Chapter 2: Stress: The Constant Challenge

LEARNING OBJECTIVES

After completing this chapter, the student will be able to:

· Explain what stress is and how people react to it—physically, emotionally, and behaviorally.

· Describe the relationship between stress and disease.

· List common sources of stress.

· Describe techniques for preventing and managing stress.

· Put together a plan for successfully managing the stress in your life.

KEY TERMS AND DEFINITIONS

stressor Any physical or psychological event or condition that produces physical and emotional reactions.

stress response The physical and emotional reactions to a stressor.

stress The general physical and emotional state that accompanies the stress response.

autonomic nervous system The branch of the nervous system that controls basic body processes; consists of the sympathetic and parasympathetic divisions.

parasympathetic division A division of the autonomic nervous system that moderates the excitatory effect of the sympathetic division, slowing metabolism and restoring energy supplies.

sympathetic division A division of the autonomic nervous system that reacts to danger or other challenges by almost instantly accelerating body processes.

norepinephrine A neurotransmitter released by the sympathetic nervous system onto target tissues to increase their function in the face of increased activity; when released by the brain, causes arousal (increased attention, awareness, and alertness); also called noradrenaline.

endocrine system The system of glands, tissues, and cells that secrete hormones into the bloodstream to influence metabolism and other body processes.

hormone A chemical messenger produced in the body and transported by the bloodstream to target cells or organs for specific regulation of their activities.

cortisol A steroid hormone secreted by the cortex (outer layer) of the adrenal gland; also called hydrocortisone.

epinephrine A hormone secreted by the medulla (inner core) of the adrenal gland that affects the functioning of organs involved in responding to a stressor; also called adrenaline.

endorphins Brain secretions that have pain-inhibiting effects.

fight-or-flight reaction A defense reaction that prepares an individual for conflict or escape by triggering hormonal, cardiovascular, metabolic, and other changes.

homeostasis A state of stability and consistency in an individual’s physiological functioning.

somatic nervous system The branch of the peripheral nervous system that governs motor functions and sensory information; largely under our conscious control.

personality The sum of behavioral, cognitive, and emotional tendencies.

gender role A culturally expected pattern of behavior and attitudes determined by whether a person is male or female.

general adaptation syndrome (GAS) A pattern of stress responses consisting of three stages: alarm, resistance, and exhaustion.

eustress Stress resulting from a pleasant stressor.

distress Stress resulting from an unpleasant stressor.

hypothalamus A part of the brain that activates, controls, and integrates the autonomic mechanisms, endocrine activities, and many body functions.

allostatic load The long-term negative impact of the stress response of the body.

psychoneuroimmunology (PNI) The study of the interactions among the nervous, endocrine, and immune systems.

acute stress Stress immediately following a stressor; may last only minutes or may turn into chronic stress.

chronic stress Stress that continues for days, weeks, or longer.

burnout A state of physical, mental, and emotional exhaustion.

rapid eye movement (REM) sleep The portion of the sleep cycle during which dreaming occurs.

non-rapid eye movement (non-REM) sleep The portion of the sleep cycle that involves deep sleep; non-REM sleep includes four states of successively deeper sleep.

sleep deprivation A lack of sleep over a period of time.

insomnia A sleep problem involving the inability to fall or stay asleep.

sleep apnea The interruption of normal breathing during sleep.

relaxation response A physiological state characterized by a feeling of warmth and quiet mental alertness.

visualization A technique for promoting relaxation or improving performance that involves creating or re-creating vivid mental pictures of a place or an experience; also called imagery.

meditation A technique for quieting the mind by focusing on a particular word, object (such as a candle flame), or process (such as breathing).

biofeedback A technique in which monitoring devices are used to help a person become conscious of unconscious body processes, such as body temperature or blood pressure, in order to exert some control over them.

LECTURE OUTLINE

This chapter defines stress and the stress response and describes ways to cope with stress to minimize its negative health effects and improve wellness.

I. What is Stress?

A. Situations that trigger physical and emotional reactions are termed stressors, and the physiological reactions are termed the stress response.

B. Stress is the general physical and emotional state that accompanies the stress response.

C. Physical responses to stressors are controlled by the nervous system and the endocrine system.

1. The autonomic nervous system, the part of the nervous system not under conscious supervision, controls the stress response. The sympathetic branch mobilizes the body for action, and the parasympathetic branch calms it down; the two constantly provide checks and balances on each other.

