Stress slides

Nature of stress

• What is stress?

  • Something in the environment putting stress on us

  • 3 ways of thinking about it

    • Stimuli/events in environment that place demands on us = Stressors

    • Our response: physiological?cognitive? Behavioural?

      • Combination?

      • Feelings, thinking, eating

    • Person-situation interaction

      • Transaction between organism & environment

      • What's going on with us, and what's going on externally

Stressors

• Stressor are Eliciting stimuli

  • Place demands on well-being & require us to adapt

  • Greater the imbalance the more stressful the situation

• Microstressors

  • Daily hassles

    • Laundry, grocery shopping, traffic

• Catastrophic events

  • Occur unexpectedly

  • Affect a large number of people

    • Tsunami, earthquake

• Major Negative Events

  • Stressful life events

  • EG??

    • Big thing that happens

Stressors: measuring stressful life events

• Life Events Scale

  • Quantify stress over a given period of time

  • Indicate whether a particular event occurred

  • Appraisal of being positive or negative

  • Indicate amount of control, predictability

• Social Readjustment Rating Scale

  • Items measured social readjustment

  • Each item assigned point value on scale of 100

    • E.g., Death of spouse = 100 points

    • E.g., Marriage = 50

  • Points = Life Change Units

    • Higher the unit, the more stressful the event

  • Can be positive or negative things

Stress response

• 4 aspects of appraisal process

  • Primary appraisal = demands of situation

    • What do I have to do?

  • Secondary appraisal = resources available to cope

    • How can I cope?

    • Do I have the ways to do this?

  • Judgments of consequences of situation

    • What are the ‘costs’ to me?

  • Personal meaning - what does the outcome imply

    • What does this say about my beliefs in myself? World?

    • What meaning could this have? Does it change my opinion?

  • Distortions and mistaken appraisals can occur at all stages - shows why there is individuals vulnerability

Chronic Stress and the GAS

• General Adaptation Syndrome = GAS

• Physiological reaction to prolonged stress

  • How our bodies respond to prolonged periods of stress

  • Continuing and not stopping

Chronic Stress and the GAS (Phases)

• Alarm

  • 1st phase - similar to ‘fight or flight’

  • Activation of sympathetic nervous system

  • Release of stress hormones - important = Cortisol

    • triggers increase in blood sugars

    • Suppresses immune system

• Cannot last indefinitely

  • Parasympathetic system tries to restore homeostasis

  • If stressor persists - so does response

• Resistance

  • 2nd phase - continued recruitment of resources

  • Can last long time, but resources being depleted

  • Eventually the bodies resources no longer sufficient

• Exhaustion

  • If stressor is intense and persists for too long

  • Resources dangerously depleted

  • Increased vulnerability to disease

  • Can manifest itself with cardiovascular problems; immune system difficulties

• All these stages are determined by a number of factors

Stress and Health

• Our responses to physical stressors may not be adaptive for dealing with psychological stressors - health problems

• Psychological distress noted for:

  • Catastrophic events

  • Combat

  • Rape

  • Concentration camp survivors

  • Stressful life events

• Some stressors have long lasting psychological impact

  • More negative life events reported - more likely to report psychological distress

  • May have 3rd causal factor

Stress and Illness

• Stress = Increase in chronic conditions

  • Arthritis, bronchitis, emphysema

• Stress = increased chance of health problems for each additional stressor

  • 8% among women; 6% among men

• Increases with # of stressors

  • 3 lasting stressors = 18% increase in males; 24% in females

• Other consequences

  • Decrease immune function

    • Demonstrated to occur within 24 hours

  • Worsen pre-existing conditions

    • Stress hormones contribute to blocked arteries

    • Deterioration of hippocampus and memory impairment

PTSD

• Not every traumatic person develops ongoing (chronic) or even short-term (acute) PTSD

• Symptoms usually begin early, within 3 months of the traumatic incident, but sometimes they begin years afterward

• Duration - 1 month - impairment in relationships or work

• The course of the illness varies - some recover in 6 months, some become chronic

• Major symptoms

  • Severe anxiety, physiological arousal

  • Reliving of the event

  • Emotional numbing

  • Intense guilt

• Can increase vulnerability to other disorders

• Unpredictability highlights prompt intervention need

  • Talking about it at least once decreases the likelihood of it

• Need to have

  • At least one re-experiencing symptom

  • At least one avoidance symptom

  • At least two arousal and reactivity symptoms

  • At least two cognition and mood symptoms - new

PostTraumatic Stress Disorders

• Checklist

  • A person is exposed to a traumatic event - death or threatened death, severe injury, or sexual violation

    • Direct exposure

    • Witnessing the trauma

    • Learning that a relative or close friend was exposed to a trauma

    • Indirect exposure to aversive details of the trauma, usually in the course of professional duties (eg. first responders, psychologists, medics) (vicarious trauma)

  • A person experiences at least one of the following intrusive symptoms:

