Applications of psychology to health

Unit 4

What is stress (as defined by Seyle 1936)

The non-specific response of the body to any demand

• Demands can be psychological or physiological

• To experience stress a stressor must be present

• Stress is experienced when a person perceives that the demands of the stressor exceed their ability to cope

What are the types of stress (Seyle; 1936)

• Distress

• Eustress

What is distress?

A negative psychological response to a stressor as indicated by the presence of negative psychological states (such as anger, fear, or feelings of hopelessness + helplessness)

*Impedes ability to perform at an optimum level

*Can lead to health risks

E.g. death of a loved one, financial difficulties, conflicts, etc.

What is eustress

The positive psychological response to a stressor, as indicated by the presence of positive psychological states (such as excitement, enthusiasm, and optimism)

*Occurs when there is stress yet a feeling of being capable to overcome

*Beneficial as it increases alertness and energy levels, leading to optimum performance

*Normally enjoyable and can motivate behaviour

E.g. exams, performances, grand final game, driving test, new job, interviews, etc.

What is a stressor?

Any person, object, or event that challenges or threatens an individual, thus causing feelings of stress

(sources of stress)

From internal or external factors

What are the types of stressors?

• Environmental stressors

• Psychological stressors

• Social stressors

• Cultural stressors

What are environmental stressors?

The conditions and physical surroundings of an individual

E.g. noise, temperature, smell, pollution, natural disasters, etc.

What are psychological stressors?

Caused by emotional and cognitive factors

E.g. graduating, new job, buying a house, relationship changes, etc.

What are social stressors?

Stems from relationships and interactions with society

E.g. peer pressure, and conflicts with family and friends

What are cultural stressors?

Cultural identity, values, and cultural norms

E.g. discrimination or loss of cultural practices

What are characteristics of stressors?

• Nature: the type of stressor

• Duration: the time frame (short-term or long-term)

• Strength: the severity/intensity of the stressor

What is the GAS model of stress - model of stress?

The General Adaption Syndrome (GAS) model is used to describe the physiological changes that the body automatically goes through when it responds to stress

SEYLE 1983 - biological perspective

Stressor = physical reactions = stress as a response

What physiological changes occur when initially exposed to stress?

• Heart rate increases

• Breathing rate increases

What are the 3 GAS stages?

1. Alarm

2. Resistance

3. Exhaustion

What is the alarm stage (GAS)?

The initial response to a stressor

First shock occurs where the body’s resistance drops below normal and responds as if it has been injured.

Then countershock occurs where the sympathetic nervous system activates to prepare for fight or flight. This occurs 6-48 hours after initial stress is detected.

The amygdala detects threat and signals the hypothalamus (SNS). This triggers the release of adrenaline, noradrenaline, and cortisol.

What do adrenaline, noradrenaline and cortisol do?

• Adrenaline: increases heart rate and supports conversion of glycogen

• Noradrenaline: causes blood vessels to constrict and blood pressure to increase

• Cortisol: increases pain tolerance, reduces performance of the immune system, and impairs cognitive ability

All secreted from the adrenal gland

What is the resistance stage (GAS)?

If the stressor remains, the body enters this stage as it attempts to re-stabilise its internal systems and fight the stressor

The parasympathetic nervous system begins to counteract the heightened arousal

Stress hormones continue to be secreted to help the body to cope and energy is directed towards maintaining the stress

If the stress is continued and not resolved, the third stage is reached

What is the exhaustion stage (GAS)?

It occurs if the stressor continues for a prolonged period, limiting the effectiveness of the adrenal glands, blood sugar drops and physical health declines

The body’s resources become depleted, which leads to fatigue, low motivation, impaired immunity, and increased risk of mental and physical illness.

How did Holmes and Rahe (1967) describe stress?

As a significant change in life that requires a response or adjustment to be made

Assumption that life changes are stressful events and according to this theory personality, life experiences, and social support do not affect the impacts of stress or adjustments made as a result

What is the Social readjustment scale - stress as a stimulus?

