Stress and Health
Stress and Health Psyx 383
Popular in Health Psychology
Popular in Psychology
This 12 page Class Notes was uploaded by Lindsay Bellinger on Monday October 10, 2016. The Class Notes belongs to Psyx 383 at University of Montana taught by Mark Primosch in Fall 2016. Since its upload, it has received 4 views. For similar materials see Health Psychology in Psychology at University of Montana.
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Date Created: 10/10/16
Health Psychology Chapter Four - Stress and Health Stress: The process by which we perceive and respond to events, called stressors, that we appraise as threatening or challenging Stressor: Any event or situation that triggers coping adjustments When a stressor is short-lived or perceived as a challenge, it can have positive effects such as mobilizing the immune system to fend off infection and promote healing Biological processes that occur when we experience stress can differ somewhat according to each individual’s unique physiology and levels of physiological reactivity, but the same basic processes affect us all Psychological influences affect how we appraise challenging situations – either as manageable or unmanageable – based on our personalities and individual life experiences. - Gender also plays a role in whether we fight or flee Sociocultural influences affect how we appraise stress from many different sources, including major life events, catastrophes, daily hassles, environmental stress, work and family ACE study (adverse childhood events) Initial study: California, 1995-1998, gave participants surveys to assess stress levels Over 17,000 participants, 54% female and 46% male Results: - Alcoholism, drug abuse, depression and suicide attempt - Smoking, poor self-related health, higher number of sexual partners and STD’s - Physical inactivity and severe obesity - Dose-response Adverse childhood experience -> disrupted neurodevelopment -> Social, emotional and cognitive impaired -> Adoption of health-risk factors -> Disease/disability and social problems -> death Is stress bad? Acute: events that are happening in the moment, short-lived, standard stress response Chronic: continuous stress Eustress: stress that is good and increases performance Stressors Significant life events: catastrophes, daily hassles, environmental stressors, work, social interactions - Leaving home, changing jobs, having a child or losing a loved one are all considered major life events that cause significant stress to an individual - Holmes and Rahe (1950’s) o interviewed more than 5000 people to identify which events forced people to make the most changes in their lives o they then assigned each event a value in life changing units to reflect the amount of change that was necessary o they then devised the social readjustment rating scale - Homes and Rahe theorized that the total number of life changing units accumulated during the previous year could predict the likelihood that he or she would become sick over the next several months Catastrophes - Catastrophes such as 9/11 have been shown to have drastic effects on the populations health and well-being o 40% of pentagon staff at 9/11 were at high risk of PTSD o Residents have been shown to face chronical stress levels: high blood pressure, elevated levels of cortisol, epinephrine and norepinephrine o Cortisol: important biomarker of hypothalamus-pituitary- adrenal axis activation that plays an important role in mediating the effects of life stressors on health Daily hassles - Everyday hassles occur frequently and are therefore the most significant source of stress (missing a train to work, losing a wallet, living with an aggravating roommate) - The impact on health of daily hassles depends on the frequency, duration and intensity - Our reactions to daily hassles are influenced by our personality, individual style of coping and how the rest of our day has gone - The counterpart of daily hassles is daily uplifts: mood lifting experiences such as receiving good feedback or listening to your favorite song – daily uplifts provide a buffer against the effects of stress - Hassles and uplifts scale: 117 events that range from small pleasures to major problems – asks respondents to focus on how much of an impact each experienced hassle or uplift had on their well-being - Hassles seem to be a better predictor of health problems than either major life events or the frequency of daily uplifts – everyday hassles or mundane irritants and stressors negatively affect physical and mental health to a degree that exceeds the adverse consequences of major life events However - Critics have argued that some of the items listed as hassles may be consequences of stress rather than causes of stress (sexual difficulties, low self-esteem, personal fears) - Individuals who have high anxiety levels to begin with will naturally find daily hassles more stressful (consistent with the diathesis-stress model) - Daily hassles have been found to interact with background stressors such as job dissatisfaction or crowded living conditions Environmental stressors Noise: - Crowded subways, noisy street corners and pollution are all stimuli that could be considered environmental stressors - Living in noisy environments: o Children around airports in Munich were found to have higher blood pressure levels and elevated levels or cortisol compared to control group o Children living near noisy airports were also found to have impaired motivation, long term memory and reading and word skills Crowding: Population density: a measure of crowding based on the total number of people living in an area of limited size Crowding: a psychological state in which people believe