Chapter 3: Stress and Its Effects

Transcription

1 Chapter 3: Stress and Its Effects Many circumstances can create stress in people s lives. Stress comes in all sorts of packages; large and small, pretty and ugly, simple and complex. All too often, the package is a surprise. The Nature of Stress Stress is neither a stimulus nor a response but a special stimulus-response transaction in which one feels threatened or experiences loss or harm. Stress is any circumstances that threaten or are perceived to threaten one s well-being and thereby tax one s coping abilities. Stress is an Everyday Event: It is a noun (we have stress), an adjective (he has a stressful job), an adverb (she acts stressed), and a verb (writing a paper stresses me). For many of us stress levels are high and are on the rise. Stress is associated with overwhelming, traumatic crises such as hijacking, floods, earthquakes, and nuclear accidents. However, these are just the tip of the iceberg. Many everyday events such as waiting in line, having car trouble, misplacing your keys, large bills, are also stressful. A major stressful event such as getting a divorce can trigger minor stressors, such as looking for an attorney. Researchers found that scores on a scale measuring minor daily hassles were more strongly related to participant s mental health than the scores of major life events. Theorists believe that stressful events can have a cumulative or additive impact stress adds up. Not everyone becomes overwhelmed by stress from daily hassles. Individuals perception are important in how people experience stress. Stress Lies in the Eye of the Beholder: Events that are stressful for one person maybe routine for another. Primary appraisal is an initial evaluation of whether an event is (1) irrelevant to you, (2) relevant but not threatening, or (3) stressful. When you view an even as stressful, you are likely to make a secondary appraisal, which is an evaluation of your coping resources and options for dealing with stress. Negative interpretations of events are often associated with increased distress surrounding these events. People are rarely objective in their appraisals of potentially stressful events classic study of hospital patients awaiting surgery. Anxious, neurotic people are more likely to make threat appraisals and report more stress than people with less anxiety. Stress May be Embedded in the Environment: Although the perception of stress is a highly personal matter, many kinds of stress come from the environmental circumstances that individuals share with others. Ambient stress consists of chronic environmental conditions that, although not urgent, are negatively valued and place adaptive demands on people. Features of the environment such as excessive noise, traffic, and pollutions can be threatening. Crowding is a major source of environmental stress. Can be crowding in trains during commute, but mainly crowding as residential density. High density is associated with increased physiological arousal, psychological distress, and social withdrawal. 1

2 There are also repercussions of living in areas that are at risk for disease. People, who live near nuclear power plants... etc, experience high levels of distress. Residents in areas prone to earthquakes or hurricanes may also experience increased stress. There is considerable evidence that exposure to community violence, either as a victim or witness, is associated with anxiety, depression, anger and aggression among urban youth. - Children who report recent exposure to traumatic events show increased stress hormones. Stress is influenced by Culture: Culture sets the context in which people experience and appraise stress. The potential importance of culture is illustrated by the substantial body of evidence that cultural change such as increased modernization and urbanization and shifting values and customs has been a major source of stress in many societies around the world. In some cases, a specific cultural group may be exposed to pervasive stress that is unique to that group. Racial discrimination negatively effects mental health and well-being this racial discrimination is said to be stressful. Everyday discrimination can take many forms, including verbal insults, negative evaluations, avoidance, denial of equal treatment, threats of aggression. - Minority group members may experience stress greatly. - It can be subtle Perceived discrimination has been linked to greater psychological distress, higher levels of depression, and decreased well-being for a variety of minority groups including sexual minorities. For immigrants, acculturation, or changing to adapt to a new culture, is a major source of stress related to reduced well-being. This even holds for children. The discrepancy between what individuals expect before immigrating and what they actually experience once they do immigrate is related to the amount of acculturation stress they report. Major Sources of Stress Acute stressors are threatening events that have a relatively short duration and a clear end point. Chronic stressors are threatening events that have a relatively long duration and no readily apparent time limit. Anticipatory stressors are upcoming or future events that are perceived to be threatening. Thus, we anticipate the impact of the event even though it has not happened yet. Four major sources of stress: Frustration: Frustration occurs in any situation in which the pursuit of some goal is thwarted. You experience frustration when you want something and can t have it. Everyone deals with this virtually every day. Frustration often leads to aggression. Some frustration such as failures and losses, can be sources of significant stress. Fortunately, more frustrations are brief and insignificant. Frustration appears to be the culprit at work when people feel troubled by environmental stress. Frustration in the workplace often results in burnout. Internal Conflict: Should I or shouldn t I? 2

