Ch 12 - Stress and health

1. Ch 12 - Stress and health

2. Study Design Dot Points • application of a biopsychosocial framework to understanding the relationship between stress and physical and mental wellbeing: • physiological and psychological characteristics of responses to stress including fight-flight response, eustress and distress; • strengths and limitations of Selyes’ General Adaptation Syndrome • psychological determinants of the stress response; • strengths and limitations of Richard Lazarus and Susan Folkman’s Transactional Model of Stress and Coping • social, cultural and environmental factors that exacerbate and alleviate the stress response • allostasis (stability through change brought about by the brain’s regulation of the body’s response to stress) as a model that integrates biological, psychological and social factors that explain an individual’s response to stress • strategies for coping with stress including biofeedback, meditation/relaxation, physical exercise, social support

3. Stress What is stress? • A state of physiological and psychological arousal produced by stressors that are perceived by the individual as challenging or exceeding their ability to cope. • It is a subjective experience and depends on our personal interpretation of a situation or event. Why do we get stressed? • When the event causing stress appears to be bigger than our ability/resources to overcome it.

4. Stressors A Stressor is any person, situation or event that causes stress. • Virtually anything can be a stressor • Stressors are different for everyone • Can be internal or external: • Internal stressors originate within the individual • Personal problem, illness • External stressors originate outside the individual from situations and events in the environment • Too much homework, bullying • Can be physical or psychological: • See next slide

5. A stressor can be either physical or psychological.

6. What causes you stress? Rank the following stressors in order of how stressed they make you feel (1=lowest to 7=highest):  conflicts with a boyfriend or girlfriend  dissatisfaction with your athletic skills  having your trust betrayed by a friend  struggling to meet your own academic standards  not having enough money  conflicts with family members  dissatisfaction with your physical appearance. Compare your responses with the person next to you.

7. The Stress Response • A stress response (or stress reaction) involves the physiological (biological) and psychological (mental) changes that people experience when they are confronted by a stressor. • May be categorised as mild, acute or chronic • Mild stress may be stimulating, exhilarating, motivating • Slightly elevated arousal levels usually enhance performance • Acute stress suddenly causes a very high arousal level • Chronic stress causes a high arousal level over a long period of time • Both Acute and Chronic Stress can result in a variety of Physiological (Biological) and Psychological responses that may be short or long term http://www.youtube.com/watch?v=xt44uDsV8PE

8. STRESS REACTION • A stress reaction is the physiological and psychological behaviour that will result when someone is confronted with a stressor. Eg. Sleeplessness, depression, nausea, loss of appetite, forgetfulness. • ..So what’s the difference between a stressor, stress and a stress reaction? • When presented with a “stressor”, an organisms overall level of arousal ’s, leading to feelings of “stress”. This “stress” can sometimes lead to certain behaviours. These resulting behaviours are called the “stress reaction”.

9. When does an event become a stressor? • When we perceive that we don’t have the ability to overcome a certain event/situation. • Stress is a very individual experience, meaning that what ‘stresses’ one person may not result in ‘stress’ in another. Consider how you’d react to the following: • Giving a speech when you’re really well prepared. • Giving a speech when you’re really unprepared. • Singing in front of an audience. • Running at Olympic Park. • Sitting a test/exam (different for each subject??). • Breaking up with boy/girlfriend.

10. Applying the biopsychosocial framework to understanding the relationship between stress and physical/mental wellbeing Biological (Physiological), Social and Psychological factors can all contribute to and effect a person’s stress levels

11. Activities to Consolidate your Understanding • Worksheet on Recognising Stress and Biopsychosocial framework of stress

12. 1. Physiological Responses to Stress • Dot Point: physiological and psychological characteristics of responses to stress including fight-flight response, eustress and distress; • strengths and limitations of Selyes’ General Adaptation Syndrome • Physiological responses are involuntary and occur in much the same way in all individuals. • Two most widely used models for describing the physiological responses to stress are: • Fight – Flight Response • General Adaptation Syndrome • This includes fight - flight in a longer sequence of reactions when stressors are long lasting

