Stress

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stress:

stress Biological Psychology

Sympathetic & Parasympathetic Branch:

Sympathetic & Parasympathetic Branch Sympathetic Part of Autonomic Nervous System which is concerned with release and use of energy when activity is required Adrenal Medulla is simulated and adrenaline is released Bronchial tubes in lungs dilate for greater oxygen intake Glucogen is converted into glucose for energy Inhibited flow of saliva Increased pupil dilation – better vision Increased heart rate – greater blood flow to muscles Sweat glands stimulate – produce more sweat Parasympathetic Part of Autonomic Nervous System concerned with storage of energy The liver stores the food eaten as glucogen Stimulates the flow of saliva Heart beat returns to normal rate for that person Pupil reacts normally to light stimulation Bronchial tubes in lungs constrict

S.A.M – Sympathetic Adrenal Medullary:

S.A.M – Sympathetic Adrenal Medullary This is the acute (immediate) response to stress it uses electrical signals. Higher brain areas (Cortex) detect and perceive something as a stresso r, triggering the Hypothalamus , which in turn activates the Sympathetic branch of the Autonomic nervous system , stimulating the Adrenal Medulla , producing two hormones, Adrenaline and Noradrenaline , which cause the Fight or Flight response, which causes bodily changes and has evolved for survival. Bodily changes may include: an increase in heart rate (to carry around oxygen around the body quicker); an increase in blood pressure (veins and arteries narrow so blood pumps faster); an increase in muscle tension (which increases reaction time) and the dilation of pupils (helps one to be more aware of one’s surroundings).

H.P.A – Hypothalamic Pituitary Adrenal:

H.P.A – Hypothalamic Pituitary Adrenal This is the chronic (slow, long-term) response to stress. Higher brain areas (Cortex) detect and perceive something as a stressor , triggering the Hypothalamus , which in turn release the hormone CRF , which activates the Pituitary gland in the brain, releasing the hormone A.C.T.H , which activates in the Adrenal Cortex – this releases corticosteroids (e.g. cortisol) that cause the liver to release glucogen (fats and sugar), which provide continued energy for the Fight or Flight response. In the long term, corticosteroids can suppress the immune system.

Stress & Illness:

Stress & Illness Direct Effect This is where stress directly causes an illness of the malfunction of the immune system. For example, coronary heart disease has been shown to the have a link with the S.A.M response. It is caused by increased heart rate and narrowed arteries (which are results of the Fight or Flight response, brought about by the S.AM response) which cause increased fats and sugars blocking arteries, as well as putting more pressure on the heart. High blood pressure and strokes are also linked to stress. Indirect Effect This is where stress may make people more vulnerable to illness, as it may weaken the immune system. Some people inherit a weak immune system and stress may make them even worse. Lifestyle also affects the immune system and stress may cause such behaviours to increase. For example, when one is stressed they may turn to drinking, drug and tobacco use, etc or change their sleeping and eating habits – or even going out all night partying. All these things can suppress the immune system if done frequently. The relationship between stress and illness may be seen as very complex.

Stress and Illness (Kiecolt-Glaser et al 1984):

Stress and Illness (Kiecolt-Glaser et al 1984) Aim Kiecolt-Glaser et al aimed to test the hypothesis that psychological stress can cause damage to the immune system. A relative looking after a person with Alzheimer’s disease was observed and compared against wound healing. Procedure Two groups in a Matched Pairs design, volunteer sample. Group 1: Caregivers looking after relative with the disease. Group 2: Control, women matched in age and family income with caregivers Caregivers (relative) scored much higher on stressed scale Small wound on forearm – punch biopsy Time taken for wound to heal was assessed by photography and examining response to hydrogen peroxide (no foaming indicates healing) Small amount of blood obtained for analysis before punch biopsy Findings Time taken for wound to heal was significantly longer for caregivers than controls. 48.7 against 39.3 Caregivers had larger wound size Analysis of blood showed caregivers produce less interleukin-1B than controls. Conclusion High levels of psychological stress can damage the functioning of the immune system It is possible that slower rating of wound healing is due to lower levels of interleukin-1B

Evaluation of Kiecolt-Glaser et al:

Evaluation of Kiecolt-Glaser et al Strengths Practical applications . We understand the negative effects of stress on health, we can take action to avoid it’s associated risks. High ecological validity . Research was natural setting, pps were in natural environment so no demand characteristics . Weaknesses Reductionist . Evans et al claims that it is too simple to say stress impairs immune system. Oversimplistic . S mall and unrepresentative sample (non smokers, married), therefore they lack population validity and they cannot be generalised . They were also natural experiments , and therefore we cannot prove cause and effect , nor see if the results are reliable as we cannot replicate them – there may be other factors – genetics, the type of stress, personality, culture etc. that may cause the findings.

