Stress

Stress

Acute Stress
1. Stress is experienced when a persons perceived environmental, social and physical demands exceed their ability to cope.
2. ANS: Subdivided into SNS and Parasympathetic branch
3. Sympathomedullary Pathway: Influence of SNS and adrenal medulla prepares body for fight/flight
4. Acute stress activates the ANS
  1. ANS=SNS + Parasympathetic branch
    1. SAM + SNS= sympathomedullary pathway
      1. SNS= fight/flight parasympathetic branch = relaxation
        SNS sends messages to organs, release of noradrenaline
        increased heart rate, pupil size + mobilise fat + glucogen= engery
        SAM alerts body to release adrenaline
        SAM regulated by SNS + adrenal medulla, above kidneys
        Adrenal gland has 2 zones, adrenal medulla +cortex
        Adrenaline boosts oxygen + glucose + suppresses non-urgent bodily functions
Chronic Stress
1. Chronic stress is caused by chronic stressors. A chronic stressor is somethings that is ongoing therefore the body doesn't heed to react as quickly.
2. The PAS is also known as the HPA Axis
  1. HPA Axis controls cortisol, the stress hormone
    1. When a chronic stressor is perceived the hypothalamus activates
      1. the PVN in the hypothalamus causes CRF to be released
        CRF travels to pituitary gland through blood and releases ACTH
        ACTH travels through blood stream to adrenal glands at the top of the kidneys
        Adrenal cortex release cortisol which is responsible for stress effects
        Low pain, burst of energy High blood pressure, impaired cognitive performance
        20 minutes to take effect, sharp rise in coritsol
        feedback system regulates hormones
Stress and Illness
1. Definitions
  1. Antigen: Bacteria, viruses, toxins and parasites
  2. Leucocyte: White blood cell, able to engulf and destroy antigens
  3. Lymphocite: Type of white blood cell
  4. NK Cell: 'Natural killer' cell, able to attack antigens and tumours
  5. Punch Biopsy: A small wound inflicted by a researcher to investigate the healing process
2. How the immune system defends against antigens
  1. barrier created to stop antigens entering e.g mucus in airways
    1. detecting + eliminating antigens if they do enter before they reproduce
      1. eliminating antigens once it started to reproduce
3. Role of Cortisol
  1. The cells of the immune system are sensitive to cortisol
  2. Fluctuations in cortisol may lead to altered immune functioning
  3. Over Vigilance: the immune system mistakenly attacks cells which are not antigens creating illness
  4. Under Vigilance: letting the infections enter without being dealt with effectively
4. Evaluation
  1. health is slow to change, therefore difficult to show effect of specific stressors
  2. long term effects would need longitudinal research which is expensive and time consuming
  3. cant establish a causal relationship as health is affected by many factors e.g genetic influences and lifestyle
5. Research Evidence
  1. Acute Stressors
    1. Kiecolt-Glaser et al (1984):
      1. A- importance of examinations on medical students
      2. M- blood samples 1 month before + during exam period
      3. R- NK cells activity was reduced in second sample
      4. C- Suggest short term stressors reduce immune functioning
    2. Marucha et al (1998)
      1. punch biopsies in mouths of students in summer holidays, and 3 days before their exams
      2. the wound inflicted nearer the exams took 40% longer to heal
  2. Chronic Stressors
    1. Kiecolt-Glaser et al(1987)
      1. Compared women separated from their partners, with matched married couples
      2. poorer immune functioning was found in women who had recently separated
    2. Kiecolt-Glaser et al (2005)
      1. found that blister wounds on the arms of married couples healed slower after a confliting rather than supportive discussion
    3. Malarkey et al (1994)
      1. 90 newly weds studied of 24 hours
      2. Discuss and resolve martial issues, which led to changes in adrenaline and noradrenaline
        led to poorer immune functioning
  3. Evans et al (1994)
    1. Students gave talks to other students (mild, but acute stress
    2. found increase in mucas in airways, but decrease before + during exam periods stretching several weeks
    3. Suggests stress may increase efficiency in short-term acute stress but down regulate for chronic stress
Stress and Life Changes
1. The events which necessitate major transitions in a certain aspect of a persons life
2. Holmes and Rahe (1967)
  1. developed SRRS to measure life changes
    1. 400 people rated 43 life changes on level of readjustment, marriage being a baseline of 50
      1. scores were totalled and averaged
  2. Testing SRRS: Normal participants 2700 men aboard US navy cruiser
    1. completed before tour of duty noting all life events they had experienced within the past 6 months
      1. Illness score was calculated based on illness during tour
        Rahe et al: found positive correlation between LCU + illness
        not a strong correlation but robust and consistent
        supports Holmes + Rahe (1967) that life changes is linked to illness
        implies life changes leads to stress
3. Evalutation
  1. x Rahe (1974): Found test-retest reliability depends on length of time between test and retest
    1. + research in general was found reasonably reliable
      1. + Hardt et al (2006): asked about childhood experiences with a time lag of 2.2 years and found moderate-good reliability
  2. Reliant on Correlational Data
    1. ill people more likely to report life changes?
