BA232 FACULTY OF BUSINESS & MANAGEMENT

(ELC501) ENGLISH FOR CRITICAL ACADEMIC READING

PORTFOLIO FOR FORUM DISCUSSION

“DOES STRESS IMPACT TO HEALTH?”

PREPARED BY:

STUDENT NAME STUDENT ID

MUHAMAD ATA'ILLAH BIN AMRI 2020643034

WAN MOHD HAFIZ BIN WAN WAN RAMLI 2020262216

MUHAMAD ARIS FIRDAUS BIN MOHD YUSOFF 2020644756

ABDUL AZIZ PUTERA BIN OTHMAN 2019160777

NORASMIZA KAMARULZAMAN 2020642934

PREPARED FOR:
MR DR ELIYAS BIN SULAIMAN MOHANDAS

DATE OF SUBMISSION:
31st JANUARY 2022
 ACKNOWLEDGEMENT

With a breath of fresh air and bismillahirrahmanirrahim, We would first like to extend our

greatest gratitude towards Allah SWT the Almighty for giving us the patience and the clear mental

presence that enabled us to conduct this task successfully.

In performing our assignment, we had to take the help and guideline of some respected

persons, who deserve our greatest gratitude. The completion of this assignment gives us much

pleasure. We would like to show our gratitude to Mr Dr Eliyas bin Sulaiman Mohandas, lecturer

for ELC501 English For Critical Academic Reading, Universiti Teknologi Mara for giving us a good

guideline for assignment throughout numerous consultations. We would also like to expand our

deepest gratitude to all those who have directly and indirectly guided us in writing this assignment.

Besides that, we would like to thank all our beloved friends that give us encouragement,

support and ideas in the process of completing this assignment. We thank all the people for their

help directly and indirectly to complete our assignment.

 PREPARATION OUTLINE
ELC501 PREPARATION OUTLINE FOR
FORUM DISCUSSION

1. Background

Title : DOES STRESS IMPACT TO HEALTH?

Moderator : Wan Mohd Hafiz, Moderator

Panel Members :
i. Dr. Norasmiza, Mass Comm Lecturer, Universiti Kebangsaan Malaysia
ii. Mr. Aris Firdaus, Social Media Analyst, NGO
iii. Dr. Muhammad Ataillah, Psychologist and Therapist, Hospital Kuala Lumpur
iv. Mr Aziz Putera. Athlete, Model & Activist

2. Timeframe for discussion

Date Time Remarks

18 January 2023 5.00pm - 7.00pm Choosing Topic for Forum

19 January 2023 1.00pm - 10.00pm Sharing the article and ideas

24 January 2023 1.00pm - 3.00pm Delegation of part

counter-argument for
each person.

25 January 2023 10.00am - 10.00pm Discussion on the outline

for the forum.

26 January 2023 7.00pm - 10.00pm Discussion on the outline

for the forum.

27 January 2023 11.00am - 11.00pm Practice Forum

28 January 2023 11.00am - 11.00pm Practice Forum

29 January 2023 2.00pm - 11.00pm - Final submission

for the outline by
the team members
- Submission of the
outline to lecturer
3. Outline for Discussion

Issue: IMPACT OF STRESS IN HEALTH

CLAIM PREMISES COUNTER-ARGUMENT

Panel 1 : Dr. Norasmiza Panel 2 : Mr. Aris Firdaus

Impact of Stress on Your According to Medically reviewed by Stress is something that we

Body Timothy J. Legg, PhD, Chronic cannot avoid BUT something
stress can cause a variety of that we can manage.
symptoms and affect your overall
well-being. Symptoms of chronic According to the National
stress include: Institute of Arthritis and
● irritability Musculoskeletal and Skin
● anxiety Diseases, Dec 2020,
Exercising, getting enough
● depression rest, and eating a balanced
● headaches diet will help to keep your
● insomnia muscles healthy for life.

Healthy muscles let you move

a. Central nervous and
freely and keep your body
endocrine systems.
strong.
Chronic stress is also a factor in
behaviors such as overeating or The activities that make your
not eating enough, alcohol or skeletal muscles strong will
drug abuse, and social also help to keep your heart
withdrawal. muscle strong to pump blood
to your whole body.
b. Respiratory and
cardiovascular systems Stress and overthinking leads
Stress hormones affect your to feelings of insecurity and
respiratory and cardiovascular makes you not in control of
systems. During the stress your life schedule, especially
response, you breathe faster in your diet.
an effort to quickly distribute
oxygen-rich blood to your body. Animal studies have found
As a result, frequent or chronic that deficiencies in zinc,
stress will make your heart work selenium, iron, copper, folic
too hard for too long. When your acid, and vitamins A, B6, C, D,
blood pressure rises, so do your and E can alter immune
risks for having a stroke or heart responses.
attack.
Diet plays a large role in
c. Digestive system determining what kinds of
Under stress, your liver microbes live in our intestines.
produces extra blood sugar
(glucose) to give you a boost of Certain helpful microbes
energy. If you’re under chronic break down fibers into short
stress, your body may not be chain fatty acids, which have
able to keep up with this extra been shown to stimulate
glucose surge. Chronic stress immune cell activity.
may increase your risk of
developing type 2 diabetes.
Stress can also affect the way Probiotic foods contain live
food moves through your body, helpful bacteria, and prebiotic
leading to diarrhea or foods contain fiber and
constipation. You might also oligosaccharides that feed
experience nausea, vomiting,
 or a stomachache. and maintain healthy colonies
of those bacteria.
d. Muscular system
Your muscles tense up to
protect themselves from injury
when you’re stressed. Tight
muscles cause headaches,
back and shoulder pain, and
body aches.

