Unit 4 - Health psychology (psych)

FINAL TOPIC! you got this, not long now - push through and achieve what i know you can :)

Stress

The non-specific response of the body to any demand

• Demands can be psychological or physiological

• To experience stress = stressor must be present

Two types of stress (Selye, 1936)

1. Distress

2. Eustress

1. Distress (Two types of stress (Selye, 1936))

The negative psychological response to a stressor, indicated by the presence of negative psychological states (e.g. fear, anger)

• Impedes ability to perform at an optimal level

• Can lead to health risks

• Experiences that can trigger include death of a loved one, financial difficulties, conflict

2. Eustress (Two types of stress (Selye, 1936))

The positive psychological response to a stressor, indicated by the presence of positive psychological states

• Improves performance/motivation

• Increases alertness and energy levels → optimum performance when facing challenging situation

• Experiences that can trigger include exam, graduating, driving test, starting a new job, interview, skydiving, etc

Stressor

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

*they are sources of stress

4 types of stressors (Selye, 1936) (define each as well)

1. Environmental stressors: stems from conditions + physical surroundings of an individual e.g. noise, temp, smell, pollution, etc

2. Psychological stressors: stems from emotional and cognitive factors e.g. graduating, new job, buying house

3. Social stressors: stems from relationships and interactions with society e.g. peer pressure + conflict with friends/family

4. Cultural stressors: stems from cultural identity, values and cultural norms e.g. discrimination or loss of cultural practices

3 characteristics of stressors

• Nature: can be categorised as environmental, psychological, social or cultural

• Duration: can be short term (acute) or long term (chronic)

• Strength: the severity/intensity of the stressor can range from mild to severe

Stress as a response

• General Adaptation Syndrome (GAS) model (Selye, 1936)

• Describes the physiological changes that the body automatically goes through when it responds to stress

2 physiological changes when exposed to a stressor and experience stress (Selye, 1936)

• Heart rate increases

• Breathing rate increases

3 stages of the GAS model (Selye, 1936)

1. Alarm

2. Resistance

3. Exhaustion

1. Alarm - GAS model stage (Selye, 1936)

• The initial response to a stressor (one of the 4 types). Has 2 substages:

  1. Shock: when we first perceive threat, body’s resistance drops below normal - responds as if it has been injured, physical effects makes person feel momentarily helpless

  2. Countershock: after shock stage, body rebounds and sympathetic NS activates to prepare for fight or flight

• The amygdala detects threat and signals the hypothalamus to initiate the SNS

• When signal reaches adrenal glands, it triggers the release of adrenaline, noradrenaline and cortisol (stress hormones)

*countershock occurs 6-48 hours after initial stressor is detected

Hormones in alarm stage (GAS model, Selye 1936)

THEY ARE ALL SECRETED FROM ADRENAL GLANDS

Cortisol:

• When body experiences stress, it increases pain tolerance but reduces performance of immune system and cognitive abilities

Adrenaline:

• Increases heart rate and supports conversion of glycogen into glucose

Noradrenaline:

• Causes blood vessels to constrict and blood pressure to increase

2. Resistance - GAS model stage (Selye, 1936)

• If stressor remains = body enters this stage → attempts to restabilise its internal systems and fight stressor

• Body tries to repair itself from initial shock by reducing SNS, initiating Parasympathetic NS to counteract SNS’s heightened arousal

• Stress hormones continue to be secreted to help the body cope

• Energy is directed to managing the stress

3. Exhaustion - GAS model stage (Selye, 1936)

• Occurs if stressor continues for a prolonged period

• Adrenal glands lose effectiveness, blood sugar drops and physical health declines

• The body’s resources become depleted, leading to…

  • fatigue, low motivation, impaired immunity, and increased risk of mental illness and physical illness

Stress as a stimulus

• Holmes and Rahe (1967)

• Describes stress as a significant change in life that requires an adjustment to be made

• Assumes:

  • Life changes are stressful events that will cause the development of physical/mental illness if change exceeds a general limit of adjustment

  • Levels of adjustment are similar among everyone

• According to the theory, personality, life experiences and social support do not affect the impact of stress or adjustments

