Reactions to socio environmental stress

Omero G. Mwale
Msc . Mental Health Nursing
reactions to socio-environmental stress.omero.Msc
mental health

Learning outcomes
 Upon completion of this topic participants should be
able to;
 Define the following terms:
 stress
 Stressor
 Adaptation response
 maladaptation
mental health

Objec,cont
 Identify the physiological responses to stress
 Explain the relationship between stress and diseases of
adaptation
 Describe the concept of stress as an environmental event.
 Explain the concept of stress as a transaction between the
individual and the environment
 Discuss adaptive coping strategies in management of stress
mental health

Definitions
 Stress –may be viewed as an individuals reaction to
any change that requires an adjustment or
response, which can be physical mental or
emotional.
 Stressor-a biological , physiological, social or
chemical factor that causes physical or emotional
tension and may be a factor in the etiology of certain
illness
mental health

Defin,cont
 adaptation- is viewed as positive and is correlated
with a healthy response.
 When behavior disrupts the integrity of the individual
it is perceived as maladaptive (negative or
unhealthy)
mental health

Physiological response to stress
 Selye, 1976, called this as state manifestated by a
specific syndrome which consists of all the
nonspecifically induced changes within a biological
system.
 Syndrome of symptoms is known as fight or flight
syndrome
 Called this general reaction of the body
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Cont,
to stress the general adaptation syndrome.
 Has three phases
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1.Alarm reaction phase
 Fight or flight syndrome are initiated
 The body prepares to fight or adjust to the stressor
by increasing ;
 heart rate
 blood sugar
 respiration and muscle tension
mental health

2.Resistance stage
 The individual uses the physiological responses of
the first stage as a defense in the attempt to adapt to
the stressor.
 If adaptation takes place the third stage is prevented
or can be delayed.
 Physiological symptoms may disappear.
mental health

3.Exhaustion stage
 It takes place when there is a prolonged exposure to
the stressor to which the body has become adjusted
 The adaptive energy is depleted
 Diseases of adaptation may occur
 Such as headaches, ulcers, coronary heart
disease, mental disorders
 Without intervention, this may result into death.
mental health

general adaptation syndrome
(diagrammatically)
Alarmreactionstage
Increased
blood sugar
Respirations
increase
Blood
pressure
increase
Resistancestage
Physiological
responses are
used
Exhaustionstage
Energy is
depleted
Death can
occur without
interventions
mental health

Stress as an environmental
event
 The event creates change in the life pattern of the
individual , requires significant adjustment in lifestyle
and taxes available personal resources.
 The change can be either positive, such as
outstanding personal achievement, or negative such
as being fired from job.
 What is important is the change from the
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cont
existing steady state of the individuals life pattern
 Miller and Rahe found that women react to life stress
events at higher levels than men,
 And unmarried people gave higher scores than
married people for most of the events.
 They used a rating scale with numerical values.
 Table 1-1 (Townsend 2012)
mental health

Cont,
 Younger subjects rated more events at a higher
stress level than older subjects
 A higher score on the recent life changes
questionnaire( RLCQ) puts the individual at greater
susceptibility to physical or physiological illness
 The questionnaire may be completed considering life
stressors within a 6 months or 1-year period.
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Cont,
 Six months totals equal to or greater than 300 life change
units(LCU’s) or
 1 – year totals equals to or greater than 500 (LCU) are
considered indicative of a high level of recent life stress,
 Thereby increasing the risk of illness for the individual.
 It is not known whether stress overload
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cont
Merely predisposes a person to illness or actually
precipitates it but there does appear to be a causal
link( Pellelier 1992 cited in Townsend 2012)
 The drawback to life changes questionnaire is that it
does not consider the individuals perception of the
event.
 Individuals differ in their reaction to life events
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Cont,
 And these variations are related to the degree to
which the change is perceived as stressful.
 The same instruments fail to account for the
individuals coping strategies and available support
systems at the time when the life change occurs.
 Positive coping mechanisms and strong
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Cont,
 Social or familial support can reduce the intensity of
the stressful life changes and promote a more
adaptive response.
mental health

Stress as a transaction between
the individual and the
environment
 The emphasis is the relationship between the individual
and the environment.
 Personal characteristics and the nature of the
environmental event are important.
 This differs with the modern explanation of the etiology of
disease
 No longer is causation viewed solely as an external entity
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Cont,
 Whether or not illness takes place depends also on
the affected organism susceptibility.
 Similarly, to predict psychological stress as a
reaction, the properties of the person in relation to
the environment must be considered.
mental health

Precipitating event
 Is a stimulus arising from the internal or external
environment and is perceived by the individual in a
specific manner.
 The determination that a particular person-environment
relationship is stressful depends on the individuals
cognitive appraisal of the situation.
 Cognitive appraisal is an individual evaluation of the
personal significance of the event or
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Cont,
 Or occurrence.
 The event precipitates a response on the part of the
individual, and the response is influenced by the
individuals perception of the event.
 The cognitive response consists of a primary
appraisal and secondary appraisal.
mental health

Individuals perception of the
event
 1. primary appraisal
 Lazarus and Folkman 1984 cited in (Townsend
2012), identified three types of primary appraisal.
 1.Irrelevant
 2.Benign-positive
 3.stressful
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1.Irrelevant
 An event is judged irrelevant when the outcome
holds no significance for the individual.
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2.A benign-positive outcome
 Is one that is perceived as producing a pleasure for the
individual
 Stress appraisal include harm/loss, threat and challenge.
 Harm/loss appraisals refers to damage or loss already
experienced by the individual.
 Appraisals of a threatening nature are perceived as
anticipated harm/loses
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Cont,
 When an event is appraised as challenging, the
individuals focuses on potential for gain or
growth, rather than a risks associated with the event.
 Challenge produces stress even though the
emotions associated with it (eagerness and
excitement) are viewed as positive and coping
mechanisms must be called
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cont
to face the new encounter.
 Challenge and threat may occur together when an
individual experiences these positive emotions along with
fear or anxiety over possible risks associated with
challenging event.
 3.When stress is produced in response to
harm/loss, threat or challenge , a secondary appraisal is
made by the person.
mental health

