TEACHER NOTES CHAPTER 13 SUMMARY STRESS AND HEALTH

(4 LESSONS)
Application of a biopsychosocial framework to understanding the relationship between stress and physical
and mental well-being:
physiological and psychological characteristics of responses to stress including fight-flight response,
eustress and distress;
psychological determinants of the stress response, strengths and limitations Richard Lazarus and
Susan Folkmans Transactional Model of Stress and Coping
social, cultural and environmental factors that exacerbate and alleviate the stress response
allostasis (stability through change brought about by the brains regulation of the bodys response to
stress) as a model that integrates biological, psychological and social factors that explain an
individuals response to stress
strategies for coping with stress including biofeedback, meditation/relaxation, physical exercise, social
support

Stress and Health

Stress is a state of PHYSIOLOGICAL and psychological AROUSAL produced by internal and/or
external STRESSORS, that are perceived by the individual as challenging or exceeding a persons
resources or their ability to COPE.
It is a subjective experience & DEPENDS ON OUR PERSONAL INTERPRETATION OF A
SITUATION OR EVENT.
A stressor is any person, situation or event that causes STRESS.
A stressor may be:
physical - example EXTREME TEMPS, INTENSE LIGHT, LOUD NOISE
psychological - eg ARGUMENT WITH FRIEND, RUNNING LATE FOR CLASS
internal eg. PHYSICAL PAIN THAT MAY BE PERCEIVED AS SIGNALLING AN
ILLNESS
external - eg. TOO MUCH HOMEWORK, NAGGED BY PARENTS
See p. 511 Table 13.1 Common Daily Hassles Children , Adolescents, Adults
Biopsychosocial Approach to Understanding the Relationship between Stress and Physical
and Mental Well-Being p. 511 Fig 13.1
Biological
Fight-flight response
HPA AXIS

Psychological
Transactional model of stress
and coping
BIOFEEDBACK

GAS

COPING STRATEGIES

ALLOSTASIS

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Social
Major life events
CULTURAL (eg
ACCULTURATION)
ENVIRONMENTAL (eg.
CROWDING)

Physiological and Psychological Responses to Stress

A Stress response or reaction involves the physiological and psychological AND
BEHAVIOURAL RESPONSES that people experience when they are confronted by a
STRESSOR.
Briefly describe the impact of:
a. mild stress STIMULATING, EXHILARATING, MOTIVATING, CHALLENGING,
DESIRABLE
b. severe, acute or chronic stress MUSCLE TENSION, HEART PALPITATIONS, SKIN
RASHES, FATIGUE, FEELING UNWELL, HEADACHES, PROBLEMS WITH DIGESTION

Physiological Responses to Stress

Fight-Flight response
General Adaptation Syndrome
Both include a pattern of involuntary minor and major bodily changes that occur when we first
become aware of a stressor.
The Fight-Flight Response
The fight-flight response is an involuntary reaction resulting in a state of physiological
AROUSAL to deal with sudden and immediate THREAT by CONFRONTING (fight) or
RUNNING AWAY (flight).
The fight-flight response is triggered by both PSYCHOLOGICAL and PHYSIOLOGICAL
threats.
The fight-flight response involves both the SYMPATHETIC nervous system and the
ENDOCRINE system
The fight-flight response is characterized by:
INCREASED heart rate
INCREASED respiration rate
DILATED bronchi in lungs, increasing oxygen uptake
INCREASED blood sugar
INHIBITED digestion
INCREASED release of adrenalin
INCREASED expenditure of energy
What happens in the brain and body during the fight-flight response (and when we face
chronic stressors)? the HPA axis
The hypothalamus in the brain stimulates the nearby pituitary gland which secretes a hormone
called ACTH which travels via the bloodstream and stimulates the adrenal glands to secrete the
stress hormones adrenaline (epinephrine) and noradrenaline (norepinephrine) and cortisol.
This chain of reactions is called the HPA axis (Hypothalamus, Pituitary, Adrenal glands)
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Hypothalamus
Pituitary secretes ACTH
Adrenal glands secrete stress hormones
stimulates Sympathetic nervous system
Adrenal glands secrete cortisol
increases metabolism & amount of glucose in blood

