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Summary Course 2.6 Stress & Anxiety
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Psychology Course 2.6 Stress & Anxiety (2016-2017)PSYCHOLOGY YEAR 2
STRESS AND ANXIETY
The specific objectives of this course:
A. To know the biological and psychological processes involved in stress and how it is experienced.
B. To know the phenomenology, symptomatology and the DSM classification of the anxiety disorders.
C. To have knowledge of the etiology of these disorders.
D. To have knowledge of the psychological pharmacological treatment of anxiety disorders.
E. To be able to critically read and summarize scientific articles on these disorders.
F. Knowing how to interpret a personality questionnaire using normalized data.
Exam components during the course:
Attendance requirement (100% attendance)
Course exam on the 21st of April (50-55 multiple-choice questions “a-b-c-d”)
Practical assignment
Professional conduct
Black=from the book or article
Orange=my own conclusion or additional information
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,Psychology Course 2.6 Stress & Anxiety (2016-2017)
Problem 6.1 Stress
Primary resources: Folkman & Lazarus (1988); Putman & Roelofs (2011)
Additional resources: Kalat (10th edition), information about the startle reflex, videos on Psyweb
Total sources: 5
FOLKMAN & LAZARUS (1988)
Historically, coping has been viewed primarily as a response to emotion. The emotion of fear
tends to lead to a behavior which includes some form of escape. This includes cognitive
processes such as denial, repression, suppression, problem solving or intellectualization.
There seem to be two mechanism through which individuals escape anxiety: motivational (1;
attention is redirected from the task to a more pressing emergency), and cognitive (2; anxiety
related thoughts are irrelevant to performance impede functioning). Emotion depends on
cognitive appraisal of the importance of the situation to the individual. This leads us to
sometime feel two emotions at the same time about an event. Coping must be seen as either
an approach-avoidance behavior or as a defense. There seems to be an unidirectional causal
pattern between emotion and how it affects coping. However, in a stressful situation there is a
bidirectional relation between emotion and coping. Reappraisal of emotion leads to a change
in quality and intensity of the emotion.
Mediator variables are generated by the encounter (e.g. stress or an emotion) whilst moderator variables are conditions such
as gender, personality traits and so on. Coping functions as a mediator. In this study, they examined the extent to which eight different
forms of coping mediated four types of emotions during stressful events. They wanted to find: if coping mediates emotional response (1),
if the effects are limited to some kind of emotions (2), and to what extent there is specificity in the association between diverse forms of
emotion-focused coping and problem-focused coping (3).
They found that, for the younger group, coping explained a significant amount of variance in the disgusted/angry scale, confident
scale and happy scale. However, coping did not have an influence on anxiety or fear. Problem solving led to a lower anger/disgust and
more confidence and happiness. Confrontive and distancing coping lead to more anger/disgust and less confidence and happiness.
Accepting responsibility led to less confidence. Self-control, escape-avoidance and seeking social support did not influence anything
significantly. In the older group, they found that problem solving led to more confidence but to less anger and happiness. Seeking social
support led to more confidence but less happiness. Accepting responsibility and positive reappraisal les to more anxiety and fear while
escape avoidance led to more confidence. Distancing led to less happiness. Note: so, it seems that age leads to different effects of
different coping styles. Of course, the only one we care about here is anxiety and fear and that did not correlate with any of the coping
styles. They seem to suggest that coping does not lead to less anxiety nor fear, except for the accepting responsibility and positive
reappraisal in older individuals.
This article refers to problem 1 part b. Mary in this case thinks “I’ll never be able to give my presentation if I feel this ill.” this is
an example of anxiety (the anticipation of fear or something going wrong). Fay thinks “It's not ideal that I'm feeling this sick, but I have
practiced my presentation, so as long as I do my best I'm sure it will be fine." this is coping behavior (e.g. positive reappraisal). Esther
says: “This is a valid reason to not have to go in today. Ah well, can't be helped. Too bad about that presentation.” this is escape behavior.
