Chapter 14

Question 1

What is the biopsychosocial model?

Answer 1

– holds that physical illness is caused by a complex interaction of biological, psychological, and sociocultural factors

Question 2

What is health psychology?

Answer 2

– concerned with how psychosocial factors relate to the promotion and maintenance of health and with the causation, prevention, and treatment of illness

Question 3

What is stress and stressors?

Answer 3

• • any circumstances that threaten or are perceived to threaten one’s well-being and that thereby tax one’s coping abilities
• • perceiving something to be exceeding your resources
• • Stressors: Events that lead to stress and have several common attributes. Perceived as uncontrollable (threat to a goal, not having resources to deal with it, or will use up all my resources)

Question 4

How is stress an everyday event?

Answer 4

• • routine hassles may have significant harmful effects on mental and physical health
• • stress adds up. Routine stresses at home, at school, and at work might be fairly benign individually, but collectively they could create great strain.

Question 5

What is the difference between primary and secondary appraisal?

Answer 5

• • primary appraisal is an initial evaluation of whether an event is (1) irrelevant to you, (2) relevant but not threatening, or (3) stressful.
• • secondary appraisal is an evaluation of your coping resources and options for dealing with the stress
• • at either stage, event could be perceived as stressful/non-stressful
• • Often, people aren’t very objective in their appraisals of potentially stressful events

Question 6

What are acute stressors?

Answer 6

• • threatening events that have a relatively short duration and a clear endpoint
• • Ex. having an encounter with a belligerent drunk, dealing with the challenge of a major exam, or having your home threatened by severe flooding

Question 7

What are chronic stressors?

Answer 7

• • threatening events that have a relatively long duration and no readily apparent time limit
• • Ex. persistent financial strains produced by huge credit card debts, ongoing pres- sures from a hostile boss at work, or the demands of caring for a sick family member over a period of years.

Question 8

What are the four major types of stress?

Answer 8

frustration, conflict, change, and pressure

Question 9

What is frustration?

Answer 9

• • frustration is experienced whenever the pursuit of some goal is thwarted (you want something and you can’t have it) Ex. traffic jams, difficult commutes, and annoying drivers
• • some frustrations are brief and insignificant, others can be the source of significant stress

Question 10

What is conflict?

Answer 10

• • conflict occurs when two or more incompatible motivations or behavioural impulses compete for expression
    1) approach–approach conflict: a choice must be made between two attractive goals. Tends to be the least stressful and have a reasonably happy ending. Nonetheless, important issues may sometimes be troublesome.
    2) avoidance–avoidance conflict: a choice must be made between two unattractive goals. Most unpleasant and highly stressful
    3) approach–avoidance conflict: a choice must be made about whether to pursue a single goal that has both attractive and unattractive aspects. Common and can be quite stressful. Often produce vacillation (you go back and forth, beset by indecision)

Question 11

What is change?

Answer 11

• • Life changes are any substantial alterations in one’s living circumstances that require readjustment
• • Social Readjustment Rating Scale (SRRS): measures life change as a form of stress. The scale assigns numerical values to 43 major life events. These values are supposed to reflect the magnitude of the readjustment required by each change. This total is an index of the amount of change-related stress the person has recently experienced
• • Studies have shown that people with higher scores tend to be more vulnerable to many kinds of physical illness and to many types of psycho- logical problems as well

Question 12

What is pressure?

Answer 12

– pressure involves expectations or demands that one behave in a certain way
– pressure to perform when you’re expected to execute tasks and responsibilities quickly, efficiently, and successfully
– Pressures to conform to others’ expectations are also common in our lives
– Sometimes the pressure comes from a mismatch between what we have to or want to do and the time available (time pressure)
» number of people who were identified as being severely time-stressed had increased between 1992 and 1998 and this trend just seems to continue and the more time pressure or time crunch we feel, the less we are able to get a good night’s sleep

Question 13

What are the three responses to stress?

Answer 13

(1) emotional responses, (2) physiological responses, and (3) behavioural responses.

Question 14

What are the emotional responses to stress?

Answer 14

• • our emotions go through phases during and after a stressful event
• • common emotional responses to stress include (a) annoyance, anger, and rage, (b) apprehension, anxiety, and fear, and (c) dejection, sadness, and grief
• • research shows that positive emotions also occur during periods of stress Ex. In the face of disasters, people are still able to feel gratitude for their own safety and that of their family, are able to take stock of what’s left and count their blessings, and develop renewed appreciation and love for their family and close friends

Question 15

What are the advantages of having a positive emotional style?

