Stress

Stress

1. Acute Stress

   • Acute Stress
   • Acute stress activates the autonomic nervous system.
     • ANS subdivided into: - Sympathetic nervous system - Parasympathetic branch
       • SNS prepares body for fight or flight, parasympathetic branch returns body to a state of relaxation.
         • Sympathetic adrenal medullary is combined with the SNS to create the sympathomedullary pathway.
           • SAM releases adrenaline. Adrenaline boosts oxygen and glucose supplies and supressed non urgent bodily functions.
             • SAM I regulated by the SNS and the adrenal medulla - just above the kidneys. The adrenal gland has two zones - adrenal medulla and adrenal cortex.
           • SNS sends messages via neurons to most body organs and causes the release of noradrenaline - a neurotransmitter.
             • Noradrenaline increases heart rate, pupil size and mobilises fat and glycogen which provides energy.
   • Caused by acute stressors - something which happens suddenly, body has to react quickly.

2. Chronic Stress

   • Chronic Stress
   • The pituitary adrenal system AKA hypothalamic pituitary adrenal axis (HPA axis).
     • HPA axis controls levels of cortisol - activated by physical or emotional stressors.
       • When chronic stressor is perceived the hypothalamus activates.
         • A region of the hympothalamus, paraventricular nucleus (PVN), causes corticoptrophin releasing factor (CRF) to be released.
           • CRF travels to the pituitary gland. Pituitary gland releases adrenocorticotrophin hormone (ACTH).
             • ACTH travels to the adrenal gland above the kidneys.
               • Part of the adrenal gland, the adrenal cortex, causes cortisol to be released.
                 • Cortisol has postive effects: + lower pain sensitivity + quick burst of energy
                 • and negative effects: - impaired cognitive performance - higher blood pressure - lowered immune response
   • Cause by chronic stressors - something that is on going, body doesn't need to react as quickly.

3. Consequences of Stress

   • Cardiovascular Problems
     • Increased blood pressure, physical damage of blood vessel lining.
   • Immunosuppression
     • Cortisol suppresses immune system, feedback system to level out cortisol may break down under prolonged stress.
   • Individual
     • Fight or flight response for males, tend and befriend response for females.

4. Stress Related Illness

   • Stress Related Illness
   • Immune System
     • Creating a barrier to prevent antigens entering - e.g. mucus in your airways.
       • Detecting and eliminating antigens if they do enter the body before it can reproduce, preventing you from getting ill.
         • Eliminating the antigen once it has started to reproduce, i.e. getting you better once the virus/illness has started.
     • Role of Cortisol
       • Under-vigilance - letting infections enter without being dealt with effectively.
       • Over-vigilance - the immune system mistakenly attacks cells which are not antigens, creating illness.
   • Acute Stressors
     • Kiecolt-Glaser et al (1984) - medical students exams, blood samples month before and during exam period. NK cell activity reduced in exam period.
   • Chronic Stressors
     • Kiecolt and Glaser (2005) - blister wounds on arms of married couples healed slower after conflicting discussions discussions not supportive.
     • Kiecolt and Glaser (1987) - women separated with matched married controls. Poorer immune functioning in women recently separated.
     • Malarkey et al (1994) - 90 newlyweds 24 hour period discussion to resolve marital issues. Changes in adrenaline and noradrenaline, poor immune.
   • Stressors Enhancing Immune System
     • Evans et al - short term stress can increase levels of slgA, which help protect against infection.
   • Evaluation
     • Research Support
       • Segerstrom and Miller (2004) - 293 studies over previous 30 years. Acute stress; boost immune system, chronic stress; supress immune system.
       • Marucha et al (1998) - punch biopsies students summer and 3 days before exams. Took 40% longer to heal near exams.
     • Stress Can Enhance Immune System
       • Evans et al - short term stress can increase levels of slgA, which help protect against infection.
     • Not Simple Relationship
       • Lazarus (1992) - suggested a number of reasons why it is difficult to establish a relationship between stress and illness.
         • Health is affected by many factors. E.g. lifestyle may affect health and stress. This is a problem of using correlational data.
         • Health is slow to change, so is difficult to show the effect of specific stressors.
         • For long term effects, longitudinal research would have to be conducted. This is expensive and time consuming so is not done often.
     • Individual Differences
       • Kiecolt-Glaser et al - women show more adverse immunological changes in the way they react to chronic stressors.
       • Segerstrom and Miller - as people age, stress has greater effect on immune system functioning making it harder for body to regulate itself.