13. a) Cannon’s Fight – Flight Response • The fight-flight response is a term used to describe ‘autonomic’ arousal. • Remember the Autonomic NS from Unit 3?? • The Autonomic Nervous System - connected to internal organs, not consciously controlled. • Keeps us alive – automatically. • Sympathetic branch controls arousal, fight or flight response / fires us up. Release of adrenaline, heart rate up, breathing up etc. • Parasympatheticcalms back down, keeps us at stable level. Digestion, resting etc.

15. The name is based on the observation that when animals are placed under threat they will always react in one of two ways: 1) To get as far away as possible from the threat (eg. to flee or take “flight”) OR 2) To confront the sudden threat by attacking or acting aggressively (eg. “to fight”). • So, the response prepares the organism to confront or flee the situation.

16. When the brain perceives a threat, the Symp NS is activated and prepares the body for that threat. • Results in: increased activity of the heart, lungs, sweat glands and gall bladder decreased activity of the stomach, salivary glands and bladder. Eg HR, BP, BR, Sugar and fat release into the blood stream, sweat production, dilation of pupils, increased glucose secretion by liver, suppression of unctions not immediately essential to survival to conserve energy, (digestion, sex drive) • Digestion (causes ‘butterflies’ in the stomach), saliva (dry mouth), bladder control Fight-Flight response can occur within seconds! • Once the threat has passed, the Parasymp NS returns the body to homeostasis.

17. Because this response is under ANS control, it is automatic. • This readiness for exertion to “Fight or Flee” increases the organism’s chance of survival. • FREEZE response- A third option for some organisms??? • Used by: • Highly camouflaged animals. • Organism has not yet been spotted. • Kangaroo’s in headlights???

18. Activities to Consolidate your Understanding • Learning Activity 12.1 Questions 1 to 4 (page 588)

19. Recent Research:Hypothalamus Pituitary Adrenal Axis – HPA Axis • When a stressor is identified the hypothalamus is activated • The hypothalamus activates the pituitary gland which releases ACTH (adrenocorticotropic) • ACTH travels through the blood steam to the adrenal glands above the kidneys, • Adrenal Glands trigger the release of the ‘stress hormones’: adrenaline, noradrenaline and cortisol • Adrenaline and Noradrenaline boost the activity of the Sym NS • Increased HR, BP, BR (respiration) etc • Causes increased O2 to muscles to help meet immediate energy needs for fight-flight • Cortisol increases metabolism and blood glucose concentration • Makes fuel available to the muscles • This chain of reactions is called the HPS Axis • Cortisol and noradrenaline in high concentrations for prolonged time can effect immune function

20. HPA AXIS • A “racing heart” during fight-flight response is explained by the surge of “stress hormones” in the body. • Once stress is removed, high level of bodily arousal subsides gradually usually within about 20 to 60 minutes.

21. Recent Research:Hypothalamus Pituitary Adrenal Axis – HPA Axis • Fight-Flight response is adaptive, as it helps ensure our survival when faced with a threat • If the threat is prolonged, the intense physiological arousal of the fight-flight response is also prolonged • This can cause harm to our health. • Body must use more resources to deal with the threat • Physiological wear and tear on the body occurs • Eg Increased levels of Stress hormones for prolonged time can effect immune function and increased vulnerability to disease

22. Activities to Consolidate your Understanding • Learning Activity 12.1, page 588 – Review Question 5 • Learning Activity 12.2, page 588 – Flow Chart on Flight-Fight Response

23. b) Selye’s General Adaptation Syndrome • Selye’s found that the body’s stress response followed a predictable three stage pattern of physiological responses. • Began with research in rats, and regardless of the type of stress they were exposed to they all appeared to go through the same physiological processes. • Injection of drugs, excessive exercise, surgical injury, exposure to cold • Also noticed the same three-phased pattern of physiological responses in humans suffering a variety of different diseases. • He referred to this three-phase response as the General Adaptation Syndrome (GAS)

24. GENERAL ADAPTATION SYNDROME • GAS is a three-phased physiological stress response that occurs regardless of the stressor that is encountered • This means that GAS is non-specific and will appear whatever the source of stress • Not everyone goes through all three stages • The stressor will often disappear before stage 3 is reached • Stage 3 (Exhaustion) is only reached if exposure to the stressor is persistent • Ultimately, GAS is the body’s way of adapting and dealing with a perceived stressor or stressors.

