Ch.5, Stress and Health

Question 1

Stressors
stress
coping strategies
distress

Answer 1

external demands
stress: produced effect in the organism
Coping strategies: efforts to deal with stress
distress: bad stress

Question 2

Original definition of stress

Answer 2

used by engineers, Hans Seyle took the term and used it to describe the difficulties and strains experienced by living organisms as they struggle to adapt to environmental conditions

Question 3

Stress and the DSM

Answer 3

the relationship between stress and pathology is considered important that it is recognized in diagnostic formulations

Question 4

PTSD in DSM 5 type of disorder

Answer 4

originally classified as an anxiety disorder in the DSM 4, now a trauma and stressor related disorder in the DSM 5

Question 5

children with parents who have depression

Answer 5

Research also suggests that adolescents with parents who are depressed are more sensitive to stressful events; these adolescents are also more likely to have problems with depression themselves after experiencing stressful life events than those who do not have parents with depression

Question 6

Individual characteristics that improve a person’s ability to handle life stress

Answer 6

greater optimism, greater psychological control, increased self esteem, better social support

Question 7

the 5HTTLPR gene) s/s and l/l genotype and depression

Answer 7

was linked to how likely it was that people would become depressed in the face of life stress. Caspi and colleagues (2003) found that people who had two “short” forms of this gene (the s/s genotype) were more likely to develop depression when they experienced four or more stressful life events than were people who had two “long” forms of this gene (the l/l genotype
REPLICATES IN SOME STUDIES BUT NOT OTHERS: nature of the life event may be a factor, interaction between the s carrier genotype and life events is marked for interpersonal events that impact relationships when compared to non-interpersonal life events that do not involve relationships

Question 8

Cumulative effects of stress and stress tolerance/ crisis

Answer 8

stress is cumulative: each stressful experience can make the overall system more reactive,
stress tolewrance: refers to a person’s ability to withstand stress without becoming seriously impaired
crisis: used to refer to times when a stressful situation threatens to exceed or exceeds the adaptive capacities of a person or group

Question 9

Characteristics of stressors (6)

Answer 9

(1) severity of the stressor
(2) how long it lasts: chronicity
(3) timing
(4) how closley it affects our own lives
(5) how expected it is
(6) how controllable it is

Question 10

Social Reajustment rating scale

Answer 10

self reported chelist of fairly common stressful life experiences

Question 11

LEDS

Answer 11

Life events and difficulties schedule: includes an extensive manual that provides rules for rating both acute and chronic forms of stress

Question 12

Resilience/ self enhancing coping style and effects/ allostatic load

Answer 12

healthy psychological and physical functioning after a potentially traumatic event
people who have a self-enhancing coping style and are overly optimistic about themselves/life tend to cope very well in traumatic situations
allostatic load: biological cost of adapting to stress

Question 13

Giving speech and impacts on cardiovascular health

Answer 13

being asked to give a 5-minute speech about an assigned topic to a small (but evaluative) audience was enough to produce detectable changes in cardiac function in about 20 percent of patients with existing coronary artery disease (see Sheps et al., 2002). Furthermore, those patients who were most reactive to this form of mental stress were almost three times more likely (compared to the less reactive patients) to die in the next 5 to 6 years

Question 14

Mental stress and physiological impacts

Answer 14

more cortisol, increased heart rate, more epinephrine

Question 15

Sympathetic-adrenomedullarly (SAM) system (first system involved in stress response)

Answer 15

designed to mobilize resources and prepare for a fight-or-flight response.
1. The stress response begins in the hypothalamus, which stimulates the sympathetic nervous system (SNS)
2. This, in turn, causes the inner portion of the adrenal glands (the adrenal medulla) to secrete adrenaline (also known as epinephrine) and noradrenaline (norepinephrine).
3. As these circulate through the blood, they cause an increase in heart rate (familiar to all of us). They also get the body to metabolize glucose more rapidly.

Question 16

HPA system (Second system involved in stress response

Question 17

Cortisol longterm effects

Answer 17

cortisol can damage brain cells, especially in the HPC
-It may even stunt growth (babies who are stressed don’t gain weight in the normal way and “fail to thrive”).
- Accordingly, the brain has receptors to detect cortisol. When these are activated, they send a feedback message that is designed to dampen the activity of the glands involved in the stress response. But if the stressor remains, the HPA axis stays active and cortisol release continues. Although short-term cortisol production is highly adaptive, a chronically overactive HPA axis, with high levels of circulating cortisol, may be problematic.

