10 - 9. Stress physiological and psychological asp

9. Stress: physiological and psychological aspects

© SPMM Course 9. Stress: physiological and psychological aspects

Stress is an organism’s response to a challenge in the environment or stimulus. The response, deemed fight-or-flight, is via the activation of the sympathetic nervous system. Though the sympathetic nervous system activation is short-lived (as the parasympathetic system calms down the physiological response), prolonged stress can have systemic effects (e.g. cardiac dysfunction). The neuroendocrine system plays an important role in regulating response to stress. (see the chapter on Neuroscience for further details.) In psychological terms, stress is the feeling of pressure – positive stress or ‘eustress’ is a small amount of stress that improves motivation and ability but large amounts of negative stress (‘distress’) can be detrimental to mental health. As well as the external environment, stress can also be caused by internal cognitions, which can be addressed in CBT for anxiety. Stress can be classified into four categories: Crises/catastrophes Completely out of the control of the individual e.g. natural disasters, war – can lead to post-traumatic stress disorder Major life events Going to university, marriage, birth of a child, the death of a loved one (NB not all life events produce detrimental stress; the context of occurrence is important). Daily hassles or microstressors Meeting deadlines, making decisions, irritating colleagues. Ambient stressors Low-grade environmental e.g. pollution, traffic, noise

Stressors can result in various levels of conflicts.  Approach-approach conflict: choosing between two equally attractive options e.g. which restaurant to have dinner  Avoidance-avoidance: choose between two unattractive options  Approach-avoidance conflict – attractive and unattractive traits e.g. going to university but incurring significant debt Stress Vulnerability model (Zubin and Spring, 1977) proposes individuals have strengths and vulnerabilities for dealing with stress. On the diagram shown here, person a has low vulnerability and thus can deal with a high deal of stress without much negative consequences, whereas person c has high vulnerability and therefore even moderately low stress can cause them to become mentally unwell. This model applies to a wide variety of psychiatric disorders including psychosis. Causes of increasing vulnerability include genetic factors, childhood loss and trauma. This is a simplistic model and more