Social Readjustment Scale (SRS) - Holmes and Rahe, 1967

*also referred to as the Holmes and Rahe Stress Scale

• Assesses amount of stress experienced by an individual in the past year

• Comprises of 43 life events that are allocated a score between 1-100

• These scores = life change unit (LCU) = estimates amount of readjustment required if event is experienced

• Individual indicates events experienced in past year + their LCU’s are added to equal their final score of total stress readjustment

• Likeliness of developing a physical/mental illness can be calculated through this

Strength and limitations of the Social Readjustment Scale (SRS) (Holmes and Rahe, 1967)

Strength:

• Quantitative data is collected, easy to statistically analyse

Limitations: 

• Checklist = subjective measure, can allow for exaggerated responses

• No reasoning for responses, limiting richness of the data

Stress as a transaction

• Lazarus and Folkman, 1984

• Suggests individuals utilise their perception of a stressful situation + their subjective past experiences to help them cope

• Stress response depends on emotions and psychological factors unique to the individual

• Emphasises relationship between person and characteristics of event that took place

Role of cognitive appraisal (Lazarus and Folkman, 1984)

• Refers to cognitive abilities used to assess situations

• Stress is present when an individual cognitively appraises an event as stressful

Stages within the transactional model of stress (Lazarus and Folkman, 1984)

• Primary appraisal: notice a stressor in the environment, decide how important the event is to ones wellbeing. Can be:

  • Irrelevant

  • Positive

  • A challenge or threat/loss risk = STRESSFUL CATEGORY - if it is either of these, proceed to secondary appraisal

• Secondary appraisal: assesses both the internal and the external resources that are available, and evaluate whether they can meet the demands of the stressor

  • if they believe they have resources to cope = positive secondary appraisal = no stress/eustress

  • if they feel demands of stressor exceeds ability to cope = negative secondary appraisal = distress

*secondary appraisal does not necessarily happen after primary appraisal

Two methods of coping

1. Emotion focused coping:

• Goal = manage emotional reactions to stress. Used when individual perceives that they don’t have the resources to deal with the stressor

• e.g. meditation, relaxation techniques, talk therapy, systemic desensitisation, etc

2. Problem focused coping:

• Goal = address the root cause of the stress. Used when an individual perceives that they do have the resources to deal with the stressor

• e.g. pitch at work, quitting a job, etc

Two types of coping strategies for stress

1. Maladaptive coping: involve harmful and unhealthy stress management that worsens negative effects of stress.

   • Avoids dealing with stressors that are causing problems.

• e.g. negative self-talk, denial, substance abuse, withdrawing from society, rumination (repetitive thoughts), self blame, procrastination

2. Adaptive coping: involve beneficial and productive stress management that decreases the negative effects of stress

• e.g. meditation, exercise, positive reframing, planning, acceptance, humour, emotional support by talking to others

Sleep

Refers to periods of altered/loss of consciousness

Sleep latency

The length of time it takes to fall asleep

Evolutionary purpose of sleep

States sleep serves as a means to increase an animals or humans chance of survival in its environment

• Early humans used daytime instead of night to eat, drink and reproduce as there was greater risk of injury/predators in the dark that could threaten survival

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

• Sleeping at night allowed for energy to be conserved

Restorative purpose of sleep

States sleep allows us to recharge, grow and recover from physical and psychological work during the day

• Claims homeostasis of the body is disrupted when humans are awake → sleep acts to restore it

• Sleeping allows energy levels that decline during wakefulness to be restored:

  • Repairs and replenishes body

  • Increases alertness

  • Increases immunity to disease

Comparison of purposes of sleep

Sleep wake cycle

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

• Measured by recording times of regular events e.g. eating and sleeping

• Regulated by the circadian rhythm, body temperature, metabolic rate, and release of hormones

Circadian rhythm

The biological cycle that lasts around 24 hours and controls the nocturnal release of hormones including melatonin

• For humans, dominant circadian rhythm = sleep wake cycle

• This is largely controlled by suprachiasmatic nucleus = the internal body clock located in the hypothalamus

Melatonin

The hormone that regulates the sleep wake cycle

4 distinct stages of the sleep cycle

• There are 3 non-REM stages and one REM

  • REM = rapid eye movement

  • NREM = non-rapid eye movement

1. Non Rapid Eye Movement (4 distinct stages of the sleep cycle)

• Sleep state: transitional period between wakefulness and sleep

• Heart rate decreases

• Eye movements are a slow rolling movement (once asleep they stop moving)