3 Internal conflict occurs when two or more incompatible motivations or behavioural impulses compete for expression. Internal conflict generates considerable psychological distress. Conflict comes in three types: approach-approach conflict, a choice must be made between two attractive goals. This conflict tends to be the less stressful. You typically have a reasonably happy ending, whichever way you decide to go. However, in avoidance-avoidance conflict, a choice must be made between two unattractive goals. Here you are caught between a rock and a hard wall. This conflict is most unpleasant and highly stressful and people delay their decision as long as possible. In approach-avoidance conflict, a choice must be made about whether to pursue a single goal that has both attractive and unattractive aspects. This conflict is common, and highly stressful. This conflict also often produces vacillation that is people go back and forth, beset by indecision that can create stress. Change: Life changes are any noticeable alterations in one s living circumstances that require readjustment. Why would positive events, such as moving to a nice home, produce stress? It is because they produce change. Disruption of daily routines are stressful. Holmes and Rahe developed to Social Readjustment Rating Scale (SRRS) to measure life changes as a form of stress. The person adds up the numbers associated with each event checked. This sum is an index of the amount of change-related stress the person has recently experienced. People with higher scores on the SRRS tend to be more vulnerable to many kinds of physical illness and psychological problems. Experts argue that the SRRS does not measure change exclusively. The list of SRRS is dominated by negative events which will generate great frustration. Pressure: Pressure involved expectations or demands that one behave in a certain way. Pressure can be divided into two subtypes: the pressure to perform and the pressure to conform. Pressure has turned out to be more strongly related to measures of mental health than the SRRS and other established measures of stress. Academic pressure, common for students, are related to increased anxiety and depression and affects students motivation and concentration. Stress resulting from academic pressure may actually impede academic performance and lead to problematic escape behaviours such as drinking. Pressure is not necessarily something imposed from outside forces, rather it is often self-imposed. For example, signing up for extra classes to get through school quickly, or seeking additional leadership positions, or rapidly climbing the corporate ladder. Responding to Stress When you groan in reaction to the traffic report, you re experiencing an emotional response to stress, annoyance or anger. When your pulse quickens and your stomach knots up, you re exhibiting physiological responses to stress. When you shout insults at another driver, your verbal aggression is a behavioural response to the stress at hand. Emotional Responses: Emotions are powerful, largely uncontrollable feelings, accompanied by physiological changes. When people are under stress they often react emotionally tends to elicit unpleasant emotions Negative Emotions There are strong links between specific cognitive reactions to stress and specific emotions. (Self blame- guilt, helplessness- sadness, etc). 3

4 Common negative emotional responses to stress: Annoyance, anger and rage Apprehension, anxiety, and fear Dejection, sadness, and grief Richard Lazarus also mentions five other negative emotions that often figure prominently in reactions to stress: guilt, shame, envy, jealousy and disgust. Positive Emotions Positive emotions also occur during periods of stress - Study done on gay men with partners containing AIDS. - The aftermath of 9/11 brought many negative emotions, but within this dense cloud of anguish, positive emotions also emerged. People felt gratitude for their safety of their loved ones, many accounted their blessings, some accounted renewed love for their family and friends. Frequency of pleasant emotions correlated positively with a measure of subject s resilience, whereas unpleasant emotions correlated negatively with resilience. - Positive emotions in the aftermath of crises buffer resilient people against depression and fuel thriving. Positive emotions appear to play a key role in helping people bounce back from the negative emotions associated with stress Effects of Emotional Arousal Emotional responses are a natural and normal part of life. Even unpleasant emotions serve as important purposes. Like physical pain, painful emotions can serve as warnings that one needs to take action. However, strong emotional arousal can sometimes hamper efforts to cope with stress. Test anxiety illustrates how emotional arousal can hurt performance. (Students who display high test anxiety tend to score low on exams). This is due to a lack of or disruption of attention to the test. Test anxiety can deplete one s capacity for self-control, increasing the likelihood of poor performance this tendency is related to a concept known as ego deletion. The Inverted-U hypothesis predicts that task performance should improve with increased emotional arousal up to a point, after which further increases in arousal become disruptive and performance deteriorates. The level of arousal at which performance peaks is characterized as the optimal level of arousal for a task. The conventional wisdom is that as a task becomes more complex, the optimal level of arousal tends to decrease - The inverted-u hypothesis provides a plausible model of how emotional arousal could have either beneficial or disruptive effects on coping, depending on the nature of the stressful demands. Physiological Responses: Emotional responses bring about physiological changes. The Fight-or-Flight Response The Fight-or-Flight response is a physiological reaction to threat that mobilizes an organism for attacking (fight) or fleeing (flight) an enemy. When you see a threatening figure, your heart rate increases, blood pressure rises, respiration increases, digestion slow all things that prepare you to act and that are evolutionary advantageous. These responses occur in the body s autonomic nervous system. The ANS is made up of the nerves that connect the heart, blood vessels, smooth muscles, and glands. The ANS is controlled involuntarily. The ANS can be broken down into two divisions. The parasympathetic division of the NS generally conserves bodily resources. It slows HR and promotes digestion to help the body store energy. The fight-or-flight response however is mediated by the sympathetic division of 4

