stress and stress management Flashcards
(19 cards)
dictionary definition of stress:
* Force that produces strain on a physical body
* State of mental or emotional strain or suspense
* Difficulty that causes worry or emotional tension
→ Why are these NOT satisfactory definitions?
what is stress:
Stress can be thought of, and studied, in three ways:
- Stimulus models: — stressful events affect us?
- (Psychological) Transactional models: — does stress affect us?
- Response/reactions models: — does stress affect us?
what
why
how
stress as a stimulus aka — :
Focus on the —-
* — (i.e. can be — ) and —- (e.g.
proximity, timeline)
Types:
* —- Events
* e.g. earthquakes, floods
* — Life Events
– Involve major — in usual functioning
* e.g. losing a job, getting married/divorced, giving birth, being
bereaved, going on holiday
* Hassles and Uplifts
– — transactions that cause demands (e.g. traffic jam),
counter-balanced by enjoyable transactions (good
conversation)
what
external enviorment
objective
labelled
measurable
catstrophobic
major
major adjustment
everyday
1- assessment of stressful life events:
* — , – and/or — of stressors
* Life — checklists – cumulative lifetime stress exposure
2- stressful life events and illness:
* Adverse Childhood Experiences (ACE) Study
– Number of ACEs (0 – 8) measure of childhood stress
and health outcomes (suicidality, heart disease,
COPD, cancer, hepatitis, autoimmune disease,
depression…)
– Dose response: Greater no of ACEs associated with
increased likelihood of hospitalisation from
autoimmune disease in adulthood
frequency, time , duration
events
life events and organic disease inter heart:
* Cases had higher prevalence of 4 stress factors
*– (23% v 17.9%)
* — (11.6% v 8.6%)
* — (14.6% v 12.2%)
* — (16.1% v 13%)
* Independent of SES, smoking; consistent across regions,
age and gender
- acute stressful life events and health as MI and World Cup score
work
home
financial
life events
Life events and psychological disorders:
* Recent stressful life events often precede —
– Effects stronger for some disorders
* E.g. —,—
– Events not disorder-specific
→ Other factors determine manifestation? e.g. —-
– Effects stronger near the onset of a disorder, episodes become more autonomous over time (Kendler & Gardner, 2016)
* Most people do not develop — problems
disorders
suicidality , depression
personality
pyschological
Life events theory: Limitations
* Are life events random?
– Cause or a consequence?
* —- factors, e.g. Life decisions, social setting, lifestyle
* — , e.g. neuroticism predicts relationship quality
– — bias in experience of major life events
* Very — measure
– Fails to address the — of stress e.g. — , —
– Fails to acknowledge — . e.g. Divorce - positive or negative?
predipositing
personality
age bias
crude
moderators
personality , coping
individual appraisal
Stress As a Transaction — does stress affect us?
* 3 key interacting contributing factors:
1. The — or —- event ( —) environment
2. Individual’s — and —-
3. The internal or external — a person has available
* Stress arises when there is a mismatch between our — of —- and of our abilities and coping—
* Defining/critical features:
– —
– — , — variables are key
– — context of appraisal
– Dynamic → — reappraisal
why
external and internal
characteristics and appraisal
respurces
appraisal of demands
resources
subjective
motivational , cognitive
social
constant
The Stress-Coping Paradigm
Lazarus’ Transactional model of stress:
1. Primary appraisal processes
* — and — of the stimulus event.
* Possible stressors:
1. those which — (damage already done)
2. those which — (possible future damage)
3. those which set a — (opportunities that can
be dealt with)
2. Secondary appraisal processes
* — and —- to cope with the stressor:
* — resources (e.g. strength, determination)
* — (e.g. social support, money).
quality and nature
harm/loss
threaten
challenge
resources and abilities
internal
external
check slide 21
stress appraisals:
* Assessment
– —- perceptions of a stressor
* e.g. the Distress Thermometer – cancer care
* Factors associated with stress appraisals
– —- : imminent events e.g. today or next month
– — or— : e.g. for life stage, redundancy
– —- : e.g. low self-control (behavioural or cognitive)
– High amounts of —- : e.g. Losing identity – redundancy, caregiving, child birth, relocation
– —- : e.g. personal role - new job, medical intervention; risk – harms are unclear e.g.