• Muscles relax

• Length of stage: 1-7 minutes

  • If uninterrupted, individuals quickly move into NREM 2 and minimal time spent in this stage

2. Non Rapid Eye Movement (4 distinct stages of the sleep cycle)

• Sleep state: light NREM sleep

• Heart rate slows down

• Eye movements stop

• Muscles continue to relax + there are occasional muscle twitches

• Length of stage: 10-25 minutes

  • First time stage occurs = lasts 10-25 minutes, then increases in length with each repetition

3. Non Rapid Eye Movement (4 distinct stages of the sleep cycle)

• Sleep state: deep NREM sleep

• Heart rate continues slowing down

• Minimal eye movement

• Muscles are at most relaxed state

• Length of stage: 20-40 minutes

  • First few stages = lasts 20-40 minutes, then reduces in length

4. Rapid Eye Movement (4 distinct stages of the sleep cycle)

• Sleep state: dreams occur during this stage

• 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 a high level of brain activity

• Length of stage: 10-60 minutes

  • Stage increases in duration over the night ranging from a few minutes to one hour

Order of stages within each sleep cycle

• Sleeper enters stage 1 NREM sleep (usually happens only once per night)

• Then sleeper progresses through stages 2 + 3, reaching deeper sleep

• They then reverse back to stage 2 before entering REM sleep

  • e.g. NREM stage 1→ stage 2 → stage 3 → stage 2 → REM

• After first cycle, sequence typically becomes: stage 2 → stage 3 → stage 2 → REM

Sleep cycles throughout the night and purpose of NREM/REM sleep

• Each night of sleep is made up of 4-6 sleep cycles lasting approx 90-110 min (first cycle is 90 min)

• From third cycle →, stage 2 NREM and REM lasts longer whilst stage 3 NREM becomes shorter

• In fourth, fifth and sixth cycle, stage 3 NREM = rare, more time spent in REM

• There is evidence that:

  • NREM sleep (stage 3) = involved with restoring the body and physical energy

  • REM sleep = important for restoring brain function e.g. memory and concentration

• These cycles can be visualised as a hypnogram

Sleep deprivation

The condition of not getting sufficient sleep

Causes for sleep deprivation

1. Shift work

2. Drugs

3. Sleep environment

4. Stressors

1. Shift work (causes of sleep deprivation)

• Involves altering sleep wake cycle and consequently reducing the amount and quality of sleep

• Trouble sleeping is caused by the disruption of hormones that regulate the sleep wake cycle + circadian rhythm, and the lack of zeitgebers (person is no longer given signals when to wake up/fall asleep)

2. Drugs (causes of sleep deprivation)

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

• Caffeine is a stimulant drug, it speeds up the CNS

• Alcohol is a depressant, it slows down the CNS - when it wears off it causes people to wake up

• Alcohol and caffeine both negatively impact sleep

3. Sleep environment (causes of sleep deprivation)

• A bright environment (reduces melatonin) and/or loud environment (wakes people up) can disrupt the sleep wake cycle

4. Stressors (causes of sleep deprivation)

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

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

2 types of sleep deprivation

1. Partial sleep deprivation

2. Chronic sleep deprivation

1. Partial/acute sleep derivation (2 types of sleep deprivation)

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

• No exact number constitutes this - generally less than 5 hours of sleep over 24 hours

• Can be due to disruptions to the normal progression/sequence of sleep stages → fragmented sleep and decreased quality

• Immediate effects can typically be reversed with adequate sleep

• Common causes: staying up to finish an assignment, illness/sickness, jet lag, pulling an all nighter, stress

2. Chronic sleep deprivation (2 types of sleep deprivation)

The persistent reduction of sleep over a long period of time.