5 the ANS it mobilizes bodily resources for emergencies, with an increase in HR and breathing rate but a decrease in digestion. - There s been research to see whether the fight-or-flight model applies equally well to both males and females. Because females have more responsibility for the care of young offspring than males do, they believe that it might be less adaptive for females, as both responses may endanger offspring and thus reduce the likelihood of an animal passing on its genes. - Therefore females are given a tend and befriend response to stress. Therefore in reacting to stress, females allocate more effort to the care of offspring and to seeking help and support. - Similarly, in infants response the threat, when frightened, female infants showed more approach to their mothers than the male infants did. This is said because the hormone oxytocin signals the need for affiliation in females in of social distress. In our modern world, the fight-or-flight response may be less adaptive for human functioning than it was thousands of generations ago. The General Adaptation Syndrome Selye concludes that stress reactions are non specific; they do not vary according to the specific type of circumstances encountered. To capture the general pattern all species exhibit when responding to stress, Selye formulates a seminal theory called the general adaptation syndrome which is a model of the body s stress response, consisting of three stages: alarm, resistance, and exhaustion. 1. Alarm reaction occurs when an organism recognizes the existence of a threat. Physiological arousal increases similar to the fight-or-flight response. 2. Selye took his investigation a step further and further exposed the laboratory animals to prolonges stress. If stress continues, the organism may progress to the second phase of general adaptation syndrome; stage of resistance. The physiological arousal continues to be higher but may level off as the organism becomes accustomed to the threat. 3. If the stress continues over a substantial period of time, the organism may enter the third stage stage of exhaustion. Physiological arousal will decrease and eventually the individual may collapse from exhaustion. The organisms resistance declines and leads to disease of adaptation Brain-Body Pathways When you experience stress, your brain sends signals to the endocrine system along two major pathways. The endocrine system consists of glands that secrete chemicals called hormones into the bloodstream. The hypothalamus, a small structure near the base of the brain, appears to initiate action along both pathways. The first pathway is routed through the ANS. The hypothalamus activates the SNS. A key part of this activation involves stimulating the central the central part of the adrenal glands to release large amounts of catecholamines into the bloodstream. These hormones radiate throughout your body, producing many important physiological changes. The net result of catecholamines elevation that your body is mobilized for action. HR and blood flow increases, pumping more blood into your brain and muscles. Respiration and oxygen consumptions speeds up, facilitating alertness. Digestive processes are inhibited to conserve your energy. The pupils of your eyes dilate, increasing visual sensitivity. The second pathway involves more direct communication between the brain and the endocrine system. The hypothalamus sends signals to the master gland; pituitary gland/ the pituitary secretes a hormone ACTH that stimulates the outerpart of the adrenal glands to release another important set of hormones corticosteroids. These hormones play an important role in the response to stress. They stimulate the release of chemicals that help increase your energy 5

