Stress - Methods of Modifying Flashcards
1
Q
What are the Methods of Modifying Stress?
A
- Beta Blockers
2. Stress Inoculation Training
2
Q
Why are Beta Blockers Needed?
Explanation
A
- Key aspect of body’s response to stress arousal of sympathetic nervous system - match physical symptoms use experience- increased blood pressure/heart rate - symptoms can cause long-term negative health effects (e.g. cardiovascular disorder)
3
Q
How do Beta Blockers Work?
A
- BBs have a antagonist action - work by reducing activity in sympathetic nervous system + reducing subsequent symptoms
- Beta Adrenoceptor Blocking Agents = block receptor sits for the hormones adrenaline + noradrenaline
- Adrenaline binds with target receptors stimulates associated muscles (causing heart to beat faster) - usual physical reaction to stress is dampened - breathing + heart rate doesn’t increase + person feels calmer + less anxious
- Beta blockers don’t completely stop anxiety but mask outward signs
- Useful for acute stress
4
Q
What are the Types of Beta Blockers?
A
- Non-Selective
2. Selective
5
Q
Describe Non-Selective Beta Blockers
A
- Propanlol
- Block adrenaline + nurodrenaline
- Block beta 1 (B1) + beta 2 (B2
- Affects heart/kidneys/liver/etc
6
Q
Describe Selective Beta Blockers
A
- Atenolol
- Affects mostly the heart + therefore has less effect on the rest of the body
- Only blocks Beta 1 (B1) - cause reduced cardiac output
7
Q
Describe the Off-Label Use of Beta Blockers
A
- Primarily prescribed + approved for high blood pressure + angina
- Prescribed off-label for anxiety conditions
- Manufacturer has not applied for licence for Beta Blockers to be used to treat anxiety - drug will not have gone under clinical Trial
- Doctors feels prescribing Beta Blockers for anxiety has benefits outweigh any risk
- Prescribed as a lower dose than that used for cardiac conditions
8
Q
How Do Some Musicians use Beta Blockers?
A
- Use to overcome stage fright + more able to perform under pressure
- Lockwood (1989) = 2000 musicians in major Us orchestra - 27% use Beta Blockers for performance + 19% used it everyday
9
Q
How are Beta Blockers Used in Sport?
A
- Since 2010 all Beta Blockers have been banned by the World Anti-Doping Agency for all Olympic sports
- In Golf 2015 Christian Bezuidenhout tested positive for BBs + faced a 2 year ban from golf - appealed as he was taking them for anxiety - ban was reduced to 9 months
10
Q
What are Benzodiazepines?
A
- Increase activity of gamma-aminobutyric acid (GABA) - increases serotonin - reduces arousal
- BZs only used to help those suffering from severe stress in a short term crisis - HIGHLY ADDICTIVE
- Causes drowsiness/impaired judgement - individuals need to be weaned off
11
Q
Beta Blockers Evaluation
Effectiveness
Benefits On Performance + Self-Reported Levels of Stress
A
- Positive
- Neftel (1982) = gave string players atenolol (BBs) or placebo 6 1/2 hours before performing - atenolol group had lower heart rates + were more able yo play complex parts of the music accurately - also reported less stage fright after performance compared with placebo
HOWEVER - Schweizer (1991) = compared effects of different types of BBs in maths test - all BBs had expected physical effects there were differences in subjective ratings of stress amougst groups
12
Q
Beta Blockers Evaluation
Effectiveness
Benefits for Other Aspects of Stress
A
- Schwabe 2011 study
- Negative effects of stress is stressed people falling into bad habits (e.g. addiction) rather than focusing on important goals
- Lab experiment concerning food rewards - 3 groups
1. No Stress
2. Stressed + BB
3. Stressed + placebo - Findings - stress + placebo continued with habits formed
- Stress + BBs just as goal directed as those that had received no stress - BBs prevented the stress induced bias towards habit behavior
- Although research was in an artificial environment - potentially useful application of BBs for dealing with psychological effects of stress
13
Q
Beta Blockers Evaluation
Effectiveness
Long Term Effectiveness
A
- NEGATIVE
- BBs criticised for their long term effectiness
- BBs don’t address the psychological + emotinal side
- Root cause of stress + individual’s reaction to it may not be addressed
- SIT may be more appropriate in giving individuals long term coping strategies to use across a range of situations
- BBs may only be useful for specific performance based scenarios + may not work for chronic stress
14
Q
Beta Blockers Evaluation
Ethical Issues
Side Effectiveness
A
- NEGATIVE
- Side effects tend to be mild + temporary (e.g. dizziness/diarrhoea/nausea/blurred vision/cold feet/cold hands/issues with sleep/shortness of breath)
- Compared with BZs effects are minimal
- Stopping taking BBs suddenly could cause problems (e.g. heart palpitations/higher blood pressure) as body will be so used to drug’s effects in slowing down sympathetic response - individual may become psychological dependent, feeling as they cannot cope without it
15
Q
Beta Blockers Evaluation
Ethical Issues
Use of Beta Blockers to Enhance Performance
A
- NEGATIVE
- Ethical question
- BBs are banned in most sports- suggesting that its unethical
- Key parts of high level performance in sport is the ability to perform under pressure - providing an unfair advantage
- BBs specifically don’t enhance performance - simply stop any anxiety interfering with performance
16
Q
Beta Blockers Evaluation
Social Implications
Off Label Use
A
- NEGATIVE
- Due to off label use prescribing of BBs they’re well controlled + long term research is limited
- Lin (2006) = proportion of off label BBs was an average of aprox. 52% of all BBs prescribed - creates a dilemma for health health professionals
17
Q
Beta Blockers Evaluation
Social Implications
Possible Over Prescriptions
A
- NEGATIVE
- Statistics from prescribing +primary health + social care information centre (2014) = prescriptions of BBs (proponlol) rose by 7% between 2012/13
- 7% increase may be due to an increase use for heart problems, medical professionals are concerned that they’re being over prescribed for stress
- Anxiety becoming a bigger issue + treatment are limited - psychological therapists are more expensive - prescribing BBs may be more cost effective - unlikely to deal with root cause
18
Q
How did Meichenboum Describe SIT?
