Stress

Question 1

Define stress.

Answer 1

Experiencing events or situations that are perceived as endangering physical of psychological well-being, feeling under pressure or threatened.

Question 2

What are the three different models of stress?

Answer 2

Stimulus - causes us to do something
Response - what we de when stressed
Interaction - can’t cope with other things do to stress

Question 3

What are stressors?
What are the different types?

Answer 3

Things that cause stress.
Acute - daily hassle, catastrophe
Chronic - occupational stress, conflict and prolonged circumstances such as illness and poverty

Question 4

How do we measure stress?

Answer 4

Daily hassle scale - 117 everyday events, exams parking and goals.
Social readjustment rating scale - rare life changing catastrophic events such as grief or divorce.

Question 5

How does stress arousal affect performance?
Yerkes-Dodson Law Bell Curve

Answer 5

Slight increase in stress - increases attention and interest
Medium stress - causes optimum arousal and performance
Too much stress - impaired performance because of anxiety.

Question 6

What is the Daily Hassle Scale?

Answer 6

A self questionnaire, rating how often each event in a list of 117 occurs in your life.
This indicators how many stressors you are exposed to.
Mainly acute stressors.

Question 7

What is the social readjustment rating scale?

Answer 7

Patients tick to show how many events in a list they have experienced in a year from a list of 43.
Each event has a specific Life Change Unit score, total score shows the likelihood of chronic stress in a person life based on their experiences.

Question 8

How does the social readjusment rating scale link to illness?

Answer 8

In those scoring over 300 70% are likely to experience ill health in the upcoming year (higher risk than other groups)
Score has a positive correlation with the risk of illness.

Question 9

What are the limitations of the social readjustment rating scale?

Answer 9

Only one year of life does not consider events before this.
Just because an event is on this list doesn’t mean an individual would have found it as stressful.
No recognition of the level of support and coping mechanisms
Cultural influence on the list of events includes, some cultures may count different events as stressful that may or may not be included in the list.
Shows only correlation only causation.

Question 10

How can the response model of stress to used to measure stress?

Answer 10

Measure the physical reaction of the body, measuring the stress reactivity (the flight or fight response or stress response)

Question 11

What were the early stress response experiments?
What are the negatives?

Answer 11

Use of animals that were stressed out, e.g in the predator and measured the physiological stress response.
-ve cognitive ability of animal is less than humans, so harder to extrapolate out.

Question 12

What are the two different stress physiological pathways?

Answer 12

1) Neuroendocrine immune pathway (HPA axis)
2) Sympathetic nervous pathway (fight or flight response)

Question 13

What is the sympathetic nervous pathway of stress response?

Answer 13

Threat triggers an instantaneous hormonal change.
Hypothalamus activates the SNS via the ANS for the adrenal gland to produce adrenaline and noradrenaline.
Increases HR,BP and blood glucose levels.
Digestive system is inhibited

Question 14

How does cortisol link to the sympathetic nervous system pathway?

Answer 14

Cortisol keeps the sympathetic nervous system maintained.
When cortisol level decreases the parasympathetic nervous system is activated.

Question 15

What is the HPA axis in the stress response?

Answer 15

Hypothalamus releases CRF
Triggers the anterior pituitary gland to produce ACTH
Causes the adrenal gland to produce cortisol.

Question 16

On a clinical level the HPA axis is associated with…..

Answer 16

Decreased immune system functioning
Chronic stress
Therefore is of more interest that the sympathetic nervous system.

Question 17

How does cortisol affect inflammation?

Answer 17

Is an anti-inflammatory short term.
Is a pro-inflammatory in the the long term, due to deregulated immune system.

Question 18

What are some ways to measure the stress as a response?
What are the limitations of these measures?

Answer 18

Endocrine system: Level of ACTH and cortisol
Cardiovascular system : BP and heart rate
Skin conductance: Sweat glands, controlled by SNS
Immune system: number of leukocytes and antibodies
Correlation between measures and the degree of stress show very little correlation

Question 19

What are the difficulties of linking stress to the immune system function?

Answer 19

Unsure if causal or correlation relationship.
Does not consider individual varriances in…
Personality - greater tendency for anxiety
Behaviour - what we do when stressed, coping mechanism
Use of health services, detect decrease in immunity.
Processes are not fully understood.

Question 20

Explain how chronic exposure to cortisol can result in inflammation.

Answer 20

Cortisol binds to Glucocortioc receptors (GR receptors).
Prolonged or excessive exposure to cortisol causes a build up in resistance or down regulation of these receptors.
Means anti-inflammatory signal of cortisol is not received by the body.

