Concepts of Stress Definition of terms: Stress
A disruptive condition that occurs in response to adverse influences from the internal or external environments
A condition in which the person responds to changes in the normal balanced state
Stressors
A stimulus or situation that causes stress.
Classification Classification of Stressors General Classification 1. Inte Intern rnal al Stre Stress ssor or
Originate within the person
2. Exte Extern rnal al Stre Stress ssor or
Originate outside the individual
3. Develo Developme pmenta ntall Stres Stressor sor
Occurs at a predictable time throughout life
4. Situ Situat atio iona nall Stres Stresso sor r
Unpredictable may occur any time during life
Can Be Positive or Negative
According to Location 1.
Physical
e.g. (Cold,Heat, chemical agents)
2.
Physiologic
e.g. (pain and Fatigue)
3.
Psychosocial
e.g. (Failing exams and losing a job)
According to involved persons 1. Day Day to to day day stre stress ssor ors s 2. Major Major complex complex occurr occurrence ences s involvin involving g large large groups groups 3. Less frequent frequent stres stressors sors involvin involving g few group groups s
According to Duration 1. Acute Acute time time limite limited d stres stresso sor r 2. Stre Stress ssor or sequ sequen ence ce 3. Chroni Chronic c interm intermitt ittent ent stre stresso ssor r 4. Chroni Chronic c Endu Endurin ring g Stre Stress ssor or
Stress as Stimulus
Stress is defined as a stimulus, life l ife event, or a set of circumstances that arouses physiologic and psychologic reactions that may increase the individuals vulnerability to illness
Adolph Meyer
Relating life response to illness
Holmes and Rahe
Life change units
A numerical scale ranking stressful life events and the amount of distress they cause( 43 life changes)
Stress as a Response
Hans Selye defined stress as the nonspecific response of the body to any demand
made upon it
Schafer defined stress as the arousal of mind and body in response to demands made
upon them
Generalized Adaptation Syndrome (GAS or Stress syndrome)
Describes stress as wear and tear on the body occurring regardless of whether the stressor is positive or negative
Localized Adaptation Syndrome (LAS)
Inflammatory and repair processes that occur in the at the local site of tissue injury
Phases of GAS/LAS A. Alar Alarm m rea react ctio ion n
2 phases 1. Shock Ph Phase
SNS and Endocrine system react to stress(fight or flight response)
2. Coun Counte ters rsho hock ck Phas Phase e
Reversal of changes brought by Shock phase
B. Stage Stage of Resist Resistan ance ce
1. Adaptive Adaptive responses responses that attempt attempt to limit limit the the damage damage of stress stress C. Stage Stage of exhaus exhaustio tion n 1.
Physiologic and psychological resources are depleted and immune system becomes depressed
Stress as a Transaction
Transactional Stress theory
Encompasses a set of cognitive, affective and adaptive(coping) responses that arise out of person-environment transaction
Mediating process(cognitive-motivational-relational) - Lazarus a. Cogn Cognit itiv ive e appr apprai aisa sall i. Prim Primar ary y appr apprai aisa sall
Event is evaluated to what is at stake
1. Stressful
2.
