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Stress is the imbalance of perceived demands and perceived
coping abilities. it varies from individual differences with the
transactional model. (Balance between perceived demands on
an individual and their perceived coping resources) a
response to something in the environment.
· Primary appraisal: · Secondary appraisal:
identifying possible appraises their ability to
threats/ demands in a cope with a threatening
situation. situation.
Higher brain centres: Autonomic Nervous System (ANS)
appraisal of situation. · Component of PNS
· Function: controls internal organs automatically & plays vital role in stress response
· Plays central role in states of bodily arousal associated with stress
· Concerned with regulation of internal environments controlling vital functions (body temp,
HYPOTHALAMUS HR, BP) (central to homeostasis)
ANS is separated into 2 divisions (sympathetic & parasympathetic) ­ the 2 branches are usually
balanced but sometimes the balance shifts and one branch becomes dominant.
Stimulates the Stimulates the pituitary 1. Sympathetic dominance: leads to bodily arousal; increases heart rate and blood pressure.
adrenal medulla gland to release ACTH 2. Parasympathetic dominance: leads to physiological calm
Shifts determined by body's physiological requirements, physical exercise needs energy ­
provided by sympathetic arousal branch.
If a dangerous or threatening situation is perceived, higher brain centres signal the
Releases Stimulates adrenal hypothalamus to activate sympathetic branch of ANS (sympathetic arousal ­ important part
adrenalin cortex of body's response to stress.)
When the HPA axis and SAM pathways are activated hormones flood into the
bloodstream in order to help the body either escape (flight )or confront(fight)
Gets body ready Releases the stressful situation.
for fight or flight corticosteroids
Adrenalin and noradrenalin (SAM)
Physiological Physiological Role: to speed up heart rate and raise blood pressure
reactions: reactions: Reason: so oxygen is rapidly pumped into muscles to increase physical activity.
-increased heart -liver releases Cortisol and corticosterone (HPA)
rate/ blood energy Role: to release or mobilise energy reserves through raising blood levels of glucose and
pressure -immune system fatty acids.
-sweaty palms is suppressed Reason: to increase physical activity
Effect: raised levels of corticosteroids suppressing the immune system.…read more

Slide 2

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Selye GAS general adaption syndrome (1956) Evaluation of GAS
Exposed rats to variety of severe stressors: exercise, injury, mutilation, poisoning = long term Extremely influential in stress research
responses. the physiological response to stress is always the same, irrespective of the nature Shows role of SAM & HPA pathways
of the stressor. Shows links between chronic stress and illnesses.
Ethical objections to animal: deliberate pain/stress,
How our body responds to stressors: alternative methods? E.g studying chronic stress patients.
1. Alarm (perceived stressor): immediate response to stressors = SAM & HPA pathways are Problems generalising: rat and human physiology have
activated. similarities and differences
2. Resistance (if stressor persists): maintains activation, levels of stress related hormones Individual differences: stress is influenced by individual
and bodily arousal remains high. Body tries to adapt to stressor through hormonal differences and peoples varied reactions (the way we
changed to cope with stress, conservation of resources, effects on activity level e.g perceive and identify (appraise) a stressful situation.
feeding etc. not necessarily harmful. reductionist = too simplistic.
3. Exhaustion (chronic stress): exhausts body's defence systems and ability to main high Stress related illness is due to the prolonged raised levels
levels of circulating stress = stress related illness may develop. Metabolic changes, decline of stress hormones not due to the exhaustion of the
in immune function = suppression = increased susceptibility to infection. body's physiological stress response.
Types of Stressors- Stress is a motivating and arousing Cohen et al (1993)
Acute time-limited stressors: factor which energises us and Investigated the role of general life stress of vulnerability to the common
· Usually lasts 5-100mins drives us to achieve goal. cold virus. 300+ P's completed questionnaires on the number of stressful
· Given in controlled The hormones released during the life events they had in the previous year. They rated their degree of stress
environment such as a lab = bodily arousal associated with and level of negative emotions (e.g depression) = combines and called
part of a study? stress can have adaptive short term stress index.
· Stressor sparks intense stress effects but can lead to chronic P's exposed to common cold virus = 82% infected. Findings- the chance of
but only for the time it takes illness in the long term ­ the effects developing a cold was significantly correlated with stress index scores.
to illicit response become pathological (pathogens, It is concluded that life stress and negative emotions reduce the
· E,g public speaking, traffic spreads and kills) effectiveness of our immune system = P's less able to resist viral
Brief naturalistic stressors: No direct measures of immune function, Evans and Edgerton (1991) ­
Immune system-
· Occurs naturally in your found the probability of developing a cold correlated with negative
Body's defence against infection
environment events in the preceding days.
and illness
· Usually lasts for the time you Did measure health outcomes showing a relationship between life
To cope with bacteria, viruses and
are in the stressful situation. stress and illness. This can be compared with studies that use measures
infections process.
· E.g exams of immune function rather than illness outomes.
Immunodeficiency diseases such as
AIDs involve destruction of immune There was no direct manipulation of the IV and so cause and effect
Chronic stressors:
system and leaves people open to relationship cannot be confirmed.
· Long-lasting stressors
illnesses and infections. P's should be in good health and given full informed consent with
· E.g caring for dementia
Sometimes the immune system debriefd.
patients, coping with long
does not recognise its own tissue P's should be constantly monitored to check for any reactions
and attacks them such as cancer Should be balanced against psychological or physical distress to P's.
nt and diabetes.…read more

