Stress: The Good, Bad, and the Ugly Part One. Catherine Nelson, Ph.D. University of Utah

Transcription

1 Stress: The Good, Bad, and the Ugly Part One Catherine Nelson, Ph.D. University of Utah

2 Course Overview: Stress Session One Definitions Physiology Toxic Stress Risk factors for experiencing toxic stress Protective Factors Stress and individuals with disabilities

3 Course Overview Session Two Research on stress and children and youth Early care-giving experiences Autism Self-injurious behaviors Deafblindness Research on stress and families of children with disabilities Implications of the research for teaching

4 Course Overview Session Three Prevention of Toxic Stress Preventing toxic stress in children and youth with disabilities Supporting families of children with disabilities Dealing with your own stress

5 Definitions of Stress Psychological Stress occurs when an individual perceives challenges as overwhelming when compared to resources and coping abilities (Greenberg, Carr & Summers, 2002; Gunnar & Quevedo, 2007).

6 Definitions of Stress Biological Organism s digression from a state of homeostasis and its activation of neurobiological systems (stress response) that enables it to return to a point of homeostasis (McEwan & Seeman, 1999).

7 Stress: The Good Stress is a part of a process we use to evaluate and attempt to cope with challenges Normal process if time limited Time limited stress is protective

8 Stress: the Good and Bad Under conditions of normal stress, children learn how to cope and manage Need supportive adults if they are to do this Prolonged stress can damage the body including the brain

9 Activity Think of a time when you felt you were under stress but actually performed better because of the stress Think of a time when the stress seemed to be more long term How did you react physically? Emotionally?

10 Physiology of Stress Sympathetic nervous system (SNS): Activates physiological responses to stress Parasympathetic nervous system: Activates relaxation response Tug of war to achieve balance or equilibrium

11 Physiology of Stress Brain Triune brain Reptilian Limbic brain Neocortex

12 Physiology of Stress SAM System (Sympatheticadrenomedullary system) Rapid fire system that releases epinephrine (adrenaline) Fight or flight response HPA Axis (hypothalamic-pituitaryadrenocortical system). Produces a cascade of longer acting hormones that ends in production of glucocorticoids including cortisol

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14 Cortisol Glucocorticoids take may minutes or hours to produce and affect physiology for long periods (Sapolsky, et al., 2000) Cortisol distributes glucose to critical organs and away from ones not immediately needed

15 Crisis passes Body attempts to return to homeostasis through parasympathetic nervous system including feedback loop of HPA axis

16 Stress and Physiological Processes: Parasympathetic Nervous System (PNS) Feedback loop reversal of HPA Counter defenses protect hippocampus from too much cortisol ordered by hypothalamus SNS is slow to shut down leaving the individual in a state of readiness for awhile

17 Video Clip Dr. Robert Sapolsky of Stanford University: The Psychology of Stress

18 Cortisol Varies on a circadian cycle and reactively in response to an acute stressor Circadian cycle Highest when you first wake up (Cortisol awakening response) Decreases throughout the day

19 Cortisol Curve may be elevated or flattened More likely to be flattened in chronic illness, PTSD Reactive cortisol response Reaches peak 20 to 30 minutes after onset of stressor Gradually returns to baseline over course of 40 to 60 minutes (Nicolson, 2007; Ramsay & Lewis, 2004).

20 Poll Raise your hand if you think women generally have a slower SNS stress reversal time. Raise your hand if you think men have a slower SNS stress reversal time

21 Stress: The Bad and the Ugly Sometimes stress hormones remain active for too long Injure and kill cells in hippocampus Hippocampus needed for memory and learning Excessive cortisol affects long-term memory

22 Stress: The Bad and the Ugly

23 Questions

24 Stress: The Bad and the Ugly Stress hormones divert glucose from brain to muscles Compromises ability to form new memories Hippocampus has fewer cells in aging brain Hippocampus tells hypothalamus to reduce cortisol Degenerative cycle set into motion (Lee, Ogle, & Sapolsky, 2002)

25 Stress: the bad and the ugly Increased risk of Heart disease Diabetes Hypertension Drug abuse Alcoholism Depression Anxiety disorders National Scientific Council on the Developing Child (2005)

26 Stress: The Bad and the Ugly Frequent, sustained stress hard-wires maladaptive responses Limbic brain receives permanent insult from cortisol Significant adversity early in life damages the architecture of the developing brain (National Scientific Council on the Developing Child, 2005)

27 Stress and the Developing Brain Toxic Stress can impair emotional well being early learning exploration and curiosity school readiness school achievement National Scientific Council on the Developing Child, 2008

28 Protective Factors Presence of sensitive and responsive caregivers Secure attachment relationships High quality early care and education Peer acceptance Responsive environments Feelings of competence

29 Activity Think again of the time when you felt you were stressed for a long period of time Which, if any, of the protective factors were in place? How do you think they helped you cope with the stress?