5. Life Changes

   • Research
     • Rahe et al (1970) - military version, SRE, given to over 2700 men. Taken before tour of duty. Illness score was calculated on the basis of the number,
       • Positive correlation between LCU (life change unit) score and illness score of +118. Scored low in term of their SRE score, low levels of illness.
     • Michael and Ben Zur (2007) - 130 men and women. Half recently divorced & half recently widowed. They looked at levels of life satisfaction.
       • Divorced: lower before separation. Widowed: higher before bereavement. Can change life changes into a positive experience in some cases.
   • Evaluation
     • Spurious Relationship
       • Only correlational data, can't establish causal relationship between life events and stress related illness. Possibly a 3rd variable.
     • Individual Differences
       • Impact of events varies from person to person, hard to predict illness from SRRS scores alone.
     • Life Changes and Daily Hassles
       • Relatively minor daily hassles are more likely to be significant cause of stress. DeLongis et al - relationship between health and daily hassles.
     • Positive and Negative Effects
       • Any life event risks health as needs readjustment. Critics argue only undesired, unscheduled and uncontrolled changes tend to be really harmful.
     • Real-World Application
       • Heikken and Lonnqvist - life events such as financial problems, physical illness and unemployment have been found to predict likelihood of suicide.
     • Reliability & Validity
       • Brown (1974) Unwell ppl feel need a reason for being ill so more likely to report life changes. Retrospective data is questioned on its validity.
   • SRRS
     • The social readjustment rating scale. Developed by Holmes and Rahe. Measures life changes.

6. Daily Hassles

   • Daily Hassles
   • Research
     • Bouteyre et al (2007) - correlational analysis of daily hassles and mental health, students transitioning from school to uni.
       • Completed hassles questionnaire and depression inventory. Over 40% suffered depressive symptoms, positive correlation of hassles scale and depression.
     • Gervais (2005)
       • A- To investigate the effects of daily hassles and uplifts.
       • M- Nurses kept diaries for a month recording their daily hassles and uplifts at work. They were also asked to rate their performance at work.
       • R- Hassles significantly contribute to increase job strain and decrease performance. Also felt that uplifts counteracted some of the stress they felt
       • C- Daily hassles increase stress however uplifts can negate some of their effects.
     • Flett et al - life events differ from daily hassles in extent of seeking and receiving social support.
       • Negative effects of daily hassles due to reduced social support.
   • Daily hassles - the minor day to day stressors which may frustrate or annoy a person.
   • Evaluation
     • Accumulation Effect
       • Accumulation of daily hassles creates persistent irritation and frustration which then creates more serious reactions such as anxiety and depression.
     • Amplification Effect
       • Major life changes may make you more vulnerable to daily hassles.
     • Methodological Problems
       • Retrospective recall for most research, unreliable, as we often forget events, particularly routine or everyday ones.
     • Cause and Effect
       • Although research identifies a correlation this does not mean that hassles directly impact stress. Potentially other factors, no causal relationship.

7. Workplace Stress

   • Workplace Stress
   • Job Strain Model
     • States that workplace causes stress and therefore illness due to high workload & low job control.
   • Research
     • Marmot et al (1997)
       • A- To investigate the job strain model.
       • M- 7372 civil servants in London were assessed on these factors and checked for signs of cardiovascular disease. They were then checked after 5 years.
       • R- No link between workload and stress illness. People who had reported low job control were more likely to have developed heart disease.
       • C- Low levels of job control is a factor associated with stress related illness.
     • Johansson et al (1978)
       • A- To investigate the effects of performing repetitive jobs which require constant attention and some responsibility.
       • M- Measured the stress of Swedish sawyers using self-report techniques (of feelings and caffeine use) and also regular urine samples.
       • R- Those responsible for sawing had higher levels of stress and adrenaline than those responsible for maintenance.
       • C- Performing repetitive jobs that require constant attention and responsibility cause more stress.
   • Role Conflict
     • Role conflict occurs when experiences at work interfere with life outside of work.
     • Pomaki et al (2007) - higher levels absenteeism, lower levels performance & poorer physical & mental health for those experiencing role conflict.

