Lecture 2 Flashcards
leading perspectives on stress, stress responses (physiological and psychological), chronic stress, PTSD, sources of stress, and good stress
What is Stress?
Describe Stress as a stimulus
defined as a stimulus, or a change in the environment
Important because it relies on a more objective definition of stress
Overlooks any internal psychological or external behavioral responses
Only considers the stressor
Two types of stressors:
* Acute: brief (seconds to minutes), something that occurs but is not ongoing
Even hours and weeks, as long as the individual eventually overcomes it
* Chronic: prolonged (repeating), the individual is having a difficult time adapting the stressor and overcoming it, and it drains the individual of their energy
This type of stressor is very harmful to wellbeing
Assumes stress can be largely determined through objective means
Assuming you are experiencing stress based on the stimuli and what youre experiencing in your life
What is stress? (Stimulus)
Describe the Major Life Events Scale (AKA Social Readjustment Rating Scale)
Events identified on psychological literature as needing lots of change or adapting from the individual
Correlation between life events stress for that year to current health condition, or reports of illness
But otherwise not much predictive validity
So no long-term results are known from correlations
Any kind of change that requires you to adjust
Change (+ or -) is assumed to be stressful. Items are assigned a life change unit score based on severity.
High stressors: death of a spouse, divorce
Low stressors: change in sleep, vacation, minor violation of law
Issues:
People can experience stressors in different ways, and consider some stressors (like a death of a friend) more harmful than divorce, etc.
Overlooks the subjective, psychological evaluation of the event from the individuals
Important contextual factors also matter, like SES or lack of resources (for stressors like “getting fired
What is stress? (Stimulus)
The Cold Virus study
Participants were exposed to cold viruses (with ethical approval), and asked people to report their life event stress on the previous year
5 = the highest level of stress
With each level of increased stress, increased infection and symptoms of cold virus was shown
The life event stress was shown to be correlated with the level of the onslaught of the cold
More stressful life events = increased likelihood of contracting cold virus
Self-reported health behaviour and stress increase poor health do to poor health behaviour but didn’t mediate it when good
What is stress? (stimulus)
Describe Daily hassles as a stimulus for stress
Day-to-day unpleasant or potentially harmful events.
Ideally measured as they unfold using daily process methods
Check-list approach and asked to respond to brief questionaries throughout the day
**Daily hassles are more problematic than major life events, the more you experience the more chronic stress compared to a major life event that is overcome **
Daily hassles can look like chronic stress over time
Not hugely impactful—like having a small fight with a loved one, sleeping in accidentally, having a headache in an exam
Something on its own that isn’t hugely disruptive, and comes across as a small annoyance
Better predictive ability for future levels of wellbeing and health
Your body is under ongoing and constant stress—and it could develop into chronic stress if a particular stressor becomes unmanageable
No recovery time from stressors
Daily hassles can look like chronic stress over time
Daily process methods
Self-report
But asks people to respond 2-3 times day, for a week
What is stress?
Describe Stress as a response
Stress can be defined as a person’s physiological response (fight-or-flight; also reactivity)
Reactivity may be higher in some people’s blood pressure, making it more difficult to handle stress, or even cortisol levels that are measured
and/or a person’s psychological response (i.e., thoughts and emotions; e.g., nervousness)
The psychological response may impact the physiological response, creating a loop
Reactivity: how quickly someone responds to their environment
Psychological perception is accounted for, including anxiety, fear, worry—like for an exam, or for an upcoming competition
These emotions then have effects on the physical body
And thus, it unfolds badly:
Intense worry —-> physiological response —> worse worst
Lots of individual strain
What is stress? (response)
What is the Fight-or-flight response
Mobilization, increased energy, increased focus (preparing for either response)
Mouth dries up (digestion system shuts down and you stop salivating)
Which neurotransmitters are being released?
Initial neurotransmitters:
Epinephrine: increase in heart rate, breath, tense muscles, SNS sends signal to adrenal glands (quickly),
Norepinephrine
Epinephrine (adrenaline) & norepinephrine (noradrenaline) are released by the adrenal glands (part of SNS)
hormones/neurotransmitters (catecholamines) that regulate heart rate, metabolism, respiration, oxygen to the brain and muscles, etc.
What is stress? (response)
What is Cortisol?