6 and help inhibit tissue inflammation in case of injury. Cortisol is a type of corticosteroid that is often used as a physiological indicator of stress in humans. Stress can suppress certain aspects of the immune system, reducing its overall effectiveness Note: Some of these responses may persist long after a stressful event has ended! Behavioural Responses: People respond to stress at several levels their behaviour is the crucial dimension of these reactions. Most behavioural responses to stress involve coping which refers to active efforts to master, reduce, or tolerate the demands created by stress. Coping efforts are either healthy or maladaptive. Therefore coping strategies help determine whether stress has any positive or negative effects on an individual. The Potential Effects of Stress Impaired Task Performance: Stress takes its toll on the ability to perform effectively on a task at hand. Pressure to perform often makes people more self-conscious and this elevated self-consciousness disrupts their attention, thereby interfering with performance. Attention may be distorted in two ways. First, elevated self-consciousness may divert attention from the demands of the task, creating distractions. Second, on well-learned tasks that should be executed almost automatically, the self-conscious person may focus too much attention on the task. Choking isn t the only impairment of task performance related to stress. Chronic stress affects the brain in a way that leads to an overreliance on habits which can result in impairment of performance Disruption of Cognitive Functioning: The effects of stress on task performance often result from disruptions in thinking or in cognitive functioning. Stress disrupts two specific aspects of attention. First, it increased participant s tendency to jump to a conclusion too quickly without considering all their options. Second, it increased their tendency to do an unsystematic, poorly organized review of their available options. Poor attention might play an important role in actually shaping one s memory for a traumatic event. Stress can have detrimental effects on certain aspects of memory functioning. Even minor stressors can have a negative impact. Stress can reduce the efficiency of the working memory system that allows people to juggle information on the spot. Therefore, under stressful situations, people may not be able to process, manipulate or integrate new information as effectively as normal Burnout: Burnout is a syndrome involving physical and emotional exhaustion, cynicism, and a lowered sense of self-efficacy that is attributable to work-related stress. Exhaustion, which is central to burnout includes chronic fatigue, weakness, and low energy. Cynicism is manifested in highly negative attitudes toward oneself, one s work, and life in general. Reduced self-efficacy involves declining feelings of competence at work that give way to feelings of hopelessness and helplessness. Burnout is a cumulative stress reaction to ongoing occupational stressors. Burnout is associated with increased absenteeism and reduced productivity, as well as increased vulnerability to a variety of health problems. 6

7 Psychological Problems and Disorders: Chronic stress might contribute to many types of psychological problems and mental disorders. Stress contribute to poor academic performance, insomnia and other sleep disturbances, sexual difficulties, alcohol abuse, and drug abuse, stress is also associated with increase in negative mood. Stress can also contribute to the onset of depression, schizophrenia, anxiety disorders, and eating disorders. Extremely stressful, traumatic incidents can leave a lasting imprint on victims psychological functioning. PTSD involves enduring psychological disturbance attributed to the experience of a major traumatic event. - 9% of people have suffered from PTSD at some point in their life and this is twice as common in women as compared to men. - Acquire PTSD occurs in both children and adults children s symptoms often show up in their play or drawings. - Sometimes patient s symptoms don t show up until many months or years after a persons exposure to severe stress. - Traumatic events don t have to be experienced firsthand. The vast majority of people who experience such events, do not develop PTSD, so why are some people more susceptible than others? It s the intensity of one s reaction at the time of the traumatic event. Individuals with especially intense emotional reactions go on to show elevated vulnerability to PTSD. Physical Illness: Psychomatic diseases are defined as genuine physical ailments thought to be caused in part by stress and other psychological factors. These psychomatic diseases include high BP, peptic ulcers, asthma, skin disorders and migraines. Stress may influence the onset of heart disease, stroke, gastrointestinal disorders, tuberculosis, multiple sclerosis, arthritis, diabetes, leukemia, cancer, various types on infectious diseases and more. Stress is only one of many factors that may contribute to the development of physical illness. Some of the physical effects of stress might be exacerbated by the risky behaviours in which people are more likely to engage when stressed. - Alcohol abuse, drug abuse, marijuana use (+ stress = more vulnerable to illnesses) Positive Effects: The effects of stress are not entirely negative. There are positive aspects including favourable outcomes that follow in the wake of stress. Three ways stress can have a positive effect: 1. Stress can promote positive psychological change; posttraumatic growth. Stressful events sometimes force people to develop new skills, re-evaluate priorities, learn new insights and acquire new strengths. 2. Stressful events help satisfy the need for stimulation and challenge most people want an intermediate level of stimulation. Over stimulated and understimulated can be boring and stressful as well. Therefore stress is a basic need of the human organism. 3. Today s stress can inoculate psychological prepare individuals so that they are less affected by tomorrow s stress; increase stress tolerance as long as the stress isn t overwhelming. Factors Influencing Stress Tolerance 7

