Stress AQA

Stress AQA

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  Stress AQA Jasmine and Ben
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  Sympathomedullary pathway: HANSAM SNS •Arousesflight or flight, neurones from SNS travel to every organ and gland. Prepares the body for rapid action (increasing heart rate, blood pressure, pupil size, mobilisation of fat + glycogen in the blood stream.) •Noradrenaline is released by the SNS to activate the organs. SAM SYSTEM •At the same time as the SNS the SAM system alerts the animal through the use of adrenaline. Which is transported in the blood stream for rapid flight or fight. •SAM system regulates the SNS and the Adrenal Medulla. ADRENAL MEDULLA •The Adrenal Medulla has 2 distinct zones – Medulla (middle) and Cortex (the outside ring.) •Neurones from the SNS travel to the Adrenal Medulla which when activated releases adrenaline having widespread effects on the body. •It boosts O2 and Glucose supply to the brain and muscles and also supresses non-emergency bodily processes such as digestion. “REST AND DIGEST SYSTEM” • Relaxes the body. Once the stressor has passed the para- sympathetic branch slows heartbeat, reduces blood pressure and digestion begins again.
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  Pituitary-adrenal system: HPACP HYPOTHALAMUS •Perceptionof the stressor by higher brain centres. •The hypothalamus is the control system for most of the body’s hormonal processes. •Activation of the paraventricular nucleus (PVN) leads to production of cortico-releasing factor (CRF) which is released into the blood stream. PITUITARY GLAND •When the CRF reaches the pituitary gland it causes the release of adrenocorticotrophic hormone (ACTH). •ACTH is transported in the blood stream to target the adrenal glands which are located on top of the kidneys. ADRENAL CORTEX •ACTH triggers the release of cortisol by the cortex which is responsible for many stress effects: GOOD – lower sensitivity to pain, quick bursts of energy BAD – lowered immune response, impaired cognitive performance, higher blood pressure •(Prolonged release of ACTH causes the Adrenal Cortex to grow in size in order to cope with the increased cortisol production. •ACTH deficiency causes it to shrink.) ↓FEEDBACK↓ It takes 20 minutes for the process to be complete – cortisol level rise sharply after 20 minutes. The hypothalamus and the pituitary gland have special receptors which monitor cortisol levels, if they rise above normal they initiate the reduction of CRF and subsequently ACTH.
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  Stress-related illness: TheImmune System • Kiecolt-Glaser et al. (1984) – short term stressors – exam stress → Natural experiment investigating whether short term exam stress affects the immune system functioning in medical students → Blood samples taken one month before and during the exam period. Immune system assessed by NK cell activity in the blood samples. PPs also completed a questionnaire to measure other life stressors. → NK cell activity was significantly reduced in the second blood sample. This shows that short term stressors reduce immune system functioning, increasing susceptibility to illness → Also found that those student who also reported high levels of loneliness had the lowest NK cell activity. • Marucha et al. (1998) – wound healing → Inflicted a ‘punch biopsy’ in the mouth of students either during the summer holidays or three days before an exam → The wounds given before the exam took 40% longer to heal than the wounds during the holidays.