8. Personality and Stress

   • Type A
     • Friedman & Rosenman created the idea of a type A personality. This is someone who is very self-motivated and achievement driven.
     • Characteristics
       • Impatience & urgency. Competitiveness. Hostility & aggression.
       • Friedman & Rosenman predicted that these characteristics lead to increased blood pressure and stress hormones (cortisol). More likely suffer CHD.
     • Research
       • Friedman & Rosenman
         • A - to assess the link between type A personality and the risk of coronary heart disease (CHD).
         • M - 3000 Californian men aged 39-59 examined for signs of CHD. Interviewed identify personality. Followed up medically.
         • R - Type A: Heart attack; 12.8%, Recurring heart attack; 2.6%, Fatal; 2.7%. Type B: Heart attack; 6%, Recurring heart attack; 0.8%, Fatal; 1.1%.
         • C- Those with type A personality are more likely to suffer from stress related illness such as coronary heart disease.
       • Ragland & Brand (1988)
         • 15% of the men had died from CHD, link between risk factors such as smoking and drinking with CHD but not the link between type A personality.
         • Follow up of Friedman and Roseman.
       • Myrtek (2001)
         • 35 studies, found a link between hostility and CHD, but not with the other characteristics of a type A personality.
   • Hardy Personality
     • Characteristics
       • Control
         • They see themselves as in control of their surroundings and are not controlled by external stimuli.
       • Commitment
         • They are involved in the world around them with a strong sense of purpose.
       • Challenge
         • They enjoy challenge and perceive stressors as obstacles to be overcome.
     • Research
       • Maddi et al (1987)
         • Studied employees of a company that was reducing its workforce. 2/3 of employees suffered SRI over the period of a year but 1/3 thrived. 1/3 has 3 Cs.
       • Lifton et al (2006)
         • Hardiness in students to see link between hardiness & probability of them completing their degree. Low on the 3 C’s were less likely to complete cours
       • Kobasa (1979)
         • 800 American business executives using the SRRS. 150 - high stress. Some high some low illness. Those with all or most of the 3 C’s had lower illness.
     • Evaluation
       • Negative Affectivity (NA)
         • Watson & Clark (1984) - argue that the characteristics of the hardy personality can be more simply explained by the concept of negative affectivity.
           • High NA ppl are more likely to report distress and dissatisfaction, dwell more on their failures and focus on the negative aspects of themselves.
           • Suggests that those with the hardy personality simply have low NA.
       • Problems of Measurement
         • Most of the research on hardiness and health has relied upon self-report questionnaires.
         • Some studies show low internal reliability for the challenge component of hardiness.

9. Stress Management

   • Stress Management
   • Biological Methods
     • Benzodiazepines (BZs)
       • Used to treat anxiety and stress.
       • Slow the central nervous system.
         • GABA is the body’s natural form of anxiety relief.
           • BZs enhance the action of GABA by binding on to the receptor.
             • This allows more chloride ions to enter the neuron making it more resistant to excitation.
               • Brain’s output of excitatory neurotransmitters is reduced.
       • BZs reduce the reduce increased serotonin levels which in turn reduces anxiety.
       • Evaluation
         • Strengths
           • Hildalgo et al - conducted a meta-analysis and found that BZs were more effective at reducing anxiety than other anti-depressants.
           • Kahn et al - followed 250 patients over 8 weeks. He found that BZs were superior to placebos.
         • Weakness
           • BZs can be addictive, patients exhibited withdrawal symptoms when they stopped taking the drug. Ashton (1997) BZs should be limited to 4 weeks.
           • BZs can have side effects. BZs can cause ‘paradoxical’ symptoms such as increased aggression and cognitive side effects.
     • Beta-Blockers (BBs)
       • BBs reduce the activity of adrenaline and noradrenaline which are part of the sympathomedullary response to stress.
       • BBs bind to beta-receptors on cells of the heart and other parts of the body stimulated during arousal.
         • Cause a slower heart rate and blood vessels don’t contract as easily meaning decreased blood pressure which in turn causes less stress on the heart.
       • Evaluation
         • Strengths
           • BBs have real world applications. For example they are used by musicians and sports where precision is important such as snooker.
         • Weaknesses
           • BBs can have side effects. Most people do not experience side effects with BBS, however there have been some links made with diabetes.
   • Psychological Methods
     • Stress Inoculation Training
       • Meichenbaum - can change way we think abotu stressors. people can be trained to inoculate themselves against stress.
       • It involves...
         • Conseptualisation
           • Clients are taught to think differently about stressors i.e. as problems that can be solved.
         • Skills Aqcuisition
           • Coping skills are taught and rehearsed in real life.
         • Application
           • Learned coping skills are applied in increasingly stressful situations.
       • Evaluation
         • Strengths
           • Effectiveness
             • Meichenbaum - compared SIT with SD, both effective but SIT helped reduce fear with a second untreated phobia.
           • Reducing Academic Stress
             • SIT sessions reduced anxiety and stress among students as well as improving performance.
           • Prep for Future Stressors
             • SIT gives clients skills so they are less adversley affected by future stressors.
         • Weaknesses
           • Time Consuming & Requires High Motivation
           • Unneccessarily Complex
             • SIT can still be achieved with just some of its elements.
     • Hardiness Training
       • Kobas and Maddi - identified hardy personality.
       • It involves...
         • Focusing
           • The client is taught to recognise sources of stress.
         • Reliving Stress Encounters
           • The client is given an insight into current coping startegies by reliving previous encounters and their response.
         • Self-improvement
           • These insights can be used to move forward and learn new techniques.
       • Evaluation
         • Stengths
           • It works
             • Shown to be effective in many different populations.
           • Real World Application
             • Used to increase commitment to training in Olympic swimmer, helps control aspect of daily life that might interfere.
         • Weaknesses
           • Overcoming Bad Habits
             • Training must address basic aspects of personality and learned habits of coping. Therefore, hardiness training cant be seen as rapid solution.