4/19/2017 Stress and Disease Dr. Donald B. Giddon Harvard University, Fall 2013 Question 2: What Direct or Indirect Neurohormonal or Behavioral Pathways.

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4/19/2017 Stress and Disease Dr. Donald B. Giddon Harvard University, Fall 2013 Question 2: What Direct or Indirect Neurohormonal or Behavioral Pathways are Activated (“Strained”) by Stressors? h13 ppts/question II

Overview of Stress and Disease Objective Stressor Subjective Stressor Coping vs. Non-Coping Cognitive Affective Behavioral

Forebrain Mid-Brain Hind Brain Ego Superego Id

Cognitive Models of Coping 4/19/2017 Cognitive Models of Coping Lazarus and Folkman: Cognitive appraisals determine stress reaction Primary appraisal: initial evaluation Irrelevant Benign-positive Stressful: harm/loss, threat, challenge Secondary appraisal: ability to cope h13 ppts/question II

Cognitive Models - continued Reappraisal: changes due to new information Vulnerability: deficiencies of resources Person and Situational Variables: Person: Commitments and beliefs Situation: Novelty, predictability, uncertainty, long duration

Richard Lazarus How Does It Work? Primary Appraisal Event Secondary 4/19/2017 How Does It Work? Richard Lazarus Coping Resources irrelevant Primary Appraisal Event Stress Secondary Appraisal Re-Appraisal h13 ppts/question II

Lazarus Cognitive Appraisal Theory 4/19/2017 Lazarus Cognitive Appraisal Theory Appraisal Stimuli Arousal Schacter Theory Appraisal Stimuli Arousal h13 ppts/question II

The Oyster Model Normal “Neurotic” Psychotic Sociopath 4/19/2017 h13 ppts/question II

Activation of Neurophysiological Pathways – QII CNS PNS Involuntary Reponses Semivolitional Voluntary Responses Neurohormonal Pathways ANS Breathing - Sexual - Facial Expression - Emotions - HPA axis Somatic NS SNS PNS Striated Muscles Smooth Muscles Motor BP HR Sweat GI GU Disease PD, etc. Communication Physical Activity Chronic Disease Acute Disease (Affect) Facial Expression Speech Normal vs. Abnormal Behavior

4/19/2017 h13 ppts/question II

Potential pathways for stress reactivity to psychosocial stressors. 4/19/2017 From The Nature and Treatment of the Stress Response: A Practical Guide for Clinicians (p.31) by G.S. Everly, Jr., and R. Rosenfeld. Copyright 1981 by Plenum Press. Reprinted by permission. Potential pathways for stress reactivity to psychosocial stressors. h13 ppts/question II