Stress In Biopsychosocial Appraoch - University - Essay

2641 words - 11 pages

stress is a biological and psychological response experienced on encountering a threat that we feel we do not have the resources to deal with.
A stressor is the stimulus (or threat) that causes stress, e.g. exam, divorce, death of loved one, moving house, loss of job.
Sudden and severe stress generally produces:
· Increase in heart rate
· Increase in breathing (lungs dilate)
· Decrease in digestive activity (don’t feel hungry)
· Liver released glucose for energy
Stress is an intimate and personal affair, and for this reason we can only infer its existence in other people from their verbal accounts, their general appearance and demeanour, and their behaviour. As we have seen, stress is generally described in terms of the emotions which include the concepts of fear, sorrow, guilt, anger, anxiety or depression. Psychologists generally propose two kinds of emotional experiences: positive emotions and negative emotions, of which one of the negative emotions is stress. Lazarus (1976) actually regards the totality of negative emotions as ‘stress emotions’, but this ignores the contributions made by other factors.
Stress is the body's biological response to an actual or perceived stressor. In our evolutionary past, stress responses would have been essential to survival as they enable the body to respond quickly to danger. Today there is less danger in our environment, but the stress response is still essential to survival, however it sometimes responds to pressures and events it was not designed for and can lead to psychological and physical illness.
There are two main stress responses in the human body. The acute stress response (also known as the SAM or sympathy adreno medullary pathway) responds very quickly to immediate danger and readies the body for the classic fight or flight response. The chronic stress response (also know as the HPA or hypothalamo pituitary adrenal pathway) responds to long-term constant stressors by keeping the body alert, however the chronic response can also have many harmful effects on the body such as reducing immune system functioning.
Stressful events that persist for an extended period of time are perceived by the hypothalamus. The hypothalamus (located in the brain) releases CRF (corticotropin releasing factor) which travels through the blood to the pituitary gland (also in the brain). The pituitary gland releases ACTH (adrenocorticotropic hormone) which travel through the blood stream to the adrenal cortex (part of the adrenal gland situated at the top of each kidney) which releases corticosteroids (including cortisol). Cortisol has a wide range of effects on the body including increased blood pressure, sweating, vigilance, improved emotional memory, increased production of glucose from glycogen in the liver, and weakens the immune system.
Stressors have a major influence upon mood, our sense of well-being, behavior, and health. Acute stress responses in young, healthy individuals may be adaptive and typically do not impose a health burden. However, if the threat is unremitting, particularly in older or unhealthy individuals, the long-term effects of stressors can damage health. The relationship between psychosocial stressors and disease is affected by the nature, number, and persistence of the stressors as well as by the individual’s biological vulnerability (i.e., genetics, constitutional factors), psychosocial resources, and learned patterns of coping. Psychosocial interventions have proven useful for treating stress-related disorders and may influence the course of chronic diseases.
stress affects health when a perceived challenge exceeds a person's ability to cope. This is especially the case when the imbalance between stressful conditions and available coping resources is severe and/or chronic.
The effects are not always negative. For example, meeting and overcoming a challenge may actually have positive health effects by leading to growth, adaptation and learning that promote a person’s resilience and capacity for coping with future hardships. Health-damaging effects of stress are more likely to occur when a person experiences ongoing or chronic exposure to stressors in aspects of everyday life over which he or she has limited control—for example, trying to juggle both family and job commitments without a flexible work schedule or personal and sick leave. This type of chronic stress leads to negative behavioral, cognitive, physiologic and neurologic changes over time that increase vulnerability to poor health.
The growing scientific knowledge about the links between stress and health has tremendous practical significance. Understanding these links is essential for raising awareness about the importance of policies and programs that can help make life less stressful, particularly for those who experience the most stress and are most vulnerable to its health-damaging effects. While much remains to be learned, current knowledge makes it clear that addressing the effects of stress—particularly chronic stress
thorough review of the Biopsychosocial Model, stress, and the efficacy of mindfulness therapy is warranted and would provide a theoretical foundation upon which to uncover methods of treating stress. While the biomedical model of health has dominated the thinking and actions of healthcare practitioners for the past 300 years (Slife & Wendt, 2006),   it tends to reduce illness to what Taylor (2009) calls “low-level processes,” placing emphasis on the biological processes such as disordered cells and chemical imbalances rather than psychological or environmental processes.  In addition, this model only takes into consideration one factor for illness.  An examination will be made into the Biopsychosocial Model, stress, and the efficacy of Mindfulness Therapy in treating stress.  Understanding how the body reacts to stress, and the way Mindfulness affects perceived stress will pave the way for future studies and understanding of the variables that affect cortisol levels and inflammation in the body.
