al-barrak 20081 2 king saud university college of nursing psychiatric nursing department master...

AL-barrak 2008AL-barrak 2008 11

Introduction to concepts of Stress & Stress Management Fred B. Newton, Ph.D., Art Rathbun


King Saud University College of nursing Psychiatric nursing department Master program


At the end of this session the student At the end of this session the student will be able to:will be able to:

• Comprehend major tips of stress Comprehend major tips of stress managementmanagement..

• Develop strategies to assist stress Develop strategies to assist stress management and self-regulationmanagement and self-regulation

• Develop and use your most effective Develop and use your most effective coping and relaxation strategies.coping and relaxation strategies.


• Definition Definition • Five Popular Views of StressFive Popular Views of Stress• The Stress Response (fight or flight response)The Stress Response (fight or flight response)• Three types of stressThree types of stress• Three types of stressorsThree types of stressors• General Adaptation SyndromeGeneral Adaptation Syndrome• Symptoms of stress Symptoms of stress • Tips for stress ManagementTips for stress Management• Stress ManagementStress Management• ConclusionConclusion• Reference Reference


““Stress is universal phenomena that color Stress is universal phenomena that color ever day life. Rapid change is very much a ever day life. Rapid change is very much a part of modern society; the number of part of modern society; the number of stressors in our lives is increasing & stressors in our lives is increasing & leisure time is decreasing.leisure time is decreasing.


stress is the most common stress is the most common aliment of modern age. It has aliment of modern age. It has been complicated in the position been complicated in the position of peptic ulcer, heart disease, of peptic ulcer, heart disease, depression, diabetics, attributed depression, diabetics, attributed to unusually stress. to unusually stress.

None of us are free from stress, None of us are free from stress, but some deal with it better but some deal with it better than otherthan other

77AL-barrak 2008AL-barrak 2008

In your own words, define the In your own words, define the term stress.term stress.

Dictionary

Webster’s

From your own observations & analysis, explain why you believe there is more or less stress present in today’s society.


Stress is the reaction people Stress is the reaction people have to excessive pressure or have to excessive pressure or other types of demand place other types of demand place upon them. It arises when they upon them. It arises when they worry that they can’t cope. worry that they can’t cope.

Help me!


Stress is the “wear and tear” Stress is the “wear and tear” our minds and bodies our minds and bodies experience as we attempt to experience as we attempt to cope with our continually cope with our continually changing environmentchanging environment

I hate you


S = P > RS = P > RStress occurs when the pressure is Stress occurs when the pressure is greater than the resourcegreater than the resource


EasternEastern

philosophies have viewed stress as an absence philosophies have viewed stress as an absence of inner peace. of inner peace.

WesternWestern

culture has more recently viewed stress as a culture has more recently viewed stress as a loss of control.loss of control.

Stress

is...


Richard LazarusRichard Lazarus’ Views of ’ Views of StressStress

Stress is a state of anxiety Stress is a state of anxiety produced when events and produced when events and responsibilities exceed one’s responsibilities exceed one’s coping abilities.coping abilities.


Hans Selye’sHans Selye’s Views of Stress Views of Stress

Stress is the nonspecific Stress is the nonspecific response of the body to any response of the body to any demand placed upon it to demand placed upon it to adapt,adapt,

whether that demand whether that demand produces pleasure or pain.produces pleasure or pain.


Holistic Medicine View of Holistic Medicine View of StressStressStress is the inability to cope with a Stress is the inability to cope with a

perceivedperceived or real (or imagined) threat to or real (or imagined) threat to one’sone’s– mentalmental– physicalphysical– emotional, andemotional, and– spiritual well-beingspiritual well-being

which results in a series of physiological which results in a series of physiological responses and adaptations.responses and adaptations.