Physiological Effects of Intense or Prolonged Arousal

Exposure to intense or prolonged arousal causes physiological wear and tear on the body
which may results in a weakened immune system resulting in increased vulnerability to disease
Make a list of some of the physiological effects of intense or prolonged stress.
MUSCLE TENSION, HEART PALPITTAIONS, SKIN RASHES, FATIGUE, FEELING
UNWELL, HEADACHES, PROBLEMS WITH DIGESTION.
Task: Learning Activity 13.1 Review Questions P. 516 Q. 1 - 9
Eustress and Distress p. 517
Eustress is a POSITIVE psychological response to a stressor as indicated by the presence of
positive psychological states such as feeling enthusiastic, excited, active and alert.
Distress is a NEGATIVE psychological response to a stressor as indicated by the presence of
negative psychological states such as anger, nervousness, irritability or tension.
Whether a situation or event results in eustress or distress depends on the persons judgment of a
stimulus as positive or negative in relation to themselves. Eg. bungee jumping
Task: Learning Activity 13.3 Review Questions P. 518 Q. 1 - 3

Psychological Responses to Stress

p. 519

NOT INVOLUNTARY, a person more or less has control over them, not directly observable.
In general psychological responses to stress are divided into 3 categories. List examples.
Behavioural apparent in how a person looks, talks, acts
Eg. STRAINED FACIAL MUSCLES, SHAKY VOICE, HAND TREMORS
Also Increase or decrease eating, sleep problems, increased aggression, withdrawal
Emotional influence the way a person feels
Eg. FEEL ANXIOUS, TENSE, DEPRESSED, ANGRY, IRRITABLE, SHORT TEMPERED.
Cognitive influence a persons mental abilities, such as perceptions of their circumstances and
environment, their ability to learn and how they think
Eg. DIFFICULTY CONCENTRATING, MAINTAINING FOCUS, MAKING DECISIONS,
THINKING CLEARLY, MORE FORGETFUL
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Task: Learning Activity 13.4 Review Questions P. 520

Q. 1 - 5

Psychological Determinants of the Stress Response p. 520

Many psychological factors cause or influence the human stress response including:
Life Events (eg changing jobs, death of spouse) and Individual Characteristics (eg. personality)
List some COPING SKILLS, ATTITUDES, MOTIVATION, LEVEL OF SELF-ESTEEM,
GENERAL OUTLOOK ON LIFE eg OPTIMISM / PESSIMISM.
Richard Lazarus and Susan Folkmans Transactional Model of Stress and Coping
Explains individual differences in the stress response from a psychological perspective
2 psychological factors 1. the meaning of the event to the individual;
2. The individuals judgment of their ability to cope with the event

Proposes that stress involves an encounter (TRANSACTION) between an individual and

their external environment, and that a stress response depends on the individuals
interpretation (APPRAISAL) of the stressor and their ability to cope with it.
The stress response is only elicited if the individual believes that the stressor will seriously
tax or exceed their available resources.
The transaction is between the stressor and the individual

Primary Appraisal an individual decides if a situation is possibly stressful, beneficial or

irrelevant in the transactional model of stress and coping
Secondary Appraisal an individual takes into account the resources available to them
personal, environmental, social and cultural and their own coping strategies to decide what way
is best to cope with or address the stressor.
Reappraisal (of an earlier stressor) determine the extent to which additional resources are
needed to cope with the situation
Coping: process of constantly changing cognitive and behavioural efforts to manage specific
internal and/or external stressors that are perceived as taxing or exceeding the resources of a
person
Lazarus proposes 2 main styles of coping: (Add 3 examples of each coping style p. 523)
PROBLEM -focused coping
o seeks to address the PRACTICAL EFECT of the stressor.
o is aimed at reducing the effect of the stressor or adapting to its impact
o Seems more appropriate but only when solutions are available to the individual
EMOTION focused coping
o seeks to primarily address the EMOTION elicited by the stressor
o may involve avoidance or denial, use of drugs or alcohol to address the emotion without
addressing the stressor.
o seems less appropriate but may be best in the situation where someone has died no
solution individual going through the grieving process - may be the best strategy

