Stress and Coping Josée L. Jarry, Ph. D., C. Psych

Stress and Coping

• Josée L. Jarry, Ph.D., C.Psych.

• Health Psychology, psy333

• Department of Psychology

• University of Toronto

• October 28, 2002

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

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

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

The Physiology of Stress

• 2 major components to the physical response to stress:

• Nervous system

• Endocrine system

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

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

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

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

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

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 secretes the 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

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

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

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

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

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)

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

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

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

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

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

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

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

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

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