Stress

• Lack of appetite
• Craving for food when under pressure
• Insomnia
• Headaches
• Nail biting
• Nervous twitches
• Constipation or diarrhoea
• Frequent heartburn or indigestion
• Tendency to sweat for no good reason
• Nausea
• Breathless with exertion
• Fainting spells
• Frequent crying or desire to cry
• Impotency or frigidity
• Inability to sit still without fidgeting
• High blood pressure

Mental Symptoms:

• Constant irritability with people
• Feeling unable to cope
• Difficulty in making decision
• Awareness of suppressed anger
• Lack of interest in life
• A feeling of being a failure
• A feeling of being bad or self-hatred
• A feeling of ugliness
• Inability to show true feelings
• Loss of sense of humour
• Feeling of neglect
• Dread of the future
• Difficulty concentrating
• The inability to finish one task before rushing on to the next

First response (startle response) is immediate and operates within 30 seconds of a threat. This is the Sympathetic Adrenal Medullary (SAM) response.

Process:

Sympathetic Adrenal Medullary -> Adrenal Medula -> Releases Adrenaline

Effects:

• Pupils dilate
• Breathing rate increases
• Heart pumps harder and faster
• Blood supply to the legs increase
• Shuts of your digestive and reproductive systems
• Adrenaline is released from the adrenal glands on the kidney

If the stress is prolonged then the "back-up system" responds and this is the Hypothalmic Pituitary Adrenal Access (HPA) response.

Process:

Hypothalmia Pituitary Adrenal Access -> Pituitary gland (releases Cortico Releasing Factor) -> Adreno Cortico Trophic Hormone ->Releases Cortisol

Effects:

• Pupils contract
• Slows heart beat
• Constricts bronchi
• Builds up energy for future use
• Stumulates activity in the digestive/reproductive systems

Seyle's GAS (General Adaptation Syndrome) Model:

Immune system

Night - body produces TH1 cells
Day - body produces TH2 cells

• With the stress response, one loses sleep therefore producing less TH1 cells and comprising one's immune system
• Low TH1 cells mean that abnormal body cells are not recognised and you are more susceptible to cancer
• TH2 cells link to inflamory responses so with a lack of cells, one will suffer from spots, IBS, constipation and infection cannot be fought as well

Segerstrom and Miller

• Meta analysis of 293 studies over 30 years
• In the short-term your immune system can be benefited
• Long-term chronic stress leads to the suppression of the immune system, the most chronic stressors associated with the global supression

Cohen and the cold

• 392 healthy participants
• Gave participants nasal drops with 5 common cold ciruses
• After two weeks 1/3 had a cold
• Those who had contracted a cold scored highest on the physicological stress scoring system
• Direct correlation between high stress levels and susceptability to a cold
• Lab setting - high control
• Took individual differences into account (weight, smoking etc)
• Unethical giving someone a cold

Kiecolt and Glaser

• Used 75 medical students (notoriously the most hard worked students)
• Took blood samples from them a month before/during their final exams
• White blood cells were considerably lower in the sample from during their exams

Carer study

• Carers (average 8 years care of Alzheimer's patients) scored much higher than controls on a stress questionnaire
• A small wound was created on the forearm
• The average time taken for the wound to heal was 48 days - the control group was 39 days
• Caregivers were on medication and there was a small sample size
• Unethical? Though the carers would know how to keep said wound clean

Type A

• Impatient
• Competitive
• Hostile cynicism
• Frustration
• Aggression
• Cortisol build up from being more stressed than Type B

Type B

• Patient
• Cooperative
• Easygoing
• Laidback

N.B: Type C is Type A repressed (more likely to get cancer from lack of TH1 cells as explained earlier) and Type D is Distressed.

A Type A personality is dangerous and can lead to:

• Hypertension
• Coronary Heart Disease (narrowing of the Coronary Arteries from high blood pressure from extra Cortisol)
• Stroke (again, disruption of blood flow to the brain from narrowing blood vessels from Cortisol)
• Stress from a Type A personality also leads to increased glucose levels leading to clumps blocking the artery
• Stressed individuals are also more likely to engage in unhealthy behaviours e.g. smoking, drinking, drug taking and binging.

