Transcript stressful situations

Stress and Health
McElhaney
November 2016
Organization
1.
2.
3.
4.
5.
How do we understand Stress? (definition
and causes)
How does stress affect us Physically and
Emotionally?
What are some behaviors associated with
stress?
How does personality relate to stress?
How can one cope to stress and maintain
health?
WE all feel stress at some time.
► Experience
being frequently overwhelmed
Relationships, deadlines, pressure,
volunteering, sports, music, theater, work,
college aps, grades, parents, AP CLASSES
Relate to stress
Big Picture: Stress Responses are
Physical/Psychological/Behavioral
► Stress
is basically a physical and emotional
response to challenges = stressors
► “Stress
occurs whenever a challenge or
threat forces a person to adjust or adapt.”
► “Stress
is a behavioral factor that directly
affects personal wellbeing.”
► Health is affected by stress.
Big Idea
► Stress
is a major risk factor for illness and
disease
► Stress
is caused by interaction between
people and the environment
► The body’s reaction to stress damages
internal organs and immune system
Some people say stress is other people.
Types of Stress
1.
Catastrophes
2.
Significant Life Changes
3.
Daily Hassles
Catastrophes
► Unpredictable
► Large Scale Events
► War/Earthquake
Creates
► Damages Physical or Emotional Health
► Trouble concentrating
► Trouble sleeping
► Suicide
► Responding to catastrophe by moving causes
more stress…
LIFE CHANGES AND STRESS:
S
TRESSFUL SITUATIONS:
► Separation
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Divorce
Unemployment
Lack of Social Support/Loneliness
Caregiving for a family member with an illness
Bereavement
(Lack of Control and Depression can amplify)
Marriage (totally stressful)
Leaving to college (depends on your view of this)
Death in the family or close friend
►
Big Problem- Cluster of Crisis (lots of things happen at once)
Daily Hassles
► Traffic
► Everyday
Aggravations (things add up)
► Frustrations
► Living with deprivation (economic)
Burnout
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Nursing, teaching, police, social work and Burnout
Burnout- being physically, mentally + emotionally drained
Emotional Exhaustion- fatigued tense +apathetic; feeling all used up
Miss work frequently
Cynicism- detached from job, “I don’t give a damn.”
Feeling of reduced personal accomplishment
Helpless, hopeless or angry, poor work performance
Indifference
 Disorganized
 Impulsive
 Accident prone
 Over sleeping
 Poor job performance
 Abuse of drugs and alcohol
 Irritability
 Suspicious
 Withdrawn
Depressed
Burnout is the opposite of –Job engagement (work seen as important and
meaningful, challenging)
► To Prevent Burnout
► Adjust workload
► Keep social support (support gives encouragement)
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PTSD
Post Traumatic Stress Disorder
A pattern of adverse reactions
following a traumatic event
Characteristics
► Anxiety
► Depression
► Irritability
► Jumpiness
► Inability to concentrate
► Sexual Dysfunction
► Difficulty getting along with
others
► Sleep disorders
► Nightmares
► Startle responses to noise or
sudden stimuli
► Vivid memories/re-experiencing
the trauma
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Long terms suppression of immune
system
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Common in Military
especially associated with
combat
Common with traumatic
experiences/assaults/abuse/
witnessing violence/bloody
scenes etc.
Some research indicates
some brain structures and
functioning are permanently
affected
How does the body react to
stress?
► Stress
response is part of a unified MindBody system
► Emotion arousing events trigger an
outpouring of the stress hormones
► Epinephrine and Norepinephrine form
adrenal glands
Sympathetic Nervous System
Stress Response System
► Stress
responses are
physiological arousal
► Cerebral cortex
► Hypothalamus
► Pituitary Gland
► Adrenal Gland
► Glucocorticoid stress
hormone = Cortisol
► Increase-
heart rate
and respiration
► Blood diverted to
skeletal muscles
► Sugars released
► Fat released
► for fight or flight
Review: Identify 5 topics we covered
yesterday and write one main ideas
about each one.
► Definition
of Stress
► Big Picture- Effects of Stress
► Types of Stressful Experiences
► Burnout- Causes, Characteristics
► PTSD- Causes, Characteristics,
► Stress Hormones
► Sympathetic Nervous System Stress
Response
Today
► Reinforce
Sympathetic Responses To Stress
► GAS: General Adaptation Syndrome
► Hans Seyle
► Diathesis Stress Model
► Stress Mediators
► Cognitive Appraisal-Lazarus
► Predictability and control
► Personality Types and Stress
Stress Physiological Response
► Short
Term
► Body needs the added
arousal
► It is useful to have the
hormones and energy
in challenging
situations
► Long
Term
► Body damage
► Emotional shocksintense, repeated,
pressure,
unpredictable,
uncontrollable=stress
is magnified
General Adaptation Syndrome
 Hans Selye (1950s)
 Alarm Reaction-Threat produces Emergency
Reaction, Body mobilizes for action, Body responds to
cope with stress
 Resistance – Body consolidates responsephysiological defense to minimize tissue damage,
 Neurotransmitters carry messages to organs, adrenal glands
release cortico-steroids= increase blood sugar for energy
while reducing inflammation and pain.