e. Sexuality and reproductive

system
Stress is exhausting for both
the body and mind. For man’s
testosterone levels can begin to
drop. Chronic stress may also
increase risk of infection for
male reproductive organs like
the prostate and testes.
For women, stress can affect
the menstrual cycle. It can lead
to irregular, heavier, or more
painful periods. Chronic stress
can also magnify the physical
symptoms of menopause.

f. Immune system
Stress stimulates the immune
system, stress hormones will
weaken your immune system
and reduce your body’s
response to foreign invaders.
People under chronic stress are
more susceptible to viral
illnesses like the flu and the
common cold, as well as other
infections. Stress can also
increase the time it takes you to
recover from an illness or injury.

Moderator : Wan Mohd Panel 3 : Dr. Muhammad

Hafiz a. Stressors During Childhood Ataillah

The most widely studied stressors Stress can be managed. Our

in children and adolescents are modern lives naturally include
exposure to violence, abuse stress. Monthly bills arrive,
(sexual, physical, emotional, or kids' activities last all year,
neglect), and divorce/marital and work never seems to
conflict calm down. It's inevitable to
(Cicchetti D. Child maltreatment. experience some stress, yet it
Annu. Rev. Clin. Psychol. 2005) can frequently be beneficial.
Which also drives you to meet
Childhood abuse is also associated your everyday obstacles and
with negative views toward learning accomplish your goals. That's
and poor school performance accurate. Good living requires
(Lowenthal 1998). healthy stress.
-Studies have also addressed the
psychological consequences of Health impact mostly from
exposure to war and terrorism other sources. We all deal
during childhood (Shaw 2003) with stress on a daily basis.
 But how do you handle stress
on a daily basis? Some
b. Stressors During Adulthood people find that the stresses
of life make them irritable,
A study of 13,006 patients in snappish, or unable to focus
Denmark, with first psychiatric on work. The slumber of
admissions diagnosed with others has been disturbed.
depression, found more recent Then there are individuals
divorces, unemployment, and who respond by consuming a
suicides by relatives compared with lot of junk food. No matter how
age- and gender-matched controls hectic your schedule, stress
(Kessing et al. 2003) can be controlled and
-The diagnosis of a major medical prevented from destroying
illness often has been considered a your life with good sports and
severe life stressor and often is neutral emotions.
accompanied by high rates of
depression (Cassem 1995). For According to Dr. Ressler, the
example, a meta-analysis found basic idea is that the brain is
that 24% of cancer patients are shunting its resources
diagnosed with major depression because it's in survival mode,
(McDaniel et al. 1995). not memory mode (Harvard
Health Publishing, 2021).

Stress helps you meet your

daily challenges and
motivates you to reach your
goals, ultimately making you a
smarter, happier and healthier
person. That’s right. Good
stress is vital for a healthy life.
(Summer Health, 2021)

Panel 4 : Mr Aziz Putera a. Athlete tend to get more

Stress and athlete stress

Stress is a factor of life that

affects everyone, but athletes
tend to suffer from it more than
non-athletes, due to the amount
they are required to balance,
between schoolwork, practices
and games, as well as family
pressures and everyday life
(Stress and Anxiety in Athletics
| the Sport Digest, n.d.).

As for me who is involve in

sports, sometimes I felt very
tired and stressful, in order to
get balancing life.

Typically, an athlete is
diagnosed with general stress
disorder, but there are more
specific stress disorders as
well. (Stress and Anxiety in
Athletics | the Sport Digest,
n.d.).
This happened to last few
months where I got diagnosed
with general stress disorder. In
which many things that makes
me feel very frustrated, angry,
or nervous.

To add, the stress that affects

me not only to my health but to
my memory and brain
functions, like mood and
anxiety, but also promotes
inflammation, which adversely
affects heart health. This can be
shown in Jill Goldstein
research, a professor of
psychiatry and medicine at
Harvard Medical School. Thus,
stress has been associated with
multiple chronic diseases of the
brain and heart.

b. Effect to the health of

young athlete

There are many health

problems related to high
levels of stress. These
include, but are not limited
to, irritable bowel
syndrome, diabetes, skin
disorders, such as hives,
ulcers, respiratory
conditions, and sexual
dysfunction.

