The old Roman saying…

“Mens sana, mens corpora” =

A healthy mind, a healthy body
 Perception of threat
(basis for a transactional model of stress)
 Lazarus, a psychological stress researcher
insisted on the idea of people & things
can only become stressor when they
pose a threat to human well-being
 Threat = physical harm / psychological in
nature (> often)
 Perception of potential stressor =
transaction
 Evaluation of stimuli = threat appraisal process
 3 appraisals of the potential stressor: primary,
secondary & reappraisal
 When there is a potential stressor, primary appraisal
determines whether it is a threat; concurrently the
secondary appraisal determines whether one is
capable of coping with the threat
 Both appraisals are reappraised and the brain
determines whether the potential stressor is the
real stressor
 This leads to whether there is stress response or not
(if not perceived as real stressor)
Stress appraisal stages:
 The importance of “stress”
(Aldwin, 2007)
1. Intrinsically important
(fundamental)
2. Relevant to psychosocial models of
adaptation
3. Relevant to biomedical model of
adaptation
 Intrinsically important
• Stressful events are important to people both direct &
indirectly)
• i.e News on tv provide stressful info on stressful events
(good news are not popular) of others (mostly
important people / public figures / or others that may
not be directly related to viewers)
• i.e. daily conversations are surrounded around
“stressful stories” both minor & major – self, spouse,
children, boss, colleagues, friends, traffic, job etc
• Interest in stress rooted in psychological / biological /
social causes
 Relevance of stress to psychosocial
model of adaptation
• Early models of mental illness (MI) focus on
internal processes as the source of
psychological problems (individual’s
“makeups” cause stress)
• i.e Psychoanalysis – MI = unconscious conflicts
between id, ego and superego from early
childhood fixation in psychosexual stages
(Sigmund Freud)
• i.e Biomedical models – MI = imbalance
neurotransmitter (low serotonin depression
• Sociologist & anthropologist – society &
culture play major roles in provoking
psychological distress & the way in which it is
expressed
• i.e mental illness differ between high vs low
SES (role of environment; social structure)
• i.e certain appropriate behaviour in one
culture may not be acceptable in others
(Margaret Mead, 1928)
• Individual’s vulnerability is acknowledged
(variability exists, socio-cultural
environmental factors have their roles)
 Relevance of stress to biomedical
model of adaptation
• Basis: people become ill because of external
agent (can be cured if the agent is known)
• Too simplistic!
• Many other factors affect health
(environmental forces & physiological
resilience)
– More recent research focus on the roles of
psychosocial factors ie stress, coping, social
support, personality etc
 Stress and health
• “Psychoneuroimmunology”: the field of study
that examines the pathway that mediates
stress & health
• Study the relationships between psyche (or
the mind), the neuroendocrine system, & the
immune system & the role of those
relationships in health maintenance or
vulnerability to illness
Psychoneuroendocrinology model of
stress & health (Aldwin, 2007)

NEUROENDOCRINE
CHANGE

NEGATIVE
HEALTH
STRESS AFFECT OUTCOME

IMMUNE SYSTEM
CHANGE
• 1ST Model: stress is assumed to activate –ve
emotions, which affect neuroendocrine
system, which in turn affects the immune
system.
• Together, all these affect over all health
• This model was found to be TOO simplistic in
explaining the relationships between all
components involved
• Variations exist
Modifide Psychoneuroendocrinology
model of stress & health
NEUROENDOCRINE
CHANGE

NEGATIVE
HEALTH
STRESS AFFECT OUTCOME

IMMUNE SYSTEM
CHANGE

CELLULAR CHANGE
• The modified model implies that there may be
other pathways that mediate the relationships
between stress and the neuroendocrine system
and the immune system
• Maybe self factors (personality, social support)
• Current biology research promotes the role of
cellular based mechanisms to reduce the
effects of stress (involving heat shock proteins,
DNA, free radicals, reactive oxygenating species
etc)
 STRESS & Health

