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Appraisal: The WYSIWYG of Stress

LindauHarbor_EN-US1129072404From the cave to the modern city, survival has depended on the ability to quickly and reliably distinguish between harmless and dangerous situations. Today, distinctions are often subtle, complex, and abstract. The ability to make these distinctions has been made possible by the evolution of the prefrontal areas of our brain, which are capable of symbolic representation and can derive new knowledge about the self, world and the future through experience. This complex process of evaluation and distinction is called cognitive appraisal.

The cognitive appraisal of possible harm or loss, threat, and challenge is intimately implicated in the stress reaction. In recognizing harm or loss, we assess that some measure of physical or psychological damage has already occurred, e.g., an injury or an illness, some damage to our well-being or self-esteem, or the loss of a loved or valued person. In evaluating a threat, we assess damage or loss that has not yet occurred but that is anticipated, or perceived as likely to occur. Harm or loss that has already occurred is always suffused with threat because every serious injury or significant loss is also full of negative implications for the future. Challenges are often perceived as threats as every challenge, either psychological or physical, calls for the mobilization of our coping resources.

Stressed_WomanThus, in this process of appraisal, we come up with an assessment of the seriousness of the situation that is before us. What we see or do not see determines the level of physiopsychological arousal and how we will respond. The idea that our emotional and behavioral response to a stressor is determined by the meaning we attribute to an event or situation has a long tradition in Western thought. The Roman philosopher Epictetus famously stated, "Men are disturbed not by things, but by the views which they take of things.” A few centuries later, the same idea was expressed by William Shakespeare in Hamlet, "There is nothing either good or bad, but thinking makes it so" (Act II, Scene 2, line 259).

The immediate outcome of appraisal, whether of a threat or a challenge, is the notion that something must be done to manage the situation, because it is serious enough to warrant our attention. This first level of assessment is often referred to as primary appraisal. Subsequently, and often almost without pause, our task becomes that of evaluating what might and can be done, a second level of processing that we call secondary appraisal. While neither is more important than the other, secondary appraisal activity is crucial in the choice we make between fight or flight, i.e., between approach and avoidance. The WYSIWYG of appraisal is that, in most cases, what we see in the situation is how we choose to respond to it. Whereas some will see in a particular event nothing but a nuisance, others will see the same event as a dangerous threat.

Primary Appraisal: How Serious Is the Stressor?

What determines the quality of our primary assessment of a situation or event are its novelty, its predictability, and event uncertainty. Also important are time factors, such as the imminence, the duration, and the temporal uncertainty of the stressor. Additionally, primary appraisal is affected by the ambiguity of the stressor and by the timing of stressful events in our life cycle.

Generally, the more imminent a stressful event, the more urgent and intense our process of primary appraisal will be, as for example in deciding whether or not to step out of the path of an oncoming truck. The less imminent an event, the appraisal process becomes more deliberate and thus more complex, as in deciding whether to take a new job. Ambiguity is unfortunately a salient characteristic of many of today’s stressors. Greater ambiguity signifies that more factors can shape the meaning of the situation, and vice versa.

The timing of stressful events as they happen throughout our life cycle can also affect the quality of our appraisal. Many life events, such as the death of a child, are more significant and turn into crises because they occur "off time." Off time events are more threatening because they are often completely unexpected and therefore pose a challenge for which no preparation or anticipatory coping was possible.

Secondary Appraisal: Can I Handle It?

BearAttackOur individual assessment of a situation leads to an appraisal of our possible responses. When our vital interests appear to be at stake, secondary appraisal takes front and center and we can become literally and figuratively frozen in place, as we feel the enormous pressure of producing the right response.

Individual temperament, upbringing, personality, life experiences, and prior traumas play a leading role in determining the quality of our secondary appraisal.

A stress-prone individual is primed to make extreme, one-sided, absolute, and global judgments. Because the appraisals tend to be extreme and one-sided, the behavioral responses also tend to be extreme. A hostility-prone individual may be primed to react to a relatively minor slight by another as if it were a criminal offense and, consequently, will be inclined to attack the other verbally or physically. A person who is susceptible to fear reactions may interpret an unfamiliar noise as a gunshot or the start of an earthquake and will have an unstoppable urge to escape. A depression-prone individual may hear an otherwise humorous comment as a rejection and will want to withdraw.

In the primitive world of an instinctual stress reaction, the complexity, variability, and diversity of human experiences are lost and quickly reduced to a few crude categories. It is do or die, eat or be eaten, a survival of the quickest and strongest. In a more mature world of cognition, stimuli are analyzed along many dimensions or qualities, appraisals are quantitative rather than categorical, and are relativistic rather than absolutistic. When it comes to stressors, what you see can be just exactly what you get.

