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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10

Potential pathways for stress reactivity to psychosocial stressors. 11