Stress and Health McElhaney November 2015

Ch 15 Key Topics ► 1. Big Picture definition and significance of stress- ► 2. Health – ► Behavior Health Risks ► Risk Factors ► Significance Chart Causes of Death page 550 ► Significance Pg 550 Chart High School Risky behavior ► Disease prone ► Health Promoting Behaviors ► Early Prevention ► 3. Stress ► Reinforce definition of stress and types of stress Eustress ► Biology and Stress- Autonomic nervous system ► Significance table Pg 554- Signs + symptoms of stress ► Role of Stressor and pressure ► Occupation and Burnout- how to prevent burnout ► Lazarus research and appraising stress ► 4. Coping ► Types of coping- problem focused and Emotion focused ► Frustration- external and Personal ► Reactions to Frustration- Hostility, Aggression, Displaced Aggression ► Conflicts- 4 basic forms- Approach-Approach, Avoidance-Avoidance, Approach-Avoidance, Multiple Conflicts ► Anxiety- Definition Defense mechanisms ► Denial, Repression, Reaction Formation, ► Regression, projection, Rationalization ► Compensation, Sublimation ► Learned Helplessness, Depression, role of hope ► Psychosomatic illness ► Type A and B personalities ► General Adaptation syndrome, alarm reaction, resistance, reaction ► Stress and the Immune System (what should we know) ► 5. Psychology in Action- ► What are the recommended ways to manage stress? ► Which are the best in your opinion? ► Pg 580- Summarize the wisdom of: “Coping with Frustration and Conflict”

3 Parts of Chapter 1. What is stress and how does it affect us? 2. Behavior health Risks and stress 3. How can one cope/respond to stress and maintain health?

WE all feel stress at some time. ► 18% of men ► 41 % of women ► Experience being frequently overwhelmed Relationships, deadlines, pressure, volunteering, sports, music, theater, work, college aps, grades, parents, AP CLASSES Relate to stress

Big Picture definition and significance of stress- ► 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 ► 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 in poverty

How does the body react to stress? ► Stress response is part of a unified Mind- Body 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

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 shocks- intense, 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 response- physiological 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

Burnout ► ► 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)

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 ► ► Long terms suppression of immune system ► Common in Military especially associated with combat ► Common with traumatic experiences/assaults/abus e/witnessing violence/bloody scenes etc. ► Some research indicates some brain structures and functioning are permanently affected

Diathesis Stress Model ► Argues that some people are pre- disposed to 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 ► ► 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 ► Lazarus- Appraisal ► Control ► Social Support ► Personality ► Adaptive Coping ► Maladaptive Coping ► Freudian Defense Mechanisms

Cognitive Appraisal ► ► Lazarus researcher on Stress said- ► ► Physiological 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

Stress Reaction- Stress Reaction- Variables ► ► Control- less controls = more stress ► ► Unpredictable events add to stress

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 ► Type A personality ► 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. ► Hardy Personality ► People who can resist stress ► Sense of personal commitment  To self, to work, to family ► Sense of control over lives and work ► Tendency to see life as a series of challenges

Personality Types Related to Stress ► 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.

Adaptive Coping ► Problem Focused Coping ► Emotion Focused Coping ► Social Support- “tend and befriend” ► Exercise ► Meditation ► Cognitive Therapy ► Relaxation Therapy

Adaptive Coping ► ► Problem-focused coping (control is the issue)   Need to manage or alter the distressing situation ►► ►► ► ► Emotion-Focused Coping: (when there is no control of the situation)   People try to control their emotional reactions to the situation

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 ► 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 ► ► Psychological Defense ► ► Psycho-dynamic-Freud identified ► ► 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

Freudian-Defense Mechanisms Displaced Aggression Conflicts Approach-Approach, Avoidance-Avoidance, Approach-Avoidance Multiple Conflicts Defense mechanisms Repression Reaction Formation Regression Projection Rationalization Compensation Sublimation Learned Helplessness Acting out Affiliation Passive aggression Avoidance Altruism Humor

Frustration ► ► Extreme Situations + Responses ► ► Frustration-negative emotional state occurs when people are prevented from reaching desired goals (2 types) ►► ►► ► ► 1 External Frustration- outside force or individual impedes progress toward a goal (flat tire)   Delays success   Can be social obstacles = people   Or   Non-social = objects ►► ►► ► ► Frustration increases-  as strength of blocked motive increases- frustration increases ►► ►► ► ► 2. Personal Frustration- based on personal characteristics or limitations

Reactions to Frustration: ► ► Aggression- any response with intent of harming a person or object   Most frequent response to frustration ► ► *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 ► ► 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 ► ► Conflict- a person must choose between contradictory desires, needs and motive demands ► ► 1. Approach-Approach Conflicts (weak conflict) ► ► Two positive choices ► ► Two desirable alternatives ► ► 2. Avoidance-Avoidance Conflicts (difficult to resolve) ► ► Choice between 2 negative undesirable alternatives ► ► Based on personal needs or bias ► ► 3. 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

Health Effects of Stress ► Extreme and prolonged STRESS damages health and inhibits our ability to resist disease ► Psychoneruoimunology is the study:  Neural Functioning  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 ► ► Not hypochondrias ► ► 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 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  Attacks foreign substances

Immune 2 ► Macrophage (big eaters) ► Identifies ► Pursues ► Ingests harmful invaders and worn out cells ► In blood stream that enter organs ► Natural Killer Cells ► Attack diseased cells ► Anti-Virol ► Anti-Tumor ► ** 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. ► Immune system--= which causes less immune system functioning.

Stress Hormones Affect Lymphocytes 1. Surgical wounds heal more slowly in stressful situations 2. Stressed people are more vulnerable to colds.