Psych1001- Ch.14

stress

a state brought on by a situation that threatens, or appears to threaten, one’s sense of well being and ability to cope

-two main factors affect severity of stress:

1. perception of situation (appraisal)

2. ability to cope

stressor

anything that triggers a stress response

• acute stressor: short term stress (psych test)

• chronic stressor: long term pain, unemployment

acute versus chronic stress

• short-term stress is often adaptive (mobilizes resources to overcome threatening event)

• long-term stress is not (may lead to physical health problems like cardiovascular disease, hypertension, and diabetes, and psychological problems such as depression, PTSD, and substance abuse)

Note: 3 out of 4 Americans report feeling stressed in past month (APA monitor)

common ways of experiencing stress

stress can arise from several psychological experiences (feelings):

1. feeling frustrated

2. feeling pressured

3. feeling conflicted

4. feeling endangered

feeling frustrated

when goals are blocked

• Acute: stuck in traffic when late for work

• Chronic: stuck in job, passed over for promotion

feeling pressured

results from perception of having to live up to some expectation (expectation set by others or our self)

• term paper due next week (another)

• what I must wear to the social event (yourself)

feeling conflicted

feeling that occurs when goals or impulses appear to clash (are incompatible). We often have to make choices by weighing alternatives

-three types of conflicts:

1. Approach-approach: must choose between two desirable options. Should I date John or Bill?

2. Avoidance-avoidance: have to choose between aversive options. Should I study math and physics tonight (usually leads to procrastination)

3. Approach-avoidance: when choices come with desirable and undesirable consequences. Like John, but I can’t stand his circle of friends. Often leads to protracted agonizing decision process

feeling endangered

life-threatening situations produce stress

• can be acute and short lived

• e.g. natural disaster, car accident, etc

• or more chronic, e.g. living in dangerous region or situation

• if intense enough can have lasting effects (e.g. PTSD)

Life changes

major shifts in life circumstances that require “adjustments”

• death of loved one, illness, break up, starting university or a new school, moving, new job, etc

• Holmes and Rahe developed Social Readjustment Rating Scale (SRRS)

-43 item check list of common life changing events

-assigned “life change units” to each event (values of life units based on rankings of perceived stressfulness)

-Little stress: 150 or less, Mild stress: 150-199, Moderate stress: 200-299, Major stress: over 300

-Note: Could be events which are generally considered positive. Example: marriage, vacation, etc

-scores on SRRS shown to predict illness (link between stress and health)

-e.g. scores of people the year before they became ill were significantly higher than people who didn’t become ill

-more recent studies with similar version of scale confirm finding: respiratory illness, cancers, etc

life changes criticisms

• has more negative than positive events

• doesn’t include stress from non-life changing events…e.g. Not getting married or a promotion

daily hassles

• common experiences that may frequently produce stress

• examples: daily traffic, bad weather, unexpected data charges, no parking, no course offered, tuition hikes, interpersonal problems, etc

• daily hassles can add up to produce excessive stress

• may be better predictor of negative health effects than major life stressors

• questionnaire developed “daily hassles scale”

three levels of responses to stress:

1. physiological (later)

2. emotional

3. cognitive

emotional responses to stress

changes in mood often accompany stress

• many studies pointed to an association between stress and anxiety and depression

• many (more) negative emotions may accompany stress: fear; dejection or grief; annoyance, anger or rage; guilt, shame or disgust; and jealousy

cognitive-mediational theory of stress

Richard Lazarus- How stressful an event is depends on how we appraise the severity of the situation and our ability to manage it

• primary appraisal: we assess the situation and determine its severity and implications for us. Ex: I have a test next week worth 25% of my final grade (that’s a fair chunk)

• secondary appraisal: we consider our ability to cope with the event (evaluate resources we have). Ex continued: OK, I’ve been attending classes all along. I’ve been reading the text also and making study notes. I got this

-Major factor in appraisal process is evaluation of our control over the situation

-People who have control over stressful events are less stressed!

executive monkey study (control and stress)

