PSYC 446 Midterm Notes PDF

Lecture 1: Cardiovascular Responses to Stress - A model for the study of biological, psychological, and environmental risk factors 3 Groupings of Risk Factors (sex) Biological Susceptibility - Family history - Race - Gender Psychological...

Lecture 1: Cardiovascular Responses to Stress - A model for the study of biological, psychological, and environmental risk factors 3 Groupings of Risk Factors (sex) Biological Susceptibility - Family history - Race - Gender Psychological Susceptibility - Hostility/anger - Anxiety - Depression Hostility and CVD - Hostility = most significant risk factor - Coronary heart disease - Myocardial ischemia - Coronary artery disease - Angina - Peripheral artery disease - Total mortality Environmental/Social Factors (ex: weather) - Interpersonal - Behavioral - Physical - Diet Mechanisms of Disease Development 1. Psychophysiological Reactivity Model: when exposed to stressors, something happens physiologically. Over time leads to damage. Ex: cholesterol leading to heart attack 2. Health Behaviors Model: don’t take good care of yourself when under stress. Ex: more likely to eat unhealthy food Psychophysiological Reactivity Model Exposure to stress Physiological Response (Ex: heart rate, blood pressure) Disease Psychophysiological Testing Paradigm - Instruments of S for physiological recording Resting period baseline measures taken Stress task period stress response recorded Recovery period recovery values recorded Physiological Measures - Heart Rate - Stroke Volume - Cardiac Output - Systolic Blood Pressure - Diastolic Blood Pressure - Forearm Blood Flow - Forearm Vascular Resistance - Total Peripheral Resistance - Blood Volume Pulse - Respiratory Sinus Arrythmia - Epinephrine/Norepinephrine - Cortisol Subject Characteristics - 100 males: age range 18-30 years - No history of physical health problems - No history of mental disorders - Not on medication that might effect response - Selected for hostility based on BDHI scores - Selected for family history CVD Rest No difference No difference No difference Math Task - Gave them a math task which increased their blood pressure but still no difference - Problem: math test won’t make a hostile person angry Interpersonal Conflict (Harassment) Protocol - Instrumentation and rationale by Experimenter A - Rest Period - Explanation of Task by Experimenter A - Experimenter A called away from experiment - Asks Experimenter B to take over - B expresses anger to A over this (overheard by subject) - B enters the subject room angry - B delivers a series of scripted statements (insults) critical of subject’s performance during the task - After task Experimenter A returns - Manipulation check and debriefing When there is harassment, everything goes up.  Nobody else reacting. Most reactive - Women showed less hostility because of societal expectations/pressure that women shouldn’t get angry EXCEPT when protecting people they love. Ex: study with friend getting harassed = got angry  Dietary Factors Salt plays a factor in physiological response Lecture 2: The Physiological Stress Response When brain detects something stressful, it tells brain to beat heart How much capacity faster but beta blocker does my body have to stops that therefore deal with the situation brain goes “I guess I’m not that stressed” Body’s responses feeds back to help appraisal. Ex: Beta blockers -> blocks receptor that tells hearts to beat faster Walter Cannon and the Fight or Flight Response Body’s natural response to stress Don’t want to be digesting To see as much as possible If you get hurt, you won’t bleed out because blood flow is reduced. People faint when they see blood because they can’t recognize if it is theirs which decreases their blood pressure To get more oxygen to oxygenated blood to the parts that need it To pump more blood to muscles Body doesn’t want to waste energy on digestion or go to the bathroom Wider space for blood to flow through Hans Selye and the General Adaptation Syndrome Doesn’t really apply today Interested in prolonged stress Fight or flight Body opens to extra Body doesn’t activity & continues respond well to to release cortisol specific hormones Physiological Systems Involved in the Stress Response - The nervous system - The endocrine system - The immune system ANS Response to Stress - Involved in major things body does (Fight or flight) The Autonomic Nervous System (ANS) - The ANS regulates visceral activities and vital