Stress- Methods of Modification Flashcards
Beta Blockers
Beta blockers are drugs that have an antagonist action, meaning they reduce the activity of the sympathetic nervous system (SNS) and the subsequent increase in heart rate, blood pressure, sweating etc.
They are beta adrenoceptor blocking agents meaning they block adrenergic and noradrenergic receptors – the usual sympathetic response is dampened so the person feels calmer and less anxious.
Non-selective beta blockers such as propranolol block adrenaline & noradrenaline in other areas of the body as well as the heart. They block beta 1 and beta 2 receptors so affect areas like the heart, kidneys and liver.
Selective beta blockers such as atenolol block only beta 1 receptors so mostly affect the heart and reduce cardiac output.
Musicians and athletes are known to be prescribed beta-blockers as an anti-anxiety measure to increase performance, however these drugs are primarily used to treat high blood pressure and angina (chest pains caused by reduced blood flow) and mask the outwards signs of stress.
Effectiveness
- Neftel (82) gave musicians a beta blocker or a placebo 6 ½ hours before performing; The experimental group had lower heart rates and played complex music more accurately. They also self-reported less stage fright post performance.
- Schweizer et al (91) gave different beta blockers to students whilst taking a maths test. Whilst all BBs reduced physical effects of stress, there were large differences in the subjective ratings of stress.
- Long term, BBs may not be effective. If stress has been caused by personality or env. factors then BBs do not address this. The root cause is not treated.
Ethical and Social Implications
Ethical
•Side effects
•Consent
•Performance enhancers – banned by Olympic committees
Social
•Over prescription as an easy remedy for stress/anxiety
•BBs are used to treat stress and anxiety but are not licensed for this so are prescribed ‘off-label’
•Wittich (2012) notes that this leaves doctors vulnerable to lawsuits because of potential adverse effects
Stress Inoculation Therapy
Stress inoculation training suggests that by exposing people to milder forms of stress it can help them develop coping strategies to deal with stress in the future; what they encounter in the training needs to be strong enough to arouse the stress response but not too strong to create negative effects.
SIT focuses on perception. It draws upon the principles of the transactional model seen in the characteristics of stress, as well as the idea of constructive narrative perspective; where people construct narratives about stressful events that hinder their ability to cope with them.
SIT is tailored to everyone usually lasting 8-15 sessions and has three phases.
1.Conceptualisation: open questioning is used to increase the client’s awareness of the nature of stress and what coping strategies they have so far, as well breaking down current problems into more manageable components
2.Skills acquisition: Clients are taught effective coping strategies and barriers that prevent their use are removed i.e., confidence levels.
3.Application: Clients will practise the taught techniques through events that become increasingly demanding; this is done through modelling and role play and aims to prevent relapse.
Effectiveness
- Saunders (96) reviewed 37 studies into workplace and SIT and concluded that it was effective in enhancing performance under stress and reducing anxiety.
- Hollandsworth (85) randomly allocated dental phobics to having conceptualisation alone, or having all components. They concluded that conceptualisation alone is not enough; anxiety was reduced in all pps groups, but those receiving skills went through with their dental apts.
Ethical and Social Implications
Ethical •Risk of harm – acute •Risk of harm- chronic Social • SIT empowers the individual to manage their stress; • Less hospitalisation/healthcare • Reduction in absenteeism at work • Engagement in an average life