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Situation or event

PRIMARY Appraisal

Perceived Threat

Reappraisal

No threat perceived

SECONDARY Appraisal

Perception of the inability

to cope with the threat

NEGATIVE Stress

No stress

Perception of the ability

to cope with the threat

POSITIVE Stress

A therapist can help the individual to improve their coping skills and reappraise the stressor in a
more positive light (as a CHALLENGE not a THREAT) eg. Public speaking; new job
Strengths and Limitations of the Transactional Model of Stress and Coping p. 5524
Strengths
Provides an EXPLANATION of how stressors can MOTIVATE people DIFFERENTLY
and ties this in with the varied EMOTIONAL responses (for different people and in
different situations)
Provides a MECHANISM of how to INTERVENE to promote COPING and adapting to
stressful environments eg. focusing people to perceive stressors as challenges rather than
threats.
Limitations
A linear model with one step leading to another resulting in emotions and thoughts Does
not take into account PRE-EXISTING states of emotion and states of mind (eg anxiety or
depression) which may have profound effects on the appraisal of the stressor and
subsequent emotions and thoughts.
Task: Learning Activity 13.6 Review Questions P. 525 - 526 Q. 1 - 7
************** COMPARE G.A.S. AND TRANSACTIONAL MODEL STRENGTHS, LIMITATIONS

Social, Cultural & Environmental Factors that Exacerbate & Alleviate Stress Response
It can sometimes be difficult to distinguish between what is a social, environmental or cultural factor.
Social Factors p. 528 (Social Readjustment and Social Capital)
Anything that DISRUPTS our social roles and social functions can serve as a stressor - EXACERBATES the
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stress response. (divorce, parenthood, retirement, loss of job etc)

Anything that SUPPORTS or facilitates our social roles and social functions can protect against or
ALLEVIATE stress.
Anything that excludes a person from a social group will be a stressor as is anything that disrupts or
threatens the social group as a whole.
Adverse life events also function as stressors eg death of family member, imprisonment, unemployment.
Social Readjustment
Refers to the amount of change or adjustment in lifestyle a person is forced to make following a specific
event in their life.
Holmes and Rahe believed that these changes cause an individual to change their ways of thinking, feeling
and behaving and would therefore cause stress in varying amounts, depending on the stressor and the
level of social readjustment. These changes are associated with the onset of illness or disease.
Holmes and Rahe developed a rating scale the Holmes and Rahe Social Readjustment Rating Scale
(1967) shown on P. 603. 43 life events that involve change requiring some level of adaptation.
Each life event is assigned a numerical rating where the life event causing the most stress (death of a
spouse) is assigned a rating of 100.
Their research found that people who score 200 or more life change units within a 12 month period are
more prone to physical and psychological stress-related illnesses. It includes both positive (e.g
marriage) and negative items that can induce a stress response.
Variations of the scale have been used to study links between number, types and duration of stressful life
event (discrete stressors) and the development of major depression. (link to Chapter 14 work).
Limitations: Does not take into account the meanings of different life events for different individuals.
Stress-producing potential of an event may vary widely. (Consequently researchers have aimed to measure
an individuals perceived stress related to specific life events)
These studies provide evidence that significant life-changing events (positive and negative) can produce,
exacerbate or alleviate the stress response, depending on the individual and their personal circumstances.
Social capital
o is the amount of social exchange, solidarity, sense of community, trust and equity that exists within a
social group.
o Where social capital is low (and the lower the socio-economic level) (eg with extreme differences in
wealth, widespread poverty or unemployment), higher levels of stress-related health risks are present
partly due to increase in unhealthy behaviours (eg smoking, poor diet) social disadvantage
o When relative social deprivation is present, it is associated with anger, hopelessness and helplessness,
which intensify subsequent negative stress responses.

