Stress Flashcards
Identify the three major theories that explain stress.
- Stress as stimulus
- Stress as response
- Stress as transaction (person and environment)
Outline the theory of stress as stimulus, providing an example.
- Focus on the environment
- Event or circumstance is the cause of stress (=stressors)
Example: ‘working with chronically ill patients is stressful’ ‘my illness is causing me stress’
Outline the theory of stress as response, providing an example.
- Focus on individual’s reaction to stressors
- Psychological + Physiological response
- Responses are known as ‘strain’
Example: ‘I feel a lot of stress just before my OSCE’
‘I find breaking bad news to a patient stressful’
Outline the theory of stress as transaction, providing an example.
- Focus on stress as a process [stressors and strains]
- Relationship between the person and environment
- Continuous interactions and adjustments – ‘transactions’
Example: person is the active agent who can influence impact of stressor
‘stress // challenge before the OSCE ??’ – coping
Define stress.
The perceived discrepancy between demands of the situation and the resources of the person that they appraise in a stressful situation’
Involves a feeling of lack of control and a sense of unpredictability.
Compare the 2 processes of stress appraisal in the ‘stress-coping’ paradigm
As a result of a stimulus:
PRIMARY APPRAISAL
1) First undergo primary appraisal in which we determine whether it represents a harm, loss or threat.
Possible conclusions include
a) Benign appraisal (leading to no further coping)
b) Irrelevant appraisal (leading to no further coping)
c) Positive appraisal (leading to no further coping)
d) Stimulus appraised as harm, loss or threat
SECONDARY APPRAISAL
2) If the stimulus is appraised as harm, loss, or threat, it is then perceived as a stressor, triggering the need for secondary appraisal (=coping).
Four actions may be reached as a result of this appraisal:
a) Seeking information
b) Taking direct action;
c) Doing nothing
d) Worrying
Identify physiological models of stress.
- Fight or flight response (acute/ short term)
* General Adaptation Syndrome (chronic/ long term)
Describe the fight or flight physiological model of stress.
Fight or flight is a physiological reaction to emergencies/acute, short lived stress) - ‘adaptive’ response
• Homeostasis threatened
• Elicited by external threats
• Increased physiological arousal enable fight or flight response
• BUT prolonged state of high arousal harmful to health
Describe the general adaptation syndrome model of stress.
• Three main stages:
1) Alarm (mobilisation to fend off stressor)
2) Resistance (continued fight against stressor)
3) Exhaustion (depletion of resources, ability to resist may collapse)
• 2 step physiological response
1) Sympathetic activation
– under stress: sympathetic nervous system stimulated
– catecholamines produced (adrenalin & noradrenalin)–
– Other characteristics (due to activity of adrenal medulla):
• Increased heart rate
• Increased BP
• Increased metabolic rate
• changes in blood flow
• dilation of bronchioles
– quick response system (within seconds)
2) Hypothalamic-pituitary-adrenocortical (HPA) activation
– Increased levels of corticosteroids (glucocorticoids e.g. cortisol)
– raised levels of brain opioids beta endorphin & enkephalin
– Other characteristics (due to activity of adrenal cortex):
• retention of sodium & water by kidneys
• Increase blood vol, BP
• P, F converted to glucose/ broken down for energy
• Increased blood sugar
• Decreased immune system
– slower response system (minutes to hours)
List the typical signs of stress
Changes in • biochemistry • physiology • behaviour • cognition • emotional state
Why do responses to stress vary?
Due to the existence of stress moderators: • coping strategy • social support • beliefs and attitudes • personality • individual differences.... • sense of control • stress reactivity • genetic predisposition (PTSD – see galen) • gender • certainty / uncertainty • lifestyle
Define burnout.
Symptomatically similar to stress, attributed to occupational stressors
Describe how stress can influence health.
Health effect of long term stress:
1) Health behaviour
– risk behaviours, health compromising behaviours, cognitive, emotional
2) Physiology
– ↑SNS, catecholamine, corticosteroid release
– May lead to:
CARDIOVASCULAR DISEASES
• Cardiovascular reactivity linked to illness
• Individual’s exhibit stable cardiovascular reactivity but individual variation in reactivity
• Stress induced increase in catecholamine and corticosteroid release can damage the arteries and heart
– promote atherosclerosis, increased heart rate
– lead to development of hypertension, CHD
• Specific examples:
-CHD (Leading single cause of death in UK)
-MI (Effect of stress is independent of SES and smoking, but consistent across regions, age groups, and genders)
IMMUNE FUNCTIONING
Impaired by:
• Physiological response to stress
– Increased catecholamine & corticosteroid release
– Increased immune cell activity (T and B cells) against antigens
– linked to development of infectious disease, cancer
• Emotion
– depression, optimism also influence immune response
• Psychosocial factors
– life events, social support, exercise, lifestyle…
WOUND HEALING
• Slowing of wound healing by psychological stress (takes longer in higher stress patients)
• Clinical implications e.g. surgical recovery…
PEPTIC ULCERS
• Psychosocial stress linked with peptic ulcer
-Also depression, asthma, headache,eczema…
3) Indirect effects of stress on health: • Health-related behaviours: – substance abuse (alcohol, drugs) – smoking – poor diet – lack of sleep – lack of exercise – poor adherence to treatment – less likely to take preventative health measures – increased engagement in reckless behaviour --> injury • Direct link to health outcome
Describe the different aspect of one’s life affected by stressors.
Stressors affect different systems:
- PHYSIOLOGICAL SYSTEM
- Sympathetic nervous system (fight or flight response = acute)
- Endocrine system
- Heart rate
- Breathing
- Muscles
- General Adaptation Syndrome (= chronic, response of body to stress in short and long term) - PHYSIOLOGICAL SYSTEM
- Cognitive functioning (attention, memory, can be positive/ negative)
- Emotion (fear, excitement, depression, anger) - SOCIAL SYSTEM
- Social behaviour
- Gender
- Socio-cultural differences
Define stressor.
Events or circumstances that we perceive as threatening or harmful