The stress response refers to an individual’s affective, cognitive, behavioral, and biological responses involved in regaining psychological and physiological balance after disrupted homeostasis (Schneiderman et al., 2005). Thus, greater perceptions of stress might result from any one of these components of the stress response. Biologically
outlines the relationships between stress appraisals, physiological reactivity, and performance in the BPS model. The relationships described in the BPS model have been supported in a variety of studies examining performance situations in adults. Several studies found that undergraduate students who appraised a mental arithmetic task to be less threatening had a higher percentage of correct responses and were more likely to exhibit a physiological challenge response than those who perceived the task to be threatening (Kelsey et al., 2000; Schneider, 2008; Tomaka et al., 1993). Participants who performed better on the mental arithmetic task also reported lower stress appraisal following the task (Kelsey et al., 2000; Tomaka et al., 1993). Tomaka et al. (1993) also found evidence for self-awareness of performance ability; participants who performed poorly also self-rated their performance as low and reported more post-task perceptions of stress
Although cognitive, physiological, and behavioral responses to stress each contribute to perceptions of stress in adults, the relationships among these components of stress responses have rarely been examined in adolescents, a time period characterized by increased stress exposure and reactivity. To address this gap in knowledge, we used the BPS model to examine the relationships among cognitive, physiological,
Table 2. Analysis of biospsychosocial model variables with cardiac output and behavioral stress responses in a sample of adolescents who completed the TSST. Our first goal was to evaluate whether physiological stress reactivity relates to stress appraisals (pre- and post-task) in adolescents, as these two facets of the stress response are aligned in adults (Kelsey et al., 2000; Schneider, 2008; Tomaka et al., 1993). Due to the fact that, relative to adults, adolescents are less able to hold in mind future events, we expected weak relationships between variables. Consistent with our hypothesis, we observed that physiological stress reactivity was neither predicted by pretask stress appraisals, nor did it predict post-task stress appraisal. Our second research goal was to investigate whether performance was influenced by pre-task stress appraisal and/or stress reactivity. Again, consistent with our
hypothesis, but in deviation from findings with adults, we observed that these variables were not related to performance in our adolescent population. Finally, the third goal of this study was to identify predictors of post-task stress appraisal. Consistent with our hypothesis, performance, instead of stress reactivity, was most strongly related to post-task stress appraisal.
The biopsychosocial model of health (Engel, 1977) claims that health and illness are: the product of a combination of factors including biological characteristics (e.g. genetic predisposition), behavioural factors (e.g. lifestyle, stress, health beliefs), and social conditions (e.g. cultural influences, family relationships, social support). (Marks et al,2005). The biopsychosocial model takes into account that each patient is completely different and as a result they are affected differently by each biological, psychological and social happening. (Atkinson et al, 2005). The biomedical model of health however sees the patient as a biological entity which has developed a fault; this model leads people to believe that all patients with the same injury/pathology will respond the same to treatment and in the same amount of time. (Atkinson et al, 2005). The main difference between these two models is the role of the patient and practitioner in each. The biomedical model see's the patient as person who has to take orders from the practitioner. The biopsychosocial model sees the treatment as a negotiation between the practitioner and patient. (Annandale, 1998) The type of model a practitioner uses will greatly impact on the eventual outcome of the patient. In the case of Mrs. Chatsworth the biopsychosocial model of health would be the best approach to take when coming up with an effective treatment plan for her as there are many biological, psychological and social factors that a practitioner will have to contend with. This essay will explore these different biological, psychological and social factors that will face Mrs. Chatsworth throughout her treatment as well as the implications for her practitioner.
The biopsychosocial model is a scientific model constructed to take into account the missing dimensions of the biomedical model. To the extent that it succeeds it also serves to define the educational tasks of medicine and particularly the tasks and roles of psychiatrists in the education ofphysicians ofthe future. How physicians approach patients and the problems they present is very much influenced by the conceptual models in relationship to which their knowledge and experience are organized.