Fight or Flight Response to Fight or Flight Response to stressstress


Symptoms of fight or Symptoms of fight or flightflight

• increased heart rateincreased heart rate

• increased blood pressure increased blood pressure

• increased ventilationincreased ventilation

• vasodilatation of arteries to vasodilatation of arteries to body’s body’s periphery (arm and periphery (arm and legs)legs)

• increased serum glucose increased serum glucose levelslevels


Symptoms of fight of Symptoms of fight of flightflight

• Increased free fatty acid Increased free fatty acid mobilizationmobilization

• Increased blood coagulation Increased blood coagulation and and decreased clottingdecreased clotting

• Increased muscular strengthIncreased muscular strength

• Decreased gastric movementDecreased gastric movement

• increased perspiration to cool increased perspiration to cool body core temperaturebody core temperature


Three types of stressThree types of stress

Eustress Eustress

NeustressNeustress

DistressDistress


Distress: Negative StressDistress: Negative Stress

•CrushesCrushes

•OppressesOppresses

•Unusual events Unusual events carried beyond carried beyond rational limitsrational limits


Eustress: Positive StressEustress: Positive Stress

•MotivatesMotivates

•ExcitesExcites

•EnergizesEnergizes


Eustress Distress

Maximum Performance

Poor High

LowGood

perf

orm

ance

illn

ess

poor performance poor performance

lowUnder aroused-

bored

moderatreoptimallyaroused

highoveraroused-overwhelmed

The Yerkes-Dodson Curve


Three types of stressorsThree types of stressors

BioecologicalBioecological

PsychointropersonPsychointropersonalal

SocialSocial


Stage 1Stage 1

Alarm ReactionAlarm Reaction

Stage 2Stage 2

ResistanceResistance

Stage 3Stage 3

Exhaustion Exhaustion


General Adaptation General Adaptation SyndromeSyndrome

Thre

e St

ages

Thre

e St

ages•Alarm StageAlarm Stage

– anxiety or fearanxiety or fear– sorrow or depressionsorrow or depression– shock or confusionshock or confusion

•Self-correctingSelf-correcting



Three Stages

Three Stages

•Resistance Resistance StageStage– AggressionAggression– RegressionRegression– RepressionRepression– WithdrawalWithdrawal– FixationFixation



•Exhaustion StageExhaustion Stage– physiologicalphysiological

•headaches, colds & fluheadaches, colds & flu

– psychologicalpsychological•severe depressionsevere depression

– interpersonalinterpersonal•end of relationshipsend of relationships

• Inability to defend against stressorsInability to defend against stressors

Three Stages

Three Stages


-Physical symptoms-Mental symptoms-Behavioural symptoms-Emotional symptoms


• Sleep pattern Sleep pattern changeschanges

• FatigueFatigue• Digestion changesDigestion changes• Loss of sexual driveLoss of sexual drive• HeadachesHeadaches• Aches and painsAches and pains• InfectionsInfections• IndigestionIndigestion

• DizzinessDizziness• FaintingFainting• Sweating & Sweating &

tremblingtrembling• Tingling hands & Tingling hands &

feetfeet• BreathlessnessBreathlessness• PalpitationsPalpitations• Missed heartbeatsMissed heartbeats


• Lack of concentrationLack of concentration

• Memory lapsesMemory lapses

• Difficulty in making Difficulty in making decisionsdecisions

• ConfusionConfusion

• DisorientationDisorientation

• Panic attacksPanic attacks


• Appetite changes - too Appetite changes - too much or too littlemuch or too little

• Eating disorders - Eating disorders - anorexia, bulimiaanorexia, bulimia

• Increased intake of Increased intake of alcohol & other drugsalcohol & other drugs

• Increased smokingIncreased smoking• RestlessnessRestlessness• FidgetingFidgeting• Nail bitingNail biting• HypochondriaHypochondria


• Bouts of Bouts of depressiondepression

• ImpatienceImpatience

• Fits of rageFits of rage

• TearfulnessTearfulness

• Deterioration of Deterioration of personal hygiene personal hygiene and appearanceand appearance


