characterized by denial and suppression of emotions, in particular anger, resentment, and hostility, and pathological niceness (p 187) Type D: a personality type associated with the development of and death from coronary heart disease Characterized by negative emotion and inhibited self-expression (p 187) U Uplifts: positive events that make us feel good (p 140) V Tailoring: making a behavior change program specific to the life of the individual (p 334) Vasopressin (ADH): a hormone secreted by the pituitary gland (p 29) Target Heart Rate Range: the low and the high heart rate during exercise to strive toward (p 314) W Temporomandibular (TMJ) Syndrome: the interference with the smooth functioning of the jaw (p 59) Workaholic: immersing oneself excessively in work at the expense of nonwork activities (p 390) Thalamus: part of the diencephalon that relays sensory impulses to the cerebral cortex (p 26) Y Thermal Biofeedback: biofeedback that measures temperature (p 279) Thyroid Gland: an endocrine gland that secretes the hormone thyroxin (p 31) Years of Potential Life Lost: the number of years between when a person is expected to live and the age of death; a measure of premature death (p 359) 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p 434 (top): © Blend Images/Alamy; p 434 (bottom): © Tetra Images/Alamy; p 437: © Fancy Photography/Veer PC-1 This page intentionally left blank Index A A,B,C lists, 160 ABC News, 423 ABCDE technique, 195–196 abdominal muscles, 266 abortion, 428 About Religion and Spirituality, 227 acculturation stressors, 355 achievement striving (AS), 184 acquaintance rape, 87–89 acquired immune deficiency syndrome (AIDS), 86, 360 ACTH, 28, 32 action stage, 339 active listening, 152–153 active stretching, 321 activities/exercises See student exercises/ activities acupressure massage, 284 acupuncture, 44, 267 Adams, Patch, 183 adenosine triphosphate (ATP), 53 Ader, Robert, 7, 44 ADH, 29, 31 adoption, 427, 428 adrenal cortex, 30 adrenal gland, 29, 30 adrenal medulla, 31 adrenaline, 31, 32 adrenocorticotropic hormone (ACTH), 28, 32 adultolescents, 295 aerobic exercise, 307 aerobic prayer, 287 affiliative humor, 206 Affordable Care Act, 358 African Americans, 353 See also Race and ethnicity afterlife, 220 Afterschool Alliance, 426 aggression, 199 aggressive behavior, 147, 149 aggressive driving, 19 aggressive humor, 206 agoraphobia, 11, 191 AIDS, 86, 357, 360–361 alarm reaction, aldosterone, 30 allergies, 56–57 allostasis, allostatic load, alternate-nostril breathing, 285–287 American Academy of Pediatrics, 426 American Cancer Society, 131 American College Health Association, 89 American College of Sports Medicine, 316, 321, 326 American Institute of Stress, 19, 296 American Psychological Association, 406 American Tai Chi and Qigong Association, 292 American Yoga Association, 296 Americansingles.com, 84 anaerobic exercise, 307 anal opening, 36 anapanasati, 237 “and,” not “but,” 155 anger, 188 angina, 47 angiogenesis, 60 angioplasty, 53 anorexia nervosa, 91–92, 125, 134 antibodies, 56 antidiuretic hormone (ADH), 31 antigen, 56 Antioch College, 89 anxiety, 190, 192 anxiety management, 190–197 ABCDE technique, 195–196 cognitive restructuring, 194–195 coping techniques, 192–196 environmental planning, 192–193, 195 managing anxiety formula, 196–197 panic disorder, 190–191 relabeling, 193, 195 self-talk, 193, 195 social phobia, 191–192 special phobias, 192 state anxiety, 190 systematic desensitization, 193–194, 195 test anxiety, 190 thought stopping, 193, 195 trait anxiety, 190 anxiety management techniques, 192–196 apoplexy, 50 appraisal, 108–109 aqua dynamics, 317 armchair desensitization, 194 aromatherapy, 284 arteriosclerosis, 52 arthritis, 58 asanas, 285 Asian Americans, 353 See also Race and ethnicity aspirin, 54 assertive behavior, 147 assertiveness, 147–150 Assertiveness Training Web Sites, 165 The Association for Applied Psychophysiology and Biofeedback, 296 asthma, 44, 56 atherosclerosis, 52 athletic injuries, 64–65 ATP, 53 attachment anxiety, 91 attitude of gratitude, 180–182 attorneys, 51 autogenic meditation, 251 autogenic training, 6, 249–255 body position, 251–252 defined, 249 how to it, 252–255 physiological effects, 250 prerequisite, 250 psychological effects, 250–251 seated positions, 252 autohypnosis, 249 autoimmune response, 58 autonomic nervous system, 27, 33–34 azidothymidine (AZT), 86 B B cells, 45, 46 backache, 58–59 bacterial vaginosis, 87 bad cholesterol, 47 balanced diet, 125 ballistic stretching, 321 Bandura, Albert, 341 barriers, 332 basal body thermometer, 277 behavior change theories, 338–342 goal-setting theory, 342 health belief model, 340–341 self-efficacy theory, 341–342 stages of change theory, 339–340 behavior management techniques, 332–338 contracting with a significant other, 335 illustrative example, 338 material reinforcement, 334 overview, 337 professional help, 336–337 reminder system, 336 self-contracting, 335 self-help groups, 336 self-monitoring, 333 shaping, 335–336 social reinforcement, 334–335 social support, 335 tailoring, 333–334 I-1 behavioral strain, 11 Benson, Herbert, 6, 50, 239, 242, 287 bereaved people, 44 beta cells, 136 beta-endorphins, 46 Beyond the Relaxation Response (Benson), 50 bicycling, 318 Big Brother and Big Sister programs, 365 binge eating disorder, 134 biofeedback, 6, 267, 277–281 defined, 277 EMG, 278–279 how to arrange training, 281 phases, 278 physiological effects, 278–279 psychological effects, 279 relaxing, 279–280 thermal, 279 blood pressure, 30, 36, 49, 359–360 BMI (body mass index), 133, 134–135 body brace, 279 body composition, 308 body language, 154 body mass index (BMI), 133, 134–135 body scanning, 282–284 body’s reaction to stress See stress psychophysiology bonding years, 425–426 bone marrow transplant, 289 boomerang kids, 295, 419 Booth-Kewley, Stephanie, 45 bracing back pain, 58 defined, 6, 37 health effects, muscle spasms, 58 progressive relaxation, 257–258 