STRESS: DEFINITION, THEORIES, MEASUREMENT, SOURCES, & coping

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STRESS: DEFINITION,THEORIES,

MEASUREMENT,SOURCES, & coping

FAREZADI ZAFRYSEMESTER 1 2009

FACULTY OF HEALTH

SCIENCES, UiTM



LEARNING OUTCOMES

Upon successful completion of this lesson

students will be able to:

1. Explain the physiological process of stress2. Discuss the theories that explain stress

3. Describe the measurement of stress

4. Discuss the sources that produce stress

5. Explain factors that influence coping &

effective strategies of coping



THE PHYSIOLOGY OF STRESS

The Peripheral Nervous System:

• autonomic nervous system (sympathetic &

parasympathetic) - neurotransmitters(acetylcholine, norepinephrine)

The Neuroendocrine System:

• hormones - pituitary gland

adrenocorticotropic hormone (ACTH)

adrenal glands (adrenal cortex & adrenal

medulla) glucocorticoids (cortisol);

catecholamines (epinephrine, norepinephrine)



THE PHYSIOLOGY OF STRESS

Physiology of the Stress Response

• Cannon‟s “fight or flight”

1. Sympathetic division of the ANS (adrenomedullaryresponse)

2. Hypothalamic-pituitary-adrenal axis (HPA)(involves all the structures)

• Allostasis – maintaining appropriate level of activation under changing circumstances

• Allostatic load – due to prolonged activation of theSympathetic NS

• Taylor‟s “tend-and-befriend”



Physiological Effects of Stress



THEORIES OF STRESS

There is no simple definition as to the term“stress ”

Stress can be defined in three ways;

1. Environmental stimulus - “I have a high-stress job”

2. Physical response - “My heart races when I feel alot of stress”

3. Interaction between environmental stimuli & theperson - “I feel stressed when I have to makefinancial decisions at work, but other types of decisions do not stress me”

Theories/views of stress;



THEORIES OF STRESS

1. Hans Selye‟s View:

stressor – stimulus; stress – response

defined stress as a nonspecific or generalized

physical response to a variety of environmentalstressors

whenever the body encounters disruptivestimulus, it mobilizes itself in a generalized

attempt to adapt to that stimulus – generaladaptation syndrome (GAS)



THEORIES OF STRESS

The General Adaptation Syndrome (GAS)

• whenever the body encounters disruptive stimulus,it mobilizes itself in a generalized attempt to adapt

to that stimulus• GAS – 3 stages:

1) Alarm reaction – body‟s defenses are mobilizedthrough activation of the sympathetic NS (activates

body systems to maximize strength, & preparesthem for fight-or-flight response); increased arousal

2) Resistance – adapts to/cope with the stressor

3) Exhaustion - body can no longer resist, results in

physiological breakdown; activation of the



THEORIES OF STRESS

Potential for trauma or illness exists at all 3stages e.g. resistance - ulcers, hypertension,CVD, asthma; exhaustion – depression, death

Selye concentrated on the physiological aspectsof stress, downplaying the psychological ones(e.g. emotional component), & ignoring theperceptual & interpretative processes that can

moderate human experience of stress



The three stages of Selye’s general adaptation syndrome – alarm, resistance,exhaustion – and their consequences



THEORIES OF STRESS

2. Richard Lazarus‟ View: person‟s perception (interpretation) of an event is

more important than the event itself

emphasizes psychological factors e.g. cognitivemediation, appraisal, vulnerability, & coping

Psychological stress: “particular r/s between theperson & the environment that is appraised bythe person as taxing/exceeding his/her resources& endangering his/her well-being” -transactional/interactional view ; person‟sappraisal; & situation – threatening, challenging,harmful



THEORIES OF STRESS

i. Psychological factors• people are harmed by –ve life events only if they

perceive those events as threatening, beingpersonally important, are in vulnerable state, &

believe that they lack the ability to successfullycope with those events e.g. ???