• monkeys shocked in pairs (yoked). One could press a lever to terminate or avoid shock, other could not

• one who controlled the shock, exhibited most signs off stress (ulcers, weight loss, etc)

• was thought that monkey in control was like a business “executive” who makes all the decisions and gets all the ulcers

• looked like a person in control would be more stressed

• study shown to be flawed (more active/vigilant monkeys were placed in executive condition)

control and stress

• Weiss (1970s) yoked rats together like executive monkey study

• randomly assigned rats to conditions

• rats received identical amounts of shock, but only those that could not control the shock were stressed

individual responses to stress

• people vary (considerably) in how easily they are stressed

• four important factors:

1. automatic nervous system reactivity

2. explanatory style

3. social support

explanatory style

our characteristic pattern of explaining events (including potentially stressful ones)

-two general styles:

• optimistic explanatory style: general belief that despite setbacks and losses, things will improve

• pessimistic explanatory style: belief that if things can go wrong they probably will and that negative effects will be enduring and global (affect many aspects of life)

• optimists are more likely to view situations as less negativity impacting (and even see a silver lining) and as being manageable

• optimists also more likely to adopt constructive coping strategies

social support

• sometimes others can be a source of stress (too many shallow friends, unruly neighbours, etc)

• however, people with strong social support (family members, good friends, member of faith communities) seem to stress less than people who are lonely or isolated

• for example: married people in healthy relationships live longer (healthier) lives

happiness in marriage better predictor of longevity than blood cholesterol!

Why?

• increased confidence or self-esteem?

• may provide sense of control or optimism (encouragement)

• others may provide ways positive ways of appeasing situation

• presence of others reduces arousal (initial reactivity)

• example: electric shock MRI studies. Married women who could hold their husbands hand showed less reactivity in brain areas that respond to anticipation of shock

• bottom line: friends don’t let friends stress

coping

refers to efforts to manage, reduce, or tolerate stress

-responses may be either adaptive or maladaptive (even if you think they are in same way adaptive)

• example: faced with poor grades

• Adaptive: join study group, reduce hours working

• Maladaptive: oh well, hit George Street

-we tend to apply strategies across situations

common coping strategies

1. lashing out

2. self-defence

3. self-indulgence

4. problem and emotion-focused coping

lashing out

tends to occur after a series of stressors (“the last straw”)

does not seem to be a good coping strategy

self-defence

may involve self-deception or repressive coping style (deny negative feelings)

can be short-term solution but not a good long-term solution

self-indulgence

May include overeating, drinking, or shopping

These are helpful if stressor is simple or short-lived, but ineffective if problem is complex or ongoing

Can also lead to weight gain or bank drain (unhealthy)

problem-focused coping

try to alleviate stress by a direct action with its source. Ex: interpersonal conflict may approach person and try to reach a compromise

-used if you have control over the stressor (e.g. can eliminate or change it)

emotion-focused coping

try to manage your responses to a stressor

-only strategy if you have no control over the stressor

-ex: try to think positive thoughts about roommate

Physiological responses to stress

Two main biological pathways are activated:

• Sympathetic Nervous System (SNS)

• Hypothalamic-pituitary adrenal axis (HPA axis)

Sympathetic nervous system (SNS)

• rapid response of nervous system to stressor

• Involves activation of the adrenal medulla

• Release of norepinephrine

• Increase HR, BP, blood sugar (energy)

• Flight or fight response (Walter Cannon)

Hypothalamic-pituitary adrenal axis (HPA axis)

• first discovered by Hans Selye

• Stressors cause anterior pituitary to release adrenocorticotropic hormone (ACTH) into blood stream

• ACTH stimulates adrenal cortex to release cortisol

• Cortisol increases blood sugar and boosts metabolism

• Also increases alertness and memory in short run and suppresses inflammation

• Note: HPA axis is critical for coping with stress…Selye found that animals without cortisol readily succumb to stressors

Hans Selye

Austrian born endocrinologist. Worked at McGill University. The stress of life. First to use the term stress (and stressor) in psychology