Socio-economic status
Levels of stress-related disorders vs SES

Socio-economic status
Levels of stressful life events vs SES

o Socially disadvantaged have both a higher level of stress-related disorders and a higher level of stressful
life events
o The rate of stress-related disorders may be improved by directly alleviating social disadvantage within
communities
Cultural Factors p. 530
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For immigrants, refugees and asylum seekers, departure can be a means of escaping famine, poverty,
torture thus alleviating the stress response.
However the demands of adjusting to a new culture can produce or exacerbate the stress response.
Cultural stress where an eco-system is compromised by environmental change (eg sea level rise
Tuvulu) , invasion or overpopulation and places the society under stress
Acculturation where one culture interacts with another leading to adoption of the values, customs and
language of the new dominant culture.
Acculturative stress the stress associated with acculturation (learning a new language, racial or ethnic
prejudice, lower SES, separation from family members)
Racism-related stress is a form of acculturative stress.
List some of the health outcomes associated with race-related stress
ANXIETY DISORDERS, DEPRESSION, DIABETES, HYPERTENSION, HEART DISEASE, POOR IMMUNE
SYSTEM FUNCTIONING, SMOKING AND ALCOHOL ABUSE.
Environmental Factors p. 532
Socio-environmental factors that affect the adverse life events experienced include: AGE, SEX, MARITAL
STATUS, RACE/ETHNICITY, EMPLOYMENT, SOCIO-ECONOMIC LEVEL.
Physical environmental factors that can influence the stress response include: CROWDING, LOUD
NOISE, AIR POLLUTION, EXTREMES OF TEMPERATURE AND TECHNOLOGICAL AND NATURAL
DISASTERS.
Effects of Crowding
Crowding = the FEELING of being cramped, of having less space than preferred.
Studied by John Calhoun with mice read about his study on page 532 534 the mice became
aggressive and cannibalistic, explored less and were either hyperactive or extremely lethargic.
Effects of crowding on the HUMAN stress response depends on both the SITUATION and the
INDIVIDUAL involved eg length of time spent in a high-density situation, personality
characteristics, perception of whether the space is constricting, sense of personal control over the
situation.
Personal Space the immediate and small area (up to 50 cm) with an invisible boundary
See Fig 13.4 p. 533
Task: Learning Activity 13.9 Review Questions P. 611 Q. 1 - 4
Practice Evaluation of Research on Calhoun experiment??

Allostasis p. 538

Fight flight response focuses on physiological responses

Transactional model focus on psychological determinants of stress response
Biopsychosocial model focus on both psychological and physiological factors HOWEVER, it
does not explain how the factors combine when we are stressed
Primarily there was a focus on homeostasis
This is the bodys ability to maintain a stable environment by keeping certain bodily conditions
constant
Limitations of the homeostatic model of ADAPTATION to change led Sterling and Eyer to
propose the construct of allostasis.

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Homeostasis which helps the body achieve stability by staying the SAME
o applies to a relatively limited number of internal bodily conditions essential for life
- keeps them within set limits for healthy functioning core body temperature,
blood oxygen level, pH, water content, ion content and oxygen-carrying capacity
o the construct of homeostasis excludes the role of cognitive processes in adaptation
and survival and is therefore of limited use in explaining the human stress
response and other states with a psychological component.
o some body systems are not held constant and actually help keep the body stable by
fluctuating eg. heart rate.
Allostasis
o the bodys ability to maintain a STABLE physiological environment by adjusting
and changing to meet internal and external demands.
o helps the body achieve stability by CHANGING
o is achieved through the brains REGULATION of the activities of our allostatic
systems.
Allostatic systems include: the HPA axis, the AUTONOMIC nervous system, the
IMMUNE system and the CARDIOVASCULAR system

