Lecture 3: stress & Health Flashcards
Define stress
According to psychological definition, stress occurs when
demands are appraised as exceeding a person’s resources to cope
What are the 4 classes of effects of stress?
Affective: shock, distress, anxiety, fear, depression, anger, frustration, lowered self-esteem, learned helplessness, guilt
Behavioural: smoking, alcohol, help seeking delay, poor adherence, relapse, social withdrawal, illicit drugs, risky sexual behaviours
Cognitive: poor attention, errors in decision-making, hypervigilance for threats, bias to interpret ambiguous events as threatening, mood-consistent memory
Physiological: activation of nervous system, hormone production, metabolic function, immune function, fatigue, disease and illness
Wha is the transactional model of stress?
demands/stressors are external or internal events that trigger stress responses
What are the different types of stressors?
Processive / psychogenic stressor; psychological in nature (complex cognitive processes that engage numerous brain areas)
Neurogenic: physical stressors
What are the stressor characteristics?
Type or duration such as acute events
Chronic stressors
Daily hassles
Traumatic stressors
Role strain
What is Burnout?
Emotional exhaustion
Depersonalisation
Reduced personal accomplishments
What is emotional exhaustion?
involves feelings of physical exhaustion, being depleted, worn out
What Is depersonalisation?
involves having an unfeeling, impersonal approach to co-workers or patients, cynicism, and a lack of engagement with the job or people.
What is reduced personal accomplishment?
involves a poor sense of effectiveness, involvement, commitment and engagement and a poor belief in one’s ability to change or improve work patterns or environment
What are resources?
are loosely defined as objects, states, conditions, and other things that people value
The value of resources varies among individuals and is tied to their personal experiences and situations
What are the different types of resources?
Psychological
Social
Material
What is personality?
Personality is a construct that is used to refer to an individual’s distinctive and characteristic patterns of behaviour, emotion and thought
Dimension of personality that have most effect on how a person responds to stress are those involving negative emotions
What is Neuroticism?
Neuroticism is a personality trait that involves tendency to experience negative emotions:
- anxious, tense, self-pitying, worrying, self-conscious, hostile, and vulnerable
People who are high in neuroticism experience?
low mood, anxiety, guilt, hostility, fear and report more somatic symptoms and are more at risk of psychological disorders
What is Coping?
Coping is defined as any attempt to cope with a stressor, irrespective of whether this is successful or not.
What does the effectiveness of coping depend on?
Type of stress
Individual
Circumstance
Type of coping responses/ strategies
What are Emotional-focused strategies?
Emotional expression (e.g., crying, anger); other-blame, self-blame, rumination, wishful thinking)
What are Problem-focused strategies?
problem solving: finding a solution to limit or eliminate the impact or presence of the stressor; cognitive restructuring (positive framing: re-assessing the situation or putting new spin)
What are Approach coping strategies?
try to deal with the situation pro-actively (overlap with problem-focused)
What are Avoidant coping strategies?
try to avoid the problem (active distraction; cognitive distraction; denial; drug use)
- e.g., avoidant coper may find it very difficult to discuss their illness, the side-effects or treatment or potential complications
What are the different types of coping strategies?
Emotional- focused strategies
Problem-focused strategies
Approach coping strategies
Avoidant coping strategies
What are the 3 perspectives to understand stress?
Response: Focus on the effect (physiological)
Stimulus: Focus on the cause (stressor)
Process: Focus on the person-environment interaction (transaction)
What is Appraisal?
an act of assessing something or someone
That are the processes of appraisal?
- Primary appraisal
- Secondary appraisal
- Reappraisal
What is Primary appraisal?
the demands of a situation are evaluated as benign or stressful/threatening
What is Secondary appraisal?
a person evaluates their resources and capacity to cope
Perceived control over the situation
- Cognitive control: ability to influence the situation by using some sort of mental strategy
- Decisional control: having choice over the coping strategies available to deal with stressor
- Informational control: degree individual is able to predict and prepare for stressful event.
What is Cognitive control in secondary appraisal?
ability to influence the situation by using some sort of mental strategy
What is Decisional control in secondary appraisal?
having choice over the coping strategies available to deal with stressor
What is Informational control in secondary appraisal?
degree individual is able to predict and prepare for stressful event.
What are the factors that influence appraisal?
Background: historical and current life context
Stable/Stress responsivity: relatively enduring individual differences (genetically determined)
Social: perceptions of supporting relationships (identification, integration)
Situational: characteristics of the event (control, predictability, time since onset)
The importance of thinking: what is the cognitive-behavioural model?
THOUGHTS influence FEELINGS which influence BEHAVIOURS which influence PHYSICAL RESPONSES
What is brain’s reaction to stress?
Sympathetic-adrenomedullary axis (SAM) undergoes Sympathetic activation:
Prolonged production of adrenalin / noradrelanin
Results in - blood clot formation, increased blood pressure and heart rate and etc
What happens at Hypothalamic-Pituitary-Adrenocortical (HPA) Axis during excessive stress?
