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STRESS DEFINITION STRESSOR DEFINITION HPA SAM Physiological Stress Response Fight or Flight.

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Presentation on theme: "STRESS DEFINITION STRESSOR DEFINITION HPA SAM Physiological Stress Response Fight or Flight."— Presentation transcript:

1 STRESS DEFINITION STRESSOR DEFINITION HPA SAM Physiological Stress Response Fight or Flight

2 Something in the environment (such as exams of work pressure) that produces a stress response in a person the reaction of the nervous system in response to a stressful situation that produces energy to prepare the body extended and demanding amounts of effort Sudden and severe stress generally produces: Increase in heart rate Alterations in digestive activity Skin becomes pale Sweating increases Muscular tremors These responses are produced by the Hypothalamic- Pituitary-Adrenal Axis (HPA) Refers to the lack of fit between the perceived demands of the situation and the person’s ability to cope Hypothalamus activates the Sympathetic branch of the Autonomic Nervous system, which tells the Adrenal Medulla to release Adrenalin and Noradrenaline, this gets the body ready for fight or flight, which causes blood pressure, heart rate and pupil size. Fast Acting. The Hypothalamus releases CRF which tells the Pituitary Gland to release ACTH which tells the Adrenal Cortex to release Corticosteroids/ Cortisol which produces energy but has the effect of supressing the immune system. Slow Acting.

3 Illnesses due to Stress Immune System Kiecolt-Glaser et al Evaluation Cohen (1993) Evaluation

4 It is an immensely complicated network of cells and chemicals that functions to seek out and destroy invading particles. An invading agent that stimulates an immune response is called an antigen. Key players in the immune system are the white blood cells which are manufactured in bone marrow and circulated in the bloodstream. White blood cells are lymphocytes and phagocytes that work in different ways to prevent disease and injection. Cortisol reduces the effect of the immune system. RESSOR DEFINI There are many strengths to this study. First of all, it was a natural experiment which means that there can be fewer ethical objections but, at the same time, it does mean it was not a true experiment. At best we can say that stress and immune response are negatively correlated (as one increases, the other decreases), we cannot say that one caused the other. The advantage of this study, again related to the choice of independent variable (exam stress), is that it was a long-term form of stress. In previous studies with human participants, stress had been artificially induced, for example by restricting sleep for several days (Palmblad et al, 1979). This is likely to produce a different kind of stress to that experienced naturally. Took blood samples from 75 medical students one month before their exams and then during their exams. Kiecolt Glaser found that there were reduced Natural Killer T cells during their exams, supporting the hypothesis that stress decreases the action of the immune system. This was an indirect study in that there were no direct measures of immune function. However it is supported by Evans and Edgington (1991) who found that the probability of developing a cold was significantly correlated with negative events in the preceding days. It did measure health outcomes (development of clinical colds), showing a relationship between life stress and illness. This can be compared with studies that use measures of immune function rather than illness outcomes. There was no direct manipulation of the independent variable (the stress index), and so a cause and effect relationship cannot be confirmed. This study does not tell us which element of the stress index is most important. Cohen et al investigated the role of general life stress on vulnerability to the common cold virus. Three hundred and ninety-four participants completed questionnaires on the number of stressful life events they had experienced in the previous year. They also rated their degree of stress and their level of negative emotions such as depression. The three scores were combined into what Cohen et al called a stress index. The participants were then exposed to the common cold virus, leading to 82% becoming infected with the virus. After seven days the number whose infection developed into clinical colds were recorded. The findings were that the chance of developing a cold, i.e. failing to fight off the viral infection, was significantly correlated with stress index scores. Cohen et al concluded that life stress and negative emotions reduce the effectiveness of our immune system, leaving participants less able to resist viral infections.

