Nature of stress
- Stressor: stimuli/ events in environment that place demands on us
- Response: stress (physiological? Cognitive? Behavioural?
- Person-situation Interaction: Transaction between organism & environment
Stressors (Situations)
- Eliciting Stimuli: Place demands on well-being & require us to adapt
- Microstressors: daily hassles
- Catastrophic Events: occur unexpectedly..affect large #’s of people
- Major Negative Events: stressful life events
- *Positive events can causes equal amounts of stress
Measuring stressful life events
- Social Readjustment Rating Scale (SSRS): item measured social readjustment
- Each item assigned point value on a scale of 100 (e.g death of spouse: 100 & marriage: 50)
- Points- Life Change Units
Student Stress Scale
- Scores 300+ high health risk, 150-300 health risk , <150 (1/3) chance of health risk
Stress Response (4 aspects of appraisal process)
1) Appraisal of demands of situation (WHAT DO I HAVE TO DO?)
2) Appraisal of your resources available (HOW DO I COPE?)
3) Judgment of consequences of situation (WHAT ARE THE COSTS TO ME?)
4) Appraisal of personal meaning (WHAT DOES THIS SAY ABOUT MY BELIEFS IN MYSELF? WORLD?)
Chronic Stress & the GAS
- General Adaption Syndrome= GAS (Physiological reaction to prolonged stress)
- 3 phases: Alarms, Resistance, Exhaustion
Alarm (similar to flight or fight)
- Activation of sympathetic nervous system AND release of adrenaline
- Cannot last indefinitely…parasympathetic system tries to restore homeostasis (if stressor persists- so does response)
- Body’s releases its chief stress fighting hormone: Cortisol
- Cannot last indefinitely: Parasympathetic system tries to restore homeostasis
- If stressor persist- so does response!
Resistance
- Continued recruitment of resources, can last long time, but resources being depleted
- Eventually no longer sufficient; depends on individual’s general health, support etc.
Exhaustion
- Resources dangerously depleted
- Increased vulnerability to disease
- Can manifest itself with cardiovascular problems; immune system difficulties
- You collapse & are sick after finals (resistance) when the vacation begins!
Stress can lead to:
- Increase in chronic conditions (arthritis, bronchitis, emphysema)
- Can worsen existing medical conditions
- Not surprisingly, stress hormones can damage the heart
- Can cause breakdown in immune system functioning
- Increase with # of stressors 3 lasting increases health risks
Protective Factors [Why do some people suffer psychological and/or physiological distress and others don’t?
Hardiness
- Commitment: What they do is important e.g stress at work but like your job
- Control: STRONGEST COMPONENT: have control (perceived) over situation e.g problems with roommate but you know how to hand her
- Challenge situation is a challenge not a treat e.g you’re stuck on holiday without your VISA card
Vulnerability & Protective Factors [Vulnerability factors increases susceptibility to stress]
What reduces resistance?
- Lack of support network
- Poor coping skills
- Pessimism
Protective factors
1) Social support
2) Coping skills
3) Optimism
Protective Factors
Social Support:
- Blunts impact of stress, products greater sense of identity & meaning; may prevent maladaptive way of coping (e.g drinking)
- Enhances Immune System
- Shown among cancer patients
- People who talk about negative life events
Coping Self-Efficacy
- Belief that we can successfully cope
- Increased efficacy from: previous success, observing other, social persuasion/ encouragement, low levels of arousal
- Shown to increase immune system functioning (YOU HAVE THE POWER!!)
Optimism
- View/ belief in the outcome
- Things will workout
- Realistic thinking or delusion?
- Either way optimists have
- Appraisal of being less helpless
- Better adjustment to negative life events
- Sense of less haplessness
- Better health
Personality factors
TYPE A
- Demanding of themselves and others
- Competitive and ambitious
- Aggressive and Hostile (OVER REACTIVE)
- Double the risk of heart disease; more likely to alienate others
TYPE B
- Relaxed and agreeable
- Less time urgency
TYPE C
- Highly sociable
- Mirror image of A
- Bottle up emotions
- Feel helpless in severe stress
- More at risk for cancer
TYPE D
- Negative perspective on life
- 3 times more likely to have heart disease
Physiological Toughness
Pattern A: Common response
Pattern B: Physiologically tough individuals
- Low resting level of cortisol; low secretion levels & quick return to baseline
- Quick, strong catecholamine response & quick decline
- B Low resting levels plus Catecholamine burst prevents hormone depletion & exhaustion
Stress & Working Memory
Stress & Frontal Cortex
- Overproduction of PKC, Protein Kinase C
- Impairs working memory
- Implicated in ADHD
- I.e sitting in examination hall, you’ve studied but, don’t understand #1, can’t remember steps to solve question #2! WHAT HAPPENED?