The Social readjustment scale or Holmes and Rahe stress scale, 1967, assesses the amount of stress that has been experienced by an individual in the past year

It is comprised of 43 life events and a score of 1 to 100 has been allocated to each event, e.g. vacation has a score of 13 LCU (life change units) and the death of a close family member has a score of 63 LCU

The LCU estimates the amount of response and readjustment required if the event is experienced

The individual receives a score based on their total stress adjustment

What are the strengths of LCU as a measurement tool?

• Quantitative data is collected, which is easy to statistically analyse

What are the limitations of LCU as a measurement tool?

• Responses rely on subjectivity and honesty from participants

• No reasoning for responses/rich data (common limitation of quantitative data)

Explain stress as a transaction, Lazarus and Folkman, 1984

They suggested that individuals utilise their perception of a stressful situation and their subjective past experiences to help them cope

The stress response depends on emotions and psychological factors that are unique to the individual

The emphasis of this theory is on the relationship between the person (including their unique traits), and the characteristics of the environmental event taken place

Lazarus and Folkman, 1984, psychological perspective

Explain stress as a transaction with the diagram:

 

What are the stages within the transactional model of stress?

• Primary appraisal

• Secondary appraisal

What is primary appraisal?

When the individual notices a stressor in their environment and decides whether it is irrelevant, a challenge, or a threat/loss/risk

What is secondary appraisal?

The individual assesses both the internal and external resources that are available and evaluate whether they can meet the demands of the stressor

What are methods for coping stress (Lazarus and Folkman, 1984)

• Emotion focused coping

• Problem focused coping

What is emotion-focused coping?

The goal is to manage the emotional reactions to stress. This will be used when an individual perceives that they do not have the resources to deal with the stressor

E.g. meditation, talk-therapy, relaxation techniques, etc.

What is problem-focused coping?

The goal is to address the root cause of the stress. This will be used when an individual perceives that they do have the resources to deal with the stressor

E.g. quitting a job, etc.

What are coping strategies for stress?

• Maladaptive coping

• Adaptive coping

What is maladaptive coping?

Coping strategies that involve harmful and unhealthy stress management that exacerbates its adverse effects

These strategies avoid dealing with the stressors that are causing the problems

E.g. negative self-talk, denial, and substance abuse

What is adaptive coping?

Beneficial and productive methods for managing stress that can decrease the adverse impacts of stress

E.g. meditation, exercise, and positive reframing

What are the two purposes of sleep?

• Evolutionary

• Restorative

What is the evolutionary purpose of sleep?

• A theory stating that sleep serves as a means to increase an animal’s or human’s chance of survival in its environment

• Early humans used the daytime rather than nighttime to eat, drink, and reproduce, as there was greater risk of injury in the dark, as well as predators at night that could threaten their survival

• Sleeping at night allowed for energy to be conserved

• Sleep depends on the need to find food and the animals vulnerability to predators

What is the restorative purpose of sleep?

• A theory stating that sleep allows us to recharge our bodies and recover from the physical and psychological work during the day; also allowing our body’s growth processes (homeostasis) to occur

• Recuperation theories of sleep claim that homeostasis of the body (balance of internal physiological functioning) is disrupted when humans are awake and that sleep acts to restore it

• Sleeping allows the energy levels that decline during wakefulness to be restored: repairs and replenishes the body, increases alertness, increases immunity to disease, enhances mood, and activates growth hormones.

Summary table comparing the two purposes of sleep:

What is the sleep-wake cycle?

The recurring pattern of wakefulness and sleep that individuals undergo on a daily basis

Usually measured by recording times of regular events, like when we eat and when we sleep

This cycle is regulated by the circadian rhythm, body temperature, metabolic rate, and the release of hormones

What is the circadian rhythm?

The biological cycle that lasts around 24 hours and controls the nocturnal release of hormones, including melatonin (hormone that regulates sleep-wake cycle)

Found in the hypothalamus and is called the suprachiasmatic nucleus (SCN)

Dominant sleep-wake cycle

Why is sleep important?

Impacts:

• Restoring energy

• Recovering from injury/illness

• Memory

What are the 4 stages of sleep?

