Stress

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What is the immediate response to short-term stressors?
Fight or flight response/ Sympathomedullary pathway
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What is the first stage of the Sympathomedullary pathway?
Sympathetic nervous system is a branch of autonomic nervous system & is alerted as soon as stressor is perceived
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What is the second stage of the Sympathomedullary pathway?
At adrenal medulla a signal is sent via central nervous system to 2 endocrine glands located above the kidneys. Middle part responds by releasing adrenaline/noradrenaline into bloodstream
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What is the third stage of the Sympathomedullary pathway?
Adrenaline/noradrenaline circulate through body & affect target organs such as heart/muscles, causing heart to beat faster & blood pressure to rise
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What is the fourth stage of the Sympathomedullary pathway?
When threat has passed, parasympathetic branch of autonomic nervous sytem dampens down stress response returning body to normal resting state
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What is the response to long-term stressors called?
Hypothalamic pituitary-adrenal system
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What is the first stage to the hypothalamic pituitary-adrenal system ?
Hypothalamus releases corticotrophin-releasing hormone into bloodstream
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What is the second stage to the hypothalamic pituitary-adrenal system ?
Corticotrophin-releasing hormone causes pituitary gland to produce & release adrenocorticotrophic hormone into bloodstream
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What is the third stage to the hypothalamic pituitary-adrenal system ?
Adrenocorticotrophic hormone stimulates the adrenal cortex to release various stress-related hormones, including cortisol.
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Name a positive & negative effect of cortisol
Positive effects such as low sensitivity to pain whereas other are negative such as impaired cognitive performance and a lowered immune response
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What effects do high levels of adrenaline have in immediate stress response?
Increased heart rate causing heart to work harder which takes a toll over time, constriction of blood vessels increases blood pressure, which puts tension on blood vessels causing them to wear away
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What else can increased pressure do?
Dislodge plaques on the walls of blood vessels & can lead to blocked arteries which may cause a heart attack or stroke
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Why did Williams et al conduct a study on cardiovascular disorders?
To see whether anger was linked to heart disease
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Outline Williams et al's study
Around 13,000 people completed a 1-question anger scale, including questions of whether they were hot-headed, if they felt like hitting someone when they got angry or whether they got annoyed when not given recognition for doing good work.
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What did none of the ppts suffer from at the outset of the study?
Heart disease
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What did the researchers find 6 years later?
The health of ppts was checked & 256 had experienced heart attacks & those who scored highest on anger scale were 2.5x more likely to have had a heart attack than lowest anger ratings
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Who completed a study on ongoing stress?
Kiecolt-Glaser
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Outline one of her studies
In one study with colleagues, she conducted a natural experience investigating whether the stress of important examinations had an effect on immune system functioning with 75 medical students
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What happened in the study?
Blood samples were taken one month before their exams (low stress) and during the exam period itself (high ongoing stress). Immune system functioning was assessed by measuring natural killer cell activity in the blood samples.
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Wha did ppts also complete?
A questionnaire to measure other life stressors they were experiencing & a loneliness scale that assessed how many interpersonal contacts they had
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What did Kiecolt-Glaser and her colleagues find?
That natural killer cell activity was significantly reduced in second blood sample compared to one month before.
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What does this suggest?
That ongoing stressors reduce immune system functioning
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How is this further supported?
By the fact that those students whose life stressors were generally high had lowest natural killer cell activity
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What are life changes?
Events that necessitate a major transition in some aspects of our life. They may form from either positive or negative events - both have one thing in common they involve change
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What did Holmes & Rahe suggest?
That psychic energy affects health
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What did Holmes & Rahe recognise?
That there needed to be a standard measuring tool for conducting research on the effect of life changes on health
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What did they develop?
The Social Readjustment Rating Scale consisting of 43 life events
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How does this work?
If individual identifies which items occurred within a set period of time e.g. 3 months, 6 months, a year etc. Each even has a score in terms of life change units & score can be calculated for each individual
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What did Rahe et al use to investigate the relationship between stress & illness?
Slightly adapted version of SRRS called Schedule of Recent Experiences
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What did the study focus on?
On a normal population - sample consistent of 2664 men who were navel & marine personnel serving abroad 3 US navy ships
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What were the men asked to fill out?
Th SRE for events experienced in the previous two years which was adapted to be specifically relevant to military experience
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What did this produce?
A total life change unit score & during the 6-8 month tour of duty, a record was kept of any time one of the men visited the sick bay as well as type/severity of illness
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What did Rahe et al find?
A significant positive correlation between life unit scores & illness scores of +.118. As men who scored low in terms of SRE scores also had low levels of illness while at sea
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What is it overall?
The amount of psychic energy required to deal with a life event that creates the stress
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What are daily hassles?
Are relatively minor events that arise in the course of a normal day. They may involve the everyday concerns of work, such as a disagreement with a colleague or issue arising from family life
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What can the negative effects of daily hassles be turned by?
