22 - Stress, Life Events, Coping

Question 1

What are the subjective sensations of stress?

Answer 1

Headache, nausea, fatigue, muscle tension

Question 2

What are behavioural characteristics of stress?

Answer 2

Crying, smoking, drinking, problems concentrating

Question 3

What are the health effects of stress?

Answer 3

CV disease, cancer, colds, skin disease, depression, weight gain/loss

Question 4

What is the Yerkes-Dodson plot of relationship between arousal and performance?

Answer 4

Level of stress on x axis Performance on y axis 3 stages: Calm, eustress, distress Calm: - Bored - Seeing improvement Eustress: - Optimal performance found at ‘eustress’ stage - Energised, focused, work feels effortless Distress: - Fatigue, exhaustion, health, breakdown and burnout

Question 5

What is eustress?

Answer 5

Beneficial stress

Question 6

How do stress levels and health relate?

Answer 6

Lack of stress = boredom

Moderate levels of stress = beneficial

Too much stress = increasing ill-health

Question 7

What are the physiological reactions to stress?

Answer 7

1. Fight or flight
2. General adaptation syndrome

Question 8

What does the fight or flight response involve?

Answer 8

• Sympathetic nervous system
• Adrenal cortical system

Question 9

What is the general adaptation syndrome? Who came up with it?

Answer 9

Selye

Three-stage process that describes the physiological changes the body goes through when under stress:

1. Alarm (initial response, adrenaline)
2. Resistance
3. Exhaustion (chronic stress can lead to disease)

Stress can lead to decreased resistance to new stresses

Question 10

What is psychoimmunology?

Answer 10

The study of the connections between the mind and the immune system. The basic concept of psychoimmunology is the concept that the mind and body are inseparable. It follows that stress affects the body’s ability to resist disease.

Question 11

What was Cohen’s 1991 study on psychoimmunology?

Answer 11

Found that immune system decreased under high psychological stress:

• MRC common cold unit
• 5.8x more likely to become infected
• 2.2x more likely to get illness (cold)

Question 12

What are long-term immunity effects of chronic stress?

Answer 12

• Increased immuno-suppression (decreased efficacy of vaccination and wound healing, decreased resistance to infection and cancer)
• Increased immuno-pathology (increased pro-inflammatory and autoimmune disease)

Question 13

How can chronic stress lead to immuno-suppression?

Answer 13

Chronic stress decreases baseline leukocyte numbers, suppresses leukocyte function, mobilises immuno-suppresive mechanisms (e.g. reg T cells, accelerates immunosenescence

Question 14

How can chronic stress lead to increased immune pathology?

Answer 14

Chronic stress induces increase in dysregulated, pro-inflammatory or Type-2 cytokine driven responses

Question 15

How can short-term stress prove beneficial to immunity?

Answer 15

Increased immuno-protection

• Increased efficacy of vaccination and wound healing
• Increased resistance to infection and cancer

Question 16

What are the psychological reactions to stress?

Answer 16

• Cognitive impairment
• Anger
• Depression
• Anxiety (PTSD, acute stress disorder)

Question 17

What is PTSD?

Answer 17

A natural emotional reaction to a deeply shocking and disturbing experience i.e. a normal reaction to an abnormal situation

Question 18

What are the key features of PTSD?

Answer 18

• Repeated re-living of traumatic event
• Persisten efforts at avoidance of memories and emotional blunting
• Persistent symptoms of hyperarousal and survivor guilt

Question 19

What was results of study on PTSD after Piper Alpha oil rig 1988 explosion that killed 200 men?

Answer 19

10 years later:

• 21% with PTSD
• Worse if injured
• Improvement over time

Question 20

What is the Social Readjustment Rating Scale? Who was it created by?

Answer 20

Holmes and Rahe 1967

Developed a questionnaire for identifying major stressful life events. Each one of the 43 stressful life events was awarded a Life Change Unit depending on how traumatic it was felt to be by a large sample of participants.

E.g. death of spouse 100 points

Question 21

What is the hassles and uplifts scale?

Answer 21

Measures respondents attitudes about daily situations defined as “hassles” and “uplifts.” Instead of focusing on highly charged life events, the HSUP provides a comfortable way to evaluate positive and negative events that occur in each person’s daily life (children, parents, spouse etc)

Question 22

What are quasi-prospective studies?

Answer 22

Studies that aim to evaluate interventions but that do not use randomisation

Question 23

What was the result of Cooper & Faragher’s quasi-prospective study about life events and breast cancer?

Answer 23

Certain types of coping strategies and personality dispositions predispose some women to an increased risk of developing breast cancer following the occurrence of a major life-event such as bereavement or other loss-related event.

• Regular exposure to stress situations appears to reduce the risk of a malignancy
• A single, major life event was found to be potentially much more damaging, particularly if the individual was unable to externalise her emotions and obtain help

Question 24

What is a type A behaviour pattern?

Answer 24

Competitve, time urgent, hostile, try to do 2 things at once, hard workers and career orientated

Question 25

What are health effects of Type A behaviour?

Answer 25

High blood pressure, heart disease

Question 26

What is type B behaviour pattern?

Answer 26

Relaxed, imaginative and creative, lower levels of anxiety

Question 27

What is the ACE pyramid?

Answer 27

Adverse Childhood Experiences (ACE) Pyramid assesses associations between childhood exposure to traumatic stressors and later-life health and well-being.

Question 28

What are appraisal approaches to stress?

Answer 28

Refers to the process by which individuals evaluate and cope with a stressful event. Concerned with individuals’ evaluation of the event, rather than with the event. People differ in how they construe what is happening to them and their options for coping.

Question 29

What is key to approaching stress?

Answer 29

Perceptions of controllability (stop, start) and predictability (if, when)

Question 30

What was Lazarus & Folkman’s appraisal process?

Answer 30

• 1ary –> perception of demands (potential for threat, harm)
• 2ary –> available coping options
• Re-appraisal –> regular re-evaluation and re-labelling of the above

Question 31

What are problem focused coping strategies?

Answer 31

Changing the situation (physical, social, work)

Question 32

What are emotion focused coping strategies?

Answer 32

1. Active

• Habits - eating, sleeping, exercise
• Managing time, priorities, delegatio
• Cognitive - positive thinking, imagery, preparation

2. Rest/habituation
   * Relaxation, leisure, holidays, exercise
   * Distraction, denial, rumination, discussion

Question 33

Stress spectrum

Answer 33

The extent and efficiency with which an organism returns to its resting zone after stress depends on RESILIENCE

Question 34

What is resilience?

Answer 34

The capacity of psychophysiological systems to recover from challenging conditions. Psychological and physiological resilience factors determine the overall effects of stress on an individual.