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Abnormal Psychology PSY404

Lesson 29

STRESS

What is stress?

Stress is a process of adjusting to circumstances that disrupt or threaten a person's equilibrium.

Scientists define stress as any challenging event that requires physiological, cognitive, or behavioral

adaptation.

Why study stress?

Scientists once thought that stress contributed only to a few physical diseases, like ulcers, migraine

headaches, hypertension (high blood pressure), asthma, and other psychosomatic disorders, a term

indicating that a disease is a product of both the psyche (mind) and the soma (body).

Today, the term "psychosomatic disorder" is old-fashioned.

How stress effects us?

Medical scientists now view every physical illness--from colds to cancer and AIDS--as a product of the

interaction between the mind and body.

Behavioral medicine is a multidisciplinary field that includes both medical and mental health

professionals who investigate psychological factors in the symptoms, cause, and treatment of physical

illnesses. Psychologists who specialize in behavioral medicine often are called health psychologists.

Learning more adaptive ways of coping responses aimed at diminishing the burden of stress, can limit

the recurrence or improve the course of many physical illnesses.

Examples

1- A works at an office for ten hours a day, in her office on most days of the week there is no

electricity, even when there is electricity the AC does not work. By the end of the day the A is tired,

depressed, hot and irritable.

2- Mr. x is waiting for an important job interview, he hopes to get the job with his charming manners

and personality because his grades are average his mouth is dry, his heart beats faster, sweat breaks out

on his forehead.

3- I have pain in my tooth , I need to see my dentist but the very thought of his dental clinic makes me

shiver, I am nervous, I sweat, my heart beats faster and I have all sorts of strange feelings in my

stomach.

All of these three examples on stress involve a relationship between people and their environments or

between stressors and stress reactions.

Stressors are events and situations to which people adjust (exam, job interview, an operation). Stress

reactions are the physiological, cognitive and behavioral responses that people display to stress (nausea,

nervousness and tired).

Major stressors may be the pleasant events such as promotion more responsibility and wedding also

acts as stressors. The unpleasant events such as being fired at work, retirement, death of a loved one,

divorce etc are events that involve frustration, pressure, boredom, trauma, conflict, or change.

How do we measure stress?

We have psychological tests like

1- The Social Readjustment Rating Scale (SRRS)

2- The Daily Hassles and Uplifts Scale

Thomas Holmes and Richard Rahe in the SRRS, included a wide range of change related stressors in

the 43 items of SRRS developed in 1967. They asked people to rate these 43 stressors in terms of life

change units that is the amount of change and demand for adjustments, these given stressors

introduce into an individual's life. In the daily hassles and uplifts scale the respondent is asked to

identify which of these items in the list she experienced in the past month and to rate them on a three

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Abnormal Psychology PSY404

point scale. Hassles include losing things or getting late for work. Uplifts include saving money, eating

out, relaxing and getting a present.

Scientists continue to debate whether stress is best defined as

1- Stress as a Life Event itself

2- Stress as Appraisal of Life Events, the event plus the individual's reaction to it.

1- Stress as a Life Event

Researchers often define stress as a life event--a difficult circumstance regardless of the individual's

reaction to it. For example, Holmes and Rahe's Social Readjustment Rating Scale (SRRS) assigned stress

values to life events based on the judgments of a large group of normal adults. The SRRS views

stressors that produce more life change units as causing more stress. Researchers consistently link stress

ratings on the SRRS and similar instruments to a variety of physical illnesses. The same stressor does

have different meanings for different people. Because of this variability, many experts believe stress

must be defined by the combination of an event plus each individual's reaction to it.

2- Stress as Appraisal of Life Events

i- Richard Lazarus defined stress by the individual's appraisal (perception) of a challenging life

event. Your primary appraisal is your assessment of the challenge, threat, or harm posed by a

particular event. Your secondary appraisal is your assessment of your abilities and resources for

coping with that event. The appraisal approach recognizes that the same event is more or less stressful

for different people.

ii- The renowned American physiologist Walter Cannon, one of the first and foremost stress

researchers, recognized the adaptive, evolutionary aspects of stress. Cannon viewed stress as the

activation of the fight or flight response. The fight or flight response has obvious survival value.

Cannon observed, however, that fight or flight is a maladaptive reaction to much stress in the modern

world such as being reprimanded by your boss or giving a speech before a large audience.

Psychophysiological Responses to Stress

Physiologically, the fight or flight response activates your sympathetic nervous system: Your heart and

respiration rates increase, blood pressure rises, your pupils dilate, blood sugar levels elevate, and your

blood flow is redirected in preparation for muscular activity. When a perceived threat registers in the

cortex, it signals, the brain structure primarily responsible for activating the stress response, which in

turn secretes a hormone that stimulates the brainstem to activate the sympathetic nervous system. In

response to the sympathetic arousal, the adrenal glands release two key hormones.