2. The endocrine system helps control body systems by releasing hormones and other chemical messengers into the bloodstream.

3. The fight-or-flight reaction is the result of a predictable set of chemical reactions in a stressful situation.

a. The hypothalamus stimulates the pituitary to send adrenocorticotropic hormone (ACTH) into the bloodstream. When ACTH reaches the adrenal glands, it stimulates them to release cortisol and other stress hormones into the bloodstream.

b. The adrenal glands secrete epinephrine (adrenaline); sympathetic nerves release norepinephrine (noradrenaline). At this point, the body experiences increased respiratory capability, increased pulse rate, perspiration, and endorphin release. These physiological changes increase reflexes and strength. The reaction is an evolutionary survival mechanism that is often inappropriate for the types of stressors faced in the modern world.

4. When a stressful situation ends, the parasympathetic division of the autonomic nervous system strives to return the body to its normal state, homeostasis.

D. Emotional and behavioral responses to stressors vary, unlike the physical fight-or-flight reaction.

1. Cognitive appraisal or perception of a potential stressor affects how a particular stressor is viewed.

2. Emotional responses, such as anxiety, depression, and fear, are determined in part by inborn personality and temperament but also can be regulated with coping techniques.

3. Behavioral responses are conscious actions that are controlled by the somatic nervous system. Effective behavioral responses promote wellness and include expressing emotion, learning new skills, exercising, and meditating. Ineffective responses can impair wellness and include overeating and using tobacco, alcohol, and other drugs.

4. Personality, the sum of behavioral, cognitive, and emotional tendencies, affects how a person perceives and reacts to stressors.

a. Type A individuals tended to me more controlling, schedule driven, competitive, and even hostile.

b. Type B individuals were less hurried and frustrated by daily events, more contemplative, and more tolerant of others.

c. Although earlier research showed that Type A individuals were more likely to have heart disease, later studies show that most Type A’s are quite healthy and possibly more successful at surviving heart disease than Type B individuals of the same age and stage of disease.

d. The only aspects of Type A personality that remain associated with a greater risk of heart disease are anger, cynicism, and hostility.

e. A Type C personality may be characterized by anger suppression, difficulty expressing emotions, feelings of hopelessness and despair, and an exaggerated response to minor stressors.

f. People with the personality trait of “hardiness” or a resilient personality can cope more positively with stress and typically have an internal locus of control.

(1) Resiliency refers to personality traits associated with social and academic success in at-risk populations such as children from low-income families and people with mental and physical disabilities.

(a) There are three basic types of resiliency: nonreactive, homeostatic, and positive growth resiliency.

(b) Resiliency is also associated with emotional intelligence and violence prevention.

(2) The term “positive psychology” is based on the idea that if young people are taught resiliency, hope, and optimism, they will be less susceptible to depression and lead more productive lives.

E. Cultural backgrounds, gender roles, and past experiences also contribute to how a person perceives and reacts to stress.

1. Women are more likely than men to find themselves balancing multiple roles.

2. Men generally feel compelled to be in charge at all times. This may create tension in interpersonal situations and limit me’s ability to build a support network

3. Perceptions of what is stressful also varies between genders.

4. There are also physiological differences in how men and women respond to stress.

II. Stress and Health

A. Evidence suggests that stress, in combination with other factors, can increase vulnerability to various illnesses and ailments. According to the American Psychological Association, 77% of adult Americans reported stress-related health problems in 2007.

B. The term general adaptation syndrome (GAS) describes what many believe is the universal and predictable response pattern to all stressors. The three stages of GAS can be triggered by a pleasant stressor, eustress, or by an unpleasant stressor, distress.

1. The alarm stage is the fight-or-flight reaction. This stage makes the body vulnerable by mobilizing it to cope with a crisis.

2. The resistance stage occurs with continued stress, the body develops a new level of homeostasis to cope with the added stress.

3. The exhaustion stage results in the depletion of resources that leave the body vulnerable to disease. The stress response itself now is believed to be the cause of disease over time.

4. Although the GAS model is viewed as a key conceptual contribution to understanding stress, some aspects of it are outdated

C. Researchers have termed the long-term wear and tear of the stress response the allostatic load. A high allostatic load is linked to a greater risk of disease.

