Stress and Coping

1. Stress and Coping Josée L. Jarry, Ph.D., C.Psych. Health Psychology, psy333 Department of Psychology University of Toronto October 28, 2002

2. Definition (1) Aldwin (1994) • Quality of experience, produced through a person-environment transaction, that through over- or under-arousal, results in psychological or physiological distress Hans Selye • The non-specific result of any demand upon the body, be the effect mental or somatic • Eustress is a positive stressful experience, a state of physical and psychological well-being that is associated with increased motivation and the acceptance of a challenge. • What is essential to well-being is a balance to produce an optimal level of arousal • Too little stress can be as harmful as too much • Stress can result from being over- or under-stimulated

3. Definition (2) Lazarus & Folkman (1984) • A relationship between a person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his/her well-being • This definition introduces the important notion of subjective appraisal Walter Canon • Introduced the concept of homeostasis: body’s attempt at maintaining a stable internal state • Stress challenges homeostasis Fight or Flight response • Complex ANS reaction in preparation for emergencies

4. Definition (3) Rice, P. R. (1999) Stressors • External, environmental demands placed on us that cause us to feel stressed Subjective response • Interpretive mental state of the individual • Allows one to diminish, augment, or distort the impact of external events Body’s physical response to stress • Physiological challenges which, if prolonged, can result in a negative state, or alternatively, an improved capacity to cope physiologically

5. The Physiology of Stress • 2 major components to the physical response to stress: • Nervous system • Endocrine system

6. Structure of the Nervous System Central nervous system is made of: • Brain • Spinal cord Peripheral nervous system is made of: Somatic nervous system • Receives information from the sensory organs • Controls movements of the skeletal muscles Autonomic nervous system (ANS) • Primarily serves internal organs Has 2 divisions: • Sympathetic • Parasympathetic

9. Sympathetic Response to Stress Hypothalamus causes: Increases arousal in the sympathetic nervous system • Increased heart rate & blood pressure • Constriction of peripheral blood vessels • Respiration rates increase • Bronchial tubes dilate • Pupils dilate • Digestive processes decrease Sympathetic activation prepares the body for intense motor activity

12. Parasympathetic response to stress Serves regenerative, growth-promoting, energy-conserving functions Its effects include the opposite of the effect of the sympathetic nervous system Functions under normal, non-stressful conditions Also activated by the hypothalamus • re-establishes homeostasis in the system • reconstructive process following stressful experience • slows the heart rate & decreases blood pressure • decreases muscle tension • slows respiration • neutralizes fight or flight response

14. Structure of the Endocrine System • The endocrine system consists of ductless glands distributed throughout the body • The neuroendocrine system is made of those endocrine glands that are controlled by the nervous system • Glands of the endocrine and neuroendocrine systems secrete chemicals called hormones • Hormones move into the blood stream to be carried throughout the body • Specialized receptors on target tissues or organs allow hormones to have specific effects even though they circulate throughout the body

16. Endocrine Responses to Stress Hypothalamus causes: • The pituitary gland to secrete adrenocorticotropic hormone (ACTH) that stimulates the adrenal cortex • Sympathetic fibers to directly activate the adrenal medulla • The adrenal glands are located on top of each kidney • Each gland is composed of: • an outer covering: the adrenal cortex • an inner part: the adrenal medulla • Both secrete hormones that are important in the stress response

18. Adrenomedullary Response - SAM Occurs through the activation of the sympathetic-adrenal medulla (SAM) complex: • Perception of stress causes the hypothalamus (via nervous connection) to activate sympathetic fibers • Sympathetic fibers activate the adrenal medulla • Adrenal medulla secretesthe catecholamines: epinephrine & norepinephrine This causes: • Increased heart rate, blood pressure, breathing rate & blood glucose levels • Shuts down digestive system • Rapid, short-lived response to stress

19. Adrenocortical Response - HPA Occurs through the activation of the hypothalamus-pituitary-adrenal (HPA) cortex complex: • Perception of stress causes the hypothalamus to release ACTH releasing hormone • This causes the anterior pituitary to secrete ACTH • ACTH stimulates the adrenal cortex to secrete glucocorticoids and mineralocorticoids Glucocorticoids • Protein and fat get metabolized into glucose • Reduce inflammation, suppress immune cells Mineralocorticoids • Blood volume and pressure increase

