Our emotional state is closely related to our motivation. For each behavior that you perform there...

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UNIT 8B: MOTIVATION AND EMOTION – EMOTION, STRESS AND HEALTH

Transcript of Our emotional state is closely related to our motivation. For each behavior that you perform there...

Page 1: Our emotional state is closely related to our motivation. For each behavior that you perform there is an accompanying feeling about that action. Emotion.

UNIT 8B: MOTIVATION AND EMOTION – EMOTION, STRESS AND HEALTH

Page 2: Our emotional state is closely related to our motivation. For each behavior that you perform there is an accompanying feeling about that action. Emotion.

THEORIES OF EMOTION Our emotional state is closely related to our motivation. For each behavior

that you perform there is an accompanying feeling about that action. Emotion influences motivation, and motivation influences emotion.

Psychologists who study emotion explore and explain the physiological states, cognitive experiences, and measurable behaviors that accompany feelings.

Where do emotions come from? Why do we have them? What are they made of?

Emotions are the body’s adaptive response. They exist not to give us interesting experiences but to enhance our survival.

Think about when you face challenges. Emotions focus our attention and energize our actions.

Describe what someone who is overwhelmingly happy would look like. Draw or discuss.

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Emotion a response of the whole organism, involving (1) physiological arousal, (2) expressive behaviors, and (3) conscious experience.

For example, let’s say a parent losses their child in a crowded mall. Their 3 points of emotions would be:

(1) physiological arousal – heart pounding

(2) expressive behaviors – running around the mall looking for their child

(3) conscious experience –thinking ‘Is this a kidnapping?’.

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EMOTION= AROUSAL PLUS INTERPRETATION

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THEORIES OF EMOTION

Does your heart pound because you are afraid... or are you afraid because you feel your heart pounding?

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KEY QUESTIONSTheories of emotion have focused on two key questions. Which comes first, physiological arousal or the subjective or one-sided experience of an emotion?

Can we react emotionally before appraising a situation, or does thinking always precede emotion?

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THEORIES OF EMOTIONThe theories of emotion complement each other. That means that each one provides some explanation into why or how we experience emotions. Let’s look at five different theories. They are:

James-Lange Theory of EmotionCannon-Bard Theory of EmotionSchacter’s Two Factor Theory of EmotionZajonc’s Theory of Emotion andLazarus’ Theory of Emotion.

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JAMES-LANGE THEORYJames-Lange Theory the theory that our experience of emotion is our

awareness of our physiological responses to emotion-arousing stimuli.

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CANNON-BARD THEORYCannon-Bard Theory the theory that an emotion-arousing stimulus

simultaneously triggers (1) physiological responses and (2) the subjective experience of emotion.

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Cannon and Bard disagreed with the James-Lange theory of emotion. They noted that the heart races when we feel a range of emotions – fear, anger, excitement. They proposed that an emotion-arousing stimulus simultaneously triggers physiological responses and the subjective experience of emotion. In other words they happen at the same time.

Each of these theories helps us to understand emotion. We observe changes in our bodies and we know that the brain and nervous system play a role in our conscious feelings. Recent research links hormone levels to emotion, namely, testosterone levels are linked to aggression. But what comes first, our thoughts about a situation or our experience of the emotion?

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TWO-FACTOR THEORYTwo-Factor Theory the Schachter-Singer theory that to experience emotion one must

(1) be physically aroused and (2) cognitively label the arousal.

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Schacter in the 1960s developed the two-factor theory of emotion. He pointed out that both our physical responses and our cognitive labels which are our mental interpretations combine to cause any particular emotional response. Emotion depends on two factors, biology and cognition. The key to this theory is the label that we give to the feeling. Our physical experiences of emotion are so similar that we must appraise and label our reactions in order to experience an emotion.

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Theories of emotions

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ZAJONC’S THEORY OF EMOTION Zajonc in the 1980s argued that emotion and cognition are separate, and

that our interpretations of situations are sometimes slower than our emotional reactions.

For example, before we know what we think about a situation, we know how we feel about it.

He believes that the pathways in our brain carry or transmit messages. Some take a short cut and go directly to the amygdala which is the emotion control center in the brain.

It is because of these shortcuts that our feelings are more likely to control our thoughts, than our thoughts are to control our feelings.

Zajonc believes that emotions are basic to human existence, and that they developed before cognition in the history of our species.

