Health Psychology: Chapter 6

How Has Stress Been Studied?

In the Lab. Exposure to short-term stressful events, and observe the impact of that stress on their physiological, neuroendocrine, and psychological responses.

Physical or sexual abuse in childhood

Increases health risks because abuse can result in intense, chronic stress that taxes physiological systems and difficulties regulating emotions. Even more modest family stress can increase risk for disease. Repetti and colleagues (2002) found that "risky families"—that is, families that are high in conflict or abuse and low in warmth and nurturance—produce offspring whose stress responses are compromised. These difficulties include problems with emotion regulation, social skills, and health habits. Children who grow up in harsh families do not learn how to recognize other people's emotions and respond to them appropriately or regulate their own emotional responses to situations. As a result, they may overreact to mild stressors. These adverse reactions can be compounded by low socioeconomic status and by exposure to trauma. Children who grow up in risky families also have difficulty forming good social relationships. These deficits in emotion regulation and social skills can persist across the lifespan long into adulthood, compromising the ways in which people from risky families cope with stress Physiological systems are affected as well. Children from risky families can develop heightened sympathetic reactivity to stress, exaggerated cortisol responses leading to health risks, and/or an immune profile marked by chronic inflammation

Sources of Chronic Stress

people can adapt to a degree but continue to show signs of stress in response to severe chronic strains in their lives. Indeed, chronic stress may be more important than major life events for developing illness.

Four pathways of stress that lead/contribute to illness

physiology, health behaviors, psychosocial resources, and use of health services

The Social Readjustment Rating Scale

1 Death of a spouse 100 2 Divorce 73 4 Detention in jail or other institution 63 5 Death of a close family member 63 6 Major personal injury or illness 53 8 Being fired at work 47 41 Vacation 13 42 Chiristmas 12 43 Minor violations of the law (e.g., traffic tickets, jaywalking, disturbing the peace) 11 Taylor, Shelley; Taylor, Shelley. Health Psychology (Page 125). McGraw-Hill Higher Education. Kindle Edition.

3 Phases of the General Adaption Syndrome

1st Phase - ALARM - The person becomes mobilized to meet the threat. 2nd Phase - Resistance - The person attempts to cope with the threat as through confrontation. 3rd Phase - Exhaustion - Occurs if the person fails to overcome the threat and depletes physiological resources in the process of trying.

Final Difficulty of the Life Event Inventory

A final difficulty concerns the time between stress and illness. Usually, in these studies, stress over a 1-year period is related to the most recent 6 months of illness bouts. Yet, January's crisis is unlikely to have caused June's cold and April's financial problems are unlikely to have produced a malignancy detected in May. Obviously, these cases are extreme, but they illustrate some of the problems in studying the stress-illness relationship over time. For all these reasons, life event inventories are no longer used as much and some researchers have turned instead to perceived stress

Ambiguity and Role Conflict

Associated with Stress. ambiguity occurs when a person has no clear idea of what to do and no idea of the standards used for evaluating work. Role conflict occurs when a person receives conflicting information about work tasks or standards from different individuals. For example, if a college professor is told by one colleague to publish more articles, is advised by another colleague to publish fewer papers but of higher quality, and is told by a third to improve teaching ratings, the professor may experience role ambiguity and conflict. Chronically high blood pressure and elevated heart rate have been tied to role conflict and role ambiguity. When people receive clear feedback about the nature of their performance, they report lower levels of stress

Immune Functioning

Among these changes is impairment of the immune system's ability to terminate inflammation, which is an early response to stress. Chronic inflammation, even low-level chronic inflammation, is implicated in many diseases including coronary artery disease, and so the impaired ability to terminate inflammation may be an important pathway by which stress affects illness outcomes.

Inducing Disease

Another way of studying the effects of stress has involved intentionally exposing people to viruses and then assessing whether they get ill and how ill they get. For example, S. Cohen and colleagues (1999) measured levels of stress in a group of adults, infected them with an influenza virus by swabbing their nose with cotton soaked in a viral culture, and measured their respiratory symptoms, the amount of mucus they produced, and immune responses to stress. They found that people experiencing more stress are more likely to get sick and mount a stronger immune response than people exposed to the virus whose lives were less stressful. This approach has also been used to study factors that protect against stress, such as social support

Work and Sedentary Lifestyle

As people have moved into sedentary office jobs, the amount of exercise they get in their work lives has declined substantially. Even jobs that require high levels of physical exertion, such as construction work and firefighting, may include so much stress that the benefits of exercise are eliminated. Because activity level is related to health, this change in the nature of work increases vulnerability to illness.