• Inadequate sleep for more than a few weeks at a time, sometimes lasting years

• The consequences are more detrimental than those caused by partial sleep deprivation

• Common causes: insomnia, sleep disturbances, work hours, life style choices

Effects of partial sleep deprivation

• Attention: lapses in attention increase when sleep deprived

• Mood: can decrease mood and cause irritability

• Reflex speed: reaction times tend to become higher which means it takes longer to react to stimuli

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

*reversible once adequate sleep is achieved

Effects of chronic sleep deprivation

• Heart disease: increased blood pressure + high cholesterol are effects, both possibly leading to heart disease

• Obesity: individuals increasing intake of high energy foods as well as amount of food they eat

• Insomnia: a sleep disorder involving difficulties falling asleep or staying asleep (low sleep latency). Also common to wake up not feeling well rested

• Anxiety: emotional regulation is negatively affected by this, possibly worsening symptoms of anxiety

Sleep hygiene

The behaviour and sleep environment that results in a healthy sleep

Zeitgebers

Cues in the environment that provide signals to our brains to do things at certain times. Sleep wake can be improved by exposure to correct zeitgebers at appropriate times

• e.g. light → when brain receives lower levels of light, SCN signals the release of melatonin, making us feel drowsy and promoting sleep

• e.g. if you brush you teeth, put on pjs and read a book prior to sleep every night, this routine will signal your brain that its time to sleep

3 techniques to improve sleep hygiene

1. Management of electronic devices

2. Consistent sleep patterns

3. Sleep environment

1. Management of electronic devices (3 techniques to improve sleep hygiene)

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

• They emit blue light that prevents melatonin production - disrupting circadian rhythm which makes it difficult to fall asleep

• Results in brain simulation that reduces both sleep quality and duration, due to heightened cognitive arousal

2. Consistent sleep patterns (3 techniques to improve sleep hygiene)

• Critical for good sleep = regulates the circadian rhythm. This increases amount of sleep.

• Consistent bed time and wake time can help prevent sleep deprivation, can achieve this by getting recommended sleep hours based on age

3. Sleep environment (3 techniques to improve sleep hygiene)

• Circadian rhythm can change due to uncomfortable sleeping space

• Bedroom should be free of distractions like electronic devices

• Bed should be used for sleeping and intimacy only - creates a cognitive link between bed and sleep

Aim (Restricting Bedtime Mobile Phone Use, He et al 2020)

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

Method (Restricting Bedtime Mobile Phone Use, He et al 2020)

• Participants: 38 University students with habit of using their mobile phone before bed AND experience poor sleep quality.

• Materials: Positive and Negative Affect Schedule (PANSAS), n-back task, Pre-Sleep Arousal Scale (PSAS), Pittsburgh Sleep Quality Index (PSQI) and an online sleep diary.

• Design:

  • IV = use of mobile phones during bedtime vs no mobile phone use for 30 minutes before bedtime.

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

Procedure (Restricting Bedtime Mobile Phone Use, He et al 2020)

1. Researchers obtained ethics approval from the Ethics Committee. Participants volunteered (via social media) and signed online informed consent sheets

2. Participants completed all tests to gain a baseline of results

3. Participants were randomly assigned to experimental group with restricted mobile phone use or control group with no restrictions (19 in each)

4. For the next 4 weeks, participants in experimental group did not use mobile phones for 30 minutes prior to bedtime. Participants in control group continued with normal mobile phone use.

5. At the four week mark, participants completed the same tests as sat during pretesting and these were compared.

Tools for measuring sleep used in He et al study

• Positive and Negative Affect Scale (PANSAS) = subjective quantitative (likert)

• n-Back Task = objective quantitative

• Pre-sleep Arousal Scale (PSAS) = subjective quantitative (likert)

• Pittsburgh Sleep Quality Index (PSQI) = subjective quantitative

• Online sleep diary = qualitative (survey)

Key findings (Restricting Bedtime Mobile Phone Use, He et al 2020)

Participants who had restricted mobile phone use had positive benefits (1 mark, if more, list the benefits shown below):

• Improved positive affect and reduced negative affect

• Improvement in their working memory

• Reduced pre-sleep arousal

• Improved quality of sleep

• Take less time to fall asleep and stayed asleep for longer

Contributions to psychology (Restricting Bedtime Mobile Phone Use, He et al 2020)

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

• With replication comes the ability to assess reliability

Criticisms/limitations (Restricting Bedtime Mobile Phone Use, He et al 2020)

• Sample characteristics: small sample size limits the ability to generalise results to the population

• Self report measures: as all measures except for the n-back task were self reports, the data was subjective and open to bias