“The stress hormone”
Hypothalamic-Pituitary-Adrenal (HPA) Axis
Cortisol complements the SNS…
I
ncreases blood pressure/blood glucose; enhances the brain’s use of glucose.
Blood glucose levels increase but also use up that glucose faster
(energy that’s readily available), tells the brain to use sugars, and suppresses non-necessary system (like the specific immune system—but in the long-term)
For the short-term, the first line of defense (skin, white blood cells) is actually enhanced, but this wears off over time
Acquired immune system for specific pathogens (like for Covid-19)
Suppresses nonessential systems (e.g., digestive, reproductive, immune).
Reduces inflammation (like cortisol cream)
and assists in return to homeostasis in an ideal situation when you’re able to overcome the stressor
Cortisol output automatically decreases over time (negative feedback loop).
Only in a stressful encounter, you are able to deal with it in some way
What is stress? (response)
How is cortisol measured?
Good biomarker of stress bc it reflects stress, so we can measure cortisol to measure stress BUT hard to study
Chewing on a cotton swab 2-3 times a day (for a week, pretty effective), urine (limited), blood (limited), hair follicles (general sense of cortisol levels)
(daily samples are key components and are very expensive and complicated)
Emotions, diet, etc. all affects cortisol output
Hard to control for only cortisol—so many factors interfere with the output of cortisol
Also natural cycles of cortisol typically looks like a spike in the morning, and slowing dissipates over the day
The issue is, there is a lot of individual difference
Makes it messier for measurement
Inconsistent results to what leads a person to release cortisol
Often inconsistent finding for the same stressor
One way of stressing people out in a lab with constant effects—public speaking
- Predictable effect of cortisol
- Social evaluation is stressful, and a potent human stressor
- Helps us understand why differences between people occur under stress
Individual differences at play as well
What is stress?
Describe Stress as a transaction
most widely adopted view; stress as a process involving continuous interactions and adjustments between person and environment; considers both stimulus and response approaches
Primary Appraisal: initial judgment of whether its worth worrying about or not
Challenge appraisal is less harmful than a threat appraisal
People with challenge appraisal are usually in better health
Stressful and harm-loss are subjective and depend on the event or individual
Secondary Appraisal: judgment of your own abilities to handle the threat or challenge
Resources, social support, skills/knowledge to handle it effectively
Yoru evaluation of your ability to control stimulus or event
Perceived control is consequential to your health both physically and psychologically, ability to control the situation
Two types
Behavioral control: fixing or overcoming the problem
Change outward behaviour or control negative emotions resulting from stress
Cognitive control: thinking about it in a better way, so that it’s no longer a threat
Generally speaking, cognitive control is more effective
Perceived control and acceptance (though paradoxal) both matters A LOT
These appraisals happen very quickly, and sometimes unconsciously; automatically
EX. Seeing a bear barreling towards you
What is stress? (transaction)
Describe the stages of the stress transaction
Stress is a transaction leading a person to perceive a discrepancy between demands of a situation and the resources of their biological, psychological, or social systems
Stimulus→ cognitive appraisal→ threat or not a threat if threat you get stress and a response
How to deal with those demands
There’s some uncertainty, always some discrepancy
Stress as the outcome of this transaction
Measuring stress appraisal
What is the Perceived Stress Scale
Measuring stress appraisal
Often in point-scales that account for the appraisal
Factors that affect our appraisal
Personality: being high in neuroticism will appriase stress more negatively
Contextual, environmental factors
Desirability: someone appraising an event is a function of how someone judges that situation
Like losing a person—usually also becomes more stressful, but society judges it as a very stressful event
Do countries that celebrate death rather than mourn it experience less stress over losing a loved one?
Chronic stress
What are the 2 types of stressors
Acute stressors (limited)
E.g. running late, fight, accident
Daily hassle and major life events
Chronic stressors (prolonged, repeated)
E,g, job strain, poverty
On-going difficulties in the family such as marriage or even schooling
What does it look like?
Chronic stress
How does chronic stress affect health?
Directly: via physiological effects on various bodily systems.
