1
Q
Mental health conditions where stress has been shown to play a significant role:
A
- anxiety, depression, schizophrenia, PTSD
2
Q
Physical health problems linked to stress
A
- viral infection, CHD, inflammation
- often accelerates progression or delays recovery
3
Q
Stressor
A
- external demands
4
Q
Stress
A
- effect stressors create on an organism
- anything that requires significant readjustment (can be good things like marriage!)
5
Q
Coping Strategies
A
- efforts to deal with stress
6
Q
Hans Selye (1956-1976)
A
- pioneer of research and conceptual models in stress
- regardless of nature of severe illness, common set of responses (stress response!)
- stress response: body’s way of mobilizing resources (ex HPA axis, inflammatory system) to deal with disruption in functioning
7
Q
Characteristics improving ability to handle stress
A
- higher levels of optimism
- greater psychological control or mastery
- increased self-esteem
- better social support (perception)
8
Q
5HTTLPR gene
A
- linked to likelihood of becoming depressed in the face of life stress
9
Q
Stress tolerance
A
- ability to withstand stress without becoming severely impaired
10
Q
Resilience
A
- healthy psychological and physical functioning after a potentially traumatic event
11
Q
Factors that increase resillience
A
- being male, being older, being well-educated
- having more economic resources
- being a positive person, being self-confident
12
Q
Factors associated with lower resillience
A
- having a more negative affect
- being more inclined to ruminate
- trying to find meaning in what happened (jury still out on this – some interventions focus on doing this)
13
Q
Key factors that make a stressor more serious
A
- severity of the stressor
- chronicity (how long it lasts)
- timing
- how closely it affects own life
- how expected it is
- how controllable it is
14
Q
Stress severity
A
- stressors involving more important aspects of life are highly stressful
- longer stressor = more severe effects
15
Q
Crisis
A
- times when stressful situation threatens to exceed (or exceeds) the adaptive capacities of a person
16
Q
Social Readjustment Rating Scale
A
- self-report checklist of common stressful life experiences
17
Q
LEDS
A
- Life Events and Difficulties Schedule
- interview-based approach
- includes extensive manual w rules for rating acute and chronic stress
- allows rater to consider context in which events occur
18
Q
Trauma and stress related disorders DSM
A
- PTSD
- adjustment disorder
- acute stress disorder
19
Q
Allostatic load
A
- biological cost of adapting to stress
- stress increases risk of getting a cold, heart attack, aggravating other issues, etc.
20
Q
2 distinct biological systems that respond to perceived stressor
A
- sympathetic-adrenomedullary (SAM) system (prepares for fight or flight response)
- Hypothalamus-pituitary-adrenal (HPA) system
21
Q
Cortisol
A
- stress glucocorticoid that prepares body for fight or flight
- glucocorticoids can cause stress-induced immunosuppression
22
Q
Stressful experiences that have associated health risks
A
- loneliness is a risk factor for heart disease in women
- childhood trauma increases risk of premature death later in life
- stress shortens length of telomeres (protective end parts of chromosomes) and leads to premature aging
23
Q
Depression and health
A
- associated w disrupted immune function
- ppl w heart disease are 3x more likely to be depressed
- ppl who are depressed have shorter telomeres than never depressed controls (more vulnerable to physical and psychological effects)
- cardiac and inflammatory systems closely linked to development of depression
- MS study: ppl previously diagnosed w depression had worse symptoms after MS diagnosis
24
Q
Adjustment disorder
A
- psychological response to a common stressor (eg divorce, death of loved one, loss of job)
- clinically significant behavioral or emotional symptoms
- symptoms must begin within 3 months of onset of stressor
- symptoms lessen or disappear when stressor ends or they learn to adapt (within 6 months or it becomes PTSD!)