signs of, 258 brain, 25–29 anatomy, 26, 27 evolution of, 28 exercise, and, 312 meditation, and, 239, 243 music, and, 290–291 neuroplasticity, 243 RAS, 27 stress, and, 29 brainstem, 26 brainstorming, 153 breakups, 90–91 breathing exercises, 282 See also diaphragmatic breathing Brosse, Therese, 6, 238 brownout, 413 bruxism, 59 Budzynski, Thomas, bulimia, 92–93, 125, 134 burnout, 384, 392–393 Burt, John, 189 “but,” 155 C caffeine, 135 calcium, 53, 135 calcium channel blockers, 53 I-2 Index CAM (complementary and alternative medicine), 61, 267 campus health centers, 100 Camus, Albert, 289 cancer, 6, 56, 127, 131, 132, 361 cancer-prone personality, 46 cancer survivors, 293 candidiasis, 87 Cannon, Walter, carcinogen, 56 cardiac muscle, 53 cardiorespiratory endurance, 308, 314 cardiorespiratory fitness, 314 cardiovascular disease, 132 cardiovascular system, 35–36 Carter, Jimmy, 182 cat pose, 285 cavemen, CBS News, 423 CCPD (cocreator perception deficiency), 189 Centers for Disease Control and Prevention, 430 Center for Spirituality and Health at Duke University, 227 Center for Spirituality at Work, 227 cerebellum, 26, 27 cerebral cortex, 26, 27 cerebral hemorrhage, 50 cerebral subcortex, 26, 27 challenge, 198 chanting, 138 Chaplin, Charlie, 182 child abuse, 429–430 chlamydia, 87 cholesterol, 36, 47 ChooseMyPlate.gov, 129–130 chronic dysregulation, church nurse, 226 closed adoption, 428 clown care unit, 65 CNN poll, 423 cobra pose, 286 cocreator perception deficiency (CCPD), 189 cognitive appraisal, 109, 111 cognitive behavioral therapy, 63, 92, 191, 267 cognitive restructuring, 194–195 cohabitation, 420–421 cold feet, 35 cold turkey, 335 collaborative religious approach to increasing control, 219 college affinity card agreements, 82 college students, 75–101 acquaintance rape, 87–89 breakups, 90–91 career and school, 93–94 course overload, 78 Credit CARD Act, 82 credit cards, 80–81, 82 eating disorders, 91–93 emotional arousal interventions, 100–101 family and school, 94 finances, 75, 76 friendship, 83 grades, 77 hassles, 140 HIV/AIDS, 86 international students, 366 jealousy, 90 life-situation interventions, 97–99 love, 83–84 minorities, 95–97 mixed race students, 364 older students, 93–95 perception interventions, 99–100 physiological arousal interventions, 101 safety, 96 self-doubt, 94–95 service-learning, 222–224 sex, 84–85 shyness, 89–90 sources of funding, 79 spirituality, 218 STIs, 86–87 stress-related illness, 45 student loan debt, 79, 81 time management, 162 younger students, 76–93 color breathing, 282 Combs, Sean “P Diddy,” 19 comforting sounds, 138 commitment, 117–118, 198 common cold, 48 communication, 153–156 community centers, 164 community involvement See “Getting involved in your community” boxes community service, 17, 222, 223 compensation theory, 400 complementary and alternative medicine (CAM), 61, 267 Complete stress management, 113–114 Complete Idiot’s Guide to Mindfulness,The, 290 compliments, 177–178 comprehensive stress management, 112–114 computer relaxation, 290 conflict resolution, 150–153 Conflict Resolution Information Source, 166 consciousness meditation, 242 Consortium for Research on Emotional Intelligence in Organizations, 156 Consumer Credit Counseling Service, 436 Consumer Financial Protection Bureau (CFPB), 82 contemplation stage, 339 Contraceptive Technology (Hatcher), 435 contract of commitment, 117 contracting with a significant other, 335 control behavior change, 332 biofeedback, 279 CCPD, 189 hardiness, 198 responsibility, 189 spirituality, 218–219 stress management, 115–117 conversion opportunity score, 175 Cooper, Robert, 288 Copernicus, 33 coping, 108–109 Coping in Today’s World airport noise/flight path, 38 anger, 19 brain neuroplasticity, 243 CAM therapies, 267 church nurse, 226 clown care unit, 65 exercise, 325 health disparities, 368 health ministries in African American churches, 226hostility, 199 humor, 118 marriage, 143, 439 relaxation technique, 295 satisfaction with life scale, 165 unethical behavior, 101 Weight Watchers, 342 work-related values, 405 coronary bypass surgery, 53 coronary heart disease, 51–53, 127 coronary heart disease-prone personality, 46 corporate scandals, 101 corpse pose, 286 corpus callosum, 26 corticotropin releasing factor (CRF), 28 cortisol, 30, 31, 135 Cosby, Bill, 182 course overload, 78 Cousins, Norman, 182 covenant marriage, 419 crane prose, 286 Credit Card Accountability, Responsibility, and Disclosure (CARD) Act of 2009, 80, 82 credit cards, 80–81, 82 CRF (corticotropin releasing factor), 28 cues to action, 340 culture clashes, 354–355 cyber-disinhibition, 156 D daily hassles, 140 daily record of activity, 159 Darwin’s theory of evolution, 33 Date.com, 84 date rape, 87–89 debt, student loan, 79, 81 See also financial stressors decibel ratings, 138 decision/determination stage, 339 decisional forgiveness, 221 decreasing stressful behavior, 331–350 barriers to action, 332 control, 332 health-behavior assessment, 331 methods See behavior management techniques theory See behavior change theories deferring religious approach to increasing control, 219 definitions (glossary), G–1 to G–5 delegating, 161 demand-control model, 387 Denollet, Johan, 7, 187 dentists, 51 depersonalization, 392 depression, 239 DESC form, 149–150 desensitization procedure, 194–195 detachment years, 426 developmental assets, 197 diabetes, 132, 136 diaphragmatic breathing, 281–282 diary stress, 123–124 time, 159 diastolic blood pressure, 30, 36, 49 diencephalon, 26, 27 diet See nutrition diet-related chronic diseases, 132 dietary guidelines for Americans, 126–127 direct effect theory, 162 disabilities, persons with, 357–358, 367 disease See illness/disease “ ‘Disease-Prone Personality,’ The” (Friedman/ Booth-Kewley), 45 distress, 5, 114 diversity and stress, 351–376 acculturation stressors, 355 AIDS/HIV, 360–361 cancer, 361 culture clashes, 354–355 disabilities, persons with, 357–358, 367 diverse populations, 