Answer 15

• • positive emotional style is associated with an enhanced immune response and physical health in general and protective against heart disease
• • Yes, people who experience a high level of positive emotions appear to live longer than others!
• • study showed greater smile intensity predicted greater longevity among baseball players
• • another study looked at the use of positive words in the autobiographies of 88 well-known, deceased psychologists and the results suggest that a positive mentality was associated with greater longevity

Question 16

What are the effects of emotional arousal?

Answer 16

– strong emotional arousal can also interfere with efforts to cope with stress ex. evidence that high emotional arousal can interfere with attention and memory retrieval and can impair judgment and decision making

Question 17

What is the inverted U - hypothesis and optimal level of arousal?

Answer 17

• • task performance should improve with increased emotional arousal, up to a point, after which further increases in arousal become disruptive and performance decreases
• • eustress; when it helps performance
• • distress when it causes upset or illness
• • the level of arousal at which performance peaks is characterized as the optimal level of arousal for a task
• • as a task becomes more complex, the optimal level of arousal (for peak performance) tends to decrease. This is because complex tasks requires a lot of focus and attention, so you don’t need a lot of external stress adding to that because then it will make you distressed, so the optimal stress required will be lower

Question 18

What is the fight or flight response (the stress response)?

Answer 18

• • a physiological reaction to threat in which the autonomic nervous system mobilizes the organism for attacking (fight) or fleeing (flight) an enemy
• • heart beats fast, blood pressure increases, sweaty palms and soles of feet
• • It’s clearly an adaptive response in the animal kingdom, where the threat of predators often requires a swift response of fighting or fleeing. But in our modern world, the fight-or-flight response may be less adaptive for human functioning than it was thousands of generations ago. Most human stresses can’t be handled simply through fight or flight.
• • this automatic reaction is a “leftover” from humanity’s evolutionary past

Question 19

What is the general adaptation syndrome?

Answer 19

• • Selye exposed laboratory animals to a diverse array of both physical and psychological stressors. The patterns of physiological arousal seen in the animals were largely the same, regardless of the type of stress. Thus, Selye concluded that stress reactions are non- specific.
• • general adaptation syndrome: a model of the body’s stress response, consisting of three stages: alarm, resistance, and exhaustion
    1. Alarm stage: acute response to stress to mobilize the body’s defenses. Fight-or- flight response
    2. Resistance stage: If the stressor continues (becomes chronic), then the body adapts and appears normal while maintaining balance until resistance is depleted. Body uses resources at above average rate, even though fight-or-flight response subsided. Body uses up resources faster than it can replenish
    3. Exhaustion stage: If stressor is constant (too severe or lasts too long), the ability to resist is eventually exceeded, the person enters the stage of exhaustion. Chronic overactivation of the stress response can have damaging physiological effects on a variety of organ systems (“diseases of adaptation.”)

Question 20

What are the brain-body pathways of stress?

Answer 20

• • the endocrine system consists of glands located at various sites in the body that secrete chemicals called hormones.
• • there are two major pathways along which the brain sends signals to the endocrine system in response to stress
• • The hypothalamus is the brain structure that appears to initiate action along these two pathways.
    1) In response to stress, your hypothalamus activates the sympathetic division of the ANS. A key part of this activation involves stimulating the central part of the adrenal glands (the adrenal medulla) to release large amounts of catecholamines into the bloodstream. These hormones radiate throughout your body, producing the physiological changes seen in the fight- or-flight response. Heart rate and blood flow increase, and more blood is pumped to your brain and muscles. Your body is mobilized for action
    2) The hypothalamus sends signals to the so-called master gland of the endocrine system, the pituitary. In turn, the pituitary secretes a hormone (ACTH) that stimulates the outer part of the adrenal glands (the adrenal cortex) to release another important set of hormones—corticosteroids. These hormones stimulate the release of chemicals that help increase your energy and help inhibit tissue inflammation in case of injury
• • stress can interfere with neurogenesis

Question 21

What is learned helpless?

Answer 21

• • Learned helplessness is passive behaviour produced by exposure to unavoidable aversive events
• • seems to occur when individuals come to believe that events are beyond their control
• • studies suggest that learned helplessness can contribute to depression
• • however, studies have shown that people who are better able to disengage from unattainable goals report better health and exhibit lower levels of a key stress hormone

Question 22

What is catastrophic thinking?