Are these effects reversible?

At present it is unknown whether early life stress permanently programs stress systems or whether some of these effects are reversible. However, some factors, such as maternal nurturance in a high poverty environment, can be protective against the health risks usually found in high-stress areas. Interventions undertaken early in childhood may have health payoffs across the lifespan

Children

Children and adolescents also experience stress that can make home life stressful. One study found that social and academic failure experiences at school, such as being rejected by a peer or having difficulty with schoolwork, significantly increased a child's demanding and aversive behavior at home—specifically, acting out and making demands for attention. Children are also affected by their parents' work and family stressors, with consequences for the children's academic achievement and acting out in adolescence. Stress in children leads to adoption of an unhealthy lifestyle

acute stress paradigm

Consistently finds that when people perform stressful tasks (such as counting backward quickly by 7s or delivering an impromptu speech to an unresponsive audience), they become psychologically distressed and show physiological arousal. The acute stress paradigm has been helpful for identifying who is most vulnerable to stress. For example, people who are chronically stressed react more during these laboratory stressors as do people who are high in hostility. Box 6.3 provides an example of how an acutely stressful event can lead to dramatic health consequences. These methods have also shown that when people experience stress in the presence of a supportive partner or even a stranger, their stress responses can be reduced.

Protective Effects of Multiple Roles

Despite the potential for working mothers to suffer role conflict and overload, there can be positive effects of combining home and work responsibilities. Combining motherhood with employment can be beneficial for women's health and well-being, improving self-esteem, feelings of self-efficacy, and life satisfaction . Being a parent also confers resistance to colds. Having control and flexibility over one's work environment, having a good income, having someone to help with the housework, having adequate child care , having a partner, and having a supportive, helpful partner all reduce the likelihood that multiple role demands will lead to stress and its psychological and physical costs.

What Makes Events Stressful ?

Dimensions of Stressful Events: 1) Negative Events: Negative events produce more stress than do positive events. Shopping for the holidays, coping with an unexpected job promotion, and getting married are all positive events that draw off time and energy. Nonetheless, these positive experiences are less stressful than negative or undesirable events, such as getting a traffic ticket, trying to find a job, coping with a death in the family, getting divorced or experiencing daily conflict. Rejection targeted at you specifically by another person or group is particularly toxic. Negative events produce more psychological distress and physical symptoms than positive ones do.

Effects of EARLY Stressful Life Experiences

Early life adversity in childhood can affect not only health in childhood, but also health across the lifespan into adulthood and old age. this work grew out of the allostatic load view of stress, which argues that major, chronic, or recurrent stress dysregulates stress systems, which, over time, produce accumulating risk for disease. These early risks include low socioeconomic status, exposure to violence, living in poverty-stricken neighborhoods, and other community level stressors

Criticisms of the General Adaption Syndrome

First, it assigns a very limited role to psychological factors, and researchers now believe that the psychological appraisal of events is critical to experiencing stress. A second criticism concerns the fact that not all stressors produce the same biological responses. How people respond to stress is influenced by their personalities, emotions, and biological constitutions A third criticism concerns whether exhaustion of physiological resources or their chronic activation is most implicated in stress; research suggests that continued activation (the second phase) may be most important for accumulating damage to physiological systems, rather than exhaustion. Finally, Selye assessed stress as an outcome, that is, the endpoint of the general adaptation syndrome. In fact, people experience many debilitating effects of stress after an event has ended and even in anticipation of its occurrence. Despite these limitations and reservations, Selye's model remains a cornerstone in the field.

Effects of Minor Hassels

First, the cumulative impact of small stressors may wear a person down, leading to illness. Although useful for identifying the smaller hassles of life, measure of daily strain have some of the same problems as the measurement of major stressful life events. For example, people who report a lot of hassles may be anxious or neurotic.

