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  • Stress
    • The body's response to stress, including the pituitary-adrenal system and the sympathomedullary pathway. Both the adrenal cortex and adrenal medula are the two adrenal glands which release different hormones in response to stress. The hypothalamus plays a central role as it controls the body's response to stress.
      • Sympathetic-adrenal- medula pathway (SAM).
        • Hypothalamic-pituary-adrenal cortex pathway. Pituary gland: releases hormones into the is about the size of a pea at the base of the brain. Adrenal Glans: sit at the top of the kidneys & are responsible for releasing stress hormones.
    • Stress: the subjective experience of a lack of 'fit' between a person and his/her environment (i.e where the perceived demands of a situation are greater than the individual's perceived ability to cope).
    • Stress related illness and the immune system: a stressor is an event that leads to the experience of being stressed, i.e. getting trapped in a lift, loosing your purse. There are 2 types of stress; Chronic ( long term) which is continuing,  it can cause prolonged glucose levels in blood and fatty acids, if this remains high it can lead to furring of the arteries this can result in heart disease and strokes. Acute (short term) is immediate i.e. taking driving test, this can cause an increased heart rate and blood pressure which can lead to physical damage to the blood vessels or heart muscles.
      • The autonomic nervous system (ANS): the role of your ANS is to control the release of hormones controlled by higher brain structures such as the hypothalamus, it also transmits hormones to all body organs via nerve pathways i.e. heart, digestive system, circulatory system. 2 branches; sympathetic branch:pattern of body arousal, activates everything,heart rate,blood pressure digestive system slows down. Parasympathetic branch: opposite to other one in that heart rate and blood pressure return to normal, digestion speeds up.
        • Kiecolt- Glaser et al study (1995)- key study. Aim: to look at immune system by looking at how quickly a would heals. Volunteer sampling of participants, it was a matched pairs design and  they found chronic stress depresses functioning of the immune system. A02: ethical issues: physical harm to participants, real world application, matching participants was not exact, weren't matched on smoker status or relationship status, sample bias which shows carers have a better functioning immune system which strengthens the validity of the study findings.
          • Kiecolt: used blood samples to test students stress levels before and after exams, they found that  Natural killer cells were significantly reduced during exams and also naturalistic stressors such as examinations significantly suppress the immune system, making people more vulnerable to illness and infections. Cohen et al found that 82% of participants with the cold virus was highly correlated with their stress score i.e. the higher the score the more likely they were to become infected with a cold, also high levels of stress reduce the effectiveness of our immune system, leaving participants less able to resist viral infections.
            • Stress can sometimes enhance the immune system:  Evans et al proposed that stress may have two effects on the immune system; up- regulation (acute stress) and down-regulation (chronic stress).
    • Life changes:  those events that require a major transition or change in our life, if our normal routines are disrupted we have to think about how we do things that we normally do on 'auto-pilot', the bigger the change the more adjustment has to be made, therefore the more energy has to be used. MAJOR LIFE CHANGING EVENTS CAN LEAD TO STRESS- RELATED ILLNESS!! stress can be measured by self report questionnaires on frequency of life stress (in relation to major life events or minor daily stressors), self report questionnaires on perceived or subjective stress, semi-structured interviews (assess stressor as they talk).
      • Holmes and Rahe created the SRRS, it was made to look at the necessitated psychological readjustment after a life event. Rahe aimed to test the SRRS in regards to whether the number of live events a 'normal' person experiences would be positively correlated with illness. A military version of the SRRS was given to men on board navy cruisers, (opportunity sample),  a positive correlation of 0.118 was found therefore there is a link between life events and illness.
        • A02: :(- men are used so its gender bias, also its culture bias because its american and uses american words, the fact navy men are used shows can't be generalised as they have experienced more than a normal person, lacks ecological validity, ethical issues of personal information. individual differences: key role in handling of stress and whether if effects the immune system, retrospective data was used as it was about  previous months and info could've been forgotten or wrong.
          • Daily Hassles: a daily hassle is a stress of everyday life as opposed to major events, a daily uplift is a positive, desirable experience that makes a daily hassle more bearable. Lazarus suggested it was daily hassles of life that lead to stress rather than life events, De Longis et al created a hassles and uplift scale and found no relationship between life events and stress but did find a significant positive correlation of +0.59 between hassles and next  day health problems.
    • Workplace stress: any stimulus in the work environment that produces the stress response, environment stressors (light, temp, space), work overload/underload, lack of control. Marmot et al investigated the workstrain model of workplace stress, they found that no link has been found between high workload and stress related illness therefore high job demand is not a significant factor in stress. A02: longitudinal study, participant drop out rates, inaccurate data and extraneous variables that can't be accounted for.