Slide 3

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Kiecolt-Glaser et al (1984) naturalistic life stressors and their impact on measures of immune function.
Used 75 medical students preparing for exams. As an index of immune function they used natural killer (NK) cell activity, part of our natural immunity system.
NK cell activity were recorded from blood samples taken from 1 month before exams (low stress) and during exams (high stress). P's completed questionnaires on
experiences of negative life events and social isolation.
Found that the NK call activity was significantly reduced in the high stress samples compared to the low samples. The greatest reductions were in students reporting
higher levels of social isolation.
It was concluded that examination stress reduces immune function = people more vulnerable to illnesses and infections. The effects are more noticeable in students
experiencing higher levels of isolation.
Did not assess actual illness outcomes but have direct measure of immune function reduction to immune function = illness. But the study shows reductions that
are too small to increase chances of stress related illness.
However, shows that small wounds took longer to heal in higher stressed groups e.g Alzheimer patients (memory loss & dementia) reduced immune function = link
between stress and health is supported.
Results cannot be generalised as they used only medical students
No manipulation of IV so cannot confirm cause and effect. However findings from different studies = highly suggest of a relationship between life stress and reduced
immune system.
Fully informed consent and debrief = they should be aware of the mild stress of having their immune function measured.
Medical supervision is essential
Pain and distress is involved so full approval from ethics committee is required.
"stress exists only when perceived demands outstrip our perceived resources and ability to cope"
Life changes (major life events): How do we measure stress?
o Big events e.g getting married, moving house, new job. 1) Self report questionnaires frequency of stress
Daily hassles: 2) Self report questionnaires perceived stress (How stressed do you feel?)
o Stresses of everyday life e.g stuck in traffic, deadlines. 3) Semi-structured interviews P's talk through their life stressors with interviewer (qualitative)
Holmes and Rahe (1967) Rahe et al (1970)
Patients with heart disease reported Investigated link between LCU and illness in sample SRRS Evaluation:
having life events in the previous year. of healthy P's. 2500 male US navy personnel filled out Can be completed confidentially = honest answers
They asked 300+ people to compare 43 SRRS for the previous 6 months. Followed up after 7 Quantity data
life events with marriage in terms of months and all the stress related illnesses were Easy to use can be distributed widely
adjustment (higher/lower). They recorded & rated for an overall illness score. Found a Can indicate relationship between variables
developed a questionnaire called the weak positive correlation (0.118) although low, it was If same event happens twice = how is it
Social Readjusting Rating Scale (SRRS) for concluded that there is a relationship between life measured/rated?
identifying major stressful events. Each events and development of stress related illness. Emotional impact of event is not taken into account
event were awarded life changing units Correlation was low therefore other factors must be may be positive or negative
(LCUs) depending on how traumatic it is. involved. No account of individual differences as we respond in
It is carried out in the US therefore it Results are specific to gender and culture, must different ways
is culturally specific and cannot be generalise with caution Retrospective = unreliable/ psychological harm
generalised to the whole population. Correlational study cannot conclude cause and Correlations do not imply causality (divorce may be
No manipulation of variables so no effect correlated with depression but depression may have
serious ethical issues. Distress recalling traumatic life events been led up to divorce)
Informed consent and debrief. (psychological harm)…read more