Beyond Reaction: An Intelligent Response to Stressors

aaAltdorfer_SusannaElternA stress reaction that gets “stuck” into alarm mode and never progresses toward a resolution of the stressor can develop into chronic stress or depression. The latter can be conceptualized as turning inward, shutting off the world and avoiding all but the most necessary contact with the stressor. It is a rather primitive and ultimately ineffective way of coping with stressful events and situations (for better ways of defending against stress see this post), but it is undeniable that it works at reducing the level of incoming inputs and the effort required to respond. When stress causes anxiety, what follows is a semi-permanent state of arousal (which can have dangerous health consequences). When the response is depression, what follows is a significant reduction in functioning—to the extent that the person is not anxious but apathetic, withdrawn, and unresponsive even to positive stimulation.

The Coping with Stressors Inventory

Adapted from the Coping Styles Questionnaire (CSQ) by Roger, Jarvis, & Najarian, (1993), this is a simple way to determine our instinctive and preferred ways of managing stressors as they appear in our lives. These are ways that are characteristic of our behavior and are most likely to be used under conditions of severe stress.

Instructions: Mark as many as apply, but make sure to choose only the ones that you are most likely to use or have definitely used in coping with severe stressors.

When I am confronted with a severe or continuing stressor:

1. I ignore my own needs and just work harder and faster.
2. I seek out friends for conversation and support.
3. I eat more than usual.
4. I engage in some type of physical exercise.
5. I get irritable and take it out on those around me.
6. I take a little time to relax, breathe, and unwind.
7. I smoke a cigarette or drink a caffeinated beverage.
8. I confront my source of stress and work to change it.
9. I withdraw emotionally and just go through the motions of my day.
10. I change my outlook on the problem and put it in a better perspective.
11. I sleep more than I really need to.
12. I take some time off and get away from my working life.
13. I go out shopping and buy something to make myself feel good.
14. I joke with my friends and use humor to take the edge off.
15. I drink more alcohol than usual.
16. I get involved in a hobby or interest that helps me unwind and enjoy myself.
17. I take medicine to help me relax or sleep better.
18. I maintain a healthy diet.
19. I just ignore the problem and hope it will go away.
20. I pray, meditate, or enhance my spiritual life.
21. I worry about the problem and am afraid to do something about it.
22. I try to focus on the things I can control and accept the things I can’t.

Results Evaluation: Even-numbered ways of coping are more constructive, while the odd-numbered ones are less constructive tactics for coping with severe or continuing stressors. Checking more even-numbered items indicates a better approach to stressors that takes into account the need for self-care, emphasizes the seeking of support, and confronts the stressor in effective ways. If more odd-numbered items are checked, this may indicate an attempt to cope with stressors by avoidance, smothering the stress reaction with chemical means, and generally retreating into tactics that may temporarily reduce the symptoms of stress but fail to address the causes.

A Woman’s Stress Relief: Tend-and-befriend

ElGreco on Stresshacker.com Reaching out vs. retreating appears to be what distinguishes the instinctual reaction to stress between men and women. For women, the choice between fight or flight in the presence of a stressor applies less frequently than tend-and-befriend.

Whereas the typical male is more likely to narrow his response to stress down to a decision whether to fight the stressor directly and aggressively or retreat from it by way of an emotional withdrawal, most women choose to turn to family and friends by tending to or cultivating connections. Forming a network of support appears to be an innate characteristic of females also among primates, intended as a form of protection for themselves and their offspring. Clearly, the assumption is that there is more safety in numbers than in trying to make it alone in potentially dangerous situations.

Most women naturally construct a more intimate and complex social network than men do, and when they are stressed, in danger, or in times of change, they can turn to this network for support. Thus, they are more likely to seek out the company of other women and less likely to flee the stressor by withdrawing or isolating or to fight it directly and single-handedly, as most men appear to do.

This natural response to the stress reaction, moderated by a support system such as tend-and-befriend, might help explain why women live an average of five years longer than men. Men are also capable of creating complex social networks (now enormously facilitated by technological connectivity), but male-created social networks may lack the necessary level of intimacy or remain underutilized as a coping mechanism.

The Science Behind Tend-and-befriend

Research being conducted at UCLA under a grant by the National Science Foundation on Biopsychosocial Bases of Social Responses to Threat indicates that, in times of danger, most people seek positive social relationships that may provide safety for themselves and their offspring.  This and prior research by Dr. Shelley Taylor at UCLA’s Social Neurosciences Lab suggests that the hormone oxytocin and other opioid peptides produced in the body stimulate these responses, most especially in women. Oxytocin in particular appears to function as a social thermostat that monitors the availability of social resources and prompts the seeking of additional connections when needed.

Hunger, Food Insecurity or Stress?

