Stress & Health Adaptation and Coping

Pattern of specific and nonspecific 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 (WHO)

Stress

Accounts for 60% of doctor visits

Stress

External demands of life

Stressors

Stressors:

• Physical, mental or emotional

• Acute or chornic

Physical and emotional effects to stressor

Stress response

A persons perception of a stressor dramatically affects the physiologic responses

Stress

Voluntary human behaviors can moderate or aggravate the effects of these responses

Stress

Stress & homeostasis

ANS
HPA

Stress & homeostasis: ANS

SNS

PNS

Stress & homeostasis: HPA

• Hypothalamus

• Anterior pituitary

• Adrenal cortex

Stress & homeostasis: ANS: Activated by consciously perceived stimuli or by reflexive unconscious response

SNS

Stress & homeostasis: ANS: Norepinephrine

SNS

Stress & homeostasis: ANS: “brake” that dampens the response

PNS

Stress & homeostasis: HPA: Releases CRH and AVP

Hypothalamus

Stress & homeostasis: HPA: Releases ACTH

Anterior pituitary

Stress & homeostasis: HPA:Releases cortisol and aldosterone

adrenal cortex

Stress & homeostasis: increase in

• ANS:

• HPA:

ANS

• HR

• BP

• CO

• Glycolysis

HPA

• Gluconeogenesis

• Salt and water retention

• Circulating volume

Physical or psychological srtess =

Physiological response is the same

Stress & homeostasis purpose

• Essential for survival

• Self regulatory

• Chronic activation impairs health

Acute and chronic activation of stress response:

• Cortisol __ insulin release, insulin dependent growth factor and insulin sensitivity

Reduces

Acute and chronic activation of stress response: __: + acutely improves immediate energy

Cortisol

Acute and chronic activation of stress response: __: –chronically contributes to development of DM, obesity and dylipidemia

Cortisol & NE

Acute and chronic activation of stress response: __: Increases inflammatory cytokines ie IL-6 and TNF-α and CRP

Cortisol & NE

Acute and chronic activation of stress response: __: + acutely activates cellular immunity to fight acute infection

Cortisol & NE

Acute and chronic activation of stress response: __: – chronically cause inflammation of the arterial endothelium contributing to development of atherosclerotic plaques

Cortisol & NE

Acute and chronic activation of stress response: __: – chronically stimulate CRF release, perpetuating the stress response

Cortisol & NE

Acute and chronic activation of stress response: __: constrict renal arterioles and promote sodium retention

Norepinephrine and AVP (Arginine Vasopressin)

Acute and chronic activation of stress response: __: + preserves circulating volume and reduces the risk of hypovolemic shock in acute injury or bleeding

Norepinephrine and AVP (Arginine Vasopressin)

Acute and chronic activation of stress response: __: – contributes to the development of hypertension

Norepinephrine and AVP (Arginine Vasopressin)

How an individual conceptualizes stress determines his __

response, adaptation, and coping strategies

Stress: Factors that contribute to it

1. Response

2. Transaction

3. Stimulus

__: Hans Selye

Response

__: Physiological response pattern

Response

__: General adaptation to stress model

Response

__: Response: 3 concepts

1. Defense mechanism

2. Follows the 3 stages of alarm, resistance, and exhaustion

3. If prolonged or severe, can result in diseases of adaptation or even death

Resistance to stress

• Alarm

• Resistance

• Exhaustion

Stress: __: Initiation of SNS response

Alarm

Stress: __: Initiates physiological systems with right or flight reaction to stressor, return to homeostasis, reducing harm or accommodating the stressor

Resistance & Exhaustion

__: A significant life event or change that demands response, adjustment or adaptation

Stress

__: Change is inherently stressful

Stress

__: Life events demand the same levels of adjustment across the population

Stress

__: There is common threshold beyod which illness will result

Stress

__: Richard lazarus

Transsaction

__: Transactional theory of stress and coping

Transaction

__: Stress as a product of transaction bw a person (including cognitive, physiological, affective, psychological, and neurological) and his complex environment