1. NREM 1

2. NREM 2

3. NREM 3

4. REM

Explain NREM 1

• Sleep state: transitional period between wakefulness and sleep

• Heart rate decreases

• Eye movements are a slow rolling movement that stop once individual is asleep

• Muscles relax

• Lasts 1-7 minutes, if the individual is not interrupted they quickly move into NREM 2 and minimal time is spent in this stage

Explain NREM 2

• Sleep state: light non-rem sleep

• Heart rate slows down

• Eye movement stops

• Muscles continue to relax and there are occasional muscle twitches

• Length of stage: 10-25 minutes, increases in length (after the first time it occurs) with each repetition of the sleep cycle

Explain NREM 3

• Sleep state: deep non-rem sleep

• Heart rate continues to slow down

• Minimal eye movement

• Muscles are at their most relaxed state

• Length of stage: 20-40 minutes, then after the first few sleep cycles it reduces in length

Explain REM (stage 4)

• Sleep state: dreams occur

• Heart rate increases to match the rate when awake (varies based on dream content)

• Rapid eye movement, visual information is not transmitted to the brain

• Muscles are temporarily paralysed (except for breathing and eye movement)

• Involves high level of brain activity

• Length of stage: 10-60 minutes, with it increasing over the night ranging from a few mins to an hour

Expand more on the sleep cycle:

• Each night of sleep is made up of (4-6) sleep cycles that last between 90-110 minutes

• The sleeper enters stage 1 NREM sleep, which usually happens once per night

• After stage 1 the sleeper progresses through stages 2 and 3, reaching deeper sleep. They then reverse back to stage 2 before entering REM sleep

• E.g.: NREM 1 - NREM 2 - NREM 3 - NREM 2 - REM

• These cycles can be visualised in a hypnogram

• In the 4th, 5th, and sometimes 6th cycle, stage 3 NREM becomes rare and more time is spent in REM

• NREM stage 3 is mostly involved with restoring the body and physical energy

• REM sleep is most important for restoring brain function, such as memory and concentration

What is sleep deprivation?

The condition of not getting sufficient sleep

What are the causes of sleep deprivation?

• Shift work

• Drugs

• Sleep environment

• Stressors

How does shift work cause sleep deprivation?

• Shift-work involves altering the sleep-wake cycle and consequently reducing the amount and quality of sleep

• Humans have hormones, such as melatonin, that help to regulate the sleep-wake cycle and circadian rhythm

• Trouble sleeping is caused by the disruption of hormones and lack of sleep cues - disrupting the consistent nature of the circadian rhythm and sleep cycle

How do drugs cause sleep deprivation?

• Some drugs impact sleep stage progression/quality, reducing NREM sleep, and affecting REM sleep

• Caffeine is a stimulant drug that speeds up the CNS

• Alcohol is a depressant that slows down the CNS

• Alcohol and caffeine both negatively impact sleep

How does sleep environment cause sleep deprivation?

• A bright environment and/or loud environment can disrupt the sleep-wake cycle

How do stressors cause sleep deprivation?

• Stressors cause anxiety and anxiety can cause issues falling and staying asleep

• E.g. test/exam, headache (illness), school, etc.

What are the two types of sleep deprivation?

• Partial/acute sleep deprivation

• Chronic sleep deprivation

What is partial/acute sleep deprivation?

The severe reduction or complete lack of sleep over a short-period of time

Usually less than 5 hours over a 24 hour period

The effects are reversed once adequate sleep returns

E.g. studying, illness, all-nighter, jet-lag, stress, etc.

What are the effects of partial sleep deprivation?

• Attention: lapses in attention

• Mood: decreases in mood and increases in irritability. Emotional processing is affected

• Reflex speed: reaction times increase, taking us longer to react to stimuli

• Vision: can become blurry, eye twitches may occur and eyes become sensitive to light

*Reversible once adequate sleep is achieved

What is chronic sleep deprivation?

The persistent reduction of sleep over a long period of time

Spans for more than a few weeks to years

The effects are harder to reverse, sometimes leading to negative health outcomes

E.g. sleep disorders, work-life balance, health conditions, etc.

What are the effects of chronic sleep deprivation?