These conditions do not

occur over night and tend to
occur over an extended
amount of time. Once an
athlete develops one of
these other conditions the
athletic trainer and health
care providers need to sit
down with the athlete and
try to figure out the cause of
the condition.

They need to keep in mind

that stress could be the
underlying cause and
suggest ways for the athlete
to help deal with their
stress. The athlete may
need to also adjust their
eating habits as well as
make other lifestyle
changes to help manage
their stress and health
problems (Stress and
Anxiety in Athletics | the
Sport Digest, n.d.).

Young athletes are quite

expose to the stress
because of the surrounding.
More and more mental
health issue to this youg
generation and no such
person want to help them to
reduce the stress.
REFERENCES

Schneiderman N, Ironson G, Siegel SD. Stress and health: psychological, behavioral, and biological
determinants. Annu Rev Clin Psychol. 200

How to tell if stress is affecting your sleep. Jon Johnson on September 5, 2018
Retrieved from https://www.medicalnewstoday.com/articles/322994

The Effects of Stress on Your Body, Medically reviewed by Timothy J. Legg, PhD, PsyD —
By Ann Pietrangelo — Updated on Mar 29, 2020

Healthy Muscles Matter: Ways to Care for the Muscular System

https://www.niams.nih.gov/health-topics/kids/healthy-
muscles#:~:text=Walking%2C%20jogging%2C%20lifting%20weights%2C,to%20work%20all%20yo
ur%20muscles.

Smart Ways to Keep Your Central Nervous System Healthy

https://www.lalpathlabs.com/blog/smart-ways-to-keep-your-central-nervous-system-healthy/

Caballero S, Pamer EG. Microbiota-mediated inflammation and antimicrobial defense in the intestine.
Annual review of immunology. 2015 Mar 21;33:227-56.

Guillin OM, Vindry C, Ohlmann T, Chavatte L. Selenium, selenoproteins and viral infection. Nutrients.
2019 Sep;11(9):2101.

Publishing, H. H. (2021, February 15). Protect your brain from stress. Harvard Health Publishing.
Retrieved January 29, 2023, from https://www.health.harvard.edu/mind-and-mood/protect-your-brain-
fromstress#:~:text=Stress%20affects%20not%20only%20memory,medicine%20at%20Harvard%20M
edical%20School.

Smith, M. W. (2021, August 20). How to manage stress. WebMd. Retrieved January 29, 2023, from
https://www.webmd.com/balance/guide/all-stressed-out.

Stress and Anxiety in Athletics | The Sport Digest. (n.d.).

http://thesportdigest.com/archive/article/stress-and-anxiety-athletics

Taylor, A. (2022, February 7). The effects of stress on athletic performance | Sidekick Blog. Sidekick
Blog | Unlocking Movement. https://blog.sidekicktool.com/the-effects-of-stress-on-athletic-
performance/World Health Organization. (n.d.). Stress. https://www.who.int/news-room/questions-
and-answers/item/stress
ARTICLE 1

The Effects of Stress on Your Body

Stress is a natural physical and mental reaction to life experiences. Everyone expresses stress from
time to time. Anything from everyday responsibilities like work and family to serious life events such
as a new diagnosis, war, or the death of a loved one can trigger stress. For immediate, short-term
situations, stress can be beneficial to your health. It can help you cope with potentially serious
situations. Your body responds to stress by releasing hormones that increase your heart and
breathing rates and ready your muscles to respond.

Yet if your stress response doesn’t stop firing, and these stress levels stay elevated far longer than is
necessary for survival, it can take a toll on your health. Chronic stress can cause a variety of
symptoms and affect your overall well-being. Symptoms of chronic stress include:

 irritability

 anxiety

 depression

 headaches

 insomnia

Central nervous and endocrine systems

Your central nervous system (CNS) is in charge of your “fight or flight” response. In your brain, the
hypothalamus gets the ball rolling, telling your adrenal glands to release the stress hormones
adrenaline and cortisol. These hormones rev up your heartbeat and send blood rushing to the areas
that need it most in an emergency, such as your muscles, heart, and other important organs.

When the perceived fear is gone, the hypothalamus should tell all systems to go back to normal. If
the CNS fails to return to normal, or if the stressor doesn’t go away, the response will continue.

Chronic stress is also a factor in behaviours such as overeating or not eating enough, alcohol or drug
abuse, and social withdrawal.
Respiratory and cardiovascular systems

Stress hormones affect your respiratory and cardiovascular systems. During the stress response,
you breathe faster in an effort to quickly distribute oxygen-rich blood to your body. If you already
have a breathing problem like asthma or emphysema, stress can make it even harder to breathe.

Under stress, your heart also pumps faster. Stress hormones cause your blood vessels to constrict
and divert more oxygen to your muscles so you’ll have more strength to take action. But this also
raises your blood pressure.

As a result, frequent or chronic stress will make your heart work too hard for too long. When your
blood pressure rises, so do your risks for having a stroke or heart attack.