5 Rahe (1970) Evaluation Holmes and Rahe SRRS (1967) Holmes and Rahe SRRS (1967) Evaluation DeLongis et al (1982) Daily Hassles Evaluation of DeLongis et al (1982)

6 This study does not take into account individual differences in reactions to stress. A correlation does not imply causality nor the direction of any effect; depression or anxiety may not be caused by life events, since depressed or anxious people may bring about life events such as separation or divorce. The sample was restricted to male US Navy personnel; therefore it was ethnocentric (Americans only) and androcentric (males only). This reduces the validity of the study and makes it difficult to generalise to other populations. The researchers concluded that as Life Change Units were positively correlated with illness scores, experiencing life events increased the chances of stress-related health breakdown. As the correlation was not perfect, life events cannot be the only factor in contributing to illness. 2,500 male American sailors were given the SRRS to assess how many life events they had experienced in the previous 6 months. The total score on the SRRS was recorded for each participant. Then over the following six- month tour of duty, detailed records were kept of each sailor’s health status. The recorded number of Life Change Units were correlated with the sailors’ illness scores. There was a positive correlation of +0.0118 between Life Change scores and illness scores. Although the positive correlation was small (a perfect positive correlation would be +1.00), it did indicate that there was a meaningful relationship between Life Change Units and health (this is often referred to as a statistically significant correlation). As Life Change Units increased, so did the frequency of illness. A weakness of the SRRS is that it is highly reductionist: The SRRS is a highly reliable method: Findings from the SRRS enable researchers to make generalisations about stress and illness: The SRRS enables valid data to be obtained: The SRRS neglects that some life changes may enhance physical and emotional health and wellbeing: The SRRS shows that all life changes draw upon emotional energy and are therefore stressful: The SRRS neglects individual differences A weakness of the SRRS is that it relies on people recounting accurate and consistent memories of events in their lives – this makes the scale unreliable. Most people experience major life events very infrequently. Therefore a better measure of stress might look at the stresses and strains of daily life. These are called “hassles”. DeLongis et al (1982) compared the two measures: a life events scale and their own hassles scale, to see which was a better predictor of later health problems. They also considered the effects of “uplifts”. Uplifts are events that make you feel good. How does that affect health? There were 100 participants from around San Francisco area, aged between 45 and 64. They were predominantly well educated and had high income. The findings were that both the frequency and intensity of hassles were significantly correlated with overall health status and bodily symptoms. Daily uplifts had little effect on health. They also found no relationship between life events and health during the study, although there was a relationship for life events recorded for the 2 ½ years before the study Based on 43 life events taken from sample of 5000 patients’ records 400 participants rated how much impact each event would have on an individual These ratings enables a stress rating to be applied to each event participants told to rate each event relative to marriage which was given a value of 50 Scores averaged then given life change units (LCU). Death of a spouse 100 This approach managed to avoid the problem of the relevance of major life events but it still overlooked many chronic “on-going” sources of stress, such as poor housing, low incomes, strains of family life, unsatisfying work and so on. Health is probably affected by all three: hassles, chronic situations, and life changes. One problem with the scales used in this study was that the same hassle can be experienced in different ways by different people or by the same person on different occasions. The same factors that are a hassle to one person may actually be uplift to another, or the same factor might mean different things to the same person on different occasions. For example, a traffic jam may sometimes give you time to relax, whereas at other times it seems highly stressful. For this reason DeLongis, Folkman and Lazarus (1988) later produced a single “Hassles and Uplifts Scale” where respondents could indicate the strength of a factor either as a hassle or an uplift. In other words, when asked to indicate how they felt about “sex” they could rate it as a 0 1 2 3 as a hassle or 0 1 2 3 as an uplift. A further problem concerns the original sample which was of people aged over 45, this sample bias may have affected the results. Khan and Patel (1996) found that older people tended to have less severe, and fewer, hassles than younger people.

7 Workplace Stress Marmot et al (1997) Evaluation Friedman and Rosenman (1974) Evaluation Emotion Focused methods of Coping with Stress Problems focused methods of coping with stress

