ACUTE stress (short term)
- stressors arouse the autonomic nervous system (ANS)
- the sympathetic nervous system (SNS) in the ANS begins the 'fight or flight' response in our body.
- this then makes the sympathetic adrenal medullary (SAM) to make adrenaline in the adrenal medulla
- the effects of the adrenaline: boosts the 02 and glucose supply to our brain. heart rate increases, pupils dilate ect ect. and surpresses all the non emergency processes so we stop digesting food
- and then once we've chilled out the parasympathetic nervous system (PNS) relaxes the body
- and all of that is called the sympathomedullary pathway
CHRONIC stress (long term)
- the brain percieves the stressors
- a message is sent to the hypothalamus which is the control centre in the brain for the hormones
- the hypothalamus then makes CRF which goes into the bloodstream
- the CRF goes to the pituitary gland which then releases ACTH which goes to the adrenal glands
- then the adrenal cortex in the adrenal glands releases cortisol which makes the liver turn stored glycogen into glucose to give the body a bit of a boost
- so if you're under too much chronic stress, the body makes a sh*ttonne of cortisol, which turns into corticosteroids which are the things that damage the immune system and we get ill
- this is called the pituitary - adrenal system
stress related illnesses and immune system
exam stress (short term) - Kiecolt-Glaser et al. took blood samples 1 month before and during exams. measured Nk cell activity and questionnaire. NK cell activity LOWER during exams so more vunerable to illness. high levels of loneliness = lowest NK cell
- punch biopsy in summer/3 days before exam. before exam took 40% longer to heal.
relationship stress (long term) - poorer immune system in women who seperated with partners in the previous year. maritial conflict = 90 newly wed over a 24 hour period, ££ etc, more adreniline produced with conflict
- stress/illness isnt a simple relationship. many diff factors eg lifestyle; long term experiments £££, health slow to change
- stress can sometimes enhance
- metanalysis 293 studies. Short term acute stressors can boost immune system but long term chronic stressors suppress immune system
CVD and psych disorders with stress
CVD: stress activates SNS, increases heart rate. this may wear away the lining of blood vessels. increasing glucose levels :(
Williams et al 13000 people, 10 questions anger scale, none of them had heart disease. 6 years later 256 heart attacks and those who had scored higher were 2x more likely.
Russek stress in medics. heart diseases were higher with GPs who have high stress.
Marital conflicts associated with 2.9 fold increase in heart attacks with CHD
Psych disorders: chronic stress conditions women more likely to get depression eg lots of young kids. survey of 100, 15% in high stress jobs had depression or anxiety within a year. PTSD (post traumatic stress disorder)
DIATHESIS STRESS MODEL:
in order to get a psych disorder, must have a biological vunerability to disorder eg genetic. stress can trigger this or worsen it.
Life changes and daily hassles
- LIFE CHANGES
- Social Readjustment Rating Scale. LCU's for each life event.
- Rahe et al used this with military men in a questionnaire. positive correlation between LCU and illness score.
- study with half divorcees and half widows. those divorced had higher life satisfaction after divorce and vice versa.
Evaluation - quality of event = crucial. daily hassles more stressful? individual differences not taken into account. not a CAUSAL relationship, this is correlational.
- Hassles and Uplifts Scale.
- Hassles: students transition to uni. 41% depressive, positive correlation between scores on the hassles scale and depressiveness
- Uplifts: nurses kept a diary for one month. felt uplifts they experienced counteracted effects of daily hassles.
Evaluation: accumulation effect (build up leads to srs stress), amplification effect (chronic stress may make daily hassles seem worse => AMPLIFY), retrospective recall (hard to remember, using a diary helps), correlational, NOT CAUSAL.
- Marmot - JOB STRAIN MODEL. proposed that stress and illness caused by 1) high workload and 2) low job control.
- 7372 civil servants in london. questionnaire and checked for signs of CVD. 5 years reassessed.
- workload = no link w high workload BUT Johansson et al looked at sawyers in a swedish sawmill (high risk) higher illness, higher adreneline, high stress hormones on work days.
- control = 5 years on, low levels of control more likely to have developed heart disease, no other factors.
- metanalysis in europe, us and japan found high job strain 50% more likely CHD
- depression more likely with work stress
- Shultz - work underload had low job satisfaction and more absence bc stress related illness.
- Lazarus - lots of individual differences in how ppl cope with stressors
- work places changing lots, psychological research may not keep up with this.
Personality factors and stress
Type A/B (Friedman and Rosenman)
Type A characteristics: competitive, impatient, hostile/aggressive,
Type B characteristic: patient, relaxed, easygoing.
