Stress

Stress

1. Acute Stress

   • Stress is experienced when a persons perceived environmental, social and physical demands exceed their ability to cope.
   • ANS: Subdivided into SNS and Parasympathetic branch
   • Sympathomedullary Pathway: Influence of SNS and adrenal medulla prepares body for fight/flight
   • Acute stress activates the ANS
     • ANS=SNS + Parasympathetic branch
       • SAM + SNS= sympathomedullary pathway
         • SNS= fight/flight parasympathetic branch = relaxation
           • SNS sends messages to organs, release of noradrenaline
             • increased heart rate, pupil size + mobilise fat + glucogen= engery
               • SAM alerts body to release adrenaline
                 • SAM regulated by SNS + adrenal medulla, above kidneys
                   • Adrenal gland has 2 zones, adrenal medulla +cortex
                     • Adrenaline boosts oxygen + glucose + suppresses non-urgent bodily functions

2. Chronic Stress

   • Chronic stress is caused by chronic stressors. A chronic stressor is somethings that is ongoing therefore the body doesn't heed to react as quickly.
   • The PAS is also known as the HPA Axis
     • HPA Axis controls cortisol, the stress hormone
       • When a chronic stressor is perceived the hypothalamus activates
         • the PVN in the hypothalamus causes CRF to be released
           • CRF travels to pituitary gland through blood and releases ACTH
             • ACTH travels through blood stream to adrenal glands at the top of the kidneys
               • Adrenal cortex release cortisol which is responsible for stress effects
                 • Low pain, burst of energy High blood pressure, impaired cognitive performance
                   • 20 minutes to take effect, sharp rise in coritsol
                     • feedback system regulates hormones

3. Stress and Illness

   • Definitions
     • Antigen: Bacteria, viruses, toxins and parasites
     • Leucocyte: White blood cell, able to engulf and destroy antigens
     • Lymphocite: Type of white blood cell
     • NK Cell: 'Natural killer' cell, able to attack antigens and tumours
     • Punch Biopsy: A small wound inflicted by a researcher to investigate the healing process
   • How the immune system defends against antigens
     • barrier created to stop antigens entering e.g mucus in airways
       • detecting + eliminating antigens if they do enter before they reproduce
         • eliminating antigens once it started to reproduce
   • Role of Cortisol
     • The cells of the immune system are sensitive to cortisol
     • Fluctuations in cortisol may lead to altered immune functioning
     • Over Vigilance: the immune system mistakenly attacks cells which are not antigens creating illness
     • Under Vigilance: letting the infections enter without being dealt with effectively
   • Evaluation
     • health is slow to change, therefore difficult to show effect of specific stressors
     • long term effects would need longitudinal research which is expensive and time consuming
     • cant establish a causal relationship as health is affected by many factors e.g genetic influences and lifestyle
   • Research Evidence
     • Acute Stressors
       • Kiecolt-Glaser et al (1984):
         • A- importance of examinations on medical students
         • M- blood samples 1 month before + during exam period
         • R- NK cells activity was reduced in second sample
         • C- Suggest short term stressors reduce immune functioning
       • Marucha et al (1998)
         • punch biopsies in mouths of students in summer holidays, and 3 days before their exams
         • the wound inflicted nearer the exams took 40% longer to heal
     • Chronic Stressors
       • Kiecolt-Glaser et al(1987)
         • Compared women separated from their partners, with matched married couples
         • poorer immune functioning was found in women who had recently separated
       • Kiecolt-Glaser et al (2005)
         • found that blister wounds on the arms of married couples healed slower after a confliting rather than supportive discussion
       • Malarkey et al (1994)
         • 90 newly weds studied of 24 hours
         • Discuss and resolve martial issues, which led to changes in adrenaline and noradrenaline
           • led to poorer immune functioning
     • Evans et al (1994)
       • Students gave talks to other students (mild, but acute stress
       • found increase in mucas in airways, but decrease before + during exam periods stretching several weeks
       • Suggests stress may increase efficiency in short-term acute stress but down regulate for chronic stress

