Overview of Stress and Disease

1. Stress and Disease Dr. Donald B. Giddon Harvard University, Fall 2013 Question 2: What Direct or Indirect Neurohormonal or Behavioral Pathways are Activated (“Strained”) by Stressors?

2. Overview of Stress and Disease Objective Stressor Subjective StressorCoping vs. Non-Coping Cognitive Affective Behavioral

3. Forebrain Mid-Brain Hind Brain Ego Superego Id

4. Cognitive Models of Coping • Lazarus and Folkman: Cognitive appraisals determine stress reaction • Primary appraisal: initial evaluation • Irrelevant • Benign-positive • Stressful: harm/loss, threat, challenge • Secondary appraisal: ability to cope

5. Cognitive Models - continued • Reappraisal: changes due to new information • Vulnerability: deficiencies of resources • Person and Situational Variables: • Person: Commitments and beliefs • Situation: Novelty, predictability, uncertainty, long duration

6. Stress Richard Lazarus How Does It Work? CopingResources irrelevant Primary Appraisal Event Secondary Appraisal Re-Appraisal

7. Lazarus Cognitive Appraisal Theory Appraisal Stimuli Arousal Schacter Theory Appraisal Stimuli Arousal

8. The Oyster Model Normal “Neurotic” Psychotic Sociopath

9. Activation of Neurophysiological Pathways – QII CNS PNS Involuntary Reponses Semivolitional Voluntary Responses Neurohormonal Pathways ANS • Breathing - • Sexual - • Facial Expression - • Emotions - HPA axis Somatic NS SNS PNS Striated Muscles Smooth Muscles Motor BP HR Sweat GI GU Disease PD, etc. Communication Physical Activity Chronic Disease Acute Disease (Affect) Facial Expression Speech Normal vs. Abnormal Behavior

11. Potential pathways for stress reactivity to psychosocial stressors.