Stress & Health

Stress & Health

Objectives

  • Defining Stress

  • Sources of Stress

  • Physiology of Stress

  • Measuring Stress

  • Stress & Illness

  • Models of Understanding Stress & Health

What is Stress?

  • Definition of Stress: Stress is a process by which we perceive and respond to events that are perceived as harmful, threatening, or challenging.

  • Stressor: Any event or situation that triggers coping adjustments.

  • Appraisal: This refers to how a potential stressor is perceived, which may be viewed as a threat.

Biopsychosocial Approach to Stress

  • Biological Processes: Experiences of stress can differ according to individual physiology and levels of physiological reactivity; despite variations, basic processes affect everyone.

  • Psychological Influences: Factors like personality and life experiences influence how challenging situations are appraised, determining whether they are seen as manageable or unmanageable.

  • Sociocultural Factors: Sources of stress can include major life events, daily hassles, work-related stress, and family issues influencing responses to stress.

Sources of Stress

  • Types of Stressors:

    • Big Events: Stressful life events, adverse childhood experiences.

    • Small Events: Daily hassles, microaggressions, work stress, work-life conflict, social stress.

Stress and Life Events

  • Research by Holmes and Rahe: They introduced Life Change Units (LCUs) and developed the Social Readjustment Rating Scale (SRRS) to quantify life events in terms of LCUs, being the first systematic effort to link stress to illness.

  • Critiques of SRRS: It is often faulted for its subjectivity and for not considering individual differences in cognitive appraisal.

  • Prediction of Illness: The total number of LCUs accumulated in the past year can predict the likelihood of getting sick in forthcoming months.

The Life-Span Perspective

  • Different Stressors Across Life Stages: Various stressors are more common at different times of life:

    • Prenatal Stress

    • Adverse Childhood Experiences

    • Emerging Adulthood

    • Adulthood

Prenatal Stress & Adverse Childhood Experiences

  • Consequences of Early Life Stress: Maternal stress during pregnancy linked to various problems.

  • Childhood Trauma: Associated with chronic diseases in adulthood, such as cardiovascular disease, diabetes, cancer, autoimmune diseases, depression, and suicide.

Stress and Emerging Adulthood

  • Transitionary Period: This stage involves completing education, leaving home, becoming financially independent, marrying, and having children.

  • Cultural Causes of Stress: Factors include the need for education, unemployment, workplace issues, and identity exploration. The age at first marriage has shifted over decades.

Daily Hassles

  • Significance of Hassles: Daily hassles are significant stress sources, influenced by their frequency, duration, intensity, and individual coping style.

  • Hassles vs. Major Life Events: Persistent hassles tend to predict health problems more reliably than major events.

  • Hassles and Uplift Scale: Critiques include a focus on symptoms rather than stressors and the interaction with broader environmental stressors.

Work Stress

  • Prevalence of Work-Related Stress: Nearly everyone experiences this at some point. High perceived work stress can lead to emotional health issues.

  • Sources of Work Stress: Include social-evaluative threats, stereotype threats, and role overload among others.

Burnout

  • Definition: A job-related state of physical and psychological exhaustion.

  • Higher Risks: Jobs with responsibilities for others, such as healthcare workers, tend to experience greater levels of burnout.

Job Demands

  • Control and Job Stress: Stress levels increase when employees have little control. The Demand-Control Model describes job strain related to low control.

  • Health Risks: Lack of control links to anger, risk of coronary artery disease, and increases mortality risk.

Other Sources of Job-Related Stress

  • Issues include role ambiguity, role conflict, shift work, job loss, and a lack of fairness in career advancement.

Social Interactions & Stress

  • Buffering Effects: Social interactions can buffer against work stress.

  • Social Stress: Includes caregiver burdens and is associated with lower life satisfaction, immunosuppression, and inappropriate cytokine production due to stress.

The Physiology of Stress

  • Fight-or-Flight Reaction: Introduced by Walter Cannon; the release of epinephrine, cortisol, and hormones prepare the organism to respond to threats. Particularly adaptive for ancestral environments, but detrimental in modern contexts.