Digestive system

Under stress, your liver produces extra blood sugar (glucose) to give you a boost of energy. If you’re
under chronic stress, your body may not be able to keep up with this extra glucose surge. Chronic
stress may increase your risk of developing type 2 diabetes.

The rush of hormones, rapid breathing, and increased heart rate can also upset your digestive
system. You’re more likely to have heartburn or acid reflux thanks to an increase in stomach acid.
Stress doesn’t cause ulcers (a bacterium called H. pylori often does), but it can increase your risk for
them and cause existing ulcers to act up.

Stress can also affect the way food moves through your body, leading to diarrhea or constipation.
You might also experience nausea, vomiting, or a stomachache.

Muscular system

Your muscles tense up to protect themselves from injury when you’re stressed. They tend to release
again once you relax, but if you’re constantly under stress, your muscles may not get the chance to
relax. Tight muscles cause headaches, back and shoulder pain, and body aches. Over time, this can
set off an unhealthy cycle as you stop exercising and turn to pain medication for relief.

Sexuality and reproductive system

Stress is exhausting for both the body and mind. It’s not unusual to lose your desire when you’re
under constant stress. While short-term stress may cause men to produce more of the male
hormone testosterone, this effect doesn’t last.
If stress continues for a long time, a man’s testosterone levels can begin to drop. This can interfere
with sperm production and cause erectile dysfunction or impotence. Chronic stress may also
increase risk of infection for male reproductive organs like the prostate and testes.

For women, stress can affect the menstrual cycle. It can lead to irregular, heavier, or more painful
periods. Chronic stress can also magnify the physical symptoms of menopause.

Immune system

Stress stimulates the immune system, which can be a plus for immediate situations. This stimulation
can help you avoid infections and heal wounds. But over time, stress hormones will weaken your
immune system and reduce your body’s response to foreign invaders. People under chronic stress
are more susceptible to viral illnesses like the flu and the common cold, as well as other infections.
Stress can also increase the time it takes you to recover from an illness or injury.

ARTICLE 2

Healthy muscles let you move freely and keep your body strong. They help you to enjoy playing sports,
dancing, walking the dog, swimming, and other fun activities. And they help you do those other (not so
fun) things that you have to do, like making the bed, vacuuming the carpet, or mowing the lawn.

Strong muscles also help to keep your joints in good shape. If the muscles around your knee, for
example, get weak, you may be more likely to injure that knee. Strong muscles also help you keep
your balance, so you are less likely to slip or fall.

And remember, the activities that make your skeletal muscles strong will also help to keep your heart
muscle strong! (National Institute of Arthritis and Musculoskeletal and Skin Diseases)
ARTICLE 3

A complex network of sensory nerves, the nervous system is one of the crucial parts of the human
body. It is responsible for reacting to both internal and external stimuli through a number of physical
actions and for carrying out many vital bodily functions as well. These typically include, taking care of
digestion, beating of the heart, responding to pain, regulating breathing, emotions, body temperature,
maintaining body’s posture and even strengthening the body to survive the day-to-day pressure and
enjoy a better quality of life.

Typically quoting, the central nervous system is able to perform such essential functions with the help
of nerves and cells that carry messages from the brain and spinal cord to the rest of the body and vice
versa. When the activities of these nerves and cells are disrupted, the central nervous system fails to
perform its basic functions. To avoid suffering from any CNS diseases and conditions, it is essential
that you adopt smart ways to keep it healthy and in shape.

Your nervous system demands and deserves as much attention as other parts of the human body. By
adhering to these above mentioned steps, you can easily maintain a healthy nervous system and even
steer away from a plethora of lifestyle as well as chronic diseases. (Team Dr Lal PathLabs)

ARTICLE 4

Stress. We all live with it each day. But how do you react to daily stress? For some people, life's
stressors cause them to become irritable, short-tempered, or unable to concentrate on tasks. Others
have interrupted sleep (trouble falling asleep or waking early in the morning with racing thoughts).
Then there are those who react by eating junk food -- and a lot of it! (Remember - desserts is stressed
spelled backward!) The good news: No matter how busy your schedule, it is possible to manage stress
and keep it from ruining your life.

Causes of Stress

Simply stated, stress describes the many demands and pressures that we all experience, to some
degree, each day. These demands are physical, mental, emotional, or even chemical in nature. The
word "stress" encompasses both the stressful situation, known as the stressor, and the symptoms
you experience under stress, your stress response.

The problem with stress is that it activates your sympathetic nervous system, stimulating the release
of stress hormones throughout your body. These hormones give you super energy and cause other
changes in the body such as the "fight or flight" response.
The "fight or flight" response makes your heart beat faster. You might feel very nervous, making it
difficult to breathe. Short term, the "fight or flight" response causes changes that allow you to handle
sudden stressful events. When you face fear -- or even recall a stressful or frightening event from the
past -- the resulting hormonal changes super-charge your body to a state of high arousal. This
prepares you for action.

But long-term stress can be particularly difficult. When stress hormones stay elevated over time, there
is a gradual and steady stream of harmful changes to the body. Long-term stress can suppress the
immune system, which may lead to the development of diseases.