-Stress: “The non-specific response of the body to any demand”

-Important: He noticed that the same stress response occurred (activation of HPA axis) regardless of the specific nature of the stressor (e.g. heat, cold, pain)

The general adaptation syndrome

Selye proposed a three-staged response to prolonged stressors:

• Stage 1 (Alarm Reaction): Body’s reaction to initial exposure to stressor as resources are mobilized (fight-or-flight)

• Stage 2 (Stage of Resistance): Body’s attempt to stabilize if stressor continues. Continues to exert energy to combat stressor. May result in vulnerability to disease

• Stage 3 (Exhaustion): Organism is depleted of energy and can no longer offer resistance. Results in organ failure and death

Note: Selye believed death (old age) itself is the end result of life’s accumulated stress

Stress and health

• Link between mental and physical suggested for thousands of years

• Freuds neurosis suggested link between (unconscious) psychological processes and medial disorders

• By 1930s-1940s medial community recognized many psychosomatic or psychophysiological diseases (e.g. ulcers, asthma, tension or migraine headaches, hypertension)

• Over time, stress pinpointed as a major contributing factor (first clue was role in Coronary Heart Disease)

• Today, 70-80% of doctor visits are for stress- related illnesses. Examples include high blood pressure, headaches, backaches, indigestion, ulcers, diarrhea, fatigue, insomnia, etc

Note: until recently, mechanisms remained elusive

Coronary heart disease

• involves blocking of coronary arteries (supply blood to heart muscles) leading to myocardial infarction (heart attack)

• Prior to 190.s practically unheard of, but steady increase since then

• Second leading cause of death after cancer in men and women over the age of 45 in Canadian about 55,000 deaths each year (Statistics Canada 2020)-17.5% of all deaths

• Many contributing factors: (family history and hypertension) high cholesterol, smoking, body weight, inactivity, and stress

• Stress increases blood cholesterol and clotting of blood (increasing risk of heart disease)

Friedman et al (1984)

• showed direct link between stress and coronary heart disease

• Studied 40 tax accountants prior to, and after tax season

• Increased blood cholesterol and blood clotting (risk factor for heart disease) during peak tax season (April)

• No one escapes death and taxes (and sometimes death from taxes)

Friedman and Rosenman (1974)

• famous type A and type B study

• Studied 3000 healthy male volunteers (ages 35-59)

• All were interviewed prior to study and traits were assessed

• Classified men as Type A (Always tense/stressed: little patience, time pressured, aggressive, easily provoked). Uptight

• Type B (opposite: patient, no sense of urgency, passive). Laid back

• Over 8 years, twice as many Type A developed coronary heart disease ( 69% of 257 heart attacks were Type A)

Personality & coronary heart disease

Follow up to Type A and Type B

• Type A now sometimes called “Coronary Prone Personality

• Anger identified as major contributor

• People classified as angry (or self described as hot headed) are 3 to 5 times more likely to have a heart attack

• Heart attacks more likely to occur within 24 hours of angry outburst

• Rage lashes back at the heart muscle

stress and the immune system

• stress associated with increased risk of many diseases including common cold, streptococcal infections, HIV, even cancer

• led to much interest in the effects of stress on the immune system

suppressed immunity has health consequnces

-in animals, stress accelerates growth of cancerous tumours and slows recovery from injury

-similar effects found in people:

1. wound healing studies (puncture wound in skin) 40% slower in dental students prior to exam. 1-2 days longer in married couples after a spat

2. common cold (virus placed directly in nose) more stressed, the more susceptible from 27% (low stress) to 47% (high stress)…

psychoneuroimmunology (PNI)

growing field which studies links between stress, the immune system, and health

• now know that physiological responses during stress have direct actions on components of the immune system

immune system

the boys system of organs and cells that defend the body from foreign invaders (viruses, bacteria) and abnormal cell growth (cancer cells)