  • Contributions to Stress-Related Illnesses: Robert Sapolsky proposes that humans have more stress-related diseases compared to other animals.

The Role of the Brain & Nervous System

  • The overall stress reaction involves the central nervous system, processing information about potential stressors, and triggering physiological responses through the sympathetic nervous system.

The Role of the Endocrine System

  • Sympatho-Adreno-Medullary (SAM) Axis: Initial rapid response to stress mediated by the adrenal medulla. Involves the release of epinephrine and norepinephrine.

  • Hypothalamic-Pituitary-Adrenocortical (HPA) Axis: Delayed stress response engaging in corticosteroid hormone secretion essential for stress adaptation.

Measuring Stress

  • Self-Report Measures: Tools like the Holmes & Rahe Life Events Index, perceived stress scale, etc.

  • Ecological Momentary Assessment (EMA): Journaling stressors throughout the day.

  • Physiological Measures: Observed changes in autonomic nervous system activation along with hormone fluctuations in response to stress.

Cardiovascular Reactivity (CVR)

  • Characteristics of CVR: Reactions to stress as influenced by individual factors like heart rate and blood pressure.

  • Reactivity Hypothesis: Individuals with pronounced responses to stress have a higher risk for heart disease.

Duration of Stress

  • Recovery Influences: The ability to recover from stress significantly affects the overall burden.

  • Allostatic Load: Represents the cumulative burden of chronic stress moderated by acute stressors.

How Does Stress Make You Sick?

  • Psychoneuroimmunology (PNI): Demonstrates that psychological and neurological factors influence immune responses. Researchers like Ader and Cohen studied immune conditioning.

  • Short-term vs. Long-term Effects: Acute stress can up-regulate immunity, while chronic stress typically suppresses it.

Pathways from Stress to Disease

  • Direct Effect Hypothesis: Stress leads to immunosuppression via HPA and SAM responses, affecting lymphocytes and cortisol responses.

  • Indirect Effect Hypothesis: Maladaptive behaviors resulting from stress can also compromise immune functioning.

Models of Stress

  • Include:

    • Immunosuppression Model

    • Glucocorticoid-Receptor (GCR) Resistance Model

    • General Adaptation Syndrome (GAS) Model

    • Transactional Model

    • Diathesis-Stress Model

    • Minority Stress Model

Stress, Inflammation, and Disease

  • Immunosuppression Model: Influences wound healing and infectious diseases.

  • GCR Resistance Model: Chronic stress impacts inflammatory responses and disease development.

Selye’s General Adaptation Syndrome (GAS)

  • GAS Stages: Alarm Reaction → Resistance → Exhaustion. Research has observed links between stress and neurogenesis, as well as telomere length impacts.

Transactional Model (Lazarus & Folkman)

  • The stress experience is moderated by cognitive appraisal of an event.

  • Cognitive Appraisal Steps:

    1. Primary Appraisal: Evaluating the danger.

    2. Secondary Appraisal: Assessing coping options.

    3. Reappraisal: Understanding status and control in the situation.

Diathesis-Stress Model

  • Factors Influencing Stress and Illness: Individual susceptibility combines predisposing factors (e.g., genetics and traits) and precipitating environmental factors (e.g., trauma).

Post-Traumatic Stress Disorder (PTSD)

  • Defined as psychological reactions triggered by extreme traumatic stress. Symptoms include haunting memories, distress, and flashbacks.

Minority-Stress Model

  • Defines how culture and stigma affect stress levels, with implications for health disparities in populations such as gay men and other marginalized groups.

Objective & Perceived Discrimination

  • Recognizes that perceptions of discrimination have significant physical and mental health impacts, compounded by socioeconomic factors.

Family Income by Race/Ethnicity

  • Statistics from 2014 show disparities in low-income and poverty levels among different racial and ethnic groups.

Microaggressions

  • Defined as subtle verbal or nonverbal slights or insults that convey hostile messages to marginalized individuals; can be intentional or unintentional and lead to microaggression fatigue.