 Reducing blood flow to other body functions (reproduction,
digestion, growth) are gradually shut down…
 over time body becomes depleted…
Exhaustion:
 At this phase, the stress has continued for some time. Your
body’s ability to resist is lost because its adaptation energy
supply is gone. Often referred to as overload, burnout, adrenal
fatigue, maladaptation or dysfunction – Here is where stress
levels go up and stay up!
 Vulnerable to Illness
Diathesis Stress Model
► Argues
that some
people are predisposed to
psychological disorders
► Whether
or not
individuals actually
display them depends
on the frequency,
nature and intensity of
the stressors.”
► So
we may have
dysfunctional
tendencies that come
out when we are under
extreme or prolonged
stress.
Stress Mediators
► Lazarus► Are
factors that
increases or decreases
the effects of stress
► Perception of stress
► Is it a threat?
 Or is it a challenge to
overcome?
► Interpretation
is key
Appraisal
► Control
► Social
Support
► Personality
► Adaptive Coping
► Maladaptive Coping
► Freudian Defense
Mechanisms
Cognitive Appraisal
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►
Lazarus researcher on Stress
saidPhysiological responses to stress
can be reduced by Cognitive
appraisal/evaluation of stressors
 Example industrial accident
movie
 Emotional responses were
reduced due to TRAINING of
research participants
 People who engage in
Catastrophic thinking
experience more physiological
stress responses
 People who have more
optimistic outlook tend to be
healthier and have milder stress
responses
1.
Primary Appraisal – Q:
Am I ok or in trouble?
a. Decide if the situation is
relevant or irrelevant
positive or negative
2.
Secondary Appraisal- Q:
What can I do about this
situation?
a. Assess resources
b. Choose a way to meet
threat or challenge
c. Coping with
threats=coping
Appraisal of Stress
► Stress-
is dependent
on how we perceive
events and react to
them.
► Eustress is good
stress- example of
seeing stress as a set
of challenges to
overcome
► Example
of the
industrial movie:
► Intellectualizers
► Deniers
► Unprepared
► People
can reduce the
impact of stress if they
are trained in advance
of the stressful
situation.
PREDICTABILITY AND CONTROL
(PG. 530)
 Anticipating Stress = predictability=
expectancy= can reduce stress
 Perception of Control over stress = can reduce
the impact of the stress
►People
who perceive no control over negative events
appear especially prone to physical and psychological
problems associated with stress.
►Example- workers who perceive they have little or no
control over their work environment were more likely
to suffer from health effects of stress.
Review: Identify 5 topics we covered
yesterday and write one main idea about each
one
► GAS
► Hans Seyle
► Diathesis Stress
► Stress Mediators
► Lazaraus
► Cognitive Appraisal (role of perception)
► Eustress
Predictability (training)
► Control
Today 10/20/16
► Personality
and Stress (Type A +Type B)
► Dispositional Optimism
► Gender Responses to Stress
► Coping
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Adaptive Coping
Problem Focused Coping
Emotion Focused Coping
Social Support- “tend and befriend”
Exercise
Meditation
Cognitive Therapy
Relaxation Therapy
Personality Types
► Disease
Prone
► Chronic depression
 Low exercise
 Poor diet
 Problematic sleep
► Anxious
► Hostile
► Frequently
ill
► Health
Promoting
Behaviors
► Exercise
► Not excessive drinking
► No Tobacco
► Not over-eating
Personality Types Continued
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Type A personality (disease
Prone)
High risk of heart attack
Hard driving
Ambitious
Reactive
Highly competitive
Achievement oriented
Persistent
Time urgency
Anger
Verbally aggressive
Hostility
Very rigid in attitudes
Toxic negative emotions
These people are also prone to
heart diseases because of the
tensions, stress and worrying
attitude.
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Hardy Personality
People who can resist
stress
Sense of personal
commitment
 To self, to work, to family
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Sense of control over lives
and work
Tendency to see life as a
series of challenges
Personality Types
Related to Stress
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Type B Personality
► These people tend to be productive
under stress.
► Relaxed, patient and have a lot of
►
self control.
► One of the type B personality traits is
that these people do not get irritated
or angry easily.
► They are less competitive and their
competitiveness is often productive
with good intentions.
►
► They rarely tend to be aggressive or
frustrated.
► People belonging to type B
personality are also very much
tolerant and flexible who can change
in order to adapt to situations and
changes.
