Types of Stressors

1. Stress and Disease Dr. Donald B. Giddon Harvard University, Fall 2013Types of StressorsQuestion I - What factors are stressful for a given individual?

2. Types of Stressors • Physical • Biological • Chemical • Psychosocial

3. What makes an event or stressor stressful? • Differences between animals and humans • Sapolsky • Executive monkey

4. - Radiation - Physical Impact - Trauma - Crowding Population density Physical Stressors

5. Biological Stressors • Predators • Micro-organisms • Food supply • Sleep deprivation • Substance withdrawal • Allergens

6. Chemical Stressors • Toxins • Water • Airborne • Chemical • weapons • Environmental • pollutants

7. Biological Stressors – Food Each year, about 76 million people in the United States become ill from the food they eat, and about 5,000 of them die. According to the C.S.P.I.*, the riskiest foods are: 1.Leafy greens 2. Eggs 3. Tuna *Center for Science in the Public Interest http://well.blogs.nytimes.com/2009/10/06/top-10-food-poisoning-risks/

8. CROWDING

9. CROWDING

10. CROWDING (at the wrong time in the wrong place in the wrong job)

11. Species Differences for Crowding as a Stressor

12. It is sometimes difficult to separate space as a physical stressor from space as a psychosocial stressor

13. Interpersonal Impact - Personal Space, cf. with Crowding as a Physical Stressor Hall, E.T. The Hidden Dimension. Anchor, 1990

14. Psychosocial Stressors Source: • Family and significant others • Care givers • Siblings • Generational • Birth order • Friends • Roommates • Colleagues

15. Psychosocial Stressors (cont’d) • Occupation • Training • Responsibilities • Job satisfaction • Interpersonal relations • Role stress and personality • Unemployment • Retirement • Predictability • Lack of control

16. Psychosocial Stressors (cont’d) • Role Stress - Overload - Conflict - Ambiguity • Role vs. Status • Situational • Religious affiliation • Gender differences • Restriction of personal space • Bereavement • Other situational stressors : • Public speaking - Daily hassles - Exams - Gender inequities • Sensory • Surprise/ Startle - Overload - Deprivation • Perception as an intervening variable

18. Links Between Work and Adult Health From: Clougherty et al., 2010, Fig. 3

19. Compare the Effect on the Developing Brain of Abuse in Early Childhood • Neurophysiologic changes • Hippocampus • Amygdala • Physical abuse • Family conflict • Sexual abuse • Prenatal substance abuse • Alcohol • Recreational drugs

20. Stress of Retirement What do you think are some of the stressors?

21. Jobless, Sleepless, Hopeless "I am not married, my parents have passed away, so am quite scared of what will happen if I do not land a job within the next couple months. The thing I identified with the most - my work - has left me feeling lost.“ So wrote one of 1,200 respondents to a survey of the unemployed conducted by Rutgers University Tens of thousands more join their ranks every week. On Friday, the government said the unemployment rate rose to 9.7 percent in August as another 216,000 jobs disappeared. That is less than a third of January's loss. But the total for the last 12 months is beyond bleak: nearly six million jobs, gone. (See highlights from the poll in next slide.) Excerpt from The NY Times, Sept. 6, 2009, by B. Marsh

22. Excerpt from NY Times, Sept. 6, 2009 , B. Marsh

23. Role Behavior x Gender • Overload!!!! • Curvilinear relationship between time / responsibility constraints and health • - Like anxiety • - Those with most and fewest time constraints are least healthy • - As roles increased, so did health- up to a point • Women have too many roles to fill • Women in the work force still do a disproportionate: • - Share of household tasks • - Spend more time with their families

25. Overload, Cont’d • Mental health disadvantage for married, working mothers. • Differences in ROLE MEANING may explain these effects. • - Future expectations • Female roles more diffuse than male • Less expected of male breadwinners • Females tend to blame themselves for marital problems.

