UNIT IV
CHAPTER 13
Lecture 21: Tuesday, November 17, 2009
Text Assignment: Chapter 13 pp. 587-625
Stress: Sources, Diseases, Health, and Coping
1. Stress: the psychological and bodily response to a stimulus that alters your equilibrium
2. Stressor: the stimulus that throws the body’s equilibrium out of balance
3. Stress Response: the body’s response to the stressor
4. Acute Stressor: a short term stressor
5. Chronic Stressor: a long term stressor
II. Hans Selye’s General Adaptation Syndrome
1. Hans Selye was an endocrinologist (he held both the M.D. and Ph.D degrees) internationally known for his theory of stress. He was born in Vienna in 1907. Selye was a professor and director of the Institute of Experimental Medicine and Surgery at the University of Montreal. He spent 50 years studying the causes and consequences of stress. He died in Montreal in 1982 when in his mid seventies.
2. Dr. Selye virtually coined the word stress 50 years ago. Selye was fluent in 8 languages, including English, and could converse in another half dozen. He had used the word “stress” in a letter to the Editor of Nature in1936 who suggested that the word stress be deleted because it implied “nervous strain”. “Stress” had been used for centuries in physics to explain elasticity. Hooke’s Law of 1658 was that the magnitude of an external force, or stress, produces a proportional amount of deformation, or strain, in a malleable metal. According to Paul Rosch, Selye complained that had his English been more precise, he would have gone down in history as the father of the “strain” concept rather than “stress”. One critic of Selye noted that “Stress, in addition to being itself, was also the cause of itself, and the result of itself”. This is why Selye used the term “stressor” in order to distinguish between the stimulus and the response.
III. General Adaptation Syndrome (GAS) Theory (Three Stages)
1. Stage 1: Alarm Phase. The body mobilizes itself to fight or to flee from a threatening stimulus, which can be either a physical or psychological threat. During the alarm phase the Sympathetic Division of the Autonomic Nervous system is activated. The hypothalamus also secrets a substance that causes the release of Glucocorticoids. Cortisol (a glutocorticoid) increases the production of energy from glucose as well as having an anti-inflammatory effect.
2. Stage 2: Resistance Stage. The body mobilizes its resources to achieve homeostasis in the presence of a stressor. The Resistance Stage is also known as the adaptation phase in which the body adapts to the stressor. Both the Alarm Stage and the Resistance Stage require considerable energy. In women, menstruation may stop or become irregular in response to chronic stress and in men, testosterone levels may decrease and the sperm count may go down.
3. Stage 3: Exhaustion. Continued efforts to achieve homeostasis lead to exhaustion. If the body is not returned to equilibrium during the resistance stage and the stressors continue, then exhaustion sets in. If the stressors continue during the stage of exhaustion, the body has used up most of its energy during the first two stages and the result of the inability to continue coping is damage to various systems of the body and the development of stress related diseases.
IV. Sources of Stress
1. Cognitive Appraisal: occurs in two phases
(1) Primary Appraisal: the stimulus is assessed for the likelihood of danger (Am I in danger?)
(2) Secondary Appraisal: determining what resources are available to deal with the stressor (What can I do about it?)
2. Coping: occurs after Secondary Appraisal and involves taking some course of
action regarding the stressor
V. The Perception of Control and Stress
1. Research has show that actual control is not important. What is important is whether you perceive a sense of control
2. Perceived lack of control can lead to Learned Helplessness
3. Some people in some situations experience more stress when they perceive themselves as having more control – for example, being a leader in a very difficult situation
4. Perceiving lack of control does no always produce stress (que sera, sera)
5. The importance of predictability: the less predictable, the less control and an increased likelihood of stress
VI. Internal Conflict: the emotional predicament people experience when they make difficult choices
1. Approach-Approach Conflict: results when competing alternatives are equally positive. For example, you can only accept one invitation but you have received two from persons you like. Or, you are in a restaurant and like two entrees on the menu
2. Avoidance-Avoidance Conflict: results when competing alternatives are equally unpleasant. For example, you don’t want to take a test for which you are unprepared, but you don’t want to just cut the class. Or, you don’t want to be unemployed but you don’t want to accept a low paying job with bad working conditions in a meat packing industry
3. Approach-Avoidance Conflict: occurs when a course of action has both positive and negative aspects. For example, you want to have several drinks at a party, but you don’t want to have to drive home. Any of our habits that are health risks can potentially involve approach-avoidance conflicts – smoking, eating tasty but unhealthy foods, drinking, etc.