Transaction

Coping with stress: Therapy

Cognitive

Coping with stress: Hobbies

Cognitive

Coping with stress: Meditation

Cognitive

Coping with stress: Mindfulness

Cognitive

Coping with stress: Planning

Cognitive

Coping with stress: Reading

Cognitive

Coping with stress: Time management

Cognitive

Coping with stress: Artistic expression

Physical

Coping with stress: Deep breathing

Physical

Coping with stress: Natural medicine

Physical

Coping with stress: Physical exercise

Physical

Coping with stress: Relaxation

Physical

Coping with stress: Yoga

Physical

Coping with stress: Music

Environmental

Coping with stress: Nature

Environmental

Coping with stress: Pets

Environmental

Coping with stress: Spa visits

Environmental

Coping with stress: Conflict resolution

Other

Coping with stress: Prayer

Other

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

Types of stress coping

Problem focused coping (active)

Emotion focused coping (passive)

Stress coping: __: Has resources to manage the challenge

Problem focused coping (active)

Stress coping: __: “I try to analyze the problem in order to better understand; im making a plan of action and follow up”

Problem focused coping (active)

Stress coping: __: Lack the capacity to respond to challenge

Emotion focused coping (passive)

Stress coping: __: Feels a lack of control

Emotion focused coping (passive)

Stress coping: __: Wishful thinking (i wish i could change what is happening or how i feel)

Emotion focused coping (passive)

Stress coping: __: Distancing (ill try to forget the whole thing)

Emotion focused coping (passive)

Stress coping: __: Emphasizing the positive (see the silver lining)

Emotion focused coping (passive)

Related concepts to stress coping: __: believes that their achievements and outcomes are determined by their own decisions and efforts

Internal locus of control

Related concepts to stress coping: __: If they dont exceed, its due to their lack of efforts

Internal locus of control

Related concepts to stress coping: __: Believes that achievements and outcomes are determined by fat, luck, or others

External locus of control

Related concepts to stress coping: __: If a person doesnt succeed, its due to uncontrollable external efforts

External locus of control

Extent to which one has a pervasive, enduring though dynamic feeling of confidence that the stimuli deriving from ones internal and external environments in the course of living are structured, predictable and explicable

Sense of coherence

Extent to which one has a pervasive, enduring though dynamic feeling of confidence that the resources are available to one to meet the demands posed by the stimuli

Sense of coherence

Extent to which one has a pervasive, enduring though dynamic feeling of confidence that these demands are challenges worth of investment and engagement

Sense of coherence

Belief in ones own ability to complete tasks and reach goals

Self-efficacy

Self-related growth or living

Self-efficacy

__: Self-related growth or living: Dispositional response to stress that enable the individual to see opportunities for growth as opposed to threat or debilitation

Self-efficacy

__: Self-related growth or living: Psychological state in which individuals experience both a sense of vitality and sense of learning at work

Self-efficacy

Neurobiological correlates of adaptation and coping: 2 primary emotions often associated with medical adversity:

• Fear

• Sadness

__: Significantly aid both adapting to and coping with major stressors alleviating much of the associated burden and preventing additional

Effects of social support on adaptation and coping

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

Effects of social support on adaptation and coping

Types of social support:

• Instrumental support

• Informational support

• Appraisal support

• Emotional support

Types of social support: __: Offering direct assistance

Instrumental support

Types of social support: __: Sharing information about the illness

Informational support

Types of social support: __: Aiding in assessing the illness and/or decision making

Appraisal support

Types of social support: __: Providing counseling

Emotional support

__: Marker of weakness and/or failure to independently cope with stresors

Barriers to seeking social support

__: May wish to utilize professional services but unable to afford

Barriers to seeking social support

Adaptive methods of adapting and coping with medical adversity: Cognitive coping strategies

• Normalizing

• Cognitive reframing and passive appraisal

• Joint problem solving

• Becoming educated

Adaptive methods of adapting and coping with medical adversity: __: Involves focusing thoughts, attention, and behaviors on the normal aspects of lufe and may be achieved through maintaining rituals and routines that preexisted the stressor, defining life as normal, participating in activities that reflect the normalcy of the individuual and/or family, and minimizing attention to any negative social effects of the stressor

Normalizing

Adaptive methods of adapting and coping with medical adversity: __: Adjusting the meaning of a situation and viewing stressors as something that will care for themselves

Cognitive reframing and passive appraisal

Adaptive methods of adapting and coping with medical adversity: __: Involves identifying and communicating in an effort to isolate, select, carry out, and monitor solutions based on shared input from everyone involved in the problem-solving process

Joint problem solving

Adaptive methods of adapting and coping with medical adversity: __: About medical adversity is an easy method for individuals to both increase the feeling of control in uncertain situations and better evaluate situations when making decisions

Becoming educated