351–352 elderly persons, 365, 367 family structure, 363–365 hate crimes, 355, 367 health, 356–358, 368 high blood pressure, 359–360 homelessness, 362–363 homicide, 361 infant mortality, 358–359 inner cities, 355 life expectancy, 359 national health objectives, 356 positive aspects of minority status, 352–353 poverty, 362 racial profiling, 355 racism, 354 sexual orientation See gays, lesbians and transgenders suicide, 361 years of potential life lost, 359 See also gender differences; race and ethnicity DiversityInc, 369 divorce, 421, 435 dogs, 293 domestic engineer, 401 domestic violence, 430–431 Dopamine, 311 Dossey, Larry, 216 double-blind studies, 220 dual-career family, 423–424 Dunbar, Flanders, 50 duration, 11 Dworkin, Barry, 279 dynamic stretching, 321, 322 dyspnea, 250 dysregulation of systems, E easy pose, 286 eating disorders, 91–93, 125, 134 Edelman, Marion Wright, 17, 223 education loans, 79 educational level, 362 effleurage, 284 effort-reward imbalance model, 387 18 Ways to Survive Your Company’s Reorganization, Takeover, Downsizing, or Other Major Change, 406 80/20 rule, 160 elderly persons cohabitation, 420–421 earnings potential, 362 elder care at work, 399 exercise, 323–324 functional limitations, 365, 367 poverty, 362, 396 electromyographic (EMG) biofeedback, 278–279 Ellis, Albert, 195 Emerson, Ralph Waldo, 17, 221 EMG biofeedback, 278–279 emotion-focused coping, 108, 403 emotional arousal, 110, 111 emotional arousal interventions college students, 100–101 family stress, 438 occupational stress, 403 emotional exhaustion, 392 emotional forgiveness, 221 emotional health, 16 emotional intelligence, 156–158 employment See occupational stress endocrine glands, 29 endocrine system, 28, 29–32 endorphins, 311 energy expenditure chart, 310 Engel, George, Enron, 101 entitlement mentality, 382 environmental health, 16 environmental planning, 192–193, 195 environmental stressors, 10 epinephrine, 31, 32 Epstein, Robert, 113 Erikson, Erik, 224 erotic love (eros), 83 esophagus, 36 essential hypertension, 49, 359–360 esteem needs, 390 ethnic food pyramids, 131 ethnicity, 352 See also race and ethnicity eustress, 5, 114–115 eustressors, 114, 121 everyday hassles, 140 Everything You Wanted to Know About Sex but Were Afraid to Ask, 36 exercise and health, 306–330 aerobic/anaerobic exercise, 307 bicycling, 318 body’s release of chemical substances, 311 cardiorespiratory fitness, 314 CDC guidelines, 323 clothing, 315–316 cognitive functioning, 312 competition and enjoyment, 316–317 cool-down, 315 elderly persons, 323–324 equipment, 316 exercise myths and facts, 330 fluids, 316 jogging, 319–321 know your body, 316 physical activity pyramid, 325 Index I-3 exercise and health (continued) physical health, 307–309, 312 principles of exercise, 313–314 psychological health, 309–311 rope jumping, 317–318 starting an exercise program, 315–317 stretching, 321 swimming, 317 train vs strain, 315 walking, 318–319 warm-up, 315 work-related benefits, 311 See also physiological arousal interventions exercise benefit zone (EBZ), 313 exercises/activities See student exercises/ activities exhaustion phase, exposure therapy, 63, 191 extended family, 417 external locus of control, 188 Eysenck, Hans, 46 fitness See exercise and health flexible work schedules, 397–398 fluoxetine, 92 focusing-of-attention meditation, 237 focusing on the positive, 178 food See nutrition food pyramid children, 127, 128 elderly people, 127, 128 ethnicity, 131 MyPyramid, 125, 128 vegetarians, 130 forgiveness, 220–221, 222 forward leg swing, 322 forward lunge and torso twist, 322 Frankl, Victor, 182 Friedman, Howard, 45 Friedman, Meyer, 6, 51, 183, 184 friendship, 83 frontal lobe, 27 Future Shock (Toffler), E–1 F G faith See spiritualityfaith factor, 287Family and Medical Leave Act (FMLA), 397 family-friendly work-related policies, 396–399 family life, 417–439 adoption, 427, 428 changing family, 418–419 child abuse, 429–430 children, 425–426 cohabitation, 420–421 covenant marriage, 419 diverse populations, 363–365 divorce, 421, 435 dual-career family, 423–424 emotional arousal interventions, 438 family planning, 426–428, 435 financial stress interventions, 435–436 financial stressors, 431–432 gay and lesbian families, 422–423 homelessness, 362–363 household work, 385 interracial marriage, 364 intimate partner violence, 430–431 life-situation interventions, 433–438 marriage, 420, 439 mobility, 428–429 model of family stress, 433 perception interventions, 436–438 physiological interventions, 438 remarriage, 432 single-parent families, 421–422 work-family balance, 399–400 family planning, 426–428, 435 family stress model, 433 family stressors, 423–432, 433 “Fat Is Where It’s At,” 277 fear, 163 fear hierarchy, 194 feedback loops, 111 fight-or-flight response, 3, 9, 32 financial stressors college students, 78–82 families, 431–432, 435–436 firearms, 361 Gallup polls, 131, 423 galvanic skin response (GSR), 38, 239 gamma-aminobutyric acid (GABA), 285 gastrointestinal (GI) system, 36–37 Gates, Henry, 355 gays, lesbians, and transgenders discrimination, 367–368 family life, 422–423 health, 358 same-sex marriage, 422–423 gender differences, 32 AIDS/HIV, 360–361 earnings potential, 362 eating disorders, 134 health, 357 homelessness, 363 homicide, 361 household work, 385 occupational stressors, 385–386 panic disorder, 191 poverty in old age, 362, 396 social connections, social support, 163 specific phobias, 192 stress reactivity, 11 See also women general adaptation syndrome, genital herpes, 87 genital warts, 87 “Getting involved in your community” boxes, 15 autogenics, imagery, progressive relaxation, 267 behavior management techniques, 336 campus health centers, 100 children (single-parent/dual-career families), 438 community centers, 164 diversity, 365 exercise programs, 324 illness, 65 life situations, 118 meditation, 243 noise, 142 I-4 Index nursing home, 198 nutrition, 142 relaxation techniques, 293 religious