Question 18

Psychoneuroimmunology

Answer 18

study of the interactions between the nervous system and the immune system.
-Evidence continues to grow that the brain influences the immune system and that the immune system influences the brain.

Question 19

Immunosuppression

Answer 19

can be stress induced by glucocorticoids (cortisol)
can be adaptive short term: escape first, heal afteter

Question 20

Immunis/immune system
Leukocytes (lymphocytes) = b cells and t cells
antigens

Answer 20

immunis: latin for exempt
immune system: protects the body from such things as viruses and bacteria
Leukocytes/lymphocytes: are produced in the bone marrow and then stored in various places throughout the body, such as the spleen and the lymph nodes. There are two important types of leukocytes. One type, called a B-cell (because it matures in the bone marrow), produces specific antibodies that are designed to respond to specific antigens. The second important type of leukocyte is the T-cell (so named because it matures in the thymus, which is an important endocrine gland). When the immune system is stimulated, B-cells and T-cells become activated and multiply rapidly, mounting various forms of counterattack
Antigens: antibody generator, are foreign bodies such as viruses and bacteria, as well as internal invaders such as tumors and cancer cells.

Question 21

Specialized functions of B cells and T cells

Answer 21

-. Each T-cell has receptors on its surface that recognize one specific type of antigen. However, the T-cells are unable to recognize antigens by themselves. They become activated when immune cells called macrophages (the word means “big eater”) detect antigens and start to engulf and digest them.
When a B-cell recognizes an antigen, it begins to divide and to produce antibodies that circulate in the blood. This process is facilitated by cytokines (like interleukin-1) that are released by the T-cells.

Question 22

Interleukin-1

Answer 22

To activate the T-cells, the macrophages release a chemical known as interleukin-1. With the help of the macrophages, the T-cells become activated and are able to begin to destroy antigens

Question 23

How long does the production of antibodies take?

Answer 23

5 days or more

Question 24

Natural killer (NK) cells

Answer 24

white blood cells that identify and destroy tumors and cells infected by viruses. In this way they keep us healthy.

Question 25

Stress and wound healing

Answer 25

slows it down by 24-40%

Question 26

Cytokines

Answer 26

cytokines are small protein molecules that are an important component of the immune system. Cytokines serve as chemical messengers and allow immune cells to communicate with each other.
Influence the brain=- act on the brain and it is the reason why we feel unwell

Question 27

Interferon

Answer 27

One cytokine that you may have heard about is interferon, which is given to patients with cancer, multiple sclerosis, and hepatitis C.

Question 28

Highway from brain to peripheral nervous system

Answer 28

esearchers have now identified a previously unknown “highway” that connects the brain directly to the peripheral immune system. This allows immune cells to travel from the brain to the peripheral immune system and back again

Question 29

Two categories of cytokines

Answer 29

proinflammatory cytokines and anti-inflammatory cytokines. Proinflammatory cytokines such as interleukin-1 (IL-1), IL-6, or tumor necrosis factor (TNF) help us deal with challenges to our immune system by augmenting the immune response. In contrast, anti-­inflammatory cytokines such as IL-4, IL-10, and IL-13 decrease or dampen the response that the immune system makes.

Question 30

stress and cytokines

Answer 30

lower productionm of cytokines during stress = longer healing time

Question 31

Why is long term stress worse for cytokines?

Answer 31

Evidence is growing that inflammation—increased levels of proinflammatory cytokines—is increased in people who are under prolonged stress. This is because long-term stress seems to interfere with the body’s ability to turn off cytokine production.

Question 32

Inflammation and stress

Answer 32

Chronic stress, however, seems to impair the body’s ability to respond to the signals that will terminate immune system reactivity. The result is inflammation.

Chronic inflammation is a risk factor for a wide range of health problems and diseases. These include cardiovascular disease, type 2 diabetes, asthma, osteoporosis, rheumatoid arthritis, and many others

Question 33

C-reactive protein

Answer 33

a molecule produced by the liver in response to IL-6—when they want to assess a person’s risk for heart disease.

Question 34

Stress and premature death/aging

Answer 34

traumatic events in childhood= seem to be predictive of premature death/aging
-People who had reported six or more adverse events during their childhood died much earlier (in fact, almost 20 years earlier) than would have been expected based on estimates of standard life expectancy. The top two leading causes of death were heart disease (or stroke) and cancer.
risk of death was 57 percent higher in men who experienced two or more adverse childhood experiences compared to men who had not experienced any childhood adversity. For women, the corresponding figure was 80 percent increased risk.