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LAZARUS’ THEORY OF EMOTION

Lazarus in the 1990s agreed that our brain can process information outside of our conscious awareness, and that some emotional responses do not require conscious thought.

But, he believed that there must be at least a minimal amount of unconscious thinking, even for emotions that we feel instantly. This is how we know what we’re reacting to.

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COGNITION AND EMOTIONThe brain’s shortcut for emotions

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TWO ROUTES TO EMOTION

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For our complex emotions such as love, happiness, shame and guilt, there is a conscious interpretation, appraisal, and memory of earlier experiences. In other words, how we think about the situation also affects these emotions.

If you think positively about a situation it makes you feel better.

If you think negatively about a situation it makes you feel worse.

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EMOTIONSHow many emotions are there? Well, Plutchik in the 1980s argued that there

are eight basic emotions and that each emotion is related to survival.

Anger which leads to destruction of the obstacle. Fear which leads to protection. Sadness which leads to a search for help and comfort. Disgust which leads to rejection and pushing away. Surprise which leads to a turning inward. Curiosity which leads to exploration and searching. Acceptance which leads to sharing. Joy which leads to reproduction, courting, and mating.

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TWO DIMENSIONS OF EMOTION

Positivevalence

Negativevalence

Higharousal

Lowarousal

pleasantrelaxation joy

sadnessfear

anger

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EMBODIED EMOTION Emotions involve the body big time.

Feeling without a body is like breathing without lungs.

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EMOTIONS AND THE AUTONOMIC NERVOUS SYSTEM Remember the Autonomic Nervous System (ANS)? Mobilizes your body for

action and calms it when the crisis passes. Without any sort of conscious thought, your body will prepare you actively for fight or flight. Sympathetic nervous system –CRISIS IN FULL SWING

Arousing – sugar in bloodstream, increased respiration, heart rate and blood pressure increase, etc.

Stress hormones adrenaline and noradrenaline released Parasympathetic nervous system – CRISIS PASSES

Calming – opposite of above. Stress hormones are not released, diminished arousal.

Moderate arousal is ideal- somewhere in the middle. Ex. Moderate arousal during a test, alert but not flipping your lid.

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Emotions and the Autonomic Nervous System

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PHYSIOLOGICAL SIMILARITIES AMONG SPECIFIC EMOTIONS

Different movie experiment – Page 370… let’s read together!

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PHYSIOLOGICAL DIFFERENCES AMONG SPECIFIC EMOTIONS

Differences in brain activity can be seen in different emotions. Amygdala – emotional response centre, especially for registering fearful emotions.

Frontal lobes - negative emotions on the right, positive emotions on the left. Ex. Stroke on the right, only happy emotions.

Nucleus accumbens – region of neurons that light up when people experience natural or drug induced pleasures. Electrical stimulation of this area has helped produce more positive feeling in depressed individuals.

Emotions are felt all through the body Ex. Victims of paralysis and their interpretation of emotions – ‘Less fiery, more mental’.

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Polygraph a machine, commonly used in attempts to detect lies, that measure several of the physiological responses accompanying emotion (such as perspiration and cardiovascular and breathing changes).

Polygraph article.

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COGNITION AND EMOTION What is the connection between how we think and what we feel?

Can we experience emotion apart from thinking?

Do we become what we think?

Whoaaa dude… heavy stuff.

Arousal fuels emotions, cognition channels it

Spill Over Effect – Sometimes our arousal response to one event spills over into our response to the next event.

Schachter-Singer experiment – Aroused college men with the hormone epinephrine. Then to a waiting room with a person who is either acting euphoric or irritated. As the subject observes this person, their heart rate increases, body flushes and breathing increases. Some subjects were told they were feeling this response because of the injection and said they felt very little emotion. Some subjects were told the injection caused no effects. These subjects ‘caught’ the emotion of the people in the room.

A stirred up state can be experienced as one emotion or another very different one, depending on how we interpret and label it.

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COGNITION AND EMOTIONCOGNITION DOES NOT ALWAYS PRECEDE EMOTION

Influence of the amygdala – Sensory input of emotions may be routed directed the amygdala (via the thalamus) for instant emotional reactions or to the cortex for analysis. This allows for quick emotional responses to situations, rather than the longer, drawn out ideas that are required with deepened emotional thinking.

Ex. Snap judgment versus ‘Sleep on it’.