organs, including: circulation digestion respiration temperature regulation Two Branches of the ANS That Act to Maintain Homeostatic Balance - Sympathetic Nervous System - Parasympathetic Nervous System Sympathetic Nervous System - Is responsible for the responses associated with the fight-or-flight response - This physical arousal is stimulated through the release of catecholamines epinephrine (adrenaline) norepinephrine (noradrenaline) Parasympathetic Nervous System - Maintains homeostasis through the release of acetylcholine (ACh) - Is responsible for energy conservation and relaxation The Endocrine System Hypothalamus is triggered during stressful situations -> releases CRH which goes to pituitary gland, releasing ACTH & sends signal to adrenal HPA axis: release cortisol Hypothalamus: eating When body thinks cortisol is behavior, sexual behavior, etc too high… negative feedback loop to stop releasing it - For longer term. How to sustain what body needs to do. - Consists of a series of hormonal glands located throughout the body which regulate metabolic functions that require endurance rather than speed - The endocrine system is a network of four components: glands, hormones, circulation, and target organs - The glands most closely involved with the stress response are the: pituitary thyroid adrenal HPA Axis Cortisol - catalyzes glucose metabolism - stabilizes blood pressure. Long term stress = don’t want increased blood pressure - maintains normal blood sugar levels - involved in the inflammatory response - facilitate energy production - improve memory capability - bolster immune function - reduce pain sensitivity - precipitate homeostasis - induces labor Three Stages of Effects Associated with the Stress Response - Immediate effects of stress -> fight or flight - Intermediate effects of stress -> addition of extra adrenaline & noradrenaline. Still part of fight or flight - Prolonged effects of stress Immediate Effects of Stress - Sympathetic nervous response - Epinephrine and norepinephrine released - Time: 2 to 3 seconds - Adrenal response - Epinephrine and norepinephrine release from adrenal medulla - Time: 20 to 30 seconds Prolonged Effects of Stress - ACTH (cortisol), vasopressin, and thyroxine affect various metabolic processes - Time: minutes, hours, days, or weeks - If stressor continues beyond the few seconds Processes stressor Two responses Hypothalamus triggers fight or flight  Triggers For fight or flight The Immune System - Stressed for a long time = compromised immune system Interaction of all the Systems - Immune system is completely integrated into stress response  Lecture 3: Psychological Factors in Stress (evaluate) Cope well (stressor) All else fails, there is another option (re-evaluating) Ex: need to do well in exam to get into med school. Don’t do well. Re-appraise: Med school was my parents’ dream, not mine (feel better now) Stress, Appraisal and Coping - Lazarus and Folkman - Primary Appraisal -> How relevant is this to me? 1) Irrelevant 2) benign or positive 3) stressful (harm, loss, threat, challenge) - Secondary Appraisal -> What will I do about it? Coping possibilities Control Moderators of Stress Appraisal - Coping Style - Locus of Control - Personality - Social Support  - Beliefs Stress, Appraisal and Coping - Lazarus and Folkman - What is coping?: “Cognitions (thoughts) & behaviours that a person used to reduce stress and to moderate it’s emotional [& physical] impact” (Lazarus & Folkman, 1980) - Coping Styles Problem-focused coping Emotion-focused coping Problem Focused Coping - Typically used in situations that are perceived to be controllable, so we try to fix it Active coping, Planning, Instrumental social support, Problem solving - “Men go in and fix things” traditionally male coping - Trying to fix problem. Ex: boss is mad = buy gift and apologize Emotion Focused Coping - Not going to fix it - Typically used in situations where the situation is perceived to be uncontrollable, or beyond the individual’s resources. Emotional social support. Ex: calling friend & crying Emotion focused Expressing emotions Keeping yourself busy to take your mind off the issue Ignoring the problem in the hope that it will go away Denial of the problem Avoidance focused -> Distracting yourself (e.g. TV, eating) usually bad unless diagnosed with terminal Praying for guidance and strength illness (temporary) Drug use for avoidance Positive reinterpretation/growth Problem vs Emotion Focused Coping - A study of nursing students found problem focused was positively correlated with overall good health whereas emotional focused was negatively correlated with overall good health (Penley et al, 2002). Problem = better - Undergraduates described their most stressful event. Results indicated problem focused coping led to more positive outcomes (Park et al, 2004). Problem = better - In women who were at increased risk of hereditary cancer, problem-based coping and sense of control resulted in greater long term sufferring (Fang et al., 2006). Problem ≠ better  - men who used emotion focused coping were better able to deal with the stress of infertility that those who didn’t (Stanton et al 2000). Emotion = better - Rukholm & Viverais (1993) have argued that emotion focused coping must precede problem –focused approaches upon exposure to a stressor. Both - Baker and Berenbaum (2007) found that individuals who were first encouraged to express their emotions were more effective in solving a problem after a stressful event. Both - Optimal = use both, emotion, then problem. Cry, then try to fix issue. - Question: Which is better? Inconclusive/neither Do you have a Stress-Prone Personality - Yes to 1 = more prone to stress 1. Do you criticize yourself when you are not perfect? 2. Do you have to be perfectly in control at all times? 3. Are you better at caring for others than yourself? 4. Does your self-esteem depend on others? 5. Do you feel you can never do as good a job as other people? 6. Do you feel lack of control is a sign of weakness/failure? 7. Do you feel you lack common sense? 8. Do you feel you can not measure up to others expectations? 9. Do you feel the need to constantly prove yourself? 10. Do you “give” a lot more than you “get”? 11. Do you have trouble delegating responsibilities to others? The Vulnerable Personality - Creative and active individuals who forget their limits and set unrealistic goals - People who believe they have to perform perfectly at all times in order to be loved and respected. Burn out at work because of pressure - Insecure individuals who always feel the need to prove themselves - Don’t love themselves. Depend on others to tell them they’re ok. Don’t want to screw up. - Ex: new relationship -> maybe text was too emotional, will they break up with me? Other Moderators of the Appraisal - Support network: acts as buffer against life’s stressors. - Internal locus of control: confidence in your ability to influence events. I control my life. - Optimistic outlook: embrace challenges and accept change - Knowledge and preparation: The more you know about, and can prepare for, a stressful situation, the easier it is to cope. Ex: exams -> study more = less stressed Psychological Responses to Stress - Emotional - Cognitive  - Behavioural The Signs of Stress – Emotional - Nervous, worried, or fearful - Irritated or impatient - Angry or argumentative - Tearful or sad - Hopeless or withdrawn - Feeling tense - Apathetic - Overwhelmed by responsibility - Emotionally drained - Hypersensitive to criticism The Signs of Stress – Cognitive - Forgetting appointments, deadlines, etc. - Misplacing items - Difficulty completing simple tasks - Trouble concentrating - Unable to get worries off your mind - Easily distracted - Indecisive - Vague feelings of confusion - Disorganized - Self-critical - general negative attitudes or thoughts - difficulty thinking in a logical sequence - start losing capacity to think clearly. Some people misdiagnosed with dementia. - Lots of kids diagnosed with ADHD are just stressed, might not actually have ADHD - Long term = can lead to disease. Ex: sadness => depression The Signs of Stress – Behavioral - Difficulty “unwinding” at the end of the day - Drinking or smoking more than usual - Difficulty falling asleep - Early morning awakening - Eating more or less than usual - No time for family or friends - No time for relaxation or exercise Psychological Consequences of Stress - Personal - Interpersonal  - Performance The Consequences of Stress – Personal - Severe Anxiety - Loss of interest in life’s pleasures - Depression - Emotional outbursts - Alcohol and drug abuse - Insomnia - Eating disorders - Physical health problems The Consequences of Stress – Interpersonal - Cynicism - Hostility - Loss of intimacy - Relationship break-up - Devalued relationships - Family conflicts - Conflicts with co-workers - Tend to push people away The Consequences of Stress – Performance - Decreased