► These people do not get hyper if their
time is wasted and do not mind
waiting in queues or wait to get their
work done.
Relaxation, enjoyment, fun comes
very naturally to them. They spend
their free time socializing, shopping
or having a good time.
They are very calm as compared to
their highly stung counterparts (type
A). People of type A personality often
wish they were working rather than
spending their time in leisure and the
type B personality traits are just the
opposite.
People of B type personality tend to
plan things in advance before
executing them.
Personality Factors and Stress
Personality characteristics can reduce stress reactions
The impact of stress is mediated by cognitive style or how we think about
stressors.
►
Optimism – Dispositional
Optimism (type of personality)
AKA “disease-resistant”
 Stressors are Challenges to
Overcome
 Expectation that things will work
out positively
 Use problem focused coping
 Think stressors are temporary
 Not catastrophic thinking
 Do not blame themselves
 Have characteristics of sociability
and optimistic outlook
 They heal faster and live longer,
and fewer health consequences
► Pessimism-
prone”
“disease
 Ignore stressors
 Think of stressors are
catastrophic events
(catastrophizing)
 Use emotion focused
coping – avoidance
 Pessimistic thinking
Gender Responses to► Female Responses
► Help others
Stress
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Male Responses
Anger
Avoid stressors
Physiological responses
are more intense for men
Heart rate
Blood pressure higher
“Fight or Flight”
Hormone- Oxytocin
(interacts with sex
hormones)
Have more intense
emotional and behavioral
responses.
► Make
use of social
support
► “Tend and befriend”
► Hormone- Oxytocin
(interacts with sex
hormones)
 Reacts in women as a
stress reducer
 Web Site Oxytocin
► Women
may live longer
5 years average
Adaptive Coping
► Problem
Focused Coping
► Emotion Focused Coping
► Social Support- “tend and befriend”
► Exercise
► Meditation
► Cognitive Therapy
► Relaxation Therapy
Coping
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People try to control their
emotional reactions to the
situation
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Self-controlling
Cognitive Appraisal
Distancing
Expressing feelings
Accepting responsibility
Humor
Search for positive aspects
Religious beliefs to bring
meaning
Escape/Avoidance
Self-Medicating=
Maladaptive/Alcohol/Drugs
Seeking Social Support
Companionship
Problem-focused coping (control
is the issue)
Need to manage or alter
the distressing situation
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► Confronting
► Seeking
Social
Support
► Plan- problem
solving
Emotion-Focused Coping: (when
there is no control of the
situation)
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 The presence of other
people can help
mediate stress
► Can
reduce the effects of
stressors
► Has health benefits
 Better immune system
functioning
 Faster recovery from
illness or surgery
 Social Support Network
► Your
friends you can rely
on for support
► Support Groups allow
people to express pent
up thoughts and
emotions
 Social Support can be
both Problem Focused
or Emotion Focused
Social Support
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Quality of Social Support
Inadequate Social Support
can be a problem (isolation)
 Can double a person’s risk of dying
from disease suicide or other
causes
Not recognizing the value of
Social Support can be a
hindrance
► Wrong Kind of Support- The
support is too invasive“overprotective” (may hinder
people being self-active in
coping)
► Support can be annoying,
disruptive, and interfering
thus increasing stress
►
Maladaptive Coping to Stress
►
Behaviors that increase
risk of disease and death
can occur as stress coping
responses
Stress- responses
► Risky Behavior
► Sensation Seeking
► High blood pressure
► Cigarette smoking
► Drug and alcohol Abuse
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Obesity/Overeating
Unsafe sex, for attention
and comfort
Exposure to toxic
substances
Aggression/Violence
45% of all deaths are due
to unhealthy behavior =
tobacco, drinking, drug
use and lack of exercise
High School Risky Behavior
► Physical
Fight 42%
► Carried Weapon 22%
► Had one or more
drinks 30%
► Mary-Jane 33%
► Sex 53%
► Unsafe Sex 47%
► Cigarette Smokers
31%
► Eating
Fatty Foods
34%
► Sedentary Lifestyle
34%
Psychological Defense
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Psychological Defense
Psycho-dynamic-Freud identified
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Anxiety- comes with threatening situations
Tense, uneasy, apprehension, worried, vulnerable
Emotion-focused coping = defense mechanism helps us reduce
anxiety
Defense Mechanism (definition) (Psychodynamic)
Any mental process used to avoid, deny, or distort sources of
threat or anxiety
► Help us keep from being overwhelmed by immediate threats
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Freudian-Defense Mechanisms
Displaced Aggression 13. Compensation
Conflicts14. Sublimation
3. Approach-Approach,
15. Learned Helplessness
4. Avoidance-Avoidance, 16. Acting out
5. Approach-Avoidance
17. Affiliation
6. Multiple Conflicts
18. Passive
7. Defense mechanisms
19. aggression
8. Repression
20. Avoidance
9. Reaction Formation
21. Altruism
10. Regression
22. Humor
11. Projection
12. Rationalization
1.