A
- Individual should develop a form of coping before a problem arises so they are protected
19
Q
What is Inoculation?
A
- Gives individuals experience of minor stressor that makes them more prepared + resilient
- Help person develop coping mechanism + confidence in their ability to deal with stressful situation
- The thing they encounter as part as inoculation process needs to be strong enough to make person’s deference aroused but not so strong that causes negative psychological effects
20
Q
Describe the Transactional Model
A
- Identifies the importance of how person perceives the stressor + how the person sees these ability to cope with it
- SIT aims to give people the tools to perceive stressor in different ways + therefore deal with it more effectively
21
Q
What is Constructive Narrative Perspective (CNP)
A
- Individual are storytellers who construct tales about themselves
- Nature of stories influence how they cope
- Help people become more aware of behavior that may be hindering rather than helping
- Helps person adopt a more constructive narrative when stressed
22
Q
What is SIT?
A
- Flexible - exact nature is customised to individual
- Therapy depends on stressor being experienced + tailored to clients exisiting coping abilities
- Carried out over 8-15 sessions + follow up
- Employed in a wide variety of settings
23
Q
What are the Stages of SIT?
A
- Conceptualisation
- Skills Acquisition + Rehearsal
- Application + follow through
24
Q
What is Concepualisation?
A
- Relationship between client + trainer established
- Open questions used to help increase the clients awareness of the nature + impact of stress + their existing coping strategies
- Trainer also helps the client to reconceptualise their problems be breaking down stressor into smaller. more manageable amounts
25
What is Skills Acquisition + Rehearsal?
- Clients helped to acquire coping skills + consolidate those they have already
- Important that any barriers that prevent them from being able to use strategies are removed
- Once participant taught they need to be practiced + generalised to everyday settings
26
What is Application?
- Client practises applying coping skills in a variety of different situations that become increasingly more demanding
- Techniques such as role play/modelling/imagine used
- Taught to prevent relapse by rehearsing situations in which Stressors might reappear
- Booster sessions used to make sure coping skills are being applied properly
27
Stress Inoculation Training Evaluation
Effectiveness
Supporting Evidence
- POSITIVE
- Effective regardless of trainer experience
- Saunders (1996) = reviewed 37 studies into effectiveness of SIT in workplace - concluded that effective enhancing performance under stress + reducing anxiety - improvements for high + low anxiety groups
- Sheehy + Horon (1984) = SIT + effective on academic performance- 4 (90 minutes) sessions - lowered anxiety levels
28
Stress Inoculation Training Evaluation
Effectiveness
Determining Which Part is Effective
- NEGATIVE
- Difficult to pinpoint which component is effective part - all overlap with each other
- Moses + Hollandsworth (1985) = randomly allocated 24 dental phonics to 4 conditions - some given only stage 1 while others given later stages - found no significant difference in terms of anxiety levels between groups - however more patients who received coping skills training went to their appointments - stage 1 alone was not effective
29
Stress Inoculation Training Evaluation
Effectiveness
Comparison to Other Methods
- A point to consider
- Foa (1991/99) = carried out a series of studies comparing SIT + prolonged exposure - SIT + PE were both effective in reducing symptoms of PTSD + depression
- Meichenbaum (2007) = Highlighted that in order to carry out their research som elements of SIT process were removed - not a fair compassion
30
Stress Inoculation Training Evaluation
Effectiveness
SIT in the Military
- A point to consider
- Driskell + Johnstone (1998) = adopted SIT could be very useful in military
- Stage 1 = aware of stress training + Stressors - appreciable physical response
- Stage 2 = Control cognitive skills, focus on task - acquire skills in practical setting that resembles active service setting = intensity increases - improved performance
- SIT = performance better in flight task
- Assessing impact in real life situation is difficult
31
Stress Inoculation Training Evaluation
Ethical Implications
Risk of Harm
- NEGATIVE
- Process = cause distress??
- Rehearse situation = cause a form of psychological harm
- Compared to drug therapies the effect may be more long lasting - benefits outweigh costs
32
Stress Inoculation Training Evaluation
Ethical Implications
SIT in the Military (pt.2)
- NEGATIVE
- Stressor too intense = counter productive
- Directly exposed to stressor
- Special forces = prepared for Acute but chronic stress
- Trainers experienced feelings of despair
- Prevent effective acquisition
33
Stress Inoculation Training Evaluation
Social Implication
Stress in Society
- POSITIVE
- SIT shown to be useful across a larger range Stressors
- Meichenbaum (2007) = highlights need for effective interactions to combat stress - given an increased range of stressor in society
34
Stress Inoculation Training Evaluation
Social Implications
Impact on the Economy
- POSITIVE
- Effects of Stress + mental health has a cost on the NHS
- Blumenthal (2002) = long-term effectiveness of stress management techniques- men with coronary heart disease given stress management training + compared to control (exercise regularly) - SMG experienced less health problems over 5 year follow up + health care costs were significantly less