    • Unwanted upsetting memories

    • Nightmares

    • Flashbacks

    • Emotional distress after exposure to traumatic reminders

    • Physical reactivity after exposure to traumatic reminders

  • Avoidance of trauma-related stimuli after the trauma:

    • trauma -related thoughts or feelings

    • Trauma-related external reminders

  • Negative thoughts or feelings that began or worsened after the trauma

    • Inability to recall key features of the trauma

    • Overly negative thoughts and assumptions about oneself and the world

    • Exaggerated blame of self or others, causing the trauma

    • Negative affect

    • Decreased interest in activities

    • Feeling isolated

    • Difficulty experiencing positive affect

  • Trauma-related arousal and reactivity that began or worsened after the trauma

    • Irritability or aggression

    • Risky or desructive behaviour

    • Hypervigilance

    • Heightened startle reaction

    • Difficulty concentrating

    • Difficulty sleeping

  • The person experiences significant distress or impairment, with symptoms lasting more than a month

Vulnerability and protective Factors

• Vulnerability factors

  • Increase susceptibility to stress

• What reduces resistance?

  • Lack of support network

    • Not being able to talk to others

  • Poor coping skills

    • Not having the tools to manage oneself

  • Pessimism

• Protective factors - environmental or personal resources that help people cope

  • Social support, coping skills, optimism

Cognitive Protective Factors

• Why do some people suffer psychological and/or physiological distress and others do not?

  • What is the essential element?

  • Appraisal

• Hardiness - 3 C’s

  • Commitment

    • What they do is important

    • Believing what you're doing is important

  • Control

    • Have control (perceived) over situation

  • Challenge

    • Situation is a challenge, not a threat

  • Control may be the most important

  • SCALE

Cognitive Protective Factors (Self Efficacy)

• Coping Self-Efficacy

  • Belief we can successfully cope

  • Card exercise

• Increased efficacy from:

  • Previous successes

  • Observing others

  • Social persuasion / encouragement

  • Low levels of arousal

• Shown to increase immune system functioning

Cognitive Protective Factors (Optimism)

• Optimism

  • View/ belief in the outcome

  • Things will work out

  • Realistic thinking or delusion?

• Either way optimists have

  • Appraisal of being less helpless

  • Better adjustment to negative life events

  • Sense of less helplessness

  • Better health

Cognitive Protective Factors (Personality Factors)

• Personality Factors

  • Type A

    • High levels of competitiveness and ambition

      • Like to win

    • Can be aggressive and hostile

    • Don't like waiting

  • Type B

    • More relaxed, agreeable

    • Less competitive

  • Type C

    • Highly sociable, inhibited in expressing negative emotion

    • People pleasing, push down feelings

Physiological Reactivity

• Physiological toughness

  • Relationship between 2 classes of hormones

  • Catecholamines & corticosteroids

• Both involved in ‘fight or flight’

  • Cortisol

    • Effects last longer; more damaging

    • What it means when you talk about someone’s toughness

• Physiological toughness consists of:

  • Low resting level of cortisol; low secretion levels & quick return to baseline

  • Quick, strong catecholamine response & quick decline in arousal

Coping with Stress

• Three broad classes of coping

  • Problem-focused

    • Deal directly with demands of situation

    • Try & change situation

  • Emotion-focused

    • Deal with ‘responses’ to situation

    • How they feel

  • Seeking social support

    • Turning to others for emotional support, assistance

Coping Strategies: Effectiveness

• Which strategy is best?

  • Problem focused & Seeking social support

• What about emotion focused?

  • Negative outcomes with

    • avoidance, denial, wishful thinking

  • Positive outcomes with

    • identifying & changing irrational thought patterns; relaxation techniques

Cost Constraints

• Inability to express negative feelings has costs

  • Higher likelihood og cancer

• Expressing emotions in an adaptive manner

  • Long-term positive consequences on health

gender, Culture, and Coping

• Gender Differences

  • Males

    • Favour problem-focused approach

  • Females

    • Favour emotion-focused approach

  • Result of socialization

• Cultural Differences

  • Problem focused = North Americans & Europeans

  • Emotion-focused = Asians & Hispanics

Stress Management

• Cognitive restructuring

  • Change appraisal

• Self-instructional training

  • Learn adaptive self-statements for all stages of the stages

• Relaxation techniques

  • Relaxation & stress = incompatible

Transtheoretical model - Stages of Change

• Precontemplation

  • No desire to change

  • Deny behaviour has negative consequences

  • Feel helpless to change

• Contemplation

  • Perceive problem or desire for behaviour change

  • Perceived benefits outweigh costs

• Preparation

  • Developing plan of action

  • Identification of conditions that affect behaviour

• Action

  • Actively modify behaviour or environment

  • Requires greatest commitment

• Maintenance

  • Avoid relapse; control target behaviour

• Termination

  • Change in behaviour is ingrained

• Important to help us understand factors of change and tailor interventions