3 - stress and illness Flashcards

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1
Q

examples of common stressors

A
small daily hassles e.g. missing the bus
academic or work related concerns e.g. exams
relationship issues
financial problems 
loss of control over goals
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2
Q

factors that make an event stressful

A

perceived as negative
lack of control
long-lasting
cannot be dealt with using current resources
amiguity
relevant to important life domains/aspects of self

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3
Q

transactional theory (Lazarus and Folkman)

A

define stress as..
“a relationship between the person and environment that is perceived by the person as taxing or exceeding his or her resources and endangering his or her wellbeing”

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4
Q

factors affecting how stressful an event is for an individual

A
appraisal differences (perception of the stress)
psychological differences
coping mechanisms --> strategies to deal with the stress
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5
Q

example of a way to measure stress

A

the social readjustment rating scale (Holmes and Rahe)

records how people rate different types of stress

measures daily hassles and uplifts

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6
Q

what are daily hassles

A

small difficulties during the day that may add up and create unmanageable demands
e.g. rising prices, noisy neighbours, too many responsibilties

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7
Q

what are daily uplifts

A

positive occurrences that may offset the daily hassles and reduce the perceived demand

e.g. good weather, getting on well with friends

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8
Q

how are hassles and uplifts measured in the social readjustment scale (Holmes & Rahe)

A

factors are rated on a scale of 0-3 of perception as a hassle or an uplift

examples included children, parents, partner, weather, news

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9
Q

results from social readjustment scale (Holmes and Rahe)

A

ratings of factors from hassles to uplifts varied from day to day

more hassles were associated with lower social wellbeing
daily uplifts made little difference

hassles were found to be good indicators of stress

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10
Q

how does stress directly effect your health

A

affects functioning of the cv and immune system
due to cortisol entering the bloodstream
chronic stress undermines general system functioning

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11
Q

how does stress indirectly affect your health

A

increases health risk behaviours e.g. smoking, alcohol use, drug use –> negative health consequences

decreases health promoting behaviours e.g. physical activity, good sleep, good diet
–> secondary consequences such as tiredness affecting eating habits, physical activity etc.

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12
Q

evidence to show that stress affects speed of wound healing

A

small biopsy wound in hard palate of dental students
taken once in summer holidays and once before major exams

healing resonse was measured as much longer for those in exam condition

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13
Q

physical effects of moderate/severe stress

A
dry mouth
perspiration
headaches
high BP
GI problems
lower back pain
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14
Q

emotional effects of moderate/severe stress

A
anxiety
depression
fatigue
irritability
impulsiveness
hypervigilance
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15
Q

cognitive effects of moderate/severe stress

A

inability to concentrate

memory problems

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16
Q

behavioural effects of moderate to severe stress

A
teeth grinding
crying
disrupted eating
aggression
sexual problems
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17
Q

how is stress induced by the nervous system

A

sympathetic nervous system
adrenal medulla releases catecholamines e.g. adrenaline to induce stress response
cortisol is released into the blood stream

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18
Q

physiological responses to sympathetic nervous system

A
bronchiole dilation
increased breathing rate
increased heart rate
increased BP
increased blood glucose
decreased metabolism
decreased digestion
decreased immune activity and pain perception
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19
Q

physiological responses to the parasympathetic nervous system

A
reduces adrenalin secretion
reduces heart rate and blood pressure
reduces breathing rate
reduces perspiration 
increases salivation
body returns to homeostasis
promotes relaxation
facilitates energy storage
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20
Q

adrenal glands

A

sit on top of kidneys
pyramid shapes
made up of cortex and medulla

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21
Q

adrenal medulla

A

secretes catecholamines e.g. adrenaline, noradrenaline

22
Q

adrenal cortex

A

outer section of adrenal gland
produces glucocorticoids
e.g. cortisol

23
Q

2 nervous and endocrine mechanisms of stress response

A

sympathetic adrenal medullary (SAM) system

hypothalamic pituitary adrenal (HPA) axis

24
Q

what does SAM stand for

A

sympathetic adrenal medullary system

25
Q

what is the SAM system

A

initial response to stress (fast and moderate)

hypothalamus in midbrain releases corticotropin releasing hormone (CRH)

CRH enters blood stream and stimulates adrenal medulla to release adrenalin

26
Q

what does HPA stand for

A

hypothalamic pituitary adrenal axis

27
Q

features of the HPA axis

A

secondary stress response
slower with longer, more extensive effects
cortisol secretion into the blood