Secondary appraisal
 This is an assessment of the skills, resources, and
knowledge that the person posses to deal with the
situation.
 The individual evaluates by considering the following;
• Do I have the resources to deal effectively with this challenge
or stressor?
• Which coping strategies are available to me?
mental health

Secondary app..Cont,
 Will the option I choose be effective in this situation
 Do I have the ability to use that strategy in an
effective manner
 The interaction between the primary appraisal of the
event that has occurred and the secondary appraisal
available coping strategies determines the quality of
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Cont,
 the individuals adaptation response to stress.
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Predisposing factors
 A variety of elements influence how an individual
perceives and responds to a stressful event.
 These predisposing factors strongly influence
whether the response is adaptive or maladaptive.
 Types of predisposing factors include genetic
influences, past experiences and
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Cont,
 Existing conditions
 Genetic influences are those circumstances of an
individual’s life that are acquired through heredity.
 Examples include family history or physical and
physiological conditions( strengths and weaknesses)
 And temperament ( behavioral characteristics
present at birth
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Cont,
that evolve with development).
 Past experiences are occurrence that result in
learned patterns that can influence an individual’s
adaptation response
 They include previous exposure to the stressor or
the other stressors, learned coping responses and
degree of adaptation to previous stressors.
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Cont.
 Existing conditions incorporate vulnerabilities that
influence the adequacy of the individual’s
physical, psychological and social resources for
dealing with adaptive demands.
 Examples include current health
status, motivation, developmental maturity, severity
and duration of the stressor,
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Cont,
 Financial and educational resources ,age, existing
coping strategies and a support system of caring
others.
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Transactional model of
stress/adaptation
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Stress management
 It involves the use of coping strategies in response
to stressful situations.
 Coping strategies are adaptive when they protect the
individual from harm ( or additional harm ) or
strengthen the individual’s ability to meet challenging
situations.
 Adaptive responses help restore homeostasis
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Cont,
 To the body and impede the development of diseases of
adaptation.
 Coping strategies are considered maladaptive when the
conflict being experienced goes unresolved or intensifies
 Energy resources become depleted as the body
struggles to compensate for the chronic physiological and
psychological
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Cont,
arousal being experienced.
 The effect is a significant vulnerability to physical or
psychological illness.
mental health

Adaptive coping strategies
 Awareness – to become aware of the factors that
create stress and feelings associated with a stressful
response
 Stress can be controlled only when one recognizes
that it is being experienced.
 As one becomes aware of stress he or she can omit
,avoid or accept them.
mental health

Relaxation
 Individuals experience relaxation in different ways.
 Exercise that require strong energy
 Use of breathing exercises and progressive
relaxation relieve stress
mental health

Meditation
 Involves assuming a comfortable position, closing
the eyes, casting off all other thoughts and
concentrating on a single word, sound or phrase that
has a positive meaning to the individual.
 Practiced 20 minutes once or twice daily , has shown
to produce a lasting reduction in blood pressure and
other stress related symptoms.
mental health

Interpersonal communication
with others
 Talking the problem out with an individual who is
empathetic is sufficient to interrupt escalation of the
stress response.
 Writing about one’s feeling in a journal or daily can
also be therapeutic.
mental health

Problem solving
 Done objectively by looking at a situation.
 After an objective assessment of the situation, the
problem solving /decision making model can be put in
place.
 Assess the facts of the situation
 Formulate goals for resolution of the stressful situation
 Study the alternatives for dealing with the situation
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Cont,
 Determine the risks and benefits of each alternative
 Implement the alternative selected
 Evaluate the outcome of the alternative implemented
 If the first choice is ineffective select and implement
a second option
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Pets
 Studies have shown that people who care for pets
especially dogs and cats are better able to cope with
stressors of life (Allen, Blascovich &
Mendes, 2002, Barker Knisely, Mccain &Best 2005
cited in Townsend 2012).
 The physical act of stroking or petting a dog or cat
can be therapeutic
mental health

Cont,
 It gives the animal an intuitive sense of being cared for
and at the same time gives the individual the calming
feeling of warmth, affection and interdependence with a
reliable trusting being.
 One study revealed evidence that individuals
experienced a statistically significant drop in blood
pressure in response to petting a dog or cat(whitaker
2000 cited in townsend 2012.
mental health

Music
 Creating and listening to music stimulate
motivation, enjoyment and relaxation.
 Music can reduce depression and bring about
measurable changes in mood and general
activity.(classical or spiritual music)
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Ethical Issues About
Stress in Organizations
 Organizational change: do managers have an ethical duty to
prepare employees for change?
 Physical work environment: is it unethical for managers to
knowingly expose workers to hazards?
 Person-environment fit: is it unethical for an organization to
distort information about a job?
 Knowledge about work and nonwork stressors: should
managers consider nonwork stressors when trying to
understand the total stress effects on an employee?
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OTHER ASPECTS -Cont,
 How would you know that your employees are
stressed up as a manager?
 Physical symptoms.
 behavioral symptoms.
 How do you deal with stress in a work place ?
mental health

References
 Townsend M,C. (2012) Psychiatric Mental Health
Nursing.Concepts of care in evidence based
practice. 7th edition. Davis company;philadephia.
 Meyer s, Naude Nierkek (2005) .the unit
manager.comprehensive guide. JUTTA; South
Africa
mental health

Reactions to socio environmental stress

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