Pender Ch. 8
“Stress Management and Health Promotion”

More than ¾ of visits to health care professionals are attributed to or made worse by stress.
Stress is inevitable, unavoidable, human experience in any society and more often with rapid and accelerating change.
General Adaptation Syndrome (GAS)= internal and external manifestations of stress; “fight or flight” response. Examples of stress behaviors: dilation of pupils, ↑ respiratory rate, ↑ heart rate, ↑ perspiration, ↑ BP, ↑ muscle tension, ↑ gastric motility, ↑ blood glucose level, release of adrenaline, cold, clammy skin.
Due to release of catecholamines (adrenaline), glucocorticoids (cortisol), and other hormones.
Allostatis= continuous process of adapting to potentially stressful events ~ achieving stability through change.
Allostatic load= cumulative negative effects of prolonged environmental and psychosocial stressors.
Allostatic load has potential to predict risk for variety of diseases, such as diabetes, cardiovascular disease, and cancer.
Stressors= environmental and internal demands and conflicts among them, which tax or exceed a person’s resources”
Body systems that respond to stress: nervous, endocrine, immunologic systems eventually affect all organ systems.
Coping regulates stressful emotions (emotion focused coping) and alters the person- environment relationship that is causing the distress (problem- focused coping).
The World Health Org, (WHO) & Global Burden of Disease Survey estimate that stress related disorders & mental illness will be the 2nd leading cause of disabilities by 2020.
Stress and Health-
In heart disease, long term stress is though to sensitize arterioles to catecholamines, (short term stress= causes over constriction of the vessels & endothelial damage).
Evidence proves that providing social support may be more beneficial than receiving it.
Psychoneuroimmunology= effects of social and psychological phenomena on the immune system as mediated by the nervous and endocrine systems.
P.197 Study of male undergraduate college students some w/ high heart rate reactivity were compared to those with low heart rate reactivity- both took a math test. High reactors showed higher stress related levels of plasma cortisol and increased natural killer cell lysis than the low reactors. Results= people deal w/stress differently possible cause is due to hypothalamic-pituitary adrenocortical axis and the sympathetic adrenomedullary systems.
Epigenetics= study of how environmental influences regulate gene expression, is an attempt to describe how experiences such as stress- though not altering the DNA sequence- may modify DNA proteins, leading to enhanced or silenced expression of a specific gene.
Stress Across the life span- childhood and adolescence are critical periods characterized by increased vulnerability to stressors.
Children experience stress and develop coping patterns early in life.
Stress factors in children: self esteem, personality characteristics, gender, social support, parental child rearing patterns, previous stressful exp., and illness.
Environmental high risk stressors for children:
Personal safety concerns
Community violence
Prolonged poverty
Increased availability of drugs
Homelessness
Child’s well being and health can be enhanced through constructive stress management.
Adolescents= most common stressors are family related, peer stressors, and academic concerns.
High stress is in early adolescence is associated with: risk taking behavior, smoking, alcohol, & sex.
Effective stress coping processes:
Behavioral coping (info gathering)
Decision making (problem solving)
Cognitive coping (minimizing distress, focusing on positive)
Adult social support (talking w/an adult)
Relaxation
As individuals age, they increase their use of problem solving coping and decrease the use of avoidance coping, compared with the preteen and adolescence years.
Young & middle adulthood= stress related to: careers, relationships (dyadic unit),