Theories of stress


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Behavioral Dentistry
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Theories of stress

  1. 1. 03/17/14 Dr. Mohamed Salah Khalil 1 Mohamed Salah Khalil Preparation by : Dr. Presentation by : Dr. Abdelaziz Elfaki
  2. 2. STRESS, HEALTH & ILLNESSWhat is stress?  Definition: any circumstances that threaten or are perceived to threaten one's well-being and thereby tax one's coping abilities Stress is generally known as pattern of disruptive physiological and psychological reaction to events that threaten the ability to cope. It has become an important topic because it is clear that the pattern of disease, especially cardiovascular disease, and other diseases such as gastrointestinal, skin, immune system, and respiratory diseases cannot be explained simply by physiological factors alone. 03/17/14 Dr. Mohamed Salah Khalil 2
  3. 3. Sources of stress Internal- Originate from within a person. Cancer, Depression External- From outside a person, including Situational stressors Marriage or divorce, Birth, death, illness. Developmental stressors (Erikson( 03/17/14 Dr. Mohamed Salah Khalil 3
  4. 4. TYPES OF STRESS Negative stress Positive stress 03/17/14 Dr. Mohamed Salah Khalil 4
  6. 6. SYMPTOMS OF STRESS Physical symptoms Mental symptoms Behavioural symptoms Emotional symptoms 03/17/14 Dr. Mohamed Salah Khalil 6
  7. 7. Approaches to The Study of Stress There are many approaches to the study of stress. Generally researchers have conceptualized stress in three Ways. In one approach, stress is seen as a stimulus, and studies focus on the impact of stressors (events(. Another approach treats stress as a response and examines the strains that the stressors produce (e.g. the the physiological consequences(. The third approach views stress as a process that involves continuous interaction and adjustment- or transaction- between the person and the environment. 03/17/14 Dr. Mohamed Salah Khalil 7
  8. 8. Three Views of Stress Focus on the environment Focus on the RESPONSE: Reaction to stress: stress as a response (distress) (F/F( Focus On The Interaction Processes: Cognitive 03/17/14 Dr. Mohamed Salah Khalil 8
  9. 9. A General Definition These viewpoints have led to the definition of stress as the condition that results when a person/environment transactions leads the individual to perceive a discrepancy between the demands of the situation and the resources of the person’s biological, psychological, and social systems. 03/17/14 Dr. Mohamed Salah Khalil 9
  10. 10. Models of stress: (A) The Stimulus-Based Model of Stress )1(Holmes and Rahes advanced this theory. It proposed that life changes (LIFE EVENTS) or (STRESSORS), either positive or negative, are stressors that tax the adaptation capacity of an individual, causing physiological and psychological strains that lead to health problems. )2(They developed the Social Readjustment Rating Scale (SRRS). They hypothesized that people with higher scores in the SRRS, -that is major life changes-are more likely to experience physical or mental illness. There is some supporting evidence to this, but the correlation is fairly low. Moreover, this theory was criticized as ignoring the cognitive aspects of the effects of stress. In other words, it does not account for the individual appraisal of the meaning of various life events. 03/17/14 Dr. Mohamed Salah Khalil 10
  11. 11. Models of stress (B)The Response-Based Model of Stress 03/17/14 Dr. Mohamed Salah Khalil 11  (1) This model emphasizes the common physiological consequences of stressful situation. It is represented in the well-known theory of Hans Selye. It is similar to the “Fight or Flight” response, which occurs in situation that perceived as very threatening.  (2) The response is a physiological one in which arousal of the sympathetic nervous system results in many physiological and somatic changes and finally disruption of homeostasis.
  12. 12. Models of stress (B)The Response-Based Model of Stress 03/17/14 Dr. Mohamed Salah Khalil 12  (3) Selye developed this idea into a theoretical model of stress called the General Adaptation Syndrome theory. He defined stress as (a non-specific response and demand made upon the body). He proposed that different types of stimuli would result in similar physiological responses.
  13. 13. General Adaptation Syndrome Theory 03/17/14 Dr. Mohamed Salah Khalil 13  (3) The GAS theory has three phases, which is based on the hypothesis that the body has normal level of resistance to stress.  (a) Phase (I): Initial alarm resulting in a slight reduction in the resistance to stress, (The Shock stage). Then reverts to the normal level in the (Counter-shock Stage,).