25. Stage 1 – Alarm Reaction • When the organism is initially presented with the stressor. • Stage 1a) SHOCK: • The organism is coming to terms with the stressor, therefore decreasing their ability to overcome the stressor. • Resistance to stressor is DECREASED (drops below the normal level) • The duration of shock will depend on the severity and size of the stressor. • Possible responses during this sub-stage may include: • Decrease in blood pressure. • Fainting. • Procrastination. • Stage 1b) COUNTER-SHOCK: • The organism very quickly mobilises (‘readies’) the body’s resources to fight the stressor by increasing arousal through activating the Symp NS. • Same physiological responses as in the fight-flight response • Adrenalin is released into the blood stream to mobilise the changes associated with dealing with the stressor. • Resistance to stressor is INCREASED (picks up back toward normal)

26. Stage 2 – Resistance • Intense arousal from ‘Alarm Reaction’ diminishes but remains higher than normal to allow the organism to fight the stressor for a period of time. • Because many body systems are working at a heightened rate, Cortisol is continuing to be released into the bloodstream to ensure fuel is available to the muscles • All of the body’s resources go directly toward dealing with the single stressor, therefore resistance to the stressor is further INCREASED (well above a normal level of resistance to Stressors) • At this stage a person is still able to work toward overcoming the stressor, but may begin to start to feel the negative effects of stress (eg. fatigue, headaches, etc). • If other stressors need to be dealt with, the organism’s capacity to deal with this 2nd stressor in significantly reduced. • This stage either ends with: • The stressor being resolved and the organism gradually returns to it normal level of resistance to stressors • OR • Organism moves into Stage 3- Exhaustion.

27. Stage 3 – Exhaustion • When the stressor is intense, prolonged or there are multiple stressors, a person’s ability to cope with the stressor(s) collapses. • Resistance to the stressor is DECREASED (drops, possibly well below a normal level) • This is the time when an organism will often fall ill because the body’s resources are depleted and can no longer continue to deal with the stressor. • Physical and Psychological exhaustion occurs, and patient may feel helpless/hopeless/depressed • Conditions that may occur: • extreme fatigue, • stomach ulcers, • nightmares, • skin rashes, • hypertension (high blood pressure) • Some conditions may be serious enough to lead to death • Psychosomatic illness (‘physical illness brought about by both psychological and physiological stressors’) will often become apparent at this point.

29. General Adaptation Ayndrome – GAS!!!! • STAGE 1: Alarm Reaction… Oh no I have to break wind! • STAGE 2: Resistance… Holding it in! • STAGE 3: Exhaustion… Can’t hold it in anymore!

30. Strengths of GAS • Contributed to our understanding of stress and allowed for further research • Provided rich, empirically based information about the physiological processes involved in an animals response to a range of stressors • Provided laboratory evidence of the role of the brain, endocrine system and PNS through the three stages of GAS • Found that the greater the intensity of the stressor, the greater the physiological response. • It made the important connection between extreme prolonged stress and certain diseases • It is now accepted that there is a relationship between stress and disease • Was able to show that exposure to prolonged stress could lead to death in lab rats