- mildest/least stigmatized diagnosis
25
Sheps coronary artery disease study
- 20% of patients had detectable changes in cardiac function when asked to give 5 min speech
- patients more reactive to this form of stress almost 3x more likely to die in next 5-6 years
26
SAM system
- sympathetic-adrenomedullary system
- mobilizes resources and prepares for fight or flight
- hypothalamus stimulates SNS, SNS causes adrenal medulla to secrete adrenaline and noradrenaline, which cause increase in heart rate and glucose metabolism
27
HPA system
- hypothalamic-pituitary-adrenal system
- stimulates SNS
- releases corticotropin-releasing hormone (CRH) which stimulates pituitary gland
- pituitary secretes adrenocorticotropic hormone (ACTH) which induces adrenal cortex to produce glucocorticoids (cortisol in humans)
28
Psychoneuroimunology
- study of interactions between nervous system and immune system
29
Past terms used for PTSD
- Soldier's Heart (heart condition)
- Shell Shock (mini hemorrages in brain)
- Combat Fatigue
- Combat Neurosis
- Traumatic War Neurosis
30
PTSD and the DSM
- entered DSM in 1980 (anxiety disorders)
- DSM IV -- trauma-and-stressor related disorders
31
PTSD general info
- has to have been a specific event (trauma experienced, witnessed, happens to close other) that caused it
- stress symptoms fail to abate, even when event has passed and danger is over
32
PTSD 4 groups of symptoms
- Intrusion: recurrent reexperiencing traumatic event
- Avoidance: efforts to avoid thoughts/feelings/reminders
- Negative alterations in cognitions and mood: detachment, distorted blame, negative emotional states
- Arousal and reactivity: hypervigilance, aggression
33
Sociocultural factors of PTSD
- being member of minority group
- in combat: justification of combat, how clear and acceptable goals are, quality of leadership, identification w combat union
34
PTSD in individuals deployed to Iraq and Afghanistan
- 12.9% in military personnel deployed to Iraq
- 7.1% of those who served in Afghanistan
- many take their own life after exposure to combat trauma
35
PTSD in the general population
- lifetime prevalence of 6.8% in US
- 9.7% of women and 3.6% of men
- more likely to get PSTD from traumatic events that are the result of human intent
36
Individual risk factors of PTSD
- being a Black american is a risk factor for experiencing trauma
- being a woman is a risk factor for developing PTSD
- low social support (unsure if cause or consequence)
- disturbing thoughts or images of potential future trauma is a risk factor for PTSD
37
Biological factors in PTSD
- women w PTSD have higher baseline cortisol lvls
- 5HTTLPR gene might be risk factor for PTSD
- hippocampus reduced in size in ppl w PTSD
38
Prevention of stress disorders
- reduce frequency of traumatic events
- psychological preparedness/adequate training for extreme stressors
- stress-inoculation training (CB techniques to help ppl manage stressful situations)
39
Treatment for Stress disorders
- telephone hotlines
- crisis intervention (right after it happens)
- psychological debriefing (talk about it! -- not as useful for people who are not 'talkers')
- medications
- cognitive-behavior treatments (most effective)
- prolonged exposure (or extended narrative exposure)
40
Cognitive Processing Therapy
- PTSD treatment
- emphasis on meaning (what about the situation affected you)
- re-appraisal (of cognitions like guilt)
41
Written Expressive Therapy
- PTSD treatment
- write about trauma for 30 mins every week
- very simple and can be delivered w less training
42
Eye Movement Desensitization
- PTSD treatment
- imagine trauma and track stimulus (ie finger or light bar)
- involves repeated exposure
- probably not literal eye mvmt that is reducing symptoms
43
Group Therapy
- PTSD treatment
- sharing trauma experiences, reduces alienation
- can be helpful for those with symptoms that don't go away
44
Leukocytes/lymphocytes
- white blood cells involved in immune protection
- B-cells produce specific antibodies for specific antigens
- T-cells can recognize specific antigens (and destroy them with help of macrophages)
45
Cytokines
- small protein molecules (important component of immune system)
- chemical messengers, allow immune cells to communicate
- ex interferon for patient w cancer, MS, hep. C
- also act on brain
- important role in mediating inflammatory and immune response (pro and anti inflammatory)
- stress disrupts production of proinflammatory cytokines
- blisters in couples took longer to heal when engaged in convo designed to provoke marital conflict
46
Chronic stress and inflammation
- inflammation (more proinflammatory cytokines) is increased in ppl with prolonged stress
- chronic stress impairs negative feedback loop (cytokines stimulate HPA axis to release cortisol and regulate cytokine production)
- chronic inflammation is a risk factor for many health problems
47
Type A behavior patterns and health
- Type A: excessively competitive, extreme commitment to work, impatience, hostility
- 2x more likely to have coronary artery disease
- 8x more likely to have heart attack in next 8.5 years
48
Type D behavior patterns and health
- Type D: more negative emotions, insecure, anxious
- men more likely to have heart attack in 5 year period
- more risks after cardiac surgery
49
Depression and health
- relationship between depression and immune system suppression at least partially independent of specific stressors
- factor in heart disease (3x more likely to be depressed)
- depression may interact with stress to further enhance inflammatory responses
50
Acute Stress Disorder
- symptoms develop shortly after experiencing a traumatic event and last 3 days - 1 month
- diagnosis can change to PTSD if symptoms persist
PSYC 337
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