Selye's General Adaptation Syndrome

Hans Selye exposed rats to a variety of stressors, such as extreme cold & fatigue, and observed their physiological responses. To his surprise, all stressors, regardless of type, produced essentially the same pattern of physiological changes. They all led to an enlarged adrenal cortex, shrinking of the thymus and lymph glands, and ulceration of the stomach and duodenum. Seyle's General Adaption Syndrome proclaims that: regardless of the cause of the threat, the person will respond with the same physiological pattern of reactions.

First pathway in which stress leads or contributes to illness

Involves direct effects on physiology. As both Cannon and Selye showed, stress alters biological functioning. The ways in which it does so and how it interacts with existing risks or genetic predispositions to illness determine what illnesses a person will develop. Direct physiological effects include such processes as elevated blood pressure, a decreased ability of the immune system to fight off infection, and changes in lipid levels and cholesterol, among other changes.

Control

Lack of control over one's work life is a major stressor. It predicts dissatisfaction at work and absenteeism as well as physiological arousal that predicts disease. Lack of control at work has been tied to greater risk of coronary artery disease and to all-cause mortality. Job control, by contrast, can improve health.

Men and Multiple Roles

Men experience stress as they attempt to combine multiple roles as well. Studies show that men are more distressed by financial strain and work stress, whereas women are more distressed by adverse changes in the home. Combining employment and marriage is protective for men's health and mental health, just as it is for women who have enough help. But multiple roles can take their toll on men, too. R. L. Repetti (1989) studied workload and interpersonal strain and how they affected fathers' interactions with the family at the end of the day. She found that after a demanding day at work (high workload strain) fathers were more withdrawn in their interactions with their children. After stressful interpersonal events at work (high interpersonal strain), conflict with children increased. Employed, unmarried fathers may be especially vulnerable to psychological distress. For both men and women, the research on multiple roles is converging on the idea that stress is lower when one finds meaning in one's life. The protective effects of employment, marriage, and parenting on psychological distress and the beneficial effects of social support on health attest to the beneficial effects of social roles. When these sources of meaning and pleasure in life are challenged, as through role conflict and role overload, health may suffer.

Mildly Stressful Events

Most people can adapt to mildly stressful events; however, it may be difficult or impossible to adapt to highly stressful events, and already-stressed people may be unable to adapt to even moderate stressors. Moreover, even when psychological adaptation may have occurred, physiological changes in response to stress may persist. Chronic stress can impair cardiovascular, neuroendocrine, and immune system recovery from stressors and, through such effects, contribute to an increased risk for diseases such as cardiovascular disorders.

Combining Work and Family Roles

Much of the stress that people experience results not from one role in their lives but from the combination of several roles. As adults, most of us will be workers, partners, and parents. Each of these roles entails heavy obligations, and stress can result when one is attempting to combine multiple roles.

4.) Overload

Overloaded people experience more stress than people with fewer tasks to perform. For example, one of the main sources of work-related stress is job overload, the perception that one is doing too much in too short of a time.

Demand-Control Support Model

R. Karasek and his associates (1981) developed a model of job strain that helps to explain its adverse effects on health. They maintain that high psychological demands on the job with little decision latitude (such as low job control) causes job strain, which, in turn, can lead to the development of coronary artery disease. The chronic anger that can result from high strain jobs may further contribute to coronary artery disease risk. When high demands and low control are combined with little social support at work, in what has been termed the demand-control-support model, risk for coronary artery disease is greater. The perception that one's effort at work is insufficiently rewarded (effort-reward imbalance) is also associated with health risks, especially coronary heart disease. .

Which Stressors?

People are more vulnerable to stress in central life domains than in peripheral ones, because important aspects of the self are heavily invested in central life domains. For example, one study of working women for whom parental identity was very important found that strains associated with the parent role, such as feeling that their children did not get the attention they needed, took a toll. To summarize, then, events that are negative, uncontrollable, ambiguous, or overwhelming or that involve central life goals are experienced as more stressful than events that are positive, controllable, clear-cut, or manageable or that involve peripheral life tasks.

Second pathway in which stress leads or contributes to illness

People who live with chronic stress have poorer health habits than people who do not, and acute stress, even when it is short-term, often compromises health habits. These poor health habits can include smoking, poor nutrition, little sleep, little exercise, and use of substances such as drugs and alcohol. Over the long-term, each of these poor health habits contributes to specific illnesses. For example, smoking can cause lung disease. Even in the short-term, changes in these health habits may increase the risk for illness and set the stage for longer term adverse health outcomes.