 The holistic health movement by WHO  Health = a

state of complete physical, social, & mental well-
being, not merely the absence of disease
 The new holistic health movement believed that
health is non static;
 It is a process of moving towards optimal functioning
(an evidence of well-being); & not only limited to
physical, social & mental dimensions
 Suggested additional dimensions: Physical, social,
intellectual, emotional, spiritual
 Wellness & health

 Wellness = a state of optimal health

 Vigorous, vital, able to live life to its
fullest
 6 dimensions of health (inclusive of one’s
micro and macro environments)
 Physical, social, intellectual, emotional,
spiritual, environmental/occupational
Stress never occurs in vacuum…
Macro
environment Micro
environment

Cognitive

Emotional

Physical

Social
Spiritual

Environmental/
occupational
 Stress & Wellness

 The amount of stress & one’s

ability to handle it can be
examined through one’s level of
functioning across the 6
dimensions of health
How to identify stress
Think of the definition of stress as a
“holistic transactions between stressor,
perception and response..”

What could be the signs / symptoms that

people are under stress?
Signs of stress
 Psychological signs
• Inability to concentrate or make simple
decisions
• Memory lapses
• Becoming rather vague
• Easily distracted
• Less intuitive & creative
• Worrying
• Negative thinking
• Depression & anxiety
 Emotional signs

• Tearful • Feeling out of

control
• Irritable
• Lack of motivation
• Mood swings • Angry
• Extra sensitive to • Frustrated
criticism • Lack of confidence
• Defensive • Lack of self-esteem
 Physical signs
• Aches/pains & muscle • Hyperventilating/lump in
tension/grinding teeth the throat/pins & needles
• Frequent colds/infections • Dizziness/palpitations
• Allergies/rashes/skin • Panic attacks/nausea
irritations
• Physical tiredness
• Constipation/diarrhoea/
IBS • Menstrual changes/loss of
• Weight loss or gain libido/sexual problems
• Indigestion/heartburn/ • Heart problems/high
ulcers blood pressure
 Behavioural signs
• No time for relaxation or • Self neglect/change in
pleasurable activities
• Prone to accidents,
appearance
forgetfulness • Social withdrawal
• Increased reliance on • Relationship problems
alcohol, smoking,
caffeine, recreational or • Insomnia or waking tired
illegal drugs
• Reckless
• Becoming a workaholic
• Poor time management • Aggressive/anger
and/or poor standards of outbursts
work
• Absenteeism
• Nervous
• Uncharacteristically lying
• The symptoms will often accumulate until the
person is to take notice of them.
• Symptoms are not supposed to be
rationalized, if one is not sure – get medical
advice
• It is often the behavioural symptoms that are
noticed, as they are more obvious, but by this
time stress has been going on for many
months, maybe even a year or more.
 About worry
• Almost everybody worries
• Can be a useful response to life, preventing us
from being reckless and stimulating us to take
control of a difficult situation.
• Some people worry a lot more than others, 
worry become a problem in itself.
• Worry is a learned/conditioned behaviour and
many people spend a lot of time thinking about
negative possibilities, mulling them over and
developing exaggerated situations and options.
• Starting thoughts and sentences with "what if",
"maybe" are all part and parcel of the worrier.
 Different types of worry
• FUTURE - frequently focusing on fears for the
future…… things that very probably won’t happen,
• PRESENT - concerns and worries about situations you
feel powerless to change,
• PAST - concern about something that has already
happened when there is often little you can do to alter
it.
• Worry can stimulate the Fight or Flight response which
is the body’s response to real or imagined danger and
whilst effective in the short term, 'Fight or Flight'
becomes damaging in the medium to long term.
 The result is:
• disturbed sleep and eating patterns
• feeling of inability to cope
• loss of confidence
• difficulty in concentrating and making decisions
• headaches
• stomach upsets, feeling sick, butterflies
• emotional distress
• depleted immune system
• irritability
• feeling de-energised
 Think….
• Stress is perceived in the
mind, suffered in the human
spirit, experienced via the
emotions, expressed in
behaviour, and "held" in the
body.