  14. 14. General Adaptation Syndrome Theory 03/17/14 Dr. Mohamed Salah Khalil 14  Phase (II): RESISTANCE remains high until the final stage of exhaustion, where resistance rapidly drops  Phase (III): which starts with exhaustion and described as Collapse, where disease occurs.
  15. 15. Stage 1 Alarm Reaction Stage 2 Resistance Stage 3 Exhaustion 03/17/14 Dr. Mohamed Salah Khalil 15 Notice how the curve first goes down before ascending upward? This is where the curve Peaks if adaptation Occurs normal
  16. 16. ALARM RESPONSE This is the “ Fight or Flight” response that prepares the body for immediate action. 03/17/14 Dr. Mohamed Salah Khalil 16
  17. 17. The GAS – Stage Two - RESISTANCE Not as intense as the Alarm Stage, but bodily levels of hormonal secretion are still above normal Occurs during the stress response and if stressor is removed helps return the body to normal levels. ADAPTATION PHASE 03/17/14 Dr. Mohamed Salah Khalil 17
  18. 18. The GAS – Stage 3 - EXHAUSTION Bodily systems have been depleted due to prolonged resistance Can bring about the threat of onset of “diseases of adaptation” 03/17/14 Dr. Mohamed Salah Khalil 18
  19. 19. EXHAUSTION In chronic stress situations, sufferers enter the exhaustion phase: emotional, physical and mental resources suffer heavily, the body experiences ‘ adrenal exhaustion’ leading to decreased stress tolerance, progressive mental and physical exhaustion, illness and collapse. 03/17/14 Dr. Mohamed Salah Khalil 19
  20. 20. Models of stress: The Transactional Model of Stress )l) Lazarus& Folkman_(1 980) proposed the third approach. They criticized the first and the second models mentioned above as treating people as machines. They believe that people have the capacity to think, evaluate, and then react. Thinking can make stress either better or worse. )2(Lazarus developed an interaction theory, which emphasize the role of cognition. This theory proposed that people engage in TWO- STAGE PROCESS of appraisal: 03/17/14 Dr. Mohamed Salah Khalil 20
  21. 21. The Transactional Model of Stress )I) A Primary Appraisal Process: Determine whether the event represents a threat to the individual. This results in three outcomes: 1.Events regarded as irrelevant. 2.Events regarded as positive to well being. 3.Events regarded as negative to well being. This negative appraisal leads to: )II) A Secondary Appraisal Process: Here the individuals assess their COPING RESOURCES. These resources include environmental factors, social support or help, knowledge, and skills to reduce this threat. 03/17/14 Dr. Mohamed Salah Khalil 21
  22. 22. Appraisal of Stress Some people are more prone to feeling stress than others, irrespective of event 􀂃 Appraisals of potentially stressful events are influenced by two factors: 􀂃 (1) the controllability of events 􀂃 (2) the predictability of events 􀂃 Events are more stressful when they are uncontrollable and unpredictable 03/17/14 Dr. Mohamed Salah Khalil 22
  23. 23. Effects of Coping Resources and Strategies When coping outcomes are positive such as accepting the death of a relative or passing an exam, a psychological adjustment or adaptation takes place. However, unsuccessful coping leads anxiety and depression or exacerbate other physical and mental disease. 03/17/14 Dr. Mohamed Salah Khalil 23
  24. 24. Effects of Coping Resources and Strategies Maladjustment or maladaptation is more frequently associated situation when Primary or Secondary Appraisals fail to identify an appropriate course of action. These may include: Uncertainty: “I don’t know what is going on” Primary Appraisal. Unpredictability: “I don’t know what is going to happen “Primary Appraisal.~ Uncontrollability: “I don’t Know what to do about it” Secondary Appraisal. OR “There is nothing that I can do” Secondary Appraisal“. OR There is nothing anyone can do” Secondary Appraisal. 03/17/14 Dr. Mohamed Salah Khalil 24
  25. 25. 03/17/14 Dr. Mohamed Salah Khalil 25