Social Class & Stress

Poverty, exposure to crime, neighborhood stress, and other chronic stressors vary with SES and are all tied to poor health outcomes. People who are low in SES typically have low-prestige occupations, which may expose them to greater interpersonal conflict and stress at work. Chronic SES related stress has also been related to alterations in cortisol patterns, catecholamines, and inflammation. Even children in low SES circumstances suffer health risks, including sleep problems, weight gain, and increases in allostatic load ). At least some of the health risks tied to low SES may be reversible if circumstances improve.

Individual Differences in Stress Reactivity

Reactivity is the degree of change that occurs in autonomic, neuroendocrine, and/or immune responses as a result of stress. Some people are predisposed by their genetic makeup, prenatal experiences, and/or early life experiences to be more biologically reactive to stress than others and, consequently, they may be especially vulnerable to adverse health consequences due to stress.

Physiological Recovery

Recovery following stress is also important in the physiology of the stress response. The inability to recover quickly from a stressful event may be a marker for the cumulative damage that stress has caused. Researchers have paid special attention to the cortisol response, particularly, prolonged cortisol responses that occur under conditions of high stress. In one intriguing study, elite athletes were divided into those who were experiencing a high versus a low amount of stress in their lives, and their cortisol response was measured following vigorous training. Those athletes under more stress had a protracted cortisol response. Stress may, accordingly, widen the window of susceptibility for illness and injury among competitive athletes by virtue of its impact on cortisol recovery.

Fight

Refers to an aggressive response to stress

Flight

Social withdrawal, substance abuse, distracting activities.

upper respiratory infections

S. Cohen and colleagues (2002) found that people who reacted to laboratory stressors with high cortisol responses and who also had a high level of negative life events were especially vulnerable to upper respiratory infections when exposed to a virus. People who reacted to laboratory stressors with low immune responses were especially vulnerable to upper respiratory infection only if they were also under high stress.

Chronic Stressful Conditions

Sometimes, chronic stress is long-term and grinding, such as living in poverty, being in a bad relationship, or remaining in a high-stress job. Chronic stress is also an important contributor to psychological distress and physical illness. In an early community study of 2,300 people, L. I. Pearlin and C. Schooler (1978) found that people who reported chronic stress in marriage, parenting, household functioning, or their jobs were more likely to be psychologically distressed. Uncontrollable stressors may be particularly virulent. Even something as mundane as commuting can affect daily cortisol levels and perceived stress, affecting the over 100 million Americans who commute to work every weekday. Research relating chronic stress to health outcomes is difficult to conduct, though, because it is hard to show that a particular chronic stressor is the factor that caused illness. Second, unlike life events, which can often be assessed objectively, chronic stress can be more difficult to measure objectively. Third, as in the measurement of life events, inventories that assess chronic strain may also tap psychological distress and neuroticism. Nonetheless, the evidence indicates that chronic stress is related to illness

Third pathway in which stress leads or contributes to illness

Stress affects psychosocial resources in ways that can adversely affect health. Supportive social contacts are protective of health, but stress can make a person avoid these social contacts or, worse, behave in ways that drive others away. Optimism, self-esteem, and a sense of personal control also contribute to good health, yet many stressors undermine these beneficial beliefs. To the extent that time, money, and energy must be put into combating the stressor, these external resources are compromised as well, falling especially hard on people who have very little of those resources.

The Physiology of Stress

Stress engages psychological distress and leads to changes in the body that may have short- and longterm consequences for health. Two interrelated systems are heavily involved in the stress response. They are the sympathetic-adrenomedullary (SAM) system and the hypothalamic-pituitary-adrenocortical (HPA) axis.

Appraisal of Stressors

Stress is the consequence of a person's appraisal process. Primary Appraisal: Understanding what an event is and what it will mean Appraised for their harm, threat, or challenge Secondary Appraisal: Assessing whether personal resources are sufficient to meet the demands of the environment. When a person's resources are more than adequate to deal with a difficult situation, he or she may feel little stress and experience a sense of challenge instead. When the person perceives that his or her resources will probably be sufficient to deal with the event but only with a lot of effort, he or she may feel a moderate amount of stress. When the person perceives that his or her resources will probably not be sufficient to overcome the stressor, he or she may experience a great deal of stress.