organizations, 225 sports, 324 stress management seminar, 404 stressors, 18 GI system, 36–37 glossary, G–1 to G–5 glucocorticoids, 29, 30, 32 gluconeogenesis, 30 glycogen, 30 goal setting, 160 goal-setting theory, 342 Goleman, Daniel, 4, 6, 156, 157 gonorrhea, 87 good cholesterol, 47 Graduate PLUS loans, 79 gray matter, 27 Green, Elmer, 278 grinding the teeth, 59 GSR (galvanic skin response), 38 Guided Imagery (website), 267 H H pylori, 53, 54 H2 blockers, 54 hacking, 284 half spinal twist, 286 hardiness, 198 hardiness theory, Harrington, Walt, 243 hassles, 7, 8, 139, 140 hassles scale, 140, 146 Hatcher, Robert, 435 hate attacks, 43 hate crimes, 355, 367 Hatha Yoga, 285 hay fever, 56 HDL (high-density lipoprotein), 47 headache, migraine, 54–55 tension, 55 health, 16 See also illness/disease Health Behavior and Health Education (Glanz et al.), 338 health-behavior assessment, 331 health behaviors, 331 health belief model, 340–341 health disparities, 356, 368 health ministries in African American churches, 226 “Health’s Character” (Eysenck), 46 healthy eating behavior, 133 healthy profile vs stress profile, 13 heart attack, 51 Heart Information Network, 326 heart rhythm, 53 heart rhythm meditation, 242 Heartland Forgiveness Scale, 233–234 heel up quad stretch, 322 Helicobacter pylori, 54 Help Now: Stress Management, 102 helper T cells, 45, 46 HELPGUIDE, 19 helping other people, 17 hepatitis B, 87 high blood pressure, 49, 359–360 high-density lipoprotein (HDL), 47 Hindu meditation, 237 hippocampus, 29 Hispanic Americans, 353 See also Race and ethnicity histamine, 56 histamine blockers, 54 historical overview, 3–7 HIV, 86, 360–361 Holistic-Online, 296 Holmes, Thomas, 6, 8, 138, 139 home-based work, 398 homicide, 361 homocysteine, 52 homosexuality See gays, lesbians, and transgenders hostility, 52, 184, 199 hot reactors, 43 household work, 385 househusband, 401 How to Master Stress, 119 HPV, 87 human immunodeficiency virus (HIV), 86, 360–361 human papillomavirus (HPV), 87 humor, 118, 182–183, 205–206 humorous videotapes, 44 hurdlers knee raise, 322 hurricanes, 63 hydrochloric acid, 36, 37, 53 hypercholesterolemia, 47 hypertension, 30, 36, 49–50, 132, 359–360 hypoglycemia, 136 hypothalamus, 26–27, 29 I “I” statements, 155–156 ibuprofen, 54 ICS (instant calming sequence), 288 illness/disease allergies, 56–57 backache, 58–59 cancer, 56 college students, 45 coronary heart disease, 51–53 hot reactors, 43 hypertension, 49–50 immunological system, 44–46 migraine headache, 54–55 miscarriage, 64 nutrition, 127, 132 obesity, 60 personality type, 183–186, 187 psychosomatic disease, 43–44 PTSD, 62–64 rheumatoid arthritis, 58 serum cholesterol, 47–48 sports injuries, 64–65 stroke, 50–51 tension headache, 55–56 TMJ syndrome, 59–60 ulcers, 53–54 U-shaped curve, 14 imagery, 255–257 immunological system, 7, 44–46 impatience/irritability (II), 184 in vivo desensitization, 194 incomplete stress management, 112 Indian yogis, Individual Retirement Accounts (IRAs), 395 individualism, 405 infant mortality, 358–359 inner cities, 355 Insight Meditation (Salzberg/Goldstein), 243 instant calming sequence (ICS), 288 insulin, 136 integrity vs despair, 224–225 intercessory prayer, 217, 219 internal locus of control, 188 international food guide pyramids, 131 international students, 366 interpersonal hostility assessment technique, 198 interracial marriage, 364 interruptions, 161 interventions defined, 108 emotional arousal See emotional arousal interventions life events See life-situation interventions perception See perception interventions physiological arousal See physiological arousal interventions intimate partner violence, 430–431 iPod, 137 irrational beliefs, 195, 196 irritable bowel syndrome, 37 isometric squeeze exercises, 262 J Jacobian relaxation, 258 See also progressive relaxation Jacobson, Edmund, 6, 258 Jaffe, Hirschel, 325 jealousy, 90, 99 job satisfaction, 389 job sharing, 397 job stress See occupational stress job stress management programs, 396 Job Stress Network, 39, 406 jogging, 319–321 jumping rope, 317–319 junk mail, 161 K Kabat-Zinn, Jon, 216, 289 Karasek, Robert, 383 Kennedy, Edward, 417 Kiddie QR, 288 KidsHealth, 426 Kiecolt-Glaser, J K., killer T cells, 45, 46 kneading, 284 koans, 237 L lab assessments active listening, 174–175 assertiveness, 169–170 autogenic training, 273 behavior change, 345–348 behavior change theory, 349–350 bias, 374 budgeting while in school, 105 burnout/brownout, 415 causing others stress, 303 conflict resolution, 171 diverse groups and individuals, 375–376 eustress, 121 exercise myths and facts, 330 forgiveness, 233–234 friendships, 106 hassles, 146 health indices, 73 healthy behaviors, 345–347 imagery, 274 irrational beliefs, 213–214 job stress, 412–414 lifestyle behaviors, 347 locus of control, 210 marriage, 443 mate, 444 meditation, 249 occupational stress, 411 pet therapy, 304 physical self-esteem, 209 physiological reactions to stress, 42 prejudice, 373 progressive relaxation, 275 PTSD, 71 resting metabolic rate (RMR), 145 roadblocks to exercise, 329 self-esteem, 208 sense of humor, 205–206 social support, 172–173 spirituality, 231–232 stress and illness, 72 stress psychophysiology, 41 stressors, 23, 24 test anxiety, 211–212 trait anxiety, 211 Type A personality, 207 lack of personal accomplishment, 392 large intestine, 36 Latinos, 353 See also Race and ethnicity laughter, 182–183 Lazarus, Richard, 108, 140 Lazarus’ model of appraisal, 109 Lazarus’s theory, 140 LDL (low-density lipoprotein), 47 Learning Meditation (website), 244 leg reclining lunge, 286 leg swing, 322 lesbians See gays, lesbians, and transgenders LeShan, Lawrence, 6, 56 lie detector test, 38 life-change units (LCU), 139, life events, 138–140 life-events scale, 138, 139 life-events theory, life expectancy, 359 life-situation interventions, 123–176 assertiveness, 147–150 college students, 97–99 communication, 153–156 conflict resolution, 150–153 eliminating unnecessary