Stress

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Sympathomedullary Pathway

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Associated with acute stress

Hypothalamus stimulates autonomic centres in the brain

Signals are sent via nerve pathways to the adrenal medulla

Adrenal medulla releases adrenaline and noradrenaline into the bloodstream

These increase heart rate and blood pressure -supplying oxygen to the muscles

liberate energy reserves for physical activity

afterwards PNS restores body to resting state.

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Pituitary-Adrenal System

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Associated with chronic stress

Hypothalamus stimulates the pituitary gland

Pituitary gland releases ACTH - travels via the bloodstream to the adrenal cortex

The adrenal cortex releases corticosteroids (cortisol)

These release stored energy reserves

other effects include suppression of the immune system.

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Kiecolt-Glaser et al (1984)

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natural experiment investigating whether the stress of short term stressors had an effect on immune system functioning in medical students.

Blood samples were taken one month before (ls) and during the exam period (hs)

Assessed measuring NK cell activity in the blood samples.

NK cell activity was significantly reduced in the second blood sample compared to the sample one month before.

Suggests: - short-term, predictable stressors reduce immune system functioning, increasing vulnerability to illness.

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Marucha et al (1998)

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Immune changes have also been shown to have a dramatic effect on the rate in which wounds heal.

Inflicted a 'punch biopsy' in the mouth of students either during the summer holidays or three days before an exam. the wounds given before the exam took 40% longer to hea than the wounds during the holidays.

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Kiecolt-Glaser et al (2005)

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tested the impact of interpersonal conflict on wound healing. She found that blister wounds on the arms of married couples healed more slowly after they had discussions which were conflicting rather than supportive.

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Kiecolt-Glaser et al (1987)

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compared women separated from their partners with matched married controls. They found poorer immune system functioning in women who had separated during the last year.

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Evans et al (1994)

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looked at activity of one antibody - sIgA - coats mucous surfaces of the mouth, lungs and stomach. He arranged for students to give talks to other students (mild/acute) stress. these students showed an increase in sIgA - decreased during an exam period over several weeks. acute-increase. chronic-decrease

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Holmes and Rahe (1967)

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Social Readjustment Rating Scale (SRRS) based on 43 life events from analysis - 5000 patient records.

they enlisted 400 participants-asked to score each event in terms of how much readjustment would be required by the average person. Numerical figure-arbitary baseline value 50 - marriage. scores for all participants were totalled/averaged to produce life change units (LCUs) for each event. Top 3 - death of spouse/divorce/jail term.

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Rahe et al (1970)

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To test SRRS Holmes and Rahe hypothesis - that number of life events a person experienced would be positively correlated with illness. 'normal' populations - distinct from populations previously studied of individuals who were already ill in hospital.

given to US Navy Cruisers - 2700 men. men filled in questionnaire - just before a tour of duty- noting all life events experienced over the previous 6 months.

an illness score waas calculated of the number/type/severity of all inesses recorded during the tour.

he found a positive correlation between LCU score and illness score pf +.118. normally not strong but number is significant. change is important not just negativity of the change.

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Michael and Ben-Zur (2007)

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130 men and women - half recently divorced. Half recently widowed. Looked at levels of life satisfaction. higher before the bereavment. divorced individuals showed that life satisfaction is higher after levels after the separation. Problem-focused coping - during separation or loss - making it positive instead of negative experience.

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evaluation of Life Changes approach

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unscheduled uncontrolled-changes being the most harmful.

individual differences

alot of the data is correlational-no cause and effect.
Lazarus (1990) - major life changes are rare in most peoples lives - minor daily hassles that are most significant.

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Bouteyre et al (2007)

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investigated the relationship between daily hassles and the mental health of students during the initial transition period from school to university. French uni - first year psychology students-completely hassles part of the HSUP and the Beck Depression Inventiry-measure of any symptoms of depression. 41% of the students studied suffered depressive symptoms. - positive correlation between scores on the hassles scale and incidence of depressive symptoms.

study shows move to uni is a daily hassle. risk factor for depression,.