VII. Holmes and Rahe Conception of Life Experiences and Stress
1. Homes and Rahe in the late sixties proposed that life experiences such as divorce, job loss, or death of a loved one, were additive and, in the extreme could result in serious illness or death
2. Subsequent research indicates that the findings of Holmes and Rahe were not reliable because stressors were defined in terms of the actual events rather than a person’s perception of events – e.g. a divorce may be very stressful to one person but minimally affect another.
3. Daily hassles can be stressful depending on the perception of seemingly small events such as misplacing one’s car keys or not being able to finish a series of planned activities for the day
VIII. Hostility
1. Hostility: a trait characterized by mistrust, an expectation of harm and provocation by others, and a cynical attitude.
2. Some research indicates that medical students who score in the top 20% on a hostility scale were four times more likely to develop heart disease 25 years later than low hostility colleagues. There were also seven times more likely to die from any cause by age fifty than low in hostility colleagues
3. Men are generally more hostile than women
4. Men’s blood pressure is more affected by their hostility than women with the same level of hostility
5. Cognitive and Behavioral treatment programs have been shown to be effective in reducing both hostility levels and reducing anger related autonomic arousal
6. Examples of rational approaches to re-interpreting events to control anger and hostility
IX. Stress and the Immune System
1. The immune system functions to defend the body against infection. Two classes of white cells are involve:
(1) B cells: which mature in the bone marrow and
(2) T cells: which mature in the Thymus
(3) One type of T cells is the Natural Killer (NK) which detect6s and destroys damaged or alter cells such as precancerous cells before they become a tumor
2. Glucocorticoids are released when the sympathetic division of the ANS is triggered by stress. They hinder the formation of some white cells, including the NK cells
3. Psychoneuroimmunology: the study of the way mental and emotional states affect the immune system
4. Some research suggests that elderly Chinese are more likely to die after the Chinese New Year whereas orthodox Jews are more likely to die around the High Holy Days. This suggests that persons may fight off illnesses until an important religious event occurs. Similarly, anecdotal stories often claim that persons “hold on” until they see their loved ones.
5. Other studies of the immune system and Alzheimer caretakers indicate s that wounds of the caretakers take longer to heal than wounds in a control group with similar backgrounds
6. Persons in neighborhoods who perceived their losses as most severe after Hurricane Andrew in 1992 showed the most changes in NK cells
X. Stress and Cancer
1. Stress does not appear to cause cancer but does affect the growth of cancerous tumors
2. Feelings of distress and the perceived lack of social support may lower Nk cell activity that normally would inhibit the growth of cancerous cells
3. Patients who perceive themselves as having little control tend to have higher reoccurrence of cancer and earlier deaths
XI. Heart Disease and Stress
1. People who have existing heart diseases tend to victims of sudden death resulting from intense emotional states (positive or negative) because excessive demands on the heart caused by increased activity of the sympathetic division of the ANS may trigger tachycardia or other irregular heart rates which are potentially dangerous or lethal
2. Depression appears to be a stressor that increases the likelihood of heart disease. Persons who have had heart attacks and depression, according to some research are at increased risk for health problems in the future
XII. Coping: an inclusive term for the multitude of techniques that people employ to handle
stress or their reactions to it.
1. Problem-focused Coping Strategies: strategies which alter either the environment or the way in which the person and environment interact. Typically, with this strategy, people believe that their actions can affect the stressor
(1) Active coping – actively seeks to remove or work around the stressor
(2) Planning – plans how to manage the stressor
(3) Instrumental social support – seeks advice and assistance
(4) Suppression of competing activities – puts other activities on hold
(5) Restraint coping- waits to act at the appropriate time
2, Emotion focused Coping Strategies: strategies that change a person’s emotional response to the stressor. This type of coping usually decreases arousal. People who use this type are likely to assume that their actions will have little effect on the stressor so they must alter their perceptions of the stressor or their response to it.
