Summary Stress & Health lectures

Lecture 1 Introduction to stress & Health

 Evidence level
1. Systematic review of RCT’s – most reliable findings, higher support  multiple RCT’s
treatment compared in different groups
2. RCT (randomized controlled trial) – group with treatment vs. group without treatment
3. Systematic review of observational studies – different groups of people, one type of
treatment
4. Observational studies - large group, one type of treatment  more reliable
5. Clinical observation – one person, one type of treatment  not generalizable
 Definition of stress
o Everyone can recognize stress, but harder to describe it
 Shift in research of stress
o Ancient history – acute physical crisis (attack, immediate danger for body); chronic
physical crisis (malnutrition)
o New – psychological crisis, social crisis, prolonged psychological stress
 Stress and Health
o Stress  health (acute)
o Stress  Psychological problems  health
o Stress (job loss)  psychological problems  behavioral components (alcoholism)
 health (liver)
 Stress in clinical practice
o Makes people “sick” without having disease (unnecessary use of healthcare)
o Increases the odds for development of mental and physical health problems
o Negatively affects
 recovery after disease or injury
 effects of medical interventions
 patient-physician communication (tend to forget more information when
stressed)
 People don’t want to hear that mental problems are the cause of their diagnosis
(depression…)
 Definition of stress
o A condition or feeling experienced when a person perceives that demands exceed
the personal and social resources the individual is able to mobilize
 Homeostasis
o Bodys ideal level of oxygen, temperature… brain seeks this base level
o Stressor is anything that disrupts homeostasis – stress response is bodys action to
reestablish homeostasis
 Is stress always a bad thing?
o Adaptive
 Acute
 Short duration
 Fast recovery after stressor passed
 Preparing body for danger
 Signaling danger
o Disruptive
 Chronic
 Long duration

,  Slow recovery
 Early onset
 Preparing the body for??
 Signaling what??
o Positive consequences of exposure to stress
 Short term stress (minutes to hours)
1. Increase in immunoprotection
2. Enhance mental and physical performance
 Chronic stress (prolonged)
1. Suppress auto-immune disease symptoms (not experiencing the
symptoms, but still negative)
o Negative consequences of exposure to stress
 Short term
- Emotional level – negative mood
- Cognitive level – concentration, memory
- Behavioral level – smoking, alcohol
- Biological level – immune, endocrine
 Long term (more indirect) – chronic conditions
- Health/disease – auto-immune disease, cardiovascular disease,
cancer
 What happens in our body when we experience stress?
o History of stress
 Darwin – organisms capable of adapting to changing environment will
survive (cope with stressful changes)
 Bernard – Milieu interieur (inner environment should be stable to cope
better)
 Cannon – Fight or flight response (in danger body prepares to fight or flight
due to NTs  norepinephrine and epinephrine)
o The ANS (parasympathetic and sympathetic) – works on its own, not controllable by
us (autonomous)
o CNS and Endocrine system (communication within NS through hormones and NTs)
o Signaling
 CNS  sympathetic adrenomedullary system – hormones (SAM) – first thing
happens when stress
 Hypothalamus  pituitary  adrenal gland  hormones (HPA-axis
produces cortisol)
 Sam HPA-axis – produce stress response together
o Stress response hormones
 SAM  Epinephrine and Norepinephrine
 HPA-axis  Glucocorticoids (Cortisol, steroids, estrogens, progestins…)
o Additional stress hormone activation
 Pancreas – Glucagon
 Pituitary – Prolactin and Vasopressin
 Pituitary + brain – Endorphins, Enkephalins
o Inhibition of hormonal systems during stress
 Reproductive hormones (estrogen, testosterone…) – not adaptive to
reproduce under stress

,  Growth hormones (insulin) – because energy is needed and should not be
stored
 Hans Selye – pioneer of stress research
o Glucocorticoids
o Every stress leaves an indelible scar and the organism pays for its survival after
stressful situation by becoming a little older
o GAS – general adaptation syndrome alarm




 Alarm stage – first encounter with stressor (high adrenaline, activated –
fight/flight response)
 Resistance stage – trying to survive, higher cortisol
- Repair (want to restore energy that was needed in alarm stage)
- Dealing with stress if not possible to repair
- Looks like coping with stress
 Exhaustion stage – developing health problems because body cannot win 
giving up on fighting stress
- Damage to body (e.g. immune, kidney, etc…)
o Symptoms associated with GAS stage
 Action stage – energy – can be also negative
 Resistance stage – irritability, frustration, poor concentration (close to burn-
out)
 Exhaustion stage – Fatigue, burnout, anxiety/depression, + physical
problems (damage to cardiovascular system)
o Stress is physiological response
o Non-specific response of body to any need/threat
o The reactivity hypothesis (vs. psychologists view)
 Stressors accompanied by physiological response – activated closely before
the stressors, then goes up and declines again when stressor is gone
(recovers to baseline like before)
 Psychologists perspective on stress
o J.W. Mason – reaction to stress varies between individuals and within individuals
(depending on time/situation)
o Susan R. Buchfield – Failure to adapt to chronic stress suggests psychological not
physiological exhaustion
o Prolonged activation model
 A stressor will only affect our health when physiological effect is prolonged
(e.g. occurring long before stressor or slow recovery)

, o Michigan stress model (Kahn et al., 1964)




o What psychologists conclude
 Stress response is NOT purely physiological
 Not everybody has same stress response
 Stress response and its duration is different between and within persons
o The cycle of stress (Reznick) – Psycho-biological response to stress
 Measuring both psychological and physiological components in 4 phases
- Resting ground phase
- Tension phase
- Response phase
- Relief phase
 Measuring frequency, duration and intensity
o Stress response activation due to anything that disrupts homeostasis
 Adaptive
 Anticipated
- Necessary  prepares you to combat
- Unnecessary  prepares you for nothing.. anxiety, neurosis
 Acute (short term) – can have negative and positive effects on health
 Chronic (long term) – can have negative effects on health
o Differences in stress response
 Individual differences in stress response (response stereotype):
- Stress perception (for someone stressor stressful for others not)
- Processing
- Appraisal
- Coping – how to deal with it is different
- Genetic make up – hormones, sensitivity different
 Situational differences (situational stereotype)
- Every Situation elicit different biological response  different stress
response physiologically
o Stressors and stress response
 Not all stressors produce same stress response
 Hormonal signature for particular stressor
 Body sensitivity to stress hormones