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.

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