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Biopsychosocial model of stress

What is Stress?
Stress is the body's response to an actual or perceived stressor
NB: Things that make you feel stressed are called "stressors."
-Stressors can be minor hassles, major lifestyle changes, or a combination of both.
The Bio-psychosocial model (BPS)
It was developed by George L. Engel in1977 due to insufficiency of other models like
medical model which was:
Dualistic (Physical and psychosocial processes are separate)
Reductionistic (Social, psychological, and other external factors, which may
influence patients behavior, may be ignored).
Components of stress according to BPS model
1. The External Component (stressors)
Involves environmental events as natural disasters.
Life events like losing a job.
Chronic condition like crowding & poverty
2. The Internal Component
It is the emotional & physical response of the body to the stressors.
It passes through 3 stages ( stress curve ):
1. Alarm: fight & flight, by release of sympathetic catecholamine.
2. Resistance: persistence of high levels of hormones.
3. Exhaustion: energy reserve is exhausted & breakdown occurs.
3. The Interaction between The External and Internal Components
Interaction between external & internal components that determine triggering
of the proper response; it passes through 2 steps :
1- Primary appraisal.
In the stage of primary appraisal, an individual tends to ask questions like, What
does this stressor and/ or situation mean?, and, How can it influence me?
According to psychologists, the three typical answers to these questions are:
-"this is not important"
-"this is good"
-"this is stressful"
After answering these two questions, the second part of Primary Appraisal is to
classify whether the stressor or the situation is a threat, a challenge or a harm-loss.
2- Secondary appraisal
-Secondary appraisals involve those feelings related to dealing with the stressor or
the stress it produces. Uttering statements like, I can do it if I do my best, I will try
whether my chances
Of success are high or not
-In contrast to these, statements like, I cant do it; I know I will fail, I will not do it
because no one believes I can and, I wont try
Biology of stress
Operates via two interrelated systems:
1- SAM (Sympathetic-adrenomedullary)
2- HPA (hypothalamic-pituitary-adrenocortical).
These balance each other, and both are triggered by the hypothalamus
SAM
-Adrenal medulla (the inner part) release hormones epinephrine (adrenaline) and norepinephrine
Stimulates rapid mobilization of metabolic resources: increased heart rate, BP, blood glucose
"Rapid response
HPA
Adrenal cortex produces glucocorticoid (GC) & mineralocorticoid (MC) hormones.
These form a back-up response"; slower effect
Cortisol is most important human glucocorticoid, involved in regulating metabolism,
immune response, and general homeostasis.
Protein & fat are metabolized into glucose; this suppresses immune response; raises
BP
Targets the brain
Receptors = GRs and MRs
Hypothalamus
It Secretes CRH > causes the pituitary to secrete ACTH > stimulates the adrenal
medulla to release epinephrine, and the adrenal cortex to release GC.
Stress related diseases
Ulcers: are caused by excessive acid stomach and studies of patients with gastric
fistulas have shown that anger and hostility increase stomach acidity while depression
decreases it.
Heart disease: Stress can directly increase heart rate and blood flow, and
causes the release of cholesterol and triglycerides into the blood stream.
Diabetes: Stress can worsen diabetes in two ways,
1- Stress increases the bad behaviors, such as unhealthy eating and excessive drinking
alcohol.
2- Stress increases glucose levels in type 2 diabetes directly due to release of cortisol.
Depression and anxiety: Chronic stress is connected with higher rates of depression and
anxiety.
Asthma: Stress can worsen asthma.
Evidence suggests that chronic stress increase the risk of developing asthma in the children.
Stress management strategies
Stress won't disappear from your life. And stress management isn't an overnight cure. But
you can learn to manage your stress level and increase your ability to cope with life's
challenges.
-Decide to make stress management
-identify your stress triggers
-think about strategies
-maintain a healthy lifestyle