Stress
High-Yield Summary
- Cognitive appraisal (Richard Lazarus): primary appraisal classifies a situation as irrelevant, benign-positive, or stressful; secondary appraisal (only if threat) weighs harm, threat, challenge; reappraisal applies to ongoing/evolving situations.
- Stressors span environmental, daily-event, workplace/academic, social-expectation, and chemical/biological categories. Distress = unpleasant stressors; eustress = positive stressors (still require adaptation, still produce a stress response).
- Social Readjustment Scale (Holmes & Rahe): measures stress in 'life change units,' assigned to both positive and negative life events.
- 4 psychological stressors: pressure (external demand/urgency), control (lack of control increases stress), predictability (lack of routine increases stress), frustration/conflict.
- Conflict types: approach-approach (2 desirable options), avoidance-avoidance (2 undesirable options), approach-avoidance (1 option, both positive and negative elements).
- Immediate response = sympathetic NS ('fight or flight'). Longer-term = General Adaptation Syndrome (Hans Selye): alarm → resistance → exhaustion.
- Alarm stage: hypothalamus → CRH → pituitary → ACTH → adrenal cortex → cortisol (blood sugar); simultaneously hypothalamus → adrenal medulla → epinephrine/norepinephrine (sympathetic activation). Two pathways, same stage.
- Coping (Lazarus & Folkman): problem-focused (directly address the stressor — dominates when controllable) vs. emotion-focused (change feelings about it — dominates when uncontrollable). Plus exercise (endorphins) and relaxation techniques.
Key Terms
- Primary appraisal
- Initial evaluation of the environment: irrelevant, benign-positive, or stressful.
- Secondary appraisal
- Evaluates ability to cope with a perceived threat: harm, threat, and challenge.
- Eustress
- Stress response from a positive event that still requires adaptation (e.g., graduating).
- General Adaptation Syndrome
- Hans Selye's 3-stage physiological stress response: alarm, resistance, exhaustion.
- Problem-focused coping
- Coping strategy that directly addresses/overcomes the stressor.
- Emotion-focused coping
- Coping strategy that changes one's feelings about the stressor rather than the stressor itself.
The Three Conflict Types
| Type | Structure |
|---|---|
| Approach-approach | Two desirable options — e.g., torn between two job offers |
| Avoidance-avoidance | Two undesirable options — e.g., stuck choosing between two unpleasant chores |
| Approach-avoidance | One option, mixed pros and cons — e.g., a promotion with more money but more responsibility |
General Adaptation Syndrome (Hans Selye)
- 1Alarm: sympathetic NS activates. Hypothalamus → CRH → pituitary → ACTH → adrenal cortex → cortisol (sustains blood sugar). Hypothalamus also directly activates adrenal medulla → epinephrine/norepinephrine.
- 2Resistance: continuous hormone release keeps the sympathetic NS engaged to keep fighting the stressor.
- 3Exhaustion: body can no longer sustain the elevated response — increased illness susceptibility, organ systems can deteriorate.
Common MCAT Trap
- Primary appraisal (is this a threat?) always precedes secondary appraisal (can I cope?) — a passage testing harm/threat/challenge judgment is testing secondary appraisal, not primary.
- Eustress is still stress — a positive life event (marriage, promotion) still produces a stress response since it requires adaptation.
- Elevated cortisol and elevated epinephrine both belong to the same alarm stage (two separate adrenal pathways), not two different GAS stages.
- Identify conflict type by counting options and their valence: 2 desirable = approach-approach; 2 undesirable = avoidance-avoidance; 1 mixed option = approach-avoidance.
Quick Recall
A person evaluates whether they have the resources to handle a newly identified threat. Primary or secondary appraisal?
Someone must choose between two job offers, both appealing. Which conflict type?
Which hormone does the hypothalamus-CRH-pituitary-ACTH cascade ultimately produce, and from where?
A stressor feels uncontrollable. Which coping strategy tends to predominate?
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