Stress

Stress

Acute
1. Response
  1. Autonomic nervous system (ANS) - automatic response
    1. Sympathetic nervous system (SNS) - Prepares fight or flight
      1. Sympathetic Adrenal Medullary (SAM) - Promotes adrenaline release
        Sympathomedullary Pathway
        Regulated by Adrenal medulla and releases adrenaline
        Adrenaline - Increases oxygen and glucose supply also suppressed non urgent bodily functions
      3. Neurons from the SNS prepare for fight or flight
        Noradrenaline is released - Increased heart rate, blood pressure, cardiac performance, pupil size and extra energy from glycogen energy
    2. Parasympathetic branch - Returns you to a state of relaxation
Chronic
1. Response
  1. Hypothalamic Pituitary Adrenal axis (HPA axis) - Controls cortisol levels and activates with chronic stressor
    1. Paraventricular nucleus (PVN) controls Corticotrophin releasing factor (CRF)
      1. CRF travels to the pituitary gland which releases Adrenocorticotrophin hormone (ACTH)
        ACTH travels to the adrenal gland (cortex) which controls cortisol release
        Cortisol - Dulled pain, Quick energy burst, Cognitive impairment, high blood pressure and lower immune response
        Full process takes 20 minutes, then there is a sharp increase of cortisol.
        Feedback system in the hypothalamus and pituitary gland monitors cortisol and releases CRF and ACTH accordingly
Illness
1. Terms: Antigen Luecocyte Lymphocyte NK cell Punch Biopsy
2. Immune system
  1. 1. Creates a barrier to prevent antigens entering the body
  2. 2. Detects and eliminates antigens if they do make it into the body
  3. 3. Eliminating antigens once they start to reproduce
3. Cortisol levels can affect the immune system
  1. Over vigilance - attacks healthy cells
  2. Under vigilance - Letting infections enter
4. Research
  1. Kiecolt-Glaser et al. NK cells low at exam time (acute stress reduce immune system)
  2. Malarkey et al. Newlyweds argument fluctuating adrenaline
  3. Evans et al. antibodies improve in short term reduce in long term
  4. Segerstrom and Miller meta-analysis agreed with Evans
  5. Evaluation Lazarus
    1. Too many variables
    2. Health is slow to change
    3. Requires longitudinal research
Life changes
1. Social readjustment rating scale (SRRS)
  1. Holmes & Rahe
  2. Rated life changes
  3. Theory
  4. Tested on navy
    1. Life changes over 6 months illness score calculated
    2. Life change correlated with illness
2. Evaluation
  1. Not causal
  2. Positive/Negative effects
  3. Recollection of life events poor
  4. Lazarus suggested that major events have little effect
Hassles
1. Hassles vs. Uplifts
  1. Delongis et al. (1982)
2. Accumulation effect
  1. Small issues more stressful
3. Amplification
  1. major changes make you more susceptible
4. Methodological problems
  1. retrospective recall
5. Cause and effect
6. Bouteyre et a. (2007) Daily hassles made you more depressive
Workplace stress
1. Job strain: high workload low job control
  1. Stress in both low and high end jobs
2. Marmot et al. (1997) checked both ends of spectrum and 5 years later
  1. Workload - No link
  2. Job control - correlation (heart disease)
3. Work underload had similar effects to low control
4. Mental health - high stress makes depression more likely
Personality
1. Type A - self motivated impatient hostile
2. Type B - Patient relaxed
3. Hardy - Control Commitment Challenge
4. Friedman & Rosenman - Type A x2 risk of CHD
5. Myrtek 2001 meta-analysis 35 studies link between hostility and CHD
6. Kobasa (1979) - high levels of 3c's less illness (business execs)
7. Negative affectivity - 3c's are irrelevant its all to do with how you think about the problem
  1. high NA stuck on failure
Stress management
1. Psychological
  1. Stress Inoculation Training (SIT)
    1. Change perception of problems
    2. Establish stressors
    3. Coping mechanisms
    4. Applying methods
    6. Challenges stressors
    7. Takes time & money
  2. Hardiness Training
    1. Identify stress
    2. Reliving events
    3. taught to see stressors as challenges
    4. teaches them how to cope
    5. Takes time & money
2. Biological
  1. Benzodiaziapenes (BZs)
    1. enchance GABA funtioning
    2. more chloride ions reduce anxiety
    3. Kahn (1986) superior to placebo
    4. Addiction
    5. Paradoxical side effects
  2. Beta-Blockers (BBs)
    1. reduce adrenaline (stress reaction)
    2. Decreased BP
    3. Real life application (sports)
    4. Diabetes side effects

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