7a: psychobiology

Question 1

How is stress defined as:

i. a stimulus
ii. ???

Answer 1

1. Stress can be a stimulus
   Events that place strong demands on us are known as stressors
2. Stress can be a response
   Physiological response to stress e.g. ‘Fight-Flight’ response
   Also, the presence of negative emotions including feeling tense, difficulty concentrating and losing your temper easily. SNS!

Question 2

What mediates the stress effects

Answer 2

Sympathetic
Nervous
System

Hypothalamic
Pituitary
Adrenocortical Axis

Question 3

What is the combination of stimulus and response known as in stress, and what are the components

Answer 3

PERSON-SITUATION INTERACTION.

PERCEIVED IMBALANCE BETWEEN:

1. PRIMARY APPRAISAL:
   cognitive appraisal, emotional reactions, physiological responses and behavioural tendencies towards SITUATIONAL DEMANDS
2. SECONDARY APPRAISAL
   cognitive appraisal, emotional reactions, physiological responses and behavioural tendencies towards RESOURCES NEEDED TO COPE WITH THE DEMANDS

i.e. SITUATION…. primary appraisal (no threat leads to no stress, perceived stress leads to:

secondary apprisal (perception of INABILITY to cope leads to negative stress, perception of the ABILITY TO COPE is positive stress)

Question 4

Stages of the general adaptation syndrome

Answer 4

1. Alarm reaction
   (shift to sympathetic dominance increases arousal). Resistance to stress increasing.
2. Resistance
   (endocrine system releases stress hormoens to maintain increased arousal). Resistance to stress continues to increase, peaks then begins to fall.
3. Exhaustion
   (adrenal glands lose their ability to function normally). Resistance to stress falls below the initial level

Question 5

Outline pathway from stress to disease

Answer 5

Event –> stress –> behavioural changes OR physiological changes –> disease

Question 6

Outline behavioural changes that can occur in response to stress that could lead to disease

Answer 6

Alcohol and smoking increased in stressful times (although this effect was less if people felt they had higher SOCIAL SUPPORT)

Question 7

Outline physiological changes that can occur in response to stress that could lead to disease

Answer 7

e. g MI increased after world cup
e. g. anxiety associated with increased risk of CVD
e. g. increases cortisol reactivity associated with greater extent of coronary artery calcification (CAC)
e. g. mucosal wound healing takes longer because production of Interleukin-1 declined by 68% during exam

Question 8

Outline type A behaviour

Answer 8

Time urgency

Free-floating hostility

Hyper-aggressiveness

Focus on accomplishment

Competitive and goal-driven

Question 9

Relatioship between type A personality and health

Answer 9

TABP doubled the risk of developing CHD in healthy males (aged 39 -59) when cardiac risk factors controlled for

Type B, characterised by patience, serenity and lack of time urgency, Type A behaviour alone accounted for 31% increase in risk

SPECIFICALLY THE HOSTILITY part of type A behaviour with relatioship to CHD

Question 10

Suggest a relationship between TABP and CHD

Answer 10

Poor health behaviours –> Increased physiological response to stressors –> endothelial dysfunction atherosclerosis

Question 11

Type D behaviour and CDH?

Answer 11

‘Type D behaviour’, characterised by social inhibition and negative affect, showed a relationship with CHD, possibly due to under-reporting of symptoms

Question 12

Depression and disease

Answer 12

etiologic and prognostic role for depression in coronary heart disease

Question 13

Differentiate approach with avoidance

Answer 13

Approach = activity that is oriented toward a threat (e.g. problem-solving, planning a response)

May want to discuss illness and treatment in detail
Avoidance = activity that is oriented away from a threat (e.g., denial, distraction)

Question 14

Social support and health (important)

Answer 14

Individuals with adequate social relationships have a 50% greater likelihood of survival compared to those with poor or insufficient social relationships.

Social relationships exert INDEPENDENT effect beyond protective psychological role.

Effect comparable with quitting smoking and it exceeds many well-known risk factors for mortality (e.g., obesity, physical inactivity).

Question 15

Study of social support

Answer 15

Breast cancer study

48 months later all the women in the control had died whereas a third of the women from the support group were still alive

Question 16

What affected headache treatment

Answer 16

Whether the tablets are branded makes differebt, both for when the pill wasgenuinelly and analgesic, and when the pill was actually just a placeb but in the same branding)

Question 17

What is the placebo effect

Answer 17

The phenomenon in which a placebo - an inactive substance like sugar, distilled water, or saline solution - can sometimes improve a patient’s condition simply because the person has the expectation that it will be helpful.

Question 18

What is the nocebo effect

Answer 18

A negative effect that occurs after receiving treatment (therapy, medication), even when the treatment is inert/sham

Question 19

What can cause nocebo

Answer 19

Warnings about the possible side effects of a medicine makes it much more likely that the patient will report experiencing those effects
One out of 20 placebo treated patients discontinued treatment due to ‘side effects’

Question 20

T/F the palcebo effect completely diminishes if the patients are told it is a sugar pill

Answer 20

F!