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Ekman’s Studies on Facial Expressions Interview with Ekman

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GENDER AND CULTURAL EFFECTS ON EMOTION

Research has shown that biological females are better at reading the nonverbal emotions we as a species express than biological males. It has also shown that both biological males and biological females are better at the body language of someone else of their own gender than of the opposite gender.

Biological Males and biological females express emotion differently. Biological females tend to smile more, gesture more and have altogether a more expressive face than biological males.

Why is this like this? Are biological females and biological males physiologically different or have they each learned to behave differently? DISCUSS!

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FACTORS - POWER There seems to be three factors that affect the way we learn to express

and interpret emotions.

1. Power is the key issue when we are interpreting nonverbal communication. The person with the less power is more motivated to read the nonverbal cues of the person who has more power. Gender doesn’t seem to matter here.

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CULTURE 2. Culture can also influence how we express emotions and how we

interpret the emotions of others. There are things called display rules that are culturally based and tell you how and when a person may express emotion. These include things like when to smile, what to do when you are angry, and when to look someone in the eye.

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REARING 3. People raised in expressive families or in cultures that value being

emotionally expressive are likely to be more expressive. Once again, gender doesn’t matter.

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DETECTING EMOTION

Reading people’s body language, listening to their tone of voice and studying their voices, help us to detect emotion.

There are called nonverbal cues. The best non verbal cues we can detect are those associated with threats. Even in another language, we can detect anger and aggression. Duchenne smile –Activated

muscles under eyes and raised cheek bones dictate a genuine smile. Which one is fake? Which is natural?

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Without body language, emotion can be difficult to interpret.

Think about when writing an email or text message how the tone of your message and can changed.

You are judged solely on your words and emotions can be very hard to convey… emojis help!

When meeting someone they have only known electronically, most people are surprised at what ‘type’ of person they are, personality wise.

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GENDER, EMOTION AND NONVERBAL BEHAVIOUR Story on Page 379 – Jackie Larson

When given ‘thin slices’ of emotional interaction, women generally surpass men on at reading people’s emotional cues.

This also may give women an advantage in spotting lies, or sensing real romantic attraction between people, or general relationships between people (ex. Who is a supervisor, who is the employee).

Men tend to use simpler emotional reactions (I feel sad that my friend is moving away) while women tend to use more complex (It’s a bittersweet moment. I feel both happy and sad).

Exception: Anger is seen as a more masculine emotion and when asked to envision an angry face, most people place it as male.

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While the face on the left is seen as more gender neutral, when the same face is made ‘angry’, it is seen as more male by more people.

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GENDER, EMOTION, AND NONVERBAL BEHAVIOR

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EMOTIONS AND FACIAL EXPRESSIONS

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READING NONVERBAL CUES

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CULTURE AND EMOTIONAL EXPRESSION Do facial expressions have different meanings in other cultures?

Different facial expressions were shown to different people around the world and they were asked to guess the expression.

Most people identified them consistently across cultures.

However, not always the case – USA captured soldiers, North Korea 1968 – Hawaiian Good Luck Sign ;)

Even blind people make the same facial expression as sighted people when expressing different emotions.

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WHAT ARE EACH OF THE EXPRESSIONS?

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The reasoning behind facial muscles may be evolutionary. Before expressive language, they were used to convey threats, greeting and submissions, which helped them to survive.

This may help to explain why all humans share the same facial muscle expressions associated with emotion.

The amount of emotion a culture will express will differ. For example, cultures that encourage individuality, such as North America, display mostly visible emotions. In Chinese culture, where people are encouraged to adjust to others, the emotions are much more with held.

Try this! What facial expression would you make when trying to think of the answer to a hard question? How does this differ in Japan?

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Levels of Analysis for the Study of Emotion

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THE EFFECTS OF FACIAL EXPRESSIONS Expressions not only communicate emotion, they also amplify and regulate

it. Ex. If you want to truly feel cheerful, having a body position that is cheerful will help.

Facial Feedback the effect of facial expressions on experienced emotions, as when a facial expression of anger or happiness intensifies feelings of anger or happiness.

Fake a big grin. Now scowl. Smile therapy!

In an experiment where subjects were asked to contract their facial muscles and bring their eyebrow together, a scowling face occurred. Subjects then communicated that they felt more angry after the test by simply mimicking the facial expression.