ii. Appraisal

• 3 kinds of appraisal to assess situations; primary,secondary & reappraisal



THEORIES OF STRESS

a. primary appraisal is one‟s initial judgment of anevent (1st time), may be seen as (1) harmful – damage that has been done e.g. illness, injury (2)threatening – anticipation of harm, or (3)

challenging – confidence in overcoming demands harm, threat, or challenge generates emotion e.g.

anger, fear, excitement

b. secondary appraisal is one‟s perceived ability to

cope with harm, threat, or challenge e.g. optionsavailable

individual attempts to determine sufficient copingstrategies and selects the best

c. reappraisal of an event is ongoing as the situation



THEORIES OF STRESS

iii. Vulnerability

• stress is likely to be aroused when people arevulnerable; when they perceive a lack of resources (i.e. personal, social) to cope with asituation of some personal importance

• psychological factors

iv. Coping

• ability or inability to cope• involves our constantly changing cognitive &

behavioral efforts to manage specific internaland/or external demands that are appraised as

taxing/exceeding our resources



THEORIES OF STRESS

• a) a process, constantly changing, b) notautomatic, c) requires effort, & d) effort tomanage, not control

• thoughts & behaviors that enable a person tohandle stress or anticipated stress

• is enhanced by resources such as health,energy, high self-efficacy, problem-solving skills,social skills, & social support



MEASUREMENT OF STRESS

(1) Physiological measures

(2) Self-reports (life events & daily hassles scales)

1. Physiological Measures• some physiological/biochemical indexes used to

assess stress: blood pressure, heart rate, galvanicskin response, respiration state, stress hormones,

etc.• disadvantage – the equipment & the setting

themselves may produce stress




2. Life Events Scales

• Self-report instruments to measure stress

• Social Readjustment Rating Scale (SRSS) –

emphasizes change in a person‟s life; lists 43events arranged in rank order from most to leaststressful

• Undergraduate Stress Questionnaire (USQ) – ask

college students to check a list of sources of stress• Perceived Stress Scale (PSS) – 14-item scale

attempts to measure the degree to whichsituations in people‟s lives are appraised as

unpredictable, uncontrollable, or overloading




3. Everyday Hassles Scales

• Daily Hassles Scale & Uplifts Scale – emphasizeperson‟s view of event, 117 + 138 items

• Revised Hassles and Uplifts Scale – shorter scale, 53 items



SOURCES OF STRESS

A. Cataclysmic Events

“Sudden, unique, & powerful single life-eventsrequiring major adaptive responses frompopulation groups sharing the experience”

Affect large numbers of people

May be unintentional major events e.g. naturaldisasters, or intentional major events e.g.

terrorist attack More stressful when they are intentional acts &

when people are in close proximity to the events

People who experience cataclysmic events may

develop posttraumatic stress disorder (PTSD)



SOURCES OF STRESS

B. Life Events Everyone experiences life events that require

change/adjustment e.g. death of a spouse,getting a divorce, being fired, moving to different

country Can be +ve events e.g. getting married, starting

a new job, becoming parent, & -ve events e.g.losing a job, being a victim of a violent crime,

death of a family member Emphasize the importance of change

Affect a few people or one only

Usually evolve more slowly



SOURCES OF STRESS

C. Daily Hassles Events that occur as part of everyday life that may

arise from the physical or psychologicalenvironment

a) Daily Hassles & the Physical Environment

• Environmental sources e.g. noise, pollution,crowding, crime, etc.

• Urban press – sources of stress such as noise,pollution, crowding, & fear of crime are associatedwith urban living

• People may feel threats from environmental

pollution, producing stress•



SOURCES OF STRESS

• Crowding, a psychological condition that arisesfrom the perception of a high-density environment(population density – physical situation), is asource of stress

• Noise & crowding are more stressful when peoplebelieve they have little control over the situation

• The „environment of poverty‟ presents anenvironment that adds fear of crime to the other hassles common in urban life



SOURCES OF STRESSb)Daily Hassles & the Psychosocial Environment

• From the everyday social environment e.g.community, workplace, family interactions, etc.