Question 35

racial discrimination and cardiovascular health

Answer 35

The findings revealed a significant correlation between everyday discrimination and CRP, where more experiences of discrimination were associated with higher levels of CRP. The association also remained even after factors such as smoking, high blood pressure, depression, and other health problems were considered.
higher CRP levels = indicate widespread inflammation in the body

Question 36

Telomeres and stress/ telomerase

Answer 36

greek for “end”
telomeres shorten with age. And if they get too short, cells do not function correctly and the risk of disease
is increased = stress shortens the length of telomeres
Telomerase: telomere length is maintained by telomerase

Question 37

Type A behavior pattern

Answer 37

contributes to the development ofd heart disease
competitive drive, extreme commitment to work, time urgency and hostility

Question 38

Framingham Heart Study

Answer 38

confirmed there is an 8 fold increase of having a heart attack when you have Type A personality in men and women
HOSTILITY IS THE COMPONENT MOST ASSOCIATED WITH THIS OUTCOME

Question 39

Type D personality type

Answer 39

tendency to experience negative emotions and also feel insecure and anxious, men who had this were more likely to have fatal and nonfatal heart attacks over a 5 year follow up

Question 40

Depression and immunosupression

Answer 40

e state of being depressed adds something beyond any negative effects of the stressors precipitating the depressed mood.: goes beyond just the negative events

Question 41

depression/heart disease

Answer 41

People with heart disease are approximately three times more likely than healthy people to be depressed; more common in this disease than cancer

Question 42

Anhedonia and increased mortality

Answer 42

symptom of depression charachterized by profound loss of interest or pleasure, may be predictive of increased mortality after a heart attack

Question 43

Depression as a risk factor CHD/ Why are depression and heart disease so closely linked?

Answer 43

depression is associoated with 30% increased risk for developing heart disease/having a heart attack in the future
-Long-term exposure to these proinflammatory cytokines is thought to lead to changes in the brain that manifest themselves as symptoms of depression. Depression may then interact with stress to further enhance the inflammatory responses that are naturally triggered by stress exposure
-Proinflammatory cytokines also trigger the growth of plaques in the blood vessels as well as making it more likely that those plaques will rupture and cause a heart attack

Question 44

Depression and telomeres/ dose response relationship

Answer 44

New findings also suggest that people who are depressed have shorter telomeres than never depressed controls, even after controlling for other health and lifestyle variables
-a dose–response relationship: meaning that the more chronic and severe the depression, the shorter people’s telomeres were.

Question 45

Sudden Cardiac Death and anxiety

Answer 45

6 times higher in men with highest levels of anxiety

Question 46

Quality of marital relationship and patients with congestive heart failure

Answer 46

quality of the marital relationship predicts 4-year survival rates in patients with congestive heart failure. Although uncertain at this time, it may be that the stress that comes from marital tension or from a lack of social support triggers an inflammatory response in the immune system, causing depression and heart problems as a result

Question 47

Positive psychology

Answer 47

This school of psychology focuses on human traits and resources such as humor, gratitude, and compassion that might have direct implications for our physical and mental well-being

Question 48

Effects of harbouring grudges/rumination on health

Answer 48

being forgiving acts a s a buffer against the effects of stress on mental health
more forgiveness = predicts fewer health symptoms

Question 49

Cognitive control and pro-inflammatory cytokine production

Answer 49

people who had better cognitive control (which was assessed via a laboratory task) had a less pronounced increase in pro-inflammatory cytokine production in response to watching an emotionally stressful video. Psychological stress is known to trigger pro-inflammatory cytokine production= individual differences in cognitive control (being better able to ignore distracting information) moderated this association.

Question 50

SSRIs and myocardial infarction patients

Answer 50

patients treated with selective serotonin reuptake inhibitors (SSRIs) were much less likely to die or have another heart attack than patients who were not taking antidepressant medications

Question 51

Expressive writing and physical illness

Answer 51

-Expressive writing also seems to provide some modest benefits (reduced fatigue at a 3-month follow-up assessment) for people who have been diagnosed with autoimmune illnesses such as lupus and rheumatoid arthritis
but in other cases like cancer or divorce findings are mixed and it might make it worse

Question 52

reframing and journalling

Answer 52

expressive writing can help reframe: reevaluate how threatening their problems seem
but sometimes could lead to rumination
expressive writing too soon after an upsetting life event may make things worse rather than better

Question 53

Biofeedback

Answer 53

aim to make patients more aware of such things as their heart rate, level of muscle tension, or blood pressure. This is done by connecting the patient to monitoring equipment and then providing a cue (for example, an audible tone) to the patient when he or she is successful at making a desired response (decreasing facial tension ex)

Question 54

Transcendental meditation vs progressive muscle relaxation meditation effects

Answer 54

Patients who practiced Transcendental Meditation for 20 minutes twice a day reduced their diastolic blood pressure significantly more than did patients who practiced muscle relaxation or who received sound health care advice.

