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Summary Problems 1-7 Clinical Psychology: Anxiety and Stress
- Instelling
- Erasmus Universiteit Rotterdam (EUR)
Summary Problems 1-7 Clinical Psychology: Anxiety and Stress + class notes!
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PROBLEM 1STRESS
Stress = A person perceive discrepancy between the physical/psychological demand of a situation and the resources
because of transactions
The discrepancy can be real or just an inaccurate perception (e.g., Studied a lot -> Not enough preparation perceived)
Stress has 2 components:
o Physical = Direct material or bodily challenge
o Psychological = Perception of the individual of a certain circumstance
1. Stressor
o Stress is seen as a stimulus
Physical (heat, cold, noise)
Psychological death of a family member
2. Strain
o Body’s response to stressor
Psychological (thoughts and emotions)
Physiological (heart pounds, dry mouth, perspire)
3. Stressor & strain
o Transactions = Continuous interactions and adjustments person-environment affecting each other
o Stress is not just a stimulus – A person can influence the impact through strategies
COGNITIVE APPRAISAL
Cognitive appraisal = Mental process used to assess -> Whether a demand threatens physical/psychological well-
being and the resource available to meet the demand
Appraisal can be vicarious -> Emphasize with others in stressful circumstances (9/11)
1. Primary appraisal
o Assess the meaning of a situation related to the well-being -> What does it mean to me?
Irrelevant = Ignored
Good (or benign-positive)
Stressful = More appraisal -> Stressful circumstances:
o Harm loss = Damage already occurred
o Threat = Future harm expected (e.g., Loss of income, medical bills)
o Challenge = Opportunity to achieve mastery/growth by using more resources than usual to meet a demand (e.g.,
Job)
2. Secondary appraisal
o Assess the resources available for coping -> In transactions happens in case of a stressful situation
Sufficient resources = Little or no stress
Insufficient resources = Great deal of stress -> Can even lead to severe reactions as PTSD
FACTORS & DIMENSIONS
Personal factors = Intellectual, motivational and personality characteristics (e.g., Perfectionism, low-self-esteem)
Situation = Events imminent with strong demands are more stressful:
o Life transition, low desirability, low controllability, ambiguity, difficult timing (earlier or late in life than expected)
Stress increase with stressor frequency, duration & intensity -> Chronic stress -> Often or long lasting
Stronger stressor -> Stronger strain – Either psychological or physiological
Whether stress is positive or negative depends on the person’s optimal level of arousal, which differs
o Eustress = Beneficial or constructive -> Adaptive
o Distress = Harmful and damaging -> Maladaptive
, STRESS & BRAIN
There are 2 pathways:
Brain -> Anterior pituitary – Adrenocorticotropic hormone (ACTH) -> Adrenal cortex = Glucocorticoids (cortisol)
= Produce many components of stress response
Brain -> Sympathetic nervous system -> Adrenal medulla = Adrenal glands -> Norepinephrine and epinephrine =
Arousal
BIOPSYCHOLOGICAL ASPECTS
Reactivity = Physiological response to a stressor/stain -> Determined by comparison with baseline (resting level)
Genetic factors influence
Chronic stress reactivity = Higher reactivity and more time needed to return to baseline level
Fight-or-flight = Organism either ready to attack the threat or to flee
Either positive effects (=respond to danger) or negative (=harmful to health when prolonged)
Allostatic load = Stress accumulating overtime impairs the ability to adapt to future stressors
Factors related to physiological stress:
Amount of exposure = More frequent, intense -> Greater amount of physiological activation
Magnitude of reactivity = Some people have more reactivity in response to stressors than others
Rate of recovery = Some people’s physiological responses take longer to return to normal -> Worrying,
revisiting etc.
Resource restoration = The physiological resources are replenished by various activities -> Sleep most
important
o Sleep deprivation = More allostatic load -> No restoration of physiological activities
GENERAL ADAPTATION SYNDROME (GAS) THEORY
In case of prolonged stress:
1. Alarm reaction = Fight-or-flight response activated by sympathetic nervous system
o First - Adrenal glands -> Release norepinephrine and epinephrine
o Second - HPA axis (hypothalamus-pituitary-adrenal) activated
2. Stage of resistance = Adaption to stressor, but physiological arousal remains higher than normal
o HPA predominates over sympathetic nervous system
o Disease of adaptation = Resisting to stress leads to vulnerability (e.g., Asthma, high blood pressure etc.)
3. Stage of exhaustion = Prolonged arousal cause weakened immune system and damage to internal organs (even
leading to death)
IMPLICATIONS OF GAS THEORY
It does not consider psychosocial factors and it is not specific to the type of stressors – it occurs regardless (illness,
death, exercise etc.)
Cognitive appraisal plays a role in physiological reactions to stress (e.g., Smart children -> Concerned about exam ->
Appraise test as more important)
Physiological arousal depends on effort and distress
o Effort with stress = Daily hassles
o Effort without distress = Joyous state, active and successful coping
o Distress without effort = Feeling helpless, losing control, giving up
, PSYCHOSOCIAL ASPECTS
High level of stress = Affects people’s memory and attention
Stress impairs cognitive functioning -> Processes that enable to intentionally drive our behaviors
Cognitive appraisal can influence both the stress and emotions
EMOTIONS
Amygdala = Important for emotions and sensitive to some categories of stimuli
Lateral nucleus = Convergence of information coming from multiple brain regions -> Connected to the central
nucleus -> Initiation of emotional response when a stimulus is considered threatening
Superior dorsal lateral = Can undergo rapid changes -> Cells reset after several trials to their starting point but
by then they have undergone a change that maintains the adverse association
o Fear eliminated can return under stress = Fear retained in the memory of those cells
PATHWAYS - Separate but simultaneous pathways:
1. Low road (fast) = Thalamus -> Amygdala = Information rapidly reach the amygdala without being filter by
conscious control
2. High road (slow) = Thalamus -> Amygdala -> Sensory cortex for a finer analysis -> Results back to the amygdala
= Analysis more thorough and complete
SOCIOCULTURAL DIFFERENCES
Women = More major and minor stress -> More willingness to talk about and it reflects real variations in
experiences (e.g., Daily workloads)
Being part of a minority group, with low income or low education increase the stressors experienced
Men = More reactivity when stressed and take longer for the physiological arousal to return to baseline levels
Discrimination can lead to health problems: earlier death, cancer or cardiovascular diseases
SOURCES OF STRESS
Within the person:
Illness = Stress especially in old age -> More understanding of disease and death -> Focus on present and future
Achievement & status
Conflicts = Opposing motivational forces -> Stressful when involves many choices, fairly equal strength and
when the “wrong” choice can lead to negative consequences
o Approach/Approach
2 appealing goals incompatible (e.g., Lose weight and eat sweats)
More important decision = More stress
o Avoidance/Avoidance
2 undesirable situations (e.g., Two treatments that cure disease with side effects)
Conflict difficult and very stressful
o Approach/Avoidance
A single goal or situation with attractive and unattractive features (e.g., Quitting smoke)
Within the family
New family member = Financial or couple problems, pre-term birth
Marital conflict and divorce = Sleep difficulties, family changes
Family illness/Death in the family = Financial problems, traumatic events
Within the community & society
School/jobs = High workload, responsibilities, physical environment (e.g., Noisy, threats, hazardous substances),
perceived insufficient control, poor relationships, perceived inadequate recognition, job loss and insecurities
MEASURING STRESS
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