Stress can be positive or negative, depending on the situation. Positive stressors (called eustress)
may include an upcoming wedding, the holidays, or pregnancy. On the other hand, negative stress
(called distress) results in the full-blown stress response. If continuous, negative stress can lead to
loss of productivity, health problems, and exhaustion. (WebMd, 2021)

ARTICLE 5

How to tell if stress is affecting your sleep

Stress often impacts sleep quality and duration. Stress and a lack of sleep can both have a severe
impact on physical and mental health. Experts recommend that people aim for 7–9 hours of sleep a
night, depending on their age and other factors.

According to the Centers for Disease Control and Prevention (CDC), 35.2 percent of adults in the
United States are getting less than 7 hours of sleep each night. This can lead to a sleep deficit that
results in lasting physical and mental health problems.

The exact role of sleep is not clear, but research has shown that it facilitates a wide range of bodily
processes. These include physical changes, such as muscle repair, and mental tasks, such as
concentration.

Not getting enough sleep can cause a negative mood, low energy, difficulty concentrating, and a
general inability to function as usual. Lack of sleep may have severe consequences in some
circumstances, such as if a person is driving or operating heavy machinery when tired. The occasional
night of poor sleep is unlikely to cause harm, but persistent sleep deprivation can increase the risk of
several chronic health conditions.

According to a report by the CDC, people who get less than 7 hours of sleep per night have an
increased risk of the following conditions:
  obesity
 heart disease
 diabetes
 stroke
 depression
 arthritis
 kidney disease

Although a range of factors can cause these conditions, sleep deprivation may contribute to their
development.

ARTICLE 6

Psychological Aspects Of Stress

Stressors During Childhood and Adolescence and Their Psychological Sequelae

The most widely studied stressors in children and adolescents are exposure to violence, abuse
(sexual, physical, emotional, or neglect), and divorce/marital conflict (see Cicchetti 2005). McMahon
et al. (2003) also provide an excellent review of the psychological consequences of such stressors.
Psychological effects of maltreatment/abuse include the dysregulation of affect, provocative
behaviors, the avoidance of intimacy, and disturbances in attachment (Haviland et al. 1995,
Lowenthal 1998). Survivors of childhood sexual abuse have higher levels of both general distress
and major psychological disturbances including personality disorders (Polusny & Follett 1995).
Childhood abuse is also associated with negative views toward learning and poor school
performance (Lowenthal 1998). Children of divorced parents have more reported antisocial behavior,
anxiety, and depression than their peers (Short 2002). Adult offspring of divorced parents report
more current life stress, family conflict, and lack of friend support compared with those whose parents
did not divorce (Short 2002). Exposure to nonresponsive environments has also been described as
a stressor leading to learned helplessness (Peterson & Seligman 1984).

Studies have also addressed the psychological consequences of exposure to war and terrorism
during childhood (Shaw 2003). A majority of children exposed to war experience significant
psychological morbidity, including both post-traumatic stress disorder (PTSD) and depressive
symptoms. For example, Nader et al. (1993) found that 70% of Kuwaiti children reported mild to
severe PTSD symptoms after the Gulf War. Some effects are long lasting: Macksound & Aber (1996)
found that 43% of Lebanese children continued to manifest post-traumatic stress symptoms 10 years
after exposure to war-related trauma.
Exposure to intense and chronic stressors during the developmental years has long-lasting
neurobiological effects and puts one at increased risk for anxiety and mood disorders, aggressive
dyscontrol problems, hypo-immune dysfunction, medical morbidity, structural changes in the CNS,
and early death (Shaw 2003).

Stressors During Adulthood and Their Psychological Sequelae

LIFE STRESS, ANXIETY, AND DEPRESSION It is well known that first depressive episodes often
develop following the occurrence of a major negative life event (Paykel 2001). Furthermore, there is
evidence that stressful life events are causal for the onset of depression (see Hammen 2005, Kendler
et al. 1999). A study of 13,006 patients in Denmark, with first psychiatric admissions diagnosed with
depression, found more recent divorces, unemployment, and suicides by relatives compared with
age- and gender-matched controls (Kessing et al. 2003). The diagnosis of a major medical illness
often has been considered a severe life stressor and often is accompanied by high rates of
depression (Cassem 1995). For example, a meta-analysis found that 24% of cancer patients are
diagnosed with major depression (McDaniel et al. 1995).
Stressful life events often precede anxiety disorders as well (Faravelli & Pallanti 1989, Finlay-Jones
& Brown 1981). Interestingly, long-term follow-up studies have shown that anxiety occurs more
commonly before depression (Angst & Vollrath 1991, Breslau et al. 1995). In fact, in prospective
studies, patients with anxiety are most likely to develop major depression after stressful life events
occur (Brown et al. 1986).

