PT 1 - Stress and Health

What is Stress?

• Stress: Physical and psychological reaction to internal and external stressors

• Stressors: Stimuli and events that represent a potential for harm, loss, damage, challenge, or other threat to well being

• Stress Responses: Internal psychological and biological responses to stressors that then work to restore a balanced state

Stressful Events

• Holhmes and Rahe (1967)

  • Major life changes from both negative and positive events can cause stress

  • Increased stress correlates with higher illness rates

Life Events

• Life Changes: any substantial alteration in your living situations that require adjustments

  • Change can be stressful

    • good and bad changes

Good and Bad Stress

• Hans Selye (1980)

  • Believed that stress is the “spice” of life, and can be a great stimulus to achievement. Also believed that stress in unavoidable.

• Eustress (good stress) - includes external circumstances, internal emotional experiences and bodily responses that can be beneficial and motivating

• Distress (bad stress) - includes external circumstances, internal experiences and bodily responses that can be harmful, reduce motivation, and impair functioning

Different Types of Stress

• Types of Stressors can be defined by duration and severity

  • Acute Stressors; short term external circumstances or stimuli, lasting minutes or hours

    • Tests

  • Chronic Stressors; enduring external; circumstances or stimuli, lasting weeks to years

    • relationships

    • jobs

  • Traumatic Stressors; stressors involving threat to your own or another’s life or physical integrity

    • experiencing a natural disaster

Threat vs Challenge

• Primary Appraisal: based on perception of characteristics of that stressor, what it requires of us (magnitude of demand), its relevance

• Secondary Appraisal: based on perceptions of the resources available for coping with a specific stressor

  • Internal factors: eg) personality and personal abilities

  • External factors: eg) social support or financial resources

• Challenge: situation where resources exceed the demands of the situation

  • Potential for positive outcomes and gain are more likely to be perceived as challenges

• Threats: Situation where demands exceed the resources exceed the resources available for coping

  • Danger, uncertainty, uncontrollability, novelty and high levels of effort all have higher demands and are more likely to be perceived as threats

Pressure

• Pressure: involves expectations (demands) that you have to behave in a certain way

  • Time pressure - get it done by a deadline

  • Pressure to conform - match group expectations

  • Performance pressure - meet a certain goal or level

• Can come from ourselves or others

Perceived Control

• The idea of having an internal or external locus of control

  • Internal locus of control - your actions influence an outcome

    • Feeling like your actions matter can reduce perceived stress

  • External locus of control - external forces influence outcome

    • Feeling like you have no control leads to greater perceived stress

Internal Conflict

Lewin (1935) described 3 basic types of conflict:

1. Approach - Approach

   • Choose between two attractive goals

   • Outcome will always be good

   • Not as stressful

2. Avoidance - Avoidance

   • Chose between two unattractive goals

   • Lesser of two evils

   • outcome will always be bad

   • More stressful

3. Approach - Avoidance

   • Choosing if you want to achieve a single goal with attractive and unattractive aspects

   • Potential positive and potential negative

   • Vasilation - back and forth indecisiveness

PT 2 - Reactions To Stress

Emotional Response

• Complicated and changing relationship between stress and emotion

• Lazarus (2006) linked specific cognitive reactions (appraisals) to specific emotions

  • Self blame leads to emotion of guilt

  • Helplessness leads to the emotion of sadness

• Chronic negative emotions are linked to negative health outcomes

Frustration

• Frustration: The feeling of being upset or annoyed, especially due to inability to change or achieve something

  • Emotion or state we experience when we fail the pursuit of a goal

  • Can lead to aggression

Physiological responses

• The stress and response serves to protect us from harm and restore balance to the body

  • Homeostasis: the state of balance that is upset by stressors, then restored by the stress response

• A coordinated response that allowed us to mobilize energy to deal with a stressor, avoid injury, and reduce risk for infection

Fight, Flight or Freeze

• Fight or Flight response: Emotional and physiological reaction to an emergency that increases readiness for action

• Freeze response: Physiological action to become immobile in the face of perceived stressors

Neurobiological Response

• Subcortal structures - in the middle of the brain

  • Hippocampus - memory formation and retrieval

    • helps learn from past experiences

  • Amygdala - helps us respond emotionally to different situations

    • Helps identify things that may be dangerous, activates fight or flight response

    • responds rapidly to potential stressors

    • works in coordination with other brain areas that can increase or decrease the amygdala’s response

