Stress and Health Flashcards
Stress
demands made by the internal or external environment that upsets balance or homeostasis affecting physical and psychological well being
Cannon: emergency reaction helps organism to mobilize energy for flight or flight. Causes Physiological changes
Seyle: General adaptation syndrom. A non speciifc response of the body to any demand placed upon it
Holmes and Rahe: Social Readjustment rating scale. Measures stressful events. Focused on identifying and quantifying potential stressors
Lazarus: A given event or situation is percieved in different ways by various individuals. Perceptions rather than objective stressors are the main determinant of effects on subsequent behaviors and health status
Acute Stressor
Stressor demand immediate attention and do not last long
They tend to appear suddenly
Chronic stressors
stresor do not require immediate attention, but last a long time and are a constant source of worry
General adaptation syndrome
- Stage 1: Alarm reaction
- The fight or flight respnse which causes you to be ready for physcial activity
- deceases the effectiveness of the immune system which makes you more susceptible to illness
- Stage 2: Stage of Adaptation
- If stress continues, body attempts to adapt to the stressor it is being exposed to o
- Stage 3: Stage of Exhaustion
- Stres persist for a long time
- the body;s resistance may be reduced or collapse quickly
Eustress
Beneficial stress that enhances one’s funcitong. Not defined as a stressor type but rather how one percieved that stressor and how one responds to the stressor
Distress
Type of stress having negative implications. Persistant stress that is not resolved thorugh coping or adaptation and may lead to anxiety, withdrawal and depressive behavior.
Allostatic load
A chronically elevated of arousal which damages the body and makes it less able to flexibly adapt to the environment. Result of chronic stressors. Associate with heart dieas, diabetesm suppressed immunity, hypertention.
Psychological stress and cardiovascular disease
may influence the development of coronary heart disease across life course
chronic stress, both at early life and adulthood, has been associated with about 40-60% excess risk of CHD
hypertention has been a major focus of stress
Childhood stress
Metanaylsis showed childhood abuse to be associated with heart attack and stroke
more than a two fold increas in risk (3 or more childhood abuse scenerios)
Adult stress
patients with CHD or other chronic conditions have significantly worse prognosis if they experience social isolation
working long hours (more than 55/week) is also related to a 40 percent increase in CHD
Biological MEchanism
Sympathetic nervous system activation
catecholamines
cortisol
increase abdominal fat deposition
carotid intima media thickness
metabolic syndrome
Environemntal mechanism
CVD risk can depend on exposure in everyday life to the conditions that elicit these responses and it isd the combination of high responsibity and exposure
BCa background
HAving one first degree relative with breast cancer doubles risk
having two first degree relative increase risk by 5 folds
20-30% of women with breast cancer have a family member with this disease
women at risk for breat cancer tend to report high levels of psychological stress
People who have a family hx of breast cancer have higher systolic blood pressures
Study Procedures for reactivity session
Rest (10min)
Math task (3 min)
rest (10 min)
Mirror tracer (3min)
rest (10min)
Psychological stress and cancer
Evidence is weak
possible link between psychological stress nad increased risk of developin cancer
some data suggest that some patients can develop a sense of helplessness when stress becomes overwhelming. This response is associated with highher rates of death, although the mechanism is unclear
physcial, emotional and social effects of diesease can be stressful
coping strategies = decrrease in depression, anxiety, and symptoms related to cancer and its treatment
psychological stress can affect a tumor’s ability to grow nad spread
norepi may promote angiogenesis and metastasis
Galen said
Women with “meloncholic” disposition were more susceptible to breast cancer than “sanguine” women
Behavioral Model of Stress and Breast Cancer
- Stressor is mediated by a person’s appraisal of the stressor
- appraisal of stress gives rise to intermediate outcomes (biological outcomes, health behaviors) and ultimately clinical health status
Sources of stress
Job, divorce or loss of spouse, cancer in child, death of child, caregiving stress
Biological mechanism linking stress to breast cancer
Epi, norepi, Cortisol, Prolactin, Estrogen, Natural killer cells
behavioral mechanism linking stress to breast cancer
- Physical Activity
- Associated with lower stress levels
- lowers the overall incidence and mortality rates of cancer
- Diet
- Chronic stress is associated with higher saturated fats
- dietary factors are estimated to account fot 35 percent of cancer deaths
- Smoking
- Stressed individuals more likely to smoke tabacco which increases cancer risk
concerns of reccurence scale
Overall concerns
Health worries
Role worries
Womanhood wories
death worries
Psychological stress and the respiratory system
SOB or rapid breathing
generally not a problem for people without respiratory disease
stress can exacerbate breathing problems for people with pre-existing respiratory diesease such as asthma and copd
prenatal maternal stress = increased asthma morbisity in childhoold
exposure to community crime and community violence may influence asthma morbidity
intimate partner violence was associated with 2 fold increased odds of physician-diagnosed asthma at age 3 years
How does stress influence asthma
thorugh effects on the immune system (enhanced Thh2 immune response
Stress modifies the effects of environamental exposures
(air pollution, parental stress is associated with increased susceptability to environmental traffic particulate exposure)
Psychological stress and the male
affect testosterone production, resulting in a decline in sex drive and can cause ED or impotence
impact sperm production and maturation
researchers have found that men who experience two or more stressfule life events in the past year had lower percentage of sperm and lower percentage of sperm of normal morphology, compared with men who did not experience any stressful life events
Psychological stress and the male
high levels may be associated with absent or irregular menstraul cycles, more painful periods and changes in the length of cycles
stress may reduce sexual desire
stress may make premenstraul symptoms worse or more difficult to cope with
emotional distress may intensify the physical symptoms of menopause.