· One is commonly known as adrenaline, which activates the sympathetic nervous system.

· The second key adrenal hormone is cortisol, often called the "stress hormone" because its release

is so closely linked with stress.

One function of cortisol is "containment" of pathogens in the body. In fact, research in this area has

started a new field of study, psychoneuroimmunology (PNI), the investigation of the relation

between stress and immune function. PNI research shows that particularly vulnerable to stress are T

cells, one of the two major types of lymphocytes, white blood cells that fight off antigens, foreign substances

like bacteria that invade the body. Decreased T cell production makes the body more susceptible to

infectious diseases during times of stress. Recent evidence suggests that stress may both inhibit and

enhance immune functioning.

Short-term stressors and physical threats enhance certain immune responses, particularly aspects

of immune functioning that respond quickly, require little energy, and may contain infection due to an

injury. When repeated over the time, your physiological reactions to stress can leave you vulnerable to

illness. Cannon hypothesized this occurs because intense or chronic stress overwhelms the body's

homeostasis (a term he coined), the tendency to return to a steady state of normal functioning. He

suggested that, over time, the prolonged arousal of the sympathetic nervous system eventually damages

the body, because it no longer returns to its normal resting state.

Canadian physiologist Hans Selye offered a different hypothesis based on his concept of the

general adaptation syndrome (GAS). Seyle's GAS consists of three stages: alarm, resistance, and

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exhaustion. The stage of alarm occurs first and involves the mobilization of the body in reaction to

threat. The stage of resistance comes next and is a period of time during which the body is physiologically

activated and prepared to respond to the threat. Exhaustion is the final stage, and it occurs if the body's

resources are depleted by chronic stress. Selye viewed the stage of exhaustion as the key in the

development of physical illness from stress. At this stage, the body is damaged by continuous failed

attempts to reactivate the GAS. Stress may create physical illness in both ways, but a third mechanism

may be as important. Because the stress response uses so much energy, the body may not be able to

perform many routine functions, such as storing energy or repairing injuries. The result is greater

susceptibility to illness.

Coping

Two general coping strategies are problem-focused and emotion-focused coping.

Problem-focused coping involves attempts to change a stressor.

Emotion-focused coping is an attempt to alter internal distress.

Studies of animals and humans show that predictability and control can dramatically reduce stress. Even

the illusion of control can help to alleviate stress in humans. However, the perception of control can

increase stress when people believe they can exercise control but fail to do so, or when they lose control

over a formerly controllable stressor. In short, control alleviates stress when it can be exercised or even

when it is illusory, but failed attempts at control intensify stress. Research also indicates that responding

with physical activity reduces physiological reactions to stress.

Repression is one form of emotion-focused coping that can be maladaptive physically.

Psychophysiological reactions to stress also are greater for "defensive deniers"--people who report

positive mental health but whom clinicians judge to have emotional problems.

Optimism

Optimism is a basic key to effective coping. People with an optimistic coping style have a positive attitude

toward dealing with stress, even when it cannot be changed, while pessimists are defeated from the outset.

Positive thinking is linked with better health habits and less illness in general, and for those with heart

disease, AIDS and other serious physical illnesses. For many people, religious and philosophical beliefs are

essential to cope with stress. Emerging evidence demonstrates the health value of religious practices, for

example, mortality risk is lower among those who attend church services, probably as a result of improved

health behavior.

Health Behavior

Stress may also cause illness indirectly by disrupting healthy behavior. Health behavior is action that

promotes good health, including positive efforts like eating, sleeping, and exercising adequately and

avoiding unhealthy activities such as cigarette smoking, excessive alcohol consumption, and drug use.

Illness behavior--behaving as if you are sick--also appears to be stress related. Considerable research

indicates that increased stress is correlated with such illness behaviors as making more frequent office

visits to physicians or allowing chronic pain to interfere with everyday activities. Social support is

important in coping with stress. Social support not only can encourage positive health behavior, but

research shows that social support can have direct, physiological benefits. Of all potential sources of

social support--or conflict--a good marriage may be most critical to physical health.

Illness as a Cause of Stress

Stress can cause illness, but illness also causes stress. Helping children, adults, and families cope with

chronic illness is another important role of experts in behavioral medicine. Historically, the only

physical illnesses thought to be affected by stress were a few psychosomatic disorders, such as ulcers

and asthma. The field of psychosomatic medicine was dominated by psychoanalytic psychiatrists who

endorsed the idea that specific personality types caused specific psychosomatic diseases.

At the beginning of the twentieth century, infectious diseases were the most common causes of death in

the United States. Thanks to advances in medical science, and especially in public health, far fewer

people are dying of infectious diseases at the beginning of the twenty-first century. Today, most of the

leading causes of death are lifestyle diseases that are affected in many ways by stress and health behavior.

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