stressors, 123–125 Index I-5 life-situation interventions (continued) emotional intelligence, 156–158 family stress, 433–439 hassles, 140 interpersonal matters, 147–176 intrapersonal matters, 123–146 life events, 138–140 noise, 137–138 nutrition See nutrition occupational stress, 402 social support networking, 162–164 success analysis, 140–142 technostress, 158–159 time management, 159–162 lifestyle behaviors, 331, 347 limbic system, 27 Lincoln, Abraham, 182 Ling, Per Henrik, 284 lipoproteins, 47 listening, 152–153, 155 listening attitude, 175 listening skill, 175 locus of control, 188–189, 332 loudness, 138 love, 83–84, 90 Love, Courtney, 19 low-birth-weight babies, 46 low-density lipoprotein (LDL), 47 ludic love (ludus), 83 lumbar back injuries, 58 Luthe, Wolfgang, 6, 249, 251 lymphocytes, 45, 46 lymphocytosis, 56 M macrophages, 45, 46 Maharishi Mahesh Yogi, 236 maintenance stage, 339 malnourished, 125 managing anxiety formula, 196–197 Managing Stress, 102 Managing Stress: A Guide for College Students, 102 mandala, 236 manic love (mania), 83 Man’s Presumptuous Brain (Simeons), mantra, 138, 237 marital discord, 143 marital reconciliation, 139 marital selection theory, 439 marital separation, 139 marriage, 143, 420, 439 marriage protection theory, 439 Maslow’s hierarchy of needs, 389, 390 massage, 284 massage therapy, 267 masturbation, 84, 85 Match.com, 84 material reinforcement, 334 Mayo Clinic: Fitness Basics, 326 Mayo Clinic: Stress Management, 343 meditation, 6, 236–248 benefits, 237–239 blood pressure, 50 brain, and, 239, 243 consciousness, 242 dietary restrictions, 240 I-6 Index emotional intelligence, 157 figure/ground, 237 focusing of attention, 237 heart rhythm, 242 how to it, 240 mantra, 138 object of focus, 236 opening up of attention, 237 physiological effects, 238–239 psychological effects, 239 reference book, 243 secular, 242 time management, 242–243 tips/pointers, 240–242 TM, 236 types, 236–237 MEDLINE Plus, 121 medulla oblongata, 26, 27 Meili, Trisha, 289 memory, 26 memory T and memory B cells, 45, 46 meninges, 26 mental health, 16 metabolic syndrome, 60 midbrain, 26 middle costal breathing, 281 migraine headache, 54–55 Miller, Neal, 279 mind-body therapies, 267 mind-to-muscle relaxation techniques, 235 mindful breathing, 289 mindful eating, 289 mindful listening, 290 mindful walking, 290 mindfulness, 288–290 mindlessness, 288 mineralocorticoids, 30, 32 minorities See diversity and stress; race and ethnicity minority college students, 95–97 mirror neurons, 156 miscarriage, 64 Mitzvah Day, 223 mixed race college students, 364 mobility, family life, 428–429 model of stress, 109–111 modern-day stressors, 295 Monitoring for Health Hazards at Work (Ashton/ Gill), 390 monounsaturated fats, 127 motivational factors, 389 muscle relaxation exercises See progressive relaxation muscle tension, 7, 261 muscle-to-mind relaxation techniques, 235 muscles, 37 muscular endurance, 308 muscular strength, 308 music, 290–291 myocardial infarction, 50 MyPyramid, 125, 128 N NA + SI model, 187 nadam, 237 naproxen, 54 nasal switching, 282 NASP Resources: Recommended Diversity Websites, 369 National Center for Complementary and Alternative Medicine (NCCAM), 61, 267 National Center for Injury Prevention and Control, 430 National Center for Post Traumatic Stress Disorder, 66 National Child Traumatic Stress Network, 89 National Council for Adoption, 428 National Eating Disorders Association, 102 National Education Association, 426 National Institutes of Health: Behavior Change and Maintenance, 343 National Institutes of Health: Office of Behavioral and Social Sciences Research, 343 National Parent Teacher Association, 426 National Study of the Changing Workforce, 365 National Survey of Family Growth, 420 Native Americans, 353 See also Race and ethnicity natural-gait walking, 319NCCAM, 61 nervous system, 33 neuromuscular relaxation, 6, 258 See also progressive relaxation neuropeptide Y (NPY), 60 neuropeptides, 46 nicotine, 135 9/11 effects, 63 NIOSH Safety and Health Topic: Traumatic Incident Stress, 66 NIOSH/Stress at Work, 406 noise, 137–138 noise level reduction, 137 nonassertive behavior, 147 nonassertive body language, 149 nonverbal assertiveness, 148–149 nonverbal communication, 154 noradrenaline, 31, 32 norepinephrine, 31, 32, 38, 312 NPY, 60 NPY2R, 60 nuclear family, 417 nursing home, 198 nutrition, 125–137 balance, 125 dietary guidelines for Americans, 126–127 disease, 127, 132 eating disorders, 125, 134 food pyramid See food pyramid foods to limit, 129–130 healthy foods, 129–130 how to reduce stress, 136–137 Internet sites, 125, 128 pseudostressors/sympathomimetics, 135 stress, and, 135–136 Obama, Barack, 355 obesity, 60, 131, 133–135 obesity measures, 133, 134–135 occipital lobe, 27 occupational health, 16 occupational stress, 378–415 absenteeism, 381–382 burnout, 384, 392–393 child care, 399 costs of, 381–382 defined, 378 demand-control model, 387 disease, and, 365, 381, 386 effort-reward imbalance model, 387 elder care, 399 emotional arousal interventions, 403 Europe, 384 family-friendly work-related policies, 396–399 flexible work schedules, 397–398 FMLA, 397 grid, 379, 380 health promotion programs, 398–399 high-stress jobs, 383 home-based work, 398 human needs/job-related satisfiers, 390 increased risks, 384 job satisfaction, 389 job sharing, 397 job stress management programs, 396 life-situation interventions, 402 model of, 379 participation, degree of, 387 perception interventions, 402–403 physiological arousal interventions, 404 physiological effects, 386 psychological effects, 386 role problems, 387–389 stressors, 284, 387–390 technological advances (always on call), 383 turnover, 382 vacation days, 383 women, 385–386, 393–396 work-family balance, 399–400 work-related values, 388 workaholic, 390–392 occupational stress cycle, 379–382 occupational stress evaluation grid, 379, 380 occupational stress model, 379 occupational stressors, 379, 387–390 Office of