STRESS RELATED ILLNESSESSTRESS RELATED ILLNESSES

Stress is not the same as ill-health, but has been related to such illnesses as;

- Cardiovascular disease- Immune system disease- Asthma- Diabetes


Tips for stress ManagementTips for stress Management 1. Monitor Your Stress Reactions1. Monitor Your Stress Reactions 2. Identify Stressful Events2. Identify Stressful Events 3. Apply QURAAN Principles3. Apply QURAAN Principles 4. Control What You Can4. Control What You Can 5. Keep a Realistic Schedule5. Keep a Realistic Schedule 6. Have an Exercise Program6. Have an Exercise Program 7. Strong Devotional Life7. Strong Devotional Life 8. Functioning Support Network8. Functioning Support Network 9. Healthy Conflict Management9. Healthy Conflict Management 10. Balance and Boundaries10. Balance and Boundaries


• Stress management is the utilization of Stress management is the utilization of coping strategies in the response to coping strategies in the response to stressful situations.stressful situations.

• Adaptive coping strategies protect the Adaptive coping strategies protect the individual from harm and restore physical individual from harm and restore physical and psychological homeostasis.and psychological homeostasis.


Stress Management Stress Management (cont.)(cont.)• Coping strategies are considered maladaptive Coping strategies are considered maladaptive

when the conflict being experienced goes when the conflict being experienced goes unresolved or intensifies.unresolved or intensifies.

• Some adaptive coping strategies includeSome adaptive coping strategies include– AwarenessAwareness– RelaxationRelaxation– MeditationMeditation– Interpersonal communication with caring Interpersonal communication with caring

otherother– Problem-solvingProblem-solving– PetsPets– MusicMusic


Another classification of Another classification of Coping StrategiesCoping Strategies

• Problem-focused strategiesProblem-focused strategies

• Confrontive copingConfrontive coping

standing one's ground or expressing standing one's ground or expressing one's angerone's angerPlanful problem solving Planful problem solving

having a plan of action or doubling having a plan of action or doubling efforteffort


• Emotion-focused strategiesEmotion-focused strategies

• DistancingDistancing

making light of the situation, pretending making light of the situation, pretending nothing has happened, trying to forget nothing has happened, trying to forget about things.about things.

• Self-controllingSelf-controlling

keeping feelings to oneself, not letting keeping feelings to oneself, not letting others know how bad things are others know how bad things are


• Seeking social supportSeeking social support

talked to somebody to find out more talked to somebody to find out more about the situation, asked a friend for about the situation, asked a friend for advice.advice.

• Accepting responsibilityAccepting responsibility

self-criticism, saying to oneself that self-criticism, saying to oneself that things will be better next time.things will be better next time.


• Escape-avoidanceEscape-avoidance wishing the situation would go away, wishing the situation would go away,

hoping for a miracle, trying to make hoping for a miracle, trying to make oneself better by eating and drinking a oneself better by eating and drinking a lot. lot.

• Positive reappraisalPositive reappraisal changing or growing up a better person, changing or growing up a better person,

discovering what is important in life. discovering what is important in life. Basically, you can try to solve the problem Basically, you can try to solve the problem

that has become a stressor or you can that has become a stressor or you can deal with the emotion.deal with the emotion.


The physiological response to stress is The physiological response to stress is the same in each of us. Our conscious the same in each of us. Our conscious mind mediates the degree of the stress mind mediates the degree of the stress response by analyzing incoming messages response by analyzing incoming messages and determining the degree of response and determining the degree of response to allow. This can heighten, neurtalize or to allow. This can heighten, neurtalize or stop the resulting stress response.stop the resulting stress response.

• Stress symptoms appear in the form of Stress symptoms appear in the form of fatigue, insomnia, nausea, a racing heart fatigue, insomnia, nausea, a racing heart or as psychological symptoms such as or as psychological symptoms such as negative attitudes, forgetfulness, negative attitudes, forgetfulness, irritability, increased errors or anxiety.irritability, increased errors or anxiety.