Harm or loss has occurred
Harm or loss is anticipated(Threatening)
Opportunity or gain is anticipated(Challenging)
Nonstressful (irrelevant/benign/positive)
ii. ii. Seco Second ndar ary y appra apprais isal al
Event is evaluated to what is might and can be done
iii. iii. Reap Reappr prai aisa sall
Change of opinion based on new information
Manifestations of Stress
Physiologic
Dilatation of Pupils
Sweat production
Heart rate & Cardiac output inc
Skin is Pale
Na and H2o retention
Respiratory rate and depth inc
Urinary output inc
Dry mouth
Peristalsis Dec
Mental alertness Inc
Muscle tension Inc
Blood sugar inc
Psychological
Depression
Extreme feeling of sadness, despair, dejection, lack of worth, or emptiness
Emotional Symptoms •
Tiredness
•
Sadness
•
Emptiness
•
Numbness
Behavioral Signs •
Irritability
•
Inability to concentrate
•
Difficulty in making decisions
•
Loss of sexual desire
•
Crying
•
Sleep disturbance
•
Social Withdrawal
Physical Signs
•
Loss of appetite
•
Weight loss
•
Constipation
•
Headache
•
Dizziness
Anxiety
State of mental uneasiness, apprehension, dread, or foreboding or a feeling helplessness related to impending or anticipated threat to self or significant relationships
Can be experienced at conscious, subconscious, or unconscious Levels of Anxiety
Level
Verbalization Changes
Motor activity changes
Perception Alteration and Attention Changes
Respiratory and Circulatory Changes
Other Changes
Mild
Increase Questioning
Mild Restlessness
Inc arousal and alertness
None
None
Sleeplessness
Uses learning to adapt
Tremors, Facial twitches, shakiness
Narrowed , inattentive and selective attention focus
Slight inc
Mild gastric symptoms
Tachycardia, Hyperventilatio n
Headache, dizziness, nausea
Mode Modera rate te
Voice oice trem tremor ors s and Pitch Changes
Slightly impaired learning Severe
Communication difficult to understand
Motor activity inc, Inability to relax, Fearful Facial
Easily distracted No Focus
Panic
Communication not understandable
Expression
Learning severely impaired
Motor activity inc, Agitation, Unpredictable responses, Trembling, Poor motor coordination
Distorted exaggerated Perception Unable to learn
Dyspnea, Palpitations, choking, Chest Pain
Feeling of impending doom, paresthesia, sweating
Fear
Emotion or feeling of apprehension aroused by impending or seeming danger pain or a perceived threat
Anger
Emotional state consisting of a subjective feeling of animosity or strong displeasure
Can be Verbal or Non verbal
Hostility – overt antagonism harmful or destructive behavior
Violence – exertion of physical force to injure or abuse
Aggression – unprovoked attack, or a hostile, injurious inj urious or destructive action or
outlook Cognitive
Problem Solving
Structuring
Thinking through threatening situations, using specific steps to arrive at a solution
Arrangement or manipulation of a situation so that threatening events do not occur
Self-control(Discipline)
Suppression
Assuming a manner and facial expression that conveys sense of being in control or in charge
Consciously and willfully putting a thought or feeling out of mind
Fantasy or Daydreaming
Unfulfilled wishes and desires are imagined as fulfilled.
PREDISPOSING FACTORS FOR STRESS
GENETIC FACTORS
INABILITY TO ADAPT
INADEQUATE RELAXATION RESPONSE
RESPONSE ACTIVITY VARIATIONS
AGE
PERSONALITY
ISOLATION
Environment
Eustress and Distress
Eustress
The pleasurable stress that accompanies positive positive events. For example, a person may receive a $10,000 bonus and experience stress in deciding how to spend the money.
Distress
The unpleasant stress that accompanies negative events.
Type a/type b (Friedman and Rosenman, 1974)
Type a
Competitive, achievements orientation. Self-critical. No joy in accomplishments.
Time urgency. urgency. Impatient. Always on the go.
Do several things at once.
Anger/hostility- easily aroused to anger, which may be overt or covert.
Type b
Low levels of competitiveness
Time urgency - patient
Hostility - not easily aroused to anger
Easy going
Philosophical
Coping
Dealing with problems and situations, or contending with them successfully
Cognitive and behavioral effort to manage specific e xternal /internal demands that are appraised as taxing or or exceeding the resources resources of a person(Folkman and Lazarus)
Coping strategy/mechanism
1. Emot Emotio ion n Foc Focus used ed Copin Coping g
Lessens emotional distress
2. Probl Problem em Focu Focuse sed d Cop Copin ing g
Direct change to the environment