they do not have enough space to function as they wish - Studies have demonstrated that the design of residential space can have negative effects on an individual health, well-being and stress levels - E.g. University housing that uses rooms branching off corridors has been shown to increase the stress levels of students due to them feeling cramped and not having enough space to function = lower feelings on control, more competitive, react more negatively to minor annoyances Work - Data from the 2010 community health survey found that respondents with higher levels of perceived work stress had higher odds of being treated for an emotional or mental health problem - These high-stress respondents also had higher odds of being diagnosed for mood and anxiety disorders - Establishing a vocational identity is a key part of biopsychosocial health - For several reasons, the older the worker is, the more stressful a job change becomes: o A loss of job seniority often means lower salary and lack of respect o Older workers may be lacking in new job skills (technology) o Having to relocate for a new job o Age discrimination is common Social-evaluative threat: a stressor in which people fear negative evaluation by others of their appearance or ability Stereotype threat: the expectance of stress in a situation where a person’s ability has potential to confirm negative viewpoint about his or her social group Overload: chronic activation of the part of the neuroendocrine system that control reactions to stress, increased the risk of developing cardiovascular disease Burnout: a job-related state of physical and psychological exhaustion that can occur among individuals who work with other, often needy people - Jobs that involve having responsibility of other people as oppose to having responsibility of products tends to lead to higher burn out rates - E.g. Hospital staff, fire fighters, air-traffic controllers Lack of control: workers feel more stress when they have little or no control over the procedures, pace and other aspects of their jobs - Lack of control has also been linked to anger and the development of coronary artery disease, as well as an increased overall risk of death Other sources of job related stress: - Role ambiguity or conflict: workers are unsure of their jobs and expected standards - Shiftwork: involves disruption to their family and biological rhythms (sleep) - Job loss: the loss of a job can seriously impact an individual’s health - Lack of fairness: not getting the recognition they deserve results in higher stress Social interactions Social relationships are an important factor in how we deal with stress, often serving as a buffer against low control and other work stress - Loneliness has been shown to affect immune functioning - Immunosuppression has been linked to interpersonal conflict among married couples Caregivers: people who are caring for grown adults have been shown to have decreased levels of T cells and abnormalities in the production or cortisol, as well as poor immune functioning - Caregivers who provide care for those with Alzheimer’s disease report higher levels of depression and lower life satisfaction The physiology of stress The role of the brain and nervous system The body’s overall reaction to stress is regulated by the central nervous system - Central nervous system - Peripheral nervous system o Somatic nervous system o Autonomic nervous system Sympathetic nervous system Parasympathetic nervous system When an external event is first perceived by your sense organs, sensory neurons in the somatic nervous system transmit nerve impulses to lower-level brain regions announcing the impending threat (The reticular formation plays a central role in alerting the brain to impending threat) The reticular formation coordinates two neural pathways of brain-body- communication - First pathway: o routes information about the existence of a potential stressor to the thalamus, which sorts this sensory information and relays it to the hypothalamus, limbic system (amygdala) in the cerebral cortex that interpret the meaning of the potential stressor - Second pathway: o carries neural instructions back from the higher brain regions to the various target organs, muscles and glands controlled by the somatic nervous system = body is mobilized for defensive action Under instruction from the sympathetic nervous system, the adrenal glands release hormones that cause the fight or flight response, in which the heart rate increases, the pupils dilate, stress hormones are secreted and digestion slows The region of the brain that most directly controls the stress response in the hypothalamus The role of the endocrine system: The SAM and HPA systems Sympatho-adreno-medullary (SAM system) - The body’s initial, rapid-acting response to stress, involving the release of epinephrine and norepinephrine from the adrenal medulla under the direction of the sympathetic nervous system Hypothalamic-pituitary-adrenocorticol (HPA system) - The body’s delayed response to stress, involving the secretion of corticosteroid hormones from the adrenal cortex Homeostasis - The tendency to maintain a balanced or constant internal state; the regulation of any aspect of body chemistry, such as glucose level Corticosteroid - Hormones produced by the adrenal cortex that fight inflammation, promote healing, and trigger the release of stored energy Cortisol - Extended levels of cortisol in the system has result in hypercorticolism (leads to atrophy in the hippocampus) The endocrine system is the body’s communication system consisting of a network of glands that secrete hormones directly into the blood stream. SAM system 1. Under stress, the hypothalamus orders