Slide 4

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Factors that cause stress at work:
Major life events are nature rare. Stress in 1. Environment: physical arrangement, intense noise and increase in temperature = frustration, stress & aggression,
peoples lives tend to be from problems of physical layout= personal space and privacy.
day to day living (hassles). = known to more 2. Home-work interface: balancing and competing demands of home and work, work-life balance=individual ideal
significant health than major life events. situation has time for both work and home responsibilities.
Kanner et al (1981) 3. Workload: long hours at work are often prioritising over social structures such as family, Dewe (1992) work over
o Original scale: 117 items covering all load and having too little to do can have similar effects.
aspects of daily life can be altered for 4. Control: degree of control a person has over their workload (decision latitude)= control over work load and how it
special groups such as students where is organised. High decision latitude = lower vulnerability to stress related illnesses.
more specific items would be more 5. Role ambiguity: when the requirements for a particular work role are unclear or poorly defined, results for having
relevant. E.g annoying teacher, study not clear guidelines or ones that are contradictory.
o Life contains uplifts (positive events Karaseks model (1979) Marmot et al (1997) study on relationship between workplace stress
opposing hassles) that counteract Shows relationships between control(decision and health.
negative effects from daily hassles. latitude), demand (workload), job strain They controlled individual and social risk factors e.g smoking, obesity,
Uplift scale: 135 positive items. E,g good (stress). Combination relationships can be blood pressure, cholesterol levels. P's were London based government
grades/friends modified by other factors such as social civil status.
Scores on hassle scale correlate with stress- support. Whitehall 1: clear differences on heart problems and mortality rates.
related problems (e.g depression and Workers in lower paid grades were twice the illness rate of higher paid
High Demand Low Demand
anxiety) grade workers. This may be because the lower paid grades were more
De Longis (1982) ­ found health outcomes likely to smoke therefore causing high blood pressures.
have greater correlations from hassles Low High strain job Passive job Whitehall 2:used 7000+ P's were followed up after 5 years , they were
scores and health than healthand life Control (vulnerable to free of heart problems at the start of the study. Shows similar
events. Uplifts were unrelated to health stress) differences in heart disease to Whitehall 1, with the rate in the lowest
outcomes. grades being 1.5 times the rate in the highest grades. Risk factors such
Ruffin found that daily hassles produce High Active job Low strain job as smoking obesity and hypertensions could account for some of the
greater psychological and physical Control increase in lower grades. However most significant factors = decision
dysfunction than major negative life events. latitude.
Measuring and dealing with workplace stress:
Self report questionnaires = biased reports e.g under estimating risk
· Cooper (1998) Self report questionnaires=
factors such as smoking
Why are daily hassles so stressful? to measure stress perceived from
Some factors that were not measured may have contributed to the
They affect well being by employee. Measures characteristics such
results e.g workers in lower grades may have a common
accumulating over a series of day or as social support, type A behaviour and
characteristic that makes them vulnerable to heart disease but that
even months coping strategies. Giving a profile of the
was not measured in the study.
Thye result in serious stress reactions individual.
Sample used government civil servants= biased sample so difficult to
­ anxiety, depression · Findings are used to come up with
generalise results to other groups of workers.
Maybe the grow out to pre-existing strategies to reduce the negative effects
Little risk of psychological harm = questionnaire study
stressors. E.g if you have suffered a on individual (health problems) and
Informed consent and debrief
bereavement and then the washing organisation ( absenteeism, lowered
Workers developing illness should have necessary support
machine breaks down = very stressful. productivity). Giving employees stress
Fox et al (1993) found combination of low control and high demands
Daily hassles therefore provide a management programmes, maybe make
was related to higher blood pressure in nurses. High blood pressure
better explanation for physical and changes to the organisation and its
is a major risk factor of heart disease. Van der Doef and Maes (1998)
psychological health than life events. structure and management. And using
hypothesis: high demand and low conreol increases the risk of
psychological methods.
heart disease.…read more