Study: 3000 men, 39 to 59. personality and CHD check. results: 8 1/2 years on, twice as many type A died of cardiovascular. 12% heart attack, B = 6%. more likely to smoke or have a family history of CHD. Mytrek - metanalysis, link between CHD and hostility. (type A component).
The HARDY personality:
characteristics: control (they need to be in control), commitment, challenge (thrive with this)
Research: Kobasa - 800 business ppl, used SRRS, around 150 high. diff illness records, suggests that hardy personality encourages resilience. high stress/low illness scored on all 3 H characteristics.
Evaluation: some suggst hardy people are those who lack negative affectivity. hard to measure
Psychological methods of stress management
STRESS INOCULATION THERAPY: 3 main phases to this
- conceptualisation phase client educated about stress, teaches to think differently about it
- skills acquisition and rehearsal practised in clinic then in real life. makes client think in diff way and learn adaptive behaviours.
- application phase apply skills learnt in increasingly stressful situations
- effectiveness - compared with SDS, reduces phobie and also helps reduce second less well known phobia (cope with future stressors)
- Sheety and Horan - 1st year law students, 4 90 minute sessions, improvement of poor students
- limitations: time consuming, high motivation, v complex, doesnt need to be
- focusing - identifying signs of stress, find sources. reliving stress encounters and analyse situation. self improvement - learn techniques etc.
- evaluation - fletcher: used with UK olympic swimmers to control stress that might increase with training. PROBLEMS are that its long term.
Biological methods of managing stress
- GABA release is bodys natural response to stress and relaxes effects of stress in the brain by attaching to receptors on outside of recieving neurons and causing release of chloride ions into the neuron
- slows down neuron activity and causes the person to feel relaxed
- BZs enter bloodstream and attach to GABA receptors on the outside of receiving neurons and boost GABA action bc more chloride ions released into neuron.
- BZs also reduce serotin activitym reduces anxiety.
Beta Blockers (BBs)
- They reduce activity of adreniline/nonadreniline (part of sympathomedullary response). BBs bind to betareceptors of heart cells.
- This reverse effects of stress hormones and the heart slows. also means blood vessels contract less easily. fall in blood pressure = relaxation
Evaluating biological methods
- Kahn et al. 250 patients over 8 weeks, BZs found to be superior to placebos.
- Beta blockers reduce anxiety in situations such as musicians performing
- metanalysis on treatment of social anxiety, BZs more effective at treating that other antidepressants
- easy to use
- addiction - BZs can give withdrawal symptoms
- side effects in BZs, 'paradoxical' eg aggressiveness and impact (bad) on memory
- treats SYMPTOM not the actual problem
Kelman proposed two types of conformity:
- Compliance - going along with others to gain approval or avoid disapproval. your private view may not agree with theirs
- Internalisation - going along with others bc you have accepted their point of view (consistent with your own). you agree publically AND privately.
- 123 male undergraduates were shown a series of lines (had to answer with line was the same as standard line)
- all but the real participant were confederates (confederates always gave the wrong answer 12 out of 18 trials)
- participant always answered last or second to last.
- 36.8% conformed, 1/4 never did. control trial w all participants - 1% mistakes.
Variations in ASCH study
- difficulty - when harder, more conformed. size of majority - not much when only 1 or 2 others. but when 3 present, conformity increased 30%. if they had someone supporting aka giving the right answer, conformity dropped to 5%. gender diffs = women more
Evaluating conformity research
- may be unique to one culture - only used Americans but study done in Britain showed similar.
- confederates may have been unconvincing
- VALIDITY = fairly insignificant task, if the task had been more important there would be less conformity.
- ETHICS = deception and lack of informed consent. didnt know they were being tricked and the presence of confederates.
- CULTURE = collectivist countries eg Japan/Fiji more conformity than individualist countries like UK/USA.
- oversimplified to conclude bc of culture diffs. task may be more meaningful for one culture. also individual differences must be taken into account
- 40 males, advertised (volunteer sampling). paid $4.50, told would recieve even if quit.
- participant ALWAYS the teacher. increase by 15V each time wrong answer. learner in the other room (fake). 315V said nothing
- experiment had prods ... 'you have no choice, you must go on' etc
Results - expected a few to go past 150v, 4% to 300V. in actual fact, 65% went to the full 450V! all went to 300V, 5 stopped.
Conclusion - people very obedient to authority, even when carrying out an inhumane task.