4. Stress and Life Changes

   • The events which necessitate major transitions in a certain aspect of a persons life
   • Holmes and Rahe (1967)
     • developed SRRS to measure life changes
       • 400 people rated 43 life changes on level of readjustment, marriage being a baseline of 50
         • scores were totalled and averaged
     • Testing SRRS: Normal participants 2700 men aboard US navy cruiser
       • completed before tour of duty noting all life events they had experienced within the past 6 months
         • Illness score was calculated based on illness during tour
           • Rahe et al: found positive correlation between LCU + illness
             • not a strong correlation but robust and consistent
             • supports Holmes + Rahe (1967) that life changes is linked to illness
               • implies life changes leads to stress
   • Evalutation
     • x Rahe (1974): Found test-retest reliability depends on length of time between test and retest
       • + research in general was found reasonably reliable
         • + Hardt et al (2006): asked about childhood experiences with a time lag of 2.2 years and found moderate-good reliability
     • Reliant on Correlational Data
       • ill people more likely to report life changes?
       • Brown (1974): Anxious people are more likely to report negative life events and be prone to illness
     • Positive + Negative Events
       • event itself/quality of event that causes stress?
     • Individual Differences
       • relates to idea of quality rather than event
       • e.g unexpected death of a spouse is going to be more stressful
     • Daily Hassles
       • Lazarus (1990): these major events in the SRRS are actually fairly infrequent
       • for most people its not the major life events which causes stress, but the everyday occurences

5. Daily Hassles

   • minor day to day stressors which may frustrate or annoy a person
     • e.g losing things, traffic, appearance, finances, deadlines
       • alone these are unlikely to cause stress but when several occur regularly this may lead to stress
   • Uplifts: Small positive experiences which may offset some of the hassles
     • e.g receiving praise, unexpected tax rebate, complements
       • Daily hassles and uplifts can be measured on the HSVP (The Hassles adn Uplifts Scale) created by Delongis et al (1982)
   • Supporting Evidence
     • Bouteyre et al: relation between hassles + mental health in transition from school to uni
       • Students completed HSVP and Beck Depression inventory
         • Showed depressive symptoms - Positive correlation
     • Gervais: nurses kept diaries for a month recording hassles and uplifts
       • asked to rate their performance at work
         • hassles were found to significantly contribute to increased job strain + decreased performance
   • Accumulation effect
     • research suggests daily hassles are more significant source of stress for most people than major life events
     • accumulation of hassles = persistent irritation and frustration, which creates anxiety and depression
   • Amplification effect
     • major life events make you more vunerable to hassles
     • presence of major life change may deplete resources needed to cope with minor stressors
       • therefore daily hassles cause stress as a result of stress from life events
   • Evaluation
     • Methodological problems
     • Retrospective recall: participants forget teh stress of an event if rating it later in life
     • Diary Method: Validity problems, unsure if all events were recorded
       • Could be affected by social desirability or demand characteristics
     • cause and effect: may be other factors that cause stress for example personality
       • no causal relationship

6. Workplace Stress

   • Job Strain Model
     • Marmot et al investigated JSM which states the workplace causes stress, therefore illness; due to high workload and low job control
       • they suggested high grade civil servants would experience high workload and low grade civil servants would experience low job control
         • This suggests they would both experience stress but for different reasons
           • Marmot et al found no link between high workload and stress related illness
   • Johansson found those responsible for sawing rather than maintenance work felt a sense of responsibilty for the whole company
     • This stress was measured by self report (of feelings and caffeine use) and also regular urine samples
       • results showed those responsible for sawing has higher levels of stress and adrenaline than those responsible for maintenance
   • Marmot et al assessed 7372 civil servants in London for signs of cardiovascular disease and checked 5 years later
     • he found people in highest grades of civil service has developed fewest cardiovascular problems
       • those highest grades expressed feelings of control over their work and reported good levels of social support

