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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?
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Overview of Stress and Disease
Objective Stressor
Subjective StressorCoping vs. Non-Coping
Cognitive
Affective
Behavioral
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3
Forebrain
Mid-Brain
Hind Brain
Ego
Superego
Id
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
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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
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Richard Lazarus
SecondaryAppraisal
Re-Appraisal
Primary AppraisalEvent
Stress
irrelevantCopingResources
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How Does It Work?
Lazarus Cognitive Appraisal Theory
Stimuli
Stimuli
Appraisal
Arousal
Appraisal
Arousal
Schacter Theory
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The Oyster Model
Normal “Neurotic” Psychotic Sociopath
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Activation of Neurophysiological Pathways – QII
CNS PNSInvoluntary Reponses Semivolitional Voluntary Responses
Neurohormonal Pathways
ANS HPA axis
Somatic NS
SNS PNS
Smooth Muscles
Acute
Disease
Chronic
Disease
Striated Muscles
Motor
Communication
Speech (Affect) Facial Expression
Physical Activity
Normal vs. Abnormal Behavior
- Breathing -
- Sexual -
- Facial Expression -
- Emotions -
BP HR Sweat GI GU
Disease
PD, etc.
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Potential pathways for stress reactivity to psychosocial stressors. 11