Answer 22

• • The tendency to become highly self-critical in response to stress (blaming oneself)
• • catastrophic thinking causes, aggravates, and perpetuates emotional reactions to stress that are often problematic
• • negative self-talk can contribute to the development of depressive disorders

Question 23

What is aggression?

Answer 23

• • any behaviour that is intended to hurt someone, either physically or verbally
• • frustration–aggression hypothesis, which held that aggression is always caused by frustration
• • catharsis: release of emotional tension. Freud theorized that behaving aggressively could get pent-up emotion out of one’s system and thus be adaptive
• • However, experimental research generally has not supported the catharsis hypothesis
• • Indeed, most studies find just the opposite: Behaving in an aggressive manner tends to fuel more anger and aggression

Question 24

What is self-indulgence?

Answer 24

• • reduced impulse control
• • When troubled by stress, many people engage in unwise patterns of eating, drinking, spending money, and so forth
• • A study of gambling found that stress related to negative life events was associated with youth problem gambling
• • Studies indicated that stress increases compulsive consumption and that this coping strategy is particularly common among those who are highly materialistic
• • Internet addiction typically involves one of three subtypes: excessive gaming; preoccupation with sexual content; or obsessive socializing
• • All three subtypes exhibit (1) excessive time online; (2) anger and depression when thwarted from being online; (3) an escalating need for better equipment and connections; and (4) adverse consequences, such as arguments and lying about Internet use, social isolation, and reductions in academic or work performance
• • Studies suggest that Internet addiction is fostered by high stress and associated with increased levels of anxiety, depression, and alcohol use

Question 25

What are defence mechanisms?

Answer 25

• • largely unconscious reactions that protect a person from unpleasant emotions, such as anxiety and guilt
• • they accomplish this purpose through self-deception, distorting reality so it doesn’t appear so threatening
• • there is some evidence that suggests that “positive illusions” can sometimes be adaptive for mental health
• • extreme distortions of reality are maladaptive, but small illusions can be beneficial (“optimal margin of illusion.”)
• • repression, projection, displacement, reaction formation, regression, rationalization, identification, and sublimation
    1) Denial of reality
    2) Fantasy
    3) Intellectualization (isolation)
    4) Undoing
    5) Overcompensation

Question 26

What is constructive coping?

Answer 26

• • refer to relatively healthful efforts that people make to deal with stressful events
• • the concept of constructive coping is simply meant to connote a healthful, positive approach, without promising success
    1. Constructive coping involves confronting problems directly. It is task-relevant and action-oriented
    2. Constructive coping is based on reasonably realistic appraisals of your stress and coping resources. A little self-deception may sometimes be adaptive, but excessive self-deception and highly unrealistic negative thinking are not
    3. Constructive coping involves learning to recognize, and in some cases regulate, potentially disruptive emotional reactions to stress.

Question 27

What is burnout?

Answer 27

• • Burnout involves physical and emotional exhaustion, cynicism, and a lowered sense of self-efficacy that can be brought on gradually by chronic work-related stress.
• • burnout is associated with increased absenteeism and reduced productivity at work, as well as increased vulnerability to a variety of health problems
• • Decades of research have shown that burnout is found all over the world in a wide variety of cul- tures

Question 28

What is post-traumatic stress disorder?

Answer 28

• • Post-traumatic stress disorder (PTSD) involves enduring psychological disturbance attributed to the experience of a major traumatic event
• • post-traumatic stress disorder is increasingly associated with people in other front-line occupations, such as police officers, firefighters, ambulance attendants and paramedics, and even transit workers
• • University of Regina psychologist Nicholas Carleton and his colleagues collected responses to online surveys from almost 6000 front- line workers from all across Canada
• • The results were striking; almost half (44.5 percent) of the sample reported symptoms consistent with a serious mental illness, with some of the highest fre- quencies of positive screens for PTSD, depression, and anxiety disorders. This is cause for real concern because the symptom frequency “appears much higher than diagnostic rates for the general population”

Question 29

What is type A/type B personality and how does it contribute to heart disease?

