Stress

Stress

Daily Hassles
1. Minor day-to-day stressors
2. Uplifts
  1. Small positive uplifts
3. Hassles and uplifts measured with Hassles and Uplifts Scale (HSUP)
4. Supporting Research
  1. Bouteyre et al
    1. Relationship between hassles and mental health during transition from school to university
    2. First year students at French university to complete hassles part of HSUP & Beck Depression Inventory
    3. 41% showed depressive symptoms > positive correlation between hassles score and depressive symptoms
  2. Gervais
    1. Nurses kept diaries for a month recording hassles and uplifts at work > Also asked to rate performance
    2. After a month hassles had contributed to increased job strain & decreased performance > Uplifts counteracted some stress
5. Accumulation Effect
  1. Persistent irritation
    1. More serious reactions
      1. Anxiety & depression
6. Amplification Effect
  1. Major life change adds vulnerability to daily hassles
  2. Major life change depletes resources needed to cope with minor stressors
  3. Hassles cause stress because of stress from life change
7. Limitations
  1. Retrospective Recall
    1. Research involves asking ppts to rate hassles over time period
    2. Overcome by using diary
  2. Cause and Effect
Workplace Stress
1. Job-Strain Model
  1. Workplace causes stress and therefore illness
  2. Marmot et al
    1. High grade civil servants=high workload > Low grade civil servants=low control
    2. > 7372 in London assessed for factors/signs of cardiovascular disorder > checked 5 years later
2. Workload
  1. Marmot et al
    1. No link between workload and stress illness
  2. Johansson et al
    1. Responsibility for sawing felt responsibility for whole company
    2. Stress measured=Self-report (feelings & caffeine use) > Regular urine samples
    3. Responsibility for sawing=Higher stress levels
3. Control
  1. Marmot et al
    1. High link between control and stress illness
4. Role Conflict
  1. Pomaki et al
    1. High absentee levels, low performance levels, poor physical and mental health in those experiencing role conflict
      1. Role conflict linked with emotional exhaustion, depressive symptoms and body complaints.
Stress and Illness
1. Immune system defends against antigens
  1. Role of Cortisol
    1. Immune system sensitive to cortisol
      1. Under vigilant - letting infections enter without being dealt with effectively
      2. Over vigilant - attacking cells which aren't antigens
  2. Barrier created preventing entry for antigens
    1. Eliminating antigens once they've entered the body
      1. Eliminating antigens once they have started to reproduce
2. Acute Stressors
  1. Marucha et al
    1. Punch biopsies in mouths of students > Summer and 3 days before exams
      1. Wounds near exam 30% longer to heal
  2. Kiecolt-Glaser et al
    1. Impact of important exams on medical students from French university
      1. Blood samples analysed month before and during exams
        NK cells reduced in second sample
3. Chronic Stress
  1. Kiecolt-Glaser et al
    1. Blister wounds on arms of married couples
      1. Slower healing after conflicting discussions
  2. Malarkey et al
    1. 90 newlyweds over 24hrs > Asked couples to discuss and resolve martial issues
      1. Leads to changes in adrenaline / noradrenaline > could lead to poor immune functioning
4. Stressors enhancing immune system
  1. Evans et al
    1. Activity of antibody sIgA > Students gave small talks to one another (mild acute stress)
      1. Increase sIgA but decrease in same students during exams
5. Segerstrom and Millar
  1. Meta-analysis of 2935 studies
    1. Long term chronic stress suppresses immune system
    2. Short term acute stress boosts immune system
6. Evaluation
  1. Lazarus
    1. Difficult to establish relationship between illness and stress
      1. Showing long term effects requires longitudinal research
        Expensive and time-consuming
    2. Health affected by many factors
      1. Problem with correlational data
    3. Health is slow to change
      1. Difficult to show effect of specific stressors
Stress and Life Changes
1. Holmes and Rahe
  1. Saw link between stress and life changes
  2. Social Readjustment Rating Scale (SRRS)
    1. Rahe et al
      1. Positive correlation between LCU and illness score
      2. Ppts aboard US Navy Cruiser (2700) complete SRRS before tour of duty
        Illness score calculated on number, type and severities of injuries on tour.
