Stress

Question 1

Sub-Topics

Answer 1

• sources of stress
– physiology of stress and effects on health: the GAS Model (Selye,
1936)
– causes of stress: work (Chandola et al., 2008), life events (Holmes
and Rahe, 1967), personality (Friedman and Rosenman, 1974)
• measures of stress
– physiological measures: recording devices and sample tests (Wang et al, Evans and Wener)
– psychological measures: self-report questionnaires (Holmes and Rahe; Friedman and Rosenman)
• management of stress
– medical techniques (biochemical)
– psychological techniques: biofeedback (Budzynski et al and imagery (Bridge, 1988)
– preventing stress (Meichenbaum, 1985)

Question 2

Stress

Answer 2

• Caused by two things: levels of anxiety and your body’s reaction to your thought processes
• stress happens when we feel that we are not in control of events in Our lives and comes in many forms both positive and negative and can have many triggers and physiological responses
• eustress: beneficial stress

Question 3

Sources of Stress

Answer 3

• The gas model (Selye)
• observed that long term adaptation to stress followed a three-stage pattern which he named the general adaptation syndrome
• Gas is a term describing the body is short and long-term reactions and adaptation to stress in order to restore homeostasis
• Homeostasis is the control of internal conditions
• Three stages are the alarm resistance and exhaustion
• The body responds identically to any stressor

Question 4

Causes of stress

Answer 4

1. Work (Chandola et al)
2. Life Events (Holmes and Rahe)
3. Personality (Friedman and Rosenman)

Question 5

Work

Answer 5

-Chandola et al
-Workplace stress is the result of a conflict between the demands that a job might place on its employees and the extent of the control an employee has to meet the demand.
-Stress associated with coronary heart disease
-wanted to determine the biological and behavioral factors linking work stress with CHD
-analysed data collected from the whitehall II study to investigate the following three questions
Is the accumulation of work stress associated with higher chances of developing CHD?
is this association stronger among the working age population?
does work stress affect CHD directly through neuroendocrine mechanism or indirectly through behavioral risk factors?

Question 6

Whitehall II study

Answer 6

• whitehall II study was established to explore the relationship between socioeconomic status, stress and cardiovascular disease
• 10308 participants, aged 35 to 55, 3413 women, 6895 men recruited from the British Civil Service
• self report questionnaires and clinical data, continue until 2030
• Work stress increased risks of heart disease obesity and cardiovascular risk

Question 7

Results (Chandola et al)

Answer 7

• Chandola et al recorded the number of non fetal heart attacks and death due to heart disease that occurred during study
• collected info on cholesterol blood pressure, blood sugar levels, waist circumference…
• Cumulative work stress is a high risk factor for developing CHD especially among the younger working age population.
• 32% of the effect of work stress on CHD can be explained by the effect of work stress on health behaviour: low physical activity and poor diet

Question 8

Life Events

Answer 8

• Holmes and Rahe
• Stress: a condition or feeling experienced when a person perceives that demands exceed the personal and social resources they are able to make use of
• Stress generated by such events seemed to build up
• whether a particularly stressful period produced illness later on depended on just how much stress had been accumulated and people who had experienced a very high number of stressful -life events in a certain period were very much more likely to experience a prolonged illness in the following year than people who had not
• 394 patients, ranked 43 life events

Question 9

Personality

Answer 9

• Friedman and Rosenman
• Believed that the causes of stress come from the individual and that a person’s personality determine whether they are susceptible to stress or not
• type a: highly competitive, time urgency, high level of anger and hostility, works fast, strong desire to succeed
• longitudinal study, 3000 healthy men ages 39-59 assessed to determine their personality types, and then followed up throughout the following 9 years.
• Divided into type a and type b personalities
• 70% of the 257 men who died were from the Type A group
• Thus, Type A are more susceptible to stress because of their behaviour traits and are consequently more likely to suffer from stress-related illnesses such as CHD

Question 10

Measures of Stress

Answer 10

– physiological measures: recording devices and sample tests (Wang et al, Evans and Wener)
– psychological measures: self-report questionnaires (Holmes and Rahe; Friedman and Rosenman)

Question 11

Physiological measure: recording device

Answer 11

One way to investigate the impact of stress on the brain is to use brain imaging techniques (FMRI)

• Wang et al Used FMRI scanner and a technique called arterial spin-labelling perfusion MRI to measure cerebral blood flow
• FMRI scan to see how the brain is working during different tasks
• 32 participants were split into a stress condition(25) and the control experiment(7)
• participants were instructed to perform a mental arithmetic task, prompted to do faster and required to restart the task if an error occurred (high stress condition)
• subjects counted aloud backwards form 1000 (low-stress condition)
• self-reports of stress and saliva samples were collected

Question 12

How does the FMRI work?