    2. Brown (1974): Anxious people are more likely to report negative life events and be prone to illness
  3. Positive + Negative Events
    1. event itself/quality of event that causes stress?
  4. Individual Differences
    1. relates to idea of quality rather than event
    2. e.g unexpected death of a spouse is going to be more stressful
  5. Daily Hassles
    1. Lazarus (1990): these major events in the SRRS are actually fairly infrequent
    2. for most people its not the major life events which causes stress, but the everyday occurences
Daily Hassles
1. minor day to day stressors which may frustrate or annoy a person
  1. e.g losing things, traffic, appearance, finances, deadlines
    1. alone these are unlikely to cause stress but when several occur regularly this may lead to stress
2. Uplifts: Small positive experiences which may offset some of the hassles
  1. e.g receiving praise, unexpected tax rebate, complements
    1. Daily hassles and uplifts can be measured on the HSVP (The Hassles adn Uplifts Scale) created by Delongis et al (1982)
3. Supporting Evidence
  1. Bouteyre et al: relation between hassles + mental health in transition from school to uni
    1. Students completed HSVP and Beck Depression inventory
      1. Showed depressive symptoms - Positive correlation
  2. Gervais: nurses kept diaries for a month recording hassles and uplifts
    1. asked to rate their performance at work
      1. hassles were found to significantly contribute to increased job strain + decreased performance
4. Accumulation effect
  1. research suggests daily hassles are more significant source of stress for most people than major life events
  2. accumulation of hassles = persistent irritation and frustration, which creates anxiety and depression
5. Amplification effect
  1. major life events make you more vunerable to hassles
  2. presence of major life change may deplete resources needed to cope with minor stressors
    1. therefore daily hassles cause stress as a result of stress from life events
6. Evaluation
  1. Methodological problems
  2. Retrospective recall: participants forget teh stress of an event if rating it later in life
  3. Diary Method: Validity problems, unsure if all events were recorded
    1. Could be affected by social desirability or demand characteristics
  4. cause and effect: may be other factors that cause stress for example personality
    1. no causal relationship
Workplace Stress
1. Job Strain Model
  1. Marmot et al investigated JSM which states the workplace causes stress, therefore illness; due to high workload and low job control
    1. they suggested high grade civil servants would experience high workload and low grade civil servants would experience low job control
      1. This suggests they would both experience stress but for different reasons
        Marmot et al found no link between high workload and stress related illness
2. Johansson found those responsible for sawing rather than maintenance work felt a sense of responsibilty for the whole company
  1. This stress was measured by self report (of feelings and caffeine use) and also regular urine samples
    1. results showed those responsible for sawing has higher levels of stress and adrenaline than those responsible for maintenance
3. Marmot et al assessed 7372 civil servants in London for signs of cardiovascular disease and checked 5 years later
  1. he found people in highest grades of civil service has developed fewest cardiovascular problems
    1. those highest grades expressed feelings of control over their work and reported good levels of social support
Personality and Stress
1. Friedman and Rosenman created the type A personality
  1. Highly achievement motivated
  2. impatience + time urgency
  3. competitiveness + achievement striving
  4. Hostility + aggression
  5. believed these 3 factors would lead to raised blood pressure and stress hormones and inparticular conorary heart disease (CHD)
2. Type B: opposite to type A; patient, relaxed and easy going therefore less vunerable to stress related illness
3. Supporting evidence for Type A
  1. Western Collaborative Group Study, participants examined for signs of CHD + assessed for personality type
    1. relationship was seen between stress + illness e.g cardiovascular probles and increased likelihood towards risk factors e.g smoking
4. Evaluation