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Gervais (2005)

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asked nurses to keep diaries for a month - daily hassles and uplifts while at work. rate their own performance. Daily hassles increase job strain and decrease job performance. some of the uplifts they experienced counteracted the negative effects of their daily hassles. daily uplifts also improved their performance on the job.

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the accumulation effect

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daily hassles more than life change events. accumulation of daily stressors creates persistant irritations, frustrations and overloads which then result in more serious stress reactions such as anxiety and depression.

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the amplification effect

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chronic stress due to major life changes may make people more vulnerable to daily hassles. recent divorce-squabbling of his children-major irritation. As the person is already in a state of distress, the prescence of associated minor stressors may amplify the experience stress. major life event -deplete a persons resources so that they are less able to cope with minor stressors than they would under normal circumstances.

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Marmot et al (1997)-job strain model

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investigated the job-strain model of workplace stress. - 2 ways- high workload (greater job demands) - low job control (deadlines etc)

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Marmot et al (1997)

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civil service. high grade - high workload, low grade employees- low job control. 7372 civil servants wokring in London- answered a questionnaire on workload/control/social support/checked for signs of cardiovascular disease. 5 years later they were re-assessed.

no link between high work load and stress-related illness. therefore concluded job demand not importantt in stress. pariticpants in the higher-grade-developed few cardiovascular - lower grade most. those in lower grades fell lower sense of job control and the poorest social support.

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Johansson et al (1978)

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effects of performing repetitive/continuous attnetion and responsibility. Sawyers-Sweden - unrelenting pace- whole company is slowed if they fall behind on work. high-risk group were found to have higher illness rates and higher levels of adrenaline in their urine than low rist. higher stress hormone levels on work days than rest days.

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Pomaki et al (2007)

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226 hospitals doctors-role conflict (occurs when experiences at weork interefere with family life and vice versa-who has to take work home or absent from work due to ill children)

role conflict was directly associated with emotional exhaustion. depressive stmpyoms and somatic complaints.

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Kivimaki et al (2006)

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meta-analysis of 14 studies - looking at risk of CHD in asociation with work place stress - 83,000 employees across Europe, US and Japan - high levels of job strain were 50% more likely to develop CHD.

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workplace stress evaluation

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out of date- new technology and virtual offices, home merging.

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retrospective recall

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participants usually asked to assess and rate daily hassles in the last month. people who are ill may want to provide an explanationso recall more stressful events-interval between testing.

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Type A Personality

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acheieve more and more in less and less time. competitiveness, impatience and time urgency, hostility and agressiveness.

raised blood pressure and rasied levels of stress hormones-both linked to CHD

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Type B personality

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patient, relaxed, and easy going.

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Friedman and Rosenmann

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3000 men aged 39-59. living in california. examined for signs of CHD-exclude any individuals who were already ill. personalities assessed using a structured interview in a provocative manner-speak slowly and hesitantly trying to elicit type A personality. asked like how they would cope having to wait in a queue.

after 8 1/2 years twice as many type A personalities had died from cardiovascular disease. over 12% (compared with 6%-type B) had died from a heart attack.also more likely to smoke and have a family history of CHD.

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Ragland and Brand (1988)

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carried out follow up to sudy of the Friedman and Rosenman Western Collaborative Group:- 1982-3. 22 years after the start of the study. 15% of the men had died of CHD. confirmed risk factors of smoking, high blood pressure. found little evidence of a relationship between Type A behviour and mortality.

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Myrtek (2001)

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meta-analysis - 35 studies - association between CHD and a componant of Type A personality - hostility. no evidence between type A and CHD.

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Hardy personality

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control - being in control of their lives rather than external factors

commitment: - involved with the world aropund them-strong sense of purpose.

Challenge: - Life challenges as problems to overcome rather than threats.

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Maddi et al (1987)

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studied employees of a US company (telephone) that was over a year dramatically recuding the size of its workforce. 2/3 suffered stress-related health problems and 1/3 thrived-more evidence of Hardy attributes.

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Lifton et al (2006)

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measured hardiness in students at 5 us universities. Hardiness likeliness of complteting their degree. Scoring low in hardiness were disproportionately represented among the drop-outs, and students with a high score were most likely to complete their degree.

