STRESS
Dr. Romany Hosny Gabra
Assistant professor of psychiatry,
Faculty of medicine
Assiut university
Objectives :
1. Outline the major stress theories.
2. Explain psychosocial factors related to stress
coping process.
3. Examples of stressors in life and everyday
activities and their effect on health.
4. Factors Moderating the Impact of Stress
Objectives :
1. Outline the major stress theories.
2. Mention examples of stressors in life and
everyday activities and their effect on health.
3. Explain psychosocial factors related to stress
coping process.
4. Factors Moderating the Impact of Stress
Introduction :
• The word stress was first was used in physics
in order to analyze the problem of how
manmade structures must be designed to
carry heavy loads and resist deformation by
external focus.
What is stress?
• Stress is a psycho-physiological response, within
an individual animal, to a perceived danger.
• Stress involves a complex interplay of nervous
and hormonal reactions to internal and external
stimuli.
• All living organisms respond to stimuli, usually
by means of gene-regulating chemical
messengers called hormones.
• Researchers are trying to answer questions
regarding how thoughts and feelings can be
translated to changes in the body and whether
prolonged stress alters health in life-
threatening ways.
Theories of Stress
• Theories that focus on the specific relationship
between external demands (stressors) and
bodily processes (stress) can be grouped in
different categories:
1- Biological Theories of Stress
• The first important theorist who attempted to
account for stress was Walter Bradford
Cannon.
• He claimed that the sympathetic nervous
system is activated by signals from the brain
when a person is exposed to an emotionally
arousing stimulus.
• This produces a series of physiological
reactions that includes increases in heart rate,
blood pressure, and respiration.
• This fight-or-flight response prepares the
person for potential vigorous physical activity.
According to Cannon, the confrontation with
an arousing stimulus produces both the
feelings and physiological reactions that are
associated with stress.
Hans Selye labeled the body’s response to stress
the general adaptation syndrome.
This process occurs in three stages:
1- The alarm reaction.
2- the resistance stage.
3- the exhaustion stage
• Stage one is the alarm reaction, during which
the body activates to handle the perceived
danger at hand.
• This activation resembles Cannon’s fight-or-
flight response.
• The shock phase exhibits autonomic
excitability, an increased adrenaline discharge
• Blood is diverted to the skeletal muscles to
prepare them for action.
• The second phase of the general adaptation
syndrome is the resistance stage.
• During this stage, the person either adapts to
or resists the source of stress.
• If noxious stimulation continues, the organism
enters the stage of resistance. In this stage,
the symptoms of the alarm reaction disappear,
which seemingly indicates the organism's
adaptation to the stressor.
• Resistance stage include hyper activity of
hypothalamo- pituitary- adrenal axis.
• The longer this stage lasts, the greater is the
danger to the person.
• If the aversive stimulation persists, resistance
gives way to the stage of exhaustion.
• The organism's capability of adapting to the
stressor is exhausted, the symptoms of stage
(alarm reaction)reappear, but resistance is no
longer possible. Irreversible tissue damages
appear, and, if the stimulation persists, the
organism dies.
2- Psychological Theories of Stress
• The psychological approach to stress is best
represented by the work of Richard Lazarus.
• Lazarus believes that it is people’s perception of an
event that is crucial. This involves a combination of
people’s perceptions regarding the potential danger
of an event and their ability to cope with it.
• Stress will occur in those circumstances in which
people perceive that they do not have the ability or
resources needed to cope with the situation.
Example:
Example:
• When people are exposed to a new event
such as a spouse returning from work, the
situation can be judged as irrelevant, positive,
or potentially stressful. The key to the stress is
the people’s appraisal of the situation, rather
than the situation itself.
Overview of the Stress Process
Objectives :
1. Outline the major stress theories.
2. Explain psychosocial factors related to stress
coping process.
3. Examples and types of stressors in life and
everyday activities and their effect on health.
4. Factors Moderating the Impact of Stress
psychosocial factors related to stress
coping process.
• Potentially stressful events occur in everyone’s
life.
• Many people, however, never develop stress-
related symptoms and illnesses.
• This may result in part from issues pertaining
to lifestyle and personality.
Personality factors
• Personality factors are helpful in people’s
efforts to avoid illness in the face of stress.
These factors are:
a- control
b- commitment
c- challenge.
A- control
• When faced with difficult events, people can
view the situation either as hopeless or as one
over which they have a degree of control.
• In a situation in which a man is notified that
the factory in which he works is going to close
in three years, it is normal initially to treat the
news with shock and disappointment, but it is
the worker’s long-term response that is
critical.
• What do you think he should do?????
• On one hand, He can make the statement that
the factory is going to close and there is nothing
he can do about it. This response is likely to lead
to gradual increases in stress and susceptibility to
illness.
• On the other hand, he could take control of the
situation by looking for other work, entering a job
retraining program. This approach is likely to
decrease his risk of stress-related illness.
