SAM PATHWAY > Adrenal Medulla > Adrenalin > Fight or Flight
HPA AXIS > Hypothalamus > CRF > Pituitary Gland > ACTH > Adrenal cortex > Cortisol
Acute time - limited stressors e.g. public speaking.
Brief naturalistic - limited duration e.g. stressors
Chronic - long term e.g. caring for ill relative.
Stress and Immunity
Cohen et al
- tested effects of stress on immunity using the cold virus.
- 394 pts completed questionnaire about stressful life events in previous year, rated degree of stress and negative emotions - giving a 'stress index'
- after being exposed to cold virus, 82% became infected - cold correlated with stress index.
Klecolt-Glaser et al
- tested effects of naturalistic stressors on immunity.
- 75 med students has NK cell activity measured before and during exams, and completed questionnaire on negative life events and social isolation.
- NK cell activity decreased in high stress, especially with social isolation.
- weak but significant correlations
- compared to other factors, stress is insignificant impact on immunity.
- hospital patients (CHD) reported significant life events the previous year.
- they compared life events with marriage in terms of adjustment needed.
- 'life change unit' = amount of stress
Daily hassles and uplifts
- looks at every day annoyances and uplifts
- studies suggest hassles are more stressful than life events
- individual differences e.g. coping mechanisms, social support
Stress and Personality
Friedman and Rosenman
- tested link between personality and CHD.
- middled aged US men were classed type A or B via interview using behavioural signs and then followed up for 8.5 years.
- of the 257 heart attacks, 69% were type A.
- longitudinal study
- androcentric and ethnocentric
- no control of extranuous variables
- is CHD an indicator of stress? genetic factors..
- early findings failed to be replicated
Marmot et al
- investigated relationship between workplace stress and health
- analysed data from 7000 london civil servants and followed up for 5 years
- lower paid workers had twice the illness of higher paid workers and had 1.5x more heart problems
- most significant risk factor was degree of decision making
- accounted for other factors
- civil servants only - generalisation problems
- relationship - no cause and effect
- difficult to test cause and effect due to ethics
- self report questionnaires could be bias
Coping with Stress
Tennon et al
- studied coping styles in pts with chronic pain - they filled out coping style questionnaire and level of pain daily
- EFC used 4.4x more when PFC was also used.
- pts assess and respond to success/failure of strategies - we tried preferred method first and may alter the approach
Factors affecting type of coping response:
- stressor e.g. work or relationships
Stress Management (Psychological)
- identify sources of stress (conceptualisation), learn coping skills or relaxation techniques, apply to real life and follow up.
- reduces mismatch between demands and resources, effective in range of settings, time consuming, expensive, need motivation.
- focus on physiological symptoms so they can recognise stress, analyse stressful situations, increasing self-efficacy.
- targets appraisal of stress source, reduce gap between demands and resources, needs time and motivation.
Stress Management (Biological)
- anxiety-related stress, increases action of calming neurotransmitter (GABA) and decreases noradrenaline and serotonin.
- safe in overdose, may have side effects, risk of dependency, only treats symptoms, effective in combination with psychological methods.
- acts on circulatory system and sympathetic pathway, reduces heart rate and blood pressure.
- acts rapidly, no severe side effects, interaction with other drugs, only treats symptoms.
Stress Management (Alternative)
- recording physiological systems e.g. heart rate, then using methods to reduce feedback e.g. muscle relaxation.
- works for some people, time consuming, effective in treating tension headaches in children, no side effects, cause of stress not targeted.
- isolation shown to cause depression in women with young children (link)
- support can protect against damaging effects of stress.
- emotional, practical, informational and general network
- file drawer problem, animal testing (monkeys), studies show support for this method.
Informational - the need to be right
Normative - the need to be liked.
- 1) Beam of light - asked how far it moved.
- 2) Asked in groups - found consensus.
- 3) Asked individually - stuck with the norm answer.
- Is this conformity? Asch says not.
- 1pt and 5conf, asked to match line X with either 1, 2, or 3.
- 82% conformed when conf gave same wrong answer, 74% conformed atleast once and 26% never conformed.
- Strong pressure to conform with unanimous majority in ambiguous situations.
- Set in 1951, USA, study was a 'child of its time.'
- non unanimous (5% dec), size of majority (13% dec)
- 172pts in groups of 6 (4pts, 2conf) estimated colour of 36 blue slides.
- When conf consistently said green, pts said green 8.4% of the time, when not consistent 1.3%
- Hard to control extraneous variables e.g. eye sight.
- 12 angry men study, tested whether minorities can exert influence through persuasive info and change in behavoiur.
- minority only influenced when they provided counter arguments - 'ceiling of influence' at 4.
- role play study - pts were prison guards or prisoners
- mock prison had to be shut down after 6 days as prison guards were getting too aggressive and prisoners became psychological harmed.
- prison guards said that when they put on the uniform they became consumed by the role.
- psychological harm
- no real deception
- male, USA, university students.
