Stress

Stress

1. Acute

   • Response
     • Autonomic nervous system (ANS) - automatic response
       • Sympathetic nervous system (SNS) - Prepares fight or flight
         • Sympathetic Adrenal Medullary (SAM) - Promotes adrenaline release
           • Sympathomedullary Pathway
           • Regulated by Adrenal medulla and releases adrenaline
             • Adrenaline - Increases oxygen and glucose supply also suppressed non urgent bodily functions
         • Neurons from the SNS prepare for fight or flight
           • Noradrenaline is released - Increased heart rate, blood pressure, cardiac performance, pupil size and extra energy from glycogen energy
       • Parasympathetic branch - Returns you to a state of relaxation

2. Chronic

   • Response
     • Hypothalamic Pituitary Adrenal axis (HPA axis) - Controls cortisol levels and activates with chronic stressor
       • Paraventricular nucleus (PVN) controls Corticotrophin releasing factor (CRF)
         • CRF travels to the pituitary gland which releases Adrenocorticotrophin hormone (ACTH)
           • ACTH travels to the adrenal gland (cortex) which controls cortisol release
             • Cortisol - Dulled pain, Quick energy burst, Cognitive impairment, high blood pressure and lower immune response
               • Full process takes 20 minutes, then there is a sharp increase of cortisol.
                 • Feedback system in the hypothalamus and pituitary gland monitors cortisol and releases CRF and ACTH accordingly

3. Illness

   • Terms: Antigen Luecocyte Lymphocyte NK cell Punch Biopsy
   • Immune system
     • 1. Creates a barrier to prevent antigens entering the body
     • 2. Detects and eliminates antigens if they do make it into the body
     • 3. Eliminating antigens once they start to reproduce
   • Cortisol levels can affect the immune system
     • Over vigilance - attacks healthy cells
     • Under vigilance - Letting infections enter
   • Research
     • Kiecolt-Glaser et al. NK cells low at exam time (acute stress reduce immune system)
     • Malarkey et al. Newlyweds argument fluctuating adrenaline
     • Evans et al. antibodies improve in short term reduce in long term
     • Segerstrom and Miller meta-analysis agreed with Evans
     • Evaluation Lazarus
       • Too many variables
       • Health is slow to change
       • Requires longitudinal research

4. Life changes

   • Social readjustment rating scale (SRRS)
     • Holmes & Rahe
     • Rated life changes
     • Theory
     • Tested on navy
       • Life changes over 6 months illness score calculated
       • Life change correlated with illness
   • Evaluation
     • Not causal
     • Positive/Negative effects
     • Recollection of life events poor
     • Lazarus suggested that major events have little effect

5. Hassles

   • Hassles vs. Uplifts
     • Delongis et al. (1982)
   • Accumulation effect
     • Small issues more stressful
   • Amplification
     • major changes make you more susceptible
   • Methodological problems
     • retrospective recall
   • Cause and effect
   • Bouteyre et a. (2007) Daily hassles made you more depressive

6. Workplace stress

   • Job strain: high workload low job control
     • Stress in both low and high end jobs
   • Marmot et al. (1997) checked both ends of spectrum and 5 years later
     • Workload - No link
     • Job control - correlation (heart disease)
   • Work underload had similar effects to low control
   • Mental health - high stress makes depression more likely

7. Personality

   • Type A - self motivated impatient hostile
   • Type B - Patient relaxed
   • Hardy - Control Commitment Challenge
   • Friedman & Rosenman - Type A x2 risk of CHD
   • Myrtek 2001 meta-analysis 35 studies link between hostility and CHD
   • Kobasa (1979) - high levels of 3c's less illness (business execs)
   • Negative affectivity - 3c's are irrelevant its all to do with how you think about the problem
     • high NA stuck on failure

8. Stress management

   • Psychological
     • Stress Inoculation Training (SIT)
       • Change perception of problems
       • Establish stressors
       • Coping mechanisms
       • Applying methods
       • Challenges stressors
       • Takes time & money
     • Hardiness Training
       • Identify stress
       • Reliving events
       • taught to see stressors as challenges
       • teaches them how to cope
       • Takes time & money
   • Biological
     • Benzodiaziapenes (BZs)
       • enchance GABA funtioning
       • more chloride ions reduce anxiety
       • Kahn (1986) superior to placebo
       • Addiction
       • Paradoxical side effects
     • Beta-Blockers (BBs)
       • reduce adrenaline (stress reaction)
       • Decreased BP
       • Real life application (sports)
       • Diabetes side effects