Disease Prevention and Health Promotion, 313 Office of Minority Health, 370 older college students, 93–95 older persons See elderly persons online matching services, 84 online personal ads, 84 open adoption, 428 opening-up-of-attention meditation, 237 optimism, 181, 182 oral sex, 85 organ transplant, 289 Ornish, Dean, 216 Ornstein, Robert, 44 Osman, Jack, 277 osteoporosis, 132, 136 ouch technique, 193 outcome efficacy, 109 ovary, 29 oxytocin, 29, 31 P pancreas, 29 panic disorder, 190–191 paraphrasing, 155 parasympathetic nervous system, 33, 34 parasympathetic rebound, 311 parathyroid gland, 29 Parent PLUS loan, 79 parietal lobe, 27 parking ticket, 139 Parkinson’s disease, 250 patent attorneys, 51 pelvic inflammatory disease (PID), 87 Penthouse magazine, 91 peptic ulcer, 53 perceived barriers, 340 perceived benefits, 340 perceived severity, 340 perceived susceptibility, 340 perception interventions, 177–214 anxiety See anxiety management attitude of gratitude, 180–182 college students, 93–97, 100–101 family stress, 436–438 hardiness, 198 humor, 182–183 locus of control, 188–189 occupational stress, 402–403 personality type, 183–186, 187 perspective, 179–180 resiliency, 197–198 selective awareness, 177–179 stop to smell the roses, 179 type A behavior pattern, 183–186 perceptions, 177 “perfect” body, 91 performance attainment, 341 periodontists, 51 peristalsis, 37 Perkins loans, 79 Persian proverb, E–1 personal efficacy, 109 personality type, 183–186, 187 Pert, Candice, 7, 46 pessimism, 181 pet therapy, 292–295 petrissage, 284 petting a dog, 294 Pew Research Center, 423 phagocytes, 45, 46 philosophical stressors, 10 phobia, 191–192 physical exercise See exercise and health physical fitness, 3088 physical health, 16 physical needs, 390 physical strain, 11 physical violence, 430 physiological arousal, 12, 110 physiological arousal interventions college students, 101 elderly persons, 323–324 exercise See exercise and health family stress, 438 occupational stress, 404 physiological state, 341–342 PID (pelvic inflammatory disease), 87 pineal gland, 29 pioneers in stress management, 3–7 piroxicam, 54 pituitary gland, 29 PKC, 26 placebo, 64 placebo effect, 220 plaque, 50 Playboy magazine, 91 pleading religious approach to increasing control, 219 PollingReport.com, 423 polyphasic behavior, 156, 185 polyunsaturated fats, 127 pons, 26, 27 portfolio, 15 See also stress portfolio portion of situations, 113 posttraumatic stress disorder (PTSD), 31, 62–64, 339, 430 poverty, 362, 363 pranayama, 237, 285 prayer, 287 See also spirituality preattack, 54 precontemplation stage, 339 pregnancy, premarital cohabitation and, 420 prehypertension, 36 premature babies, 46 presenteeism, 398 President’s Council on Fitness, Sports & Nutrition, 326 President’s Council on Physical Fitness and Sports: Resources, 317 prevention, 113 primary appraisal, 108, 109 primary control, 218 prioritizing, 160 problem-focused coping, 403 processed flour, 136 Prochaska, James, 339 prodrome, 54 progressive relaxation, 6, 257–266 body position, 260 bracing, 258 cues identifying anxiety, 260 defined, 258 exercises, 261–264, 266 physiological effects, 259 prerequisites, 260 psychological effects, 259 simplified, quick version, 266 step-by-step instructions, 262–266 See also relaxation techniques Progressive Relaxation (Jacobson), 258 protease inhibitors, 86 protective factors, 197 protein kinase C (PKC), 26 Providence General Medical Center, 311 Prozac, 92 pseudostressors, 135 psychogenic psychosomatic disease, 44 psychological strain, 11 Psychological Stress and Cancer, 369 psychological stressors, 10 psychoneuroimmunology, 7, 44, 48 psychophysiology See stress psychophysiology psychosomatic disease, 43–44 PTSD, 31, 62–64 Puerto Rican Food Guide Pyramid, 131 Q Quaker Oats, 311 quieting reflex (QR), 288 Index I-7 R race and ethnicity AIDS/HIV, 360–361 CAM, 61 cancer, 361 college students, 94–97 death, cause of, 359 definitions, 352 family structure, 363–365 food pyramids, 131 hate crimes, 355 health msinistries in African American churches, 226 homelessness, 362–363 infant mortality, 358–359 interracial marriage, 364 life expectancy, 359 poverty, 362 prayer, 215 single-parent families, 421–422 suicide, 361 U.S population, 351, 352 See also diversity and stress race walking, 319 racial profiling, 355 racism, 354 Rahe, Richard, 6, 8, 138, 139 RAS (reticular activating system), 27 Rathus assertiveness scale, 169, 170 Reader’s Digest: Health, 200 real-world effects See Coping in Today’s World reappraisal, 108–109 recreational music, 44 reflective listening, 152–153 reflexology, 284 reframing, 219 reinforcement, 334 relabeling, 193, 195 relaxation response, 239, 240 Relaxation Response, The (Benson), 50, 287 relaxation technique trials, 235 relaxation techniques, allergies, 57 aromatherapy, 284 autogenic training, 249–255 biofeedback, 277–281 body scanning, 282–284 computer soft ware, 290 diaphragmatic breathing, 281–282 imagery, 255–257 instant calming sequence (ICS), 288 lab assessment rating scale, 235 massage, 284 medical caution, 235 meditation See meditation migraine, 55 mind-to-muscle techniques, 235 mindfulness, 288–290 muscle-to-mind techniques, 235 music, 290–291 progressive relaxation See progressive relaxation quieting reflex (QR), 288 reflexology, 285 repetitive prayer, 287 reservoir of relaxation, as, E–1 I-8 Index sounds, 138 tai chi, 291–292 tension headache, 55–56 thought stopping, 193 yoga, 284–287 religion, 216 See also spirituality religious approach to increasing control, 219 remarriage, 432 reminder system, 336 repetitive prayer, 287 reprogramming ourselves, 11 resiliency, 197–198 resistance phase, resource drain theory, 400 resting metabolic rate (RMR), 145 reticular activating system (RAS), 27 reunion years, 426 rheumatoid arthritis, 58 rheumatoid factor, 58 RICE, 311 Rinzai Zen meditation, 237 road rage, 295 roadblocks, 111–112 See also interventions Rockport fitness walking test, 314 