Person-Environment Fit

Stress results from the process of appraising events (as harmful, threatening, or challenging), of assessing potential resources, and of responding to the events. To see how stress researchers have arrived at this current understanding, we examine the origins of stress research.

Other Occupational Outcomes

Stress shows up in ways other than illness that may be extremely costly to an organization. Workers who cannot participate actively in decisions about their jobs show higher rates of absenteeism, job turnover, tardiness, job dissatisfaction, sabotage, and poor performance on the job. Workers may take matters into their own hands and reduce stress by not working as long, as hard, or as well as their employers expect

Stressful Life Events

T. H. Holmes and R. H. Rahe (1967), maintained that when a person must adjust to a changing environment, the likelihood of stress increases. They created an inventory of stressful life events by developing ratings of stressful events based on the amount of change those events cause.

Oxytocin

Tend-and-befriend has an underlying biological mechanism, in particular, the hormone oxytocin. Oxytocin is a stress hormone, rapidly released in response to some stressful events, and its effects are especially influenced by estrogen, suggesting a particularly important role in the responses of women to stress. Oxytocin acts as an impetus for affiliation in both animals and humans, and oxytocin increases affiliative behaviors of all kinds, especially mothering animals and humans with high levels of oxytocin are calmer and more relaxed, which may contribute to their social and nurturant behavior. Research supports some key components of the theory. Women are indeed more likely than men to respond to stress by turning to others. Mothers' responses to offspring during times of stress also appear to be different from those of fathers in ways encompassed by the tend-and-befriend theory. Nonetheless, men, too, show social responses to stress, and so elements of the theory apply to men as well.

Must Stress Be Perceived as Such to Be Stressful?

The discussion of stress thus far has emphasized the importance of perception, that is, the subjective experience of stress. However, objective stressors can have effects independent of the perceived stress they cause. For example, in a study of air traffic controllers, Repetti assessed their subjective perceptions of stress on various days and also gathered objective measures of daily stress, including the weather conditions and the amount of air traffic. She found that both subjective and objective measures of stress independently predicted psychological distress and health complaints. Even when the air traffic controllers reported that they were not under stress, if air traffic was heavy and weather conditions poor, they were more likely to show evidence of stress, both physiologically and behaviorally.

Which of these responses to stress have implications for disease?

The health consequences of HPA axis activation may be more significant than those of sympathetic activation Sympathetic arousal in response to stress by itself may not be a pathway for disease; HPA activation may be required as well. This reasoning may explain why exercise, which produces sympathetic arousal but not HPA activation, is protective for health rather than health compromising. However, unlike exercise, stressors can be experienced long after a stressful event has terminated, and cardiovascular activation may persist for hours, days, weeks, or even years after an initial stressful event has occurred, even without awareness. Such wear and tear on the cardiovascular system may foster illness.

HPA Activation

The hypothalamic-pituitary adrenal (HPA) axis is also activated in response to stress. The hypothalamus releases corticotrophinreleasing hormone (CRH), which stimulates the pituitary gland to secrete adrenocorticotropic hormone (ACTH), which, in turn, stimulates the adrenal cortex to release glucocorticoids. Of these, cortisol is especially significant. It acts to conserve stores of carbohydrates and helps reduce inflammation in the case of an injury. It also helps the body return to its steady state following stress. Repeated activation of the HPA axis in response to chronic or recurring stress can ultimately compromise its functioning. Daily cortisol patterns may be altered. Normally, cortisol levels are high upon waking in the morning, but decrease during the day (although peaking following lunch) until they flatten out at low levels in the afternoon. People under chronic stress, however, can show any of several deviant patterns: elevated cortisol levels long into the afternoon or evening, a general flattening of the daily rhythm, an exaggerated cortisol response to a challenge, a protracted cortisol response following a stressor, or, alternatively, no response at all . Any of these patterns is suggestive of compromised ability of the HPA axis to respond to and recover from stress

Social Relationships

The inability to develop satisfying social relationships at work has been tied to job stress, to psychological distress at work, and to poor physical and mental health. Having a poor relationship with one's supervisor predicts job distress and may increase a worker's risk for coronary heart disease. To a degree, having an amicable social environment at work depends on being an amicable coworker. A study of air traffic controllers found that people who were not particularly well liked by their coworkers and who consequently did not have much social contact were more likely to become ill and to experience an accidental injury than were people who enjoyed and contributed to a more satisfying social climate. Social relationships not only combat stress in their own right, they also buffer other job stressors, such as low control over one's work.