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Type A: more vulnerable to stress related Type B: Roseman et al (1976)
illnesses. And there is evidence to suggest they - Relaxed Interviewed 3000+ middle aged men from US, by observing behaviours and
are twice likely to develop coronary heart - One thing at a time analysing their answers to questions , the men were categorised as either type A or
disease (CHD) - Express feelings B.P's were followed up after 8.5 years, and found that there were 200+ heart
- Competitive achievement orientated,
attacks and 69% were from the Type A group. They controlled other risk factors
always want to win
People vary in their vulnerability to such as smoking and obesity. And concluded that the high TAB individuals was
- Time urgent multitasking= sever jobs
stress related problems, they may vulnerable to heart disease. The role of hostility = risk factor.
at a time
react to stressors differently to have Even though they controlled for some factors, they cannot be sure everything
- Hostile and aggressive easily angered,
different methods with coping with was controlled for.
irritated and impatient.
stress. Difficult to generalise as the study is culturally and gender specific. May be
Hardiness High ecological validity as it is a real life study.
1. Control = feel more control over their lives Informed consent and debrief
2. Commitment = have a sense of purpose in their work and social lives No manipulation so little chance of psychological behaviour.
3. Challenge = see challenge as an opportunity not a threat. However..
Shekelle et al (1985) found no relationship between CHD with TAB and type B
Kobasa (1982)
Various other reviews only found a small significant link.
Devised questionnaires to male white collar workers to assess the 3C's. and found that people
Other characteristics such as hostility and other negative emotions mau be key
with high scores in the three C's reported feeling less stress symptoms. in linking TAB and CHD (Miller et al 1996, Debroski et al 1989).
It was a correlational study so we cannot assume personality difference causes the We can conclude that in TAB..
differences in response to stress cannot conclude cause and effect. Friedman and Roseman has stimulated an enormous amount of interest and
3C's are very vague research.
Pergilly (1997) found that commitment was more important in moderating stress in Demonstrated links between personality and heart diseases.
college students then control or challenge. Hostility is most important risk factor for heart disease.
However.. High TAB individuals seem to cope with stress may also suggest that some of
Beasly et al (2003) studied university students and found those with a hardy personality their characteristics protect them against the negative effects of stress.
showed less stress. hardiness.
Turnispeed (1997) studied 87 nurses and found those who scored high on the hardiness
scale were less likely to feel under pressure at work than those with low scores.
Other personality types: Does being competitive and
Eyseneck (1998) propsed 2 types of personalities: achievement orientated mean you
- Vulnerable to cancer associated with difficulties in expressing emotions and with social relationships. need to be committed and like a
- Vulnerable to CHD high levels of anger and hostility. challenge?
However.. No consistent evidence linking these personality types to either cancer or CHD In TAB with high levels of
Denollet (2000) Type D `distressed' (vulnerable to heart disease) They experience high levels of negative emotions and social inhibition competitiveness and achievement
(tend to avoid social interactions) high levels of negative emotions combined with social inhibition are associated with increased risk of heart orientated you can agree to showing
disease. commitment also means having
These approaches assume that personality is a factor influencing the relationship between stress and its effects on the individual. challenges to overcome.
Such relationships are difficult to demonstrate consistently. Conclusion:
TAB, hardiness and other personality types negative emotions such as anger and hostility do seem to increase stress related vulnerability TAB pattern is made up of factors,
to heart disease
some of which increase and some of
Other factors that could influence the results. High level of hostility and anger may be associated with smoking and drinking and other
which decrease resistance to stress.
dysfunctional lifestyles leads to social isolation, which Denollet's work suggests is another important factor in the stress/illness
relationship. This might explain why the results of
No consistent evidence linking to either cancer or CHD studies trying to link TAB and heart
Hostility is a big factor to heart disease increased risk of vulnerability to heart disease. diseases are inconsistent.…read more

