1. To describe general stress theory.
2. To review empirical research about stress and its effects.
3. To outline the major elements of coping theory.
4. To consider practical strategies for managing stress, including mindfulness and resilience
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| 1596404552 | Can stress cause heart attacks? | Viewing a stressful soccer match more than doubles the risk of acute cardiovascular event | 0 | |
| 1596404553 | What is stress? What are exposures and appraisals? What happens when demand > resources? | Stress is the body's non-specific response to a demand placed on it 1 Stressor exposure: - any event/situation of potential demand, harm or threat 2 Stressor Appraisal: - evaluation of available resources to deal with stressor (cognitive response) 3. Stress response: = non-specific (but well recognised) physiological and psychological changes Plus (potentially) -learned and rehearsed responses | 1 | |
| 1596404554 | What are the 3 models of stress? | 1. Stimulus based model - stress is external to the person, who experiences a reaction to the stress 2. Response based model - focuses on the physiological, psychological, or behavioural response of the person to stress 3. Transactional Model (BEST) - regards the stress process as a transaction between the environment and the person | 2 | |
| 1596404555 | What is the weakness of the stimulus based model? | Weakness: treats the person as a passive respondent to a stress event, with no contribution to the event or outcome ("external locus of control") | 3 | |
| 1596404556 | What is the weakness of the response based model? | Weakness: Mainly concerned with dealing with the symptoms of stress, without trying to alter the response (stress interpreted as "bad") | 4 | |
| 1596404557 | What is the strength of the transactional model? | Strength: Allows for modification of the perception and responses to stress - Situation can be perceived in different ways - Coping can be planned / rehearsed - Support can be provided at an appropriate level | 5 | |
| 1596404558 | What is the stress performance curve? | We all experience stress We may become distressed If we are distressed for long, function may become impaired |  | 6 |
| 1596404559 | How do external and internal stresses? |  | 7 | |
| 1596404560 | What is the continuum of stressors | Stresses are on a continuum |  | 8 |
| 1596404561 | What are the acute physiological changes in the stress response? | Arousal of Sympathetic Nervous System (SNS), and the Hypothalamic/Pituitary/Adrenal (HPA) axis Heightened cardiovascular, respiratory, skeletal muscle function ("fear, fight and flight") Changes in blood flow to skin and digestive tract, decreased skeletal muscle tone Decrease in immune responses | 9 | |
| 1596404562 | What are the chronic physiological changes in the stress response? | Accelerated atherosclerosis Metabolic syndrome (diabetes, hypertension, central obesity) Bone demineralisation Concept of "Allostatic Load" = chronic wear and tear on the body | 10 | |
| 1596404563 | What are the psychological changes? | Increased alertness Narrowed attention Strong negative emotions - anxious, vulnerable, helpless, irritable Poor problem-solving/task performance Decreased ability to relate socially | 11 | |
| 1596404564 | What are the CV and immune effects of chronic stress? | Cardiovascular system, e.g. ischaemia or arterial occlusion heart attacks arrhythmias Immune system, e.g. infectious disease cancer progression (angiogenesis 'up-regulation') | 12 | |
| 1596404565 | What are the effects of chronic stress on the brain? | Atrophy of : 1. Hippocampus (responsible for learning and memory) 2. Prefrontal cortex (responsible for working memory and executive function) dysfunction in e.g. Alzheimers Hypertrophy of: Amygdala (mediates the fear response) Psychoneuroimmunology and Psychoneuroendocrinology via neurotransmitter and endocrine pathways | 13 | |
| 1596404566 | What is tend-and-befriend (compared to flight-or-fight)? | although fight-or-flight may characterise the primary physiological responses to stress... behaviourally, females' responses are more marked by a pattern of 'tend-and-befriend' | 14 | |
| 1596404567 | What is burnout? | A syndrome reported frequently among those who work at an intense level with others, including health professionals Key features of burnout include: - increased feelings of emotional exhaustion - depersonalisation - feelings of reduced personal accomplishment "Burnout" is a good proxy for "distress" | 15 | |
| 1596404568 | What are the effects of burnout? | Anxiety and depression (psychological morbidity) |  | 16 |
| 1596404569 | What are 2 key coping strategies? | 1. Problem-focused coping (reduce stressor intensity) e.g. seeking information, avoiding, taking direct action) 2. Response-focused coping (manage emotional and physical component of stress response) e.g. humour, detachment, fatalism, acceptance, fantasy, physical and psychological "fitness" 1+2 = Resilience | 17 | |
| 1596404570 | What are the defensive copying styles (can be adaptive or maladaptive)? | 1. Adaptive e.g. cognitive reframing humour, acceptance 2. Less Adaptive e.g. rationalisation, withdrawal 3. Maladaptive e.g. projective identification 4. Pathological e.g. delusional beliefs | 18 | |
| 1596404571 | What are the BASICs of coping? | Body Affect Social Intellect Cosmos | 19 | |
| 1596404572 | Body strategies? | Nutrition - avoid dehydration, minimise toxins Exercise Rest - sleep is not a luxury Recreation - "rest for mind and spirit" Good Medical Care Boundaries and Balance | 20 | |
| 1596404573 | Affect strategies? | Mood Attitudinal and Emotional Health "Emotional Intelligence" - self awareness - ability to manage emotions positively - empathy - delayed gratification, but not indefinitely! Dealing with negative emotions "Mindfulness" | 21 | |
| 1596404574 | What is mindfulness? | Mindfulness is all about learning to direct our attention to our experience as it unfolds, moment by moment, with open-minded curiosity and acceptance. Rather than worrying about what has happened or might happen, it trains us to respond skilfully to whatever is happening right now, be that good or bad. | 22 | |
| 1596404575 | Social strategies? | Pay attention to your loved ones "In and through community lies the salvation of the world" (MS Peck) Trust and take risks Give and receive feedback Support each other Experience love and intimacy | 23 | |
| 1596404576 | Intellect strategies? | Hobbies Current events Reading *Intellectual Health* allows you to re-evaluate your worldview, belief systems, ethical and moral standards, ideals and expectations Deal with feelings of entitlement | 24 | |
| 1596404577 | Cosmos strategies? | A personal sense of meaning and purpose Spiritual Health It is easy to lose perspective in the rigours of daily medical practice We need to keep the ability to experience awe, wonder and surprise | 25 | |
| 1596404578 | What are the signs of "distress"? | Depression (and anger) Burnout Changes in behaviour e.g. drinking more, taking risks Relationship problems (family, patients, staff) Financial problems Withdrawal | 26 | |
| 1596404579 | What are the 4 things that build resilience? | 1) attitudes and perspectives, including maintaining interest, developing self-awareness, and accepting personal limitations 2) balance and prioritization, including setting limits, effective approaches to continuing professional development, and honouring the self 3) management style, which includes sound business management, good staff, and effective time allocation 4) supportive relations, including positive personal relationships, effective professional relationships, and good communication. | 27 |