20. Sympathetic and Endocrine Responses to Stress • Stress perception causes a chain reaction: SAM • rapid, short-term stress reaction • the sympathetic NS stimulates the adrenal medulla • the adrenal medulla produces epinephrine and norepinephrine HPA • slower but longer-lasting response • the pituitary releases ACTH • ACTH causes the adrenal cortex to release glucocorticoids and mineralocorticoids

22. Brain Response to Stress Limbic System • Adds an element of emotion to the experience of stress • Usually negative emotions: fear, anger, anxiety, pain Reticular formation • Communication network that filters messages to the body • Receives input from all the sensory systems and determines which sensory information is processed or blocked • This allows us to selectively attend to specific tasks while ignoring irrelevant information

25. The General Adaptation Syndrome (1) Defined by Selye in 1956. Comprises 3 stages: Stage I: Alarm • The body’s defences against stressors are mobilized through activation of the sympathetic nervous system • Activation of the SAM complex • Arousal of the sympathetic nervous system releases hormones (adrenaline) that help prepare the body to meet stress and danger • Highly adaptive short term response to an emergency situation

26. The General Adaptation Syndrome (2) Stage II: Resistance • The body enters this stage if the stress is prolonged • Activation of the HPA complex • Arousal is lower • But the body continues to draw on internal resources at an above normal rate • Outwards appearance seems normal • Physiologically, the body’s internal functioning is not normal • Sets the stage for diseases of adaptation (e.g., peptic ulcers, ulcerative colitis)

27. The General Adaptation Syndrome (3) Stage III: Exhaustion • Continued exposure to the same stressor drains the body further • The capacity to resist is depleted • Illness results • This stage is characterized by activation of the parasympathetic division of the ANS • But at an abnormally low level • In severe cases, results in death

29. Cognitive- Transactional Model Lazarus & Folkman (1984) • Propose that the interpretation of stressful events is more important than the events themselves • It is neither the environmental event nor the person’s response that defines stress • It is the individual’s perception of the psychological situation that defines stress • Stress is a function of the person’s feeling of threat, vulnerability, and ability to cope rather than a function of the stressor • Distinguish three kinds of appraisal

30. Primary appraisal • Initial evaluation of a situation 3 possible outcomes: Irrelevant • the event has no implication for the individual’s well-being Benign-positive • the event may increase well-being Stressful • the situation is perceived as harmful, threatening, or challenging

31. Primary appraisal (2) Harm/loss • involves actual significant physical or psychological loss • psychological damage that has already been done Threat • the anticipation of harm or loss • allows to anticipate and prepare for the future Challenge • the event is perceived as stressful • the focus is on positive excitement • refers to the person’s confidence in overcoming difficult demands

32. Secondary Appraisal Concerned with a person’s evaluation of his/her ability to cope with the situation The individual asks 3 questions: • which coping options are available? • the likelihood that one can apply the strategy • the likelihood that any given options will work: will it reduce stress? Reappraisal • continuous reappraisal on the basis of new information • identical to the initial process • may lead to more stress

34. Coping (1) Lazarus and Folkman (1984) • Constantly changing cognitive and behavioural efforts to manage specific internal and/or external demands that are appraised as taxing or exceeding the resources of the person Several important elements of the definition: • Coping is a process of constant evaluation of the success of one’s strategies • Coping is learned as one encounters situations • Coping requires effort • Coping is an effort to manage. Success is not contingent on mastery, just good enough

35. Coping (2) Health & energy Positive belief • the ability to cope is enhanced when people believe they can successfully bring about desired consequences Problem-solving skills • having specific knowledge or abilities related to specific problem Social skill • ability to get other people to cooperate Social support • feeling of being accepted, loved, or prized by others Material Resources

36. Coping (3) Problem Focussed Coping • consists of changing the situation • redefining the problem • looking at alternative solutions • evaluating the implications of the alternatives • choosing the best one to act on Emotion-focussed coping • consists of controlling and possibly changing the emotional response to an event • cognitive responses such as avoidance or minimization • the goal is to decrease emotional distress • often used when the individual feels that nothing can be done about the situation

37. Stress and Control Stephen Weiss (1968, 1971) Study 1 • reliable escape response reduces development of ulcers Study 2 • predictable stressors produced fewer ulcers • true even in the absence of an escape response option Study 3 • feedback about effectiveness of response results in fewer ulcers Conclusion • the physiological effects of stress can be greatly reduced if the organism can engage in controlling behaviour • getting feedback that one’s behaviour is effective can further reduce the physiological effects of stress