  1. Ragland + Brand: Follow up research found approx 15% of the men died of CHD
    1. confirms importance of risk factors and CHD but not the link between Type A and morality
  2. Myrtek: analysis of 35 studies
    1. found hostility to be linked to CHD but no other factors of type A
      1. undermines link between type A and stress related illness
Hardy Personality and Stress
1. Definitions
  1. Hardy Personality: Characteristics which appear to provide defence against the negative effects of stress
  2. The 3 Cs
    1. Control: in control of their lives rather than controlled by external factors
    2. Commitment: involved with world around them, strong sense of purpose
    3. Challenge: see challenges as problems to overcome rather than threats or stressors. Enjoy change as oppurtunity for development
2. Supporting
  1. Maddi et al:
    1. Studied employees that was dramatically reducing workforce
      1. 2/3 suffered stress related health problems over the year, 1/3 thrived
        1/3 showed more evidence of hardiness attributes
  2. Lifton et al:
    1. measured hardiness of student to see if hardiness was related to likelihood of completing degree
      1. among dropouts, little showed low scores on the 3 Cs
        Students who scored highly on the 3 Cs were more likely to complete their degree
3. Limitations
  1. Hardiness + Negative Affectivity
    1. 3 Cs not characteristics but way of thinking about success and failure?
    2. some people dwell on failure, report more distress +dissatisfaction + focus on negative characteristics
      1. referred to as high negative affectivity
        negative affectivity and hardy personality are negatively correlated
        Suggests those 'hardy' are low in negative affectivity
Psychological Methods
1. cognitive approach: Challenging negative thought
2. Behavioural Approach: rewarding desirable behaviours
3. STEP 1-Conceptualisation Phase
  1. Therapist and cliient establish relationship and identify stress sources
4. STEP 2-Skills acquisition phase
  1. Coping skills taught and practised initially in clinic then rehearsed in real life (positive thinking, relaxation
5. STEP 3-Application Phase
  1. Encouraged to use coping skills in real life and therapist monitors client
6. Evalutation
  1. + focuses on challenging what stressors are and teaches techniques
  2. + can be applied to many individuals
  3. found to be more effective than other forms of stress managment
  4. Sheeky + Horan
    1. + examined effects of SIT on anxiety, stress and academic performance in law students
      1. + found those with SIT sessions had lower anxiety and higher academic performance
  5. x SIT takes time, commitment and money, due to 1-1 therapy over a long period of time
7. Stress Inoculation Training (SIT)
  1. Michebaum developed this to deal with stress
  2. Suggests an individual should develop a form of coping before stress arises
Physiological Methods
1. Physical aspects of behaviour and these managements focus on physical ways in which the body responds
2. Benzodiazepnes (BZs)
  1. slow activity of CNS and enhances natural action of GABA
    1. GABA is natural form of anxiety relief, it locks onto receptors on surface of neuron, increasing how of Cl irons into neuron
      1. Cl ions slow down CNS activity making someone feel more relaxed
        BZs bind to GABA sites and allow even more Cl ions to flow into neuron
  2. Evaluation
    1. + Kahn (1986): followed 250 patients over 8 weeks and found BZs were significantly superior to placebos
    2. + Hildago (2001): meta analysis found BZs more effective at reducing anxiety than other antidepressants
    3. x Patients can show withdrawal symptoms
    4. x Ashton (1997): BZs should not be used and 4 weeks
    5. x Negative side effects such as paradexical symptoms (aggressiveness and cognitive effects)
3. Beta Blockers (BBs)
  1. reduce activity of adrenaline and noradrenaline by binding to receptors on heart cells and other organs stimulated during growth
    1. block receptors making it harder to stimulate cells
      1. puts less pressure on body and person feels calmer and less anxious
      2. Enter text here
  2. Evalutation
    1. + used in real life settings to reduce anxiety and more effective (snooker players)
    2. x Some research has linked BBs with increased risk of developmental diabetes

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