Stress

Physiology:

GAS

AO1

Selye (1936) universal stress response = adaptive

Non specific - same all stressors

Body attempts to remain balanced through activation / recovery

Stage 1: Alarm reaction, SAM pathway, adrenaline released from adrenal medulla

Stage 2: Resistance, body adapts by resisting stressor, hormones depleted, parasympathetic NS activated to conserve energy. HPA axis releases cortisol

Stage 3: Exhaustion, Adaptation to chronic stressor fails - all resources depleted, symptoms of sympathetic arousal, adrenal glands damaged, stress related illnesses e.g. CHD, depression

AO3

+ Selye research on rats​

- Not replicated on monkeys (Mason, 1971)

- Animal extrapolation​​​​

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Stress & Illness: Cardiovascular

AO1

Cardiovascular disorders = heart & blood vessels e.g. CHD, stroke

Acute stress = high adrenaline - direct effects on heart muscles

Acute stress & football match: Wilbert-Lampen, heart attacks German 1996 World Cup. Day Germany play, cardiac emergencies x2.66

Chronic stress in workplace: Yusuf Interheart Study. 15k people with heart attack & control. Chronic stressors had strong link to heart attack. Stress greater than obesity 3rd after smoking & cholesterol

AO3

- Link appears to be indirect. Orth-Gomer marital stress x3 risk of heart attack but only if pre-CVD

+ Supportive evidence. Song (2019) ppts with stress related disorders compared to siblings/controls. Stress led to 64% greater risk CVD.

- Cause physiological or psychological?

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Sources of Stress: Workplace Stress

AO1

Workload is the amount of time/ effort required in a job

Control is the extent a worker can make decisions & be independent

Job demands -control model: only those who lack control become ill

Whitehall Study (1997): prospecitve study: 10k civil servants, questionnaire (workload & control), examined for CHD - follow up 5 yrs.

No correlation between workload & illlness. But low control was +ve correlated with CHD for all job grades.

Johansson et al (1978) Swedish Saw Mill: natural experiment, wood finishers & cleaners. Measured illness, absenteeism and stress hormones. Finishers - high work demands and low control. Results: Higher stress hormones, illness and absenteeism in finishers.

AO3

+ Workload culturally generalisable

- Job demands-control too simple

- High control is even > stressful

+ High ecological validity of studies​​​​​

Individual Differences: Personality

AO1

Friedman & Rosenman observed a personality type of ppts with CHD

Type A: Competitive, time urgent, hostile

Type B: Laid back, reflective and tolerant - not linked to CHD

Western Collaborative Group Study: 3000 males, USA, no CHD at start of study. Answered 25 qus to assess personality type. Interviews conducted to incite Type A traits.

8.5 yrs later 257 men had CHD and 70% of men were assessed as Type A. Impatience and hostility -> physiological stress response.

Type C: Pathological niceness - compliant, passive, repress emotions. Linked to cancer.

Dattore (1980) studied 200 veterans of Vietnamese War - 75 cancer patients vs other diagnoses. Cancer ppts reported significantly greater suppression and fewer depression symptoms.

AO3

+ Real world application. Type A change behaviours after CHD and live longer

- Too broad? Linked to hostility mostly (Carmelli 1991)

- Type C and cancer link not reliable finding - mediating factors

- Too binary of A/B. Personality is more nuanced.

Managing Stress: Stress Inoculation Therapy

AO1

Coming soon

AO3

Coming soon

Managing Stress: Social Support

AO1

Coming soon

AO3

Coming soon

Physiology: Stress Response

AO1

Acute (short term): SAM pathway -> Hypothalamus -> Activates sympathetic branch NS -> Triggers  adrenal medulla release adrenaline / noradrenaline -> prepares body F or F. When passed parasympathetic NS activated.

Chronic (long term): HPA system activated. Hypothalamus -> corticotropin releasing factor (CRF) -> pituitary gland releases ACTH -> adrenal cortex releases cortisol -> glucose metabolism, restores energy, suppresses immune system. HPA self regulating. High levels of cortisol reduces CRF & ACTH reducing cortisol.

AO3

+ Real life: Addison's disease - cortisol replacement therapy

- Ignores psychological factors. Speisman (1964) medical procedure

- Gender bias acute stress - Taylor's "tend and befriend"​

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Sources of Stress: Life Changes

AO1

Life changes are important but infrequent life events

Need psychological adjustments

Bigger change = more stress

They are cumulative & can apply to + and - events

Holmes & Rahe Social Readjustment Rating Scale gives number of life changing units - higher the value = more stress e.g. divorce is 73. Self report (12 mths)

More LCU, more stress.

Rahe (1972) claimed that <150 LCU = reasonable health, 150-3000 LCUs 50% chance of illness, >300 LCUs 80% chance illness in next yr

Rahe (1970) US Navy Study +ve LCU in last 6 mths & illness on ship 

AO3

+ Evidence: Lietzen (2011) 16k asthma free ppts. LCU predictor.

