Stress

Anlagen:

• Acute Stress

1. Acute stress activates the autonomic nervous system.
   1. ANS subdivided into: - Sympathetic nervous system - Parasympathetic branch
      1. SNS prepares body for fight or flight, parasympathetic branch returns body to a state of relaxation.
         1. Sympathetic adrenal medullary is combined with the SNS to create the sympathomedullary pathway.
            1. SAM releases adrenaline. Adrenaline boosts oxygen and glucose supplies and supressed non urgent bodily functions.
               1. SAM I regulated by the SNS and the adrenal medulla - just above the kidneys. The adrenal gland has two zones - adrenal medulla and adrenal cortex.
            2. SNS sends messages via neurons to most body organs and causes the release of noradrenaline - a neurotransmitter.
               1. Noradrenaline increases heart rate, pupil size and mobilises fat and glycogen which provides energy.
2. Caused by acute stressors - something which happens suddenly, body has to react quickly.

Anlagen:

• Chronic Stress

1. The pituitary adrenal system AKA hypothalamic pituitary adrenal axis (HPA axis).
   1. HPA axis controls levels of cortisol - activated by physical or emotional stressors.
      1. When chronic stressor is perceived the hypothalamus activates.
         1. A region of the hympothalamus, paraventricular nucleus (PVN), causes corticoptrophin releasing factor (CRF) to be released.
            1. CRF travels to the pituitary gland. Pituitary gland releases adrenocorticotrophin hormone (ACTH).
               1. ACTH travels to the adrenal gland above the kidneys.
                  1. Part of the adrenal gland, the adrenal cortex, causes cortisol to be released.
                     1. Cortisol has postive effects: + lower pain sensitivity + quick burst of energy
                     2. and negative effects: - impaired cognitive performance - higher blood pressure - lowered immune response
2. Cause by chronic stressors - something that is on going, body doesn't need to react as quickly.

1. Cardiovascular Problems
   1. Increased blood pressure, physical damage of blood vessel lining.
2. Immunosuppression
   1. Cortisol suppresses immune system, feedback system to level out cortisol may break down under prolonged stress.
3. Individual
   1. Fight or flight response for males, tend and befriend response for females.

Anlagen:

• Stress Related Illness

1. Immune System
   1. Creating a barrier to prevent antigens entering - e.g. mucus in your airways.
      1. Detecting and eliminating antigens if they do enter the body before it can reproduce, preventing you from getting ill.
         1. Eliminating the antigen once it has started to reproduce, i.e. getting you better once the virus/illness has started.
   2. Role of Cortisol
      1. Under-vigilance - letting infections enter without being dealt with effectively.
      2. Over-vigilance - the immune system mistakenly attacks cells which are not antigens, creating illness.
2. Acute Stressors
   1. Kiecolt-Glaser et al (1984) - medical students exams, blood samples month before and during exam period. NK cell activity reduced in exam period.
3. Chronic Stressors
   1. Kiecolt and Glaser (2005) - blister wounds on arms of married couples healed slower after conflicting discussions discussions not supportive.
   2. Kiecolt and Glaser (1987) - women separated with matched married controls. Poorer immune functioning in women recently separated.
   3. Malarkey et al (1994) - 90 newlyweds 24 hour period discussion to resolve marital issues. Changes in adrenaline and noradrenaline, poor immune.
4. Stressors Enhancing Immune System
   1. Evans et al - short term stress can increase levels of slgA, which help protect against infection.
5. Evaluation
   1. Research Support
      1. Segerstrom and Miller (2004) - 293 studies over previous 30 years. Acute stress; boost immune system, chronic stress; supress immune system.
      2. Marucha et al (1998) - punch biopsies students summer and 3 days before exams. Took 40% longer to heal near exams.
   2. Stress Can Enhance Immune System
      1. Evans et al - short term stress can increase levels of slgA, which help protect against infection.
   3. Not Simple Relationship
      1. Lazarus (1992) - suggested a number of reasons why it is difficult to establish a relationship between stress and illness.
         1. Health is affected by many factors. E.g. lifestyle may affect health and stress. This is a problem of using correlational data.
         2. Health is slow to change, so is difficult to show the effect of specific stressors.
         3. For long term effects, longitudinal research would have to be conducted. This is expensive and time consuming so is not done often.
   4. Individual Differences
      1. Kiecolt-Glaser et al - women show more adverse immunological changes in the way they react to chronic stressors.
      2. Segerstrom and Miller - as people age, stress has greater effect on immune system functioning making it harder for body to regulate itself.