productivity - Deterioration in work quality - Declining work habits - Inability to meet deadlines - Work absenteeism - Complete breakdown in functioning - Burn out There’s a certain amount of stress you need to perform Burn out  Lecture 4: Stress and Sociocultural Factors Sociocultural Factors - Socioeconomic Status - Cross cultural differences - Cultural deprivation - Family Structure - Kinship - Child rearing practices - Caregiving Socioeconomic Status - SES and Stress - Role of subjective SES - Chronic stressors - Mediators Race Hostility Perceived control - Whitehall study: people who work in the government in Britain. Looked at health outcomes. - Glasgow: students went into cemetery. Measured height of tombstone & correlate with lifespan. Direct correlation. Proof of SES predicting health. More money = buy bigger tombstone = how long they lived. *** SES and Stress - What effect on stress can we expect from higher/lower SES? - Stress is also a key variable in understanding the relationship between SES and health outcomes - Relationship between SES and stress/health may be mediated by: Available resources è Education (opportunity), income, employment (position in company, working conditions), status (Ex: Dr = reservations @ resto), wealth Social status è The relative position within a hierarchy Environmental aspects è Neighborhood, social support - Money buys you things that makes life more manageable - Money -> school -> better job Subjective SES - Refers to ones perception of social status in comparison to others. How much money do I make relative to the people I compare myself to.  - Feeling others are better off than you may lead to stress - Ayalon (2008) Participants: Long-term care staff Assessed: è Burnout è Positive aspects of caregiving: how much they like their job è Subjective SES: tends to be more important è Objective SES: how much money you make Results: è Perceived ↑SES predicted lower levels of burnout and more positive caregiving experiences - Doctors in this sector make less compared to other doctors therefore subjective SES isn’t that high. - Nurses = higher SES. Mostly immigrant because they’re comparing to their community - Better to be a big fish in a small pong than a small fish in a big pond SES and Chronic Stressors - Lower SES is related to increased incidence of socioecological stressors: Living situation Financial status Employment The worse these factors the greater impact SES has on health (stress as a mediator) SES and Ethnicity/Race - The effect of SES on stress/health may also be mediated by ethnicity. - Disadvantaged minorities tend to be of lower SES - African Americans (discrimination in hiring… lower SES) have been found to be at higher risk for hypertension - However, Latin-Americans have not been found to be at higher risk despite low SES - The effect of discrimination may explain these differences SES and Ethnicity/Race – Grothe et al. (2008) - Participants: Low SES African Americans with CHD vs Healthy - Measures: Self-reported hostility Chronic stressors during the past week Perceived social support - Results: CHD linked to higher hostility, increased stress and lower social support Individuals with a hostile style are more likely to experience  è More stressful interpersonal environment è Higher degree of social conflict è Less social support - Darker skin = more stress SES and Perceived Control - Low feelings of control have been correlated to stress/negative health outcomes. Lower SES = in more situations you can’t control - Work stress more common in ¯SES Individuals report more chronic stressors: conflict, boredom, social strain, hostility, job insecurity, and dangerous working conditions - Why is work more stressful at ¯SES levels? Position at work confers respect through recognition of valuable individuals to the organization SES directs people’s appraisal of their environment ¯SES groups experience less control SES and Perceived Control - Christie & Barling (2009) - Lower SES -> lower control -> increased stress -> decreased health - Participants - Canadian workers taken from the NPHS 3,419 working Canadians (mean age = 39.5; 57% male) - Measured SES: income, occupational prestige, education Personal control: Pearlin and Schooler’s (1978) mastery scale Work stressors: Karasek and Theorell’s (1990) work stress scale Health: number of health problems experienced by the participants - Results: ¯income, ¯occupational prestige, and ¯education associated with