Answer 12

• patients are positioned in a large scanner that send a strong magnetic field through their head
• the magnetic field causes the nuclei in hydrogen molecules in the brain to spin in a particular way and this is picked up by the scanner

Question 13

Physiological measure: Sample Test

Answer 13

Evans and Wener

• Conducted Research looking at how easily and how frequently personal space may be intruded upon and how this may be one of the key underlying processes that underlie stressful experience is when travelling.
• 139 adult commuters, 54% male
• Provided a free monthly rail pass for their participation
• Two measures of crowding were taken for each participant’s journey: car density and seat density
• salivary cortisol was collected from each participant through a chewable swab.
• Density of the train car was inconsequential for levels of stress whereas the seating density near to the passenger significantly affected both self-reported stress and levels of cortisol in the Participant’s saliva.
• Shows stress can be measured through physical measures such as taking a sample of saliva

Question 14

Physiological measures: self-report measures

Answer 14

1. Holmes and Rahe
2. Rahe et al
3. Friedman and Rosenman

Question 15

Physiological measures: Holmes and Rahe

Answer 15

• Investigated the causes and sources of stress and focused on life events as stressors
• developed the social readjustment rating scale
• Score of 300 higher puts the person at risk of illness

Question 16

Physiological measures: Rahe et al

Answer 16

• Tested the reliability of the scale again
• asked 2500 us military members to rank stressful events in their life against the scale
• Tracks them for 6 months noting their visits to the dispensary to see if there is a correlation Between their visit to the doctor and the stressful events they had reported
• proved the reliability of the study

Question 17

Physiological measures: Friedman and Rosenman

Answer 17

-Classifying behaviour into type a and type b category is usually done by interview or questionnaire

Question 18

Management of stress

Answer 18

• Medical techniques
• Psychological techniques:Biofeedback (Budzynski et al) and Imagery (Bridge)
• Preventing Stress (Meichenbaum)

Question 19

Medical Techniques

Answer 19

• Stress is often accompanied by anxiety and depression and so drugs used to treat these disorders are often prescribed when a person is experiencing any symptoms of stress.
• SSRIs
• Benzodiazepines: Drugs that can be used to treat anxiety (which of often results from stress) and work by releasing inhibitory neurotransmitters, meaning that the brain is less aroused so the person is calmer and less anxious.
• effectiveness of benzodiazepines was researched by Kahn et al. 250 patients. 8 weeks later found out that the drug was more effective than placebo.

Question 20

Biofeedback

Answer 20

• is a technique in which an electromechanical device monitors the status of a person’s physiological processes, such as heart rate or muscle tension, and immediately reports that nformation back to the individual.
• the info enables the person to gain voluntary control over these processes through operant conditioning.
• electromyography electrodes attached to the skin surface over a particular muscle
• subjects hear a tone with a pitch proportional to the electromyographic activity in a given muscle group
• as the patient gets better at this they have to maintain a higher level of relaxation in the muscle to hear a low tone.

Question 21

Study on Biofeedback

Answer 21

• Budzynski et al
• Wanted to assess the effect of biofeedback in reducing tension headaches
• Electrodes attached to the head above the eye across the forehead
• Three conditions: 1 experimental into control groups
• experimental group a significant reduction in their muscle tension
• The study showed that patients can be trained to voluntarily lower than muscle through the use of biofeedback

Question 22

Imagery

Answer 22

• Bridge
• involve the systematic practice of creating a detailed mental image of an attractive and peaceful setting or environment
• read the process from the book
• use it to promote relaxation

Question 23

Bridge’s experiment

Answer 23

• looking at the effect of relaxation and imagery on the stress levels of women who are undergoing treatment for cancer
• 139 out patients undergoing radiotherapy at the middlesex hospital London under the age of 70
• completed the leeds general scales measure and a mood scale
• three groups relaxation, relaxation + imagery or a control group
• no significant differences On The Leeds general scale
• The total mood disturbance score on the profile of mood States differed significantly in the predictive way.
• Relaxation + imagery was the most effective

Question 24

Preventing Stress

Answer 24

• Meichenbaum
• Stress inoculation training (SIT) consists of three overlapping phases
• A key part of the training is the idea that stressors are creative opportunities and puzzles to be solved rather than obstacles
• of form of cognitive behavioral therapy
• it attempts to get the patient to recognise the cognitions that trigger a stressful experience and then skill them with intervention strategies to help relief the stressful experience.
• Coping strategies