Stress, anxiety and health

Question 1

What are the 3 characters of stress and examples of each of these

Answer 1

Subjective sensations - headache, nausea, fatigue, muscle tension

Behaviour - crying, smoking, drinking, problems concentrating

Health - CVD, cancer, colds, skin disease, depression

Question 2

What is eustress?

Answer 2

Beneficial stress - optimal performance

energised, focused, work feels effortless

Question 3

What is stress?

Answer 3

A response (physiological, emotional)
A stimulus (an event)
A cognitive appraisal (coping)

Question 4

What controls the fight or flight response?

Answer 4

Sympathetic NS

Adrenal cortical system

Question 5

What is general adaptation syndrome? (Selye)

Answer 5

A physiological response pattern to stress
The health affects of stress are diseases of adaption - a normal response to an abnormal situation

Immediate depression in physiological activity in response to a single stress, followed by a period of increased activity. In response to continuing stress, physiological system starts to slow down reaching a stage of exhaustion.
If a second stresser is introduced, the period of resistance to stress is very brief

Question 6

Who came up with the general adaptation syndrome?

Answer 6

Selye

Question 7

What does the general adaption syndrome explain?

Answer 7

Occupational burn out e.g. in health staff

Question 8

How does stress affect the immune system?

Answer 8

Depresses immune function

Question 9

What are some of the psyhcoligcal reactions to stress?

Answer 9

Cognitive impairment (concentration, disorganised thoughts)
Anger
Depression
Anxiety

Question 10

What is PTSD?

Answer 10

a natural emotional reaction to a deeply shocking and disturbing experience i.e. a normal reaction to an abnormal situation

Question 11

What are the key features of PTSD?

Answer 11

repeated re-living of a traumatic event
avoidance of memories and emotional blunting (withdrawal)
persistent symptoms of hyper arousal (e.g. easily shocked, jumping) and survivor guilt

Question 12

What is the social re-adjustment scale? Holmes & Rahe 1967

Answer 12

Can stressful events be put on a scale and can this be related to susceptibility to health problems?

e.g. the events requiring the most social re-adjustment are death of a spouse, or divorce, jail time

Question 13

What is the hassles and uplifts scale? Lazarus and Folkman, 1981

Answer 13

Rates how much each item (e.g children, parents, relatives, spouse, sex, health of family member, friends) was a hassle or a uplift that day, which can be linked to susceptibility of eating ill e.g. a cold

Question 14

What are the difficulties with linking major life events to major health problems?

Answer 14

Breast cancer study Protheroe - malignancies not associated with life events and difficulties

(although, there is better evidence now so a weak link)

Question 15

What did Cooper and Faragher’s breast screening study show?

What were the issues with this study?

Answer 15

Malignancy was associated with a single major life event
Weak relationship, but significant

BUT those who went to screening are more likely to have breast cancer in their family etc.

Question 16

What is a type a behaviour pattern?

Answer 16

Type A people are 2x as likely to have a heart attack

personality type is a risk factor

Question 17

What is type A behaviour?

Answer 17

thinking of or doing two things at once
scheduling more and more activities into less and less time
hurrying the speech of others
becoming unduly irritated when waiting in line or in slow moving traffic
having difficulty sitting and doing nothing
playing nearly every game to win, even when playing with children
etc.

competitiveness, time urgency, hostility

Question 18

What were the mixed outcomes of the type A CVD study?

Answer 18

Related to coronary atherosclerosis only in under 45s

Type A survivors of heart attack less likely to die in next few years than type B

Question 19

What are modifiable and less modifiable risks?

Answer 19

Some risks are genetic and cannot be changed
Behavioural risk can be changed

Lifestyle interventions can therefore be successful in reducing health issues

Question 20

What is the Ornish programme?

Answer 20

Diet, exercise, stress management, group support

Question 21

What is a life-course approach to life events? What effect do ACEs have?

Answer 21

A whole set of exposures throughout life make up an accumulation of events

Adverse childhood events can mean you’re more likely to suffer health problem/mental illness. Some events can effect development.

Question 22

What is the main reason ACEs cause early death?

Answer 22

Disrupted neurodevelopment causes social, emotional and cognitive impairment

this causes adoption of health-risk behaviours

this causes disease, disability and social problems

Question 23

Links between stress and anxiety

Answer 23

Physical symptoms (raised heart rate, tension, dizzy, headache)
Thoughts and feelings (on edge, will lose control, might die) --> out of proportion to the threats and persist

Question 24

What is the problem with uncertainty?

Answer 24

Drives worry (what if..?) and leads you to overestimate risk

Question 25

How is uncertainty shown?

Answer 25

Seeking excessive reassurance
list making
double checking
refusing to delegate
procrastination
avoidance
distraction

Question 26

What are appraisal approaches to stress?

Answer 26

Focus on person-environment transaction

Key perceptions are controllability (can stop/start something) and predictability (know if/when something occurs)

Question 27

What is the primary appraisal process?

Answer 27

Perception of demands - potential for threat, harm challenge

Question 28

What is secondary appraisal?

Answer 28

Capacity to manage the threat of the primary concern - available coping methods

Question 29

What are problem focused strategies for coping with stress?

Answer 29

Changing the situation

Avoiding the situation in the future

Question 30

What are emotion focused coping strategies fro stress?

Answer 30

Behavioural - exercise, drinking, venting anger

Cognitive - denial, rumination, discussion

Question 31

Examples of ways to manage stress

Answer 31

Relaxation training & biofeedback (measuring heart rate, muscle tension etc Meditation
Exercise (physiological and self perception effects)