-includes: lymphocytes (white blood cells)

nature killer cells

-classic study: Bartrop (1977) demonstrated suppression of lymphocyte activity in stressed (recently widowed) women

-Since then many stressors shown to suppress measures of immune function in lab animals: cold, heat, electric shock, restraint, and social stress (over crowding or subordination stress, maternal separation)

biological mechanisms

• Ader and Cohen (1975): Demonstrated that immune system could be conditioned (classical conditioning)

• First evidence that brain regulates the immune system

• Then came discovery of receptors for stress hormones on cells of immune system

• Norepinephrine and cortisol bind to lymphocytes. They initially increase but then decrease cells responses

• Cortisol also increases release of cytokines which under prolonged stress leads to increased inflammation throughout body (heart disease, stroke, illness, “blahs”)

behavioural effects

• stress can produce behavioural changes which in turn can lead to poor health

• may lead to anxiety or depression resulting in poor eating habits (patterns), less exercise, sleep disturbances, substance abuse (smoking, drinking, drugs)…all linked to poor health

aerobic exercise

• 3 times a week: reduces stress, depression and anxiety

• people who do not exercise regularly twice as likely to report “not being happy” in Gallup surveys

• extends life on a average by 2 years

• and improves quality of life in the meantime!

-study: Somewhat depressed (stressed) undergraduates assigned to aerobic exercise group, relaxation group or control group

• exercise groups reported less depression 10 weeks later..

spirituality and faith communities

• long standing relationship between faith and well being

• study of over 5000 Californians showed that (after controlling for age, gender, ethnicity, education) in any given year, there are 36% fewer deaths in those who attend religious services regularly

• a large (over 20,000 people) study funded by U.S. centre for diesel control

• life expectancy was 83 years for those who frequently attend religious services compared to 75 years for those who do not

-Why?

• could be related to lifestyles (drink less, smoke less etc)

• but even after these factors are controlled for, 75% of longevity difference remains

• unexplained faith factor

benefits of stress

Selye drew distinction between pleasant and unpleasant stressors

• Distress: stress resulting from unpleasant stressors

• Eustress: stress from positive stressors

• Selye suggested eustress is adaptive (healthy). Example: eager anticipation of a date

• Today eustress is defined as optimal level of stress that promotes physical and psychological health

• Stress sometimes forces us to confront challenges, adapt to new situations, and to develop resilience (post-traumatic growth)

• Note: Stress inoculation promotes resiliency to stresses of life

PTSD

anxiety disorder in response to a traumatic event(s)

symptoms of PTSD

1. intrusive memories, dreams, or nightmares about event

2. avoid activities, thoughts, feelings, conversations that are reminders of the event

3. depression, anxiety, guilt, fear, helplessness

4. sleep problems

5. hyper-reactivity to noise

social withdrawal is also common

who develops PTSD?

• first studied in soldiers

• once called “Shell-shock” or “battle fatigue”

• high prevalence: overall about 19% Vietnam veterans developed PTSD, 37% of those in heavy combat

• Iraq War: about 1 in 6

• Afghanistan: perhaps as high as 1 in 4

• in some wars accounted for as many “casualties” as physical injury or death

• also common in survivors of accidents, disasters, violent and/or sexual assaults

• Can occur at any age, even childhood

• 10% of Canadians during course of lifetime

• Twice as common in women than men

biological factors

• likely involve intense biochemical stress reactions that persist beyond fight-or-flight response

• abnormal cortisol and norepinephrine in rape victims and others who experienced severe stressors

• may have exaggerated sympathetic nervous system responses and blunted HPA axis responses to stress

• may have smaller hippocampus or the biochemical arousal may eventually shrink the hippocampus

• vulnerability may be related to biological differences in structure of amygdala

• spontaneously high anxious rats had more dendrites in amygdala and were more likely to develop symptoms of PTSD

personality factors

people with existing psychological disorders (e.g. more anxious individuals)

childhood experiences

poverty, abuse, assault, catastrophe

social support

individuals with strong social support are less likely to experience PTSD (recovery better from trauma)