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Hardy Personlaity- evaluation

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relied upon self-report data- questionnaire. problem of measurement,

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problem focused coping

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taking control (finding out as much as possible)

eval pros and cons of different options - whether or not to have surgery

suppressing competing acitvities - avoiding temptation of surgery cos of work commitments.

active.

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problem and emotion focused coping

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seeking social support can be both. people with supportive relationships might feel more in control of a situaion-rely on others. feel engage in more pfc behaviours. the existance of social support may also decrease the amount of psychological distress associated with a stressor (efc)

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emotion focused coping

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passive

denial - going on as if nothing happened

distancing - not thinking about it

focsuing on and venting emotions-crying, getting angry with others

wishful thinking-dwelling on what might have been

can be positive-reinterpeting the event

negative-constantly thinking about the problem without trying to change it.

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Penley et al (2002)

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problem focused coping - positively correlated with overall health outcvomes. negative emotion focused coping was associated with poor health outcomes.

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Gilbar (2005)

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examined associations among copign strategies and psychological distress in patients with breast cancer (major life event) result showed that use of emotion-focused coping (avoidance, distraction) was associated with high psychological distress, problem focused cping (social support resources) was beneficial to allaying the distress.

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Folkman and Lazaurs (1985)

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response of students running uop to exmas and wait for resutls. problem-focused coping - evident before the exam. emoption-focused coping was more evident during wait for the results.

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eval of pfc and efc - Stone et al (1991)

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ways of coping measures - more approriate to some types of stressor than others. relevent to relationship stressors - 3/4 inapproproate for health problems. finding a new faith-on the scale- little relevence to stressor of borken down car or crippling debt.

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Benzodiazepines (BZs)

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Gaba- neurotransmitter - bodys natrual form of anxiety relief. 40% of brain neurons respond to Gaba. when Gaba locks into the receptors-opens a channel which increases the flow of chloride ions into the neuron- chloride ions make it harder for the neuron to be stimulated by other neurtransmitters - trhus slowing down its acitivity-making a person feel more relaxed. BZs enhance the action of Gaba - binding to special sites on the Gaba receptro-boosten Gaba actions - more chloride ions to enter - more resistant to excitation. person feels calmoer. BZs reduce any increased serotonin activity which then reduces anxiety.

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Beta-Blockers (BBs)

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stress-arousal of nervous system. rasied blood pressure/HR etc. these can lead to cardiovascular disorder. Beta Blockers reduce the activity of adrenaline and noradrenaline-part o sympathomedullary response. bind to receptiorrs of the heart and other body parts. by blocking the cells-harder to stimulate. heart beats slower and less froce, blood vessles do not contract so easily. peson feels calmser and less anxious.

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effectiveness of drugs- Kahn et al (1986)

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250 patients- 8 weeks - found that BZs were more superior to the placebo.

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Life Changes

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Events in a persons life (such as divorce of bereavement) that require a significant adjustment in various aspects of a persons life. they are significant sources of stress.

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Daily Hassles

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are irritating, frustrating distressing demands that to some degree characterise everyday transactions with the environment.

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Workplace stress

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Aspects of our working environment (such as work overload) that we experience as stressful, and which can cause a stress reaction in the body.

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Meichenbaum (1985) stress innoculation training

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although we cannot change the cause of stress in our life (usually) - we can change the way we think about stressors. negative thinking-negative outcomes- anxiety. positive thinking leads to more positive positive attitudes and feelings. reduce stress response.

form of Cognitive Behavioural Therapy developed specifically to deal with stress. individual should develop a form of coping before the problem arises.

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three main pahses of innoculation training

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conceptualisation: - the therapist and client establish a relationship. therapist learns of nature/impact of stress. client is taught to view perceived threats as problems to be solved-break down the stressor so it can be coped and dealt with.

skills acquisition phase:- coping skills are taught and practised - in the clinic and then in real life. positive thinking, relaxation, social skills and methods of attention diversion, time management. 'relax you are in control.' cognitive and behavioural:- to think differently, and inolving new behaviours.

application phase:- oppotunity to apply new coping skills in diff situations which become increasingly stressful. imagry, moddeling and then imitating and role playing. client may be asked to train others.