Answer 29

• • The Type A personality includes three elements: (1) a strong competitive orientation, (2) impatience and time urgency, and (3) anger and hostility. Involves self-imposed stress and intense reactions to stress
• • the Type B personality is marked by relatively relaxed, patient, easygoing, amicable behaviour. Type B’s are less hurried, less competitive, and less easily angered than Type A’s
• • Decades of research uncovered a relatively modest correlation between Type A behaviour and increased coronary risk
• • However, researchers have found a stronger link between personality and coronary risk by focusing on a specific component of the Type A personality: anger and hostility
• • investigators found an elevated incidence of heart attacks among participants who exhibited an angry temperament
• • The results of this study and many others suggest that hostility may be the crucial toxic element in the Type A syndrome

Question 30

How can emotional reactions contribute to heart disease?

Answer 30

• • laboratory experiments with cardiology patients have shown that brief periods of mental stress can trigger sudden symptoms of heart disease
• • the evidence suggests that mental stress can elicit cardiac symptoms in about 30–70 percent of coronary patients
• • A recent meta-analysis of available evidence concluded that in the two hours immediately following an outburst of anger, there is nearly a fivefold jump in an individual’s risk for a heart attack and a more than threefold increase in the risk for a stroke.

Question 31

How can depression contribute to heart disease?

Answer 31

• • In many studies, elevated rates of depression have been found among patients suffering from heart disease.
• • the emotional dysfunction of depression may cause heart disease. Participants who suffered from depression were 2.7 times more likely to die of heart disease during the follow-up period than people who were not depressed

Question 32

How can stress contribute to other diseases?

Answer 32

• • researchers have found an association between life stress and the course of rheumatoid arthritis
• • Other studies have connected stress to the development of diabetes, herpes, fibromyalgia, and flare- ups of inflammatory bowel syndrome
• • A wealth of studies indicate that experimentally induced stress can impair immune functioning in animals
• • Research suggests that exposure to long-term stress can sometimes promote chronic inflammation
• • Research has also demonstrated that chronic inflammation contributes to a diverse array of diseases, including arthritis, osteoporosis, respiratory diseases, diabetes, Alzheimer’s disease, and some types of cancer
• • Thus, chronic inflammation resulting from immune system dysregulation may be another key mechanism underlying the association between stress and a wide variety of diseases.
• • stress contributes to the causation of illness
• • some evidence suggests that neuroticism may make people overly prone to interpret events as stressful and overly prone to interpret unpleasant sensations as symptoms of illness, thus inflating the correlation between stress and illness

Question 33

What is social support and how does it contribute to health?

Answer 33

• • Social support refers to various types of aid and emotional sustenance provided by members of one’s social networks
• • Many studies have found positive correlations between high social support and greater immune functioning and physical health
• • The importance of social support and familiar, comfortable surroundings is especially true for those with long-term illnesses, disability, or those who are aging
• • solid social support increased people’s odds of survival by roughly 50 percent
• -positive marriages are associated with a range of positive health indicators, including a lowered risk of mortality
• • people suffering from depression and low self- esteem are particularly sensitive to the absence of social support
• • While those with low self-esteem may need and want positive, social support from their relationship partners, because they doubt their own value, they may resist and/or distort positive, supportive feedback from their partners and may behave in ways that serve to alienate those partners
• • When faced with someone who seems to hold him- or herself in low regard, we often simply try to highlight the positive and reframe any negative experiences he or she may have had. According to Marigold, that strategy may not be the optimal one. As an alternative, her research suggests that “when [support] providers offer support that validates LSE’s negative thoughts and feelings (and supports their self-verification and mood regulation goals), such interactions appear to be more successful”
• • Interestingly, a recent study suggests that even superficial social interactions with acquaintances and strangers an be beneficial (weak ties)

Question 34

What are cultural disparities in social support?

Answer 34

• • Studies have found that Asians are reluctant to seek support from others and that they assert that social support is not all that helpful to them
• • explicit social support (overt emotional solace and instrumental aid from others)
• • implicit social support (the comfort that comes from knowing that one has access to close others who will be supportive)
• • Research has shown that Americans generally prefer and pursue explicit social support. In contrast, Asians do not feel comfortable seeking explicit social sup- port because they worry about the strain it will place on their friends and family but Asians do benefit from the implicit sup- port that results when they spend time with close others (without discussing their problems) and when they remind themselves that they belong to valued social groups that would be supportive if needed
• • Canadians who perceive a strong sense of connection to their community were more likely to report having both good physical and mental health
• • individuals from cultures emphasizing community and interdependence benefiting more from emotional social support than those from cultures where independence is emphasized

Question 35

What is optimism and how does it contribute to health?