Rockport Walking Institute, 319 role ambiguity, 388 role conflict, 389 role insufficiency, 388 role overload, 388 Ronald McDonald House, 162, 180–182, 404 rope jumping, 317–318 Rosenlund, Mats, 38 Rosenman, Ray, 6, 51, 183, 184 runner’s high, 311 S S-IgA levels, 46 safe sex, 85 safety needs, 390 saliva, 36 salivary IgA, 46 Sallie Mae smart option student loan, 79 salt, 136 same-sex marriage, 422–423 sandwich generation, 295 satisfaction with life scale, 165 saturated fat, 126, 127 saying “no,” 160 scheduling, 160 schizophrenia, 239, 285 school-associated violence, 96 Schultz, Johannes, 6, 249, 251 Schwartz, Gary, 4, scoliosis, 279 secondary appraisal, 108–109 secondary control, 218 secular meditation, 242 secular volunteerism, 222 selective awareness, 177–179 self-assessment See lab assessments self-contracting, 335 self-defeating humor, 206 self-directing religious approach to increasing control, 219 self-doubt, 94–95, 97, 114 self-efficacy, 109, 187–188, 340–342 self-efficacy theory, 341–342 self-enhancing humor, 206 self-esteem, 186–188, 208–209 Self-Esteem and Stress Management, Ezine Articles, 200 self-help groups, 336 self-monitoring, 333 self-realization needs, 390 self-talk, 193, 195 Selye, Hans, 3–5, 10 September 11 terrorist attacks, 63 serum cholesterol, 47–48 service, 17 service-learning, 222–224 sense of belonging, 335 setting goals, 160 sexual myths, 85 sexual orientation See gays, lesbians and transgenders sexual thoughts and fantasies, 85 sexual violence, 430 Sexuality Education: Theory and Practice (Bruess/Greenberg), 150 sexually transmitted infections (STIs), 85–87 shaping, 335–336 shiatsu, 284 Short-Term Therapy for Long-Term Living (website), 267 shoulder stretch, 261 shyness, 89–90, 97, 98 side leg swing, 322 significant other, 335 Simeons, A T W., Simonton, Carl, single-parent families, 421–422 60/60 rule, 137 skeletal muscles, 37 skin, 38 small intestine, 36 smart option student loan, 79 smooth muscles, 37 Sobel, David, 44 social animal, 98 social anxiety disorder, 191 social health, 16 social isolation, 173 social needs, 390 social phobia, 191–192 social physique anxiety, 191 social readjustment rating scale, 138-139 social reinforcement, 334–335 social support athletic injuries, 64 behavior change, 335 defined, 139, 162 direct effect theory, 162 forms of, 162 gender differences, 7, 163 humor, 182 immune response, 44 pets, 294 roadblock, as, 139 self-help groups, 293 spirituality, 219–220 stress buffering theory, 162 tai chi, 294 tend-and-befriend, 32 walking, 318 Weight Watchers, 342 social support networking, 162–164 social support theory, sociological stressors, 10 sodium, 136 somatogenic psychosomatic disease, 44 soothing music, 290 Soto Zen meditation, 236–237 soul prints, 225 sound, 290 source management, 113 special phobias, 192 speed walking, 319 sphygmomanometer, 49 Spielberger, Charles, 190 spillover theory, 400 spiritual disease, 225 spiritual health, 16, 215 spirituality, 215–234 advice support, 220 business, 217–218 college students, 218 defined, 216 financial support, 220 forgiveness, 220–221, 222 health, and, 216–218 informational support, 220 integrity vs despair, 224–225 major religions, 217 placebo theory, 220 resiliency, 197 service-learning, 222–224 social support theory, 219–220 volunteerism, 221–222, 223 Spirituality in Higher Education (website), 227 sports injuries, 64–65 Stafford loans, 79 stage of exhaustion, stage of resistance, stages of change theory, 339–340 state anxiety, 190 static stretching, 321 stationary bicycle, 318 Steinmetz, Jenny, 262 STIs (sexually transmitted infections), 85–87 stop to smell the roses, 179 storgic love (storge), 83 strain, 11 stress body’s reaction See stress psychophysiology brain damage, 29 causes, 10 defined, 5, 12–13 demand, 108–109 effects of, 10 model of, 109–111 performance, and, 114 Stress and Aggression Reinforce Each Other at the Biological Level, Creating a Vicious Cycle, APA Online, Media Information, 200 Stress and Communication, 166 Stress and Infertility, 439 stress appraisal, 108, 109 stress buffering theory, 162 Stress Cure, 343 stress diary, 123–124 Stress Education Center, 20, 267 Stress in College: Common Causes of Stress in College, 102 Stress Less, 143 stress management blood pressure, 50 comprehensive, 112–114 confidence, 187–188 eliminate unnecessary stressors, 123–125 goals, 14 historical overview, 3–7 interventions See interventions pet therapy, 292–295 wise vs smart, 123 The Stress Management and Health Benefits of Laughter, 200 Stress Management Associates, 267 Stress Management for Patient and Physician, 66 stress management goals, 14 Stress Management Information, 200 stress management seminar, 404 Stress Management Tip.com: Family Stress Management, 439 stress management workshops, 224 stress model, 110–111 Stress of Life, The (Selye), stress phrases, 35 stress portfolio autogenic training, 273 focusing on the positive, 178 managing anxiety formula, 196–197 meditation, 249 progressive relaxation, 275 satisfaction with life scale, 165 setting goals, 160 sexual behavior, 84–87 stress diary, 123–124 stress products, 10 stress profile vs healthy profile, 13 stress psychophysiology, 25–42 autonomic nervous system, 33–34 brain, 25–29 cardiovascular system, 35–36 endocrine system, 29–32 GI system, 36–37 muscles, 37 skin, 38 stress reactivity, 11, 12, 110, 117 stress reactivity pathways, 28 stress-related hormones, 32 stress-related illness See illness/disease stress-related national health objectives, 223–224 stress theory hardiness theory, life-events theory, social support theory, stressors defined, 3, domestic engineering, 402 eliminate, 123–125 family, 423–432, 433 minorities, and, 354–356 modern-day, 295 occupational, 379, 387–390 questions to ask, 124–125 types, 10 stretching, 321 stretching neck muscles, 261 striving to get ahead, 405 Stroebel, Charles, 288 stroke, 50–51 student exercises/activities community involvement See “Getting involved