ACCTG 1 Lecture Notes - Lecture 18: Behavioral Activation, Ant-Zen, Insomnia
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Stress, health and illness: theory
Experience of stress depends on stimulus events, internal representations of events, and nature and
extent of physiological and behavioural activation
Stress by definition: different concepts
Stress as a stimulus
• External stress factor
o Catastrophic events
o Major life events
• Life events theory (Holmes and Rahe, 1967)
o Life event consequences seen as cumulative → the more life events experienced
(e.g. within past year), the greater the likelihood of health problems
o Some events are weighted more than others
o Social readjustment rating scale (SRRS)
▪ List of life events ranked by values called ‘life change units’ (LCU)
▪ The greater the LCU score, the higher the risk of ill health
▪ Mild life crisis = 150-199 LCUs, moderate life crisis = 200-299 LCUs, major life
crisis = >300 LCUs
o Limitations
▪ Retrospective assessment was used with participants in ill health → leads to
more explanations/ attributions for the health status
▪ Items are not globally appropriate/ applicable
▪ Items may cancel each other out (e.g. positive with a negative life event)
▪ Some items are vague and ambiguous
▪ Not everyone ranks life events in the same way
▪ Inconsistencies in ratings
• Difference between life events and life hassles
o Hassles are day-to-day ‘irritating, frustrating, distressing demands’
o Hassles approaches take ‘uplifts’ into account as well
▪ Men do not tend to experience psychological symptoms to uplifts, whereas
women do
▪ Uplifts only seem to have a weak/moderate effect on health outcomes
though
Stress as a transaction between stimulus event and appraisal
• Appraisal is key to whether an event is deemed stressful or not
o Appraisal of situation and appraisal of self
o Appraisal is influenced by
▪ Imminent events
▪ Unexpected events
▪ Unpredictable events
▪ Ambiguous events
▪ Uncontrollable events
▪ Life-changing events
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▪ Acute and chronic physical stressors
▪ Long-term physiological demands
▪ Psychosocial stressors
• Cognitive transactional model of stress (Lazarus, 1978/84)
o Primary appraisal (considering quality and nature of stimulus event)
▪ 3 types of stressor
• Posing harm
• Threatening
• Challenging
▪ Appraisal types and emotional response (ego involvement)
• Threat to self/ social esteem → anger
• Threat to moral codes → guilt
• Threat to existence → anxiety
▪ Sequential assessments
• Motivational relevance: extent to which event is relevant to goals/
commitment
• Motivational congruence: extent to which situation is congruent
with other goals
o Secondary appraisal (assessment of coping resources)
▪ Internal/ external accountability (attributing responsibility)
▪ Problem-focussed coping potential (is
situation changeable?)
▪ Emotion-focused coping potential
(ability to emotionally cope)
▪ Future expectancy concerning danger (refers to possibilities of
(un)changeability)
Stress as a biological and physiological response
• Appraisal of the event through central nervous system (CNS) → Initiation of autonomic (part
of the peripheral nervous system) and endocrine (hormonal) responses → Feed back into
cortex and limbic system, which links with hypothalamus and brainstem
o Autonomic nervous system comprised of sympathetic and
parasympathetic nervous systems, which are in tension with
one another (SNS activates flight-or-fight, PNS activates
relaxation)
o SNS and PNS control many organs, and activity initially
mediated by acetylcholine. Acetylcholine links neurons of
spiral synapse to brain. Nerves act on target organs
▪ Final SNS mediation: noradrenaline (and adrenaline)
Coping potential
Activation of
sympathetic-
adrenomedullary
system (SAM) for
acute responses
Document Summary
Experience of stress depends on stimulus events, internal representations of events, and nature and extent of physiological and behavioural activation. Stress as a stimulus: external stress factor, catastrophic events, major life events. Items may cancel each other out (e. g. positive with a negative life event: some items are vague and ambiguous, not everyone ranks life events in the same way. Stress as a transaction between stimulus event and appraisal: appraisal is key to whether an event is deemed stressful or not, appraisal of situation and appraisal of self, appraisal is influenced by. Imminent events: unexpected events, unpredictable events, ambiguous events, uncontrollable events. 1: acute and chronic physical stressors, psychosocial stressors. Internal/ external accountability (attributing responsibility: problem-focussed coping potential (is situation changeable?, emotion-focused coping potential (ability to emotionally cope) Coping potential: future expectancy concerning danger (refers to possibilities of (un)changeability) Acetylcholine links neurons of spiral synapse to brain. Nerves act on target organs: final sns mediation: noradrenaline (and adrenaline)