• Heart disease: increases blood pressure and high cholesterol (leading to heart disease)

• Obesity: increases the intake of high energy foods, as well as overall amount of food intake

• Insomnia: difficulties falling and staying asleep (low sleep latency)

• Anxiety: emotional regulation is negatively impacted, which can increase anxiety (cycle of anxiety = trouble sleeping = anxiety)

*Typically hard to reverse

What is sleep hygiene?

The behaviour and sleep environment that can result in a healthy sleep

What are techniques to improve sleep hygiene?

• Management of electronic devices

• Consistent sleep patterns

• Sleep environment

How can management of electronic devices improve sleep hygiene?

• It is recommended that electronic device use is ceased one hour before bedtime

• Electronic devices emit blue light which prevents melatonin production

• This results in brain stimulation that reduces both sleep quality and duration

How can consistent sleep patterns improve sleep hygiene?

• It is critical for the circadian rhythm to have a consistent bed time routine and sleep hygiene

• Consistent bedtime and wake time helps the body clock and prevents sleep deprivation

How can sleep environment improve sleep hygiene?

• Bed should be used for sleeping and intimacy only - including minimal use of electronic devices - this creates a cognitive link between the bed and sleep

What was the aim of study: restricting bedtime mobile phone use?

To determine how limiting use of mobile phones before bedtime affects mood, working memory, pre-sleep arousal, sleep quality, and sleep habits

He et al, 2020

What were the participants and materials of He, et al, 2020 study

• Participants: 38 university students who had the habit of using mobile phones before bed, as well as experiencing poor sleep quality

• Materials: positive and negative affect schedule (PANSAS), n-back task, pre-sleep arousal scale (PSAS), Pittsburg sleep quality index (PSQI), and an online sleep diary

What is the Positive and negative affect schedule (PANSAS)

• Self-report measure

• 20 statements each requiring the completion of a 5-point likert scale

• Positive and negative emotions over the past week were assessed

What is the n-back task?

• Working memory is tested

• Computer program used where participants are presented with a series of numbers and required to respond when; a specific number is presented, when two identical numbers are presented one after the other, and finally when a number is identical to the one that appeared two numbers prior

What is the pre-sleep arousal scale (PSAS)?

• Self-report measure

• 5-point likert scale for each of the 16 statements that pertain to cognitive and somatic arousal experienced when trying to fall asleep in bed

• Cognitive arousal refers to thoughts (e.g. worrying about falling asleep)

• Somatic arousal refers to physiological symptoms (e.g. increased heart rate)

What is the Pittsburg sleep quality index?

• Self-report measure

• 19 items that assess sleep quality and disturbances over the past month where a high score of 21 indicates sleep disturbances

What is the online sleep diary

• Self-report measure

• Daily record, including bedtime, time taken to fall asleep, wake up time, time arisen from bed, sleep duration, length of time mobile phone was used during the day and length mobile phone was used between 9pm and sleep time

What was the design for He, et al, 2020

• IV: use of mobile phones before bedtime vs no mobile phone use for 30 minutes before bedtime

• DV: mood, working memory, pre-sleep arousal, sleep quality, and sleep habits

What was the procedure of the He, et al 2020 study?

1. Researchers obtained approval from the ethics committee, participants volunteered and signed online informed consent sheets

2. Participants completed all tests to gain a base-line of results

3. Participants were randomly assigned to either the experimental or control group (19 in each)

4. Participants in the experimental group did not use mobile phones for 30 minutes before bedtime. Participants in the control group continued with their normal mobile phone use

5. At the 4 week mark, participants completed the same tests and results were compared

What was the key findings of the He, et al, 2020 study?

• Participants who did not use their mobile phone for 30 minutes before bedtime were shown to take less time to fall asleep, stayed asleep for longer, had improved quality of sleep, reduced pre-sleep arousal, improved positive affect, reduced negative affect, and showed improvement in their working memory

What was the contribution of the He, et al, 2020 study?

• Recent study that uses established measures, allowing it to be replicated by other researchers

• With replication comes the ability to assess reliability

What are the limitations of the He, et al, 2020 study?

• Sample size was small, limiting ability to generalise results to the population the sample was taken from

• All measures, except n-back test, gathered subjective data from participants as they included self-report measures and online diary entries

• Subjective measures should ideally be used in combination with physiological measures, as these collect objective data that is likely to be less biased