Behavioral Medicine Lecture 19

BPS Model of Challenge & Threat

• Focuses on acute stress responses in active performance situations

• Considers the ratio of perceived task demands to per levied coping results

• Emphasizes motivational orientation over valance

• Posits two types of acute stress responses

Threat

• Demands > resources

• We are telling our bodies we cannot cope with the situation

• Social threat responses are built on systems originally in place to deal with physical threats

• Centers blood in the core & releases chemicals to help minimize damage to the body

Challenge

• Resources > demands

• Appraisals let the body know that we can successfully cope with situational demands

• Increases blood flow (& O2) to the periphery: major muscle groups in the brain

  • MORE blood to the brain

• Associated with improved cognitive performance and beneficial health outcomes

  • Don’t see the negative downstream consequences as you would under a threat

BPS Model of Challenge & Threat

Motivated Performance Situation → task engagement → evaluation of coping resources vs task demands

Resources > Demands

• Challenge

• Sympathetic-Adrenal-Medullary (SAM) activation

• Low peripheral resistance, high cardiac output

  • Body relaxes, allows oxygenated blood to flow properly

Resources < Demands

• Threat

• Hypothalamus-Pituitary-Adrenal (HPA) activation

• High peripheral resistance, low cardiac output

KNOW

• The difference between threat vs challenge mindset

• Peripheral difference

• Cardiac output

Challenge state

• Approach oriented: body is preparing to meet the demands of the situation

• Activated by the Sympathetic-Adrenal-Medullary (SAM) axis activation which causes:

  • Adrenaline release

  • Blood vessels remain open, not constricted = increased blood flow to major muscle groups & brain = increased cardiac efficiency

• Enhanced performance

Threat state

• Avoidance oriented

• SAM activation + Hypothalamic-pituitary-adrenal (HPA) axis activation

  • Release of cortisol

  • Blood vessels constricted

  • Decreased cardiac efficiency

• Worsened performance

  • Release of stress hormones

  • Brain is not getting the blood it needs

Process Model of Emotion Regulation

• Affective responses (including stress responses) can be regulated at various points in the emotional experience

• Situation selection and modification → attentional deployment → cognitive change or reappraisal → emotion is experienced → response modulation

(cont)

• Appraisals of bodily signs of stress are typically negative

  • “Nervous energy” or “butterflies in my stomach”

• Appraisal of stress can also be good

  • “Amped up” or “bursting with excitement”

• Interventions that alter appraisals of stress such that coping resources are elevated relative to task demands can elicit more adaptive stress responses

Is “calming down” the best strategy??

• Not necessarily!

  • It DEPENDS on which stress state you are in.

  • It is better to be in a challenge state than to be relaxed!

  • Threat < Relaxed < Challenge

Arousal Reapprasial

• Acts at the appraisal stage of the emotional experience to change downstream biological, cognitive, and performance outcomes

• Signs of stress arousal - racing hearts & sweaty palms - are not longer seen as negative, but rather as adaptive coping tools = stress is positive!

• Doesn’t seek to eliminate stress completely; sympathetic activation is needed when demands are high

• 91% of people believe that relaxation is the best way to maximize your performance

• BUT Excited > Relaxed > Anxious

Stress Reappraisal

• Teach people about the benefits of stress

• Signs of stress no longer appraised as detrimental, but instead as adaptive coping tools:

  • “Oh no I’m freaking out!” → “Yeah, my body is harnessing its resources”

*video on slides

Had people talk about themselves while giving them nonverbal cues

Studies on stress reappraisal

• 1) Dr. Jamieson’s studies on the GRE in the classroom and the real world

• 2) Dr. Jamieson and Dr Hangen’s reappraisal in a community college math class

• 3) Dr. Hangen’s research on risk taking & challenge vs. threat tasks

• 4) Dr Jamieson’s study on threat reappraisal stereotype threat

Study 1: Stress reappraisal & the GRE

• Goal: to see efficacity of arousal reappraisal outside of the lab

• Participants:

  • 60 undergraduate students (31/, 29f) who were planning to take the GRE

Method

• Time 1: students provided a saliva sample when they arrived

• Told that they would be taking a practice GRE test in the lab as advertised

• Randomly assigned to one of two conditions

  • Control: no further instruction

  • Reappraisal: received reappraisal instructions

• Second saliva sample: target being measured was salivary alpha amylase which is proxy for SNS arousal