Life Change (Rahe et al 1970):

Life Change ( Rahe et al 1970) Aims Test hypothesis that number of life events a person encountered would be positively correlated with illness Procedure Military version of SSRS – given to 2700 male US Navy cruises Filled out questionnaire just before tour of duty Illness score calculated on the basis of the number type and severity of all illness recorded during the tour of duty Findings Significant correlation between LCU score and illness score (+0.118) Findings support hypothesis Conclusion Life change rather than negativity of a change that is important in stress/illness. Overall psychic energy required to deal with live events to adapt to them.

Evaluation of Rahe et al:

Evaluation of Rahe et al Strengths Natural experiment so no demand characteristics Weaknesses Questionnaire, social desirability bias Lacks population validity . Pertaining to their occupation, we can imagine that members of the navy would in fact be particularly healthy or less likely to admit to injury and/or resilient to stress . The study relies on retrospective information – participants had to recall events, therefore relying on memory which may be interchangeable, inaccurate or unreliable.

Hassles and Uplifts (Delongis et al 1982):

Hassles and Uplifts (Delongis et al 1982) Most people experience major life events fairly infrequently, therefore a better measure of stress might look at the stresses and strains of daily life, hassles. Delongis et al compared a life events scale and own hassles scale to see which was a better indicator of later health problems. They also considered the effect of uplifts. De Longis et al compared scores on the SSRS and Hassles and Uplifts scale. She found no link between life events and illness but found a positive correlation between daily hassles and next day ill health (flu, aches and sore throats). It was concluded that daily hassles may be more important than life events as a source of stress . Procedure Participants were asked to complete four questionnaires once a month for a year, these questionnaires included: hassles scale, uplifts scale, life events questionnaire and a health questionnaire. 100 participants from San Fran ages between 45 and 64, well educated, high income. Findings Frequency and intensity of hassles were significantly correlated with over all health status and bodily symptoms. Daily uplifts had little effect No relationship between lift events and health

Evaluation of Delongis et al:

Evaluation of Delongis et al Strengths Support from Bouteyre et al who found a positive correlation between daily hassles and mental health issues Weaknesses C orrelation , we cannot prove that daily hassles cause next day ill health as all the factors and extraneous variables have not been controlled She also gathered her data using self-report measures which are considered unreliable because we may give socially desirable answers and memory itself is not accurate – all this questions the validity of the findings

Workplace stress:

Workplace stress Lack of control There is evidence to suggest that people may feel more stressed if they have little or no control in their job. For example, they may not be given any freedom over their work hour or rota, holiday time, the people they work with, their breaks, uniforms or their salary or wages. Marmot’s study supports the idea that low control is associated with high stress. Role conflict Stress may be experienced when workers must balance between two roles, their professional and their personal/home role – if they feel they are struggling to perform adequately in either or dedicate an equal amount of time and effort to both of their responsibilities, they may feel a large amount of stress. Parents with young children who must also work may suffer from this ‘role conflict’ or those who must care for ill relatives as well as earn a living. Environmental Factors Stress generated by the workplace may be linked to environmental stressors (a noisy atmosphere, high temperature, poor/artificial lighting). These make workers uncomfortable, so brings about stress (as well as the flight or fight response) which impact health negatively.

Workplace Stress (Johansson):

Workplace Stress (Johansson) Aim Investigate role of control in work place Relate stress in workplace to physical health Procedure Sample of finishers from end of production like in Swedish sawmill Very little control over rate of production Recorded levels of stress hormones during work days and rest days and looked at abstenteeism Findings Finishers working days were stressful – little control but felt responsible over wages of whole sawmill Physical stress because environment was noisy High levels of adrenaline on work days Took more days off than control group of cleaners Conclusion Finishers day involved lots of stressors with consequently lead to illness (shows as days off) Suggested job/responsibility rotation reduced stress levels

Evaluation of Johansson:

Evaluation of Johansson Strengths Supporting evidence ; Marmot examined 7000 people in civil service – found lower status, less control , more chance of heart disease Practical applications ; may be possible to reduce stress and any associated illnesses – e.g. job rotation, improve quality of lives . Weaknesses Opposing evidence ; Banyard argued many factors affect stress at work besides control. E.g. boring and repetitive, low income, low status thus poor housing. Which factor causes stress? Incorrect, oversimplification, not testing what it sets out to . Individual differences not taken into consideration – stress dealt with differently, over generalisation