Task: Label the following graph p. 540

Allostatic systems respond to stress by initiating an adaptive response, sustaining it until the
stress ceases, and then shutting it off (recovery)
Allostatic Load - See p. 541 Fig 13.23
The cumulative exposure to increased secretion of the stress hormones (over weeks, months or
years) (If the allostatic load is high it can result in wear and tear on the brain and body)

Perception of stress is influenced by ones experiences, genetics and behaviour.

When the brain perceives an experience as stressful, physiological and behavioural
responses are initiated, leading to allostasis and adaptation.
Over time, allostatic load can accumulate and have adverse effects on various bodily
organs and systems leading to disease.

Task: Learning Activity 13.10 Review Questions P. 542 Q. 1 - 5

Strategies for Coping with Stress p. 543

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The strategies described here reflect the close mind-body relationship in mental and physical
health.
Biofeedback

A technique that enables an individual to receive information (feedback) about the state of a
bodily process (bio) and, with appropriate training, learn to control a related physiological
response using thought processes.
Biofeedback training:
o Electrical or mechanical sensors are attached to the person respond to a particular
physiological response eg. blood pressure, skin temp, tension in a particular muscle.
o Signals are detected and displayed to provide the person with info about the state of a
relevant bodily process
o The person is taught a series of physical and mental exercises designed to help them
learn how to gain control over the physiological response being monitored.
Used most often to relieve stress-induced problems related to blood flow such as headaches,
migraines and hypertension.
A common criticism - its effects do not last after the person leaves the laboratory setting.
New, less expensive biofeedback device now available the Biodot Skin Thermometer.

Meditation and Relaxation p. 545

Meditation an intentional attempt to bring about a deeply relaxed state in order to reduce one or
more effects of stress-related symptoms.
Meditation is different from relaxation as it involves focussing the mind on a single stimulus.
Meditation is a self-induced altered state of consciousness that is used in order to gain a form of
personal benefit, e.g. pain relief, spiritual growth, stress reduction.
This is achieved by focusing on a single stimulus such as breathing, or the visualisation of an
object and blocking out of all external stimuli.
Effects on the stress response: FEEL CALM, LOW LEVEL OR ABSENCE OF ANXIETY,
RESPONSES ASSOCIATED WITH A LOW LEVEL OF PHYSIOLOGICAL AROUSAL eg.
LOWER HEART RATE, LOWER BREATHING RATE, DECREASE IN MUSCLE TENSION.
Relaxation is any activity that brings about a state of reduced psychological and/or physiological
tension
Effects on the stress response: SIMILAR TO MEDITATION

Physical Exercise p. 547

Physical Exercise is physical activity that is usually planned and performed to improve or to
maintain ones physical condition.
Substantially reduces the risk of a serious disease, including diseases associated with chronic
stress, such as CVD, KIDNEY DISEASE, HYPERTENSION, DIGESTION DISORDERS,
STROKE, CERTAIN FORMS OF CANCER
Regular exercise and physical activity can enhance psychological health and overall sense of
wellbeing. It helps people to reduce their anxiety levels and cope with stress more effectively.

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Exercise helps reduce the adverse effects of stress in several ways:

Uses up the stress hormones, so helps immune system return to normal sooner; also works
out tension built up in muscles
Increases the efficiency of the CV system & increases strength, flexibility and stamina for
encountering future stressors
Brain releases beta-endorphins during exercise relieve pain and increase a feeling of
well-being and relaxation
Can divert a persons attention away from the stressor and associated negative emotional
states
If exercise with others - long-term psychosocial benefits from the social interaction and
potential social support