Answer 35

• • Optimism is a general tendency to expect good outcomes
• • Studies have found a correlation between optimism and relatively good physical health, more effective immune functioning, greater cardiovascular health and increased longevity
• • Research suggests that optimists cope with stress in more adaptive ways than pessimists do (more likely to engage in action - oriented, problem-focused coping, and they are more likely to emphasize the positive in their appraisals of stressful events, and enjoy greater social support than pessimists)
• • evidence that the link between optimism and health can be found around the world

Question 36

How can conscientiousness contribute to health?

Answer 36

• • Research has shown that conscientiousness is associated with good physical health and increased longevity
• • First, people who are high in conscientiousness are less likely than others to exhibit unhealthy habits, such as excessive drinking, drug abuse, etc
• • Second, they tend to rely on constructive coping strategies and they are persistent in their efforts, so they may handle stressors better than others.
• • Third, conscientiousness appears to promote better adherence to medical advice and more effective management of health problems
• • Fourth, conscientiousness is associated with higher educational attainment and job performance, which both foster career success and increased income, meaning that people high in conscientiousness tend to end up in the upper levels of socioeconomic status (SES). Age-adjusted mortality rates are two to three times higher among the poor than among the wealthy
• • These well-documented health disparities exist because wealthier people tend to endure lower levels of stress, benefit from better nutrition and more exercise, exhibit fewer unhealthy habits are exposed less to pollution and work in less toxic environments, and can afford easier access to higher-quality medical care

Question 37

What is hardiness?

Answer 37

• • hardiness is a constellation of attitudes, beliefs, and behavioural tendencies that consists of three components: commitment, control, and challenge
• • They tended to approach difficult tasks as challenges, they viewed their work as important and they were committed to it, and they saw themselves as in control of their time and efforts
• • they can withstand stress better; correlated with better health (fewer sick days, fewer hospital visits)

Question 38

How can your stress mindset influence your ability to handle stress?

Answer 38

• • our attitudes and beliefs about stress and its effects influences your capacity to handle stress effectively
• • most people assume stress is generally harmful: stress-is- debilitating mindset
• • some people view stress as an invigorating challenge and opportunity for growth: stress-is-enhancing mindset
• • one’s stress mindset may turn out to be another factor moderating the impact of stressful events

Question 39

What are the positive effects of stress?

Answer 39

• • Research on resilience suggests that stress can promote personal growth or self-improvement
• • For example, studies of people grappling with major health problems show that the majority of respondents report they derived benefits from their adversity
• • Stressful events sometimes force people to develop new skills, re- evaluate priorities, learn new insights, and acquire new strengths
• • High levels of adver- sity predicted poor mental health, as expected, but people who had faced intermediate levels of adver- sity were healthier than those who experienced little adversity, suggesting that moderate amounts of stress can foster resilience

Question 40

What is health?

Answer 40

“A complete state of physical, mental, and social well-being and not merely the absence of disease or infirmity.”

Question 41

How can personal control impact stress?

Answer 41

• • Having a general sense of personal control reduces stress and can lead to the development of problem-solving strategies to cope with the stress
• • Rodin and Langer’s study of elderly nursing home residents; If given more control (allowing them to make decisions for themselves), better overall health and less likely to die during next 18 months (lower mortality).

Question 42

How can major life events contribute to stress?

Answer 42

• • People who experienced most stress also are more likely to have a serious illness over the next year
• • Subsequent experimental work suggests that people under chronic stress deplete bodily resources and become vulnerable to infections
• • Current thinking is that stress lowers the functioning of immune system, leading to lowered immunity to infection and resulting in illness

Question 43

How can poverty be a source of stress?

Answer 43

• • Poverty undermines sources of social support and leads to a sense of powerlessness
• • Poverty is related to threatening and uncontrollable life events
• • Disproportionately more ethnic minority families and female- headed families (single mothers)

Question 44

What is acculturative stress?

Answer 44

• • When the individual is trying to navigate between the demands (norms, expectations) of two different cultures (two different ways of behaving)
    1) Marginalization: weak native cultural identity and weak identity with new culture. Causes the most stress out of the rest.
    2) Assimilation: weak native cultural identity but strong identity with new culture. Not necessarily a source of stress, but still not optimal.
    3) Separation: strong native cultural identity but weak identity with new culture.
    4) Integration: strong native cultural identity and strong identity with new culture. This is optimal as it causes the least source of stress out of all

Question 45

What is the evolutionary perspective of the stress response?