Marmot:

Marmot Aim I nvestigate the link between workplace stress and illness. Marmot argued that jobs with high demand and low control created the most stress. Procedure 7,372 civil servants answered a questionnaire C hecked for signs of cardiovascular disease. Job control and demand were measured using self-report surveys and observations by managers. Records were kept of stress-related illnesses and other variables were correlated. This was a longitudinal study so five years later the participants were reassessed. Findings P articipants that had higher status in the profession had the fewest cardiovascular problems. Those with low job control were four times more likely to die of heart attacks than those that had high control – they were also more likely to suffer from cancers, stroke and gastric ulcers. Negative correlation between job control and illness Conclusion It was concluded that low control is associated with high stress and stress-related illnesses

Evaluation of Marmot:

Evaluation of Marmot Strengths Supporting evidence ; Johansson Practical application Weaknesses The sample used was unrepresentative and biased – only one profession was focused on and therefore cannot be generalised to all workplaces. It also only represents a busy, western city and culture as the study was carried out in London – it does not apply to non-western ( collectivist ) cultures. Volunteer sample , may be motivated and do not represent all, making the findings biased. Questionnaires and self-report measures were used to gather information on job control and health – however these methods may be unreliable as participants can give socially desirable answers, as well as forget due to memory ( retrospective ) and therefore question the validity of the findings.

Type A Personality:

Type A Personality Personality Types It has been suggested that a reason as to why some people are more sensitive to stressors than others is due to personality type. Personality may modify how people experience stressors. For example, Type A behaviour seems to increase the effects of a stressor whilst Type B and ‘Hardy ’ Type behaviour seem to decrease the effect . Characteristics of “Type A” They are known to be excessively competitive to the extent where they may not play unless they are confident that they will win. Therefore, if they lose, the stress responses are triggered. They may be impatient and time-pressured – they tend to work to deadlines, attempting to multi-task and are unhappy having nothing to do. If they are made to wait, miss a deadline or are late, the stress-response will be triggered. They may be hostile , easily angered and aggressive – quick-tempered, easily vexed and may direct anger at others or to themselves. The smallest things may trigger the stress responses repeatedly. They may move and speak quickly , and act intensely – they may move excessively and are never calm, serene, slow ors till. Therefore, their fidgeting for example is the result of the stress response. These characteristics cause the SAM and HPA response that in the long term, leads to raised heart rate and blood pressure, as well as a heightened level of stress hormones (adrenaline, noradrenalin, and cortisol) which are all heavily associated with illness. Type As are associated with an increase in the chance of coronary heart disease and stroke .

Type A (Friedman & Rosenman):

Type A (Friedman & Rosenman) Aim N oticed that some of their patients who had heart conditions were impatient whilst waiting to be seen. They proposed that they had a specific personality type A that was more likely in heart patients. Procedure Questionnaire to distinguish between the two personality types. S tructured interviews (with closed questions) and observations in which they looked for signs of impatience, anger and fidgeting. Categorised over 3,200 male volunteers from San Fran, between the ages of 39-59 (the risk age) into types A, B and X (a mix of A and B). Initially participants were free from heart disease and other lifestyle factors (smoking, diet, obesity etc ) were controlled. Longitudinal study, the participants were followed up 8.5 years later and their health was assessed . Findings Type As were twice as likely to develop coronary heart disease than type Bs (12.8% against 6%) Twice as many type As died from cardiovascular problems (2.7% against 1.1%). T hey also had the highest level of adrenaline, noradrenalin and cholesterol (brought about by the recurrent triggering of the SAM and HPA responses). A positive correlation between type As and coronary heart disease as found. Conclusion Type A are more at risk for CHD

Evaluation of Friedman & Rosenman:

Evaluation of Friedman & Rosenman Strengths Practical application Weaknesses Correlation ; can’t draw cause and effect , extraneous variables Self-report measures were used and as people are always liable to giving socially desirable answers it makes the findings unreliable Observations were also used, which can lead to unreliability as behaviour is interpreted differently. Population validity ; sample is androcentric as only men were used. It is also ethnocentric (culture-biased) as only men from San Francisco. There is a lack of consistent research that supports the link between Type A behaviour and heart disease

Hardy Personality (Kobasa):

Hardy Personality (Kobasa) Maria Kobasa suggests that ‘hardiness’ helps is to understand why some are resistant to stress. It is a range of factors and traits that defend us from the negative effects of stress. There are three characteristics (known as ‘the 3 Cs’): Control – An individual believes that they are the sole influential factor in their life – that is to say, they feel they have complete control over their lives and its events. This belief is empowering and enables one to defend himself against stress. Commitment – An individual’s awareness of their own purpose and sense of involvement in the world and of their own life. They see the world as something they should connect with rather than avoid. They are unlikely to give up in stressful situations and display perseverance. Challenge – An individual may see changes or events in life as obstacles that they are able to overcome, even as opportunities that will enable them to grow as a person instead of threats/stressors. It is seen as a learning experience.