Psychological stress and the NS
SNS release epi and cortisol under stress
- Increase HR, Increase RR, Blood vessels in the arms and legs dilate, digestive process change, increase blood glucose
Recovery - PNS
- overactivity of PNS = stress reactions = bronchoconstriction (asthma)
Coping
To invest own conscious effort to solve perosnal and interpersonal problems in order to try to master, minimize, or tolerate stress
Coping effors: strategies used to mediate primary and secondary appraisal
Transactional model of stess and coping
framework for evaluating the process of coping with stressful events
stressful experience are constructed as person-environement transactions
these transactions depend on the impact of the external stressor
this is mediated by the persn’s appraisal of the stressor and on the coial and cultural resources at his or her disposal
Transaction model of stress and coping
- Primary appraisal: a personal judgement about the significance of an event as stressful, positive, controllable, challenging, or irrelevent. “Evaluate Potential threat”
- Percieved susceptability
- percieved severity
- motivational relevance
- causal focus
- Secondary appraisal: an assesment of people’s coping respources and options. “What one can do about the situation”
- Percieved control over outcomes
- percieved control over emotions
- self-efficacy
- Meaning based coping: coping strategy that is especially meaningfull to the person (positive reinterpretation, acceptance, religion)
- Positive rappraisal
- revised goals
- spiritual beliefs
- positive events
- Coping effort: strategies used to mediate primary and secondary appraisal
- problem management: directed at changing stressful situation (most effective for stressors that are changeable)
- emotional regulation: when stressor is appraised as uncontrollable (detach, avoid, distraction, denial)
- Moderators
- dispositional coping style: dispositional or stable characteristics of the individual, enduring traints believed to drive appraisal and coping effors
- social support: availability of friend could influence person’s perception of severity, can also improve coping
Outcomes
- Adaptation
- emotional well being
- funtional status
- health behaviors
Types of Coping styles
- Informational seeking
- monitoring:seeking information
- bluntin: avoiding information
- Monitoring may contribute to herightend distress or it may lead to greater adhearance to recommended health practices
- Optimism
- Tendency to have posotuve generalized expecatncies for outcomes
- expectancies shown to relatively stable over time
Examples of Social support
- EMotional
- Instrumental
- Informational
Social support can have buffering effects
- support has a stronger effect when stressor is more intense or persistent
Post-traumatic growth
Describes the positive life changes that develop thorugh a stressful experience
not the same as resilience (this describeds people returning to their previous levels of functioning) Post-traumatic growth refers to positive personal change
Types of post-traumatic growth
- Improved relations with others (grow closer to family member)
- New life experiences (change in priorites, possible change in career)
- greater appreciation for life
- a sense of personal strength (empowered)
- spiritual development (more interest in religion or add spiritual depth to life
Factor contributing to post traumatic grwoth
Those who generally adapt well to new experiences and challenges
those who keep a cheerful outlook
those who have a stonge social support netwoek
Stres management intervention
Techniques used to manage strss and improve coping
S.E.E.D.S
Support, Education, Encouragement, and Determination to Succeed
PAtient support
caregiver support (discussion groups for family and frineds)
free service
HU Cancer center support group services
Stress management and Chemo
nausea and vomiting = emotional stress
Psycosocial intervention: progressive muscle relaxation, guided imagery
costly and limited acess to psychosical interventions
stress management techniques: Paced breathing, muscle relaxation, cognitive reframing
Self administer stress management leads to a better outcome in stress management..
Burnout
measure of physical exhaustion and mental distress, which is catalyzed primarly by occupational and professional demands
Associated with decreased job performance and reduce job commitement
predicts stress-related health problems and low career satisfaction
Coping strategies to reduce burnout
- Strategies that involve engagement such as problem solving, positive reinterpretation and expression of emotion
- Extracurricular activites: music and physical exercise
- Student led support programs that are designed to promote the mentorship of junior students by senior students
- Peer discussion groups providing oppourtunities for students to express, analyze and share feeling, which decreases the likelihood of burnout