Answer 45

• • based on the fight or flight
• • females are more likely to protect their young (tend and befriend) than to flee
• • Male responses of fight or flight may be mediated by testosterone
• • Evolutionary Perspective: it was more adaptive (reproductive success) for females to nurture their offspring (tend), and to form social alliances (befriend)
• • both males and females will do the fight or flight, and tend and befriend but they do it in different proportions

Question 46

What is coping?

Answer 46

• • Consists of cognitive and behavioural efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person
• • There is also an Emotional response to stressors that both influences, and is influenced by, our coping response
• • A given coping process may be effective in one situation, but not in another - depending on the controllability of the situation
• • in situations where the stressor is uncontrollable, then it is more adaptive to take an emotion focused approach to coping
• • in situations where the stressor is controllable, it is more adaptive to take a problem focused approach
• • Coping responses may produce mixed results

Question 47

What is problem-focused coping?

Answer 47

• A rational approach that attempts to change the situation by changing either something in the environment or how the person interacts with the environment
• Includes both cognitive and behavioural coping
• Adaptive if the stressor is controllable
• Includes – planning, analyzing information, seeking information, recruiting allies, asking for help, fixing or removing the stressor

Question 48

What is emotion-focused coping?

Answer 48

• The person addresses the emotions that accompany the problem, not the environmental stressor itself (allow you to feel the emotion)
• Adaptive if the stressor is uncontrollable
• Includes – seeking emotional support, meditation, prayer, exercise, venting, ruminating
• Can also include “avoidant” coping strategies (denial)

Question 49

What is reappraisal?

Answer 49

• Our coping strategies leads to a re-appraisal of the stressor and new resultant emotional responses based on this reappraisal.
• When we can’t fix or change the past. Changing the way you think with that past stressor. A new emotional style to deal with past stressor. Learning from past experience/stressor

Question 50

What are the 14 coping styles?

Answer 50

1. Active Coping – taking active steps to try to remove the stressor. Focusing on the problem
2. Planning – thinking about how to cope with a stressor. Coming up with a strategy to cope
3. Suppression of competing activities – putting other projects aside and trying to avoid being distracted.
4. Restraint coping – waiting until an appropriate opportunity to act presents itself.
5. Seeking social support for instrumental reasons – seeking advice, assistance, or information.
6. Seeking social support for emotional reasons – getting moral support, sympathy, or understanding.
7. Positive reinterpretation and growth – managing distress emotions resulting from the stressor. This is re-appraisal
8. Acceptance – accepting the reality of the stressful situation and move past that. Emotional style of coping
9. Turning to religion – the tendency to turn to religion in times of stress.
10. Focus on and venting of emotions – the tendency to focus on whatever distress or upset one is experiencing and to ventilate those feelings.
11. Denial – refusal to believe that the stressor exists or trying to act as though the stressor is not real.
12. Behavioural disengagement – reducing one’s efforts to deal with the stressor. Typically, not functional or adaptive
13. Mental disengagement – using alternative activities to take one’s mind off a problem. Doesn’t make you feel any less stressed
14. Humour – creating humour about the situation diffuses the associated tension

Question 51

What is proactive coping?

Answer 51

– The ways people cope in advance to prevent or mute the impact of events that are potential stressors (the results of an upcoming test, a medical procedure, a lay-off)
– Focuses on
• recognizing and appraising potential stressors,
• preliminary coping efforts, and
• the importance of building a reserve of resources that can be used to prevent/offset future problems

Question 52

How does humour buffer against stress?

Answer 52

• Reduces the threatening nature of stressful situations through cognitive reappraisal.
• Lessens depressive symptoms by reframing the situation as less threatening, fostering positive perspective, reducing tension and discomfort, and attracting social support.

Question 53

What is psychoneuroimmunology?

Answer 53

• The field that explores connections among psychological factors (such as attitudes and emotions), the nervous system, and the immune system
• Acute stressors can produce immunological changes (increase in the immune response in the short term)
• Chronic stressors are associated with an increasing downturn in immune system responsiveness, rather than adaptation.
• Positive social circumstances and low stress are associated with increased ability to fight cancer (increase in immune system functioning

Question 54

How does the body protect itself from invasion?