Question 21

How was the link between stress and the common cold identified by experiment?

Answer 21

Pre-stress levels were measured by a questionnaire.
Split into control group who were exposed to saline drops and and a test group exposed to cold virus.
Pre and post neuroendocrine and immune system function measurements were taken.
Increased stress volunteers were more likely to develop the common cold.

Question 22

How was the link between wounds and stress found?

Answer 22

Students were split into two groups, given a small skin wound.
A) during summer vacation
B) Prior to exams
B - those given during exams took three days long to heal.

Question 23

How is life event research used in relation to stress?

Answer 23

Identify chronic stress
Explores the relationship between potentially stressful life events and ill health.
Burns et al (2003) saw that students with mode major life events hence stress had a smaller antibody production from the influenza vaccination.

Question 24

The HPA axis is considered a cascade of ….

Answer 24

hormones

Question 25

What are the main problems with measuring the stress response model?

Answer 25

not specific to the stressor
does not consider other cognitive, behavioural and emotional responses
Does not consider differences in stress reactivity, stress resilience, stress recovery time and allostatic load.
Considers everybody and their responses are the same ( based on the biomedical model of health), this is not necessarily true.

Question 26

What are ACEs?

Answer 26

Adverse Childhood Experiences
these are potentially traumatic experiences
e.g death of a parent, abuse etc.

Question 27

How do ACEs link to attachment?

Answer 27

The toxic stress on the body decreases the biological ability to regulate emotions by biological pathways, meaning children and more likely to be severely stressed in later life and struggle to create secure attachment.
Children feel overwhelmed, intense fear and terror, helplessness and loss of safety and control

Question 28

How are ACEs linked to stress?

Answer 28

Repeated ACEs can cause chronic stress, meaning over activated of the SNS and HPA system pathways, can cause the pathways to become non or malfunctions later in life.

Question 29

What are some of the impacts of ACEs on health?

Answer 29

ACEs are linked to increased mental illness, substance misuse and poor employment behaviour.
More likely to be diabetic, develop STDs, heart disease, cancer, stroke or COPD and broken bones.

Question 30

How does the parent response link to the child response to stress?

Answer 30

Those with nurturing mothers are likley to have a reduced stress response,
child adapts their stress response to reflect those of the parent.

Question 31

What is meant by dandelion and orchid children?
How does this link to attachment theory?

Answer 31

Dandelion children - are more robust and bounce back after stress
Orchid children - need more tender care and attention, more affected by stress
Links to attachment as based on internal working mechanism of what to expect from situations, exposure and early dealings with stress. Secure attachment, always confident that they have a safe base to return to in the parental figure are less likley to be stressed.

Question 32

What are the different types of ACEs?

Answer 32

Abuse - physical, emotional, sexual
Neglect - emotional or physical
Household dysfunction - mental illness, mother victim of domestic abuse, divorce, incarcerated relative, substance abuse.

Question 33

How does emotion link to stress and immune function?

Answer 33

Those with a more negative emotions such as depression have less resilience to stress, are more likely to have an impaired immune function.
Depression is linked to rapid progression of immunocompromised diseases
Psychotherapy can improve the course of immune diseases.

Question 34

What are the implications of inderstadning the link between negative emotions, decreased stress resilience and impaired immune function?

Answer 34

Patient management of long term conditions often includes social support and coping strategies to reduce anxiety and depression.
Psychological support improves clinical outcomes

Question 35

What is the transaction model (Lazarus 1960) stress model?

Answer 35

Stress is the respnse which occurs when a person BELIEVES demands on them outweigh their capacity to cope.
Focuses on individual characteristics and stress appraisal.
Measured by perceived stress scale.

Question 36

What are the different stress appraisals?

Answer 36

Primary appraisal - the impact of stressor, what is the threat? How big is the threat?
Secondary appraisal - what will happen after the stressor has occurred? Can I cope? What resources will help me to recover?
Can exacerbate the stress response

Question 37

What are the different stages in the Lazarus transactional model of stress?

Answer 37

Event
Appraisal
Coping
Outcomes
All of these stages are influenced by stable factors such as personality and gender, also contextual factors what is going on, beliefs of others

Question 38

What is eustress?

Answer 38

A positive response to stress (the opposite of distress).
Uses the stress response as motivation.

Question 39

What is the limitation of the transactional model of stress?

Answer 39

Doesn’t consider physiological (processes in the body) that can vary and effect how stressed we are.

Question 40

What is diathesis?

Answer 40

A person’s natural predisposition to have a certain condition or response.

Underlying genetic predisposition etc
Biology develops alongside early experiences.