• Discrimination can create daily hassles in community

& at work• Ethnic groups & women also experience stress due

to discrimination e.g. racism & sexism

• Other situations that produce stress at work include

jobs with high demands & low control e.g. foodservers, middle-level manager, secretary,construction worker, etc.

• Workplace stress may also affect personal

relationships, producing conflict between work &



Job Strain – Karasek et al., 1981

DemandsHigh Low

Control

High

physician,

police officer,bank officer

architect,

dentist, naturalscientist

Low

STRAIN

food servers,

secretary,

construction

worker

carpenter, bill

clerk, truck

driver



COPING WITH STRESS

Coping – strategies people use to managedistressing problems and emotions in their lives

1. Personal resources that influence coping

•

Lazarus & Folkman (1984)• Health & energy ; healthy, robust individuals are

better in managing external & internal demandsthan sick, tired people

• Positive belief ; ability to cope is enhanced whenpeople believe they can successfully bring aboutdesired consequences

• Problem-solving skills ; e.g. knowledge

• Material resources ; e.g. having the money to get



COPING WITH STRESS

• Social support ; a variety of material & emotionalsupports that people receive from others

Differs from social contacts & social networks(number & types of ppl) in that it is a measure of the

quality of one‟s social contacts Social isolation – absence of meaningful personal

relationship

Can be linked to good health & decreased mortality

May help people‟s health by providingencouragement to adopt healthy habits or seekmedical care, by helping people cope with stress, bychanging the physiological responses to stress, or

by buffering against stress



COPING WITH STRESS

• Personal control ; confidence that you have somecontrol over the events that shape your lives

Rotter‟s Locus of control (a continuum):

a. Internal locus of control; people who believe that

they control their own livesb. External locus of control; those who believe that

luck, fate, or the acts of others determine their lives

When people are allowed to assume even small

amounts of personal control & responsibility, theylive longer & healthier lives

Personal control may help people cope with stresseither by having an internal locus of control or by

exerting control over one‟s environment



COPING WITH STRESS

• Personal hardiness ; explanation for why somepeople are resilient to stress & others are not

Individuals who are especially resistant to illness inspite of increased stress, different from other highly stressed people who become ill

Kobasa‟s hardy personality model : hardyindividuals

a.

have a strong sense of commitment to self,b. demonstrate an internal locus of control , &

c. are likely to see necessary adjustments as achallenge



COPING WITH STRESS

2. Personal coping strategies

• Coping strategies may be classified in many ways,but generally can be divided into problem-focused& emotion-focused coping



COPING WITH STRESS

A. Problem-focused coping is aimed at changing the source of the stress

managing or changing the event/stressor

is used if situation seems controllable andalterable

confrontive coping

generally more effective than emotion-focused

coping examples: seeking information; think of options;

devise plan; change job; etc.



Th i f C i



Theories of Coping:

Problem- & Emotion-Focused

Lazarus & Folkman(1984) (Strategy)

Problem-

Focused

Emotion-Focused

Seeking infoThink of options

Devise plan

Change job

Talk to friendsGoing shopping

Drinking

Relaxing

Avoidance

Resolve cause

of problems

Managing

emotional impact of

problem



COPING WITH STRESS

• Other categories: Social coping ; e.g. seeking support from others

Meaning-focused coping ; person concentrates onderiving meaning from stressful experience

Proactive coping ; involves taking steps to avoid ananticipated stressor

• Culture might affect the choice of coping strategy

• The relationship between coping strategy andhealth is complex, involving an interactionbetween the type of coping strategy & whether theoutcome is measured in terms of physical or

mental health

STRESS: DEFINITION, THEORIES, MEASUREMENT, SOURCES, & coping

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