Study into Hardiness (Kobasa):

Study into Hardiness (Kobasa) Aim Test hypothesis that hardy personality dealt with stressors better Procedure 800 business executives assessing stress using SRRS 150 had high stress, but some were ill and some weren’t so something else was affecting it Findings High stress, low illness scored highly on characteristics of hardiness High stress and high illness scored low on characteristics of hardiness Conclusion Commitment, challenge and control affect stress and in turn illness

Evaluation of Kobasa:

Evaluation of Kobasa Strengths There is a great deal of research that supports the idea that this personality type promotes stress resilience. Research by Kobasa herself ( bias elements ) has found that people who scored highly on ‘The 3 Cs’ questionnaire had fewer stress related problems. Lifton et al, low drop out of university with low hardiness score, and vice versa Practical application Weaknesses Self report – socially desirable answers Low population validity – business executives, can’t generalise Watson & Clark thought hardiness could be better explained with negative affectivity (NA). Refers to how well individuals cope with negative emotions and overall distress

Approaches to dealing with stress:

Approaches to dealing with stress Problem-focused approach to stress This is an active coping strategy which deals with the actual stressor , aiming directly to alleviate the stressful situation a targets the causes of the stressor – it is used when the stressor is/seems controllable . Strategies include taking control of the stressful situation, evaluating the pros and cons of different options to deal with the stressor, suppressing ‘competing’ activities (avoiding procrastination and distraction of other things, e.g. shutting of the internet when you need to revise) and seeking support and advice from others (e.g. information that is practical and informed, like gaining advice from teachers around exam time). Emotion-focused approach to stress This is a passive coping strategy which deals with negative emotions that are produced by the stressor. It attempts to deal with the emotional distress that an individual feels due to a stressful event (reduces arousal). It is used when the stressor seems or is uncontrollable . Strategies include denial ( cognitive strategy that involves pretending that the stressor does not exist, carrying on as normal and as a result you do not feel the negative emotions) ; distraction ( cognitive strategy that involves doing other things so you don’t think about the stressor or have time to deal with it, avoiding the stressor itself and the negative emotions it brings about) ; focusing on venting the emotions of the stressor (e.g. shouting, screaming, becoming aggressive to express the emotions you feel because of the stressor to ‘let of steam ’) ; using wishful thinking (a cognitive strategy which tends to dwell on what might have been or could have happened, or even trying to see the stressor as positive, e.g. if you fail a mock exam thinking “Ah, it’s only a mock, it’s not important...” or “If only I’d revised...” ).

Hardiness Training:

Hardiness Training This therapy is based on the aforementioned “hardy personality type” - Maddi & Kobasa believed that having traits associated with this type could make people practically immune to stress and devised a way to teach it to individuals. There are three stages: Focusing – This is where the client is trained to spot and stop physical signs of stress (such as muscle tension, high heart rate, anxiety, headaches, ease to cry/get angry, sweat, dizziness, restlessness) so that the individual can identify when they are stressed . By doing this, clients have more control over their stressors . Reliving stressful situations – This is where the client analyses stressful events and how they were resolved, thinking up better ways and worse ways that they could have been dealt with. This provides the client with valuable insight into the effectiveness of their current coping strategies and therefore is able to recognise and identify their behaviour, and so they admit their weaknesses. Once this has been done, the client is able to change their strategies . Self-improvement – This is where the client learns to build their confidence by taking on new challenges which increase in difficulty but the client will surely be able to cope with. By completing challenges, they experience positive outcomes and so feel more control and confidence over their lives. It helps one to see stressors as a challenge that will enable them to learn and grow rather than something distressful and negative. For example, a mother who has stopped work to raise her children can take a part-time job as a challenge or even take classes to learn new skills.