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  cont. • On-going stressors:Relationship stress • Kiecolt-Glaser (2005) → Tested impact of interpersonal conflict on wound healing. → Found that blister wounds on the arms of married couples healed more slowly after they had discussions which were conflicting rather than supportive • Kiecolt-Glaser et al. (1987) → Compared women separated from their partners with matched married controls. → Found poorer immune system functioning in women who separated during the last year. • Malarkey et al. (1994) → Studied 90 newly-wed couples over a 24-hour period in a laboratory. → They were asked to discuss and resolve marital issues likely to produce conflict (e.g. finances). → Marital conflict produced significant changes in adrenaline and noradrenaline, which could lead to poorer immune functioning. → The researchers believe that mental conflict would be more negative and last longer at home, therefore these adverse effects would be even greater. RESEARCH SUPPORT • Segerstrom and Miller 2004 • Meta-analysis of 239 studies • Past 30 years • Short term, acute stressors boost immune system, prompting it to ready itself for infections • Long-term, chronic stressors lead to immunosuppression • The longer the stress the more the immune system shifted from potentially adaptive changes to potentially detrimental changes
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  Cardiovascular Psychiatric Chronic stressmay cause • Hypertension • CHD • Stroke Williams et al – acute stress • Looked at anger + heart disease • 13,000 completed question based anger scale • No pps suffered from CHD at start – 6 years later 256 had experienced heart attacks • Higher on scale 2.5x likely to have a heart attack Russek 1962 – work stress – chronic • Heart disease in medical professionals • High stress (GPs) = 11.9% heart disease • Low stress (Dermatologists) = 3.2% heart disease Stress and depression Brown + Harris • Women w/ chronic stress conditions (such as 3 or more children under 14) • More likely to experience depression Melchoir et al • 1 year survey in New Zealand with 1000 people • 15% in high stress jobs suffered from first clinical depression episode the same year Stress and other disorders Rohlf + Bennet • 1/10 (10%) of workers who euthanized animals had PTSD symptoms Cardiovascular Psychiatric Sheps at al Effects on existing conditions • Volunteers with reduced blood flow to heart • 173 men + women • Psych tests such and public speaking • 50% had erratic palpitations in left ventricle • 44% died within 3 or 4 years Stress doesn’t cause symptoms but worsens or triggers them – Brown + Harris • Not just stress but also absence of close confiding relationship • Makes them more vulnerable to stressors which can subsequently result in depression
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  Life changes (LCU) •Holmes and Rahe – SRRS • SRRS contained 43 life events • 2,500-2,700 navy sailors • Questionnaire before duty based on the last 6 months • Positive correlation of + 0.118 between LCU score and illness score • Low LCU scores – low illness • Michael and Ben-Zur 2007 • 130 men and women • Half-divorced • Half-widowed • Level of life satisfaction • WIDOWED – high before, low after • DIVORCED – low before, high after Life changes and daily hassles: Lazarus 1990: Major life events relatively rare, minor daily stressors contribute more to stress DeLongis et al: • 75 married couples • Life events questionnaire (q) , daily hassles q and uplifts scale • No relationship between life events and illness • Significant positive correlation of +0.59 between hassles and next day health problems Individual differences: Life events will have different effects on different people
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  Research on DailyHassles • Bouteyre et al. (daily hassles) • Relationship between daily hassles and mental health of students at initial transition from school to uni • First year psychology students, French uni • Completed hassles part of ‘Hassles and Uplifts Scale’ (HSUP) and Beck Depression Industry • 41% suffered from depressive symptoms, positive correlation between scores on hassle scale and incidence of depressive symptoms • Gervais (daily uplifts) • Asked nurses to keep diaries for a month recording all hassles and uplifts at work. • Also asked to rate their performance over the same period. • At the end of the month daily hassles found to increase job strain, decrease job performance • Daily uplifts improved performance on job as well as counter-acting negative effects and overcoming stress associated with daily hassles. DAILY HASSLES VS LIFE CHANGES • Daily hassles same as/more significant than life changes. • Ruffin – Australian study – daily hassles linked to greater psychological and physical dysfunction than major negative life events. • Flett – 320 students, 50/50 men/women – had to read a scenario describing an individual who had experienced either a major life event or daily hassle. They then rated the amount of support that that person would receive or seek from others. Findings – greater negative influence of daily hassles is down to reduced social and emotional support from others. • The accumulation effect – Minor daily stressors add up, and create persistent irritation, frustrations and overloads which then result in more serious stress reaction such as anxiety and depression . • The amplification effect – A person already in distress, maybe due to major life event, the presence of minor stressors may amplify the experience of stress. • Retrospective recall – pps are usually asked to rate hassles experienced over the last month, some researchers over come this with the diary method.