Offset to some degree by the more positive experiences that we have everyday
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What are daily uplifts?
Such as smile from someone in the street are thought to counteract the damaging effects of stress
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What is one explanation for this?
An accumulation of minor daily stressors creates persistent irritations, frustrations & overloads which then result in more serious stress reactions such as anxiety/depression
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What is a second explanation?
Amplification - chronic stress due to major life changes may make people more vulnerable to daily hassles e.g. a husband trying to come to terms with a recent divorce may find relatively minor squabbling of his children as a major irritation
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What did Kanner et al test?
The view that daily hassles might be a better predictor of illness than the life changes approach
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What did the study involve?
100 ppts aged 45-67.
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What did each ppt complete?
The Hassles & Uplifts Scale for events over previous month & continued to do this once a month for 9 months. Also a life events scale for 6 months preceding the beginning of study, 2 years before & at end of study
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What were the 2 measures used to assess psychological well-being?
The Hopkins Symptom Checklist & Bradburn Morale Scale which were filled out every month
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What did Kanner et al find?
A significant negative correlation between frequency of hassles & psychological well-being - ppts with fewest hassles showed highest levels of well-being
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What else was found?
That hassles were a better predictor of well-being than life events and hassles were a better predictor of well-being uplifts
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Who completed on the job-strain model - The Whitehall study?
Marmot et al
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What did Marmot et al do?
Followed over 10,000 Uk civil servants who worked in Whitehall, London since 1985
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What was the difference between ppts?
Some who work in higher grades have high levels of workload & control whereas those at lower grades have less workload & control so both are likely to experience stress just at different levels
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What happened at the beginning of the study?
Ppts completed a range of questionnaires assessing their job workload, subjective sense of job control & social support they had
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What happened 11 years later?
Coronary heart disease risk was assessed as a measure of the effects of stress
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What did the researchers find?
That highest-grade workers tended to have highest workload & also highest sense of job control. High workload was not associated with coronary heart disease whereas low job control was
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Who completed on the job-strain model - The Swedish sawmill study?
Johansson et al
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What did Johansson et al do?
Studied 28 manual labourers in a sawmill
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Who were the high-risk group?
14 sawyers, edgers & graders
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Who were they compared to?
A low-risk group of repair men & maintenance workers who they were matched to in factors such as education & job experience
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What did the researchers measure?
Levels of adrenaline daily & obtained self-reports of job satisfaction & illness
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What was found among the high-risk group?
Found to have higher illness rates & higher levels of adrenaline in their urine than low-risk groups
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What did the self-report data confirm?
That the sawyers, edgers & graders had a greater workload & lowered sense of control. Also reported more sense of social isolation
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Why did Holmes & Rahe develop the SRRS?
In order to test their hypothesis about the relationship between life changes & physical illness
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How did they do this?
Analysed 5,000 patient records & identified 43 common life events reported by patients as issues in their lives
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How did they establish the stressfulness of each event?
They enlisted the help of 400 ppts. Who were asked to score each event in terms of how much readjustment they felt would be required by average person in terms of a numerical figure
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What happened to the scores of each ppt?
They were totalled & averaged to produce a life change unit for each event.
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How is the scale completed?
By selecting the life events that have occurred within a particular time period & then the life change units for those events are added up
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Why was Hassles & Uplifts scale produced?
To test Kanner et als hypothesis
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What did Kanner et al do?
Asked research staff to generate a list of hassles & uplifts related to work, health, family, friends, environment, practice considerations & chance occurrences creating a list of 117 hassles & 135 hassles
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What happened initially?
Ppts were asked to rate each hassle on a 3-point scale in terms of severity & persistence
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What did Kanner et al find?
That the two scaled elicited very similar responses and so now only severity is used & uplift items were rated for this & frequency on a 3-point scale but again very similar response so now just frequency
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What did scientists in the 19th century discover in related to skin?
That skin is electrically active & this electrical activity is conducted when skin is wet - Skin conductance response
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How is skin conductance response measured?
Two electrodes are placed on persons index & middle finger. Small voltage is applied across these electrodes
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What did Kamarck et al look at?
The effect of social support on stress by measuring a persons blood pressure & heart rate before doing a set of mental tasks and again afterwards
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What did Kamarck et al find?
That those ppts who had a close same-sex friend touching their wrist throughout the task were less stressed
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What did doctors Friedman & Rosenman find when asking people about what they thought major causes of coronary heart disease are?
Exposure to chronic emotional trauma as a consequence of excessive drive & competitiveness, having to meet deadlines & economic frustration
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What are the three major characteristics that possess a type A individual?
Competitiveness & achievement striving, Patience & time urgency AND Hostility
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What were these characteristics linked to?