ambiguity about diagnosis and treatment
– — , — : e.g. self-efficacy
- Issues with assessment:
– – desirable responses
– — bias
subjective
proximity
unexpected/ unpredictable
uncontrollable
life chnage
ambiguous
familiarity/condifecne
socially
recall bias
- Theories on the
relationships between
stress and performance:
- The Positive Linear theory
- The Negative Linear Theory
- Inverted-U Theory of Stress
- Yerkes-Dodson Law (YDL)
Behavioural responses: Coping strategies
* — we do to — or — stress
* Specific efforts ( —/—) used to master, tolerate, reduce or minimise stressful events
* Can be – or —
1- maladaptive coping - behavioural risk factors:
* Health-impairing behaviours common in response
to stress
– Poor nutrition
– Lack of exercise
– Alcohol and drug use
– Risky sexual behaviour
– Smoking
– Learned helplessness
anything
reduce or overcome
behavioural/cognitive
adaptive or maladaptive
2- adaptive coping:
* — strategies
– Problem-focused coping:
dealing — with the stressor
– Emotion-focused coping:
changing our — about the
stressor (e.g. — reappraisal)
* Factors that improve coping:
– — support: correlates with better physical and mental health
– — : appraise events in a less threatening way; less susceptible
to illness (Kubzansky et al., 2001)
– Perceived – : perception of control over our circumstances
constructive
directly
feelings
cognitive
social
optimism
control
common coping responses in chronic illness:
* —
– Acknowledges — but redefines them as — to neutralise threat
* —
– Not acknowledging that something is wrong
* —
– Don’t deny but avoid situations that make
symptoms worse or may cause problems
* —
– Illness becomes all consuming
* —
– Acknowledges and deals with the problems e.g. — symptoms
normalising
symptoms
normal
denial
avoidance
resignation
accommodation
managing
physiological stress response :
1- Endocrine response (— )
Activation of the — system
↓
—–releasing hormone/factor
(CRH/CRF)
↓
Affects every major
organ system:
— blood flow
— immune functioning
— inflammation of any damaged tissue
— glucose and fat reuptake by tissue cells
— vigilance (attention and memory)
2- Autonomic response (—)
Activation of the —
nervous system (SNS)
↓
Releases catecholamines
(—and—)
↓
Mobilises body for action:
dry mouth
rapid breathing
↑ heart rate
↑ blood glucose levels
dilation of skeletal muscle blood vessels
↓ nonessential functions (digestion, reproduction)
slow
Hypothalamic-pituitary-
adrenocortical (HPA)
corticotrophin
high
low
low
low
high
fast
sympathetic
adrenaline and noradrenaline
- Stress and susceptibility to
the common cold aka —-response - Stress and immune response to vaccinations
– 3 Hep B inoculations in students taking exams - Less stressed students seroconverted (displayed antibody response) after first
inoculation - Greater social support predicted — immune (antibody) response
dose
greater
Stress and recovery from illness
* Stress and Wound healing
– Dental students – compared wounds before exams vs during holidays
* Healed 40% slower during exams
* No student healed more rapidly or produced as much IL1 during exam
→common stressors can — immune functioning
* Distress (anxiety, depression etc.) and recovery and mortality
– Greater distress prior to surgery predicts poorer post-op — and greater — (e.g. Coronary artery bypass grafting; Tully & Baker, 2012)
– Pre-existing unipolar depression predicts increased risk of – during hospitalisation for serious — (sepsis, pneumonia, and urinary tract
infection; Davydow et al, 2016)
– Distress and Cancer mortality: stronger evidence for hormone-related
cancers… mediated by immune dysregulation?
down regulate
recovery
mortality
death
infection
practical stress management tips:
Changing lifestyle habits
* Sleep:
* Stress → —
* Decrease caffeine intake
* Caffeine → release of stress hormones, affects sleep; high doses can
increase anxiety and risk of panic attacks
* Low doses may have protective effects on psychological stress and
cognitive functioning during stress
* Regular exercise:
* Redirect energy/high level of arousal; releases endorphins
* Time-out/Pacing and maintaining a good work-life balance
* Monitor stress and energy levels and take breaks vs. Working
through stress
* Modify if work is >60% or self <10%
–Venting/Support system
* “a problem shared is a problem halved”
* Expressive writing (Seligman, Pennebaker)
–Changing triggers
* Identifying situations that contribute to stress and
changing them
–Behavioural techniques
* Identify triggers and practise behavioural responses
* Plan responses to stressors rather than reacting
fatigue
practical stress management tips:
* Relaxation techniques:
– Skills to stay relaxed during stress: lower BP, slower pulse, slower breathing
– Meditation – incorporating set periods of relaxation or “time-out”
* Cognitive techniques:
– —/—-
* Doesn’t change the external reality but changes perspective
* Identifying and challenging stress-evoking cognitions e.g. CBT, positive
self-talk
– Maintaining — expectations
* → more predictable → greater control e.g. fatigue after
chemotherapy
* “Third wave therapies”
– — rather than challenging responses
– e.g. Mindfulness – increases engagement, minimise emotional impact
restructioning.reframing
realistic
tolerating
conclusions and practical applications:
* Stress is —- – a stimulus, a transaction, a reaction
* Experience of stress depends on — interpretation
– Definition: Stress arises when there is a mismatch between our appraisals of — and of our abilities and coping —
* Stress associated with disease outcomes through stress-related — and — dysregulation
– Coping behaviours influence self-management
* Stress management can improve health – can be achieved in
several practical ways
multi faceted
psychological
demands
resources
behaviours
immune