      • Johansen et al aimed to investigate if workplace stressors like repetitiveness, machine-regulated work and high responsibility= stress related illness. Used 14 finishers in a  sweedish saw mill (experimental group- high stress) compared to 10 cleaners (control group). combination of work stressors (repetitiveness, machine pacing of work and high levels of responsibity)= long term physiological arousal= stress related illness and absenteeism. A02: :(- indy
        • Personality factors and stress: personalityis a set of characteristic behaviours, attitudes and general temperament that remain relatively stable and distinguish one induvidualfrom another. Type A: ambitious and competitive with a strong sense of time urgency, competitiveness and achievement striving,  impatient, hostility and aggressiveness (anger). Type B: opposite of A, relaxed, one thing at a time, patient, express feelings. Type X: combination of A and B.
          • Type A research: Friedman and Rosenman found that participants with high type A behaviour were more vulnerable to heart disease. A02: culturally and gender specific, findings can't be generalised or if they are with caution, the definition of type A behaviour is based on western cultural concepts. Myrtek found an association between CHD and type A component of hostility however no association between type A and behourious and CHD.
            • The hardy personality:(Kobasa) it was suggested that some type a induvidualscan be resistant to CHD, these people are psychologically 'hardy'. 3 elements; control: you can influence events in your life, including stressors, commitment: the individuals sense of involvement and purpose in life , challenge: the idea that changes in life should be viewed as an opportunity rather than a sours of stress. Hardy participants have high stress and low illness showing a resistance to stress. Lifton et al said students who had hardy personality were most likely to complete their degree.
    • Physiological methods of stress management: (drugs) Benzodiazepines (BZ): most commonly used to treat anxiety and stress i.e., valium and librium, they act in the brain and increase action of GABA ( neurotransmitter which is bodes natural anxiety relief), by increasing action this inhibits neurotransmitter activity in the brain making you calmer, serotonin and noradrenaline arouses brain, BZ'S reduce theses= reduced anxiety.
      • A02 of BZ's:  :)- relatively safe in cases of overdose, ease of use, act quickly to reduce heart rate and blood pressure, no severe side effects, effective when used alongside psychological treatment. :(- side effects: tiredness, and memory impairment,can be addictive and person will experience withdrawal symptoms like sleeping problems, sweating, raised heart rate, do not target source of stress, ethical issues: informed consent needs to be obtained before hand by someone else.
        • Beta blockers (BB's): act directly on the heart and circulatory system, they reduce activity of sympathetic nervous system (reduce adrenaline and noradrenaline, SAM pathway), bond to receptors on cells of heart and other body parts that are usually simulated when anxious, heart beats slower- fall in BP- less stress- feel calmer, often used by sports people and musicians where performance can be affected by nerves.
          • A02: (BB's): :)- they have a life saving function in people with life threatening hypertension by reducing heart rate and blood pressure, do not have severe side effects, clearly target physiological responses to stress. :(- does not cure the source of the stress, only the symptoms and so therefore inappropriate in the long run.
            • SIT: stress inoculation training and hardiness training are both forms of CBT. SIT has been developed specifically to deal with stress, it is different from other methods as it suggests the individual should develop a form of coping before the problem arises.
              • Meichenbaum suggested 3 stages of the therapy: conceptualisation- therapist and client work together to identify the sources of stress in their lives, enables the client to think differently about their problem. Skills training and rehearsal: coping skills are taught and practiced and then rehearsed in a real life setting, includes positive thinking, relaxation, social skills etc. Real life application:  client is encouraged to apply to different situations. A02:
                • A02:  :)- it addresses the first stages in managing stress, the cognitive element of SIT aims to reduce the gap stress. :(- takes time, commitment and money, not appropriate for everyone, stress is complex and SIT is reductionist.
                • Hardiness training: another form of CBT and it aims to increase your self confidence and sense of control so that individuals can more successfully navigate change. 3 stages: (Kabasa) Focusing- client focuses on physiological symptoms associated with stress, also acquire new strategies with coping with stress. Reconstructing stressful situations: client relives stressful situations. Self improvement- client is taught to focus on seeing stressors as a challenge that they can take control of rather than problems they must give in to.
                  • A02: :)- Targets stress and reduces the gap between demands and coping resources, gives an increase in the sense of self efficiency allowing them to deal with future situations more effectively. :(- it takes time commitment and money so its not appropriate for everyone.


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