D. Psychoneuroimmunology (PNI) studies the interactions among the nervous, endocrine, and immune systems. Hormones and other chemical messengers released during the stress response may inhibit or strengthen the immune system.

E. Many health problems have links to stress.

1. Blood pressure rises during the stress response, and chronic high blood pressure leads to atherosclerosis, a major component in cardiovascular disease. Emotional responses that include hostility, anger, and mistrust seem to be especially harmful.

a. Stress has also been associated with inflammation throughout the body. Stress-induced increases in inflammatory messenger molecules are also linked to elevated levels of homocysteine and c-reactive protein (CRP), two markers that appear to be markers for CVD risk.

b. Researchers now think that inflammation is a key component of the damage to blood vessels that leads to heart attacks.

2. Health problems linked to impaired immune functioning include colds, infections, asthma, allergies, cancer, and flare-ups of chronic diseases.

3. Many stressors are inherently anxiety-producing, depressing, or both. Two-thirds of visits to family practitioners are due to stress-related issues.

4. Other health concerns with demonstrated links to stress are digestive problems, headaches and migraines, insomnia and fatigue, injuries, menstrual irregularities, impotence, and pregnancy complications.

III. Common Sources of Stress

A. Any major life change that requires adjustment and accommodation can be stressful. Personality, emotional, and behavioral factors are important moderating influences on the health effects of life changes.

B. Each of life’s daily hassles may provoke a moderate stress response that cumulatively may have a significant effect.

C. College is the site of major life changes and daily hassles, including academic stressors, interpersonal stressors, time pressures, financial concerns, and worry about the future.

1. Test anxiety is a source of stress for many students. (See the Behavior Change Strategy to learn

some proven techniques for overcoming test anxiety).

2. Nontraditional students face unique stressors, including family responsibilities, time pressures,

social and extracurricular activities, and commuting.

D. Financial, time-related, and interpersonal stressors all can contribute to job-related stress. Severe or chronic stress can cause burnout. Absenteeism, illness, disturbed relationships with family and friends, mood and sleep disturbances, and reduced work productivity are examples of the effects of job stress.

1. Nearly 40 million workdays are lost annually because of illness.

2. The effects of stress on chronic diseases are hard to see because they develop over time.

3. Health care costs are nearly 50% greater for workers with high levels of stress.

F. Social aspects of a person’s life can be both helpful and also a source of stress. Prejudice and discrimination are forms of stress created by the community and society in which a person lives. New technologies, although helpful in bringing instantaneous information, can impinge on personal space, waste time, and cause stress.

G. Conditions or events in the physical environment are environmental stressors. These can range from unavoidable inconveniences to major life stressors.

1. Environmental stressors can include anything from a noisy restaurant to natural disasters.

H. Internal stressors such as unrealistic expectations of yourself can cause stress and damage self-esteem.

1. Other internal stressors are physical and emotional states such as illness and exhaustion; these can

be both a cause and an effect of unmanaged stress.

IV. Managing Stress

A. Social support systems may be one tool people can use to buffer themselves against the damaging effects of stress. People who have family and friends to help them through times of stress stay healthier and recover faster than those who do not. Consider volunteering to help build your social support system and enhance your spiritual wellness.

B. Communication skills that help people express feelings nonaggressively, overcome shyness, and improve listening skills help reduce stress in interpersonal relationships.

C. Regular exercise can reduce various effects of stress and even stimulate the birth of new brain cells. It can also reduce many of the negative effects of stress.

D. A healthy diet provides energy stores for use in stressful situations; eating wisely also improves feelings of self-control and self-esteem. Limiting or avoiding caffeine may be helpful in stress management. Many people overeat in response to stress.

E. Lack of sleep can be both a cause and an effect of excess stress. It can affect physical and mental functioning.

1. The lack of sleep has the greatest impact on stress.

2. Poor-quality sleep has long been associated with stress and depression.

F. Efficient time management may help to lower stress levels. Common factors that negatively affect time management for college students are perfectionism, overcommitment, and procrastination. Some suggestions for avoiding procrastination and managing time better include the following.

1. Setting priorities. Focus on essential and important tasks.

2. Scheduling tasks for times of peak efficiency.

3. Setting realistic goals and committing to achieving them by writing them down.