Indirectly: via health behaviours. substance use, unhealthy eating, lack of exercise, poor sleep, etc
Stress often leads people to engage in poor behaviours
abuse, drinking, poor sleep, unhealthy eating
Chronic stress
What is the General Adaptation Syndrome
-
Alarm physiological mobilization of action
Fight or flight response
Returns to normal when stress is resolved
Cortisol plays an important role
(if they overcome the stressor, then stress ends at this stage) -
Resistance if stress continues. The body tries to adapt to stimulus
(if they overcome the stressor, then stress ends at this stage) -
Exhaustion if stress continues. Breakdown of organs, disease, death; Burnout/ emotional exhaustion due to lack of recovery time
Technically, you can see the wear accumulate to the extent of death
Chronic stress
Discuss the relation between Chronic Stress and Cortisol
(There’s a graph)
Highly variable
Heightened cortisols in stage one, can last for days or years/ intermittent or trauma
You cannot predict how stress unfolds—there are individual differences that you cannot control for
And this could be caused by chronic stress or constant daily hassles
Stage two, there is an attempt by cortisols but it lowers to normal levels
Stage three, hypo-cortisols, lower than normal levels of cortisols causing fatigue or increased inflammation, plays a role in your sleep levels and everything is thrown off
Chronic stress results from the over-elevated levels of cortisol
Chronic stress
Discuss the effects of chronic stress
HPA axis becomes** dysregulated**, leading to elevated cortisol
Elevated blood glucose; increased storage of visceral fat
Cortisol causes an increase of blood glucose during the stress response
To provide more energy
But over time, elevated blood glucose can result in diabetes
Chronic stress in this way can have serious health effects
Also glucose can be converted into visceral fat, which can result in weight gain and obesity
Affects metabolic processes and increases in heart disease/attacks
Fat cells also grow faster
Affects circadian rhythms and sleep—which helps regulate fat
Also higher levels of** blood pressure and cholesterol**
Over time, there’s chronic hypertension develop
Inflammation also gets out of control—and other substances that builds plaque in arteries
plaque build-up in arteries (atherosclerosis)
Impaired **immune functioning **
Generally speaking
Reduced healing time, and an increased susceptibility to infection
Inflammation is out of control
It isn’t suppressed—the body is theorized to build resistance
Inflammation is a precursor to variety of diseases
EX. Risk of heart attack, alzheimer’s disease
Sometimes it’s seen that stress causes damage to brain cells (in the hippocampus)
Epinephrine:
Surges of Epinephrine affect cardiovascular health, anxiety, blood pressure
Many adverse health effects from cortisol
Hypertension, weight gain, fatigue, depression, sleep problems, heart disease, stroke, obesity, etc.
Even suicidal ideation or suicide can be attributedd
Chronic stress
Discuss the link to increased risk of Cancer
Estimated that 30-50% of cancer are potentially preventable**
**Potentially, because we might not always be able to change our environments
Can stress cause cancer?
Chronic stress weakens the immune system (via cortisol), which may accelerate cancer or tumour growth
Or via health-compromising behaviours in response to stress- drinking or smoking more
Chronic stress —> weakened immune system —> cancer growth/tumor growth
Hard to measure and research stress because you can’t administer a particular level of stress and say “x amount of stress causes x reactions”
Chronic stress
Discuss insights from Animal Research on chronic stress
Experimental design – mouse model with control group.
Injected human ovarian carcinoma cells into mice.
Dilute cancer cells
Mice were exposed to chronic stress (2 hours of physical restraint per day for 21 consecutive days)
Tumor weight in chronic stress group was exceptionally higher than the control group
No matter how they stressed the mice, a similar pattern was observed
One group of mice were stuck in a tube for two hours
Chronic isolation and repeated uncontrollable electrical shock are other groups tested, found same effect no matter how chronic stress was manipulated
Psychophysiological disorders
Physical symptoms or illnesses that result from the interplay of psychosocial and physiological processes.
Previously referred to as “psychosomatic” may be caused by or aggravated by stress
Caused directly or worsened by stress
Involves conditions like
Digestive diseases (EX irritable bowel syndrome, developing an ulcer)
Asthma
Recurrent headaches and migraines
Direct effect, dilation and contraction of blood vessels in the headache
Rheumatoid arthritis (inflammation in the joints)
Allostatic Load
Accumulating effects (wear and tear) that result from the body adapting repeatedly to stressors over time.