- 40 male pts set in Yale University in a science lab. Pt acted as a teacher to learner (conf).
- Teacher had to increase voltage or shock when learner gave wrong answer.
- ALL went up to 300V, while 65% went to the end.
- Pressure to continue
- Protection of pts
- No fully informed consent
- Debriefing and counselling
- Lab based
People obey because: legit authority, gradual commitment, buffers, agentic shift.
Moved to bridgeport (47.5%), no buffers (40%), supported by 2 teachers (10%)
People resist because: individual differences, feeling responsible, disobedient models.
- to see if pts would rebel against unjust authority when encouraged.
- in the USA, newspaper advert was paying people to take part in discussion on standards of behaviour in the community
- put in groups of 9
- pts met a consultant who said they were taking legal action against a petrol station manager due to an offensive lifestyle
- the manager argued he was sacked for speaking publicly of high petrol prices
- consultant wanted them to argue in favour, it was filmed and shown in court.
- 32 out of 33 rebelled in some way, 25 refused to sign the consent form
Why did people disobey?
- strong group identity, they agreed demands of authority were unreasonable
- rebelled against attempts to control behaviour (reactance)
- pts had sufficient time to think about their actions
Deviation from the social norm
- cultural norms can vary (AO2) so the measuring tool is inconsistent and unreliable.
Failure to function adequately
- focuses on every day behaviour of individuals, it is a sign of a general problem
- does failure to function have to be every day? how do we measure this? (AO2)
Deviation from ideal mental health
- Jahoda lists: empathy, coping with stress, high self esteem, sense of identity, personal growth etc.
- how far does someone need to deviate from ideal mental health? (AO2)
Explaining Abnormality (Behavioural)
- Classical conditioning - association, pairing of two stimuli to bring about a response e.g. little Albert.
- Operant conditioning - reinforcement, behaviour shaped by consequences.
- Social Learning Theory - imitation and role models.
- Evidence such as Little Albert and his phobia.
- Behaviour-based treatments are effective.
- Deterministic - no free will.
- Reductionist - biological factors?
Explaining Abnormality (Cognitive)
- Processing information, schemas, perception, memory.
- Beck's negative triad: Self, world and future.
- Ellis' ABC model: Activating event, beliefs, consequences.
- Includes individual differences of perception
- Effective treatment (CBT)
- Deterministic - no free will.
- Reductionist - acknowledges biology can affect processing.
Explaining Abnormality (Biological)
Genetic - tested using blood sample, looking at family background.
AO2: problem identifying genes, limited samples, look at concordance rates.
Viral - test using blood test
AO2: evidence in Sz patients but this is a limited sample.
Hormones - tested using blood test.
AO2: need evidence over time, problems with causality.
Brain structure - use scans
AO2: difficult to know when to test.
- Some evidence
Explaining Abnormality (Psychodynamic)
Freud - unconscious mind.
Personality: ID (pleasure), Ego (rational), Super Ego (moral)
Psychosexual stages - oral, anal, phallic, latency, genital.
Defence mechanisms e.g. repression, regression.
- Difficult to test
- Psychoanalysis based on this
- Largely theoretical, little evidence
- Deterministic - no free will.
- antipsychotic e.g. chlorpromazine - blocks dopamine neurotransmitter to stop hallucinations in Sz sufferers.
- antidepressants e.g. SSRIs - block transporter mechanisms so transmission of serotonin is easier.
- anti-anxiety e.g. BZs - slow down activity of CNS and enhance GABA to quieten down other neurotransmitters and reduce serotonin to become more relaxed.
- 0.6amps lasting 0.5secs to produce a seizure, 3x a week. Given short acting barbituate, nerve blocking agent and oxygen.
- 60-70% improve after, 84% relapse within 6 months.
- aim to release problems in unconscious mind so issues can be dealt with.
- FREE ASSOCIATION - expressing thoughts as and when they come to mind, revealing areas of conflict.
- THERAPIST INTERPRETATION - drawing conclusions about possible causes; this may be discussed and disgarded in attempt to avoid painful discussion. 'Transference' may occur.
- WORKING THROUGH - meet 4/5 times a week to gain a greater clarity about the causes of behaviour.
- 80% of 10000 pts benefitted from psychotherapy.
- the longer the treatment, the better the outcome.
- Based on Freud's theory of personality.
- possibility of 'false memories'
- forced termination could be distressing.
- hierarchy of least to most feared. Most successful for treating phobias.
- overloading of the stimuli. Can be stressful.
- Pairing two stimuli to treat addictions.
- Used often in institutions, reinforcement to modify behaviour.
- Need to alter schedules to take focus away from rewards and more on good behaviour.
- Aims to challenge irrational thinking, testing reality and making goals.
- based on ABC model
- client and therapist identify situations and the reactions they producse
- rationalisation - offering a more realistic perspective
- challenge patient's beliefs
- aims to correct dysfunctional thoughts
- gets to cause
- effective for depression and anxiety
- benefits last longer than drugs