L6: Stress

Question 1

resultaten: Assessing stress in students (To what extend did you experience stress in the past 4 weeks?)

Answer 1

No/low/moderate stress = 37.6 %
High/very high = 62.3 %

Question 2

After this lecture you are able to explain

• what stress is
• (chronic) stress from the perspective of conventional stress theories and new theory (GUTS)
• why standard interventions may not always work

Answer 2

oke

Question 3

2 soorten klachten over stress bij de studenten

Answer 3

• internalizing complaints (i felt very nervous)
• emotional exhaustion (i feel emotionally drained by my study)

Question 4

percentage studenten dat stress heeft door performance pressure, en vanaf welke bronnen komt dat

Answer 4

Stress because of performance pressure = 71%

Performance pressure:
- from self: 45%
- from others: 30%
- from self & others: 21%

Question 5

conventional stress theories

Answer 5

1) Traditional theories centered on identifying and categorizing external threats or challenges (stressors) that trigger stress responses. They also assumed that the stressors can just be added up to each other, to show how severe the stress would be.
2) Direct cause-effect relationship: These theories assumed a relatively straightforward relationship between stressors and stress responses. They posited that the presence of stressors directly leads to physiological and psychological stress reactions.
3) Focus on specific stressful events that they tried to rank: Much attention was given to identifying particular life events or situations that could be classified as stressors, such as job loss, relationship conflicts, or financial difficulties.

(Limited explanation for prolonged stress: Conventional theories struggled to fully explain prolonged or chronic stress responses, especially in situations where clear stressors were not present or were of insufficient magnitude to account for the observed stress reactions.
Environmental focus: The emphasis was largely on external factors in the environment that could be identified as sources of stress, rather than on internal physiological or psychological processes that might contribute to stress responses.)

Question 6

voorbeeld van zo’n stress event ranking

Answer 6

holmes-rahe life stress inventory

Question 7

problemen met die inventories

Answer 7

• people differ in what they experience as stressors
• researchers differ in what they perceive as stressors (maybe separation of parents is a good thing, if there were many fights at home) -> is it traumatic exposure or relief from exposure?

Question 8

Stressors associated with behavior show contrasting outcomes:

Answer 8

emotional overeating and restrained eating have the same associations with adverse life events

Question 9

Stressor, coping behavior, and the health outcome can be the same factor:

Answer 9

bv. drinking: drinking can be the stressor, but also a form of coping mechanism, and also the health outcome.

hard to define, and also hard to operationalise

Question 10

dus 4 problemen met conventional stress theories

Answer 10

1. People differ in how they experience stressors
2. Researchers differ in what they perceive as stressors
3. Stressors associated with behavior show contrasting outcomes
4. Stressor, coping behavior, and the health outcome can be the same factor

Question 11

integrated definition of stress

Answer 11

Stress is a constellation of events, consisting of a stimulus (stressor), that precipitates a reaction in the brain (stress perception), that activates physiological fight or flight systems in the body (stress response)

Question 12

stress is not a negative response per se!!!!

Answer 12

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Question 13

stress perception

Answer 13

“Threat or defense system is activated, but this is not the same as fear” (LeDoux)
Stressors can activate the unconscious quick & dirty pathway, and after which the conscious slow pathway can get activated (not always)

Question 14

difference between fear and stress

Answer 14

Both stress and fear involve the body’s stress response system and can have similar physiological effects (increased heart rate, rapid breathing, etc.). However, fear is more closely tied to immediate danger, while stress is a broader response to challenging situations or perceived pressures.

Question 15

stress physiological pathways

Answer 15

Physiological stress response:
- Autonomic Nervous System (ANS): This system controls involuntary bodily functions and has a quick response to stress.
- Hypothalamus-Pituitary-Adrenal (HPA) axis: This is a slower-acting system that releases stress hormones like cortisol.

Question 16

hoe ga je dus van stressful events naar stress

Answer 16

Fear/courage/anxiety/stress/challenge -> schemas /cognitive interpretation/body feedback.
This together leads to pattern completion.

Question 17

short term stress: two-wave defense system

Answer 17

Two-phase response:
The stress response typically involves two main phases or “waves”:

a) Fast response:
This is the immediate “fight-or-flight” response. It involves the sympathetic nervous system and the release of catecholamines (like adrenaline), FRF, prolactin, glucagon and more. This response occurs within seconds to minutes of the stressor.

b) Slower response:
This involves the hypothalamic-pituitary-adrenal (HPA) axis. It leads to the release of glucocorticoids (like cortisol) and gonadal steroids go down (sexual hormones, not a priority during periods of stress). This response takes minutes to hours to fully develop.

