Behavioral Dentistry Second Year

1. 03/17/14 Dr. Mohamed Salah Khalil 1
Mohamed Salah Khalil Preparation by : Dr.
Presentation by : Dr. Abdelaziz Elfaki

2. STRESS, HEALTH & ILLNESSWhat is stress?

Definition: any circumstances that threaten or are perceived
to threaten one's well-being and thereby tax one's coping
abilities
Stress is generally known as pattern of disruptive
physiological and psychological reaction to events that
threaten the ability to cope.
It has become an important topic because it is clear
that the pattern of disease, especially cardiovascular
disease, and other diseases such as gastrointestinal,
skin, immune system, and respiratory diseases cannot
be explained simply by physiological factors alone.
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3. Sources of stress
Internal- Originate from within a person. Cancer,
Depression
External- From outside a person, including
Situational stressors Marriage or divorce, Birth, death,
illness.
Developmental stressors (Erikson(
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4. TYPES OF STRESS
Negative stress
Positive stress
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5. THE RELATIONSHIP BETWEEN STRESS AND
LEARNING/PERFORMANCE
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6. SYMPTOMS OF STRESS
Physical symptoms
Mental symptoms
Behavioural symptoms
Emotional symptoms
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7. Approaches to The Study of Stress
There are many approaches to the study of stress.
Generally researchers have conceptualized stress in three
Ways.
In one approach, stress is seen as a stimulus, and studies
focus on the impact of stressors (events(.
Another approach treats stress as a response and
examines the strains that the stressors produce (e.g. the
the physiological consequences(.
The third approach views stress as a process that involves
continuous interaction and adjustment- or transaction-
between the person and the environment.
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8. Three Views of Stress
Focus on the environment
Focus on the RESPONSE: Reaction to stress: stress
as a response (distress) (F/F(
Focus On The Interaction Processes: Cognitive
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9. A General Definition
These viewpoints have led to the definition of stress
as the condition that results when a
person/environment transactions leads the individual
to perceive a discrepancy between the demands of the
situation and the resources of the person’s biological,
psychological, and social systems.
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10. Models of stress:
(A) The Stimulus-Based Model of Stress
)1(Holmes and Rahes advanced this theory. It proposed that life
changes (LIFE EVENTS) or (STRESSORS), either positive or negative,
are stressors that tax the adaptation capacity of an individual, causing
physiological and psychological strains that lead to health problems.
)2(They developed the Social Readjustment Rating Scale (SRRS).
They hypothesized that people with higher scores in the SRRS, -that is
major life changes-are more likely to experience physical or mental
illness.
There is some supporting evidence to this, but the correlation is fairly
low. Moreover, this theory was criticized as ignoring the cognitive
aspects of the effects of stress. In other words, it does not account for
the individual appraisal of the meaning of various life events.
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11. Models of stress
(B)The Response-Based Model of Stress
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 (1) This model emphasizes the common physiological
consequences of stressful situation. It is represented in the
well-known theory of Hans Selye. It is similar to the “Fight or
Flight” response, which occurs in situation that perceived as
very threatening.
 (2) The response is a physiological one in which
arousal of the sympathetic nervous system results
in many physiological and somatic changes and
finally disruption of homeostasis.

12. Models of stress
(B)The Response-Based Model of Stress
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 (3) Selye developed this idea into a
theoretical model of stress called the
General Adaptation Syndrome theory. He
defined stress as (a non-specific response
and demand made upon the body). He
proposed that different types of stimuli
would result in similar physiological
responses.

13. General Adaptation Syndrome Theory
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 (3) The GAS theory has three phases, which is
based on the hypothesis that the body has
normal level of resistance to stress.
 (a) Phase (I): Initial alarm resulting in a slight
reduction in the resistance to stress, (The
Shock stage). Then reverts to the normal level
in the (Counter-shock Stage,).

14. General Adaptation Syndrome Theory
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 Phase (II): RESISTANCE remains high until
the final stage of exhaustion, where
resistance rapidly drops
 Phase (III): which starts with exhaustion
and described as Collapse, where disease
occurs.

15. Stage 1
Alarm Reaction
Stage 2
Resistance
Stage 3
Exhaustion
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Notice how the
curve first
goes down
before
ascending
upward?
This is where the curve
Peaks if adaptation
Occurs normal

16. ALARM RESPONSE
This is the “ Fight or Flight” response that prepares
the body for immediate action.
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17. The GAS – Stage Two - RESISTANCE
Not as intense as the Alarm Stage,
but bodily levels of hormonal
secretion are still above normal
Occurs during the stress response
and if stressor is removed helps
return the body to normal levels.
ADAPTATION PHASE
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18. The GAS – Stage 3 - EXHAUSTION
Bodily systems have been
depleted due to prolonged
resistance
Can bring about the threat of
onset of “diseases of
adaptation”
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19. EXHAUSTION
In chronic stress situations, sufferers enter the
exhaustion phase: emotional, physical and mental
resources suffer heavily, the body experiences ‘
adrenal exhaustion’ leading to decreased stress
tolerance, progressive mental and physical
exhaustion, illness and collapse.
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20. Models of stress: The Transactional Model of
Stress
)l) Lazarus& Folkman_(1 980) proposed the third
approach. They criticized the first and the second
models mentioned above as treating people as
machines. They believe that people have the
capacity to think, evaluate, and then react.
Thinking can make stress either better or
worse.
)2(Lazarus developed an interaction theory,
which emphasize the role of cognition. This
theory proposed that people engage in TWO-
STAGE PROCESS of appraisal:
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21. The Transactional Model of Stress
)I) A Primary Appraisal Process: Determine whether
the event represents a threat to the individual. This
results in three outcomes:
1.Events regarded as irrelevant.
2.Events regarded as positive to well being.
3.Events regarded as negative to well being. This
negative appraisal leads to:
)II) A Secondary Appraisal Process: Here the
individuals assess their COPING RESOURCES. These
resources include environmental factors, social support
or help, knowledge, and skills to reduce this threat.
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22. Appraisal of Stress
Some people are more prone to feeling stress than
others, irrespective of event
􀂃 Appraisals of potentially stressful events are
influenced by two factors:
􀂃 (1) the controllability of events
􀂃 (2) the predictability of events
􀂃 Events are more stressful when they are
uncontrollable and unpredictable
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23. Effects of Coping Resources and Strategies
When coping outcomes are positive such as accepting
the death of a relative or passing an exam, a
psychological adjustment or adaptation takes place.
However, unsuccessful coping leads anxiety and
depression or exacerbate other physical and mental
disease.
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24. Effects of Coping Resources and Strategies
Maladjustment or maladaptation is more frequently
associated situation when Primary or Secondary
Appraisals fail to identify an appropriate course of action.
These may include:
Uncertainty: “I don’t know what is going on” Primary
Appraisal.
Unpredictability: “I don’t know what is going to happen
“Primary Appraisal.~
Uncontrollability: “I don’t Know what to do about it”
Secondary Appraisal.
OR “There is nothing that I can do” Secondary
Appraisal“.
OR There is nothing anyone can do” Secondary
Appraisal.
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