Class 8: Stress, Continued Class Project: Emotions, Stress, and Health Tracking Purpose: To observe changes in emotions, stress, and health, and see how they interact. Method: Complete Daily Events Diary at the start of each class, beginning today (9/21) and ending on Nov. 2. Make 14 copies of Daily Events Diary, staple into a booklet, and bring to class. Analysis: You will sum up your scores, and also chart them. I'll show how this is done. Write up: You will write a 3-page summary based on your Diary data AND class readings. You will have 2 weeks to do so. Daily Events Diary Date:_________________ Event None Very Little Moderate Amount A Lot A Great Degree Happy Mood Sad Mood Anxious Mood Angry / Irritable Mood Relationship Stress Work/school/financial Stress Very Sick (Flu, severe cold) How would you rate your current health, compared to normal? Sick (mild cold) Fair (sympts, but not very sick) Good (few sympts, mainly well) Excellent (no symptoms) Daily Events Diary Date:_________________ Note and observations about significant events or experiences going on in your life. Write only the facts of what is happening to you, DO NOT write about your feelings or opinions. __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ __________________________________________________ Prolonged Stress Widens “Window of Vulnerability” Chronic stress ↑ recovery phase ↑ cortisol phase ↑ immune suppression ↑ illness risk. Allostatic load = effects of cumulative stress exposure Signs of allostatic load: Decreased cell-mediated immunity Reduced inhibition of cortisol response Lowered HR variability Elevated epinephrine Higher waist:hip ratio Atrophied hippocampus Reduced memory Increased BP Allostatic load accelerates aging process. Reactivity and Stress Vulnerability People vary in stress reactions NOT just a matter of being mentally tough / whimpy Physical constitutions differ: Autonomic NS Neuroendocrine response Immune response Study of children 3-5 yrs old, reactivity Measure reactivity to stressor -- a. cardio (HR, BP) b. immune Parents track stressor reactions, illness for 12 weeks Result: Stress leads to illness among ____ Low Reactive X High Reactive ____ Stress Recovery and Window of Susceptibility Inability to recover quickly from stress = marker of cumulative stress damage. Prolonged cortisol levels is key risk factor. Why? Cortisol immune system inhibition illness vulnerability Stressed/non-stressed athletes study (Perna & McDowell, 1995) Elite athletes, experiencing much/little daily stress Cortisol measured after serious workout. Finding? Stressed athletes showed longer cortisol recovery. Stress: A Matter of Perspective? Subjects view gruesome film of tribal initiation rites. Given one of following frames: Intellectual description De-emphasize pain, focus on excitement X X Emphasize pain and suffering No Framing Which frames produce the most stress in subjects? Lazarus Two Factor Model of Stress Appraisal Primary Appraisal ___Pos ___ Neutral ___ Negative If Neg: How harmful now? In future? Stress Potential Stressor Secondary Appraisal Internal coping abilities adequate? External coping resources adequate? Stress as Function of Person-Environment Fit Relation of Resources to Challenge Resources >> Challenge Stress Level Low Resources ≥ Challenge Medium Resources < Challenge High Class 8: Stress II Classes of Stressful Life Events 1. Negative events (but also positive pos events?) 2. Uncontrollable events 3. Ambiguous events & role ambiguity 4. Work overload 5. Challenges to central domains Objective and Subjective Stress What matters, objective stress or subjective stress? Both matter. Air traffic Controllers (Repetti, 1993) Common Cold Study (Cohen et al., 1993) Temporal Dimension of Stress Stress can occur: X Before stressor onset? ___ X During stressor onset? ___ X After stressor onset? ___ Med Students and Exam Study (Sausen et al., 1992) Cardio Activity Stress anticipation: At least as stressful as actual stressor 9 8 7 6 5 4 3 2 1 0 Long before exam Day before exam Day of exam Aftereffects of Stress Effects of stress can persist long after stressful event. Aftereffects can be more devastating than the stressful event itself. Stress depresses