7. Personality and Stress

   • Friedman and Rosenman created the type A personality
     • Highly achievement motivated
     • impatience + time urgency
     • competitiveness + achievement striving
     • Hostility + aggression
     • believed these 3 factors would lead to raised blood pressure and stress hormones and inparticular conorary heart disease (CHD)
   • Type B: opposite to type A; patient, relaxed and easy going therefore less vunerable to stress related illness
   • Supporting evidence for Type A
     • Western Collaborative Group Study, participants examined for signs of CHD + assessed for personality type
       • relationship was seen between stress + illness e.g cardiovascular probles and increased likelihood towards risk factors e.g smoking
   • Evaluation
     • Ragland + Brand: Follow up research found approx 15% of the men died of CHD
       • confirms importance of risk factors and CHD but not the link between Type A and morality
     • Myrtek: analysis of 35 studies
       • found hostility to be linked to CHD but no other factors of type A
         • undermines link between type A and stress related illness

8. Hardy Personality and Stress

   • Definitions
     • Hardy Personality: Characteristics which appear to provide defence against the negative effects of stress
     • The 3 Cs
       • Control: in control of their lives rather than controlled by external factors
       • Commitment: involved with world around them, strong sense of purpose
       • Challenge: see challenges as problems to overcome rather than threats or stressors. Enjoy change as oppurtunity for development
   • Supporting
     • Maddi et al:
       • Studied employees that was dramatically reducing workforce
         • 2/3 suffered stress related health problems over the year, 1/3 thrived
           • 1/3 showed more evidence of hardiness attributes
     • Lifton et al:
       • measured hardiness of student to see if hardiness was related to likelihood of completing degree
         • among dropouts, little showed low scores on the 3 Cs
           • Students who scored highly on the 3 Cs were more likely to complete their degree
   • Limitations
     • Hardiness + Negative Affectivity
       • 3 Cs not characteristics but way of thinking about success and failure?
       • some people dwell on failure, report more distress +dissatisfaction + focus on negative characteristics
         • referred to as high negative affectivity
           • negative affectivity and hardy personality are negatively correlated
             • Suggests those 'hardy' are low in negative affectivity

9. Psychological Methods

   • cognitive approach: Challenging negative thought
   • Behavioural Approach: rewarding desirable behaviours
   • STEP 1-Conceptualisation Phase
     • Therapist and cliient establish relationship and identify stress sources
   • STEP 2-Skills acquisition phase
     • Coping skills taught and practised initially in clinic then rehearsed in real life (positive thinking, relaxation
   • STEP 3-Application Phase
     • Encouraged to use coping skills in real life and therapist monitors client
   • Evalutation
     • + focuses on challenging what stressors are and teaches techniques
     • + can be applied to many individuals
     • found to be more effective than other forms of stress managment
     • Sheeky + Horan
       • + examined effects of SIT on anxiety, stress and academic performance in law students
         • + found those with SIT sessions had lower anxiety and higher academic performance
     • x SIT takes time, commitment and money, due to 1-1 therapy over a long period of time
   • Stress Inoculation Training (SIT)
     • Michebaum developed this to deal with stress
     • Suggests an individual should develop a form of coping before stress arises

10. Physiological Methods

    • Physical aspects of behaviour and these managements focus on physical ways in which the body responds
    • Benzodiazepnes (BZs)
      • slow activity of CNS and enhances natural action of GABA
        • GABA is natural form of anxiety relief, it locks onto receptors on surface of neuron, increasing how of Cl irons into neuron
          • Cl ions slow down CNS activity making someone feel more relaxed
            • BZs bind to GABA sites and allow even more Cl ions to flow into neuron
      • Evaluation
        • + Kahn (1986): followed 250 patients over 8 weeks and found BZs were significantly superior to placebos
        • + Hildago (2001): meta analysis found BZs more effective at reducing anxiety than other antidepressants
        • x Patients can show withdrawal symptoms
        • x Ashton (1997): BZs should not be used and 4 weeks
        • x Negative side effects such as paradexical symptoms (aggressiveness and cognitive effects)
    • Beta Blockers (BBs)
      • reduce activity of adrenaline and noradrenaline by binding to receptors on heart cells and other organs stimulated during growth
        • block receptors making it harder to stimulate cells
          • puts less pressure on body and person feels calmer and less anxious
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      • Evalutation
        • + used in real life settings to reduce anxiety and more effective (snooker players)
        • x Some research has linked BBs with increased risk of developmental diabetes