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Pen test coming up in next slide. Books away! ½ with eyes closed.

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PEN TEST 1 – PLACE A PEN IN YOUR TEETH AS MRS.CONNOR SHOWS YOU. DO NOT TALK!

Rate the funny level of this comic from 1 – 10.

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PEN TEST 2

Rate the funny level of this comic from 1 – 10.

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EXPERIENCED EMOTION According to psychologists, there are 10 distinct, isolated emotions:

1) Joy

2) Interest-excitement

3) Surprise

4) Sadness

5) Anger

6) Disgust

7) Contempt

8) Fear

9) Shame

10) Guilt

Do you think any are missing? Some argue that pride and love are missing. Some argue that love is simply a mix of a bunch together.

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FEAR

Fear is contagious. In 1903, during a comedy show a small fire broke out. Someone yelled out ‘FIRE’! Even though the comedian onstage tried to reassure the crowd, over 500 people died in the 10 minutes before the fire department even got there to put out the fire. How did they die? By being trampled while trying to escape.

Fear is adaptive. It allows our bodies to flee from danger. It binds people together and protects us from harm. Fear helps us focus on problems and come up with solutions.

Fearful expressions improve peripheral vision and speed eye movements, boosting sensory input.

This is the adaptive value of fear.

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LEARNING FEAR You can be afraid of almost

anything… remember Baby Albert with white furry bunnies?

When infants begin to crawl and walk, they fall down. This may create a fear of heights.

Wild monkeys are afraid of snakes. Monkeys in labs are not. When reared together, the lab monkeys became scared of snakes as they saw the wild monkeys resist food with snakes near it. Therefore, fear can be learned.

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THE BIOLOGY OF FEAR We fear things that may harm us – spiders, snakes, heights, etc.

These are usually evolutionary leftovers designed to keep us alive in the past.

However, they do not prepare us to be afraid of more modern dangers, such as cars, bombs and electricity.

Understanding fear lies in the amygdala. It associates various emotions with certain situations. Ex. Rabbits fear a noise, when it is associated with a small shock. Unless their amygdala is damaged. Then no fear.

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OTHER EXPERIENCES OF FEAR Some people have fears that run outside of the normal levels.

These are called phobias and disrupt their ability to cope with normal life.

Ex. Agoraphobia – fear of leaving ones house.

On the flip side. Some people can also use fear to fuel reactions in stressful situations. Ex. Astronauts seem to be able to cope in highly stressful, life threatening situations…. Ever see Gravity or Interstellar?

Genes can also play a role in fear. Identical twins tend to have the same fear level.

Serotonin reuptake is slowed in people who seem to experience higher levels of fear.

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ANGER The smallest incidences can make us angry. It is evoked by events and can be

different for each person.

What makes you angry? Is there anything that makes you angry that doesn’t seem to both other people? DICUSS?

There may be a benefit from anger in that it helps us to release and express the feelings we are having. Retaliating against a provoker may make you feel better.

This is called Catharsis emotional release. The catharsis hypothesis maintains that “releasing’ aggressive energy (through action or fantasy) relieves aggressive urges.

However, releasing anger can sometimes increase anger. It may provoke further retaliation, escalating minor conflicts into major ones. It can also magnify the anger into something greater.

Sometimes when we release our anger, we later regret it. This is maladaptive.

The best policy may be the ‘sleep on it’ rule.

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HAPPINESS

People who are happy, perceive the world as safer, feel more confident, more decisions more easily, rate job applicants more favourably, are more cooperative and tolerant and live healthier, more energized and satisfied lives.

Feel Good Phenomena people’s tendency to be helpful when already in a good mood.

Well-being self-perceived happiness or satisfaction with life. Used along with measures of objective well-being (for example, physical and economic indicators) to evaluate people’s quality of life.

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A HAPPINESS TRAIT

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HAPPINESSTHE SHORT LIFE OF EMOTIONAL UPS AND DOWNS

Watson’s studies – happiness peaks in the early/middle part of peoples days.

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HAPPINESSWEALTH AND WELL-BEING – MONEY DOES NOT EQUAL HAPPINESS.

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HAPPINESSTWO PSYCHOLOGICAL PHENOMENA: ADAPTATION AND COMPARISON

Happiness and Prior Experience Adaptation-level phenomenon our tendency to form judgments (of sounds, of lights, of income) relative to a neutral level defined by our prior experience.

