Stress : Managing And Coping With Stress

Question 1

What are drug therapies

Answer 1

Can offer some effective relief from stress-related anxiety.

Question 2

What is Benzodiazepines

Answer 2

Such as Valium increase the activity of the neurotransmitter GABA, which decreases serotonin activity. As serotonin is linked to arousal , low serotonin activity reduces arousal , thus reducing stress

Question 3

What are beta blockers?

Answer 3

• Beta blockers act directly on the sympathetic nervous system and so reduce the arousal of the “fight or flight” response of the SAM axis and HPA axis, by acting on the CNS and ANS.
• They reduce heart rate and lower blood pressure, which are symptoms associated with stress, and act on the body not the brain.
• Beta-blockers reduce the responsiveness of the sympathetic ganglia and nerves.

Question 4

What is the pathway for managing stress with drugs -(biological methods)

Answer 4

Benzodiazepines (BZs)
-> Most common drug to treat stress and anxiety
-> Slows down the CNS activity
-> GABA is the neurotransmitter responsible for anxiety relief naturally in the body.
-> 40% of neurons in brain respond to GABA -> BZs enhance GABA -> BZs also reduce the serotonin activity in the brain as this is the neurotransmitter which causes the arousal; this also reduces anxiety.

Question 5

What can stress cause?

Answer 5

Stress causes an arousal of the sympathetic nervous system (SNS) and this can lead to: - raised blood pressure
- increased heart rate
- elevated levels of cortisol
These then can cause:
- cardiovascular disorders
- reduction in the effectiveness of the immune system

Question 6

What do beta blockers achieve?

Answer 6

• By blocking these receptors, it is harder to stimulate the cells.
• An example would be the heart; it begins to beat slower and with less force so blood vessels do not contract easily. This then leads to a fall in blood pressure which in turn means less stress on the heart. The person would begin to feel calmer and less anxious

Question 7

Strengths of Drug Therapy?

Answer 7

• Drugs are effective
• By comparing drugs to placebos you can see if the drug has pharmacological or psychological effects.
• Kahn et al (1986) used 250 participants over 8 weeks. Found that BZs were superior to a placebo.
• BZs have been found to be better than other antidepressants.
• Beta blockers are useful in real-life situations where accuracy is more important than stamina (e.g. golf and snooker).
• Drugs are easy to use.
• Require little effort compared to psychological methods (e.g. SIT).

Question 8

Limitations of drug therapy?

Answer 8

• BZs are addictive even in low doses.
• Using BZs results in withdrawal symptoms.
  -Ashton (1997) recommends taking them for no more than 4 weeks.
• Side-effects of BZs include aggressiveness and cognitive impairment (e.g. the ability to store new knowledge in LTM is reduced).
• Some studies have linked BBs to diabetes.
• The effects of drugs last only as long as they are taken; the effectiveness stops when the drugs are stopped.
• If the problem has not passed then the individual’s problem could return, along with addictive side-effects. A psychological method may be recommended at the same time.

Question 9

Evaluation of Physiological Methods of Stress Management ( Beta-Blockers )

Answer 9

Beta - Blockers :
• Quick and effective way of reducing dangerous symptoms such as high blood pressure
• They do not produce harmful side effects.
• They only reduce the physical symptoms of stress; they do not deal with the source of that stress.
• Therefore, they are not a long-term solution.

Question 10

Evaluation of Physiological Methods of Stress Management ( Benzodiazepines)

Answer 10

• Relatively easy to prescribe and use help to relieve the symptoms associated with stress such as a lack of sleep

• However, these drugs only help with the symptoms and only so long as the drugs are taken.
• BZ’s can have minor side effects such as dizziness and tiredness or more serious effects such as blurred vision and changes in sex drive.
• Another major problem with these drugs is that they can become addictive. Therefore, patients may experience withdrawal symptoms such as increased anxiety, seizures, tremors and headaches when they come off the medication, which can be distressing.
• Such issues give rise to ethical concerns regarding the prescription and management of such treatments and whether or not patients who are experiencing high levels of stress and anxiety are able to give fully informed consent.

Question 11

What is Biofeedback?

Answer 11

􏰀 Biofeedback involves the individual being connected to a machine that provides feedback (visual or auditory) on ANS arousal/signs of stress e.g. heart rate, muscular tension etc.
􏰀 Heart rate is usually measured and feedback will indicate if it is too high or OK.
􏰀 They use the feedback try and alter their own heart rate, breathing etc.

Question 12

What steps can a Person learns how to control and regulate symptoms of stress?

Answer 12

• 1.electro codes are attached to your skin. Person attached to machine that monitors and gives feedback on heart rate
• 2.They then send information to a monitoring box which translates measurements onto a computer screen.
• 3. Person is taught relaxation techniques reducing the activity of the SNS and activate the parasympathetic nervous system, slowing heart rate and makes them feel relaxed. This means that adrenaline and noradrenaline are no longer produced, this results in reduced heart rate, blood pressure and all other symptoms associated with stress.
• 4.Relaxation acts like reward and encourages person to repeat this involuntarily-Person learns to use it in
  real-life situations

Question 13

What are the Biofeedback steps?

Answer 13

􏰀 Learning to control ANS/involuntary body activities:
􏰀 Feedback: Patient connected to a machine that provides
information about ANS activity.
􏰀 Relaxation: Learn to control ANS.
􏰀 Operant conditioning: Successful behaviours are repeated because they are rewarding.
􏰀 Transfer to everyday situations.

