Chapter 7

Question 1

• physiological response is often implicated as a contributor to a variety of individual physical and mental challenges and societal problems
• factors: political climate, personal safety, the future, police violence, work and economy, terrorism, mass shootings, and gun violence
• increased from 71% in 2016 to 85% in 2017

Answer 1

Stress

Question 2

• a multicellular organism is able to survive only as long as the composition of the internal environment is compatible with the survival needs of the individual cells
• achieved through a system of carefully coordinated physiologic processes that oppose change
  
  • these processes are largely automatic and emphasized that homeostasis involves resistance to both internal and external disturbances
  • when a factor is known to shift homeostasis in one direction, it is reasonable to expect the existence of mechanisms that have the opposite effect
• as long as the responding mechanism to the initiating disturbance can recover homeostasis, the integrity of the body and the status of normality are retained

Answer 2

Homeostasis

Question 3

• consist of a collection of interconnected components that function to keep a physical or chemical parameter of the body relatively constant -regulate cellular function, control life processes, and integrate functions of the different organ systems
  
  • biochemical messengers in the brain, control nerve activity, regulate info flow, and influence behavior
    
    • mediate the physical, emotional, and behavioral reactions to stressors that are called stress response
• Stress Response: involves a sensor to detect the change, an integrator to sum all incoming data and compare them with “normal” and effector(s) to try to reverse the change
• complex stressors invoke more complex control systems and the stress response cannot restore balance and homeostasis
  
  • impact may appear decades later, in the form of mental health issues, immune dysregulations, cardiovascualr diseases, cancer; important to identify early negative experiences and treat them for the future health of the adult
• beneficial to actively create a feeling of balance (keep a journal)

Answer 3

Control Systems

Question 4

• most control systems in the body operate by negative feedback mechanisms
• the reason most physiologic control systems function under negative rather than positive feedback mechanisms is that a positive feedback mechanism interjects instability rather than stability into a system
  
  • produces a cycle in which the initiated stimulus produces more of the same

Answer 4

Feedback systems

Question 5

• increased focus on health promotion has heightened interest in the role of stress and biobehavioral stress responses in the development of disease
• stress may contribute directly to the production or exacerbation of a disease, or it may contribute to the development of behaviors
  
  • smoking, overeating, and drug abuse (increase risk of disease)

Answer 5

Health promotion

Question 6

• describes stress as a state manifested by a specific syndrome of the body developed in response to any stimuli that made an intense systemic demand on it
  
  • noticed that people with diverse disease conditions had many signs and symptoms in common
• labeled response to stressors as the General Adaptation Syndrome (GAS)
  
  • general:the effect was a general systemic reaction
  • adaptive:the response was in reaction to a stressor
  • syndrome: the physical manifestations were coordinated and dependent on each other
  • involves stages:
    
    • Alarm stage: characterized by a generalized stimulation of the sympathetic nervous system and the HPA axis, resulting in the release of catecholamines and cortisol
    • Resistance stage: the body selects the most effective and economic channels of defense, the increased cortisol level drop because they are no longer needed
    • Exhaustion stage: when the stressor is prolonged or overwhelms the ability of the body to defend itself, resources are depleted and signs of wear and tear or systemic damage appear
• many ailments appear to be initiated or encouraged by the body because of its faulty adaptive reactions to potentially injurious agents
• stressors: events or environmental agents responsible for initiating the stress response
  
  • could be endogenous, arising from w/in or exogenous, arising from outside the body
• 2 factors determine the nature of stress response
  
  • properties of the stressor
  • conditioning of the person being stressed
• not all stress is detrimental
  
  • mild, brief, and controllable periods of stress could be perceived as positive stimuli to emotional and intellectual growth
  • severe, protracted, and uncontrollable situations of psychological and physical stress that are disruptive to health
• conditioning factors: stressors producing different responses in different people or in the same person at different times, indicating the influence of adaptive capacity of the person
  
  • may be internal (genetic predisposition, age, sex) or external (exposure to environmental agents, life experiences, dietary factors, level of social support)

Answer 6

Selye and Stress

Question 7

• confers an adaptive advantage during a stressful situation
• fight or flight response
  
  • most rapid of the stress responses
  • increases attention and arousal
  • heart and respiratory rates increase, hand and feet become moist, pupils dilate, mouth becomes dry, and the activity of the GI tract decreases

Answer 7

Locus Coeruleus (LC)

Question 8

• secreted from the hypothalamus in response to stress stimulus induces secretion of ACTH and then stimulates the adrenal gland to synthesize and secrete glucocorticoid hormones
• cortisol acts not only as a mediator of the stress response but as an inhibitor
• meant to protect the organism against the effects of a stressor and to focus energy on regaining balance in the face of an acute challenge to homeostasis

Answer 8

Corticotropin-Releasing Factor (CRF)

Question 9

-enhances CRF formulation and release, contributes to the release of ACTH from the pituitary, enhances stress-induced release of vasopressin form the posterior pituitary, and stimulates the release of NE from the LC