- Ignores individual differences - subjective opinion of LCU needed

- +ve and -ve events not the same

- Ignores third variables

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Measuring Stress:

Self Report

AO1

Self report measures

Social Readjustment Rating Scale (SRRS) - Holmes & Rahe (1967) used medical records to identify events that happened before becoming ill. 43 life events: major +/- changes.

Life Change Units (LCU) calculated for each life event - asked people to estimate readjustment required for each event (marriage = 500 as baseline). Ppts indicate life events in past 12 months, LCU added for total score.

Hassles & Uplifts Scale (HSUP) -Kanner (1981) created scale with 117 'hassle' items inc. work, health, environment on 3 point scale. 135 'uplift' items were produced from same categories e.g. sleep, colleagues etc.

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AO3

+ Subjective measure of stress = higher validity

- Correlation = issues with cause and effect

- Social desirability bias 

Individual Differences: Hardiness

AO1

Kobasa (1979) hardiness protects against stress & Maddi (1986) stress gives existential courage - strength to keep going.

3 dimensions; commitment (deply involved in relationships & activities), challenge (resilient & welcome change) & control (belief they are in charge)

Kobasa (1979) Procedure: 670 male USA 40-49yrs managers, used schedule of recent experiences to identify stress over 3yrs, absenteeism & illness. Findings; Resilient managers: coped with stress without ill or time off. Scored high on the 3 Cs.

Maddi (1987) Procedure: 400 managers at Bell Telephone Co USA. Underwent large reorganisation (high stress). Significant declines in performance (2/3rds) ppts. 1/3rd managers = high on 3 Cs flourished. Happier & more fulfilled. 

AO3

+ Good real life application - Army Special Forces

+ Contrada: Lowest blood pressure = Type B personality​​​​​​​​​​​​​​​​​​​​​​​​​​

- Hardiness as a concpet is too broad​​​

- Correlational issues

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Managing Stress: Biofeedback

AO1

Coming soon

AO3

Coming soon

Stress & Illness: Immunosuppresion

AO1

Directly: cortisol produced by the HPA inhibits production of immune cells

Indirectly: stress can lead to unhelpful lifestyle choices e.g. drinking that -ve effects immune functioning

Chronic stress of exams: Kiecolt-Glaser medical students, decrease in natural killer and killer T cells when highly stressed. Greatest when student lonely or other stress

Chronic stress of caring for ill relative: Kiecolt-Glaser compared carers (of Alzheimers) with control. Over 13 months carers had weaker cell based immune response & more infectious diseases/ depression (32%) compared to control group (6%).

AO3

- Acute stress can have immunoenhancing effects​​​​​​​​​​​​​​​​​​​​​​

+ Real life application: stress hormones before life stressor

- Methodological issues in lab

Sources of Stress: Daily Hassles

AO1

Daily hassles include minor inconveniences e.g. lost keys and greater pressures e.g. no time

Primary appraisal - assess subjectively how psychologically threatening something is 

Secondary appraisal - if threatening we assess how equipped we are to deal with it

Hassles and Uplifts Scale (HSUP) = self report. How many / severity of halles & how many uplifts

Life changes = indirect effects = distal sources of stress

Daily hassles = direct and immediate threat = proximal sources of threat

Kanner et al (1981) 100 ppts did HSUP every mth x 9

Life changes scale one month before study and at end

Hopkins symptom checklist for anxiety & depression

+ve correlation hassles frequency & symptoms

Hassles greater predictor than life changes.​​​​​​​​​​​​​​​​​

Measuring Stress: Physiological

AO1

Skin conductance response (SCR)

Stress = arousal in ANS = more sweat which enhances conductance of electricity

Electrodes on index and middle fingers, current applied, conductance measured (tonic %& phasic)

Other measures: Increased adrenaline (acute stress), cortisol (chronic stress)

Measured in unrine and blood (also saliva for cortisol)

Baseline measures taken for comparison as level change throughout the day.

AO3

- Individual differences - stabiles and labiles

+ Scientific and objective

- Does not consider the subjectove experience of stress​​​​​​​​​​​​​​​​​​​​​​​​​​

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Managing Stress: Drug Therapies

AO1

Benzodiazepines (BZs) reduce activity in CNS which reduces anxiety. They increase GABA activity which is inhibitory neurotransmitter. Reduced charge at post synaptic membrane. Neurons cannot be stimulated temporarily. 

Beta blockers (BBs) reduce the arousal of SNS. Normally prescribed to reduce blood pressure. BB combine with adrenaline & noradrenlaine in the CVS when SAM pathway is activated. BBs block beta-adrenergic receptors sothey cannot be stimulated by hormones. BBs do not affect the brain so ppts remain alert.

AO3

+ Supportive evidence BZ: Baldwin review of high quality studies​

+ Supportive evidence BB: Kelly - exams & public speaking​​​​​​​​

-Do not remove the cause of the stress - short term only

- Side effects: breathing problems, impulsive behaviours & uncontrollable emotions​​​​​​​​​​​​​​​​​​

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Managing Stress: Gender Differences

AO1

Coming soon

AO3

Coming soon