- proximity - obedience dropped by 40% when could see the learner. when experimenter left the room, onlyu 21% went to 450V
- allies - when 2 didnt want to continue, all stopped (only 10% went max)
Why people conform
- influence and SMOKING - campaigns about what is 'normative' is effective eg w smoking
- campaign in USA: 10% took up smoking after message that most people their age didnt smoke
- study: control group had a hanger saying environ benefits of reusing towels in their hotel room, the experimental group had one saying 75% choose to reuse... and this reduced demands for fresh towels by 25%!!!!!
- mass 'psychogenic' illness - teacher at school said could smell a petrol smell, and got a headache and other symptoms; soon after, students began to feel the same, building was evacuated but there was no evidence found......
Evaluating obedience research
- Ethical issues - depection and lack of consent. wasnt clear to what extent they had the right to withdraw. psych harm... Lifton: ppl in Nazi death camps were ordinary but turned into killing machines.
- Validity - realism: some suggested ppl guessed purpose which is why they went so much higher. generalisability: real life, 95% nurses obeyed (from unknown doc, 2x recommended dose). individual differences: cultural differences.
Why people obey.
- gradual commitment: hard to change mind
- agentic shift: person sees themselves as carrying out the wishes of another.
- buffers eg teacher couldnt see student so people more willing to obey.
- justifying (people try to do this)
Evaluation - agentic shift eg in the Holocaust
Evaluating independant behaviour
Resisting pressure to conform
- Role of allies (Asch). Allen and Levine carried out a similar study; 1 with an invalid social supporter (with thick glasses), the other with valid social support. Both reduced conformity especially the valid one. people more willing to stay independant if its a MORAL not a PHYSICAL judgement.
Resisting pressures to obey
- When Milgrams study carried out in a downtown office, more people reisted (other was @ Yale)
Locus of control
- persons perception of personal control over behaviour. high internal > caused by themselves. high external > believe caused by fate
- high internals = less reliant on others' opinions, more achievement orientated, can resist coercion from others.
Twenge et al - young Americans increasingly think lives are controlled by external forces
Understanding Social Change
role of minority influence
- (conditions needed for social change through minority influence)
- drawing attention to an issue
- the role of conflict - in cant dismiss as a minority, makes us think more about it
- consistency - if consistent over time then views are taken more seriously
- the augmentation principle - if theres a risk involved in putting a view forward, likely to be taken more seriously.
Evaluation: suffragettes - drew attention to the issue in several ways. used the role of conflict. consistent; continued for 15 years. augmentation principle - were willing to suffer for the cause.
Deviation from social norms
Definition: deviation from standards set by society about how one ought to behave. anything that goes against these rules is considered abnormal.
- susceptible to abuse - varies with time eg 50 years ago homosexuality was not accepted but now is
- context and degree - eg a person on a beach wearing bikini is normal, but a person walking down a street in this is NOT.
- cultual relativism - influenced by cultural factors, diagnosis may be different in two different cultures for the same person.
Failure to function adequately
Definition: if abnormal behaviour interferes with your ability to function on a day to day basis. judged in terms of not being able to cope.
- who judges? - who has the right to judge what is considered abnormal.. the patient may be quite content with the situation and not judge it as abnormal.
- adaptive or maladaptive - some 'abnormal' behaviour can actually be adaptive for the person and functional for the individual. eg with depression some ppl may welcome the extra attention.
- cultual relativism - different diagnosis in different cultures.
Deviation from ideal mental health
Definition: deviating from an ideal of positive mental health (Jahoda)
- self attitudes: high self esteem, strong sense of identity
- personal growth and self actualisation: how an individual demonstrates full capabilities.
- integration: being able to cope w stressful situations
- autonomy: being independant and self regulating.
- having an accurate perception of reality.
- mastery of environment: ability to love, function @ work and in relationships, adjust to new situations and solve problems
- who can achieve all these criteria?
- is mental health same as physical health? - can it be detected in the same way
- cultural relativism
Biological approach to abnormality
Outline of approach:
- genetic inheritance - can be observed by studying pairs of identical twins. low concordance rates some mental disorders eg phobias but high for some eg schizoprenia.
- biochemistry - high levels of serotin associated with anxiety, low levels in depressed ppl.
- neuroanatomy - schizophrenics have enlarged spaces (ventricles) in their brains, indicating shrinkage of brain tissue around these spaces.
- viral infection - some disorders such as schizophrenia may be due to some viruses gained in the womb; Torrey found some mums of schizophrenics had had a particular strain of flu during pregnancy. may enter childs brain and remain dormant until puberty when other hormones activate it.
- humane or inhumane? - critics claim the medical model is inhumane bc mental illnesses dont have a physical basis so shouldnt be thought of in the same way.
