Chapter 5 Flashcards

1
Q

Mental health conditions where stress has been shown to play a significant role:

A
  • anxiety, depression, schizophrenia, PTSD
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2
Q

Physical health problems linked to stress

A
  • viral infection, CHD, inflammation
  • often accelerates progression or delays recovery
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3
Q

Stressor

A
  • external demands
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4
Q

Stress

A
  • effect stressors create on an organism
  • anything that requires significant readjustment (can be good things like marriage!)
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5
Q

Coping Strategies

A
  • efforts to deal with stress
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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
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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)
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8
Q

5HTTLPR gene

A
  • linked to likelihood of becoming depressed in the face of life stress
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9
Q

Stress tolerance

A
  • ability to withstand stress without becoming severely impaired
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10
Q

Resilience

A
  • healthy psychological and physical functioning after a potentially traumatic event
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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
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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)
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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
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14
Q

Stress severity

A
  • stressors involving more important aspects of life are highly stressful
  • longer stressor = more severe effects
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15
Q

Crisis

A
  • times when stressful situation threatens to exceed (or exceeds) the adaptive capacities of a person
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16
Q

Social Readjustment Rating Scale

A
  • self-report checklist of common stressful life experiences
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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
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18
Q

Trauma and stress related disorders DSM

A
  • PTSD
  • adjustment disorder
  • acute stress disorder
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19
Q

Allostatic load

A
  • biological cost of adapting to stress
  • stress increases risk of getting a cold, heart attack, aggravating other issues, etc.
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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
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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