Slide 6

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Psychological methods of stress management Physiological methods of stress management drugs:
Meichenbaum's stress inoculation training (SIT): Benzodiazepines:
A cognitive behavioural approach used to manage stress thinking and · Stressful situations = anxiety
behaviour. It involves changes to your thought patterns and your behaviour · BZs = most prescribed drug for clinical disorders. Librium & Valium anti-anxiety
1. Conceptualisation (thinking about situation) ­ think about the stress, drugs. Mogadon --> sleeping pills.
think about how we appraise our stress. Identifying source of stress. · BZs act in the brain, they increase action of the neurotransmitter GABA (its role is
may be asked to keep diary to write about stressful experiences. May to reduce the activity of other neurotransmitter pathways throughout the brain.
challenge clients appraisal of stressful situations if they seem BZs therefore produce greater inhibition of neurotransmitter of noradrenalin and
exaggerated serotonin is particularly important for the anti-anxiety and anti stress effects of
2. Skills training and rehearsal- developing skills to cope in a particular BZ.
stressful situation. Developing a relaxation technique that can be used in · BZs are relatively safe in overdose
the stressful situation. · Side effects: tiredness, sedation, impaired motor coordination, memory
3. Application to the real world. When you encounter a stressful situation, impairment during long term treatment
apply the skills you have learnt (appraisal, skills, relaxation techniques) · Can lead to dependence, so if stopped person can have withdrawal symptoms:
Encourages identification of what is causing the stress. sleeping problems, sweating, tremors, raised heart rate. recommended for
From the transactional model stress occurs when there is an imbalance prescriptions for short period
between perceived demands and perceived coping resources. SIT · Reduces the gap between perceived demands and perceived resources.
encourages realistic appraisal and offers coping resources. · BZs most effective if combined with psychological and alternative methods.
Lack of control may lead to stress. SIT offers to aim help us gain control · Fully informed consent before prescription, however people with severe stress-
through relaxation techniques. related anxiety would not be fully competent..
Takes time, commitment& money.
Berger (2000) good for exams stress in students Beta-blockers:
Meichenbaum (1985) good for snake phobia · Act directly on the heart and circulatory system of the body. Reduce activation of
the cardiovascular system (heart and blood vessels)
Kobasa's hardiness training: · Directly reduce increase of heart rate and blood pressure that are associated with
1. Focusing: on what your body is doing when you are in a stressful stressful situations., also sued in management of chronic hypertensions (raised
situation. blood pressure)
2. Reconstruction of a stressful situation: Think about a stressful · Useful in controlling bodily arousal.
situation. How could it have been better? How could it have been · Prescribed for musicians and snooker players whose smooth motor control can be
worse? It could always be worse. Help them feel more positive and upset by high levels of arousal.
optimistic. · Directly reduce heart rate and blood pressure. Can act rapidly to have a life saving
3. Self improvement: improve your self-efficiency (control and function with people with life threatening hypertension.
effectiveness over your life) · They can interact with other drug treatments, however it does not have severe
Encourages us to change the way we think appraisal of a situation side effects. They do not penetrate the brain easily.
Increase sense of self efficiency should enable them to deal with future · Targets the physiological stress response. Lowers stress related bodily arousal.
stressful situations . · They are not targeting the sources of stress but only the physical symptoms. So
Time, commitment & money they are inappropriate for the long time management of stress related arousal,
which is more effectively treated with psychological methods.…read more

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