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Summary Exam 1 Current Topics: Stress in Health and Disease UvA Year 3
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Summary of Current Topics: Stress in Health and Disease Exam 1
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W1.1CHAPTER 3 – STRESS AND HEALTH
Stress: Originated in physics and engineering to describe the internal forces in a system
caused by external pressures – Over time the word stress has become widely used to mean
many things, such as a negative situation, a feeling of pressure, tension or negative emotion
- Stressors: External or internal events that may trigger stress responses → Divided into
acute stressors, chronic stressors, daily hassles, traumatic stressors and role strain
- Stress responses: The various ways we respond to a stressor → Divided into cognitive,
affective, behavioural and physiological responses – Not always a strong association
between different responses!
Peripheral nervous system (PNS): Connects the central nervous system (CNS) (i.e. consisting
of the brain and spinal cord) to the rest of the body
1. Autonomic nervous system: Regulates involuntary physiological functions – Operates
without conscious control, meaning it is responsible for automatic bodily functions
- Sympathetic nervous system/fight-or-flight response: Prepares the body for
stressful or emergency situations – Fast, first-wave response → Adrenal
medulla is stimulated to produce stress hormones such as adrenaline (i.e.
epinephrine) and noradrenaline (i.e. norepinephrine), which causes stimulation
of the heart and lungs and the diversion of energy away from unnecessary
functions, such as saliva production, digestion and reproduction
- Hypothalamic-pituitary-adrenal (HPA) axis: Functions as a slower,
second-wave response → The hypothalamus releases corticotrophin
releasing factor, which sets off the release of cortisol and other
hormones from the adrenal cortex, resulting in an increase in blood
sugar levels and metabolic rate → Under prolonged periods of stress
the HPA-axis can become dysregulated and result in chronically
elevated levels of cortisol, evident in Cushing’s syndrome
- Parasympathetic nervous system/rest-and-digest: Conserves energy and
restores the body to a state of calm
2. Somatic nervous system: Controls voluntary movements of skeletal muscles
Stress responsivity: The way an individual’s body and mind respond to stressors
- Dandelion children: Are able to thrive in almost any environment – Tend to be more
resilient, adaptable and less affected by stress or adversity
- Orchid children: Are highly sensitive – Flourish in supportive, nurturing environments
but may struggle in difficult or harsh conditions
Tend-and-befriend: An alternative to the traditional fight-or-flight response, suggesting that
there is another adaptive stress response characterised by nurturing and seeking social support
– Particularly linked to females – May be more effective for dealing with chronic or ongoing
stress by promoting social networks
1. Oxytocin: Associated with social bonding, maternal behaviours and affiliation
2. Endogenous opioids: Aid in mitigating physical pain and emotional distress related to
social separation or loss
,Stress and the immune system:
- Acute stress → Triggers a quick, temporary increase in immune response, mobilising
immune cells to provide immediate defence against potential injury
- Brief stress → Shifts the immune system’s focus from cellular immunity (which
protects against physical injuries) to humoral immunity (which protects against
infections) – Explains why students often become ill after exams, as during the exam
period, the body prioritises infection defence, which decreases once the stress ends
- Chronic stress → Has a negative impact on immune function, reducing overall
immunity and making individuals more susceptible to illness
Interactional approach: Outlines three processes of appraisal (= the evaluation process by
which an individual assesses a situation to determine its significance for their well-being)
1. Primary appraisal: The demands of a situation are evaluated as benign or stressful
2. Secondary appraisal: A person evaluates their resources and capacity to cope
3. Reappraisal: After applying a coping strategy, a person reconsiders the situation
Thee main issues with establishing the definitive
pathways between stress and health:
1. Variation in how people respond to stressors
2. It is usually not possible to state if an illness is
due entirely to stress or entirely to other factors
3. The effect of stress on health can be due to
behavioural, emotional or physical responses to
stressors (E.g.; people who are stressed are also
more likely to smoke, drink alcohol and have a
poor diet)
Allostasis: The process of regulating a physiological state to achieve stability or homeostasis
Allostatic load: The ‘wear and tear’ on the body that accumulates when an individual is
exposed to repeated or chronic stress – Captures the idea that there is a cost to the body’s
efforts to maintain stability through change
Experiment: People with a negative emotional disposition are more susceptible to developing
a cold when they feel stressed regardless of their levels of social support, whereas for people
with a positive emotional disposition, social support acts as a buffer against the effects of
stress
Resilience: People showing swift recovery from stressful events, having sustainability of
purpose in the face of adversity, and growth or new learning from adversity
1. Emotion and emotional disposition
2. Coping: Any attempt to cope with a stressor, irrespective of whether this is successful
- Emotion-focused strategies: Concentrate on managing emotional reactions
- Problem-focused strategies: Concentrate on dealing with the problem to
decrease or eliminate the stress – Healthier alternative
- Approach coping strategies: Dealing with a situation proactively – Active
- Avoidant coping strategies: Trying to avoid a problem – Emotion-focused
, 3. Social relationships and social support
- Experiment: For people from a collectivistic culture, receiving unsolicited
support was less stressful compared to having to ask for it, while for people
from a individualistic culture, the form of support (i.e. whether solicited or
unsolicited) did not significantly affect stress levels
Stress burnout has three main symptoms:
1. Emotional exhaustion: Feelings of physical exhaustion, being depleted or worn out
2. Depersonalisation: Having an unfeeling, impersonal approach to co-workers or
patients, cynicism and a lack of engagement with the job or people
3. Reduced personal accomplishment: A poor sense of effectiveness, involvement,
commitment and engagement, and a poor belief in one’s ability to change or improve
work patterns or environment
Risk of burnout operates at three levels
1. Individual → Healthy lifestyle/behaviours, adequate coping
2. Individual and environment → Social support structures, relationships, improving
person-organisation fit
3. Organisational level → Adequate working conditions, organisation of work, design
Two main categories of stress management:
1. Those that focus on physical and mental relaxation
2. Those that focus on cognition and behaviour
Stress inoculation: A intervention for stress management that involves exposing people to
potential stressors and training them in skills so they become ‘inoculated’ against these
stressors and are able to work effectively under potentially stressful conditions
ARTICLE BY COHEN, MURPHY & PRATHER (2019) – TEN SURPRISING FACTS
ABOUT STRESSFUL LIFE EVENTS AND DISEASE RISK
Life Events and Difficulties Schedule (LEDS): A structured interview method used to assess
the impact of major life events on an individual’s health – Threat level of an event is
evaluated by comparing it to a reference ‘dictionary’ of similar events that have been
previously rated in interviews with others
Fact 1: There is little agreement on the characteristics that define a stressful event
1. Adaptation: The amount of adaptation or change an event requires of an average
individual – Implies that stressful events are cumulative, with each additional event
adding to the overall burden of change, and implies that positive events can be
stressful events if they require substantial adaptation
2. Threat or harm: Stressful events are those that are consensually seen as threatening or
harmful → Most commonly accepted perspective
3. Demands exceed success: A demanding situation results in psychological distress and
strain when decision autonomy and control over a situation are insufficient
4. Interruption of goals: Stressful events are interruptions of major goals, including goals
to maintain one’s physical integrity and one’s psychological well-being
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