Stress, illness and coping Flashcards
Define stress
Stress- A physical and emotional response to any situation that may be perceived as threatening or exceeding the person’s ability to cope with it, depends on specific psychobiological determinants that trigger a stress response in each individual, can be different types of stressors:
- External traumatic - Real threat of serious injury or death
- Internal conflicts - Indecision, uncertainty, imaginary stressors - “What if?”
- Life events - Divorce, bereavement
- Daily hassles - commuting, relationships
- Environmental - Unsafe neighbourhood, loud noise, crime levels
Social evaluative stressors:
- Threats to social status - Fear of failure, stigma
- Esteem + self worth - Social position, poverty
- Acceptance within group or community - Peer pressure etc.
How can stress influence health?
Biopsychosocial stress response
- Physiological body - Headaches, fatigue, muscle tension, skin irritation, breathlessness etc.
- Emotional - Anxiety, sadness, irritability, depression, hopelessness, apprehension, alienation, fear, loss of confidence
- Cognitive - Worry, negativity, hasty decisions or indecisive, catastrophising, difficulty concentrating, muddled thinking, affects memory, intrusive thoughts
- Behavioural - Accident prone, escapism, avoidance, social withdrawal, change in exercise pattern, distraction, restlessness, comfort seeking-drugs/alcohol, tearful
- Biomedical - E.g. hunger, tiredness, illness, pain etc
- Psychological - E.g. personality factors, self confidence
- Social - E.g. gender, socio-economic group, deprivation etc.
What are situational factors that increase stress?
- Control
- Predictability
- Novelty - new situations
Describe general adaption syndrome
Stress viewed as response - the way we react to stressful stimuli
Stress is a ‘nonspecific response of the body to any demand’
All organisms display a series of automatic, non-specific, universal, physiological responses to stressors
3 stages of response:
- Alarm reaction
- Resistance
- Exhaustion
What are the main limitations of GAS?
- Assumes automatic response to an external stressor
- All stressors do not produce the same uniform, physiological responses. They are not ‘non-specific’.
- Individual variability - No consideration to influence of individual psychological factors
Describe the life events model
Stress viewed as something we encounter in our environment, something that happens to us
- Assumes life events can adversely affect health due to the amount of adjustment required
- Stress relates to amount of adjustment or number of life events or changes a person is faced with in a certain timeframe e.g. moving house, bereavement, new job
- Distinguishes stress from stress response
- Life events can be pin-pointed in time so that it’s possible to examine the temporal sequences b/w life experiences and symptom onset
- Easy to measure
What are the main limitations of the life events model?
- People react differently to similar events - Can we say a stressor is inherently stressful? (e.g. divorce)
- Recall - People who are ill are more likely to look for a cause, and if no obvious cause, may attribute it to stress
- Severity e.g. sudden death or expected? Do circumstances mediate stress?
- Restricted range – omissions & non-events e.g. not becoming pregnant, being overlooked for promotion)
- Moderating variables (e.g. social support, financial status) not considered
- Ignores relationship between stressors (major events can trigger minor ones and vice versa). Difficult to establish causality.
- Ignores role of psychological processes (individual coping strategies) – people are not passive.
Describe the transactional model
Stress viewed as series of continuous interactions b/w an individual and the environment
- Stress is a process/series of transactions b/w individual and environment
- Appraise stressor - primary and secondary appraisal
- Primary - Assessment of the stressor itself and demands it makes. Irrelevant, benign, positive - Not stressful. Harmful, challenge or threat - Stressful
- Secondary - Individual’s assessment of perceived resources required to cope e.g. material resources - finance, time etc.
- Adopt a coping strategy
- Re-appraise stressor in the light of the coping strategy
- Re-appraisal - Evaluate how well the coping strategy is working and review - Make adjustments as necessary
What are the strengths of the transactional model?
- Cognitive approach – not limited to physiological processes
- Takes psychological and emotional responses into account
- Dynamic – we can evaluate and change coping strategies
- Allows individuals to change their minds and find alternative strategies
- Allows for circumstances and situations to change
- Acknowledges individual differences
- Suggests individual have control over their response
What are the limitations of the transactional model?
Lack of empirical evidence – difficult to test - subjective
Variability and complexity of individual stress – subjective
perception
Difficulty differentiating factors that determine stress - subjective
Pre-existing factors may influence appraisal (depression, anxiety)
Primary and secondary appraisals may interact and overlap
Stress response may not depend on appraisal
How can stress be managed in a healthcare setting?
Reducing pre-operative anxiety using psycho-educational interventions e.g. information leaflets & videos, distraction, relaxation strategies etc:
- Increases patient co-operation, reduces length of stay, medical complications, reduces analgesic use, improve respiratory function tests, helps to stabilise BP & HR, hastens return to resumption of daily activities, supports adherence behaviour.
- Stress reduction interventions improve wound healing, immune function, reduce pain, increase self efficacy.
What are some coping styles and strategies?
Styles:
- Approach
- Avoidant
Strategies:
- Problem-focused (action coping)
- Behavioural - E.g. Attempts at control, pro and cons, time management
- Cognitive - E.g. Information seeking/avoiding, positive reframing, goal setting
- Emotion-focused
- Behavioural - E.g. Seeking support, emotional expression, distancing
- Cognitive - E.g. Denial, inhibition, suppression
Describe social support for stress
- Emotional
- Esteem support
- Informations
- Companionship (prevents isolation and inactivity)
- Instrumental (practical help)
Describe adaptive coping strategies
- Reduce demands (e.g. problem solving, adjust/change goals, improve time management)
- Increase resources (e.g. social support, skills, finance, confidence)
- Dampen the physiological stress response (e.g. relaxation, meditation, exercise)
- Psychological processes (e.g. re-structuring, appropriate goal setting, rehearsal/preparation, short term denial and avoidance can avoid feeling overwhelmed) - Improve mood