(1) Emotional social support – seeks sympathy and understanding
(2) Venting emotions – talks about distressed feelings
(3) Positive reinterpretation/growth – reinterprets stressor in a positive way
(4) Behavioral disengagement – as in learned helplessness
(5) Mental disengagement – turns to other activities to use as distracters
XIII. Research findings on Emotion-focused Strategies
1. Venting: students who were asked to write about upsetting experiences for 20 minutes a day for four days expressed more negative moods immediately after writing but were more positive by the end of the school year and had fewer visits to the health center in the months following
2. The interpretation of research n venting is that focusing on and working through feelings about upsetting or traumatic experiences has positive effects in the long run
XIV. Thought Suppression: purposefully trying not to think about something emotionally
arousing or distressing
1. Thought Suppression is a fairly common coping strategy that appears to have more negative consequences than positive ones
2. You have no doubt heard advice like “just don’t think about it”, “just put it out of your mind”, “think about something else”, or even “quit being so negative and think positive.”
3. Research tends to suggest that people who actively try to suppress thinking about emotionally arousing or distressing events, tend to have the suppressed thoughts pop into consciousness more often (rebound effect). Generally, thought suppression tends to magnify the intensity of the thoughts and the emotional reactions to the thoughts
XV. Aggression as a Coping Mechanism
1. Aggression: behavior that is intended to harm another person who does not wish to be harmed
2. Research findings indicate that couples who were more verbally and physically aggressive toward each other were more likely to report a higher number of stressful events than couples who were not abusive
3. Environmental factors such as noise and heat can spark aggression toward innocent bystanders
4. Hostile Attribution Bias: some people are more likely to make a negative appraisal of an ambiguous or neutral stimulus and misread the intention of others – this bias could lead to aggressive behavior
5. Some persons – for whatever reason (environmental, biological, or genetic) appear to be predisposed to respond by aggression to certain stimuli
XVI. Gender Differences in Aggression
1. Both as children and adults, males are more physically aggressive than females
2. Females are less likely to be aggressive if they think the aggression will physically harm another person, backfire on them, or cause them guilt or shame
3. Males are more likely than females to become aggressive if their intellectual ability is criticized
4. In terms of nonphysical aggression, males and females differ little. Females are as likely as males to use social exclusion, gossiping, and withdrawal of acceptance as nonphysical forms of aggression These forms of aggression may also be referred to as relational aggression
XVII. Self-Esteem, Narcissism, and Aggression
1. Contrary to conventional thinking, males with high self-esteem are more likely to be aggressive than males with low self-esteem
2. Men score higher than women on scales of self-esteem and narcissism
3. Narcissistic males are more likely to view criticism or insults as a threat to their high self-esteem
4. Males who feel insulted because they were passed over for promotion or merit increases may, as a result of a threat to their high self-esteem and narcissism, become violent
XII. Coping and Social Support
1. Social Support: social support is positively correlated with life expectancy
2. Lack of social support is associated with a higher probability of heart disease, cancer, and other illnesses
3. Perceived Support (not Enacted Support which involves actual support) provides the buffer against stress
XIII. Interventions for Coping with Stress
1. Stress management interventions that change the cognitive appraisal of stimuli enhance immune functioning in those experiencing stressors
2. Placebos with no medicinal value can affect the immune system – simply believing that an inert substance is effective
XIV. Gender Differences in Stress and Coping
1. There is some evidence that women in Western cultures experience more stress than men
2. A survey of 2,500 Swedes found that women, especially younger women, reported feeling more hassled, depressed, anxious, and hostile
3. There may be biological differences in the response to stress. For example, men produce more cortisol when hassled than women
XV. Voodoo Death
1. The Placebo Effect: placebo in Latin means “I will please”
2. The Nocebo Effect: nocebo in Latin means “I will harm”
3. Expectations of sickness can cause sickness (the Nocebo Effect)
4. The Nocebo Effect may play a role in asthmatic responses and allergies (almost half of a group of research participants who were told that they were inhaling an irritant or allergen (which was a harmless saline solution) experienced an asthmatic reaction