Ex. If your current situation – income, academic average, social status – increases, we feel an initial surge of happiness. We then adapt to this new level, consider it normal and require something even greater to bring back the surge of happiness.

Happiness and others’ attainments Relative deprivation the perception that we are worse off relative to those with whom we compare ourselves.

Ex. Whether we feel good or bad depends on how we compare ourselves with others. When Alex Roriguez got a $275 million baseball contract, others around him felt less.

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HAPPINESSPREDICTORS OF HAPPINESS

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DEVELOPMENT OF DISGUST

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STRESS AND HEALTH Stress the process by which we perceive and respond to certain events,

called stressors, that we appraise as threatening or challenging.

Stress is a necessary part of our everyday life. But stress is not all bad. Without stress we might not be motivated to finish things that we need to accomplish. Too much stress and how we deal with it can have negative effects on our health.

As stress becomes more and more prevalent in people’s lives, both physically and mentally a new branches of psychology have popped up: Behavioural medicine an interdisciplinary field that integrates behavior and medical knowledge and applies that knowledge to health and disease and health psychology a subfield of psychology that provides psychology's contribution to behavioral medicine.

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Both fields are trying to address some of the following questions:1) How do our emotions and personality influence our risk of disease?2) What attitudes and behaviors help prevent illness and promote health and wellbeing?3) How do our perceptions of a situation determine the stress we feel?4) How can we reduce or control stress?

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The term stressor is used to describe the factors creating stress.

The stress reaction is the defense used to respond to or conquer stress.

Remember, stress is a process of perceiving and responding. Our appraisal of an event as potentially threatening or challenging can make a huge difference in what we experience and in how effective we respond.

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RESPONDING TO STRESS

Depending to how you react to stressors, your health many suffer. If you see a stressor as a threat, you’re far more likely to panic and freeze up. If you view the stressor as a challenge, your response will be focused, and you’re more likely to overcome the obstacle. Your perception directly affects your emotional responses.

Our emotional responses to stress vary, but so do our physical responses.

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STRESS APPRAISAL

Stressful event(tough math test)

Threat(“Yikes! This isbeyond me!”)

Challenge(“I’ve got to apply

all I know”)

Panic, freeze up

Aroused, focused

Appraisal Response

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FLIGHT OR FIGHT Walter Cannon in the 1920s found that stressors trigger the release of

stress hormones into the nervous system. This increases your heart rate, dulls your sensation of pain, and sends more blood to your larger muscles. This is the flight or fight response that we talked earlier in this course.

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Pituitary hormone in the bloodstream stimulatesthe outer part of the adrenalgland to release the stress hormone cortisol

Sympathetic nervoussystem releases the stress hormonesepinephrine andnorepinephrinefrom nerve endings in the inner part ofthe adrenal glands

Thalamus

Hypothalamus

Pituitary gland

Adrenal glands

Cerebral cortex(perceives stressor)

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SELYE’S STRESS RESPONSE STUDIES

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THE STRESS RESPONSE SYSTEM Selye’s general adaptation syndrome (GAS) Selye’s concept of the body’s adaptive response to stress in three phases – alarm, resistance, exhaustion.

3 Parts: AlarmResistanceExhaustion

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ALARM

An alarm reaction happens when your nervous system is activated following an emotional or physical trauma – like in Cannon’s flight or fight response. Your body is ready for the challenge.

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RESISTANCE

In this phase, stress-related hormones keep your respiration, temperature, and blood pressure high. But your body can’t keep this pace. Your body’s reserves become depleted. It appears that the hippocampus shrinks when these hormones are released. Remember that this brain structure is responsible for memory. There has been research to indicate that those people experiencing trauma may experience memory difficulties.

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EXHAUSTION

With exhaustion comes greater susceptibility to illness and disease. Our bodies can handle temporary stress but prolonged stress will produce physical deterioration.

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Stress and IllnessGeneral Adaptation Syndrome

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STRESSFUL LIFE EVENTS Catastrophes – Can you think of an example?

In the wake of catastrophes physiological disorder rates soar.

Significant life changes - Can you think of an example?

Young people experience significant stress when going into college/university, etc.

Daily hassles - Can you think of an example?

Daily hassles have been shown to cause the most damage to people over time.