Answer 54

• Skin & mucous membranes
• Non-specific cells & substances that attack all invaders
• Antibodies and cells specifically tailored for the antigen

Question 55

What are antigens and epitopes?

Answer 55

• • Foreign invaders - Antigens include toxins, bacteria, parasites, viruses, and fungi
• • These are the proper targets of the immune system
• • antigens carry distinctive markers, characteristic shapes called epitopes that protrude from their surfaces. Epitopes elicits the immune response
• • Endogenous antigens don’t typically elicit an immune response. Foreign antigens elicit an immune response

Question 56

What are lymphoid organs?

Answer 56

• • •Organs of the immune system, are stationed throughout the body
• • •They are concerned with the growth, development, and deployment of lymphocytes - white blood cells that are key operatives of the immune system

Question 57

What are lymphocytes and the types?

Answer 57

– Lymphoid precursors develop into the small white blood cells called lymphocytes. The two major classes of lymphocytes are B cells and T cells

Question 58

What are B-cells?

Answer 58

• • B-cells or B-lymphocytes are the cells responsible for producing antibodies
• • Antibodies are proteins that circulate in our blood stream looking for antigens (foreign invaders)

Question 59

What are T-cells?

Answer 59

•T cells contribute to the immune defenses in two major ways. Some help regulate the complex workings of the immune system, while others are cytotoxic and directly contact infected cells and destroy them. Helper t cells activate or suppress other immune cells. Cytotoxic t cells are toxic to cells that directly kill antigens

Question 60

What are natural killer cells?

Answer 60

• • At least two types of lymphocytes are killer cells - cytotoxic T cells and natural killer cells
• • To attack, cytotoxic T cells need to recognize a specific antigen, whereas natural killer (NK) cells do not (will kill anything)

Question 61

What are cytokines?

Answer 61

• Chemical messengers secreted by the cells of the immune system
• Cytokines encourage cell growth, promote cell activation, direct cellular traffic, and destroy target cells—including cancer cells

Question 62

How do cancerous cells develop?

Answer 62

• • When normal cells turn into cancer cells, some of the antigens on their surface change
• • Normal cells pass through a limited number of cell divisions before they die
• • Cancer cells may be immortal – they may reproduce indefinitely
• • (contact inhibition); normal cells stop growing when they come in contact with other cells. Cancerous cells do not have contact inhibitions

Question 63

What virus is associated with cancer?

Answer 63

Epstein-Barr Virus

Question 64

How is Psychoneuroimmunology & cancer related?

Answer 64

• behavioural and psychological factors have an impact on cellular immune response – ultimately affecting the occurrence and progression of certain tumours

Question 65

How is Psychoneuroimmunology & Alzheimers related?

Answer 65

• For the caregivers, poor NK response to cytokines (poor immune) correlated with less social support, less emotional closeness, and more physician visits

Question 66

What are indirect effects of stress?

Answer 66

• Bereaved spouses had elevated cortisol and decreased NK cell activity.
• Spouses of cancer patients – social support positively correlated with NK cell activity.
• Inciting an argument among newlyweds – the amount of negativity or hostility in the argument was negatively correlated with NK cell activity 24 hours later (more hostility, more suppression of the immune system )

Question 67

What are direct effects of stress?

Answer 67

• Most carcinogens appear to induce tumours by damaging cellular DNA – producing abnormal cells.
• The body defends against this by attacking the carcinogen, repairing the DNA, and destroying the abnormal cells.
• Patients with emotional stress exhibited poorer ability to repair damaged cellular DNA (relative to controls).
• Contrasting findings – medical students’ perceived stress was positively associated with DRC (DRC = DNA Repair Capacity). They have a perception of control which may be why they are not negatively affected by stress

Question 68

How does stress impair immune response?

Answer 68

• At lower levels of stress, norepinephrine increases lymphocyte activity. But at higher/chronic stress levels, norepinephrine lowers lymphocyte activity.
• For acute stress, the adrenal glands release cortisol to stimulate the body’s organs into action. But for chronic stress, cortisol slows down the functioning of the immune system (slows lymphocyte activity).

Question 69

What was the Fawzy & colleagues study of people recovering from cancer?

Answer 69

• Evaluated the immediate and long-term effects of a 6-week structured group intervention (health education, problem solving training, stress management techniques, social support).
• Treatment condition subjects – increased NK cell number and NK cytotoxic activity.
• In a 6-year follow up, the treatment condition subjects demonstrated lower disease recurrence and lower mortality rates.