8 We can classify individuals in terms of their socio-economic status (SES) – a measure of the kind of job they do (skilled or unskilled), how much money they have, the kind of house they live in and so on. People who are of low SES are more likely to smoke, live in more stressful environments and have poorer diets – all factors linked to cardiovascular problems. This means that low-grade civil servants may have more cardiovascular problems than high- grade civil servants because of factors related to low SES rather than because they lack job control. The conclusions of this study are biased on the sample studied- civil servants. The response s of such individuals may not be typical of all adults as they are urban dwellers who are probably quite job oriented and ambitious, in contrast with rural inhabitants whose jobs may play a less significant role in their lives. One study found that ambitious individuals were more affected by workplace stressors (Caplan et al 1975). Therefore, we might conclude that not everyone will be affected by low control in the way that these individuals were. Marmot et al sought to test the job-strain model. This model proposes that the workplace creates stress and illness in two ways: (1) high demand and (2) low control. Marmot et al suggested that this could be tested in context of civil service employees where the higher grades would experience high job demand, and low-grade civil servants would experience low job control. Civil service employees (men and women) working in London were invited to take part in this study. A total of 7,372 people agreed to answer a questionnaire and be checked for signs of cardiovascular disease. About 5 years later each participant was reassessed. For each participant the following information was recorded: signs of cardiovascular disease (e.g. ischemia or chest pains), presence of coronary risk factors (e.g. smoking), employment grade (a measure of the amount of job demand an individual experienced), sense of job control (measured by questionnaire) and amount of social support (also measured by a questionnaire). At the end of the study it was found that participants in the higher grades of the civil service had developed the fewest cardiovascular problems. Participants in the lower grades expressed a weaker sense of job control and also had poorest social support. It was also found that cardiovascular disease could in part be explained in terms of risk factors such as smoking (i.e. people who developed cardiovascular disease were more likely to be smokers and be overweight). The main conclusion is that low control appears to be linked to cardiovascular disorder, whereas high job demand is not linked to stress and illness. This does not fully support the job-strain model because it does not show that high demand is linked to illness, but lack of control does appear to be linked to stress and illness. Although this was a large sample we can still question the population validity as there is a gender bias. Riska claims that psychology's Type A personality was a reflection of the traditional importance of masculinity in the 1950’s & 60’s and not so relevant today. This will focus on the stressor itself trying to devise ways to deal with it, for instance planning behavioural strategies such as time management or gaining practical support from your social network. Emotion focused coping focuses on the emotion caused by stress, either by denial, distraction, diverting energy into something else or seeking emotional support. Drug therapy can be seen as emotion focused coping as it focuses on the arousal caused by stress not the problem. Freidman and Rosenman conducted a structured interview to establish personality type of 3000 men in California. Type A personality describes a person who is struggling to achieve more and more in less and less time. Friedman and Rosenman believe that the Type A individual possessed three main characteristics Competitiveness and achievement striving Impatience and time urgency Hostility and aggressiveness Characteristics which could lead to raised blood pressure & levels of stress hormones linked to ill health. 8 ½ years later twice as man type A personalities had died of a heart attack than type B. This is interesting to Psychologists as it shows the effect of Individual Differences on the stress response.

9 Johansson et al Workplace Stress Johansson et al Evaluation Workplace Stressors Biofeedback Physiological Stress Management technique Beta Blockers & BZ’s Physiological stress management Kobassa’s Hardiness Training Psychological stress management technique

10 - Research has shown that as other cultures (e.g. eastern Europe, Asia) adopt working practices of the West a similar relationship between lack of control and stress related illness is emerging.  - Individual differences - Personality was not controlled in the studies. Certain personalities may be attracted to stressful jobs, which causes health problems. Work overload : Johansson et al (1979) Studied Swedish saw mill workers to find the effect of doing repetitive jobs requiring continuous attention and some responsibility compared to low risk group (maintenance workers with more flexible and less monotonous jobs). Findings –High risk group had higher illness rates and higher levels of adrenaline in urine than low risk group. High risk group had higher hormone levels on workdays than rest days Conclusion – a direct link between job demand, stress hormones and illness Combines physiological & psychological techniques to develop control of the symptoms of stress. Equipment dependant Needs training and practice May not be superior to relaxation etc. alone May be effective for some groups e.g. children. Harmless and no side effects. Work Environment Noise – can affect concentration Temperature – the hotter we are the more likely we are to be aggressive, leading to frustration and stress Work Overload Quantitative – More work to do than the time given to it Qualitative – the work you have to do is too complex under the work- conditions. Control More stress is felt where the person feels they have little or no control Benzodiazepines or Beta Blockers – both deal with the physical effects of stress to reduce the bodily arousal. Side effects Physical dependence –BZs only Treat symptoms only BUT can be effective quickly against life threatening conditions Useful in conjunction with psychological therapies. Focusing: be aware of physical signs of stress, identify stressful situations Reconstruction: think about stressful situations, how could they have turned out better? Or worse? Helps feel more positive. Self improvement: take on challenges that can be coped with, increases sense of being able to cope – self efficacy.