26. Societal Stressors

27. Crowding: Psychosocial Overall Pace Walking Bank Speed Talking Watches Worn (%) Boston 1 2 6 6 2 Buffalo 2 5 7 15 4 New York 3 11 11 28 1 Salt Lake City 4 4 16 12 11 Columbus, 5 22 17 1 19 Worcester 6 3 22 6 6 Providence 7 7 9 9 19 Springfield, MA 8 1 15 20 22 Rochester, NY 9 20 2 26 7 Kansas City, MO 10 6 2 3 15 St. Louis, MO 11 15 20 9 15 Houston, TX 12 10 8 21 19 Paterson, NJ 13 17 4 11 31 Bakersfield, CA 14 28 13 5 17 Atlanta, GA 15 3 27 2 3 Detroit, MI 16 21 12 34 2 Youngstown, OH 17 13 18 3 30 Indianapolis, IN 18 18 23 8 24 Chicago, IL 19 12 31 3 27 Philadelphia, PA 20 30 5 22 11 Louisville, KY 21 16 21 29 15 San Francisco, CA 24 19 35 26 5 Dallas, TX 26 26 28 15 28 Memphis, TN 32 34 10 19 34 Los Angeles, CA 36 24 36 35 13

29. Willingness to help

30. Gender and Evolutionary Aspects of Stress • Women more likely to perceive more stressors in their life • Perceive same events as more stressful than men do • - Loma Prieta earthquake— • Women perceived it as lasting longer, showed more stress* • Gender differences in physiological responses to stressors • - Differences between animal and human studies • Physiological coping with stressors • - “Tend and Befriend” versus “Fight or Flight.” • - The importance of oxytocin (tend and befriend) vs. male testosterone *Anderson and Manuel: Gender differences in reported stress response to the Loma Prieta earthquake. Sex Roles, 1994; 30(9):725-733

31. Actual vs. Perceived Risk As a Stressor - Compared with Actual Risk

32. Actual Risk Estimates of annual risk of death for US population* • Nature • Lightning: 1 in 3 million • Electrocution: 1 in 300,000 • Shark attack: 1 in 300 million • Man-made • Suicide: 1 in 9,000 • Murder: 1 in 13,500 • Airplane crash: 1 in 3.1 million • Car crash: 1 in 7,100 • Falls: 1 in 20,000 • Industrial accident: 1 in 48,000 *Harvard Public Health Review, Fall 2004, p. 11

33. Actual Risk – Cont’d Biomedical • Heart disease 1 in 430 • Cancer (all) 1 in 550 • Skin cancer from sun 1 in 4,200 • Flu (36,000 deaths per year)1 in 8,300 • West Nile Virus 1 in 30,400 *Harvard Public Health Review, Fall 2004

34. “Mad cow disease [Bovine spongiform encephalopathy] bumped flu shots from page one in the U.S. Yet Mad Cow caused one cow’s death—while flu kills 36,000 people annually.”* 17-year latency *Harvard Public Health Review, Fall 2004, p.10

35. Perceived Risk: Psychosocial • Threat vs. trust in individuals or institutions • Control • Free will • Determinism • Religious beliefs • Other directed vs. inner directed • Dread • Risk vs. Benefit • New or Familiar • Children • Uncertainty vs. Predictability

36. Race x Gender Differences

37. Integration

38. STEP 1 Life Situation Perception 1. Past Experience 2. Social Supports 3. Biographic Assets

39. StressWhat is stressful for a given individual? • The appraisal process • Based on our individual perceptions we appraise: • Demands of the situation (primary appraisal) • Resources available to cope with the situation (secondary appraisal) • The consequences of the situation • The personal meaning of the situation to us • Emotional response (how we feel about the situation) In psychological terms, it depends upon:

40. Attempts to Measure the Effects of StressorsAs Well as the Magnitude of Stressors - Direct observation - Inference from response to noxious stimuli or stressors

41. The Life Events ScaleHolmes and Rahe Social Readjustment Rating Scale(Holmes & Rahe, 1967) Death of spouse 100 Divorce 73 Marital separation 65 Jail term 63 Death of close family member 63 Personal injury or illness 53 Marriage 50 Fired from job 47 Marital reconciliation 45 Retirement 45 Change in health of family member 44 Pregnancy 40 Sex difficulties 39 Gain of a new family member 39 Business readjustment 39 Change in financial state 38 Death of a close friend 37 Change to a different line of work 36 Foreclosure of mortgage 30 Change in responsibilities at work 29 Son or daughter leaving home 29 Trouble with in-laws 29 Outstanding personal achievement 28 Wife begins or stops work 26 Begin or end school 26 Change in living conditions 25 Revision of personal habits 24 Trouble with boss 23 Change in residence 20 Change in school 20 Change in recreation 19 Change in church activities 19 Change in social activities 18 Change in sleeping habits 16 Vacation 13 Christmas 12 Minor legal violations 11

43. See course web site for list of other psychometric methods for determining stressors, coping, and other psychosocial variables

44. Items of the CALES and their endorsed percentages by a sample of Hong Kong adolescents