DISORDERS RELATED TO TRAUMA Lifetime exposure to traumatic events in the general

population is high, with estimates ranging from 40% to 70% (Norris 1992). Of note, an estimated
13% of adult women in the United States have been exposed to sexual assault (Kilpatrick et al.
1992). The Diagnostic and Statistical Manual (DSM-IV-TR; American Psychiatric Association 2000)
includes two primary diagnoses related to trauma: Acute Stress Disorder (ASD) and PTSD. Both
these disorders have as prominent features a traumatic event involving actual or threatened death
or serious injury and symptom clusters including re-experiencing of the traumatic event (e.g.,
intrusive thoughts), avoidance of reminders/numbing, and hyperarousal (e.g., difficulty falling or
staying asleep). The time frame for ASD is shorter (lasting two days to four weeks), with diagnosis
limited to within one month of the incident. ASD was introduced in 1994 to describe initial trauma
reactions, but it has come under criticism (Harvey & Bryant 2002) for weak empirical and theoretical
support. Most people who have symptoms of PTSD shortly after a traumatic event recover and do
not develop PTSD. In a comprehensive review, Green (1994) estimates that approximately 25% of
those exposed to traumatic events develop PTSD. Surveys of the general population indicate that
PTSD affects 1 in 12 adults at some time in their life (Kessler et al. 1995). Trauma and disasters are
related not only to PTSD, but also to concurrent depression, other anxiety disorders, cognitive
impairment, and substance abuse (David et al. 1996, Schnurr et al. 2002, Shalev 2001).
Other consequences of stress that could provide linkages to health have been identified, such as
increases in smoking, substance use, accidents, sleep problems, and eating disorders. Populations
that live in more stressful environments (communities with higher divorce rates, business failures,
natural disasters, etc.) smoke more heavily and experience higher mortality from lung cancer and
chronic obstructive pulmonary disorder (Colby et al. 1994). A longitudinal study following seamen in
a naval training center found that more cigarette smoking occurred on high-stress days (Conway et
al. 1981). Life events stress and chronically stressful conditions have also been linked to higher
consumption of alcohol (Linsky et al. 1985). In addition, the possibility that alcohol may be used as
self-medication for stress-related disorders such as anxiety has been proposed. For example, a
prospective community study of 3021 adolescents and young adults (Zimmerman et al. 2003) found
that those with certain anxiety disorders (social phobia and panic attacks) were more likely to develop
substance abuse or dependence prospectively over four years of follow-up. Life in stressful
environments has also been linked to fatal accidents (Linsky & Strauss 1986) and to the onset of
bulimia (Welch et al. 1997). Another variable related to stress that could provide a link to health is
the increased sleep problems that have been reported after psychological trauma (Harvey et al.
2003). New onset of sleep problems mediated the relationship between post-traumatic stress
symptoms and decreased natural killer (NK) cell cytotoxicity in Hurricane Andrew victims (Ironson et
al. 1997).

Variations in Stress Responses

Certain characteristics of a situation are associated with greater stress responses. These include
the intensity or severity of the stressor and controllability of the stressor, as well as features that
determine the nature of the cognitive responses or appraisals. Life event dimensions of loss,
humiliation, and danger are related to the development of major depression and generalized anxiety
(Kendler et al. 2003). Factors associated with the development of symptoms of PTSD and mental
health disorders include injury, damage to property, loss of resources, bereavement, and perceived
life threat (Freedy et al. 1992, Ironson et al. 1997, McNally 2003). Recovery from a stressor can also
be affected by secondary traumatization (Pfefferbaum et al. 2003). Other studies have found that
multiple facets of stress that may work synergistically are more potent than a single facet; for
example, in the area of work stress, time pressure in combination with threat (Stanton et al. 2001),
or high demand in combination with low control (Karasek & Theorell 1990).

Stress-related outcomes also vary according to personal and environmental factors. Personal risk
factors for the development of depression, anxiety, or PTSD after a serious life event, disaster, or
trauma include prior psychiatric history, neuroticism, female gender, and other sociodemographic
variables (Green 1996, McNally 2003, Patton et al. 2003). There is also some evidence that the
relationship between personality and environmental adversity may be bidirectional (Kendler et al.
2003). Levels of neuroticism, emotionality, and reactivity correlate with poor interpersonal
relationships as well as “event proneness.” Protective factors that have been identified include, but
are not limited to, coping, resources (e.g., social support, self-esteem, optimism), and finding
meaning. For example, those with social support fare better after a natural disaster (Madakaisira &
O’Brien 1987) or after myocardial infarction (Frasure-Smith et al. 2000). Pruessner et al. (1999)
found that people with higher self-esteem performed better and had lower cortisol responses to acute
stressors (difficult math problems). Attaching meaning to the event is another protective factor
 against the development of PTSD, even when horrific torture has occurred. Left-wing political
activists who were tortured by Turkey’s military regime had lower rates of PTSD than did nonactivists
who were arrested and tortured by the police (Basoğlu et al. 1994).

Finally, human beings are resilient and in general are able to cope with adverse situations. A recent
illustration is provided by a study of a nationally representative sample of Israelis after 19 months of
ongoing exposure to the Palestinian intifada. Despite considerable distress, most Israelis reported
adapting to the situation without substantial mental health symptoms or impairment (Bleich et al.
2003).