31. Limitations of GAS • Only examined the stress response from a physiological (not psychological) bases • Does not take into account individual differences, but assumes everyone has the same general, predictable and automatic physiological responses to any kind of stressor. • Overemphasised the biological processes in his GAS • Model was predominantly based on his research with lab rats • Did not consider that a rats responses to stressors are less varied than a persons stress response • Used rats in research and then applied the research to humans without considering key psychological and environmental factors that are unique to humans, such as perception and interpretation • The model fails to recognise the role of emotion and cognition in how a person perceives and evaluates the stressor • Selye’s findings could not be generalised to people because his research involved non-human subjects

32. Summary of GAS

33. Activities to Consolidate your Understanding • Selye’s GAS 3 Stage summary on diagrams of the body

34. c) Eustress and Distress • Selye proposed that the experience of stress is different to other psychological phenomena because bodily arousal (initiated by SympNS fight or flight) can occur regardless of whether a person receives good or bad news • The experience of eustress and distress can vary between people • May be positive for some and negative for others • Eustress = a positive psychological response to a stressor • Stress that comes from good news/positive experiences • Eg winning something, riding on a rollercoaster • Stress that is beneficial or desirable • Indicated by the presence of positive psychological states such as enthusiasm, excitement, alertness. • Distress = a negative psychological response to a stressor • Stress that comes from bad news/negative experiences • Eg failing an important exam, breaking up with someone • Stress that is objectionable or undesirable • Indicated by the presence of negative psychological states such as anger, anxiety, nervousness, irritability.

35. Activities to Consolidate your Understanding • Learning Activity 12.4, page 594 – Review Questions • Learning Activity 12.5, page 594 – Comparison. (you don’t have to do a ‘report’ just dot points)

36. 2. Psychological Responses to Stress • Dot Points: • physiological and psychological characteristics of responses to stress • psychological determinants of the stress response; • strengths and limitations of Richard Lazarus and Susan Folkman’s Transactional Model of Stress and Coping • Psychological Responses are voluntary (so we have control over them to a certain extent) and occur differently in everyone.

37. a) Psychological characteristics of Responses to Stress • Psychological response cannot be directly observed: • Inferred from observable reactions • Determined through the use of self-reports • Psychological responses are divided into three categories: • Behavioural changes – Influence how a person looks, talks, acts etc • shaky voice, hand tremors, muscle stiffness etc • Emotional changes – Influence the way a person feels • anxious, tense, depressed angry etc • Cognitive changes – Influence a persons mental abilities • perception distorted, difficulty concentrating, making decisions, forgetful etc.

38. Activities to Consolidate your Understanding • Learning Activity 12.6, page 596 – Review Questions • Learning Activity 12.7, page 596 – Visual Presentation

39. b) Psychological Determinants of the Stress Response • There are many psychological factors that cause or influence the human stress response • Prior experience with the stressor, attitude, motivation, self –esteem, personality, coping skills etc • All these factors work together with each individual to have an impact on how the stress response is experienced

40. Comparison of Models • Selye’s: • Used a traditional biological approach to stress • Used non-human subjects • Based on a three-phased pattern of physiological responses • Is a ‘one size fits all’ approach • Lazarus: • Emphasised the importance of mental processes in dealing with stress. • Used human subjects • Showed that it is not just the response to the stressor, or the stressor itself, that is important in a stress response but also the individual’s perception and assessment of the stressor. • Is more personalised

41. Lazarus and Folkman’s Transactional Model of Stress and Coping • Realised that different people could evaluate a potentially stressful situation differently • Stress is regarded as a ‘transaction’ between the person and the environment where the persons individual interpretation determines how to deal with the situation. • Losing your job may be very stressful if you have a family to support and a mortgage to pay but may not be so bad if you are single and still living at home with your parents • Lazarus Transactional Model of Stress and Coping emphasises the importance of the interaction (‘transaction’) between the individual and their environment in interpreting (‘appraising’) whether the stressor is threatening, challenging or potentially dangerous.

