8.4 Stress

• Stress

  A physiological response of body to external stimuli and emotional reaction to something
• General Adaptation Syndrome

  Seyle's concept that the body responds to stress with alarm, resistance and exhaustion
• Stages of stress

  Alarm

  Resistance

  Exhaustion
• Alarm stage

  Initial symptoms when a body is put under stressful situation

  Fight or flight

  Adrenaline

  Cortisol

  Heart and Breathing Rate increase
• Resistance stage

  Stressful situation has ended

  Body tries to go back to normal and repair itself

  If stressful situation is ongoing...

  Body maintains stress hormone cortisol, and high blood pressure

  Q
• Exhaustion stage

  The third stage of general adaptation syndrome, the body remains at the resistance stage for too long and it can no longer fight stress

  It feels fatigue depression and anxiety
• Health implications of stress

  Nausea

  Heartburn

  Depression

  Insomnia
• Causes of stress

  1. Life events

  2. Work

  3. Personality type
• Life events

  These can be positive ( marriage and pregnancy)

  They can be negative (job loss or death)

  They are major events that require a transition.
• SSRS (social readjustment rating scale)

  Measure effect of major life events

  Given to 2500 male american sailors and found that there is a POSITIVE CORRELATION in change score to illness score
• Work

  This can be physical or interpersonal and it may be associated with coronary heart disorder.

  It was an investigation linking workplace stress with CHD. It found that on younger people there is the highest association as work stress leads to unhealthy behaviours
• Personality Type (friedman and roseman)

  TYPE A

  Most prone to heart related disorders related to stress

  Time urgency

  Competitiveness

  Hostility

  TYPE B

  Less prone to heart related disorders related to stress

  More relaxed

  Patient

  Easy going
• Friedman and roseman

  Conducted a longitudinal study to show that type a personality more likely to predict heart disease
• FREE WILL vs DETERMINISM

  Free will

  All 3 causes of stress ignore free will as they are based as something either intrinsic that you cannot control or something that happens to you

  However, free will is that people might make certain choices making them more likely to be in a stressful situation
• Measures of stress

  Recording devices (FMRI and OXIMETER)-biological

  Sample tests for salivary cortisol

  FRIEDMAN AND ROSEMAN test-physiological

  HOLMES AND RAHE TEST(Social Readjustment Rating Scale) -physiological
• Recording devices used to measure stress

  Pulse Oximeter

  This measures the levels of oxygen in the brain and the amount of oxygen that is passed in the blood

  It is non invasive and painless
• WANG ET AL

  Measured how self reported stress is positively correlated with cortisol levels and anxiety

  There is also a positive correlation between change in Cerebral Blood Flow and RPFC
• Sample tests for salivary cortisol

  Showing the different levels of salivary cortisol in different situations can be a significant and valid way of measuring stress

  
  

  PROXIMAL CROWDING has positive correlation with stress and cortisol levels in the brain
• Friedman and Roseman (personality test)

  Test to measure whether a person has type A or type b personality with a range of questions e.g

  Do you feel guilty when you use spare time to relax?
• Holmes and Rahe (social readjustment rating scale)

  Compiled a list of 43 life events that occured prior to patients illness and ranked them on the amount of change each can cause
• Issues and debates

  Being able to measure stress allows us to understand

  Causes
• What are the physiological ways of managing stress

  1. Biofeedback

  2. Relaxation + imagery

  3. Stress inoculation therapy
• Biofeedback

  A technique that uses electrical sensors to receive information about different body functions, through beeping noises

  Study has shown that there is a significant different in muscle tension between groups that receives feedback, irrelevant feedback, and no feedback.

  This shows it is a valid way of reducing overall stress and anxiety
• Relaxation and imagery (bridge et al)

  It is believed that muscle relaxation and deep breathing as well as use of imagery can help reduce stress.

  
  

  Use of imagery

  Imagining a relaxing scene leading to sense of calm and relaxation

  Muscle relaxation

  Focuses on particular groups of muscles and relaxing these.
• Aim of bridge et al


  To find out the effect of relaxation and imagery on stress experienced by cancer patients

  This is because cancer can lead to high stress as it is a major negative life event.

  Hypothesis- relaxation and imagery will lead to reduced stress compared to those that wont undergo either

  Hypothesis- women who underwent relaxation and imagery will have a better effect than those with just relaxation
• Design

  139 women with breast cancer from hospital in London

  Less than 70 years old

  Conducting a 6 week course of radiotherapy

  Informed that they would be randomly assigned into 1 of 3 conditions

  Informed to fill questionnaire before and after end of programme
• What where the 3 conditions

  Condition 1

  No relaxation or imagery (CONTROL)

  Condition 2

  ONLY Relaxation (ppts taught deep breathing and muscle relaxation techniques on directing sensory awareness to muscle groups)

  Condition 3

  Relaxation and imagery(ppts given same as 2 but also taught how to imagine peaceful scene)
• Questionnaires used

  LEEDS General Scale

  Used for people with undiagnosed anxiety and depression symptoms

  Profile of Mood States

  65 items testing tension fatigue anger
• Results

  This shows that for participants with only relaxation there was a positive effect on mood states.

  HIGHEST for RELAXATION + IMAGERY

  WORSENED for control group

  Least effect on women with high anger
• Issues + debates

  Application to everyday life

  Very effective on advising people how to reduce stress, especially cancer patients although only done on women, however there are no major gender differences that could imply that this wouldn't be effective on men too or other cancer problems.

  NOMOTHETIC APPROACH- it was done on a large group of people with questionares so it does not measure individual thoughts and feelings, just mood states as a whole.
• Evaluation

  Random allocation leads to reduced bias and higher validity

  Low generalisability as they were all women and same hospital, however this can also reduce confounding variables

  Use of self reports- quantitative no qualitative

  Relatively large sample
• Stress Innoculation Therapy


  CBT METHOD

  Expose people to high levels of stress and then helps them deal with it

  Has 3 phases

  1. Conceptualisation

  Client talks through experiences + current methods of dealing stress

  Therapist shows client how to reframe from stressor as a problem that can be solved

  2. Skills acquisition and rehearsal

  Client learns new coping skills and then applies them to real life

  3. Application and follow through

  Patients follow what they have just learned