ARTICLE 7

It's not uncommon to feel disorganized and forgetful when you're under a lot of stress. But over the
long term, stress may actually change your brain in ways that affect your memory.

Studies in both animals and people show pretty clearly that stress can affect how the brain functions,
says Dr. Kerry Ressler, chief scientific officer at McLean Hospital and professor of psychiatry at
Harvard Medical School. Scientists have seen changes in how the brain processes information when
people experience either real-life stress or stress manufactured in a research setting. (For the latter,
researchers might challenge subjects to perform a difficult task, such as counting backward from the
number 1,073 by 13s while being graded.) Either type of stress seems to interfere with cognition,
attention, and memory, he says.

Stress affects not only memory and many other brain functions, like mood and anxiety, but also
promotes inflammation, which adversely affects heart health, says Jill Goldstein, a professor of
psychiatry and medicine at Harvard Medical School. Thus, stress has been associated with multiple
chronic diseases of the brain and heart. In addition, it can affect men and women differently, she says.

Stress and the brain

To understand why stress affects thinking and memory, it's important to understand a little about how
the brain works. Your brain isn't just a single unit, but a group of different parts that perform different
tasks, says Dr. Ressler. Researchers believe that when one part of your brain is engaged, the other
parts of your brain may not have as much energy to handle their own vital tasks, he says. For example,
if you are in a dangerous or emotionally taxing situation, the amygdala (the part of your brain that
governs your survival instincts) may take over, leaving the parts of your brain that help to store
memories and perform higher-order tasks with less energy and ability to get their own jobs done. "The
basic idea is that the brain is shunting its resources because it's in survival mode, not memory mode,"
says Dr. Ressler. This is why you might be more forgetful when you are under stress or may even
experience memory lapses during traumatic events.
The effect that stress has on the brain and body may also differ depending on when it occurs in the
course of someone's life, says Goldstein. Certain hormones, known as gonadal hormones — which
are secreted in large amounts during fetal development, puberty, and pregnancy and depleted during
menopause — may play a role in how stress affects an individual, says Goldstein. "For example,
reductions in the gonadal hormone estradiol during the menopausal transition may change how our
brain responds to stress," she says.

ARTICLE 8
Stress and Anxiety in Athletics

Stress is a factor of life that affects everyone, but athletes tend to suffer from it more than non-athletes,
due to the amount they are required to balance, between schoolwork, practices and games, as well as
family pressures and everyday life (Stress and Anxiety in Athletics | the Sport Digest, n.d.).

Stress Disorders
The study of stress in sport lies within the realm of sport psychology. There are many disorders which
are related to stress. Typically, an athlete is diagnosed with general stress disorder, but there are more
specific stress disorders as well. These disorders include, but are not limited to, obsessive-compulsive
disorder (OCD), depression, and post-traumatic stress disorder (PTSD). Stress can be manifested in
people with OCD because the person will become so obsessed with their traditions, whether it is the
number of times they must turn a light off, or clean their hands, if the person does not do it the correct
number they will because stressed and will consume their thoughts until they go and correct it.
Depression can cause a person to become stress, and stress can cause depression because a person
will become preoccupied with what is stressing them out, and will begin to focus only on that and soon
not find pleasure in their normal everyday activities which will end up like a snowball effect and continue
to get worse, unless they get help. Post-traumatic stress disorder is not usually a disorder that affects
athletes but sometimes it may, especially after a traumatic car accident, or serious injury. PTSD is a
very serious condition that can lead to further problems such as suicide. This is a condition not to be
taken lightly and if the athlete is showing any signs of PTSD, they should be referred to a counseling
center in order to get proper treatment.
There are many different stress disorders, many which need specialized treatment. At any time an
athletic trainer feels like the athlete’s stress level is becoming too high and unmanageable then the
athlete needs to set up with a counseling center so they can get proper help, and tools to help lower
their stress level.
Signs and Symptoms

There are many signs and symptoms of stress, and everyone is different, so one sign or symptom
described by one athlete may not be what another athlete experiences. Ray and Weise-Bjornstal
(1999) described seven categories in which an athlete may experience stress. These categories are:
affective, behavioral, biological/physiological, cognitive, imaginal, interpersonal, and sensory (Ray and
Weise-Bjornstal, 260). Each category has its own signs and symptoms. Affective signs and symptoms
include: anxiety, anger, guilt, depression, shame and feeling sorry for oneself. Behavioral signs and
symptoms include: sleeping disturbances, restlessness, aggressive behavior, alcohol or drug abuse,
sulking, crying, poor performance, absenteeism, and clenched fists. Biological or physiological signs
and symptoms include muscle tension, increased heart rate, indigestion, stomach spasms, pain and
headaches.
Cognitive signs and symptoms are frustration, worries, distortion, exaggeration, unrealistic
performance expectations, self-defecting statements and self-handicapping. The imaginal signs and
symptoms include images of failure, images of preinjury, flashbacks of being injured, images of
helplessness, and images of embarrassment. The interpersonal signs and symptoms include
withdrawal, manipulation and argumentation. The last category, sensory, includes tension, nausea,
cold sweat, clammy hands, pain and butterflies in the stomach (Ray and Weise-Bjornstal, 260). There
are many signs and symptoms of stress, which are not all experienced by each person, and each
person can experience a variety of signs and symptoms.

