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Current topics: stress in health and disease final exam summary
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Current topics: stress in health and disease final exam summary
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Current Topics: Stress in Health and DiseaseLecture 1: lecture
Conceptualizing stress: different definitions. “stress can be defined as a negative emotional
experience accompanied by predictable biochemical, physiological, cognitive, and behavioral
changes that are directed towards either altering the stressful event or accommodating its
effects.” -Taylor, 1995
On a general sense, it’s the reaction to an influence that causes tension. Stress can be a stimulus
(stressor), perception and evaluation or a response.
Stressors can be life events (social readjustment rating scale), or daily hassles. Negative life
events and daily hassles contribute to depression too. An acute test can be induced in a lab
setting-> anxiety, heart rate and epinephrine are measured.
Stress as an evaluative process: step 1-> primary appraisal (can be without conscious evaluation
such as in the thalamus and amygdala). Step 2-> secondary appraisal. Therefore either emotional
focused or problem-focused coping. The perceived stress scale can be used.
Brady’s experiment: there are two monkeys in cages, and they get electric shocks. One monkey
can control the shock. The monkey who couldn’t control it experienced later cardiovascular
diseases even though they both received the same shock.
Workplace stress: demand control model-> job control-job demands matrix.
,It is known that stress and health are connected. In a study, people filled out a stress index then
got infected with a cold virus. Higher percentage of higher scores had a higher percentage of
becoming ill.
Lecture 1: reading 1
The focus is on stressors that affect health problems, problems regarding the self and so on.
These are measured by stress scales. Life events and difficulties schedule-> a method in which
a detailed interview is conducted about the threat of an event by comparing the perceived stress
of similar events experienced by others.
The ten facts->
● There is little agreement on the characteristics that define a stressful event. The
necessary criteria for an event to be considered stressful is unclear. Four approaches are
taken:
o Adaptation: the burden they put on adapting the change (event can be positive or
negative)
o Threat or harm: the intensity, duration and extent are considered as well.
o Demands exceed resources: when control over the situation is insufficient.
o Interruption of goals: goals to maintain one’s physical integrity and
psychological well-being.
Threat or harm approach is the most accepted approach.
● A stressful event can impact most diseases. These are seen in affective regulation, health
behaviours, neurohormonal systems and the autonomic nervous system. These in result
can affect organs and bodily systems.
o Depression-> stress predicts the onset. Individuals who develop depression are
estimated to be between 2.5 and 9.4 times as likely to have experienced a major
stressful life event prior to the first onset of depression.
, o Cardiovascular diseases-> associated with the development of premorbid
processes (increased central adiposity, dysregulation of lipid and glucose levels,
heightened exposure to inflammation, and elevated resting blood pressure). Even
minor stressors can affect CVS.
o Infectious diseases-> viruses and bacteria. Consider the experiment mentioned in
the lecture with the cold virus.
o Cancer-> recent studies don’t give much support due to methodological
difficulties. stressful life events were associated with poorer survival among
samples of patients with cancer.
Stressful events may be associated with decreased cancer survival but are probably not
associated with disease incidence.
● Most people get exposed to a stressful event (even traumatic events) don’t get sick.
Some people are resilient (greater perceived control, greater self-efficacy, and lesser
negative affectivity and rumination).
● Stressful events do not fall randomly from the sky. They depend on environmental
circumstances and psychological characteristics (such as SES). For example, divorce
is more common in people scoring high on neuroticism. Attributional style, attachment
type and coping strategies also play a part. The dominos effect can be seen regarding
stressful events.
● Stressful events may not cause disease in healthy people. events may influence risk for
disease by either suppressing the body’s ability to fight invading pathogens or
exacerbating the progression of ongoing premorbid processes. The early premorbid
disease can be difficult to identify.
● Certain types of stressful events are particularly potent. Threats to the sense of
competence or status are the costliest.
o Interpersonal problems-> centred around relationships and interactions.
o loss of social status-> exclusion or break-ups are examples.
o Employment difficulties-> becoming unemployed or underemployed increases
o risk for depression, CVD, and premature mortality.
, ● Chronic stressful life events are worse than acute ones, except when they are not. Chronic
problems wear people out with their persistence. Acute events such as rape can have
great long-lasting effects.
● Multiple events may be more potent than individual ones, or they may not. LEDS
interview suggests that experiencing a single event that meets a moderate or severe threat
criterion is sufficient to put people at risk, but that experiencing multiple events does not
further increase that risk. The interview is insufficient in terms of the details of events. It
is not clear whether an event needs to meet a threshold of threat or adaptation, whether
events that cluster together should be considered a single experience or multiple ones, or
whether event domains are a better way of defining the stress experiences than the
occurrence of single events.
● Stressful events vary in frequency and potency as a function of where an individual is in
the life course. Individuals have expectations about when Important life events are
supposed to happen, and violations of these expectations can have deleterious
consequences for health and well-being. Losing a spouse will have more negative
outcomes if it happens earlier in life. Sensitive periods can be more prone to
longer-lasting effects of stress.
● Different types of stressful events influence women and men. Women focus more on
communal goals whereas men focus more on self-focused agentic goals, therefore
stressors are more related to the stereotypical goals. Changing socio-cultural norms are
closing the gap between the two genders.
Reflections and conclusions
● What we know about stressful life events and disease risk-> stress predicts increases in
severity and progression of diseases. Two endocrine response systems, the
hypothalamic-pituitaryadrenocortical (HPA) axis and the sympathetic-adrenal-medullary
(SAM) system, are particularly reactive to psychological stress. Chronic stress has the
worst outcomes. These include the acute events that have prolonged effects.
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