Cortisol & Memory
- Compared effect of oral cortisol & placebo
- Asked to memorize 60 nouns presented on a screen
- Tested for free recall, recognition and delayed 24 recall
- Found that the cortisol group did worse in tests of recall than control (no differences in ability to recognize words)
Coping with Stress
Problem-focused (men)
- Deal directly with demands of situation…try & change situation
Emotion-Focused
- Dealing with ‘responses’ to situation
Seeking Social Support (Women)
- Turning to others for emotional support, assistance
Controllability & coping
Hostage Situation
- You cannot always change the situation
- With little control over the situation which is best?
- Fewer maladaptive behaviors with emotion-focused (no strategy works for all situations)
Health Promotion
Health Psychology
- Study of psychological & behavioral factors in: prevention & treatment of illness…promotion of health
- Why is this important? Leading causes of death are now influenced by behavioral factors
- Health Impairing Behaviors: Smoking, Fatty Diets, Sedentary lifestyle, Binge drinking
- Health Enhancing Behavior: Eating healthy, Exercise, Weight control, Self-reinforcements
How to make changes: Transtheoretical Model
6 MAJOR stages in behavioural change process
- Precontemplation
- No desire to change
- Deny behavior has negative consequence
- Feel helpless to change
- Contemplation
- Percieve problem or desire for behavioral change
- Perceived benefits outweigh costs
- Preparation
- Developing plan of action
- Identification of conditions that affect behavior
- Action
- Actively modify behavior or environment (require greatest commitment)
- Maintenance
- Behaivour change is being maintained
- Termination
- Change in behavior is ingrained
Treatment & Prevention Changing Behaviour
- Lapse: “one-time” slip
- Relapse: Return to undesirable behavior
- Relapse Rate: 30% of treated alcoholics after one year remain improved (70% relapse)
- 20% abstinence for smoking (80% relapse within a year)
- Self-initiated changes (40%-45% maintain them for 4 months)
What causes relapse?
- Insufficient coping skills
- Lack of self-efficacy
- Expected positive benefits from substance
- High risk situation
Abstinence violation effect: self-blame & guilt reinforce sense of helplessness
Can include:
- Biological Measure: e.g Nicotine patches
- Aversion Therapy: Noxious taste on cigerettes
- Stress Management: relaxation techniques
- Coping/ Social Skills: how to diffuse a stressful social situation
- Counselling: Support systems
- Positive Reinforcement: reward yourself
Harm Reduction Approaches
Harm Reduction: Goal is not to eliminate behaviour to reduce harmful effects (e.g reduction of binge drinking, needle exchange programs)
What is Binge Drinking?
- Blood alcohol concentration (BAC) to 0.08 gram-percent or above in about 2 hours
- Corresponds to consuming: MALE 5 or more drinks FEMALE 4 more drinks
- Binge Drinking leads to: Death, injury, assault, sexual abuse, unsafe sex, academic problems, health problems, suicide, drunk driving
SBIRT: Screening Brief Interventions, Referral to Treatment
- Screened for at-risk behaviours
- Offered progressive levels of intervention
- Brief intervention, brief treatment, referral to specialty treatment
PAIN
- Pain: sensory & emotional component
- Biological mechanism of pain: nerve endings in skin & internal organs, which are sent through the spinal cord to the thalamus-> somatosensory cortex and limbic cortex
Gate control theory of pain
- Opening and closing of gating mechanisms
- Pain depends on amount of gate opening
- 2 types of fibres…thick and thin
- Thin: sharp pain impulses
- Thick: dull-pain & touch
- Greater thick fibre activity closes gates…ration of thick:thin
Pain
- Also have control mechanism: messages from brain influences experience of pain
- Endorphins: natural opiates- modify action of neurons
- Inhibit the release of neutrotansmitters involed in pain transmission
- Up to 200x more potent than morphine
Stress induced analgesia
- Reduction/ absence of pain under stress
- Adaptive response of threatening situation
Cultural & Psychological Factors
Meanings & Beliefs
- Self-perception matters!
- Appraisal of pain influences pain response (soldiers vs. civilians)
- Placebos beliefs in taking something affects response (brain releases endorphins)
Personality and social support
- Neuroticism: greater pain reposes
- Optimism & control: lower pain responses, less suffering
- *Once you learn to accept the pain, they experience less pain
- Social support: recent loss of social support= greater pain & distress
Control Pain…Cognitively
- Dissociation strategy: distraction from painful input…directing attention elsewhere, effective for less painful situations
- Association strategy: focus on pain sensations, not label as painful…effective with intense pain
- Combined strategies better than placebos
Information Control: KNOWING WHAT TO EXPECT
- Sensory info: what you will feel, pain seen as normal consequence
- Procedural info: information about surgical procedure…gives sense of predictability
- Coping guidance: techniques to handle pain or complications
- Inactivity & overprotection- can lead to chronic pain…modify pain signals damage..decrease in disability
Happiness (Hyperthymina): cheerful despite life’s misfortunes, energetic and productive, they are often the envy of all who know them because they don’t even have to work at it.