Healthy Response

There are many ways an athlete can respond to stress. Many times athletes do not handle stress
properly, nor do they know how to, so they must seek outside help in order to deal with it. Healthy ways
for athletes to deal with stress are to engage in pleasurable activities, take care of their body, maintain
a positive perspective, laugh, practice relaxation techniques, talk to others, and get help from a
professional. Many athletes do not know how to handle their stress and usually need help when it
comes to dealing with the stress. Due to this fact many times the athletic trainer or coach is the first
person the athlete turns to when they are stressed out. The coach and athletic trainer both need to
know the available resources and know the proper steps to go to in order to get the athlete the proper
help they need.

Related Health Problems

There are many health problems related to high levels of stress. These include, but are not limited to,
irritable bowel syndrome, diabetes, skin disorders, such as hives, ulcers, respiratory conditions, and
sexual dysfunction. These conditions do not occur over night and tend to occur over an extended
amount of time. Once an athlete develops one of these other conditions the athletic trainer and health
care providers need to sit down with the athlete and try to figure out the cause of the condition. They
need to keep in mind that stress could be the underlying cause and suggest ways for the athlete to
help deal with their stress. The athlete may need to also adjust their eating habits as well as make
other lifestyle changes to help manage their stress and health problems.
ARTICLE 9
The effects of stress on athletic performance

By definition, stress is a physiological response from the brain and body as a reaction to mental,
physical or emotional pressure (World Health Organization, n.d.). We often associate stress with a
negative connotation, but there are many positive external stressors that can motivate you to achieve
goals or function at your fullest potential. The difference between good stress and bad stress is often
how the individual perceives the mental, physical or emotional pressure. If it feels like something that
is within their control, it is finite or there is a reward that makes the extra pressure feel worth it, the
stress is perceived as ‘good’. On the other hand, stress that is ongoing or feels like there is very little
control from the person experiencing it is categorized as ‘bad’ or negative stress. Negative stress is
responsible for impacting performance and pouring into virtually every facet of life if techniques are not
developed to better address it, or if the stressor itself does not go away. The reason why it’s important
to figure out ways to manage this stress effectively is every person will experience a period of time
where there are external obstacles out of their control, and there may not always be an immediate
solution for repairing it (Center, 2016).

Positive Stress:

Some may hear the term stress and assume that it is always better to avoid it. The opposite is actually
true. Positive stress can help you overcome obstacles, challenge yourself and build self-confidence. It
is associated with feelings of fulfillment, accomplishment and happiness, because situations allow you
to prove your capability to yourself and those around you. Positive stress is usually acute and is directly
associated with achieving a goal. Examples of positive stress are training for a competition, getting
ready to give a speech or meeting a deadline on a project.

It’s important to remember that the act of working out is also a stressor on your body, and that the
process of being active is actually breaking down muscle tissues to repair and rebuild stronger than
before. When you increase resistance, intensity or weight this process is known as hypertrophy and
leads to building stronger skeletal muscles. We often don’t think about this process as ‘stress’ because
the benefits are positive. Another way to think about this is if you never challenged your body, your
body would degenerate over time. The same can be said with mental challenges which is why it’s
important to set goals that cause some positive stress so you can enjoy rewards from success and
build resilience and strength from failures.

The dark side of positive stress can be when you are consistently in a state of trying to achieve and
never give yourself an opportunity to rest and recover. While it can feel almost addictive to consistently
one-up yourself, it’s important to check in at every milestone to evaluate what you need to recover so
you can continue to perform at a high-level.
Negative Stress

Negative stress is often referred to as the “fight or flight” reaction, which throws your body into an
extremely sensitive state in order to escape a specific danger and to ensure survival. From a biological
standpoint, this kind of stress is useful because it can ensure you have the ability to get to safety in
emergency situations. The problem can be when someone remains in a state of chronic negative stress
for long periods of time. This can lead to burn out, and also can severely impact mental and physical
processes (Center, 2016).

One of the more prominent negative stress hormones, cortisol, has the ability to cross the blood-brain
barrier and interfere with cognition. When your ability to think clearly has been impaired, you are more
vulnerable to becoming overwhelmed by other situations and continuing a cycle of greater stress and
burnout. High levels of negative stress over time can impact attention, memory, decision making and
overall tolerance to new stressors and situations. Negative stress can also be responsible for weight
gain, performance anxiety, reproductive challenges and heart disease. Negative stress can also
contribute to or exacerbate mental health conditions such as depression, anxiety and PTSD (Center,
2016).