• Completed practice GRE quantitative & verbal (old scoring system)

(cont)

• Time 2: 1-3 months after the lab study pps completed the GRE in the “real world”

• Pps reported back to the lab with a copy of their real GRE scores

• Completed post-test questionnaires

  • Amount of stress experienced during the testing session

  • Whether pps believed stress helped or hurt performance

  • Feelings of anxiety prior to & during the testing

  • How confident pps felt during testing

Results: Effects in the lab

• Encouraging participants to reappraise stress arousal as a coping tool elicited an increase in sympathetic activation and improved performance on the math section

  • Much more amylase production

Study 2: reappraisal in the classroom

• N = 93 students in a community college math course

• 2 Conditions:

  • Stress reappraisal: stress can help you

  • Placebo: Ignore stress (people think this is good advice)

  • Materials 5-8 minute readings (journal summaries) with comprehension questions

Exam 1 (pre-intervention)

Exam 2 (post intervention)

Significant improvement in the reappraisal group

How did the reappraisal materials impact exam performance?

• Reappraisal condition → resource appraisal → exam 2 score

  • It is a partial mediation

KNOW

• The manner in which the exam 2 scores were increased

• Explain this model

  • It is a partial mediation 

  • What does it explain

Study 3: Competition, threat, and risk taking

• Competition 

  • Challenge state → more risk taking

  • Threat state → more cautious

Sensors - Autonomic sensors:

• Impedance cardiography (ICG)

• Electrocardiography (ECG)

• Blood pressure (BP)

Autonomic measures

• PEP (pre-ejaculation period) = SNS arousal (contractile force of heart)

• CO (cardiac output) = cardiac efficiency; blood ejected per minute

• TPR (total peripheral resistance) = blood pressure

Determining stress state

-

Challenge state

• Improved cardiac efficiency

• Peripheral vasculature not constricted

  • Low PEP

  • High CO

  • Low TPR

Threat state

• Decreased cardiac efficiency

• Peripheral vasculature constricted

  • Low PEP

  • Low CO (or no change)

  • High TPR

Results

There was a challenge state, and threat state, and an indeterminate state

Risk-Taking measure: Columbia Card Task

You flip over cards, some can give you points some can lose you points

Results

• Greater Challenges states predict more risky behavior;

• Greater Threat states predict more cautious behavior

Stereotype threat

• fear of confirming a negative group stereotype. Often the anxiety over the negative stereotype results in reduced performance

  • E.g. women & math

Arousal reappraisal & stereotype threat

• Examined effects of arousal reappraisal on math performance and inflammatory cytokines (IL 6) on a stereotype threat environment

• Female participants were told that they would be completing

  • a) gender biased math test or b) an Unbiased math test

  • For both conditions, there was a control group and an arousal reappraisal group

• DVs: performance on math test & levels of IL 6

Levels of IL 6

• Higher numbers mean worse outcomes

• When stereotype threat is activated, you see huge levels of IL 6 activation

Final take-aways

• There are different TYPES of acute stress responses

• Challenge stress states are healthy and helpful

• By changing the way you THINK about stress, you can change the way your BODY reacts in stressful situations (stress reappraisal)

• Instead of trying to relax, next time you notice signs of stress (pounding heart, rapid breathing) remember the benefits of stress and embrace it!

*video on slides

• She always treated stress as the enemy, but she realized that she was wrong

• People who experienced high stress and believed that stress was harmful had a much higher risk of dying

• But people who had high stress but didn’t view stress as harmful had the lowest risk of death amongst all groups

• Many people died from the belief that stress is bad for you

(Cont)

• Talked about stress studies

• What if instead of viewing the symptoms of stress as bad, what if they viewed it as helpful

  • Example: breathing fast is just getting more oxygen to your brain

Oxytocin

• Stress makes you social

• Stress release oxytocin (the cuddle hormone), motivates you to seek support

Morbidity

• Every major stressful experience increased the risk of dying by 30%

• People who spent time caring for others had no risk of dying, caring created resilience