Question 55

CBT

Answer 55

cognitive behavioural therapy is more useful than standard medicalk treatments
(works for headaches chronically occuring)

Question 56

Adjustment disorder

Answer 56

-trauma and stressor related disorder in DSM
-An adjustment disorder is a psychological response to a common stressor (e.g., divorce, death of a loved one, loss of a job) that results in clinically significant behavioral or emotional symptoms.
***Adjustment disorder is probably the least stigmatizing and mildest diagnosis a therapist can assign to a client.

Question 57

PTSD history and contested inclusion in the 1980 DSM

Answer 57

• first entered diagosis in 1980
  -due to traumatized war veterans from Vietnam
  -original inclusion was opposed: including a disorder that had a clear and explicit cause (trauma) was inconsistent with the atheoretical nature of the DSM that had already been established
• PTSD was viewed as a normal response to an abnormal stressor

Question 58

PTSD nonrecovery

Answer 58

n the case of PTSD, however, the stress symptoms fail to abate even when the traumatic event has passed and the danger is over. This makes PTSD a disorder of nonrecovery. What becomes established is a memory of the traumatic event that results in the traumatic event being reexperienced involuntarily and with the same full emotional force that characterized the original experience

Question 59

Traumatic stressors and responses as different from PTSD

Answer 59

Traumatic stressors include combat, rape, being confined in a concentration camp, and experiencing a natural disaster such as a tsunami, earthquake, or tornado. These are all terrible experiences and, as would be expected, stress symptoms are very common in the immediate aftermath of a traumatic event. However, for most people, these symptoms decrease with time: PTSD symptoms do not

Question 60

Ptsd as a pathological response (before DSM 4 AND DSM 4) AND women as overrepresented

Answer 60

BEFORE DSM 4: ptsd was conceptualized as a normal response to an abnormal stressor
in the DSM4: PTSD was viewed as a pathological response to an extreme form of stress: but the kind of emotional response that qualifies for PTSD was much more likely to be reported by women than by men

Question 61

DSM 5 AND PTSD CRITERIA

Answer 61

In DSM-5, the diagnostic criteria for PTSD were tightened. The traumatic event must now be experienced by the person directly, either because the event happens to you or because you witness, in person, something traumatic happening to someone else. No longer is it possible to experience trauma indirectly through electronic media (which could occur when someone watches video footage of a terrible event)
-another change is the removal of the requirement that the person respond in a particular way (i.e., with fear, helplessness, or horror) because this confounds the response with the event itself; d also makes it more likely that women will receive the diagnosis
-symptoms must last for at least 1 month

Question 62

Acute distress disorder

Answer 62

Acute stress disorder is a diagnostic category that can be used when symptoms develop shortly after experiencing a traumatic event and last anywhere between 3 days to one month.
-The existence of this diagnosis means that people with symptoms do not have to wait a whole month to be diagnosed with PTSD. Instead they can receive treatment as soon as they experience symptoms

Question 63

4 main areas of DSM-5 20 symptoms of PTSD

Answer 63

Intrusion: Recurrent reexperiencing of the traumatic event through nightmares, intrusive images, and physiological reactivity to reminders of the trauma. (In DSM-IV ruminative thoughts about the trauma were also considered to reflect intrusion. This is not the case in DSM-5.)

Avoidance: Efforts to avoid thoughts, feelings, or reminders of the trauma.

Negative alterations in cognitions and mood: This includes such symptoms as feelings of detachment as well as negative emotional states such as shame or anger, or distorted blame of oneself or others.

Arousal and reactivity: Hypervigilance, excessive response when startled, aggression, and reckless behavior.

Question 64

Lifetime prevalence of PTSD

Answer 64

Estimates from the National Comorbidity Survey Replication (NCS-R) suggest that the lifetime prevalence of PTSD in the United States is 6.8 percent
Over the course of their lives, 9.7 percent of women and 3.6 percent of men will develop this disorder.
even when type of traumtic event is controlled for, women have higher rates of PTSD and greater symptom severity (societ?)