More stress + less time to recover = more allostatic load on the body
Measured differently in different studies
The more allostatic load, the less ability that person has to escape and deal with future stress
A vicious cycle: Allostatic load —> less ability to cope —> more stress —> more allostatic load
Is there a genetic component to allostatic load? Is it possible to be more predisposed to stress?
Exercise isn’t just good for releasing endorphins—it also trains your body to handle low amounts of physical stress
Allostatic load impairs the body’s ability to adapt to future stressors.
Higher allostatic low cases more difficulty to cope in the future
The more stress you were in the pass, and unable to overcome it, you’ll have just as much of a difficult time
Daily hassles on stress
Even daily hassles may cause serious health problems…
Piazza et al. (2013) examined the relationship between daily hassles and later-reported health problems.
Greater emotional reactivity to daily hassles at Time 1 was associated with an increased risk of reporting a chronic physical health condition 10 years later.
Aldwin et al. (2014) also found an increased risk of mortality among those reporting high frequency of daily hassles over time
Trauma matters, small things add up
Daily hassles consistently affecting life has been reported to having a chronic physical health condition 10 years later
Also reported to have an increased risk of mortality
The stress response today, we face social, emotional and psychological stressors
We do need the stress response, but oftentimes it can serve a redundant purpose
Engaging with the fight or flight response 50-100 times per day
It’s fairly normal to engage with it, but the issue is engaging with it so much that you don’t have proper recovery time
Effects of things like Covid-19 will indefinitely cause us a mental and physical toll
Increase in heart disease, stroke, diabetes, as a result of chronic stress
Outcomes from the pandemic can have other effects other than the biological one
The Stress response today…
It was always worth it to engage in the stress response in the past, the result would’ve been death or serious injury, they were often physical
Today, the problem isn’t the stress response but we engage that response is no longer physical while the system is still the same
Trauma & Stressor-Related Disorders
Trauma
an emotional response to a distressing event (e.g., accident, assault)
Trauma & Stressor-Related Disorders
two main diagnosis in the DSM-5
Acute Stress Disorder
Severe anxiety, dissociation, and other symptoms within one month after exposure to an extreme traumatic stressor (e.g., witnessing a death, or a serious accident).
Similar symptoms to PTSD but happen early on
Most people don’t seek out medical or support until it has occurred for a prolonged time that turns into PTSD
Development of trauma symptoms in 30 days after teh traumatic experience
High anxiety, dissociative effects, hard time thinking about the event itself, troubled returning to everyday life
Most people after developing a traumatic response would not see a clinician after 30 days, but not during
Most symptom alleviate after a few weeks
Posttraumatic Stress Disorder (PTSD)
A psychiatric disorder resulting from exposure to a highly stressful or traumatic event, with symptoms lasting for more than one month.
Estimated to be as high as 30%
Results from a highly stressful or traumatic event
Symptoms lasting more than 30 days
Trauma & Stressor-Related Disorders
Discuss the DSM-5-TR Criteria for PTSD
Diagnosis needs to identify a stressful event
Direct exposure; Witnessing, in person; Indirectly, by learning that a relative or friend was exposed to trauma; Repeated or extreme indirect exposure to aversive details of the event (e.g., on job)
DSM suggests PTSD cannot be achieved by viewing something
Idea of control of what you expose yourself to; it’s voluntary
Seeing violent imagery online is not sufficient for PTSD, as there’s a sense of distance and because there’s a level of control (you can look away, for the most part)
The stressor
Intrusion: intrusive and recurrent memories, nightmares, flashbacks, etc.
Uncontrollable
[Need one]
Avoidance: Avoidance of trauma-related reminders (people, places, activities, objects, situations, etc.)
Cause intrusion, avoidance lead to thinking of events
[Need one]
**Negative cognition/mood: **Negative thoughts and emotions (fear, horror, anger, survivor’s guilt, blame, alienation, etc.)
[Need two]
Alteration of arousal: Reckless behaviour; Exaggerated startle response; Hypervigilance; Sleep disturbance, etc.
On edge, leads to distress (hyperactive fight or flight response)
[Need two]
Need all five to be present
Complex PTSD include the factor of being unable to escape
Must have been more than 1 month, affects daily life, and cannot be caused by medication or drugs
Trauma is not just an emotional response—it’s also a physical response
It takes years and decades to return your body back to homeostasis
