[2Y2T3S] [PT10110] [2] Stress and Health Adaptation and Coping

Pattern of specific and non-specific responses an organism makes to stimulus events that disturb its equilibrium and exceeds its capacity to cope

Stress

• State of worry or mental tension caused by a difficult situation

• A human response that prompts us to address challenges and threats

Stress

This accounts for 60% of doctor visits

Stress

• Refers to external demands of life

• May be physical, mental, or emotional

• May be acute or chronic

Stressor

Physical and emotional effects to stressor

Stress response

STRESS

A person’s perception of a stressor dramatically affects the ______

A person’s perception of a stressor dramatically affects the physiologic responses

STRESS

What can moderate or aggravate the effects of stress responses?

Voluntary human behaviors

STRESS PHYSIOLOGY

Stress and homeostasis are regulated by two systems of the body, which are?

1. Autonomic Nervous System (ANS)

2. Hypothalamus-Pituitary-Adrenal Axis (HPA)

STRESS PHYSIOLOGY

Activated by consciously perceived stimuli or by reflexive unconscious response

Sympathetic nervous system (SNS)

STRESS PHYSIOLOGY

What neurotransmitter is highly associated with the SNS?

Norepinephrine

STRESS PHYSIOLOGY

“The brake” that dampens the response

Parasympathetic nervous system (PNS)

STRESS PHYSIOLOGY

This releases CRH and AVP to stimulate the next structure during stress responses

Hypothalamus

STRESS PHYSIOLOGY

When stimulated by the hypothalamus, this releases ACTH to stimulate the next structure

Anterior pituitary

STRESS PHYSIOLOGY

When stimulated by the anterior pituitary, this releases cortisol and aldosterone during stress

Adrenal cortex

STRESS PHYSIOLOGY

Give the respective neurotransmitters released by the hypothalamus, anterior pituitary, and adrenal cortex during stress response

Hypothalamus – CRH & AVP

Anterior Pituitary – ACTH

Adrenal Cortex – Cortisol & Aldosterone

STRESS PHYSIOLOGY

When a person is stressed, how does the body respond? (7)

1. Increased HR

2. Increased BP

3. Increased CO2

4. Glycolysis

5. Increased gluconeogenesis

6. Increased salt and water retention

7. Increased circulating volume

True or False: Stress is essential for survival

True

True or False: Acute activation of stress impairs health

False: Chronic activation of stress impairs health

What are the POSITIVE (Acute) and NEGATIVE (Chronic) effects of the following stress response:

• Cortisol reduces insulin release, insulin-dependent growth factor, and insulin sensitivity

(+) - Acutely improves immediate energy

(-) - Chronically contributes to development of DM, obesity, and dyslipidemia

What is the POSITIVE (Acute) effect of the following stress response:

• Cortisol and NE increases inflammatory cytokines ie IL-6 and TNF-α and CRP

(+) - acutely activate cellular immunity to fight acute infection

What are the NEGATIVE (Chronic) effects of the following stress response:

• Cortisol and NE increases inflammatory cytokines ie IL-6 and TNF-α and CRP

(-) - chronically cause inflammation of the arterial endothelium contributing to development of atherosclerotic plaques

(-) - chronically stimulate CRF release, perpetuating the stress response

What are the POSITIVE (Acute) and NEGATIVE (Chronic) effects of the following stress response:

• Norepinephrine and AVP constrict renal arterioles and promote sodium retention

(+) - preserves circulating volume and reduces the risk of hypovolemic shock in acute injury and bleeding

(-) - contributes to the development of hypertension

What are the three stages of the General Adaptation to Stress Model

1. Alarm

2. Resistance

3. Exhaustion

True or False: How an individual conceptualizes stress determines his response, adaptation, and coping strategies

True

Who developed the General Adaptation to Stress Model?

Hans Selye

What stage/s of the General Adaptation to Stress Model is this found?

• Initiation of SNS response

1. Alarm stage

What stage/s of the General Adaptation to Stress Model is this found?

• Initiates physiological systems with fight or flight reaction to stress

• Return to homeostasis

• Reducing harm or accommodating the stressor

1. Resistance stage

2. Exhaustion stage

Who developed the Transactional Theory of Stress and Coping?

Richard Lazarus

Stress as a product of transaction between…?

Stress as a product of transaction between person and his complex environment

What are the cognitive ways to cope with stress? (7)

1. Therapy

2. Hobbies

3. Meditation

4. Mindfulness

5. Planning

6. Reading

7. Time Management

What are the physical ways to cope with stress? (6)

1. Artistic expression

2. Deep breathing

3. Natural medicine

4. Physical exercise

5. Relaxation

6. Yoga

What are the environmental ways to cope with stress? (4)

1. Music

2. Nature

3. Pets

4. Spa visits

What are other ways to cope with stress? (2)

1. Conflict resolution

2. Prayer

Process of cognitive appraisal to determine whether an individual believes he or she has the resources to respond effectively to the challenges of a stressor or change

Stress coping

Two kinds of stress coping

1. Problem-focused coping (active)

2. Emotion-focused coping (passive)

What type of stress coping is described:

• Has resources to manage the challenge

• “I try to analyze the problem in order to better understand”

• “I’m making a plan of action and follow-up”

Problem focused coping (active)

What type of stress coping is described:

• Lack the capacity to respond to challenge

• Feels a lack of control

• Wishful thinking

• Distancing

• Emphasizing the positive

Emotion-focused coping (passive)

RELATED CONCEPTS TO STRESS COPING

What locus of control is described below:

• Believes that their achievements and outcomes are determined by their own decisions and efforts

• Do not succeed = lack of effort

Internal locus of control

RELATED CONCEPTS TO STRESS COPING

What locus of control is described below:

• Believes that achievements and outcomes are determined by fate, luck, or others

• Do not succeed = uncontrollable external forces

External locus of control

Extent to which one has a pervasive, enduring though dynamic feeling of confidence

Sense of coherence

Belief in one’s own ability to complete tasks and reach goals

Self-efficacy

• Dispositional response to stress

  • Enables the individual to see opportunities for growth as opposed to threat or debilitation

• Psychological state in which individuals experience both a sense of vitality and a sense of learning at work

Self-related growth or thriving

Two (2) primary emotions often associated with medical adversity

1. Fear

2. Sadness

Significantly aid both adapting to and coping with major stressors alleviating much of the associated burden and preventing additional stress and negative consequence

Social support

True or False: Passive participation in and promotion and maintenance of relationships in the individual’s immediate and larger social network are vital

False: Active participation in and promotion and maintenance of relationships in the individual’s immediate and larger social network are vital

Four (4) types of social support

1. Instrumental support

2. Informational support

3. Appraisal support

4. Emotional support

What type of social support is described below:

• Offering direct assistance

Instrumental support

What type of social support is described below:

• Sharing information about the illness

Informational support

What type of social support is described below:

• Aiding in assessing the illness and/or decision-making

Appraisal support

What type of social support is described below:

• Providing counseling

Emotional support

Two barriers to seeking social support

1. Marker of weakness and/or failure to independently cope with stressors

2. May wish to utilize professional services but unable to afford