Question 18

verschil short term acute stress en long term chronic stress

Answer 18

• short term acute stress = minutes to hours
• long term chronic stress = several hours per day for weeks or months

A range of intermediate types of stress:
* Repeated short-term stress with return to resting baseline between “hits”
* Prolonged short-term stress with delayed return to baseline
* Repeated and/or prolonged stress with delayed/minimal return to resting baseline, which over time can transition into chronic stress

Question 19

dus hoe kan long term stress ontstaan uit short term stress

Answer 19

als er herhaaldelijk en/of verlengde stressresponse is met minimale terugkomst bij de rustgrens, kan uiteindelijk chronische stress ontstaan

Question 20

optimize good stress=

Answer 20

• Moderate and regular exercise associated with reduced risk of cancer occurrence, progression and mortality
• Exercise induces physiological stress response
• Keeping the short term stress response well oiled’: exercise as protective stressor (= hypothesis)

Question 21

wat zijn 2 fouten die we hebben gemaakt over cortisol

Answer 21

• vrouwen hebben veel minder grote cortisol response, zeker als ze de pil gebruiken
• cortisol levels zijn niet gerelateerd aan subjective stress experience.
• Greater stress-induced cortisol increases are associated with smaller increases in negative affect during stress (dus meer cortisol leidt tot steeds kleinere increases in negatief affect)

Question 22

cortisol response interpretation in de laatste 30 jaar

Answer 22

• unpredictable
• uncontrollable
• negative evaluative threat
• novel

Question 23

exp. ‘zen’ mensen vs. ‘stressed out’ mensen

Answer 23

2 groepen: zen vs. stressed out
lab visit: exposure to the trier social stress test
measure of cortisol and alpha-amylase

resultaten:
subjective stress scores van very stressed waren hoger dan zen
maar cortisol concentraties verschilden niet van elkaar
verschil tussen de groepen: tendency to ruminate over stressful events

Question 24

Perserverative cognitions =

Answer 24

worry/rumination and negative mind wandering about perceived stressors and potential dange

Question 25

mensen maken zich veel zorgen over waargenomen stressors

Answer 25

zelfs als er geen echte stressor is, kan je je zorgen gaan maken wat tot stress leidt

Question 26

Autonomic nervous system during acute stress:

Answer 26

Major driver of fight-flight response
* Higher sympathetic activation (blood pressure up, heart rate up)

Major driver of recovery from stress
* Lower parasympathetic activity (e.g. dry mouth – lower heart rate variability (HRV)

Question 27

Heart rate variability in rest

Answer 27

• variation in heartbeats high
• greater cardiovascular fitness

Question 28

Heart rate variability in fight/flight mode

Answer 28

• variation in heartbeats is low
• increased risk of death and cardiovascular disease
• worsening of anxiety or depression

Question 29

model over hoe stressors kunnen leiden tot organic disease

Answer 29

stressor -> appraisal and coping -> short stress response -> can be combined with perseverative cognition about stressor -> prolonged stress response (<-> health behaviour ->) pathogenic state -> organic disease

zie schrift

Question 30

Chronic stressful conditions do not contain
that many events to explain prolonged
physiological stress activity that lasts even
during sleep, dus stressors kunnen niet de enige verklaring zijn.

Answer 30

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Question 31

generalized unsafety theory of stress (GUTS)

Answer 31

• chronic stress responses are caused by the generalized perception of unsafety, independent of stressors or their cognitive representation.
• the stress response is a default response inhibited by the perception of safety.
  NOT: “what causes chronic stress responses?”
  BUT: “what mechanism allows the default stress response to be turned off? and when does this ‘switch off’ mode fail to work?”
• early adversities affect safety learning: social safety schemas, influence the perception of others as friendly vs. hostile, predictable vs. unreliable, supportive vs. critical, etc.

Question 32

Conditions carrying health risks relevant to generalized unsafety:

Answer 32

• compromised bodies (overgewicht -> je kan niet wegrennen)
• compromised social network
• compromised contexts

Question 33

wat is een manier om naar deze omstandigheden te kijken (zodat we mensen beter kunnen helpen):

Answer 33

kijken naar bronnen van onveiligheid in plaats van bronnen van veiligheid
- social support -> lack of friends/loneliness
- self-efficacy -> uncertainty about control/ability
- optimism -> not having hope for the future

Question 34

where should future interventions focus on?

Answer 34

1. Interventions directed at the (assumed) stressor or coping with stress (e.g. worry postponement) too often do not work.

-> Are there sources of generalized unsafety? Tackle those!

2. Address the prolonged physiological stress response (teach relaxation, positive challenges)

Question 35

how to maximaze restoration of stress

Answer 35

• Breathing 0.1 Hz increases HRV
• Exercising before relaxation facilitates
  relaxation
• Mentally detaching from work is
  important
• Relaxational behaviours (reading, watching tv, walk in the woods), especially with slow breathing
• Positively challenging behaviours: playing sports, learning a craft, meeting new people (better recovery and decreased burnout)

Question 36

risk factors for mentale gezondheid

Answer 36

mentaal niet wel: vrouw
psychische klachten: vrouw en internationale student

Question 37

bevorderende factoren voor mentaal welbevinden

Answer 37

bijbaan van meer dan 16 uur
voldoende tijd voor achtiviteiten die ontspanning bieden