Answer 9

Angiotensin II

Question 10

• females
  
  • stress and severe trauma can cause menstrual irregularities, anovulation, and amenorrhea
• males
  
  • stress can induce decreased spermatogenesis, ejaculatory disorders, decreased levels of testosterone, and infertility

Answer 10

Stress in Genders

Question 11

• hallmark of stress response are the endocrine-immune interactions
  
  • known to suppress the immune response
  • produce the physical and behavioral changes designed to adapt to acute stress
• exact mechanisms by which stress produces its effect on the immune response is unknown and probably varies from person to person, depending of genetic and environmental factors
• 2nd route for neuroendocrine regulation of immune function is through the sympathetic nervous system and the release of catecholamines
• not only is the quantity of immune expression changed because of stress, but the quality of the response is changed as well
  
  • stress hormones differentially stimulate the proliferation of subtypes of T lymphocyte helper cells
    - they stimulate different aspects of the immune response

Answer 11

Immune Responses

Question 12

• human beings usually have alternative mechanisms for adapting and have the ability to control many aspects of their environment
• many of the body’s responses to physiologic disturbances are controlled on a moment-by-moment basis by feedback mechanisms that limit their application and duration of action
• the response to physiologic disturbances that threaten the integrity of the internal environment is specific to the threat
• the response to psychological disturbances is not regulated with the same degree of specificity and feedback control
  
  • effect may be inappropriate and sustained

Answer 12

Coping and Adaptation to Stress

Question 13

• Adaptation: an individual has successfully created a new balance between the stressor and the ability to deal with it
• coping mechanisms: means used to attain the balance between the stressor and the ability to deal with it
  
  • physiological and anatomic reserve
  • time
  • genetics
  • age
  • gender
  • health status
  • nutrition
  • circadian rhythm
  • hardiness
  • psychosocial factors
• how we cope with stressful events depends on how we perceive and interpret the event

Answer 13

Factors Affecting the Ability to Adapt

Question 14

• one that occurs over a short time and does not recur
• reactions are associated with the ANS; fight or flight
  
  • pounding headache, cold and moist skin, stiff neck, arousal, alertness, vigilance, cognition, and focused attention
• can result from either psychologically or physiologically threatening events

Answer 14

Acute stress

Question 15

• frequency or chronicity of circumstances to which the body is asked to respond often determines the availability and efficiency of the stress response
• function can be altered in several ways, including when a component of the system fails, when the neural and hormonal connections among the components of the system are dysfunctional, and when the original stimulus for the activation of the system is prolonged or of such magnitude that it overwhelms the ability of the system to respond appropriately
  
  • system may become overactive or underactive
• chronicity and excessive activation of the stress response can result from chronic illnesses as well as contribute to the development of long-term health problems
• linked to a myriad of health disorders: cardiovascular, GI, immune, neurologic systems, depression, chronic alcoholism, drug abuse, eating disorders, accidents, and suicide

Answer 15

Chronic Stress

Question 16

• a disabling syndrome caused by the chronic activation of the stress response as a result of experiencing a significant traumatic event
• may occur with no recollection of an earlier stressful experience
• PTSD with delayed onset: manifested 6 months after the traumatic event
• at risk for the development of major depression, panic disorder, generalized anxiety disorder, substance abuse, physical symptoms and illnesses (hypertension, asthma, and chronic pain syndromes)
• characterized by a constellation of symptoms that are experienced as states of intrusion, avoidance, and hyperarousal
  
  • intrusion: occurrence of flashbacks during waking hours or nightmares in which the traumatic event is relived, often in vivid and frightening detail
  • avoidance: emotional numbing that accompanies this disorder and disrupts important personal relationships
  • hyperarousal: presence of increased irritability, difficulty concentrating, and exaggerated startle reflex, and increased vigilance and concern over safety
• memory problems, sleep disturbances, and excessive anxiety
• for it to be diagnosed the person must have experienced, witnessed, or confronted a traumatic event, which caused a response in the person involving horror and fear
• healthcare professionals need to be aware that people who present with symptoms of depression, anxiety, and alcohol or drug abuse may in fact be suffering from PTSD
• person with PTSD should not be made to feel responsible for the disorder or that it is evidence of a so called character flaw

Answer 16

PTSD

Question 17

• early intervention can assist the person in adapting new and effective coping mechanisms to better manage stress in the future
• should be directed toward helping people avoid coping behaviors that impose a risk to their health and providing them with alternative stress reducing strategies
• use purposeful priority setting and problem solving
• relaxation, guided imagery, music therapy, massage, and biofeedback

Answer 17

Treatment of stress

Question 18

• not everyone who experiences stressful life events develops a disease
• although healthcare professionals continue to question the role of stressors and coping skills in the pathogenesis of disease states, we must resist the temptation to suggest that any disease is due to excessive stress or poor coping skills

Answer 18

Research