S.I.T Stress Inoculation Therapy:

S.I.T Stress Inoculation Therapy This was developed by Meichenbaum designed to prepare people for future stressors by making them resilient to them. In this therapy (abbreviated to SIT), the individual develops a better method of coping with the stressor and learns to perceive it accurately to effectively inoculate oneself from stress. There are three phases: Conceptualisation – This is where a relationship is established between the therapist and the client so that there is trust between them. The client is also educated about the nature of stress. The client mentally relives stressful situations , analysing how they normally deals with them and tries to reach a realistic understanding of what is expected of them. The client is taught to see stressors as ‘ problems to be solved ’ and to break them down into more manageable components – the client thinks over typical stressors again. (For example, if you were stressed about exams and the possibility of failing, and therefore distract yourself from revising properly, the therapist may teach you to think about it sensibly, in that it is not possible to get 100% in every exam but you will be able to do well if you break down your revision into a manageable schedule). Skills training and practice – This is where the client is taught both specific and non-specific coping strategies to help him/her cope with stressors more effectively. Examples of ­non-specific strategies are relaxation techniques such as controlled breathing and progressive muscle relaxation. Non-specific skills can be applied to any stressor but specific coping skills will be taught so the client can deal with a particular thing that causes them stress. (For example, a specific skill for exam revision may be to know the specification for the exam in great detail, learning time management skills etc ). These skills are practised until the client has mastered them and can use them confidently . They may be given positive ways of thinking (e.g. “I’ll do well!”) so that they react well and change their views about the stressor. Real life application & f ollow up – This is where the client must put the skills they have learnt to use in their lives. The therapist takes the client through stressful situations by teaching them to apply the skills to these new stressors. The client maintains contact with the therapist and if there are further problems, the client returns back to training. This reinforcement of positive behaviour means that resilience to stress is sustained .

Evaluation of S.I.T:

Evaluation of S.I.T Strengths D eals with the underlying causes of a person’s stress rather than dealing with the symptoms alone. For this reason, they are more useful than drugs as the person understands the causes of their stress and how to prevent it It is also a long -lasting solution E xtremely flexible in that it can be adapted to deal with acute and chronic stressors – a wide variety – daily hassles, work stress, public speaking, exams, pain, death etc – whereas drugs are temporary and limited. E ffectiveness of SIT is supported by research, studies on law students and athletes have found that this therapy boosted their performance and reduced their anxiety. This gives it scientific credibility . Weaknesses R equires a large deal of time , effort , motivation and money on the patient’s part C omplex technique so there is a lack of therapists that have been adequately trained – this keeps the cost of the therapies high as well as the waiting list . N ot possible for SIT to work for all clients – it is difficult or often near impossible to change aspects of one’s personality or their ways of thinking

Meichenbaum (1975):

Meichenbaum (1975) Aim Investigate effectiveness of SIT. Procedure Studied pre-exam college students. Quasi-experimental method with three conditions Eight weeks of SIT Eight weeks of systematic desensitisation No therapy – students told they were on waiting list Efficiency was evaluated through exam performance and self reports. If students felt successful and performed well – therapy worked Findings SIT group gave most positive reports and out-performed other students. Students on waiting list remained anxious Reduces anxiety in stressful situations but does not apply for depression Conclusion SIT is great

Evaluation of Meichenbaum:

Evaluation of Meichenbaum Strengths Natural experiment – high ecological validity Practical application Weaknesses Self report (if they felt they did well) may not be reliable. Demand characteristics, social desirability Only exam students – low population validity

Benzodiazepines:

Benzodiazepines Group of anxiolytic (anti-anxiety) drugs which work directly on the brain and central nervous system, they dampen the CNS GABA Neurotransmitter which is the body’s natural form of relief Reacts with GABA receptors in the membrane of the post synaptic cell which has a quieting affect on neurons When GABA is locked to receptors, it opens a channel which increases the flow of chloride ions in the neurons Chloride makes it harder for other neurotransmitters to pass Strengths Work quickly Supported by scientific research (Kahn – found more effective than placebos and other drugs) – scientific credibility. Effortless, cheap Good with dealing with short term stressors Combination to aid motivation in psychological therapies Weaknesses Side effects (tiredness, motor coordination impairment, reduced concentration/energy) Addiction, dependency Cure symptoms rather than cause Ethics, need to be informed of all side effects and give full consent

Beta-Blockers:

Beta-Blockers Bind with receptor sites of heart and other parts of the body normally stimulated during sympathetic arousal Work directly on internal organs, used in SAM response rather than the brain Reduce activity of adrenaline and noradrenaline Organs are not stimulated by fight or flight response Strengths Many instances for real -life applications where they have proven to be effective in reducing stress, particularly in musical and sport related performances (Lockwood 2000 musicians, 27% took beta blockers and received better reviews from critics . Quick, effective, cheaper No serious side effects – body rather than brain so no dependency Combination Weaknesses Recently a link has been made with beta blockers and diabetes when taken for a long time so only short term relief Symptoms rather than cause

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