- cause and effect? - evidence does not support a simple cause + effect between stuff like schizo and altered brain chemistry. eg schizo is assocated w excess dopamine but some patients have some deficincies of dopamine in some parts of brain diff levels
- inconclusive evidence - genetic evidence never 100% concordance rate. genetic twins - 50%, so genes are the complete cause. diathesis stress model (disorder develops w stressful life condition)
Freud: ID: irrational part, driven by the pleasure principle. Ego: rational part, develops by the end of the 1st year, driven by the reality principle. Superego: age of 5, sense of right and wrong.
- believes that mental disorders come from unresolved childhood conflicts.
- conflicts - ego defends itself w ego defences (repression, or regression - can become the cause of disturbed behaviour).
- early experiences - feelings may be repressed and reemerge
- unconscious motivations
- ABSTRACT concepts - id etc are hard to define and research.
- sexism, Freud is sexist.
- lack of research evidence.
Methods of investigation - case studies eg Little Hans all are unique and hard to generalise, experiments.
- only behaviour is important
- abnormal behaviour is learned through conditioning/social learning
- learning environments - may reinforce bad behaviour, another example is developing a fear of flying because you saw a plane crash on the TV.
- v limited (ignores the role of cognition)
- counter evidence - eg Seligman suggested basic anxieties are 'hard wired' into our brains so easy to develop phobias.
- symptoms not cause
Investigating: experiments eg ABBA, Animal studies - some basic laws also apply to animals.
The cognitive approach
- ABC model (Ellis). A refers to the Activating Event (eg sight of dog). B refers to Belief (rational or irrational, eg dog will attack me). C is the consequence eg irrational beliefs will lead to unhealthy emotions.
- individual is in control so abnormality is the result of faulty control.
- experiments - cognitive therapy works just as well as medicines, better tolerated
- metaanalysis - eg found that cognitive therapy as having the 2nd highest success rate.
- Blames patient - may be other situational factors
- Consequences not cause - is person negative and depressed or negative BECAUSE depressed?
- not all irrational beliefs are irrational - some suggest that depressed people see the world as it really is.
Biological therapies : Drugs
- antipsychotic drugs - 2 types: convential - block action of dopamines by binding to but not stimulating dopamine receptors. other type is atypical - temporarily block dopamine receptors then rapidly disassociate to allow normal dopamine transmission.
- antidepressants. SSRIs: block transporter mechanism that reabsorbs serotin into presynaptic cell after fired. this means more serotin left in synapse, longing out activity. makes transmission of next impulse easier.
- strengths - effective; study showed that relapse after 1 year was highest w placebos, 2 to 23% when antipsychotic combined with therapy. easy to use!
- limitations - placebos; 38 studies showed almost the same success rate when placebos were used. tackles symptoms rather than the actual problem. side effects.
- electrodes placed on head.
- patient unconscious and nerves blocked. O2 given
- electric current passed through brain, 1 minute seizure
- 3x a week, 3 to 15 treatments.
why it works? noone really knows :( alters the way neurotrasmitters acting in the brain
- strengths: can save lives, effective - 60/70% improved after, but diff study showed that 84% relapsed within 6 months.
- limitations: sham ECT (without electric shock), some got better anyway. side effects can be bad memory and headaches :((((
- repression and unconscious mind - uncovering repressed memories.
- free association - patients say thoughts exactly as they occur.
- therapist interpretation
- working through - several times a week, allows understanding and gain of CONTROL.
- strengths - effectiveness; data from 10000 patients, 80% benefitted (length and intensity was the critical factor). length of the treatment (450 patients, the longer it took, the better the outcomes.)
- limitations - theoretical limitations; based on Freud, if Freud is wrong then so is the therapy???, appropriateness, repressed memories may be fake ones.
- patient taught to relax muscles completely
- therapist and patient construct a desensitation hierachy (scenes, each one causing more anxiety than the last)
- patient works through this using relaxation techniques
- when mastered one step, can move onto next
- patient masters fearful situation :)
- strengths - appropriate (quick, patient is active in treatment). effective (75% of people with phobias reacted well to SDS)
- limitations - SDS may appear to resolve but actually just repress. some phobias are less effective with this eg ones with underlying evolutionary stuff eg fear of the dark
Negative event A => Rational belief B => Healthy emotion C
Negative event A => Irrational belief B => Unhealthy emotion C
- logical disputing - is it logical to think like that?
- empirical disputing - is this accurate?
- pragmatic disputing - how will this help me?
- strengths - effective (metaanalysis 28 studies concluded so). appropriate (useful for both clinical and non clinical purposes). can be done via a computer so it is useful for those suffering with anxiety
- limitations - irrational environments (situations like bullying partners continue despite therapy). not suitable for all; doesnt always work.