  • Thalamus - all sensual info comes through here as it runs up spinal cord; except sense of smell

    • then gets split to parts of brain

  • Prefrontal cortex - frontal lobe, decision making and evaluations

Biological Response

• Autonomic nervous system - works automatically in the background

  • Sympathetic nervous system

    • Fight or Flight

    • Release of Stress Hormones

      • epinephrine and norepinephrine

• Parasympathetic nervous system

  • Dampens the stress response

• Autonomic nervous system works us up, Parasympathetic nervous system calms us down

• Hypothalamic pituitary adrenal (HPA) axis

  • Amygdala —> hypothalamus (then sends a signal to the pituitary gland)

    • Releases corticotropin-releasing hormone

    • monitors signals coming from brain

  • CRH —→ pituitary gland

    • Release adrenocorticotrophic hormone (ACTH)

    • sends signals to other glands

  • ACTH —> adrenal glands

    • release of stress hormone

Regulation

• Feedback Loops: output from one system influences the output of another by either increasing (positive feedback) or inhibiting (negative feedback) the seocnd system

  • HPA axis has negative feedback loops

  • negative feedback loops are more common

  • No hormones spiraling out of control

• ANS (Autonomic Nervous System) can work by reciprocal inhibition

  • sympathetic nervous system serving as the activator and the parasympathetic nervous system acting as the regulator/inhibitor

General Adaptations System

Different Stages of Stress Response

1. Alarm

   • Encounter something that is dangerous

   • Increased arousal

   • Shift to sympathetic nervous system

   • Signals sent to adrenal glands to recruit sources throughout the body

2. Resistance

   • Adrenal glands release epinephrine, nonepinephrine, and cortisol to maintain increased arousal

   • release stress hormones

   • blood sugars increased

   • suppresses immune system

   • Cannot last indefinitely - Parasympathetic system tries to restore homeostasis. If the stressor persists, so does the response

3. Exhaustion

   • Adrenal glands lose their ability to function normally

   • Resources dangerously depleted

   • Increased vulnerability to disease

   • Can manifest itself with cardiovascular problems; immune system difficulties

The Immune System

• Stressors can cause hormones (glucocorticoids) to flood the brain, wearing down the immune system and making it less able to fight invaders

• Inflammatory response: immune response to injury, infection, and psychological stressors that allows for killing of any foreign invaders such as viruses and bacteria, as well as healing of bodily tissue

  • When encountering acute psychological stressors, the body increases levels of proteins called cytokines that regulate inflammation

Pathways from stress to disease

• Chronic inflammation: increased levels of inflammatory proteins in the body

  • Prolonged exposure to pro-inflammatory cytokines can lead to cell death and tissue damage

  • Bodies become oversensitive, and damage regular cells thinking they are bad cells

• Biological Aging: tendency for reduced cellular performance as we age

  • Cells can only remake what is already there as we get older

    • Diseases consist of cardiovascular, autoimmune, and neurodegenerative

    • Telomore - section of DNA that doesn’t have important information in it

      • Shorten and wear off as we age, and the coding DNA wears off too, so the cells eventually become unable to function and die

      • Their function is to protect the DNA from damage

Behavioural Responses

• Coping Stress: active efforts to master, reduce, or tolerate the demands that are created by stress

  • Efforts can either be beneficial or maladaptive

• Constructive Coping: relatively healthful efforts to deal with stressful events

  • Doesn’t guarantee successful outcome

  • Always allows us to approach or frame the stressor in a useful way

• Learned Helplessness: passive behaviour due to exposure to unavoidable aversive events

  • Give up, fatalism and resignation, acceptance

    • “It’s out of my control”

    • More negative

    • Can cause catastrophic thinking

• Self Blame - become overly self-critical

• Self Indulgence: reduced self control, acting on impulses

  • Increased levels of stress can lead to changes in eating habits, spending habits, etc.

    • Linked to addictions

• Defence Mechanisms: (mainly) unconscious actions to handle emotions triggered by stress

Burnout

• Burnout: physical and emotional exhaustion, negative thought patterns (cynicism), and lowered sense of self efficacy

  • Come on gradually due to chronic work-related stress

  • Linked to:

    • too much work

    • too few resources

    • lack of recognition

    • lack of control

Post Traumatic Stress Disorder

• PTSD: Enduring psychological disturbance after experiencing traumatic event(s)

  • Distress

  • Flashbacks

  • Depression

  • Anxiety

  • Insomnia