Wednesday, October 16, 2013

Acute, Chronic, and Distant Stress

Acute, Chronic, and Distant Stress
Acute stress is brief, temporary, and immediate, and although can vary in intensity from minor to severe, the duration of this type of stress is limited and can ordinarily be mediated by removing oneself from the situation, or changing one's behavior (Dallman & Hellhammer, 2011). An example of acute stress is suddenly learning that one must present information for a meeting at work.

Chronic stress, on the other hand, cannot be easily mediated or resolved by a change in behavior or escaping from a situation. Chronic stress is ongoing and sustained over a longer period or may be more intense than other types of stress (Dallman & Hellhammer, 2011). An example of chronic stress is caring for a partner with cancer for several years. An individual cannot escape from the situation, nor can changing one's behavior resolve the challenge.

Distant stress is type of chronic stress related to discrete circumstances that took place in the past, but the effects of which continue to have negative effects on the individual and the immune system because of thought processes and emotions associated with the stressful experience (Dhabhar, 2009). An example of this type of stress is child abuse. Distant stressors can lead to post traumatic stress (Laureate Education, Inc., n.d.). Avison & Turner (1988) believed stress arises out of two distinct experiences, the occurrence of discrete events and problems that are continuous or chronic. Further, the two can compound the effects of the other . Distant event stressors are discrete, in that they happen over a period that may be limited, although the effects of the stress may continue for longer.

Physiological Differences
Physiological differences between acute and chronic stress (including distant stress) is that acute stress enhances immunity while chronic stress suppresses it by altering glucocorticoid levels and relocating blood leukocytes (Dhabhar & McEwen, 1997; Dhabhar, 2009). As a result of discovering the bidirectional immune response to the different forms of stress, Dhabhar and Mcewen (1997) suggested the movement of lymphocytes in the body may serve to mediate both types of stress.

In a response to acute stress, the body releases stress hormones from the adrenal glands (Dallman & Hellhammer, 2011). The body is provoked into a fight or flight response, the heart rate increases and other bodily functions slow to preserve energy needed to respond to the stressor (Dhabhar, 2011). When the stressor is no longer eminent, the body and brain return to their natural states. In chronic stress (including distant stress), a part of the brain is activated and the adrenal cortex initiates the release of cortisol (the HPA Axis). Additionally, because chronic stress is sustained over a longer period than acute stress, the adrenal response continues and the body remains in a sustained reactive state (Dallman & Hellhammer, 2011). A sustained increase of cortisol causes an increase in blood sugar levels which suppress the immune system and promotes the storage of body fat among other deleterious health effects (Torres & Nowson, 2007).

Managing Various Types of Stress

Managing acute stress may be as simple as applying problem-solving to the challenge (Marks et al., 2011). In my example above of experiencing stress as a result of being given an inadequate amount of time to create a presentation for work, by taking the steps to initiate the project and managing the time available to accomplish the task may help mitigate the stress associated with the challenging undertaking. For example, the mediation of stress could be accomplished by taking a few hours and working on the presentation, in effect, mediating the stress. For some types of acute stress, a problem focused solution, such as problem solving can have a mediating effect on acute stress (Marks, Murray, Evans, & Estacio, 2011). Problem-focused coping lowers cortisol levels and helps the body recover from stress (Carver, 2011).

Chronic stress, on the contrary may not be so easily managed because one of the characteristics of this type of stress is that it is, by human standards, unmanageable, and problem-solving skills may not readily affect this type of stress (Dallman & Hellhammer, 2011). Hart (2009) found individuals with chronic stress from disease benefitted from stress management plans that helped the individuals gain a sense of personal control and the ability to manage their circumstances. Considering this, stress management might consist of gaining knowledge about the disease and treatment options as well as cognitive behavioral techniques such as guided imagery and meditation (Parker et al., 2009). In addition, Carver (2011) claimed the ability to express one's emotions seemed to strengthen the immune system.

Distant stress is chronic, in the sense that it can affect an individual over a long period (Laureate Education, Inc., 2012). Effective coping strategies for distant stress include emotion-focused coping, which can be a salient strategy when an individual attempts to manage self failures. Problem solving can prove counterproductive, especially when distant stress develops from a situation from the past that cannot be resolved or changed (Lilly & Graham-Bermann, 2010). Emotion-focused coping can be effective when the perception or the reaction to the trauma can be altered (Laureate Education, Inc., 2012). In addition, biology-focused coping strategies that use relaxation techniques such as meditation or guided imagery may effectively influence the physiological stress response (Laureate Education, Inc., 2012). Distant stress plays an important role in an individual’s overall burden of stress because it can affect the way an individual copes with daily and other chronic stressors (Avison & Turner, 1988). Women are more prone to the effects of distant stress than are men.

Avison, W. R., & Turner, R. (1988). Stressful Life Events and Depressive Symptoms: Disaggregating the Effects of Acute Stressors and Chronic Strains. Journal Of Health & Social Behavior, 29(3), 253-264.

Carver, C. S. (2011). Coping. In R. J. Contrada & A. Baum (Eds.), The handbook of stress science: Biology, psychology, and health (pp. 221–229). New York, NY: Springer Publishing Company.

Dallman, M. F., & Hellhammer, D. (2011). Regulation of the hypothalamo-pituitary-adrenal axis, chronic stress, and energy: The role of brain networks. In R. J. Contrada & A. Baum (Eds.), The handbook of stress science: Biology, psychology, and health (pp. 11–36). New York, NY: Springer Publishing Company.

Dhabhar, F. & Mcewen, B. (1997). Acute Stress Enhances while Chronic Stress Suppresses Cell-Mediated Immunity in Vivo: A Potential Role for Leukocyte Trafficking. [Abstract]. Brain, Behavior, and Immunity, 11(4), 286-306. doi: 10.1006/brbi.1997.0508

Hart, J. (2009). Stress management and chronic disease. Alternative & Complementary Therapies, 15(3), 109-112.

Laureate Education, Inc. (2012). The Focus of Coping. [Handout]. Baltimore: Author.

Lilly, M., & Graham-Bermann, S. (2010). Intimate partner violence and PTSD: the moderating role of emotion-focused coping. Violence & Victims, 25(5), 604-616. doi:10.1891/0886-6708.25.5.604

Marks, D. F., Murray, M., Evans, B., & Estacio, E. V. (2011). Health Psychology: Theory, Research, and Practice (3rd ed.). London: Sage.

Torres, S. J., & Nowson, C. A., 2007. Relationship between stress, eating behavior, and obesity. Nutrition, 23, 887-894.

Parker, P. A., Pettaway, C. A., Babaian, R. J., Pisters, L. L., Miles, B., Fortier, A., ... Cohen, L. (2009). The Effects of a Presurgical Stress Management Intervention for Men With Prostate Cancer Undergoing Radical Prostatectomy. Journal of Clinical Oncology, 27(19), 3169-3176. doi: 10.1200/JCO.2007.16.0036

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