Question 65

Traumatic natural events vs traumatic events by human intent

Answer 65

More specifically, traumatic events that result from human intent (such as rape) are more likely to cause PTSD than are traumatic events (such as accidents and natural disasters) that are not personal in nature

Question 66

PTSD and degree of direct exposure

Answer 66

direct experience of trauma muich more likely to have PTSD

Question 67

PTSD assessment and definitions and the impact on prevalence

Answer 67

Estimates based on questionnaires tend to be higher than those based on clinical interviews; Reasons for the overestimates when questionnaire measures are used include misunderstanding the meaning of items on the questionnaire, presence of symptoms that cause little impairment in functioning, and inclusion of symptoms that began at times other than during or after a traumatic event.

Question 68

“A” Criteria of PTSD

Answer 68

Exposure to actual or threatened death, serious injury, or sexual violence in one (or more) of the following ways:

Question 69

“B” criteria of PTSD

Answer 69

Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s),

Question 70

“C” criteria for PTSD

Answer 70

Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred, as evidenced by one or both of the following:

Question 71

“D” criteria for PTSD

Answer 71

Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

Question 72

“e” criteria for PTSD

Answer 72

Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred, as evidenced by two (or more) of the following:

Question 73

Shell shock

Answer 73

term coined by a British pathologist, Col. Frederick Mott (1919), who regarded these reactions as organic conditions produced by minute brain hemorrhages during WWI
NOT TRUE: Most victims were suffering instead from the general combat situation, with its physical fatigue, ever-present threat of death or mutilation, and severe psychological shocks.

Question 74

Operational fatigue/war neuroses vs combat fatigue/exhaustion

Answer 74

During World War II, traumatic reactions to combat were known as operational fatigue and war neuroses,
finally being termed combat fatigue or combat exhaustion in the Korean and Vietnam Wars.

Question 75

“forward psychiatry” and WWII

Answer 75

soldiers received supportive therapy at their battalion aid stations and were returned to combat within a few hours
this practice of “forward psychiatry” was not effective at returning soldiers with shell shock to combat, but their improved mood and adjustment allowed them to be reassigned to noncombat roles, resulting in reduced manpower losses overall
GREATEST LOSS OF PERSONNEL IN WW2 DUE TO THIS

Question 76

PTSD in military personnel in combat role vs support role

Answer 76

As might be expected, rates of PTSD tend to be higher in military personnel who were deployed into a combat role versus a support role (12.4 versus 4.9 percent). Reflecting this, army and marine personnel had higher rates of PTSD (13 and 10 percent, respectively) than those who had served in the navy (7 percent) or air force (3 percent;

Question 77

Problems with studying causal factors PTSD

Answer 77

-we already know trauma causes it, why look further
-if some people are more likely to develop PTSD in the face of severe stress than other people are, might this not lead to double victimization, with victims of trauma also being stigmatized and being blamed for the troubles that they have?

Question 78

Factors that increase risk for developing PTSD

Answer 78

-being female
-higher neuroticism
-preexisting depression/nxiety
-family history of depression/anxiety/substance use
-low social support (but difficult to tell whether low support is a risk factor or a result of PTSD isolating the person)

Question 79

Pretraumtic stress reactions and development of PTSD

Answer 79

how much people had been bothered by thoughts or images of possible future stressful experiences, or whether they had strong physical reactions when something reminded them of a stressful event they might experience at a later time. The measure of pretraumatic stress that the soldiers completed before deployment predicted their level of PTSD symptoms both during and after their service in Afghanistan, even after such factors as combat exposure and baseline PTSD symptoms were accounted for.

Question 80

protective factors against PTSD

Answer 80

-higher IQ: individuals with more intellectual resources might be better able to create some meaning from their traumatic experiences and translate them into a personal narrative of some kind

Question 81

Cortisol and people with PTSD

Answer 81

Under conditions of imposed experimental stress (trauma reminders, cognitive challenges), people with PTSD do seem to show an exaggerated cortisol response; except for women bc they do have higher levels of baseline cortisol than women without PTSD;lower in those who have experienced some kind of sexually traumtic event

Question 82

5HTTLPR gene and PTSD

Answer 82

. However, people who had the high-risk (s/s) genotype of the serotonin-transporter gene were at especially high risk for the development of PTSD if they also had high direct exposure to trauma and low social support.
-people with the s/s form of the serotonin-transporter gene may be especially sensitive to certain environmental experiences such as war zone stress, and that one consequence of this is that they become more attentive to negative stimuli
-the interaction between certain genes and certain environmental experiences may prime the attentional system to develop cognitive biases toward negative stimuli