post-stress task performance (Glass & Singer, 1972) Stress and social behavior (Cohen & Spacapan, 1978) a. Helping: Unavoidable stress ___ increases helping. X decreases helping. ___ Stress as an “overzealous teacher.” Social rejection Failed relationship Job loss Ostracism and Visual Performance Gorman & Harber, in Prepartion Ostracism “classic” stressor: Ambiguous, painful, enduring effects Do aftereffects of ostracism affect visual ability? Why should this be so (think Pennebaker, attention, and symptoms)? Cyberball Person Detection Task Perceptual Accuracy as a Function of Social Exclusion and Self-Confidence 1.2 1 D' 0.8 Included 0.6 Excluded 0.4 0.2 0 Low Self-Confidence Average Self-Confidence p < .01 High Self-Confidence Learned Helplessness and Surrender Measuring Stress How could stress be measured? Stress Over the Past Year (A Home Grown Scale for This Class) Over the past 12 months, how much stress did you experience, overall? ___ 1. ___ 2. ___ 3. ___ 4. ___ 5. ___ 6. ___ 7. None or almost none Far less than usual Somewhat less than usual Same as usual More than usual Far more than usual An extreme amount Problems with this measure? Definitions of “House” House as object 2400 sq feet, large back lot, aged heating and plumbing Colonial style House as place Where grandparents settled after WW II Where mom and Uncle Joe were born Where we had 4th of July every year Where Suzy learned to drive. Definitions of “Stress” Stress as Event Number of tasks due Clarity re. stressors Degree of control Consequences of failure Stress as Experience How confident I feel. How overwhelmed I feel Point: How a thing is defined affects how it is understood. Defining stress in terms of events (Holmes & Rahe) vs. in terms of how people feel about events (Cohen, et al). Social Readjustment Scale Holmes & Rahe, 1967 In the past year, have you experienced: 1. __ Death of a spouse 100 26. __ Wife starting/ending work 26 2. __ Divorce 73 29. __ Change in personal habits 24 3. __ Marital separation 65 32. __ Change in residence 20 7. __ Marriage 50 33. __ Change to a new school 20 8. __ Being fired 47 35. __ Change in church activities 19 17.__ Death of a close friend 37 36. __ Change in social activities 18 18.__ Changing to different work 36 38. __ Change in sleeping habits 16 19.__ Change # spouse arguments 35 41. __ Vacation 13 20.__ Taking a loan on house 31 43. __ Minor law issue (ticket, etc.) 11 CRITIQUE OF SOCIAL READJUSTMENT RATING SCALE (Holmes & Rahe, 1967) 1. Vague terms 2. Numeric values 3. Relevance across populations 4. Doesn’t distinguish between pos and neg events 5. Doesn't consider how well event was resolved 6. Individual diffs. in propensity to mark events 7. Memory lapses SUBJECTIVE STRESS MEASURE Cohen, Kamarck, & Mermelstein, (1983) For each question, choose from the following alternatives: 0 Never 1 Almost never 2 Sometimes 3 Fairly often 4 Very often 1. In the past month, how often have you been upset because of something that happened unexpectedly? 2. In the last month, how often have you felt nervous and “stressed”? 3. In the last month, how often have you found that you could not cope with all the things that you had to do? 4. In the last month, how often have you been angered because of things that were out of your control? Hassles The Measurement of Hassles Severity 1. somewhat severe 2. moderately severe 3. extremely severe 1. 2. 3. 4. Misplacing or losing things. Troublesome neighbors. Social obligations. Inconsiderate smokers. 1 1 1 1 2 2 2 2 3 3 3 3 5. Thoughts about death. 6. Health of a family member. 1 1 2 2 3 3 Chronic Stress and Acute Stress Chronic Acute On-going illness Natural disaster Family responsibilities Childhood sexual abuse Workload Auto accident Environmental noise Job loss Financial worries Loss of loved one Workplace Stress Workplace stress is most common, most preventable, chronic stressor What are elements of workplace stress? Overload: perception more important than total hours. Time pressure: Time pressed 3X more likely to die early Role conflict /ambiguity: Japanese baseball interpreters Social isolation: Higher catecholamines, higher BP Lack of control: Person/environment fit. Leads to coronary heart disease