1. Research
   1. Rahe et al (1970) - military version, SRE, given to over 2700 men. Taken before tour of duty. Illness score was calculated on the basis of the number,
      1. Positive correlation between LCU (life change unit) score and illness score of +118. Scored low in term of their SRE score, low levels of illness.
   2. Michael and Ben Zur (2007) - 130 men and women. Half recently divorced & half recently widowed. They looked at levels of life satisfaction.
      1. Divorced: lower before separation. Widowed: higher before bereavement. Can change life changes into a positive experience in some cases.
2. Evaluation
   1. Spurious Relationship
      1. Only correlational data, can't establish causal relationship between life events and stress related illness. Possibly a 3rd variable.
   2. Individual Differences
      1. Impact of events varies from person to person, hard to predict illness from SRRS scores alone.
   3. Life Changes and Daily Hassles
      1. Relatively minor daily hassles are more likely to be significant cause of stress. DeLongis et al - relationship between health and daily hassles.
   4. Positive and Negative Effects
      1. Any life event risks health as needs readjustment. Critics argue only undesired, unscheduled and uncontrolled changes tend to be really harmful.
   5. Real-World Application
      1. Heikken and Lonnqvist - life events such as financial problems, physical illness and unemployment have been found to predict likelihood of suicide.
   6. Reliability & Validity
      1. Brown (1974) Unwell ppl feel need a reason for being ill so more likely to report life changes. Retrospective data is questioned on its validity.
3. SRRS
   1. The social readjustment rating scale. Developed by Holmes and Rahe. Measures life changes.

Anlagen:

• Daily Hassles

1. Research
   1. Bouteyre et al (2007) - correlational analysis of daily hassles and mental health, students transitioning from school to uni.
      1. Completed hassles questionnaire and depression inventory. Over 40% suffered depressive symptoms, positive correlation of hassles scale and depression.
   2. Gervais (2005)
      1. A- To investigate the effects of daily hassles and uplifts.
      2. M- Nurses kept diaries for a month recording their daily hassles and uplifts at work. They were also asked to rate their performance at work.
      3. R- Hassles significantly contribute to increase job strain and decrease performance. Also felt that uplifts counteracted some of the stress they felt
      4. C- Daily hassles increase stress however uplifts can negate some of their effects.
   3. Flett et al - life events differ from daily hassles in extent of seeking and receiving social support.
      1. Negative effects of daily hassles due to reduced social support.
2. Daily hassles - the minor day to day stressors which may frustrate or annoy a person.
3. Evaluation
   1. Accumulation Effect
      1. Accumulation of daily hassles creates persistent irritation and frustration which then creates more serious reactions such as anxiety and depression.
   2. Amplification Effect
      1. Major life changes may make you more vulnerable to daily hassles.
   3. Methodological Problems
      1. Retrospective recall for most research, unreliable, as we often forget events, particularly routine or everyday ones.
   4. Cause and Effect
      1. Although research identifies a correlation this does not mean that hassles directly impact stress. Potentially other factors, no causal relationship.

Anlagen:

• Workplace Stress

1. Job Strain Model
   1. States that workplace causes stress and therefore illness due to high workload & low job control.
2. Research
   1. Marmot et al (1997)
      1. A- To investigate the job strain model.
      2. M- 7372 civil servants in London were assessed on these factors and checked for signs of cardiovascular disease. They were then checked after 5 years.
      3. R- No link between workload and stress illness. People who had reported low job control were more likely to have developed heart disease.
      4. C- Low levels of job control is a factor associated with stress related illness.
   2. Johansson et al (1978)
      1. A- To investigate the effects of performing repetitive jobs which require constant attention and some responsibility.
      2. M- Measured the stress of Swedish sawyers using self-report techniques (of feelings and caffeine use) and also regular urine samples.
      3. R- Those responsible for sawing had higher levels of stress and adrenaline than those responsible for maintenance.
      4. C- Performing repetitive jobs that require constant attention and responsibility cause more stress.
3. Role Conflict
   1. Role conflict occurs when experiences at work interfere with life outside of work.
   2. Pomaki et al (2007) - higher levels absenteeism, lower levels performance & poorer physical & mental health for those experiencing role conflict.