Is hunger an “alarming” and “dramatic” problem in the United States today? Widespread famine is the impression one might get from headlines in the New York Times (“Hunger in the US at a 14-year high”), USA Today (“1 in 6 went hungry in America in 2008”), and The Washington Post (“America’s economic pain brings hunger pangs”).  In fact, a closer reading indicates not so much a decrease in food availability (which is reported to be at or near historic highs), as much as a decrease in food security. The reason for the insecurity (“Will I have enough food for me and my family?”) has been linked to the current and persistent economic downturn.

maslows-hierarchy-of-needs1Since time immemorial food insecurity has been and continues to be one of the most important stressors of the human race. The innate and genetically programmed need to eat enough food is the primary driving force of human activity. Food is at the basis of the pyramid of needs (Maslow,1943), along with water, warmth, clothing, shelter and rest. It supersedes all other needs, including safety, relationships, self-esteem, and creativity. Which means that, for food, humans will take the greatest risks, go to war with each other, stoop to begging and stealing, and revert into pure hunters and scavengers. Such is the power of the food insecurity drive.

Too Little or Too Much

Depending on type and duration, stress can either increase or decrease food intake. Mental disorders such as depression and anorexia nervosa trigger changes in food intake that are activated by the stress response. The psychological alteration in perceived body image is a factor not only in anorexia but also in obesity; both conditions are associated with a variety of psychological stressors, primarily interpersonal in nature.

When stressed, 70% of individuals experience mild to severe anorexia, whereas 30% tend to overeat. For stressed overeaters, chewing appears to be as important as the actual type, quality or quantity or food. In other words, chewing is reported to be the stress response, rather than the food itself. When the stressor is boredom, overeating appears to be the most common behavior.

Well, I think probably the main reason people overeat is stress.
–Jenny Craig

Here’s a brief technical explanation of how stress influences the brain’s perceptions and contributes to the formation of the food insecurity we often mistake for real hunger.

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Why Can’t I Just Fall Asleep!

Aaah, to sleep. Peacefully. Like a baby, a puppy, a kitty… Is that possible anymore? I haven’t slept well in so long. Every night is a struggle. I futz and futz and go to bed later and later—it doesn’t do the trick. Tell me doc, what do I gotta do?

Villefrance at Stresshacker.com Sleep deprivation is literally a form of torture, and a very effective one at that. You don’t have to be a fiendish Capulet spy to find out how true that can be. US statistics from the Department of Transportation estimate that 20% of drivers doze off regularly at the wheel, while the National Highway Traffic Safety Administration estimates conservatively that, during an average year, “drowsy driving” causes 100,000 automobile wrecks, 71,000 injuries and 1,550 fatalities. These staggering stats are supplemented by data from the US military, children studies, surveys of truck drivers, shift workers, couples, medical students—all pointing to one simple fact: we can’t sleep. Let’s see what is happening, why, and look at some possible remedies.

What’s Happening to Sleep?

Sleep is under attack from many sources. First and foremost, especially in the westerly and northerly parts of the planet, our schedules simply allow much less time for sleep. While this may seem like a no-brainer and suggest that there is a simple remedy (just allocate more time to sleep!), the problem of sleep scheduling is actually very complex and with no easy solution. The reason for this is below the surface and can be uncovered only by identifying that our fundamental belief about sleep has changed. To put it simply, many of us no longer believe in the necessity of sleep, while continuing to proclaim its virtues and benefits, at least out loud. Secretly, don’t we wish we could simply do away with sleep altogether?

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eClass 2: Coping and Risk Factors in Stress Responses

Lion-Frieze-from-the-Palace-of-Darius-I-mid Coping is positive response outcome expectancies. This means that the individual expects that he or she will be able to handle the situation with a positive result. In these situations, there is a low level of subjective health complaints and low levels of psychophysiological, psycho endocrine, and psycho immune arousal[i].

Coping can be divided into two general categories:

  • Problem-focused coping: those strategies aimed at doing something to solve the problem.
  • Emotion-focused coping: its goal is emotion-regulation.
Helplessness and Hopelessness

When it is impossible for the individual to establish coping, other expectancies may develop. When the individual learns that there are no relationships between anything the individual can do and the outcome, we refer to this as helplessness. Overmier & Seligman found that dogs with previous experience with inescapable shocks did not learn avoidance tasks[ii]. They found that this state of “helplessness” generalized to situations where control is possible. Helplessness occurs when the perceived probability of avoiding the aversive stimulus with a response is the same as for no response. In other words, the response is without any perceived consequence for the occurrence of the aversive event. The organism has no control. This expectancy has been accepted as a model for anxiety and depression[iii].

Hopelessness is even worse. This term is used for an acquired expectancy that most or all responses lead to negative results. Hopelessness is more directly opposite of coping than helplessness, since it is negative response outcome expectancy. There is control, responses have effects, but they are all negative. The negative outcome is his or her fault since the individual has control. This introduces the element of guilt, which may make hopelessness an even better model for depression than helplessness.

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