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  Workplace stress Workload andcontrol: • Marmot et al. • Investigated job strain model, proposes that workplace creates stress and illness in two ways 1. High work load (creating greater job demands) 2. Low job control (e.g. over deadlines, procedures etc.) • Total of 7372 civil servants, London, agreed to answer a questionnaire on workload, job control and amount of social support, checked for signs of cardiovascular disease • 5 years later – participants reassessed • Found no link between high workload and stress-related illness • 5 years later – men and women who had initially reported low levels of job control were more likely to develop heart disease • Johansson et al. • Effects of performing repetitive jobs that require continuous attention • The sawyers in a Swedish sawmill have a stressful job (repetitive, unrelenting pace, sense of responsibility for whole company) • Low risk group (maintenance workers who have less monotonous jobs and more flexibility) • High risk group were found to have higher illness rates and also higher levels of adrenaline in their urine than a low risk group, high risk group also had higher levels of stress hormones on work days than on rest days. Cont.
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  Evaluation • Kivimäki etal. • Meta-analysis 14 studies • Looking at relative risk of CHD in association with work stress • 83,000 employees across Europe, USA and Japan • Found that employees with high level job strain 50% more likely to have CHD. • Shultz et al. (work underload) • 16,000 adult employees across 15 European countries • Employees with work overload had highest levels of stress related illness but also those who reported work underload also recorded low job satisfaction and significant levels of absence due to stress related illness. • PROBLEMS WITH THE STUDY OF WORKPLACE STRESS • Lazarus suggests that high job demands and role ambiguity may be perceived as stressful to one person but not so much to another particularly those with high hardiness. Cont.
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  Personality factors andstress Type A: • Competitiveness and achievement striving • Impatience and time urgency • Hostility and aggressiveness Type B: • Being patient • Relaxed and easy going Research on type A behaviour: • Friedman and Rosenman – 3,000 men aged 39-59, California • Examined for signs of CHD • Personalities assessed by interview • Provocative manner to try and elicit Type A behaviour • Findings: • After 8 ½ years twice as many Type A pps had had died of cardiovascular disease • Heart attack: 12.8% (type a) and 6% (type b) Evaluation: • Ragland and Brand – follow up study of F + R – 22 years after the study • 214 men had died of CHD – little evidence of relationship between Type A behaviours and mortality. • Myrtek – meta-analysis, 35 studies • Found association between CHD and an aspect of Type A personality – hostility.
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  The Hardy Personality Researchon hardy personality: • Kobasa 1979 – 800 US business executives, assessing stress using SRRS, 150/800 regarded as high stress. • Some of these 150- some had low illness records, some had high record, something else must’ve been modifying the effects of stress. • Kobasa suggested having the hardy personality encourages resilience. • Maddi et al 1987. • Studied employees of US company who were dramatically reducing work force size over the period of a year • 2/3 suffered stress related health problems over this period but the remaining 1/3 thrived – this thriving group showed more evidence of hardiness attributes. • Lifton et al 2006. • Students at 5 universities (USA) • Those who had more hardiness were more likely to complete degree with the low hardiness being represented mainly among drop-outs The hardy personality: Type A resistant to heart disease – some individuals more ‘hardy’ than others – prevents negative effects of stress Control – hardy people see themselves as being in control of their lives Commitment – hardy people are involved with the world around them, strong sense of purpose Challenge – see life changes as problems to overcome rather than as stressors, enjoy opportunity for development Most data for health problems has come through self-report questionnaires (LIMITATION)
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  Psychological methods ofstress management • How can you teach hardiness? • Maddi worked with Kobasa and founded the Hardiness Institute of California; the aim of hardiness training is to increase self-confidence and sense of control so that individuals can more successfully navigate change. • Focusing – client is taught how to recognise the biological signs of stress, such as muscle tension, increased heart rate and also to identify the sources of stress. • Relieving stress encounters – relives stress encounters and is helped to analyse the situations and their response to them. This gives them an insight into current coping strategies and how they can be more effective tan they thought. • Self-improvement – Insights found can now be used to move forward and learn new techniques of dealing with stress. In particular the client is taught to focus on seeing stressors as challenges that they can take control of rather than problems they must give in to. Hardiness training EVALUATION: • It works: Student Support Services provided hardiness training to their at risk students in Utah Valley State College. Hardiness training helps them to stay in and graduate from school, by mastering stressors they come across whilst they work to develop themselves. • Problems with Hardiness Training: Must first address basic aspects of personality and learned habits can be very difficult to modify, therefore it is not a rapid solution for stress management.