B- commitment
• The second factor, commitment, involves
people’s dedication to and involvement with
other people, activities, institutions, and
themselves. Some people have nowhere to
turn in the presence of a stressful event.
• They have no friends, family ties have been
severed, and they are loners who have no goal
in life other than to wake up the next
morning.
• These individuals will find it extremely difficult
to cope with a stressful event such as the
death of a parent or loss of a job. They may
feel that they have nowhere to turn in the
face of stress .
C- Challenge,
• The final factor, challenge, relates to people’s
view of changes in their life.
• For example, a secretary who is transferred from
one department at work to another, and who
views this change as presenting interesting and
new challenges, is likely to remain healthy.
• However, if she views the new position as a
threat that should be avoided at all costs, she is
likely to become ill.
Objectives :
1. Outline the major stress theories.
2. Explain psychosocial factors related to stress
coping process.
3. Examples and types of stressors in life and
everyday activities and their effect on health.
Types of Stressors
1- Eustress vs. Distress
• stress is not always a bad thing.
• there is a difference between eustress, which
is a term for positive stress, and distress,
which refers to negative stress.
• In daily life, we often use the term "stress" to
describe negative situations. This leads many
people to believe that all stress is bad for you,
which is not true.
Eustress, or positive stress, has the following
characteristics:
1. Motivates, focuses energy.
2. Is short-term.
3. Is perceived as within our coping abilities.
4. Feels exciting.
5. Improves performance.
In contrast, Distress, or negative stress, has the
following characteristics:
1. Causes anxiety or concern.
2. Can be short- or long-term.
3. Is perceived as outside of our coping abilities
4. Feels unpleasant.
5. Decreases performance.
6. Can lead to mental and physical problems.
Examples of negative personal
stressors include:
• The death of a spouse
• Filing for divorce
• Losing contact with loved ones
• The death of a family member
• Hospitalization (oneself or a family member)
• Injury or illness (oneself or a family member)
• Being abused or neglected
• Separation from a spouse or committed
relationship partner
Examples of positive personal stressors
(EUSTRESS)include:
• Receiving a promotion or raise at work.
• Starting a new job.
• Marriage.
• Buying a home.
• Having a child.
• Moving.
• Taking a vacation.
• Holiday seasons.
2- EXTERNAL VERSUS INTERNAL
• Stressors are not always limited to situations
where some external situation is creating a
problem.
• Internal events such as feelings and thoughts
and habitual behaviors can also cause
negative stress.
Common internally caused sources of
distress include:
• Fears: (e.g., fears of flying, heights, public
speaking, chatting with strangers at a party)
• Repetitive Thought Patterns such as :
Worrying about future events (e.g., waiting for
medical test results or job restructuring)
Unrealistic, perfectionist expectations.
3- Stressor impact
• Life events scales can be used to assess
stressful things that people experience in their
lives. One such scale is the Social Readjustment
Rating Scale(SRRS).
• To calculate one's score, add up the number of
"life change units" if an event occurred in the
past year.
• Try to calculate how much stress have you
been exposed in the last year
Life change Change in financial state 38
Life event
units Death of a close friend 37
Death of a spouse 100 Change to different line of work 36
Change in frequency of arguments 35
Divorce 73
Major mortgage 32
Marital separation 65 Foreclosure of mortgage or loan 30
Change in responsibilities at work 29
Imprisonment 63
Child leaving home 29
Death of a close family member 63 Trouble with in-laws 29
Outstanding personal achievement 28
Personal injury or illness 53 Spouse starts or stops work 26
Marriage 50 Begin or end school 26
Change in living conditions 25
Dismissal from work 47
Revision of personal habits 24
Marital reconciliation 45 Trouble with boss 23
Retirement 45 Change in working hours or conditions 20
Change in residence 20
Change in health of family
44 Change in schools 20
member
Change in recreation 19
Pregnancy 40
Change in church activities 19
Sexual difficulties 39 Change in social activities 18
Gain a new family member 39 Minor mortgage or loan 17
Change in sleeping habits 16
Business readjustment 39
• A score of more than 300 means that
individual is at risk for illness, a score between
150 and 299 means risk of illness is moderate,
and a score under 150 means that individual
only has a slight risk of illness.
Stress effects on health
• Almost all body organs can be affected by
stress .
Responding to Stress Physiologically
• Physiological Responses
– Fight-or-flight response
– Selye’s General Adaptation Syndrome
• Alarm
• Resistance
• Exhaustion
Responding to Stress Behaviorally
• Behavioral Responses
– Frustration-aggression hypothesis
– catharsis
– defense mechanisms
• Coping
– Reappraisal
– Confronting problems
– Using humor
– Expressing emotions
– Managing hostility
Effects of Stress:
Behavioral and Psychological
• Impaired task performance
• Burnout
• Psychological problems and disorders
• Positive effects
Effects of Stress: Physical
• Psychosomatic diseases
• Heart disease
• Emotional reactions and depression
• Stress and immune functioning
– Reduced immune activity