more stressful work and with less personal control ¯personal control lead to ­work stressors over time ­work stressors lead to ­health problems Culture and Stress - A culture is a group of people with shared values, characteristics, and interests. - Culture influences the stress response as follows: A. The types of stressors experienced. Ex: marrying outside your culture. Paternalistic culture -> girl can’t go clubbing B. The appraisal of these stressors C. The choice of coping strategies D. The institutional mechanisms for coping with stress (Aldwin, 2000) - Some cultures see psychology as taboo Culture and Types of Stressors - Different cultures create different sets of stressors - Social role expectations, geopolitical circumstances - Values and our social expectations - There are also subcultures within the culture who experience/respond to stress differently - Poverty creates its own stressors - Affluence also has pressures Culture and the Appraisal of Stressors - The meaning of stress is different in many cultures - What is considered stressful also differs (e.g. looking someone in the eye) - Affected by conscious and unconscious processes - Affected by family and social ties Culture and the Choice of Coping Strategies - Coping strategies mediated by cultural values - e.g Emotional expression of stress may be less acceptable in Asian cultures - These cultures may report bodily symptoms instead - Spiritual Coping - Collective vs Individualistic Coping Independent vs Interdependent Cultures (O’Kearney & Jobson, 2009) - Impact of cultural differences in self on Cognitive appraisals in Posttraumatic Stress Disorder - Trauma survivors with and without PTSD from independent (individualist) and interdependent (collectivist) cultures N= 106 - Participants provided trauma narratives which were coded for negative cognitive appraisals (ie mental defeat, control strategies etc O’Kearney & Jobson, 2009: Results - Culture determines stress response even for severe things (PTSD) Sociocultural Trends - People live longer due to an increase in life expectancy - Marriage is delayed - Couples have fewer children - More adult children choose to live at home while pursuing a higher education - Increased number of adult children are returning home after divorce Lecture 5: Stress and Fetal Development Introduction - Barker’s Hypothesis ‘Coronary heart disease, Type 2 diabetes, stroke and hypertension originate in developmental plasticity, in response to undernutrition during fetal life’. Originate in the womb Stress during sensitive periods in fetal development may explain the origin of adult diseases. Can impact all systems Programming Hypothesis - Non-genetic factors can organize or imprint permanently on physiological systems - Maternal stress can directly affect the structure and function of biological systems. - Expansion of Barker’s theory Intrauterine programming by prenatal determinants and life course factors in heart diseases (GF, growth factor).  In amniotic fluid Married people live longer Ex: spina bifida HPA Axis Hypothalamus CRH - Pituitary - ACTH - Negative feedback loop Adrenals Cortisol - estrogen stimulates cortisol production - increases during pregnancy - ↑ cortisol is bound - ACTH secretion ↑ - Cortisol production ↑ - Mother’s hpa axis is reset, positive feedback loop created by crh from placenta - Cortisol and acth increase throughout pregnancy - Up to 20 times regular levels Positive Aspects - Glucocorticoid in Fetal Development-> to make fetus grow & trigger birth Influence growth in uterus, activity of pancreas, HPA axis & cardiovascular activity Maturation of organ system - end of pregnancy ↑ in level of glucocorticoid Trigger of mechanism that leads to birth - Postnatal survival & postnatal adaptation - Accelerate lung maturation, decreases respiratory distress syndrome in premature infants -> give baby extra cortisol in NICU - Moderate levels of stress may be beneficial for optimal development Sensitizes developing nervous system Develop adaptive response to stress (excess cortisol) Rats: benefits later learning Physiological impact of maternal stress - Too much cortisol (maternal stress creates these issues - ↑ infant mortality and preterm births - ↓ birth weight and head circumference - Foetal movement & heart rate (hear after 6-8 weeks) - HPA axis response - Brain structure - Stress = less movement of baby - Preterm Births and Low Birth Weights Inuterine Growth Restrictions (IUGR) = birth weight