Task: Learning Activity 13.12 Review Questions P. 549 Q. 1 - 3

Social Support p. 549
Social support is help or assistance from other people when needed.
includes support from family, friends, neighbours, work colleagues, peers at school,
teachers we trust, fellow members of a church, self help groups, professionals, online
support groups, telephone help lines.
Suls and Wallston (2003) identified 4 main forms of social support: (p. 549 550)
Type of Social
Support
Appraisal
support

Description

How it alleviates stress

Tangible
support
Information
support
Emotional
support

Task: Learning Activity 13.13 Review Questions P. 551 Q. 1 3

Ch 13 True / False Quiz p. 552
Ch 13 Test p. 553 - 556
Place the following in a table change in breathing rate, memories associated with Post
Traumatic Stress Disorder; HPA axis; work stressors; anxiety; homeostasis, relationship break
up; unemployment; allostatic load; feeling of powerlessness.
Biological

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Social

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NOT ON 2013 COURSE

Selyes General Adaptation Syndrome Hans Selye p.588 - 592
Selye we have 2 types of responses to stress - both:

Non-specific that occur regardless of the type of stressor e.g. increased blood pressure

Specific responses appropriate for particular stressors eg. running away

The general adaptation syndrome (GAS) is a 3 stage physiological stress response that occurs
regardless of the stressor that is encountered.
The GAS consists of three stages:
1. Alarm Reaction Stage

2. Stage of Resistance

3. Stage of Exhaustion

1. Alarm Reaction Stage

Occurs when the person initially becomes aware of the stressor. The body goes into a temporary
state of shock and its ability to deal with the stressor falls to below its normal level.
Heart Rate and body temperature drop and a temporary loss of muscle tone occurs.
Countershock is a rebound from this level of reaction.
During countershock the sympathetic nervous system is activated and the bodys resistance to the
stressor increases. This first stage of the GAS results in a state of tension and alertness and a
readiness to respond to the stressor.
2. Stage of Resistance
This stage occurs if the stressor is not dealt with immediately.
During this stage the bodys resistance to the particular stressor rises above normal.
The intense arousal of the alarm reaction stage diminishes but physiological arousal remains at a
level above normal. (unnecessary physical processes are shut down eg. Digestion, sex drive,
growth, menstruation)
The hormones cortisol (and adrenaline) are released and help to repair any damage, but it
interferes with the bodys ability to fight disease and protect itself against further damage
weakens immune system
Resistance to the initial stressor increases but resistance to other stressors such as disease may
decline.
3. Stage of Exhaustion
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This stage occurs if the stressor has not been dealt with and it continues.
The organisms resistance to disease is very weak and it becomes vulnerable to physical and
psychological diseases.
This stage is characterized by extreme fatigue, high levels of anxiety and depression,
nightmares, impaired sexual function.
This can lead to wear and tear on organs such as the heart as well as suppression of the immune
system resulting in illnesses such as arthritis, colds, flu, heart disease, high blood pressure.
Task: Copy Fig. 12.6 p. 590 into your notes Hans Selyes General Adaptation Syndrome
Strengths and limitations of Selyes GAS
Strengths - Aspects of Selyes GAS that are widely accepted now:
Stress can weaken the bodys ability to resist infection
Identification of some of the physiological mechanisms associated with the stress response
eg. endocrine system
GAS occurs in response to any type of stressor
Our bodies have only a limited amount of resources in coping with prolonged stress
Limitations
A one size fits all model does not fully take into account or explain INDIVIDUAL
DIFFERENCES in response to stressors
Overlooks the role of other body systems in the stress response
Ignores our psychological response to different TYPES of stressors
It does not take into account COGNITIVE aspects of the stress response, specifically the
role of the brain in interpreting the situation or event as stressful differences in what a
person sees as stressful, and in the way 2 people might respond to exposure to chronic
stress.
Research evidence shows that different types of stressors can trigger their own distinct
physiological reactions.
Selyes GAS is based on ANIMAL research may be limited relevance to human stress
response
Overemphasises PHYSIOLOGICAL factors and does not take into account psychological
factors

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