30 Magnitude of Stress Response Novelty of threat Unpredictable nature Threat to person or ego Sense of lack of control (Guilliams & Edwards, 2010)

31 Poll Raise your hand if you think bosses experience higher chronic stress than employees Raise your hand if you think workers experience higher stress than bosses

32 Toxic Stress Pathological or toxic stress occurs: Perceived lack of control Experience of negative emotions Resources are judged to be not effective or not available Absence of supportive relationships

33 Stress and Temperament Variations in perception of stressful events and vulnerability to them Temperamental characteristics play large role in vulnerability to effect of stress Temperament must be considered in context of social relationships (Gunnar & Quevedo, 2007)

34 Stress and Individuals with Disabilities Challenging behaviors may be maladaptive responses to stress May have difficulty anticipating what is coming up May have difficulty with state regulation Sleep disturbances Poor physical health

35 Stress and Individuals with Disabilities May have feelings of incompetence Learned helplessness Often perceive stress in more frequent, intense, and sustained manner (Lovallo, 1997) Unable to communicate to tell others about the stressor Janssen, Schuengel, & Stolk (2002)

36 Stress and Individuals with Disabilities Frequent, sustained stress hard-wires maladaptive responses Limbic brain receives permanent insult from cortisol Degenerative cycle is in place

37 Implications of Physical Impairments May not be able to physically reach needed or desired items May not be able to physically escape from perceived threats May not be able to get physical exercise

38 Implications of Sensory Impairments Sensory impairments limit ability to orient to changes in stimuli Habituation-dishabituation Individual who cannot habituate is in constant state of threat Hyper or hypo response

39 Implications of Sensory Impairments May not hear or see threats approaching People and things appear and disappear with little perceived reason Threat to contingent learning Contributes to learned helplessness Disturbances to circadian rhythm

40 Stress and Attachment If early relationships are reliably warm, they can buffer child from the affects of other stressors Individuals who have secure relationships have more controlled stress hormone reaction when upset or frightened Presence of sensitive responsive caregiver, can prevent elevated cortisol levels in toddlers

41 Stress and Attachment Many threat to secure attachment between caregiver and child with severe multiple disabilities Time spent in NICU units Severe health problems Low arousal levels- not enough time for attachment to occur Hyper arousal- unable to cope with too much interaction Misunderstood communication cues on both sides

42 Questions

43 References Greenberg, N. Carr, J. A., & Summers, C. H. (2002). Causes and consequences of stress. Integrative and Comparative Biology, 42, Doi: /icb/ Guilliams T. J. &Edward, L. (2010) Chronic stress and the HPA axis. The Standard; Point Institute of Neuraceatical Research, 9; 1-12 Janssen, C.G.C., Schuengel, C. & Stolk, J. (2002). Understanding challenging behaviour in people with severe and profound intellectual disability: a stress-attachment model. Journal of Intellectual Disability Research. 46: Lee, A.L., Ogle, W.O., & Sapolsky, R.M. (2002). Stress and depression: Possible link to neuron death in the hippocampus. Bipolar Disorders, 4; McEwen, B. S., & Seeman, T. (1999). Protective and damaging effects of mediators of stress: Elaborating and testing the concepts of allostasis and allostatic load. Annals of the New York Academy of Sciences, National Scientific Council on the Developing Child (2005). Excessive Stress Disrupts the Architecture of the Developing Brain: Working Paper #3.Retrieved from: National Scientific Council on the Developing Child (2008). Mental Health Problems in Early Childhood Can Impair Learning and Behavior for Life: Working Paper #6. Retrieved from: Nicolson, N. A. (2007). Measurement of cortisol. In L J. Luecken & L. C. Gallo (Eds.), Handbook of Physiological Research Methods in Health Psychology (pp ). Thousand Oaks, CA: Sage Publications.

44 References Ramsay, D., & Lewis, M. (2003). Reactivity and regulation in cortisol and behavioral responses to stress. Child Development, 74(2), doi: / Sapolsky, R. M., Romero, L. M., & Muck, A. (2000). How do glucocorticoids influence stress responses? Integrating permissive, suppressive, stimulatory and preparative actions. Endocrine Review, 21,

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