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  Psychological methods ofstress management Stress Inoculation Therapy • Meichenbaum 1958 believed that although we can’t change sources of stress we can change the way we think about the stressors • Type of Cognitive behavioural therapy developed specifically to deal with stress, the individual should develop a coping strategy if the problem arises 1. Conceptualisation phase: • Therapist and client establish relationship, the client is educated to the nature and impact of stress • Client is taught to view perceived threats as problems to be solved, enables the client to think differently about the problem 2. Skills acquisition phase (and rehearsal) • Taught and practice of coping skills primarily in clinic with gradual rehearsal in real life • Positive thinking, relaxation, social skills, methods of attention diversion, time management. • Self-coping statements ‘relax you’re in control’ 3. Application therapy (and follow-through) • Opportunities for newly learned strategies in different situations which become increasingly stressful • Various techniques include that of imagery (imagining how to do deal with stressful situations, modelling (watching someone else demonstrate) and role playing (acting out scenes involving stressors). Strengths Limitations • Sheehy and Horan examined the effects if SIT on first year law students… • Participants received 4 weekly SIT sessions, each lasting 90 minutes • Results showed all who received SIT showed greater reduction of anxiety over time + those expected to finish in bottom 20% of class also reflected significant improvements, more than half improved class rank. • Future stressors  Time-consuming + high motivation: • SIT requires a lot of time, effort, money and motivation. However Meichenbaum also demonstrated that results even with brief amounts of therapy. Unnecessarily complex: • Effectiveness of SIT due to certain elements of the training rather than all of it. This means that a range of activities and time could be reduced without losing much of the effectiveness.
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  Biological methods ofstress management: • Benzodiazepines (BZs) • GABA is a neurotransmitter that is the body’s natural form of anxiety relief. About 40% of the neurons in the brain respond to GABA which, when released, have a quietening effect of many neurons in the brain. When GABA locks into receptors it opens a channel which increases the flow of chloride ions into the neuron. Chloride ions make it harder for the neuron to be stimulated so slows it down. • BZs enhance the action of GABA by binding to special sites on the GABA receptor and boosting the actions of GABA. • BZs and serotonin – serotonin is a neurotransmitter that has an arousing effect in the brain. BZs reduce any increased serotonin activity, which reduces anxiety • Beta-blockers (BBs) • Sympathetic arousal – arousal in the sympathetic nervous system and creates raised blood pressure, increased heart rate, elevated levels of cortisol and so on. • How do they work? Reduce the activity of adrenaline and noradrenaline which are part of the sympathomedullary response to stress. Beta- blockers bind to beta-receptors on the cells of the heart and other body parts. • What do they achieve? By blocking these receptors, beta-blockers cause the reverse-effect of stress hormones, causing the heart to beat more slowly and with less force. Strengths Limitations Effectiveness • Two groups can be given a drug and a placebo to identify how well the drug works • Kahn et al. (1986) – followed nearly 250 patients over eight weeks and found that BZs were significantly superior to the placebo • Hildalgo et al. (2001) – meta-analysis on treatment of social anxiety, found that BZs were more effective at reducing anxiety than any other drugs. • Beta-blockers are effective in reducing anxiety in a variety of stressful situations Addiction Side Effects: BZs – episodic memory problems, drowsiness, dependence, withdrawal symptoms Treating symptoms rather than problem: As soon as they stop taking the drugs the effectiveness ceases, acting only as a temporary bandage on the problem