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Stress, happiness and health - Coggle Diagram
Stress, happiness and health
What is stress?
Stessor - something in the environment that causes stress
Distress - harmful response to stressor
Eustress - positive response to stress
Acute stress - short-term
Chronic stress - long term stress
Appraisal - event and personal resources
Historical models of stress -
Fight or flight - Cannon, 1932
General adpatation syndrome (Seyle, 1956)
-> Alarm -> resistance -> exhaustion
But - not all stressors are the same, and not all people respond the same
Life events theory -
list of life events - different events allocated 'life changing units' in social readjustment scale
Different life events are given different numbers, and then calculate the life stress
Transactional model of stress - primary appraisal -> potential stressor -> stress -> coping
Secondary appraisal - reassess the stressor -> coping
Primary appraisals are -
-> Irrelevant
-> Benign or positive
-> Harmful and a threat
-> Harmful and a challenge
Coping - direct action, seeking information, doing nothing, coping in some way, trying to relax and defence mechanisms
What is stressful - salient events (present events), overload, ambigious events and uncontrollable events
Measuring stress
Self-report -
Social readjustment rating scale (Homes and Rahe, 1967)
Perceived stress scale (Cohen et al, 1983)
Hassles and Uplifts Scale (DeLongis, Folkman and Lazarus, 1988)
-> Hassles are irritants - things that annoy or bother, they can make you upset or angry
-> Uplifts - events that make you feel good, joyful or satisfied
-> Some hassles and uplifts occur regularly and some are rare, some only have small effects and others have large effects
-> This questionnaire lists things that can be hassles or uplifts - some are both
-> directed to mark each event on a hassle or uplift scale
In the lab -
Physiology - heart rate, respiration and blood pressure
Biomarkers - blood, urine, saliva and hair (stress hormone)
Stress management -
Physical activity
Arts interventions (Martin et al, 2018)
Mindfulness (Sharma et al, 2014)
Cognitive behavioural therapy (Nakao et al, 2021)
Stress and illness
Stress and the body -
blood pressure (awake and asleep)
heart rate variability
dysregulation of the immune system - increased activation and decreased activation
Stress and the sympathetic adrenal medullary system - catecholamines (adrenaline and noradrenaline)
Blood pressure, heart rate, sweating, pupil dilation and tissues and immune function
Stress and the hypothalamic-pituitary-adrenal medulla system - HPA axis
Corticosteroids (e.g. cortisol)
Increases access to energy stores
Tissue damage
Pressure on bodily systems
Inverted U theory of arousal - Caroll et al, 2017
Stress and viruses - Common cold, Cohen et al, 1991 -
measure stress
Give virus via nasal drops
Quarantine
Infection rates increased with stress
Clinical cold increased with stress
Stress caused infection more infection than the ones influenced by illness
Stress and wound-healing - Walburn et al, 2009 -
a systematic review and meta-analysis
22 studies
There was a negative relationship in all studies between recovery (wound healing) and stress and/or mood
For example - students took longer to heal during exams - holidy v exam times
Carers took longer than controls to heal
Greater levels of psychological stress were associated with impaired wound healing
Stress and cardiovascular disease (Kivimaki and Steptoe, 2018)
Pooling data across studies
Adults with stress - increased risk of CHD and stroke
Risk from adult stress not as high from smoking, high blood pressure, cholesterol, obesity or childhood stress
Stress plays a role as a disease trigger in those with atherosclerotic plaque
Stress influences outcomes in those with CVD
Need scalable, evidence-based interventions
Changes in behaviour -
Smoking - initiation, relapse and amount smoked linked to stress
Alcohol - people drink more when stressed
Eating - some people eat more, some eat less when stressed
Exercise - lower when stressed
Accidents - higher when stressed
If habits of bad behaviour have been formed, it is much harder to break these responses to stress
Moderators of stress
Physiological moderators -
Higher stress reactivity leads to poorer health if exposed to stress (e.g. hypertension, coronary artery calcification, cellular ageing)
Blunted stress reactivity in those chronically stressed also leads to negative health outcomes
Slower stress recovery related to poorer health
Allostatic load builds over time as experience more stressors and recover less completely
Psychological moderators
Health behaviours -
Wouldn't want to promote smoking - people report smoking decreases anxiety and stress, but it increases heart rate
-> Does reduce late positive potential (brain activation shows arousal induced by emotional stimuli) - Choi et al, 2015
Would want to promote physical activity - physical activity leads to lower depression, anxiety and fatigue, and ability to cope with stressful encounters