42. Types of Appraisal of Situations • Defines two main states in perception/interpretation of a situation. • These occur in a sequence in response to a potential stressor. • 1) Primary appraisal = the recognition of a potentially stressful situation. • The person evaluates/judges the significance of the situation • Assesses it as stressful, neutral or irrelevant. • If assessed as stressful, then we engage in additional appraisals: • Harm/loss – how much damage has already occurred? • Threat – what harm/loss could occur in the future? • Challenge – what potential for personal gain or growth is there from the situation? • 2) Secondary appraisal = considering what options are available and how best to respond to the situation • Evaluate our coping options and resources • Internal resources – strength, determination • External resources – money, support from family • May go through a third stage called reappraisal in which we reassess the situation and the coping resources. • If the coping demands are perceived as being greater that the resources available we are likely to experience a stress response.

43. Coping Strategies • We can’t escape a stress response so must learn how to effectively cope with it • Lazarus Transactional Model of Stress and Coping also describes coping strategies. • Coping = the process of constantly changing cognitive and behavioural efforts to manage specific internal and/or external stressors that are appraised as exceeding the resources of the person. • In other words, an attempt to manage the demands of a stressor in some effective way • Coping is a process that enables us to deal with various stressors

44. Types of Coping Strategies • Coping strategies are classified into: • 1) Problem-focused coping which involves efforts to manage or change the cause or source of the problem – the stressor. • Tend to be used when we believe that we have some control over a situation and think that we can change the circumstances or at least change ourselves so we can deal with the circumstances • Examining the stressor from new perspectives • Obtaining more information about the stressor by talking to someone who could help • Generating alternate ways of dealing with the stressor • Learning new skills to more effectively manage the stressor • Focusing on changing only what is changeable • Redefining the stressor in ways that are more manageable

45. Types of Coping Strategies • Coping strategies are classified into: • 2) Emotion-focused coping which involves strategies to attend to our emotional responses to the stressor. • Tend to be used when we believe that we have little or no control over a situation and therefore can’t do anything to change the circumstances • Denial (I’m not stressed) • Distancing (I won’t let it get to me) • Avoiding (I just won’t do it) • Minimising (I’m not really that stressed) • Wishful thinking (The situation might just resolve itself) • Acceptance (I accept that this can’t be changed) • Venting emotions • Seeking emotional support from others

46. Strengths of Lazarus’ Transactional Model of Stress and Coping • Bridged the gap between the biological and cognitive explanation of stress • Explained the interaction (transaction) that occurred between the individual and their environment, giving a greater focus on how the person perceived the situation • Used human subjects in developing the model • Focus’s on psychological determinats of the stress response (rather than involuntary physiological responses which were the bases of GAS and fight-flight. • Used a cognitive approach to stress with a focus on how people cope with psychological stressors • Took both mental processes and emotions into account when examining how an individual interprets a situation as stressful or not • Allows for the fact that stressors change over time (by including a reappraisal process)

47. Limitations of Lazarus’ Transactional Model of Stress and Coping • Difficult to test through experimental research as the persons responses are subjective, variable and complex. • Difficult to isolate primary and secondary appraisals for research purp0ses because they interact • Individuals may not always be conscious of or able to label, all the factors that are causing stress. • The greater focus on psychological factors meant that less emphasis was placed on the physiological elements of the stress response • It did not include cultural, social or environmental factors in looking at how individuals perceive a stressful event.

48. Activities to Consolidate your Understanding • Learning Activity 12.8, page 601 – Review Questions • Learning Activity 12,9, page 601 – Visual Presentation

49. 3) Biopsychosocial Model of Stress • Dot point: Social, cultural and environmental factors that exacerbate and alleviate the stress response • Selye’s GAS provided a physiological explanation of the stress response • Lazarus’ Transactional Model addressed the Cognitive/Psychological aspects of the stress response • The Biopsychosocial Model indicates that Stress is not only influenced by Physiological (biological) and Psychological Factors but also Sociocultural Factors • These can be further divided into: • Social Factors, Cultural Factors and Environmental Factors Exacerbate = make worse Alleviate = reduce

50. The biopsychosocial framework Mental health and wellbeing depends on a combination of biological, social and psychological factors