Raised blood pressure & raised levels of stress hormones both linked to ill health such as coronary heart disease
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Outline Type B personality
Person lacking Type A characteristics - Patient, Relaxed & easy-going
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What were these characteristics linked to?
Decrease an individuals risk of stress-related illness
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Outline those involved in Freidman & Rosenmans study
Beginning of longitudinal study, 3,000 men 39-59, living in California were examined for signs of CHD & personalities were assessed by interview
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What did the interview consist of?
25 questions about how they respond to everyday pressures e.g. respondents were asked how they would cope with having to wait in a long queue, was conducted in a provocative manner to cause TA behaviour
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What was found after 8.5 years?
257 of original ppts had developed CHD. Over 12& of TA ppts had experienced a heart attack, compared to 6% of TB
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Outline TA ppt findings
Twice as many TA ppts had died of cardiovascular problems, more likely to smoke & have family history of CHD
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Outline Type C personality
Strongly suppress their emotions, especially negative ones, are unassertive, liable people who rarely get into arguments & generally helpful to others
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How do they cope with stress?
In a way that ignores their own needs, even physical ones in order to pleasure others & this has negative physiological consequences
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Outline those involved in Morris et als study
Over two year period women attending a cancer clinic in London were asked to participate in a study in total 75 women were involved
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When interviewed what kind of things were they asked?
How often they expressed affection, unhappiness by crying or losing control when angry in order to assess typical patterns of emotional behaviour
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What was the interviewer not aware of?
The initial diagnosis of cancer
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What did Morris et al find?
Those women whose breast lumps were found to be cancerous were also found to have reported that they experienced & expressed far less anger than those whose were non-cancerous
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What are benzodiazepines most commonly used for?
to treat anxiety and stress are BZs. They aim to slow down the activity of the central nervous system
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What is one way that they reduce anxiety?
Enhance action of the neurotransmitter GABA which is the body natural form of anxiety relief
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How many neurons in the brain respond to GABA?
40%
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How do the neurons in the brain respond to GABA?
Reacting with GABA receptors on the outside of postsynaptic neurons.
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What happens when GABA locks into these receptors?
Opens a channel that increases the flow of chloride ions into postsynaptic neuron
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What do chloride ions make it harder to do?
For postsynaptic neuron to be stimulated by other neurotransmitters therefore slowing down overall activity & making person feel more relaxed/ less anxious
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What are beta blockers?
Block sites which normally are activated by the hormones adrenaline and noradrenaline which are produced as a result of the sympathomedullary response to immediate stressors
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What does stress lead to?
The arousal of sympathetic nervous system which triggers the production of adrenaline/noradrenaline from adrenal medulla
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What do adrenaline/ noradrenaline have an immediate effect on?
The target organs especially the heart muscle, leading to raised blood pressure/ increased heart rate
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What do beta blockers bind to?
Beta-receptors in cells of heart & other parts of body that are usually stimulated during sympathetic arousal so prevent adrenaline/noradrenaline having such a strong effect
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What happens as a result of beta blockers
Heart rate, Blood pressure, Breathing rate & sweating do not increase and person feels calmer & less anxious
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What is stress inoculation therapy?
A type of CBT which trains people to cope with anxiety and stressful situations more effectively by learning skills to inoculate themselves against the damaging effects of future stressors
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Why is SIT different from other stress treatments?
Meichenbaim suggested than an individual should develop a form of coping before the problem arises
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What did Meichenbaim suggest?
That a person could inoculate themselves against the disease of stress in the same way as infectious illnesses
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What did Meichenbaim believe?
That although a person cannot change the causes of stress in their life, they can change the way that they think about these stressors.
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What may negative thinking lead to?
Negative outcomes such as anxiety & depression
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What may positive thinking lead to?
More positive attitudes and feelings which reduce the stress response and help us to cope better in the future
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What is the conceptualisation phase?
A collaborative process between therapist and client. The therapist investigates the client’s sources of stress through interviews with the client and significant others. It is important that the client is allowed to ‘tell their story
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What should the client be helped to see during this phase?
What current strategies are maladaptive and identify the things that can be changed
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What is the client taught at this stage?
To view perceived threats as problems to be solves and to break down global stressors into specific components
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What is the skills acquisition, rehearsal & consolidation stage?
Coping skills are taught and practised primarily in the clinic and then gradually rehearsed in real life. The therapist selects skills that match the client’s preferred mode of coping and that are tailored to the individual’s own specific problems
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What do such skills include?
Positive thinking, relaxation, social skills etc
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Outline cognitive & behavioural skills
Cognitive (as they encourage the client to think in a different way) and behavioural (as they involve learning new, more adaptive behaviours)
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What sis the application & follow-through stage?
