Stress, Stressors, and Life Events Lecture Notes PDF

1  PSYCHOLOGY Credit hours: (2-0) Lecture Topic Stress, Stressors and Life Events Ms. Gul-E-Sehar (Senior Lecturer) UIPT,FAHS...

1  PSYCHOLOGY Credit hours: (2-0) Lecture Topic Stress, Stressors and Life Events Ms. Gul-E-Sehar (Senior Lecturer) UIPT,FAHS 2  Learning objectives By the end of the lecture, students will be able to: – Enlist the life events/stressors influencing human physiology – Identify the psycho-physiological mechanism by which stressors lead to psychosomatic diseases 3  Stress and Stressors Stress is a slippery concept. At times it is the stimulus (missing an appointment) and at other times it is a response (sweating while taking a test). 4  Stress and Stressors Stress is not merely a stimulus or a response. It is a process by which we appraise and cope with environmental threats and challenges. Bob Daemmrich/ The Image Works When short-lived or taken as a challenge, stressors may have positive effects. However, if stress is threatening or 5 prolonged, it can be harmful.  The Stress Response System Research on the sympathetic adrenal- medullary (SAM) system has its roots in the work by Walter B. Cannon in the beginning of this century (Cannon, 1914). Medulla: Epinephrine Cortex: Cortisol 6  Sequence of Steps in the Fight or Flight Behaviors. The brain appraises a situation as threatening and dangerous. The lower brain structure secretes a stress hormone. The stress hormone signals the adrenal glands to secrete adrenaline. This causes the muscles to tense, the heart to beat faster, and the liver to send out sugar to be used in the muscles. 7 8  Stress theories 9  Lazarus’s Cognitive Theory Stressor Lazarus proposed Selye assumed that stress that a mental process determines depended only Appraisal whether stress on the intensity of the stressor. occurs. G. A. S. Healthy Adaptation or Illness 10  The General Adaptation Syndrome Hans Selye explained his stress model based on physiology and psychobiology as (GAS). It defined as a series of stages the body goes through when exposed to stressful situations. 1. The alarm stage is the initial stage where the body prepares for attack—either psychological or physical. 2. The second stage is called the stage of resistance. The body uses up a great amount of energy to prepare for the stressor. 3. The third stage is exhaustion. It is marked by body exhaustion and health problems. 11  CLASSIFICATION OF STRESS POSITIVE STRESS - Mental Alertness - Motivation - High Efficiency NEGATIVE STRESS - ACUTE STRESS - CHRONIC STRESS 12  SYMPTOMS OF STRESS Behavioral symptoms - Productivity - Absenteeism - Turn Over Physiological symptoms - Headache - Heart disease - High BP Psychological symptoms - Anxiety - Depression - Decrease in job satisfaction 13  Major Types of Stress CONFLICTS incompatible motivations – Approach-approach – Approach-avoidance This conflict is considered the most stressful because the choice has both an appealing and unappealing aspect. – Avoidance-avoidance 14 Overview of the Stress Process Accident 15 Factors Moderating the Impact of Stress Social support – Increased immune functioning Optimism – More adaptive coping – Pessimistic explanatory style Conscientiousness – Fostering better health habits Autonomic reactivity – Cardiovascular reactivity to stress 16  Coping Skills Problem-focused coping Problem-focused coping targets the causes of stress in practical ways which tackles the problem or stressful situation that is causing stress, consequently directly reducing the stress. Problem focused strategies aim to remove or reduce the cause of the stressor, including: – Problem-solving. – Time-management. – Obtaining instrumental social support 17  Emotion focused coping Emotion-focused coping involves trying to reduce the negative emotional responses associated with stress such as embarrassment, fear, anxiety, depression, excitement and frustration. This may be the only realistic option when the source of stress is outside the person’s control. 18 Emotion focused coping emotion focused coping techniques include: Distraction, e.g. keeping yourself busy to take your mind off the issue. Emotional disclosure. This involves expressing strong emotions by talking or writing about negative events which precipitated those emotions. Praying for guidance and strength. Meditation, e.g. mindfulness. Eating more, e.g. comfort food. Using drugs. 19 Emotion focused coping Journaling, e.g. writing a gratitude diary Cognitive reappraisal. This is a form of cognitive change that involves interpreting a potentially emotion-eliciting situation in a way that changes its emotional impact (Lazarus & Alfert, 1964). 20 Emotion focused coping Suppressing (stopping/inhibition of) negative thoughts or emotions. Suppressing emotions over an extended period of time compromises immune competence and leads to poor physical health. 21  Types of illness caused by the most stressful life events The types of illness that top stressors can cause are not particularly surprising. They include: Chronic pain, such as lower back pain and neck pain Obesity: While not an illness in and of itself, obesity is the root cause of many other serious and lethal conditions. Excess levels of cortisol, the stress hormone that floods our body during stress, causes fatty deposits around the midsection when stress becomes chronic. 22  Diabetes: Stress raises the glucose levels of those with Type 2 diabetes directly. It also seems to increase unhealthy types of eating and lowered levels of physical activity. Depression and anxiety: Stress increases the chances of developing depression and anxiety by as much as 80%. 23  Gastrointestinal disorders: Contrary to popular belief, stress doesn’t cause ulcers. It can, however, make gastrointestinal issues worse. It also contribute to the development of chronic heartburn (or gastroesophageal reflux disease, GERD) and irritable bowel syndrome (IBS). 24  Accelerated aging: One study found that chronic stress can accelerate the pace of aging. This may be due to stress’s effect on telomeres, a structure at the end of each chromosome that protects against deterioration of that chromosome. Stress shortens telomeres, in effect offering less protection. 25  Alzheimer’s disease: Stress causes the brain to form lesions more readily. This can accelerate the progression of Alzheimer’s disease. 26  How to handle the most stressful life events 1. Acknowledge the stress You know the saying that the first step to solving a problem is to recognize that you have one? Start dealing with stress by acknowledging that you are currently experiencing it. This may seem oversimplified, but it is an important first step. 27 2. Don’t do anything While this advice may seem counter- intuitive, sometimes the best thing to do is… nothing. Mindfulness meditation is gaining widespread popularity as a complementary pain treatment, and with good reason. 28 3. Practice self-care The most stressful life events can consume our lives and daily routines until there is no time for anything else. Once we do get time, we may tend to collapse on the couch in front of the TV and call it “relaxation.” 29 4. Get support Chronic pain can be a lonely, isolating condition. Too often even our loved ones don’t truly understand what we are going through. Support groups and online forums can make dealing with chronic pain easier, especially if stressful life events occur in addition to your daily pain. 30 5. Clear the clutter The ancient Chinese art of feng shui deals with improving the energy flow of your space so that you feel calm and more harmonious. When stressors in life take over, our personal spaces may get cluttered and disorganized. 31 6. Exercise We have said it so often that it may begin to sound routine, but it is absolutely true. One of the best ways to manage the most stressful life events is with exercise. 32 7. Go for a massage We don’t all have the luxury of regular bodywork like massage. When possible, though, this complementary therapy is a great way to manage stress and treat pain at the same time. 33 8. Eat well The most stressful life events can sometimes send us running to the kitchen for a snack. 34  Reference Rana MH, Ali S & Mustafa M. A handbook of behavioral sciences for medical and dental students. 2nd ed. Lahore : university of health sciences; 2013. Dowrick C. Medicine in society: behavioral sciences for medical students. CRC Press; 2001 35  Learning outcomes By the end of the lecture, students will be able to: – Cope with stressors through problem focus and emotional focus coping – Identify the psycho-physiological mechanism by which stressors lead to psychosomatic diseases 36 37