Tend-and-Befriend

The theory maintains that, in addition to fight or flight, people and animals respond to stress with social affiliation and nurturant behavior toward offspring. These responses to stress may be especially true of women.

Women and Multiple Roles

These problems are particularly acute for women. More than half of married women with young children are currently employed. Managing multiple roles is most difficult when both work and family responsibilities are heavy, and having many responsibilities at home has health risks of its own. Because concessions to working parents are rarely made at work and because mothers take on more household tasks and child care than fathers, home and work responsibilities may conflict with each other, increasing stress. Working women who have children at home have higher levels of cortisol, higher cardiovascular reactivity, and more home strain than those without children at home. Single women raising children on their own are most at risk for health problems, whereas women who are happily married are less likely to show these negative effects

2.) Uncontrollable Events

Uncontrollable or unpredictable events are more stressful than controllable or predictable ones especially if they are also unexpected. When people feel that they can predict, modify, or terminate an aversive event or feel they have access to someone who can influence it, they experience less stress, even if they actually can do nothing about it. Feelings of control not only mute the subjective experience of stress but also influence biochemical reactions to it, including catecholamine levels and immune responses

retrospective study,.

V. J. Felitti and colleagues (1998) asked adults to complete a questionnaire regarding their early family environment that inquired, among other things, how warm and supportive the environment was versus how cold, critical, hostile, or conflictridden it was. The more negative characteristics these adults reported from their childhood, the more vulnerable they were in adulthood to many disorders, including depression, lung disease, cancer, heart disease, and diabetes . Because children from risky families often have poor health habits, some enhanced risk for disease may come from smoking, poor diet, and lack of exercise.

Must a Stressor be Ongoing to be stressful?

We do not have to be exposed to a stressor to suffer stress. ANTICIPATING STRESS: The anticipation of a stressor can be as stressful as its actual occurrence, and sometimes more so. Consider the strain of anticipating a confrontation with one's partner or worrying about an upcoming test. Sleepless nights and days of distracting anxiety attest to the human being's capacity for anticipatory distress. In one study that illustrates this point, medical students' blood pressure was assessed on an unstressful lecture day, on the day before an important examination, and during the examination itself. Although the students had stable blood pressure on the lecture day, blood pressure on the preexamination day, when the students were worrying about the exam, was as high as that seen during the examination

Sympathetic Activation

When events are perceived as harmful or threatening, they are identified as such by the cerebral cortex in the brain, which, in turn, sets off a chain of reactions mediated by these appraisals. Information from the cortex is transmitted to the hypothalamus, which initiates one of the earliest responses to stress—namely, sympathetic nervous system arousal. Sympathetic arousal stimulates the medulla of the adrenal glands, which, in turn, secrete the catecholamines epinephrine (EP) and norepinephrine (NE). These effects result in the cranked-up feeling we usually experience in response to stress: increased blood pressure, increased heart rate, increased sweating, and constriction of peripheral blood vessels, among other changes. The catecholamines modulate the immune system as well. Parasympathetic functioning may also become dysregulated in response to stress. For example, stress can affect heart rate variability. Parasympathetic modulation is an important restorative aspect of sleep, and so, changes in heart rate variability may both represent a pathway to disturbed sleep and help to explain the relation of stress to illness and increased risk for mortality.

Can People Adapt to Stress?

Will people adapt to stress if they are continually exposed to it? Will they habituate to it, or will it cause CHRONIC STRAIN? The answer to this question depends on the type of stressor, the subjective experience of stress, and the indicator of stress. Most people are able to adapt psychologically to moderate or predictable stressors. At first, any novel or threatening situation can produce stress, but such reactions subside over time. For example, research on the effects of environmental noise and crowding indicates few or no long-term adverse physiological or psychological effects, suggesting that most people simply adapt to this chronic stressor.