Question 14

Research into biofeedback?

Answer 14

􏰀 Lemaire et al (2011) found that doctors who were taught biofeedback techniques and used them over 28 days reported much more reduced levels of stress (measured through a questionnaire) than a control group, supporting the effectiveness of biofeedback in managing stress.
􏰀 But also measured the physiological symptoms of stress, such as heart rate and blood pressure, in the same participants, and found no significant changes over the 28-day period.
􏰀 These findings weaken the use of biofeedback, as the effect on the physiological effect of stress seem to be very limited, or non-existent

Question 15

What is Budzynski research?

Answer 15

􏰀 Budzynski et al conducted research into the effectiveness of biofeedback as a way of treating tension headaches.
􏰀 He assigned 18 participants into 3 groups of six. Group A had biofeedback sessions,
􏰀 Group B were taught relaxation techniques
􏰀 Group C were a control who received no intervention.
􏰀 Group A reported a significant decrease in headaches; this shows biofeedback can be effective

Question 16

Strengths of Biofeedback

Answer 16

• It is effective for a range of health problems - Lack of side effects
• It reduces pain
• It is effective in children as well; it can be effective with children who treat it as a game as they are less skeptical and so it has a greater chance of working.

Question 17

Limitations of Biofeedback

Answer 17

• Requires specialist equipment
• Can be more expensive and difficult to use at home than other methods.
• Time consuming-need to be committed
• Implications for the economy

Question 18

What is CBT?

Answer 18

• CBT was developed by psychotherapists such as Aaron Beck, from two earlier types of psychotherapy; cognitive therapy, designed to change people’s thoughts, beliefs, attitudes and expectations and behavioural therapy designed to change how people acted.

Question 19

What is Stress Innoculation Therapy?

Answer 19

Is a cognitive approach to stress management, it advocates that we change the ways we think about stress.

Question 20

Examples of negative and positive thinking?

Answer 20

• (1) Negative thinking (e.g. ‘I failed to hit a deadline, people must think I’m hopeless’) may lead to negative outcomes such as anxiety and depression.
• (2) Positive thinking (e.g. ’my boss will still be delighted by what I achieved) leads to more positive attitudes and feelings. These reduce the stress response and help us to cope better in the future.

Question 21

What is are the three main phases to the stress inoculation process by Meichenbaum? (Stage 1)

Answer 21

• In Stage one a person might believe that they are going to not get the job that they are being interviewed, so they start getting stressed and reaffirm that they cannot get the job and from that they really do perform poorly in the job interview and fail to get the job.

Question 22

What is are the three main phases to the stress inoculation process by Meichenbaum? (Stage 2)

Answer 22

• In stage two people are taught coping strategies to enable them to restructure their thoughts. For example the person going for a job interview may start to think about what they have done to prepare and they will tell themselves to take it one step at a time

Question 23

What is are the three main phases to the stress inoculation process by Meichenbaum? (Stage 3)

Answer 23

• In stage three the person will use everything they have learned and put it into practice, which will help them succeed. In this case it can help our person succeed in their job interview.

Question 24

What is the study by Meichenbaum ( method )

Answer 24

• 21 students ages 17 – 25 responded to an advert about treatment of test anxiety
• field experiment p’s put into three groups
• SIT, standard desensitisation and a control group
  -P’s tested using a test anxiety questionnaire.
  • The SIT group received 8 therapy sessions and positive statements to say and relaxation techniques to use in test situations.
  • systematic desensitisation groups were also given 8 therapy sessions with only progressive relaxation training
  • control group were told they were on a waiting list for treatment

Question 25

What is the study by Meichenbaum ( findings and conclusions)

Answer 25

• Findings: performance in tests in the SIT group improved the most although both therapy groups showed improvement over the control groups
• Conclusions: that SIT is an effective way of reducing anxiety in students who are prone to anxiety in test situations and more effective than simply behavioural techniques when a cognitive component is added in.

Question 26

STRENGTHS OF Stress Inoculation
Therapy

Answer 26

• SIT can provide the individual with a toolkit for dealing with
future stressful situations as well as offering help with the current problems. It, therefore, provides a long-term solution which other treatments, e.g. medication, may not.
• SIT is a very flexible treatment which can range from simple problem-solving taking just 20 – 40 minutes of therapists’ time to a year of weekly or bi-weekly sessions.
• The end result still relies on the person themselves to put the techniques into action within their daily lives and enforce the change required.
• The skills taught during SIT may be more beneficial than the whole training, e.g. Learning to think more positively.
• Implications for the economy

Question 27

WEAKNESSES OF SIT

Answer 27

-Where the needs of the client are such that SIT requires a lot of time, it will only be appropriate if the individual is very determined and highly motivated.
• Anti-anxiety drugs may need to be prescribed as an interim measure to reduce stress so that the individual can cope with the stress inoculation training.
• SIT also takes commitment and persistence and can be hard work.
• The ‘homework’ may be difficult and challenging and clients are often taken ‘out of their comfort zone’ when asked to discuss situations which cause stress.
• The effectiveness of SIT may be as good as the therapist delivering it.
• Compared with medication, SIT may take longer to make any difference to
the client.
• SIT will be costly, usually offered by a private therapist.
• Implications for the economy