8 Some people seem to be able to withstand the ravages of stress better than others because a number of moderator variables can soften the impact of stress on physical and mental health. Social Support: Social support refers to various types of aid and assistance provided by members of one s social networks. Social support is favourably related to physical health & a medicine for the mind as well as the body. In the workplace: social support reduces the prevalence of burnout. Can also decrease the chance of PTSD, and increase posttraumatic growth. Both physiological & physical benefits. - Social support can be many aspects, friends (humans), or even pets. Hardiness: Hardiness may moderate the impact of stressful event (if stress affects some people less than others, some people must be hardier than others). Hardiness is a disposition marked by commitment, challenge, and control that is purportedly associated with strong stress resistance. Hardiness may reduce the effects of stress by altering stress appraisals, or fostering more active coping. Higher hardiness is related to a lower likelihood of developing a PTSD Optimism: Optimism is a general tendency to expect good outcomes. Optimism is associated with better mental and physical health. Research has identified a pessimistic explanatory style, in which people tend to blame setbacks on their own personal shortcomings, versus optimistic explanatory style, which leads people to attribute setbacks to temporary situational factors. Optimists cope with stress in more adaptive ways than pessimists. Optimists are more likely to engage in action oriented, problem-focused, carefully planned coping and more willing than pessimists to seek social support. Optimism is also related to constructs of hardiness and posttraumatic growth. Pessimists are more likely to deal with stress by avoiding it, giving up, or engaging in denial. Optimism may not always be beneficial like when times when a rosy outlook is inaccurate and unrealistic. Also, being optimistic can lead to risk behaviours if one holds an itcan t-happen-to-me attitude. Optimism that is closely tied to the strength of wisdom Self-control or rather lack of it underlies many of the stressors that people struggle with in everyday life. Behaviour modification is a systematic approach to changing behaviour though the application of the principles of conditioning. Specifying your Target Behaviour: The first step in self-modification program is to specify the target behaviour(s) that you want to change. The man who said he s too irritable instead, pinpoint exact behaviours constantly arguing with this wife, or snapping at his children these are specific behaviours for which he could design a self-modification program. Gathering Baseline Data: 8

9 The second step in behaviour modification is to gather baseline data. You need to systematically observe your target behaviour for a period of time (a week or two) before you work out the details of your program. In gathering your baseline data, you have to monitor three things. First, you need to determine the initial response level of your target behaviour. You might count the daily frequency of snapping at your children. Whatever the unit of measurement, it is crucial to gather accurate data. Keep permanent writing records. Second, you need to monitor the antecedents of your target behaviour. Antecedents are events that typically precede the target response. Often, these events play a major role in evoking your target behaviour. Third, you need to monitor the typical consequences of your target behaviour. Try to identify the reinforcements that are maintaining undesirable target behaviour or the unfavourable outcomes that are suppressing desirable target behaviour. Designing your Program: Once you have selected a target behaviour and gathered your adequate baseline data, it is time to plan your intervention program which is designed to increase/decrease the frequency of a target response. Increasing Response Strength Efforts to increase the frequency of a target response depends largely on the use of positive reinforcement. Selecting a reinforcer: you need to find a reward that will be effective for you. Be realistic, and a reinforce that is really available to you. Arranging the contingencies: once you have chosen your reinforcer, you have to set up reinforcement contingencies. These contingencies will describe the exact behavioural goals that much be met and the reinforcement that may then be awarded. Set goals that are both challenging and realistic. You need to be concerned about doling out too much reinforcement, if reinforcement is too easy to get, you bay become satiated, and the reinforcer may lose its motivational power. One way to avoid the satiation problem is to put yourself on a token economy a system for doling out symbolic reinforcers that are exchanged later for a variety of genuine reinforcers. Shaping: in some cases, you may want to reinforce a target response that you are not currently capable of making, such as speaking in front a large group. This situation is calls for shaping, which is accomplished by reinforcing closer and closer approximations of the desired response. Decreasing Response Strengths The challenge of reducing the frequency of undesirable response. Reinforcement: reinforcers can be used in an indirect way to decrease the frequency of a response. Control of antecedents: identify antecedents and avoid exposure to them. This strategy is especially useful when you are trying to decrease the frequency of a consummatory response, such as smoking or eating. Punishments: this strategy decreases unwanted behaviour by punishing yourself that that behaviour. The difficulty is following through and actually punishing yourself. First, do not use punishment alone, use it along with a positive reinforcement. Second, use a relatively mild punishment to that you will actually be able to administer it to yourself. Executing and Evaluating Your Program: Once you have designed your program, the next step is to put it to work by enforcing the contingencies that you have carefully planned. Continue to accurately record the frequency of your target to evaluate progress. 9

10 - Don t cheat main type of cheating is rewarding yourself even though you didn t earn it. You can do two things to increase the likelihood that you will comply with your program one is to make up a behavioural contract a written agreement outlining a promise to adhere to the contingencies of a behaviour modification. Ending your Program: involves setting a terminal goal. 10