in your community” boxes control, 116 daily record of activity, 159 forgiveness, 222 portfolio See stress portfolio stress reactivity, 12 success chart, 141 target heart rate range, 313 workbook See your personal stress profile and activity workbook See also lab assessments student loan debt, 79, 81 students See college students Study Guides and Strategies: Time Management, 165 subcortex, 26, 27 subsidized Stafford loans, 79 Success: You Can Make It Happen (Swell), 140 success analysis, 140–142 success chart, 141 sugar, 136 suicide, 361 sulcus, 26 suppressor T cells, 45, 46 Swedish massage, 284 swimming, 317 symbolic stressors, 10 sympathetic nervous system, 33, 34 sympathomimetics, 135 synovial membrane, 58 syphilis, 87 systematic desensitization, 63, 193–194, 195 systolic blood pressure, 30, 36, 49 T T cells, 45, 46 T-lymphocytes, 56 T tubules, 53 tai chi, 291–292 taiji, 291 taijiquan, 291 tailoring, 333–334 Take Five: Relaxation at Your Fingertips, 290 taking charge, 125 talk therapy, 63 target heart rate change, 313–314 task-oriented coping, 108 Taylor, Shelly, 7, 11 tea, 135 techno-cocoons, 156 technological addiction, 158 technostress, 158–159 telephone operators, 295 temporal lobe, 27 temporomandibular joint, 59 temporomandibular joint (TMJ) syndrome, 59–60 tend-and-befriend, 11, 32 tension headache, 55–56 terminology (glossary), G–1 to G–5 test anxiety, 190 Index I-9 testis, 29 thalamus, 26, 27 theobromine, 135 theophylline, 135 thermal biofeedback, 279 Third Wave, The (Toffler), E–1 thoracic breathing, 281 thought management, 113 thought stopping, 193, 195 three Cs, 198 thymus, 29 thyroid gland, 29, 31 thyrotropic hormone (TTH), 28 thyrotropic hormone releasing factor (TRF), 28 thyroxin, 28, 32 TIA See transient ischemic attack (TIA) Tibetan Buddhists, 236 tightening calf muscles, 261 tightening facial muscles, 261 time diary, 162 time management, 159–162 assessing how you spend time, 159–160 college students, 162 delegating, 161 evaluating tasks once, 161 interruptions, 161 investing time, 161 junk mail, 161 maximizing your rewards, 160 meditation, 242–243 prioritizing, 160 saying “no,” 160 scheduling, 160 setting goals, 160 Timeless Healing (Benson), 50 TM (transcendental meditation), 236 TMJ syndrome, 59–60 Toffler, Alvin, E–1 trait anxiety, 190 trans fats, 126, 129 transcendental meditation (TM), 236 Transcendental Meditation Program, 244 transient ischemic attack (TIA), 50–51 transverse tubules, 53 TRF (thyrotropic hormone releasing factor), 28 trichomoniasis, 86 trophotropic response, 239 TTH, 28 Type A Behavior and Your Heart (Friedman/ Rosenman), 183 Type A behavior pattern, 51–52, 156, 183–184, 207, 437 Type B behavior pattern, 184 Type C personality, 187 Type D personality, 7, 187 U ulcers, 53–54 unethical behavior, 101 I-10 Index university See college students University of Minnesota’s Center for Spirituality and Healing, 227 unsubsidized Staff ord loans, 79 uplifts, 8, 140 upper costal breathing, 281 upper respiratory infectious illness, 48 uptight, 35 U.S Bureau of Labor, 221 V Varma, Mahest Prasod, 236 vasopressin (ADH), 29, 31, 36 vegan, 130 vegetarian, 130 verbal assertiveness, 149–150 verbal communication, 154–156 “and,” not “but,” 155 beginning with agreement, 155 “I” statements, 155–156 listening, 155 planning time to talk, 155 “why” questions, 156 verbal persuasion, 341 very deep breathing, 281 vicarious experience, 341 violence child abuse, 429–430 firearms, 361 hate crimes, 355 inner cities, 355 intimate partner violence, 430–431 weapons and school, 361 virtual reality exposure therapy, 63 visualization therapy, 56 vitamin B, 136 vitamin C, 136 vitamins, 135–136 Vogt, Oskar, 6, 249 volunteerism, 17, 221–222, 223 See also “Getting involved in your community” boxes W waist-hip ratio, 133 Walkablock Club of America, 319 walking, 318–319 walking tip toe, 322 Wallace, Robert Keith, 6, 239 warrior pose, 286 Washington Post poll, 423 weight loss, 133 Weight Watchers, 342 wellness, 16 Wellness Book, The (Benson), 50 The Wellness Community, 369 When Bad Things Happen to Good People (Kushner), 220 white blood cells, 46 white noise, 138, 290 Why Me, Why Anyone? (Jaffe), 325 “why” questions, 156 Wolf, Stewart, Wolff , Harold, Wolpe, Joseph, 193 women empty-nesters, 402 full-time homemakers, 400–402 household work, 385 retirement, 395–396 work outside the home, 393–400 work stress, 394–395 See also gender differences work and stress See occupational stress work-family balance, 399–400 work-related values, 405 workaholic, 390–392 workbook See your personal stress profile and activity workbook worksite health-promotion programs, 398 World Wide Online Meditation Center, 244 WorldCom, 101 Worthington, E L., www.choosemyplate.gov, 129 www.jmcbrooklyn.org, 237 www.mypyramid.gov, 125 www.tensionrelief.info, 284 Y years of potential life lost, 359 Yerkes-Dodson curve, 115 yoga, 284–287 Yoga Journal Magazine, 296 yogic stretching positions, 285, 286 “you” statements, 156 younger college students, 76–93 your personal stress profile and activity workbook autogenic training, 273 body scanning, 282 contract of commitment, 117 diaphragmatic breathing, 281 ICS, 288 meditation, 249 mindfulness, 288 nasal switching, 282 perception interventions, 177 progressive relaxation, 257, 275 social phobia, 191 social support networking, 162 Z Zen meditation, 237 Zen monks, .. .Comprehensive Stress Management fourteenth edition Jerrold S. Greenberg Professor Emeritus, University of Maryland COMPREHENSIVE STRESS MANAGEMENT, FOURTEENTH EDITION Published by McGraw-Hill... intervention 108 Coping with a Stressor 108 A Model of Stress? ?? 109 Feedback Loops in the Stress Model 111 Setting Up Roadblocks 111 Comprehensive Stress Management? ?? 112 Eustress and the Model 114... What Is Stress? 19 charge of their health and well-being and make healthy choices Among these is the management of stress Stress Education Center www.dstress.com A site devoted to stress management