    2. 43 life changes > asked 400 people to give numerical score
      1. Marriage baseline at 50 LCU
        High score if more readjustment required
        Score totalled and averaged to create life change unit values.
2. Evaluation
  1. Daily Hassles
    1. Lazarus
      1. Events in SRRS are fairly infrequent
  2. Inclusion of positive and negative events
    1. Event or quality of event causes stress
    2. Undesired/unscheduled events are more harmful
  3. Correlational data
    1. Are people are ill more likely to report a life change?
    2. Third variable may be cause
      1. Brown
        Anxious people more likely to report negative life events and prone to illness
  4. Individual differences
    1. Relates to quality of event
Personality Factor
1. Friedman and Rosenman
  1. Type A
    1. Impatience and Time-Urgency
    2. Competitiveness and Achievement Striving
    3. Hostility and Aggression
    4. Lead to raised blood pressure and stress hormones
      1. Linked to Coronary Heart Disease (CHD)
  2. Type B
    1. Patient
    2. Relaxed
    3. Easy-going
    4. Less vulnerable to stress related ilness
  3. Western Collaborative Group Study > Ppts examines for signs of CHD & assessed for personality
    1. Relationship found between stress related illness and increased likelihood towards risk factors.
  4. Evaluation
    1. Ragland and Brand
      1. Follow-up 22 yrs later > 15% of men died of CHD
        Importance of risk factors but not link between Type A and mortality
    2. Myrtek
      1. Meta-analysis of 35 studies
        Hostility linked to CHD > No link with other Type A factors
        Undermines link between Type A and stress related illness
Hardy Personality
1. Control
2. Challenge
3. Commitment
4. Maddi et al
  1. US company reducing size of workforce
    1. 2/3 employees suffered stress related health problems over year
      1. 1/3 thrived & showed Hardy traits
5. Lifton et al
  1. Hardiness of students at 5 universities to see if linked with chances of completing degree
    1. Students who scored high were more likely to complete their degree
6. Evaluation
  1. Hardiness and Negative Affectivity
    1. 3 C's not characteristics but way we think about success and failures
    2. Some dwell on failure, report more distress and dissatisfaction
      1. Referred to as 'High on Negative Affectivity'
    3. Hardy Personality and NA negativly correlated
Psychlogical Methods of Stress Management
1. Cognative Behavioural Therapy
  1. Challenging negative thoughts
  2. Rewarding desirable behaviours
2. SIT
  1. Conceptualistation Phase
    1. Client and therapist establish relationship
    2. Identify source of stress
  2. Skills Acquisitions Phase
    1. Skills taught to cope with stress
    2. E.G. Positive thinking, social support
  3. Application Phase
    1. Client practises skills in real world
    2. Monitor success/failure
  4. Evaluation
    1. Applied to many individuals and situations
    2. Effective
    3. Time, commitment and money
3. Hardiness Training
  1. Focusing
    1. Client taught to recognise symptoms of stress
    2. Indentify source
  2. Relievng stress encounters
    1. Patient encouraged to think about recent stressful situations
    2. Analyse response to situations
  3. Self Improvement
    1. Patients taught to see stressors as challenges
  4. Evaluation
    1. Targets perception and coping
    2. Time, commitment and money
    3. Teaches ability to cope with variety of situations
Biological Methods of Stress Management
1. Benzodiapines
  1. Enhances GABA
  2. Binds to special sites on receptors
  3. Increase chloride ion flow
  4. Strengths
    1. Effective
      1. Kahn et al
        250 patients over 8 weeks > Bzs superior to placebos
      2. Hildalgo et al
        Meta-analysis > Bzs more effective at reducing anxiety than other antidepressants
  5. Weaknesses
    1. Addictive
      1. Ashton
        Bzs should not be used for more than 4 weeks
    2. Side Effects
      1. Increased aggressiveness
      2. Cognitive side effects
2. Beta-Blockers
  1. Reduce activity of adrenaline and noradrenaline
  2. Bond to cells on heart
  3. Hard to stimulate cells
  4. Less pressure on body
  5. Strengths
    1. Effective
      1. Used in real life settings
  6. Weaknesses
    1. Side Effects
      1. Linked to increased chance of developing diabetes

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