The psychological component of the biopsychosocial model seeks to find a psychological foundation for a particular symptom or array of symptoms (e.g., impulsivity, irritability, overwhelming sadness, etc.). Individuals with a genetic vulnerability may be more likely to display negative thinking that puts them at risk for depression; alternatively, psychological factors may exacerbate a biological predisposition by putting a genetically vulnerable person at risk for other risk behaviors. For example, depression on its own may not cause liver problems, but a person with depression may be more likely to abuse alcohol, and, therefore, develop liver damage. Increased risk-taking leads to an increased likelihood of disease.
Social factors include socioeconomic status, culture, technology, and religion. For instance, losing one’s job or ending a romantic relationship may place one at risk of stress and illness. Such life events may predispose an individual to developing depression, which may, in turn, contribute to physical health problems. The impact of social factors is widely recognized in mental disorders like anorexia nervosa (a disorder characterized by excessive and purposeful weight loss despite evidence of low body weight). The fashion industry and the media promote an unhealthy standard of beauty that emphasizes thinness over health. This exerts social pressure to attain this “ideal” body image despite the obvious health risks.
The Biopsychosocial model of health looks at the physical factors of health, incorporating the psychological and social factors of health also (Brannon L. and Feist J. 1992). This is with the view to determining a holistic picture of the health of an individual. Biological(physical), social and psychological factors can all play a role in affecting an individual's health, and particularly can all attribute or be a result of a person's stress levels.
tress is a 'non specific response of the body to any demand made on it; the arousal, both physical and mental to situations or events that we perceive as threatening or challenging.'
Seyle identified different types of stress: eustress which is seen as beneficial or distress which is unpleasant. He also recognised that stress is an inevitable part of life, required by the body to function. The absence of stress would mean the absence of any stimuli in the body which would inevitably result in death.
Stress can be caused by: people i.e. conflict with others, situations i.e. work, exams or driving or it can be environmental i.e. high temperature or noise.
In addition, there are different situations which can be regarded as 'stressful'. Life events such as marriage, divorce, death of a loved etc can be extremely stressful for a person; however this depends on how a person appraises the situation.
Daily hassles also contribute to an individual's stress levels. Driving to work can be stressful if a person is stuck in traffic jams for the journey, or worrying about weight issues.
There are 3 general theories for Stress. Stress may be a stimuli, a response to a stimulus or a combination of both (Brannon L. and Feist J. 1992).
The Biological Model of Stress
Stress can be attributed to many health issues ranging from mild problems such as irritability, food cravings and loss of libido, through to severe health issues such as cardiovascular disease, panic attacks and bowel problems.
As early as 1914, Cannon suggested that emotional reactions may be involved in physical changes which relate to illness (Brannon L. and Feist J. 1992).
This notion was taken up by Hans Seyle who developed the term 'stressor' meaning the stimulus, and 'stress' to be the response to the stressor (stimuli).
Lazarus and Folkman (1984) recognise that different people and group react differently to different demands and pressures. Different people and groups also vary in their vulnerability and sensitivity to situations and in turn, their interpretations and reactions to the event also differ. They noted that a person's cognitive appraisal of a situation reflects the relationship between an individual who has their own characteristics i.e. values, perceptions, thoughts, and the environment where the characteristics are unknown and need to be assessed and deduced. This is known as the Transactional Model of Stress which is the transaction between an individual and the stressor (environment)
The bio psychosocial model of health looks at the way in which stress affects the body physically, psychologically and socially. Stress can negatively impact each of these areas in a person's life and it important that appropriate coping strategies are put in place to work against this. As discussed, there are various ways which stress can be managed, and it is up to the individual how which way works best for them. Equally, stress affects everyone different, and how the situation is appraised is important to what sort of impact the stressor has on the individual. Essentially, the bio psychosocial model approach to stress makes an important contribution to understanding the stress and its impact on the body.
considerable advances have been made in developing biopsychosocial models to describe the transition from acute injury to chronic pain. These advances utilized novel conceptualizations of cognitive-behavioral factors, such as pain-related fear and avoidance which appear to influence the development of chronic pain in many individuals. The cyclical process whereby pain produces fear, which leads to behavioral avoidance, inactivity
The ability of psychological factors to influence the development of chronic pain by shaping behavior and amplifying peripheral sensations, as highlighted in these models, is well supported by considerable research (6,7). However, there is increasing evidence that specific neurobiological mechanisms within central stress systems may participate in this process, derailing recovery and mediating progression to chronicity. These mechanisms have been most thoroughly examined in studies of PTSD but may be equally relevant to the development of chronic pain syndromes. Indeed, evidence suggests that PTSD and chronic pain disorders after trauma have many common links

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