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CATASTROPHES

Catastrophes are large, unpredictable, and life-threatening events. Examples include earthquakes, war, floods, tornados, and fire. Catastrophes often mean prolonged exposure to stress which puts us in psychological and physical risk due to the stress

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SIGNIFICANT CHANGES

Significant personal changes in your life are the second category of stressors. These can include the death of a loved one, leaving home, living on your own, divorce, and any kind of life transition.

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DAILY STRESS

Daily stress can be thought of as hassles. Every incident by itself is not a big deal.

Hassles that are continually being repeated can have an effect on your health depending on your reaction to them.

The persistent hassles in the work place can produce physical, mental and emotional exhaustion. This is often referred to as burnout.

The results of burnout include depression from the emotional exhaustion, a decrease in performance or productivity from the physical exhaustion, and cynicism or pessimism from the mental exhaustion.

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STRESS

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STRESS ON THE JOB

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EFFECTS OF PERCEIVED CONTROL

The effect on your health that life events may have depends on how you appraise the situation and your own personal outlook.

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PESSIMISM

If you think of the stressor in a negative way and as something that is beyond your control then your health may be impacted. This is called having a pessimistic outlook.

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OPTIMISMOn the other hand, being positive and feeling that you have a sense of control is called having an optimistic outlook. Optimism seems to offer some protection against the effects of stress by affecting the immune system. Those with strong immune systems are less likely to become or fatigued.

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MIND AND BODYOnce again there is interplay between mind (your perceptions or appraisals) and body (your physiology). How is the immune system involved? Stress hormones are released which use up your body’s reserves of disease fighting white blood cells. The immune system is then weakened to fight off disease. This can have a huge impact on minor illnesses. But is there an impact on major illnesses like cancer and heart disease? We can’t know for sure, but we do see people who have these diseases having more stress in their lives.

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STRESS AND THE HEART The heart is the organ we see the most common connection between disease

and stress.

Coronary Heart Disease the clogging of the vessels that nourish the heart muscle; the leading cause of death in North America.

Research has shown that there seems to be connection between stress and heart problems. High levels of stress increase the risk of heart disease. Friedman and Rosenman discovered this connection over 50 years ago. Their findings led to the terms Type A and Type B personalities.

Type A personality These people tend to be impatient, competitive, hard-driving, verbally aggressive, and anger-prone. They are more likely to have heart attacks.

Type B personality These people tend to be more laid-back, easygoing, and relaxed. They are less likely to have heart attacks.

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WHICH TYPE ARE YOU?

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EXPERIENCE AND EXERCISE

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STRESS AND SUSCEPTIBILITY TO DISEASE Psychophysiological Illness literally, “mind-body” illness; any stress-related physical

illness, such as hypertension and some headaches.

Psychoneuroimmunology (PNI) the study of how psychological, neural, and endocrine processes together affect the immune system and resulting health.

Lymphocytes the two types of white blood cells that are part of the body’s immune system; B lymphocytes form in the bone marrow and release antibodies that fight bacterial infections; T lymphocytes form in the thymus and other lymphatic tissue and attack cancer cells, viruses, and foreign substances.

Wounds in stressed animals will heal slower.

Colds and flus take longer to pass in stressed humans.

Most people over 100 years of age tend to be able to ‘manage stress’ easier.

Sick days put into peoples schedules as a way to allow people time to get better without ‘stressing over it’.

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Cancer and Stress

The research on the relationship between cancer and stress is not definitive. This means that some studies have shown a connection between stress and cancer and other studies that have found no connection of any significance. The research has shown that stress does not appear to create cancer cells and stress definitely affects the body ability to fight off disease.

AIDS and Stress

If stress restrains the immune systems response to infections, it also will exacerbate the course of AIDS in humans. People who are stressed tend to progress from HIV into AIDS faster and they decline faster once AIDS has been developed.

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STRESS AND DISEASE

Conditioning of immune suppression

UCS(drug)

UCR(immunesuppression)

UCS(drug)

UCR(immunesuppression)

CS(sweetenedwater)

CS(sweetenedwater) CR

(immunesuppression)

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STRESS AND DISEASE

Negative emotions and health-related consequences

Unhealthy behaviors(smoking, drinking,

poor nutrition and sleep)

Persistent stressorsand negative

emotions

Release of stresshormones

Heartdisease

Immunesuppression

Autonomic nervoussystem effects

(headaches,hypertension)

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STRESS MANAGEMENT