Coping styles - efforts to manage environment or internal demands (Lazarus and Laurnier, 1978)
Can involve re-appraisal and re-evaluation
Try to change the external stressor or internal resources
Aim of coping -
-> Reduce stressful environmental conditions
-> Adjust or tolerate negative events
-> Maintain positive self image
-> Maintain emotional equilibrium
-> Continue satisfying relationships with others
Approach - confront the problem, gather information, direct action
Avoidant - minimise event
Problem focused - action to reduce demands of stressor or increase resources available
Emotion focused - try to change emotions evoked by the event (behavioral or cognitive)
Benefit finding - finding meaning in stressful events
Social support - perceived comfort, caring, esteem or help one individual receives from another
Decreased mortality rates, improved immune functioning, improved health behaviours
Direct effect - lack of social support is stressful
Buffering - social support influences appraisal of stressor
Hugging (Cohen et al, 2015) - N = 404 - perceived social support (interpersonal support evaluation list)
Daily interpersonal conflict v hugs received
Exposed to virus and quarantine
Perceived social support protected against conflict - infection association
Hugs protected against conflict -> infection association
Hugs explained 32% of stress effect
In those infected, support and hugs reduced illness signs
Personality -
Type A - excessive competitiveness, impatience, hostility, vigorous speech (Friedman and Rosenman, 1959) - conflicting results linking to CHD
Type D - negative emotions, inhibit emotions and avoid social contact - CVD mortality - poor physical and mental health and poor self-management of disease
Hostility - links to CHD and overall poorer health (physiological stress reactivity, behaviour and other moderators e.g. social support)
Control -
attributions (Kelley, 1967)
self-efficacy (Bandura, 1977)
Categories of control (Thompson, 1986) - behavioural, cognitive, decisional and information
Reality control
Job strain model -
-> Low job demands + high job control = low strain
-> High job demands + high job control = active jobs
-> Low job demands + low job control = passive jobs
-> High job demands + low job control = high strain
Happiness
Happiness (Steptoe, 2015) -
Affective wellbeing - positive feelings
Eudaimonic well being - meaning and purpose
Evaluative well-being - appraisals of satisfaction
Not just the absence of negative states, and many experiences are bittersweet
Positive psychology - focuses on optimal functioning of people, what makes life worth living, focuses on strengths not weaknesses
Happiness and health (2019) -
Subjective wellbeing - mortality, often independent of negative affect
Happiness and morbidity - hedonic and eudaimonic wellbeing -> CHD, Stroke, Diabetes, Arthiritis and prognosis
Happiness -> health pathways - behaviour and biological processes - cortisol, inflammation, cardiovascular effects e.g. blood pressure, metabolic effects e.g. cholestreol
Happiness and inflammatory responses (Panagi et al, 2018) - N = 140, adults with Type 2 diabetes
Daily diaries 7 days, assess daily happiness and sadness
Blood tests (Markers of inflammation, IL-6, IL-1RA, MCP-1)
Mental stress tests
Blood tests immediately after, 45 mins after and 75 mins after
Lower baseline stress in those happier, for IL-6 this was independent of sadness
No association between happiness and response to stress
Factors that contribute to happiness - marital status, family, stress exposure, time use and activities, social network, socioeconomic status, education, genetics and personality
Molinger, 2019 -
Focus on time - when value time over money, you are happier
Amount of time - having too much or too little limits happiness
Spending time - people are happiest when engaged in active leisure - socialising, volunteering, exercising
-> Connecting with others is essential
-> Quality time - focusing on doing
Stress in research
Evaluation of stress, burnout and hair cortisol levels in health workers during the COVID-19 pandemic - Ibar et al, 2021
First study in which a stress biomarker such as hair cortisol evaluated in this population
Healthcare workers subjected to increased levels of stress and burnout
High depersonalisation, emotional exhaustion and decreased personal sense of accomplishment characterise the population
-> It is the responsibility of the health authorities to implement strategies to manage the psychological emergency
Psychological stress and susceptibility to the common cold (Cohen, Tyrell and Smith, 1991)
Psychological stress associated with a dose-response manner with an increased risk of acute infectious rates of infection rather than to an increased frequency of symptoms after infection
Happiness and inflammatory responses to acute stress in people with Type 2 Diabetes (Panagi, 2019)
Happier individuals with T2D have lower inflammatory markers before and after acute stress responsivity - findings could provide a protective physiological pathway linking daily happiness with better health in people with T2D