Summary Problems 1-7 Clinical Psychology: Anxiety and Stress

PROBLEM 1


STRESS

Stress = A person perceive discrepancy between the physical/psychological demand of a situation and the resources
because of transactions

 The discrepancy can be real or just an inaccurate perception (e.g., Studied a lot -> Not enough preparation perceived)
 Stress has 2 components:
o Physical = Direct material or bodily challenge
o Psychological = Perception of the individual of a certain circumstance

1. Stressor
o Stress is seen as a stimulus
 Physical (heat, cold, noise)
 Psychological death of a family member
2. Strain
o Body’s response to stressor
 Psychological (thoughts and emotions)
 Physiological (heart pounds, dry mouth, perspire)
3. Stressor & strain
o Transactions = Continuous interactions and adjustments person-environment affecting each other
o Stress is not just a stimulus – A person can influence the impact through strategies

COGNITIVE APPRAISAL

Cognitive appraisal = Mental process used to assess -> Whether a demand threatens physical/psychological well-
being and the resource available to meet the demand

Appraisal can be vicarious -> Emphasize with others in stressful circumstances (9/11)

1. Primary appraisal
o Assess the meaning of a situation related to the well-being -> What does it mean to me?
 Irrelevant = Ignored
 Good (or benign-positive)
 Stressful = More appraisal -> Stressful circumstances:

o Harm loss = Damage already occurred
o Threat = Future harm expected (e.g., Loss of income, medical bills)
o Challenge = Opportunity to achieve mastery/growth by using more resources than usual to meet a demand (e.g.,
Job)

2. Secondary appraisal
o Assess the resources available for coping -> In transactions happens in case of a stressful situation
 Sufficient resources = Little or no stress
 Insufficient resources = Great deal of stress -> Can even lead to severe reactions as PTSD

FACTORS & DIMENSIONS

 Personal factors = Intellectual, motivational and personality characteristics (e.g., Perfectionism, low-self-esteem)
 Situation = Events imminent with strong demands are more stressful:
o Life transition, low desirability, low controllability, ambiguity, difficult timing (earlier or late in life than expected)

 Stress increase with stressor frequency, duration & intensity -> Chronic stress -> Often or long lasting
 Stronger stressor -> Stronger strain – Either psychological or physiological
 Whether stress is positive or negative depends on the person’s optimal level of arousal, which differs
o Eustress = Beneficial or constructive -> Adaptive
o Distress = Harmful and damaging -> Maladaptive

, STRESS & BRAIN

There are 2 pathways:

 Brain -> Anterior pituitary – Adrenocorticotropic hormone (ACTH) -> Adrenal cortex = Glucocorticoids (cortisol)
= Produce many components of stress response
 Brain -> Sympathetic nervous system -> Adrenal medulla = Adrenal glands -> Norepinephrine and epinephrine =
Arousal


BIOPSYCHOLOGICAL ASPECTS

Reactivity = Physiological response to a stressor/stain -> Determined by comparison with baseline (resting level)

 Genetic factors influence
 Chronic stress reactivity = Higher reactivity and more time needed to return to baseline level

Fight-or-flight = Organism either ready to attack the threat or to flee

 Either positive effects (=respond to danger) or negative (=harmful to health when prolonged)

Allostatic load = Stress accumulating overtime impairs the ability to adapt to future stressors

Factors related to physiological stress:

 Amount of exposure = More frequent, intense -> Greater amount of physiological activation
 Magnitude of reactivity = Some people have more reactivity in response to stressors than others
 Rate of recovery = Some people’s physiological responses take longer to return to normal -> Worrying,
revisiting etc.
 Resource restoration = The physiological resources are replenished by various activities -> Sleep most
important
o Sleep deprivation = More allostatic load -> No restoration of physiological activities

GENERAL ADAPTATION SYNDROME (GAS) THEORY

In case of prolonged stress:

1. Alarm reaction = Fight-or-flight response activated by sympathetic nervous system
o First - Adrenal glands -> Release norepinephrine and epinephrine
o Second - HPA axis (hypothalamus-pituitary-adrenal) activated
2. Stage of resistance = Adaption to stressor, but physiological arousal remains higher than normal
o HPA predominates over sympathetic nervous system
o Disease of adaptation = Resisting to stress leads to vulnerability (e.g., Asthma, high blood pressure etc.)
3. Stage of exhaustion = Prolonged arousal cause weakened immune system and damage to internal organs (even
leading to death)

IMPLICATIONS OF GAS THEORY

 It does not consider psychosocial factors and it is not specific to the type of stressors – it occurs regardless (illness,
death, exercise etc.)
 Cognitive appraisal plays a role in physiological reactions to stress (e.g., Smart children -> Concerned about exam ->
Appraise test as more important)
 Physiological arousal depends on effort and distress
o Effort with stress = Daily hassles
o Effort without distress = Joyous state, active and successful coping
o Distress without effort = Feeling helpless, losing control, giving up

, PSYCHOSOCIAL ASPECTS

 High level of stress = Affects people’s memory and attention
 Stress impairs cognitive functioning -> Processes that enable to intentionally drive our behaviors
 Cognitive appraisal can influence both the stress and emotions

EMOTIONS

Amygdala = Important for emotions and sensitive to some categories of stimuli

 Lateral nucleus = Convergence of information coming from multiple brain regions -> Connected to the central
nucleus -> Initiation of emotional response when a stimulus is considered threatening
 Superior dorsal lateral = Can undergo rapid changes -> Cells reset after several trials to their starting point but
by then they have undergone a change that maintains the adverse association
o Fear eliminated can return under stress = Fear retained in the memory of those cells

PATHWAYS - Separate but simultaneous pathways:

1. Low road (fast) = Thalamus -> Amygdala = Information rapidly reach the amygdala without being filter by
conscious control
2. High road (slow) = Thalamus -> Amygdala -> Sensory cortex for a finer analysis -> Results back to the amygdala
= Analysis more thorough and complete

SOCIOCULTURAL DIFFERENCES

 Women = More major and minor stress -> More willingness to talk about and it reflects real variations in
experiences (e.g., Daily workloads)
 Being part of a minority group, with low income or low education increase the stressors experienced
 Men = More reactivity when stressed and take longer for the physiological arousal to return to baseline levels
 Discrimination can lead to health problems: earlier death, cancer or cardiovascular diseases

SOURCES OF STRESS

Within the person:

 Illness = Stress especially in old age -> More understanding of disease and death -> Focus on present and future
 Achievement & status
 Conflicts = Opposing motivational forces -> Stressful when involves many choices, fairly equal strength and
when the “wrong” choice can lead to negative consequences
o Approach/Approach
 2 appealing goals incompatible (e.g., Lose weight and eat sweats)
 More important decision = More stress
o Avoidance/Avoidance
 2 undesirable situations (e.g., Two treatments that cure disease with side effects)
 Conflict difficult and very stressful
o Approach/Avoidance
 A single goal or situation with attractive and unattractive features (e.g., Quitting smoke)

Within the family

 New family member = Financial or couple problems, pre-term birth
 Marital conflict and divorce = Sleep difficulties, family changes
 Family illness/Death in the family = Financial problems, traumatic events

Within the community & society

 School/jobs = High workload, responsibilities, physical environment (e.g., Noisy, threats, hazardous substances),
perceived insufficient control, poor relationships, perceived inadequate recognition, job loss and insecurities

MEASURING STRESS