PUTMAN & ROELOFS (2011)
Cortisol is the end-product of the HPA-axis and is also known as the stress hormone because it is related to affective psychopathology.
It is not sure, however, whether cortisol causes stress or whether stress causes cortisol to be created. Cortisol has effects on the central
nervous system. Noradrenaline can affect the central nervous system very rapidly but cortisol can only act minutes after the stressor has
occurred (the peak can be as late as 25 minutes after the onset of the stressor). Note: cortisol is more used in the aftermath of stress
than in the immediate sense of danger. When cortisol is injected it can lead to immediate aggressive behavior in male animals. It seems
that cortisol leads to more award driven behavior. This is true because cortisol interacts with neurotransmitters that lead to motivation
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,Psychology Course 2.6 Stress & Anxiety (2016-2017)
(e.g. serotonin, dopamine and GABA). Cortisol binds to two receptors: mineralocorticoid receptors and glucocorticoid receptors. Cortisol
is very likely to be involved in adaptive cognitive processing of stress-related information because it operates through the prefrontal and
limbic areas. They hypnotize that cortisol restores the function of balance between stimulus-driven and goal-directed behavior.
A lot of emotional responses are influenced by learned automatic cognitive processes. When we sense that there is a threat in
the environment we tend to direct all our attention towards it. This is an automatic bias in information processing which also seems to
influence interpretation and memory processes. Cortisol might inhibit the retrieval of traumatic memories. Depending on the context,
cortisol may either inhibit vigilant processing of emotional information or facilitate it. Note: usually, easier tasks are facilitated and harder
tasks are not.
When cortisol was injected, it did not seem to have an effect or self-reported affective state or the modulation of the startle reflex.
The unmodulated startle reflex was influenced by cortisol in a non-linear fashion (low dose made it increase and a high dose made it
decrease). It also seemed that a high or low doses led to a mood improvement. It also led to individuals taking a bigger risk when gambling
than the control group. Note: so indeed, it influences goal-directed behavior. But cortisol injections led to avoidance in highly anxious or
inhibited individuals. After an injection, individuals tended to remember angry faces better instead of fearful faces. Note: but this result
varies among studies. Cortisol does seem to lead to attentional inhibition of task-irrelevant threat stimuli and reduce avoidance behavior.
In another study, was found that cortisol in combination with a re-uptake inhibitor
lead to more activity in the amygdala for fearful faces and less activity for happy
faces. Note: again, further evidence is required. Cortisol increased the resting state
in EEG. It appears that in the aftermath of acute fear and stress, endogenous
cortisol may serve to reset behavior and cognitive processing of affectively
significant information from a fearful stimulus-driven reflexive mode to a more
adaptive goal-directed mode. Cortisol has immediate effects on emotional processing that promote coping with stress which may
accumulate over time and induce relevant changes in affective functioning. Note: in sum, cortisol leads to less fear and more attention
for task relevant information which makes behavior more goal directed. Cortisol is therefore good during brief stress because it resets
the mind onto a state as it was before being anxious or fearful.
KALAT (10th EDITION)
Short stress is called eustress but long-term stress is called distress. The term stress, is hard to define or quantify. Stress can be
defined as the nonspecific response of the body to any demand made upon it. In the short term, it produces adaptive changes that help
the animal respond to the stressor. In the long-term it produces changes that are maladaptive. Bruce McEwen proposed an alternative
definition for stress that is better for most purposes: “events that are interpreted as threatening to an individual and which elicit
physiological and behavioral responses.” When the body is exposed to harm or threat, the result is a cluster of physiological changes
that is generally referred to as the stress response or just stress. Stressors (experiences that induce the stress response): external (1;
e.g. car), cognitive (e.g. apprehension of the car; anxiety), physiological (e.g. higher heart rate). An individual has two types of
responses to stress: behavior (e.g. fight or flight) or process stress (an interaction between person and environment). Note: a fear
response is very similar in humans because it is an universal emotion (think of the picture in problem 1 part a).