Question 83

PTSD and brain pathology/ third variable problem with depression

Answer 83

• hippocampus seems to be reduced in size in people with PTSD
  -small hippocampal volume may be a vulnerability factor for developing PTSD in people who are exposed to trauma
  -reduced hippocampal size could be both a risk factor for PTSD and also be a consequence of trauma exposure.
  Because PTSD and depression are highly comorbid and co-occurring disorders, it is therefore hard for researchers to be sure which brain abnormalities are specific to PTSD and which might stem from depression

Question 84

Ethnic minorities and PTSD

Answer 84

more likely to have PTSD: being more educated and having higher annual income = associated with lower rates of PTSD overall

Question 85

Delayed onset PTSD

Answer 85

not well defined a very difficult to diagnose: very rare, only one civilian case of this: some contest whether this should be a [TSD diagnosis at all
in soldiers; delayed onset PTSD may occur on the way home

Question 86

Prevention of PTSD

Answer 86

-reduce frequency of traumatic events
-preparing people in advance with coping strategies may be effective before traumatic event
-stress inoculation training: prepares people to tolerate an anticipated threat by changing the things they say to themselves before or during a stressful event

Question 87

short term crisis therapy

Answer 87

brief duration and focuses on the immediate problem with which an individual or family is having difficulty with

Question 88

Tetris study and traumatic flashbacks

Answer 88

two groups that viewed traumatic material, one played tetris other sat quietly
tetris group: got in the way of memory consolidation bc it is a visuospatial task,
tetris could work as a “cognitive vaccine” if it is administered early enough; factual memory remains intact about the trauma but they have less intrusive flashbacks

Question 89

Critical Incident Stress debriefing

Answer 89

A single session of CISD lasts between 3 and 4 hours and is conducted in a group format, usually 2 to 10 days after a “critical incident” or trauma. seen to “prevent PTSD”

Question 90

Psychological debriefing and controversies

Answer 90

Although those who experience the debriefing sessions often report satisfaction with the procedure and with the organization’s desire to provide assistance, no well-controlled study has shown that it reduces symptoms of PTSD or hastens recovery in civilians

Question 91

Antidepressants and traumatic situation

Answer 91

-patients are often treated with antidepressants
-Antidepressants (particularly SSRIs such as fluoxetine [Prozac], paroxetine [Paxil], and venlafaxine [Effexor]) provide modest benefits compared to placebo.

Question 92

Prolonged exposure therapy for PTSD

Answer 92

-The patient is asked to vividly recount the traumatic event over and over until there is a decrease in his or her emotional responses. This procedure also involves repeated or extended exposure, either in vivo or in the imagination, to feared (but objectively harmless) stimuli that the patient is avoiding because of trauma-related fear
-The client has to trust in the therapist enough to engage in the exposure treatment.
-HIGHER DROPOUT RATE DUE TO STRESS IT CREATES
-may not be beneficial longterm, only short term

Question 93

cognitive therapy for PTSD focuses

Answer 93

Cognitive therapy for PTSD is designed to modify excessively negative appraisals of the trauma or its consequences, decrease the threat that patients experience when they have memories of the traumatic event, and remove problematic cognitive and behavioral strategies.
-much lower dropout rates

Question 94

Virtual reality exposure treatment for PTSD in military personnel

Answer 94

. Treatment is typically short term (4 weeks), consisting of four to six 90-minute individual sessions. The first session is devoted to obtaining sufficient details of the trauma (time of day, weather conditions, location, sounds, smells, etc.) to make the virtual reality experience as realistic as possible. As the therapy progresses, new cues may be added to the program to provide further exposure experiences.
-. Treatment is typically short term (4 weeks), consisting of four to six 90-minute individual sessions. The first session is devoted to obtaining sufficient details of the trauma (time of day, weather conditions, location, sounds, smells, etc.) to make the virtual reality experience as realistic as possible. As the therapy progresses, new cues may be added to the program to provide further exposure experiences.

Question 95

Why Is the Study of Trauma So Contentious?

Answer 95

-identifying individual risk factors could be seen as victim blaming
-minimizes trauma in some respects

Question 96

specific activities that can lengthen/shorten telomeres

Answer 96

We are also learning that drinking too much sugar-sweetened soda might shorten telomeres (Leung et al., 2014), pessimism may accelerate the rate of telomere shortening (O’Donovan et al., 2009), and meditation may promote telomerase activity; exercise seems to act as a buffer against the bad effects of stress on telomeres