the pituitary gland to secrete ACTH 2. ACTH is taken up by receptors in the adrenal gland 3. The adrenal medulla then secretes epinephrine (adrenaline) and norepinephrine (noradrenaline) into the blood under the instruction of the hypothalamus 4. This triggers the fight or flight response This system lasts much longer than those generated directly by the sympathetic nervous system, when combined this creates the sympatho-adreno-medullary system HPA system 1. Activated by messages relayed from the central nervous system to the hypothalamus 2. This then results in the secretion of CRH 3. CRH then secretes the production of ACTH by the pituitary gland 4. This then activates the adrenal cortex to secrete corticosteroids Measuring stress Ecological momentary assessment (EMA): A method of measuring stress that involves repeated sampling of people’s behaviors and experiences in real time, and in their natural environment - Collection of information at specified time intervals (e.g. once a day diaries) Psychological measures: - Heart rate - Blood pressure - Respiration rate - Electrical conductance in the skin These measures occur in response to stress or emotion-induced activation of the sympathetic division of the autonomic nervous system More commonly, psychologists measure stress through its association with hormones (cortisol, epinephrine, norepinephrine) How does stress make you sick? Ader – rat experiment (1985) - found that over the course of a few weeks, laboratory rats began to get sick and died - he concluded this was due to the stress of being in a confined space and being repeatedly handled by human Conditioning the immune system: - In Ader’s study, even when the rats were given pure water with no drug, their immune systems responded as if the drug was circulating in their bloodstream - Classical conditioning had created a learned association between the taste of the water as a conditioned stimulus and the suppression of T cells as a conditioned response - Over time, conditioned responding made the animals increasingly susceptible to disease as their immune system weakened PTSD: an example of how a conditioned stimulus can cause stress - E.g. Soldiers returning from Afghanistan often had a fear of white cars due to the large number of car bombs (specifically in white cars) Cadance Pert’s findings: 2003 - The brain has receptors for immune molecules that enable the brain to monitor, and therefore influence, the activity of the immune system Psychoneuroimmunology (PNI) - The field of research that emphasizes the interaction of psychological, neural and immunological processes in stress and illness o Psycho: psychological processes o Neuro: neuroendocrine system o Immunology: immune system Stress to disease The direct effect hypothesis - Stress may directly affect immune efficiency through the activation of the HPA and SAM systems. - T cells and B cells have receptors for corticosteroid ‘stress’ hormones - Lymphocytes have catecholamine receptors - Stress activates these systems o The hormones released attach to the receptors of the T cells, B cells and lymphocytes suppressing the immune system The indirect effect hypothesis - Stress-induced delays in healing and other adverse health outcomes may occur because stress alters immune processes indirectly by encouraging maladaptive behaviors o Smoking o Alcohol o Drug abuse o Fragmented sleep o Poor nutrition - All of which are considered symptoms of stress Duration of stress - Acute stressors that last half an hour or less produce transient immune changes, with most immune cell parameters returning to pre-stress levels within an hour or so - Allostatic load (allostasis): The cumulative long-term effects of the body’s psychological response to stress (hugely influenced by the neuroendocrine system - Stress, inflammation and disease - Immunosuppression model of relationships among stress, immunity and disease o Stress suppresses the immune system, which leaves the individual vulnerable to opportunistic infection and disease o Offers a plausible explanation for how stress influences wound healing, infectious diseases and some forms od cancer o BUT, it does not explain how stress might affect diseases whose central feature is excessive inflammation (cardiovascular diseases) Glucocorticoid receptor resistance model (GCR) The idea that chronic stress promotes the development and progression of disease by reducing the sensitivity of immune system receptors to glucocorticoid hormones such as cortisol, therefore interfering with the body’s ability to regulate the inflammatory response Selye’s general adaptation syndrome 1. Alarm - Fight or flight response occurs 2. Resistance - The body tries to adapt to the emergency by replenishing adrenal hormones - Inability to cope with everyday events and hassles at this stage 3. Exhaustion - The body’s energy reserves are depleted Transactional model of stress (Lazarus and Folkman) Potential stressor: Loud noise Primary appraisal: Why was there a loud noise? Irrelevant: It doesn’t matter Benign-positive: It was just something silly Challenging or threatening: I am in danger Secondary appraisal: What can I do about it? Behavioral and cognitive coping responses: Adjustment to make myself safe Reappraisal: How am I doing? Have I handled the situation Diathesis-stress model - The model that proposes that two interacting factors determine an individual’s susceptibility to stress and illness: predisposition such as genetic vulnerability, and precipitating factors from the environment - Reactivity: Our physiological reaction to stress, which varies by individual and affects our vulnerability to illness
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