Williams

• 13,000 healthy people completed a 10 question anger scale
• Six years later 256 had experienced heart attacks
• Those who had scored highest on the anger scale were over 2.5 x more likely to have a heart attack

Friedman and Roseman:

• 3524 Calfornian men aged 39 - 59 (all free from CHD)
• After 8.5 years, 7% had some signs of CHD and 2/3 of those men were Type A and no overly-strong correlation - only 7%

Men and heart attacks

• 500 men with 13.2% annually at risk of a heart attack
• Given sounselling designed to reduce Type A behaviour (and hostility)
• Reduced to 7.2% annually at risk of further heart attacks

Holmes and Raye created the Social Readjustment Rating Scale giving each Life Event a "mean value" of Life Change Unit (LCU) showing how stressing it will be on the person experiencing it e.g. Death of a spouse has a LCU of 100.

Kannet et al also created a similar scale of "The Hassles of Middle-aged Adults." It was a simple rating of concerns of adults on a scale of 1 - 10, with the most distressing thought for an adult being number 1 (Concerns about weight.)

Rahe did a quesstionnaire of life events experience over the previous six months with the illness score calculated on the 7 month tour of duty of Navy soliders and found that a LCU of 118 was given. There was no strong correlation but the number was significant.

Johansson et al

• Researcher identified a high-risk group of 14 finishers in a Swedish sawmill
• The job was machine-paced, isolated, very repetitive yet highly skilly
• They were compared with a low-risk group of 10 cleaners whose work was more varied
• The high-risk group secreted more stress hromones on work days than on rest days and higher levels than the control group

Marmot et al

• Job strain model - 7372 civil servants (from London)
• High workload creating greater job demands
• Low job control over deadlines and procedures
• Higher grade employees would experience a high world load whereas lower grade exployees would experience low job control
• No link between high workload and stress-related illness in the higher grades

(If you are too stressed then you cannot solve anything at all)

Problem focussed coping:
N.B: If the problem cannot be solved then this is a limitation

• Thoughts or action acting directly on a stressful situation
• Seeking information
• Emotional regulation
• Direct action
• Planning
• Decision making

Emotional focused:
N.B: Doesn't solve problem direction but a change of emotion may help solve problem.

• Talking to a friend
• Support seeking
• Distraction
• Doesn't tackle the problem itself

Kobasa

• The Hardy Personality - to see situations as challenges
• Control - in stresssful situations you need control
• Commitment - problem focused
• See stress as a challenge - eustress
• Social support - women (though a social network can also cause stress)
• Exercise - gender approach

The Transactional Model of Stress - Cox/EEA - Environmental enolutionary approach

Primary appraisal: Is it a threat? Is it a challenge?
If it is a challenge/threat then move on to the secondary appraisal.
Secondary appraisal: Can I cope? Do I have the resources?
If you do not have the resources then you will feel negative stress
If you do then it becomes eustress (positive stress)

Klag and Bradley

• Assessed hardiness, neuroticism, stress, symptoms of illness and approach/aviodance coping
• Male and female staff at an Austrailian University
• Commitment and control correlate negatively with stress and illness
• Neuroticism was the most significant thing
• Neuroticiam may be the cause as commitment, challenge and control were non-significant if neuroticism was controlled
• Adverse effects of stress on health are significantly less on hardy men and it acts as a buffer
• Benefits of hardiness are not linked to emotion/problem focussed coping

 Beta blockers:

• Contain Beta Adrenergic blocking drugs
• Fills the adrenaline receptor so it cannot affect the heart during the stress response
• Good for people with heart disease
• Can up the effects of obesity
• Can cause sleep disturbance and muscle fatigue

Buspirone

• Treats Generalised Anxiety Disoder
• Shows no signs of addiction or dependancy
• Different from Benzodiazipines
• Acts against seritonin
• Headaches
• Better tolerated

Barbituates

• "Sleeping tablets"
• Easily addictive
• Serious side effects - cognitive impairment
• Tolerance can be built up
• Depresses CNS (physical effects)

Benzodiazipines

• Minor tranquilisers
• Increase the action of the neurotrnasmitter
• Mimcs the body's stress relievers
• Effective with the greater majority of people
• Rapid onset of action and can reduce stress quickly and are generally well tolerated for a short period of time

SSRI - Selective Seritonon Reuptake Inhibitor

• Used effectively to treat depression - effective in the exhaustion phase
• Most common
• Leaves seritonin in the synaptic gaps
• 80% effective against depression

SIT - Stress Inoculation therapy

• Adv:
  Conceptualisation
  Review of past situations, realistic understanding of demands
  Sources stress and works on coping strategies
  Real life application
• Disadv:
  Requires time and commitment
  Changing behaviour will always be difficult
  Stress and anxiety levels (through personality) are difficult to change