Prolonged production of cortisol can result in the following:
●Decreased immune function
●Damage to neurons in the hippocampus
●Negative feedback loop
What is the action of cortisol during and after stress moments?
Cortisol in blood will stop hypothalamus to stop producing CRH
Cortisol will return to normal levels 40-60 minutes after a stressful event
What are the 9 functions of the Prefrontal cortex?
Empathy Insight Response flexibility Emotion regulation Body regulation Morality Intuition Attuned communication Fear modulation
What are the functions of the Limbic Brain?
Fight, flight, freeze response
Thinks “am I safe, do people want me?”
Emotions live here
Where do emotions live in the brain?
Limbic brain
What are the stages of stress?
SAM (Sympathetic-adrenomedullary axis) and HPA (Hypothalamic-Pituitary-Adrenocortical axis): hypothalamus secretes corticotropin-releasing hormone (CRH)
SAM and HPA: CRH causes the pituitary gland to secrete ACTH (adrenocorticotrophic hormone)
SAM: ACTH cause the sympathetic ganglia to stimulate the adrenal medulla to release a mixture of EPINEPHRINE and NOREPINEPHRINE that triggers FIGHT OR FLIGH RESPONSE: increased heart rate, breathing, blood pressure
HPA: ACTH cause the adrenal cortex to secrete corticosteroids AND cortisol to combat inflammation, promote healing and mobilise the body’s energy resources
What are the cardiovascular symptoms of stress?
Changes in heart rate, blood pressure, and hormones
Vascular responses
Peripheral resistance (myocardial reactivity)
These results in increased risk of developing heart disease •Hyperreactors
What are the respiratory reactions due to stress?
Variability in heart rate in synchrony with breathing (vagal tone)
High RSA linked to better emotional well-being than lower RSA
Low RSA linked to poor health outcomes (cardiovascular disease, obesity, diabetes)
RSA: Respiratory Sinus Arrhythmia
What is the duration or stress?
The ability to recover after a stressful experience strongly influences the total burden that the experience has on an individual
Stressors can be?
Acute
Chronic
Individual’s susceptibility to stress and illness is determined by which two interacting factors?
1- Predisposing Factors (in the person)
•Genetic vulnerability
•Acquired behavioral or personality traits
•Biological system reactivity
2- Precipitating Factors (from the environment)
•Traumatic experiences
What are the different ways if managing stress?
●Cognitive behavioural stress management programmes
➢focus on appraisal / coping
●Relaxation techniques
➢Yoga, progressive muscle relaxation, mindfulness training)
●Physical Exercise
●Expressive writing
What is mindfulness?
mindfulness means knowing directly what is going on inside and outside ourselves, moment by moment.
What is mindfulness meditation?
Mindfulness meditation involves sitting silently and paying attention to thoughts, sounds, the sensations of breathing or parts of the body, bringing your attention back whenever the mind starts to wander
Stress has negative implications for both psychological and physical health
True or false?
True
Illness is inherently stressful, whilst treatment referral compounds the experience
True or false
True
The harmful effects of stress cannot be avoided, removed or reduced in advance
True or false?
False, they can
Transactional model provides?
Organising framework
What will Proactive early intervention enhance?
Clinical effectiveness and patient health outcomes
Which of the following symptoms can you experience in case of Acute Stress?
(a) Sweating, palpitations, arousal, feeling overwhelmed, nervousness.
(b) Mood Swings.
(c) Anger, Irritability.
(d) Isolation and loneliness.
(e) Depression & long-term unhappiness.
A
Dave views his graduation and new job as a stressor, while his friend Brad in a similar situation doesn’t. What is the reason for the different view?
(a) Brad is overconfident.
(b) Dave isn’t prepared for his job.
(c) Difference in appraisal.
(d) Brad is confident.
(e) Dave has an anxiety disorder.
C
What is the ‘Fight or Flight’ reaction in the stress cycle described as?
(a) Alarm
(b) Coping mechanism
(c) Exhaustion
(d) Resistance
(e) Susceptibility
A
Which hormone is strongly associated with the second wave response to stress (HPA-Axis)?
(a)Adrenaline
(b) Cortisol
(c) Melatonin
(d) Noradrenaline
(e) Oxytocin
B
Which subsystem of the autonomic nervous system helps the body return to
“business-as-usual” after an emergency?
(a) Central
(b) Parasympathetic
(c) Peripheral
(d) Somatic
(e) Sympathetic
B
Which of the following conditions is related to overproduction of the stress hormone cortisol?
(a) Acromegaly
(b) Addison’s disease
(c) Cushing’s syndrome
(d) Diabetes mellitus
(e) Hypothyroidism
C
Why do people tend to stay in a slightly elevated state of arousal after a crisis has occurred?
(a) Their adrenal glands continue to secrete adrenaline even after the crisis is over
(b) Their bloodstream continues to contain elevated levels of adrenaline
(c) Their neurons continue to keep the body in an alert state
(d) Their neurons remain in a state of graded potential even after they have fired
(e) Their parasympathetic nervous system remains in a state of fight or flight
B
