Stress & illness

===Lecture Details===
Rob Selzer; Week 11 MED1011; Medicine of the Mind
===Lecture Content===
Stress can be an external stimulus, a reaction between an external event and an individuals reaction, and an internal physiological reaction. It is any outside force that has an effect on our body and mind. Stress can be good, too much is risky physically and psychologically. Life events theory measures the effect of various external events and relates them to health. Marriage is 50. Produces social readjustment rating scale. If over 300, 70% chance of ill health.
Primary appraisal of stress is how the subject appraises the event, secondary appraisal is how subject appraises their own resources and ability to cope, emotional element comes in later. Factors influencing appraisal are timing, predictability of the event, percieved control, amount of life change required. 
Acute stress can be cataclysmic (PTSD), routine (exams). Chronic can be work stress. Cataclysmic stress initially causes panic, anxiety, withdrawal, anger, disorientation, sleep disturbance, eating problems. Yerkes-Dodson law says a certain amount of stress is required for optimal performance.
Stress mainly involves ANS and neuro-endocrine system. If SNS activity is high for too long it suppresses immune function, leading to other health consequences. Neuro-endocrine produces hormones. Direct link between stress and illness is physiological changes in endocrine and immune system, indirect route is via response to stress, manner in which people respond to stress, and increased use of health resources.
Social support, coping, personality, loss of control, depression/anxiety are factors that affect stress response. Social support can be esteem, emotional, instrumental, information and network. Social support causes healthier lifestyle, decreased physiological reactivity, immunity and endocrine effects. 
Coping is done to reduce the impact of a percieved stressor. Can be adaptive or maladaptive. Adaptive can be problem focused, emotion focused, attentional or avoidant. Personality feeds into behaviour/thoughts/emotions which leads to stress and illness.
Type A personality is competitive, time urgent, impatient, achievement oriented, easily annoyed. Hostility has angry, negative worldview, is aggressive. Neuroticism has anxious thoughts, feelings and behaviours, has higher self-reported illnesses. Optimism has positive outlooks and expectations.
Locus of control is belief as to where responsibility or control lies for factors that affect ones life, can be internal or external.
===Readings===