Overload

Work overload is a chief factor producing high levels of occupational stress. Workers required to work too long and too hard at too many tasks feel more stressed, have poorer health habits, and have more health risks than do workers not suffering from overload. The chronic neuroendocrine activation and cardiovascular activation associated with overcommitment can contribute to cardiovascular disease. Monday may indeed be one of the most stressful days of the week. Weekdays more generally are associated with more worry and chronic work overload than weekends, resulting in altered cortisol levels. Unfortunately, many people, particularly in the United States, don't use their weekends to recover and instead work through the weekend. Then they dump the work they did over the weekend onto their coworkers on Monday. Incomplete recovery from work contributes to death from cardiovascular disease.

Stress in the Workplace

Workplace stress is estimated to cost $300 billion a year (American Institute of Stress, n.d.). ' Studies of stress in the workplace are important for several additional reasons: ∙ They help identify some of the most common stressors of everyday life. ∙ They provide evidence for the stress-illness relationship. ∙ Work stress may be one of our preventable stressors and so provide possibilities for intervention. ∙ Stress-related physical and mental health disorders account for a growing percentage of disability and social security payments to workers.

Stress in adolescence

affects health both during adolescence, and into adulthood. For example, social disadvantage in adolescence is linked to increased body weight, to inflammation, and to high-blood pressure and poor blood pressure recovery from stress. Perceived financial stress is especially strongly related to multiple health markers and outcomes, attesting again to the adverse health effects of low SES. GOOD Parenting can mitigate these effects.

3.) Ambiguous Events

are more stressful than clear-cut events. When a potential stressor is ambiguous, a person cannot take action, but must instead devote energy to trying to understand the stressor, which can be a time-consuming, resourcesapping task. Clear-cut stressors, on the other hand, let the person get on with finding solutions and do not leave him or her stuck at the problem definition stage. The ability to take confrontative action is usually associated with less distress and better coping

People who experience a lot of stress

are most vulnerable to illness. Although scores on life event inventories predict illness, the relation is quite modest. Why is this the case? First, some of the items on the list are vague; for example, "personal injury or illness" could mean anything from the flu to a heart attack. Second, because events have preassigned point values, individual differences in how events are experienced are not taken into account. For example, a divorce may mean welcome freedom to one partner but a collapse in living standard or self-esteem to the other. Third, inventories include both positive and negative events, as well as events that people choose, such as getting married, and events that simply happen, such as the death of a close friend. As noted, sudden, negative, unexpected, and uncontrollable events are reliably more stressful. Fourth, researchers typically do not assess whether stressful events have been successfully resolved, which mutes adverse effects

Poor Sleep

can be a consequence of chronic stress. Because sleep represents a vital restorative activity, this mechanism, too, represents a pathway to disease

Daily Stress

daily hassles, and their cumulative impact on health and illness. Such hassles include being stuck in traffic, waiting in a line, doing household chores, having difficulty making small decisions, and daily conflict. Daily minor problems produce psychological distress, adverse physiological changes, physical symptoms, and use of health care services

High Immune Reactors

did not show differences in upper respiratory illness as a function of the stress they experienced, perhaps because their immune systems were quick to respond to the threat that a potential infection posed Studies like these suggest that psychobiological reactivity to stress is an important factor that influences the stress-illness relationship. Differences in reactivity are believed to contribute to the development of hypertension and coronary artery disease.

Origins of Stress: Fight-or-Flight Response

earliest contribution to stress research was Walter Cannon's Fight or Flight Response. Cannon proposed that when an organism perceives a threat, the body is rapidly aroused and motivated via the sympathetic nervous system and the endocrine system. This concerted physiological response mobilizes the organism to attack the threat or to flee; hence, it is called the fight-or-flight response. On the one hand, the fight-or-flight response is adaptive because it enables the organism to respond quickly to threat. On the other hand, it can be harmful because stress disrupts emotional and physiological functioning, and when stress continues unabated, it lays the groundwork for health problems.