•We all have a unique coping We all have a unique coping style for responding to style for responding to stress. This style is formed stress. This style is formed by our personality traits, by our personality traits, the degree of change we the degree of change we are subjected to and the are subjected to and the quality of our support quality of our support networks. networks.


• Schill, Thomas and Beyler, Jane. 1992 "Self-Schill, Thomas and Beyler, Jane. 1992 "Self-Defeating Personality and Strategies for Coping Defeating Personality and Strategies for Coping with Stress. " Psychological Reports. 71: 67-70. with Stress. " Psychological Reports. 71: 67-70.

• Schlaadt, Richard G. Drugs, Society and Behavior. Schlaadt, Richard G. Drugs, Society and Behavior. Guilford, CT: Duskin Publishing Group, pp. 108-Guilford, CT: Duskin Publishing Group, pp. 108-109, 1992. 109, 1992.

• Seaward, Brian Luke. Managing Stress. Boston: Seaward, Brian Luke. Managing Stress. Boston: Jones and Bartlett Publisher, pg. 143, 1994. Jones and Bartlett Publisher, pg. 143, 1994.


• Sheets, Kent J.,Gorenflo, Daniel W., and Forney, Mary A. Sheets, Kent J.,Gorenflo, Daniel W., and Forney, Mary A. "Personal and Behavioral Variables Related to Perceived "Personal and Behavioral Variables Related to Perceived Stress of Second Year Medical Students." Teaching and Stress of Second Year Medical Students." Teaching and Learning in Medicine. 5: 90-95, 1993. Learning in Medicine. 5: 90-95, 1993.

• Simon, Sidney, B. Getting Unstuck: Breaking Through the Simon, Sidney, B. Getting Unstuck: Breaking Through the Barriers of Change. New York: Warren Books, pg. 223, Barriers of Change. New York: Warren Books, pg. 223, 1988. 1988.

• Stacy, Alan W., Newcomb, M.D., and Bentler, Peter M. Stacy, Alan W., Newcomb, M.D., and Bentler, Peter M. "Cognitive Motivation and Drug Use. A Nine Year "Cognitive Motivation and Drug Use. A Nine Year Longitudinal Study." Journal of Abnormal Psychology. 100: Longitudinal Study." Journal of Abnormal Psychology. 100: 502-515, 1991. 502-515, 1991.

• Staffehhagen, R. The Social Dynamics of Self-Esteem: Staffehhagen, R. The Social Dynamics of Self-Esteem: Theory to Therapy. New York: Praeger, 1990. Theory to Therapy. New York: Praeger, 1990.

• St. Mary, Sharon and Pasco, Thomas. "A Self-Efficacy Scale St. Mary, Sharon and Pasco, Thomas. "A Self-Efficacy Scale for Chemical Dependency in Adolescence." Journal of for Chemical Dependency in Adolescence." Journal of Human Behavior. 27: 27-28, 1991. Human Behavior. 27: 27-28, 1991.


– https://https://assesshealth.ucs.ksu.edu/cs_surveyassesshealth.ucs.ksu.edu/cs_survey//

– http://http://www.spsu.edu/sis/psycho.htmwww.spsu.edu/sis/psycho.htm – http://http://

www.nationalwellness.org/testwell/index.www.nationalwellness.org/testwell/index.htmhtm

– http://www.humanmetrics.com/cgi-win/JThttp://www.humanmetrics.com/cgi-win/JTypes2.aspypes2.asp

https://assesshealth.ucs.ksu.edu/cs_survey/



http://www.spsu.edu/sis/psycho.htm

http://www.spsu.edu/sis/psycho.htm

http://www.nationalwellness.org/testwell/index.htm



http://www.humanmetrics.com/cgi-win/JTypes2.asp

http://www.humanmetrics.com/cgi-win/JTypes2.asp

al-barrak 20081 2 king saud university college of nursing psychiatric nursing department master...

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