Any threat to the body, activates a generalized response to stress, which is called the general adaptation syndrome:
First stage (alarm): short period; is characterized by increased activity of the sympathetic nervous system, readying the body for
brief emergency activity. Epinephrine and norepinephrine is released.
Second stage (resistance): longer period; the sympathetic response declines, but the adrenal cortex secretes cortisol and other
hormones that enable the body to maintain prolonged alertness, fight infections, and heal wounds.
Third stage (exhaustion): during this stage, the individual is tired, inactive, and vulnerable because the nervous system and immune
systems no longer have the energy to sustain their heightened responses
Note: stress responses are complex and varied, with the exact response depending on the stressor, its timing, the nature of the stressed
person, and how the stressed person reacts to the stressor
Page 3 of 46
, Psychology Course 2.6 Stress & Anxiety (2016-2017)
Stress activates two body systems. The sympathetic nervous
system (increasing the amounts of epinephrine and norepinephrine
released from the adrenal medulla) and the HPA axis: the hypothalamus,
pituitary gland, and adrenal cortex. The HPA axis acts in the following way:
activation CRH in the hypothalamus induces the anterior pituitary gland to
secrete adrenocorticotropic hormone (1), this stimulates the human
adrenal cortex to secrete glucorticoids (e.g. cortisol in humans) or
cortcosterone in animals (2), this enhances metabolic activity, blood
pressure and elevates blood levels of sugar and other nutrients. Many
researchers refer to cortisol as a “stress hormone”. Cortisol gives feedback
through the hippocampus to the thalamus to produce less cortisol.
Compared to the autonomic nervous system, the HPA axis reacts more
slowly, but it becomes the dominant response to prolonged stressors, such
as living with an abusive parent or spouse. Note: this system is slower because it moves through the bloodstream. The response of this
axis lasts longer because it takes longer for the blood to break down the hormones.
The autonomic nervous system (ANS) reaction moves through the hypothalamus (1), then goes to the sympathetic nervous
system (2) and the adrenal medulla (3). This increases heart beat and makes digestion processes decrease. Instead it leads blood to the
muscles so you are ready to move in a rapid fashion when needed. The blood now contains more sugars because this can be turned
into energy straight away and more oxygen foyr the same reason. Memory and attention are increased as well as breathing. The
parasympathetic nervous system gets you back into a rest state and the sympathetic nervous system gets you ready to get into
action. Note: this system uses hormones through the bloodstream and neurotransmitters, which makes the process go faster. This
response does not last as long because you can’t shut down the parasympathetic nervous system for too long.
Positive effects of stress Negative effects of stress
Helps the body mobilize its energy to fight a stressful event Prolonged stress leads to episodic memory impairment
Brief and moderate stress improves attention and memory (reduction of branching in the hippocampus) and a decreased
formation immune system (cortisol increase causes receptors in the
Stress improves performance on relative simple tasks but immune system to inhibit creation of new T and B cells).
impairs performance on complex tasks It can lead to depression, infertility, inhibits growth in children,
Stress, in the short term, enhances the immune system loss of sex drive and a bigger amygdala
No new neurons are produced
Note: when we are talking about short term stress, we mean a few minutes up to an hour. Any longer produces the negative effects.
Whether you are sensitive to stress depends on: coping systems, social situation, neuroticism, if you can affect the situation and if the
situation is predictable or not.
The more predictable and controllable the situation is, the less stress you feel.
In the rat experiment from Weisse where two rats: one could run in order to prevent the
shock from being administered and one could do nothing. The rat in control gained weight
and was fine, and the rat without the control lost weight and learned to be passive and
gives up even if it could save itself sometimes. Individuals vary in their reactions to a
stressful experience. In humans, resilience in the face of stress correlates with stronger
connections between the amygdala and the prefrontal cortex. People have found many
ways to control their stress responses. Possibilities include special breathing routines,
exercise, meditation, and distraction, as well as trying to deal with the problem that
caused the stress. Social support is one of the most powerful methods of coping with
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