Effects of Long Term Stress

excessive discharge of epinephrine and norepinephrine can lead to suppression of immune function; produce adverse changes such as increased blood pressure and heart rate; provoke variations in normal heart rhythms, such as ventricular arrhythmias, which can be a precursor to sudden death; and produce neurochemical imbalances that may contribute to the development of psychiatric disorders. The catecholamines may also have effects on lipid levels and free fatty acids, which contribute to the development of atherosclerosis, Corticosteroids have immunosuppressive effects, which can compromise the functioning of the immune system. Prolonged cortisol secretion has also been related to the destruction of neurons in the hippocampus, which can lead to problems with verbal functioning, memory, and concentration and may be one of the mechanisms leading to senility. Pronounced HPA activation is common in depression, with episodes of cortisol secretion being more frequent and longer among depressed than nondepressed people. Storage of fat in central visceral areas (i.e., belly fat), rather than in the hips, is another consequence of prolonged HPA activation. This accumulation leads to a high waist-to-hip ratio, which is used by some researchers as a marker for chronic stress

Allostatic Load

has been developed to refer to the physiological costs of chronic exposure to the physiological changes that result from repeated or chronic stress. Allostatic load can begin to accumulate in childhood, affecting multiple disease risks across the lifespan. The buildup of allostatic load can be assessed by a number of indicators, including increasing weight and higher blood pressure. May be thought of as accelerated aging in response to stress. Over time, this kind of wear and tear can lead to illness and increased risk of death. The damage due to chronic stress is made worse if people also cope with stress via a high-fat diet, infrequent exercise, alcohol abuse, and smoking. The relationship of stress to both acute disorders, such as infection, and chronic disorders, such as heart disease, is now well known.

Fourth pathway in which stress leads or contributes to illness

involves the use of health services and adherence to treatment recommendations. People are less likely to adhere to a treatment regimen when they are under stress, and they are more likely to delay seeking care for disorders that should be treated. Alternatively, they may not seek care at all.

Stress

is a negative emotional experience accompanied by predictable biochemical, physiological, cognitive, and behavioral changes that are directed either toward altering the stressful event or accommodating to its effects.

Threat

is the assessment of possible future damage, as a person anticipates the problems that loss of income will create for him and his family.

Unemployment

major life stressor. It increases psychological distress, physical symptoms, physical illness , alcohol abuse, difficulty achieving sexual arousal, low birth weight of offspring, elevated inflammation, and compromised immune functioning. For example, in a study of SES-related decline in the wake of Hurricane Katrina, those who suffered trauma or who lost their jobs and experienced other deprivations showed enduring health effects. Uncertainty over employment and unstable employment have also been tied to physical illness. For example, a study found that men who had held a series of unrelated jobs were at greater risk of dying than were men who remained in the same job or in the same type of job. Being stably employed is protective of health.

Stressors

money, the economy, work, family health problems, and family responsibilities are their top five stressors.

Aftereffects of Stress

often persist long after the stressful event itself is no longer present. These aftereffects include a shortened attention span and poor performance on intellectual tasks as well as ongoing psychological distress and physiological arousal. Cognitive disruptions such as difficulty concentrating are common, and social behavior is affected as well; people seem to be less willing to help others when they are suffering from the aftereffects of stress. Worry or rumination, even when one is not aware that one is doing it, can keep heart rate, blood pressure, and immune markers at high levels

Vulnerable Populations

such as children, the elderly, and the poor, show little adaptation to chronic stressors. One reason is that these groups already experience little control over their environments and, accordingly, may already be at high levels of stress; the addition of an environmental stressor may push their resources to the limits.

Harm

the assessment of damage that has already been done, for example being fired from a job.

events may also be appraised in terms of their challenge

the potential to overcome or even profit from the event. For example, a man who lost his job may regard his unemployment as an opportunity to try something new. Challenge assessments lead to more confident expectations that one can cope with the stressful event, more favorable emotional reactions to the event, and lower blood pressure, among other benefits

Japan & Work

work overload and poor health in Japan, a country notorious for its long working hours, long work weeks, little sleep, and lack of vacations, has a term, karoshi, that refers to death from overwork. One study found that men who worked more than 61 hours a week experienced twice the risk of a heart attack as those working 40 hours or less; sleeping 5 hours or less at least 2 days a week increased this risk by two to three times. Under Japanese law, families are entitled to compensation if they can prove that the breadwinner died of karoshi.