2.
Frustration
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Extreme Situations + Responses
Frustration-negative emotional state occurs when people are
prevented from reaching desired goals (2 types)
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1 External Frustration- outside force or individual impedes progress
toward a goal (flat tire)
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Delays success
Can be social obstacles = people
Or
Non-social = objects
Frustration increases- as strength of blocked motive increasesfrustration increases
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2. Personal Frustration- based on personal characteristics or limitations
Reactions to Frustration:
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Aggression- any response with intent of harming a person or
object
 Most frequent response to frustration
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*Persistence as a response to frustration- varied vigorous efforts
to overcome frustration help
Displaced Aggression
 Focusing aggression toward some-other person or object- whoever
or whatever is available
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Redirection – usually to a safe, less likely to retaliate direction
*Chains of displacement
*Hostility and violence are largely due to displaced aggression
*Scapegoating- available sources blaming
Withdrawal or Escape, Avoidance
Conflicts
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Conflict- a person must choose between contradictory desires, needs
and motive demands
1. Approach-Approach Conflicts (weak conflict)
Two positive choices
Two desirable alternatives
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2. Avoidance-Avoidance Conflicts (difficult to resolve)
Choice between 2 negative undesirable alternatives
Based on personal needs or bias
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Approach-Avoidance Conflicts (difficult to resolve)
People are attracted to
+
same goal or activity
Repelled
fear + attraction—could result in ambivalence= mixed positive and negative feelings
Multiple Conflicts- neither complete positive or negative options
 AKA- double approach-avoidance- each alternative has positive + negative
qualities
PHYSIOLOGY AND PSYCHOLOGY OF
HEALTH AND ILLNESS (P537)
► The
Relationship between stress and illness
 “ways in which stress can directly or indirectly
lead to physical illness by affecting immune
system and cardiovascular system.”
► Example: Physiological Stress Response and
Louis Pasteur 3 chickens
 1 healthy no treatment
 1 healthy but infected with bacteria
 1 dead, infected but also stressed by cold
weather (Bacteria + Stress = Death)
Health Effects of Stress
► Extreme
and prolonged STRESS damages
health and inhibits our ability to resist
disease
► Psychoneruoimunology is the study:
 Neural Functioning
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psychosomatic Illness
Endocrine/hormones
Immune System
Cardio-vascular System- heart disease
Neural Effects of Stress
► Nerve
growth is slowed
► Degeneration of neural circuits
► Pre-mature aging
► DNA cells replication slowed
► Resembles old cells
Psychosomatic illness:
► Psychological
►
factors
contribute to actual body ►
damage
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► Not
hypochondrias
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Dyspepsia- stomach pain- not an
ulcer
Eczema
Hives
Migrane headache
Rheumatoid arthritis
Hypertension
Colitis
Heart disease
Head, neck ache
Back ache
Indigestion
Chronic diarrhea
Fatigue
Insomnia
Sexual dysfunction
Immune System:
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Is weakened by stress  then the vulnerability
to infectious disease increased
Function is to attack foreign and harmful
substances/viruses/bacteria
o Consists of White Blood Cells  Leukosites 
o B-Cellsformed in bone marrow produce
antibodies that attack foreign cells
o T-Cells mature in the Thymus kill other cells
o Natural Killer Cells kill other cells  anti-viralanti-tumor
o Macrophage digest foreign cells Phagocytosis
“Eating Cells”
Immune Functioning
► Stress
suppresses the
immune system
► Immune
system
isolates and destroys
bacteria and viruses
► Lymphocytes
► White
blood cells
►2
types of Lymphocytes
► B-Lymphocytes
 In bone marrow
 Produces antibodies
 Antibodies attack foreign
cells and toxins
 Attack bacterial infections
► T-Lymphocytes
 In Thymus
 Attack cancer cells
 Attacks viruses
Immune 2
► Macrophage
(big
eaters)
► Identifies
► Pursues
► Ingests harmful
invaders and worn out
cells
► In blood stream that
enter organs
► **
when immune
system is not working
properly – could allow
dormant disease to
erupt= Herpes+Cancer
Immune 3
► Key
Idea:
► Energy during stressful
times is directed to
brain and muscle vs.
►
The Brain influences
functions of immune
system through:
 Nerves affect the Thymus
 the secretion of hormones
(Cortisol)
 All are affected by the
release of
which suppresses immune
functions
 Thus people under stress
are more likely to develop
infectious disease
Cortisol
► Example
students
law school
Stress Hormones
Affect Lymphocytes
1.
Surgical wounds heal
more slowly in
stressful situations
2.
Stressed people are
more vulnerable to
colds.