Clients given opportunities to apply newly learned coping skills in different situations, which become increasingly stressful. It is particularly important for clients to be taught to anticipate situations where it may be difficult to apply skills
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What does biofeedback deal with?
Bodys physiological response to stress
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What is the body physiological response to stress?
The arousal of the sympathetic nervous system which can lead to increased heart rate and blood pressure
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What is biofeedback?
Is a method by which an individual learns to exert voluntary control over involuntary behaviours by being made aware of what is happening in the ANS
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What is relaxation?
Have the effect of reducing the activity of the sympathetic nervous system and activating the parasympathetic nervous system. This means that adrenaline and noradrenaline are no longer produced, and the result should be reduced heart rate, blood pres
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What is feedback?
Client is attached to various machines which provide info about activity of ANS e.g. client can hear their heartbeat
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What are the kinds of machines use?
EMG which responds to changes in muscles; skin conductance response which measures sweat activity and EEG which measures electoral activity in the brain.
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What is operant conditioning?
When relaxation leads to a reduction in heart rate, this is experienced as rewarding as the person has achieved their goal and this reinforces the behaviour. This increases the likelihood of the same behaviour being repeated
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How does such behaviour take place?
Learning takes place without any conscious thought and the reward leads to an unconscious ‘stamping in’ of the behaviour
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What is transfer?
The client finally needs to learn to transfer the skills learned to the real world, using their relaxation techniques in response to stressful situations that they encounter 
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What was the biofeedback technique based on?
Study by Miler et al who used a curare to paralyse 24 rates, keeping them alive using artificial respiration
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Outline the rewards system
Half of the rats were rewarded whenever their heart rates slowed down and the other half were rewarded when their heart rates speeded up
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What was the reward?
a sense of pleasure
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What was the outcome?
The heart rates of the rats in the ‘fast’ group speeded up, and the heart rates of the rats in the ‘slow’ group slowed down.
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Who was the first person to proposed the notion of tend-and-befriend?
Taylor et al
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What did Taylor et al suggest?
That this would have evolved as a typical response in females to situations of threat
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What did she argue?
That there would be a greater adaptive advantage to produce a tend-and-befriend response due to differential parental investment so female stress response has evolved to maximise the survival of self & offspring
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How do both males and females experience the same physiological response to stress?
By producing adrenaline, noradrenaline, cortisol & oxytocin (promotes feelings of bonding)
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What happens in males?
Testosterone levels rise which has a dampening effect on oxytocin therefore males become more aggressive
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What did Lazarus & Folkman distinguish between?
Two coping styles for dealing with stress: problem focused and emotion-focused coping styles
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What did Matud in a study of 3,000 Spanish men & women aged between 18 &65 find?
That men listed relationship, finance & work-related events as most stressful whereas women listed family & health-related events. So women = emotion-focused/ Men = problem-focused
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Outline what is meant by sources of social support
People are supported by having a general safety net of relationships
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What did Nabi et al find when surveyed 400 undergraduate Facebook users?
That number of friends was associated with stronger perceptions of social support & lower levels of stress
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What did Nabi et al conclude?
The more friends, the better was the best predictor of reduced stress
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Outline instrumental support
Offers of tangible assistance such as providing money/driving you to doctor. Problem-solving kind of approach where focus is on doing something.
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Outline emotional support
Where another person is aware of the associated emotions that a stressed person is presenting & will address those needs. Might just mean listening to a friend or giving them advice about how to reduce the emotions. Less likely to be offered by stran
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Outline esteem support
Someone else makes you feel better about yourself & would reduce a sense of being stressed. Refers to way that you value yourself, so aims to improve your feelings of self-worth, giving you more confidence & greater self-efficacy about coping
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What does the buffering hypothesis suggest?
That social support is especially important at times of stress but not necessarily at other times.
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What happens at times of stress?
Friends protect an individual from negative effects of stress, help friends think about stress differently - seen as instrumental as its problem-focused
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Who was involved in Kamarck et als study?
Involved 39 female psychology student volunteers who recruited to perform a different mental task while physiological reactions were monitored
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What happened during mental task?
Friend was told to touch ppt on wrist to avoid ppt feeling evaluated by friend, the partner was given a task to complete at the same time
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For some of Type A ppts what did they show?
Reduced physiological responses which supports buffering hypothesis, which suggests buffering is only experienced by those who show high levels of response to stressful situations
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What is the first stage of the Sympathomedullary pathway?

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Sympathetic nervous system is a branch of autonomic nervous system & is alerted as soon as stressor is perceived

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What is the second stage of the Sympathomedullary pathway?

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Card 4

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What is the third stage of the Sympathomedullary pathway?

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Card 5

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What is the fourth stage of the Sympathomedullary pathway?

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