1. Type A
   1. Friedman & Rosenman created the idea of a type A personality. This is someone who is very self-motivated and achievement driven.
   2. Characteristics
      1. Impatience & urgency. Competitiveness. Hostility & aggression.
      2. Friedman & Rosenman predicted that these characteristics lead to increased blood pressure and stress hormones (cortisol). More likely suffer CHD.
   3. Research
      1. Friedman & Rosenman
         1. A - to assess the link between type A personality and the risk of coronary heart disease (CHD).
         2. M - 3000 Californian men aged 39-59 examined for signs of CHD. Interviewed identify personality. Followed up medically.
         3. R - Type A: Heart attack; 12.8%, Recurring heart attack; 2.6%, Fatal; 2.7%. Type B: Heart attack; 6%, Recurring heart attack; 0.8%, Fatal; 1.1%.
         4. C- Those with type A personality are more likely to suffer from stress related illness such as coronary heart disease.
      2. Ragland & Brand (1988)
         1. 15% of the men had died from CHD, link between risk factors such as smoking and drinking with CHD but not the link between type A personality.
         2. Follow up of Friedman and Roseman.
      3. Myrtek (2001)
         1. 35 studies, found a link between hostility and CHD, but not with the other characteristics of a type A personality.
2. Hardy Personality
   1. Characteristics
      1. Control
         1. They see themselves as in control of their surroundings and are not controlled by external stimuli.
      2. Commitment
         1. They are involved in the world around them with a strong sense of purpose.
      3. Challenge
         1. They enjoy challenge and perceive stressors as obstacles to be overcome.
   2. Research
      1. Maddi et al (1987)
         1. Studied employees of a company that was reducing its workforce. 2/3 of employees suffered SRI over the period of a year but 1/3 thrived. 1/3 has 3 Cs.
      2. Lifton et al (2006)
         1. Hardiness in students to see link between hardiness & probability of them completing their degree. Low on the 3 C’s were less likely to complete cours
      3. Kobasa (1979)
         1. 800 American business executives using the SRRS. 150 - high stress. Some high some low illness. Those with all or most of the 3 C’s had lower illness.
   3. Evaluation
      1. Negative Affectivity (NA)
         1. Watson & Clark (1984) - argue that the characteristics of the hardy personality can be more simply explained by the concept of negative affectivity.
            1. High NA ppl are more likely to report distress and dissatisfaction, dwell more on their failures and focus on the negative aspects of themselves.
            2. Suggests that those with the hardy personality simply have low NA.
      2. Problems of Measurement
         1. Most of the research on hardiness and health has relied upon self-report questionnaires.
         2. Some studies show low internal reliability for the challenge component of hardiness.

Anlagen:

• Stress Management

1. Biological Methods
   1. Benzodiazepines (BZs)
      1. Used to treat anxiety and stress.
      2. Slow the central nervous system.
         1. GABA is the body’s natural form of anxiety relief.
            1. BZs enhance the action of GABA by binding on to the receptor.
               1. This allows more chloride ions to enter the neuron making it more resistant to excitation.
                  1. Brain’s output of excitatory neurotransmitters is reduced.
      3. BZs reduce the reduce increased serotonin levels which in turn reduces anxiety.
      4. Evaluation
         1. Strengths
            1. Hildalgo et al - conducted a meta-analysis and found that BZs were more effective at reducing anxiety than other anti-depressants.
            2. Kahn et al - followed 250 patients over 8 weeks. He found that BZs were superior to placebos.
         2. Weakness
            1. BZs can be addictive, patients exhibited withdrawal symptoms when they stopped taking the drug. Ashton (1997) BZs should be limited to 4 weeks.
            2. BZs can have side effects. BZs can cause ‘paradoxical’ symptoms such as increased aggression and cognitive side effects.
   2. Beta-Blockers (BBs)
      1. BBs reduce the activity of adrenaline and noradrenaline which are part of the sympathomedullary response to stress.
      2. BBs bind to beta-receptors on cells of the heart and other parts of the body stimulated during arousal.
         1. Cause a slower heart rate and blood vessels don’t contract as easily meaning decreased blood pressure which in turn causes less stress on the heart.
      3. Evaluation
         1. Strengths
            1. BBs have real world applications. For example they are used by musicians and sports where precision is important such as snooker.
         2. Weaknesses
            1. BBs can have side effects. Most people do not experience side effects with BBS, however there have been some links made with diabetes.
2. Psychological Methods
   1. Stress Inoculation Training
      1. Meichenbaum - can change way we think abotu stressors. people can be trained to inoculate themselves against stress.
      2. It involves...
         1. Conseptualisation
            1. Clients are taught to think differently about stressors i.e. as problems that can be solved.
         2. Skills Aqcuisition
            1. Coping skills are taught and rehearsed in real life.
         3. Application
            1. Learned coping skills are applied in increasingly stressful situations.
      3. Evaluation
         1. Strengths
            1. Effectiveness
               1. Meichenbaum - compared SIT with SD, both effective but SIT helped reduce fear with a second untreated phobia.
            2. Reducing Academic Stress
               1. SIT sessions reduced anxiety and stress among students as well as improving performance.
            3. Prep for Future Stressors
               1. SIT gives clients skills so they are less adversley affected by future stressors.
         2. Weaknesses
            1. Time Consuming & Requires High Motivation
            2. Unneccessarily Complex
               1. SIT can still be achieved with just some of its elements.
   2. Hardiness Training
      1. Kobas and Maddi - identified hardy personality.
      2. It involves...
         1. Focusing
            1. The client is taught to recognise sources of stress.
         2. Reliving Stress Encounters
            1. The client is given an insight into current coping startegies by reliving previous encounters and their response.
         3. Self-improvement
            1. These insights can be used to move forward and learn new techniques.
      3. Evaluation
         1. Stengths
            1. It works
               1. Shown to be effective in many different populations.
            2. Real World Application
               1. Used to increase commitment to training in Olympic swimmer, helps control aspect of daily life that might interfere.
         2. Weaknesses
            1. Overcoming Bad Habits
               1. Training must address basic aspects of personality and learned habits of coping. Therefore, hardiness training cant be seen as rapid solution.