28
Q

mechanism of HPA axis

A

hypothalamus releases CRH
CRH travels in blood stream to pituitary gland
adrenocorticotrophic hormone (ACTH) released
ACTH stimulates adrenal cortex to release corticoids and cortisol

29
Q

effects of cortisol

A

increased protein and fat mobilisation
increased access to energy storage
decreased immune response
decreased inflammation

30
Q

how does chronic stress cause illness

A

increased risk of viral infection
triggers histamines which lead to bronchoconstriction –> exacerbates asthma
increases risk of diabetes mellitus
alters acid concentration in stomach –> leads to pepti ulcers, ulcerative colitis
arterial plaque build up (atherosclerosis)
psychiatric illness e.g. depression, anxiety, schizophrenia
tumour development and NK cell suppression –> metastasis no longer prevented

31
Q

how does chronic stress cause cardiovascular disease

A

leads to the continual release of catecholamines and corticosteroids
increases HR
increases BP
increased force on heart muscle walls and circulatory system
increased platelet count
increased growth of plaques

32
Q

how does stress cause damage to the heart

A

heart muscle walls become enlarged and damaged
particularly left ventricle (main pumping chamber) –> LV hypertrophy
muscles lose elasticity –> cant pump with sufficient force

33
Q

effects of damage to the heart caused by stress

A
shortness of breath
fatigue
chest pain 
heart palpatations
dizziness
increased risk of heart attack and stroke
34
Q

effect of chronic stress on circulation

A

blood vessels and arteries become distended/inflamed due to increased blood flow
vessels become rigid (wrapped with more muscle)
fat and cholesterol attracted and forms plaques which can rupture causing blood clots

35
Q

what happens in plaques formed on blood vessels rupture

A

stroke if occurs in the brain
myocardial infarction if occurs in the heart
blood clot if anywhere else

36
Q

how can chronic stress lead to depression

A

high cortisol levels makes brain more susceptible to depression when stressed

37
Q

evidence that stress is linked to depression

A

daily cortisol measured from 3 groups –> depressed group had higher morning cortisol levels and higher net secretion of cortisol in response to stressful task

38
Q

what is autoimmunity

A

when the immune system attacks self-cells

39
Q

what do vaccines take advantage of

A

the natural, non-specific response to pathogens

40
Q

function of immune system

A

to recognise and destroy pathogens based on markers on their cell walls (antigens)

41
Q

features of innate immune response

A

immediate
fast
general
phagocytes migrate from bloodstream to site of infection and consume pathogens
display pathogens on walls (antigen presentation)

42
Q

features of adaptive immune response

A

secondary
specific
slow

B and T cells respond to the displayed antigens
antigen specific receptors required through cell multiplication

43
Q

outline cell-mediated immunity

A

NK cells directly attack via toxin secretion
helper T cells and T cells secrete cytokines to stimulate other immune cells
B cells become plasma cells which produce antibodies

44
Q

outline antibody mediated immunity

A

B cells attach themselves to a pathogen and produce specific antibodies
antibodies bind to pathogen receptors
- cause them to burst
- OR mark pathogen for other immune cells to kill

antibodies assist in formation of memory B cells

T helper cells produce B-cell growth factors casing B cell proliferation and inreased antibody production

45
Q

effect of stress on immune system

A

initial effect
- activates immune system e..g acute stressor such as a wound to avoid potential infection

chronic stress
- glucocorticoid shrinks thymus gland decreasing cell-mediated immunity

46
Q

importance of thymus gland in immunity

A

T and B cells formed there

47
Q

how can you measure immune function

A

count B, T and NK cells in blood samples
- examine how rapidly cells proliferate

measure how much antibody our body cotrains against common antigens

measure production of antibody in response to ingested substance that produces antigens

48
Q

main man in measuring immune function

what did he find

A

Glaser

collected blood from med students 1 month and 1 day before exams

found NK cell activity much lower 1 day before exams

49
Q

overall effect of stress on illness

A

stress increases cortisol which causes immunosuppression increasing risk of illness

50
Q

rhinovirus study to show stressful life events increases risk of illness

A

17 subjects exposed to rhinovirus
symptoms measured over 5 days
recent stressful life events recorded

greater number of stressful recent life events had occurred in those that developed colds