11 Stress Inoculation Therapy Michenbaum Hardy Personality Kobassa Michenbaum Study on Exams (1975) Evaluation Michenbaum Study on Exams (1975) Effectiveness of SIT Emotion focused coping Evaluation of effectiveness Carver (1993) De Boer (1999) Problem focused coping Evaluation of effectiveness Lazarus & Folkman (1987)

12 People clearly differ in their abilities to resist a stressor's effects. One characteristic that apparently helps resist stress is hardiness (Kobasa, 1979). Those higher in hardiness tend to be healthier even though the levels of stress that they have suffered have been similar to less hardy individuals. According to Kobasa people can be trained to be hardy. Maddi, a colleague of Kobasa, devised a series of programmes for increasing hardiness. These include ‘Hardiness Training’ and Hardiness Workshops.’ 'Hardy' individuals differ in three main ways: Commitment: they have more direction to their lives. For example, they tackle tasks because they want to, are organised and give themselves plenty of time to prepare for events, e.g. exams, work schedules Challenge: interpreting any stress as making life more interesting. Are willing to devote time and energy to what they want to achieve. Control: the amount of stress experienced can be regulated. See themselves as being in charge of their lives. If they lack the skills they acquire the knowledge in order to do well. Kobassa believes that psychological hardiness is a buffer or protection against the negative effects of stressors. Individual differences. This is a form of cognitive behavioural therapy. A lot of stress arises from our interpretation of events. If you perceive an event as threatening and feel you do not have the resources to deal adequately with it, a stress response occurs. Cognitive therapy is based on the view that the cognitive representation of the environment, rather than the environment itself, determines stress responses. Meichenbaum's (1976, 1985) stress inoculation therapy assumes that people sometimes find situations stressful because they think about them in catastrophising ways. Stress inoculation therapy aims to train people to cope more effectively with potentially stressful situations. It is similar to hardiness training and has three stages. 1. Cognitive preparation (or conceptualisation) involves the therapist and patient exploring the ways in which stressful situations are thought about. Typically, people react to stress by offering negative self-statements like 'I can't handle this'. This makes the situation worse. 2. Skill acquisition and rehearsal, attempts to replace negative self-statements with incompatible positive coping statements. These are then learned and practised. (See examples that follow, practise a few if you so desire).3. Application and follow through involves the therapist guiding the person through progressively more threatening situations that have been rehearsed in actual stress- producing situations. Initially the person is placed in a situation that is moderate to cope with. Once this has been mastered, a more difficult situation is presented. According to Meichenbaum et al (1982), the 'power of positive thinking' approach advocated by stress inoculation therapy can be successful in bringing about effective behaviour change, particularly in relation to anxiety and pain. What he was doing and why: To investigate the effectiveness of his Stress Inoculation Therapy (SIT). How he did it: Meichenbaum studied anxious pre-exam college students. He used a quasi-experimental method. There were three conditions: Condition 1: eight weeks of SIT Condition 2: eight weeks of systematic desensitisation Condition 3: no therapy – students were told they were on a waiting list The efficiency of SIT was evaluated through exam performance and self-reports. If the students felt it had been successful and they performed well in the exam, SIT was judged to work. What did he find: The SIT group gave the most positive self- reports and out-performed the other students. The students on the waiting list remained anxious. SIT proved to be very successful and is often shown to help reduce anxiety in stressful situations, however it does not apply to depression. Carver et al ( 1993)Emotional Support has been found to help those coping with cancer De Boer ( 1999) Emotion focused strategies of denial led to better adjustment in women with breast cancer Self-reports are not always reliable. It may not have worked. The main advantage over other interventions such as drugs is that they try to deal with the problem of stress directly, teaching people how to identify stress and develop effective techniques for dealing with it. SIT is flexible. Cognitive methods also consider the needs of the individual and if used properly can be tailored to a person’s specific situation. SIT is not quick, easy or cheap. Clients have to be motivated to openly discuss their experiences, practice stress management techniques and confront the stressor. The effort and expense of SIT is preferable to other psychological treatments, such as drugs. The benefits of SIT can be long-term; deals directly with the stressors and teaches ways of handling stresses which may appear in the future. Lazarus and Folkman suggest that people use more problem focused coping when they see a situation as controllable, and emotion focused when they see it as out of control.


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