Introduction to Stress Flashcards
What is a Stimulus in stress?
Stressor
What is a Response to stress?
Strain
What is the process of stress?
Interactions between stimulus and response
What are two definitions of stress?
- “A physical or emotional factor that causes bodily or mental tension and may lead to disease causation”
- “A negative emotional experience accompanied by biochemical, physiological, cognitive and behavioral changes that are directed toward altering the stressful event.”
What is physical stress?
A direct physical threat to one’s well-being - cold, heat, infection, extended exercise, etc.
What is psychological stress?
An event that is perceived as negative (not physically threatening) —> Loss of a loved one, major personal disappointment, unemployment
What are two pathways that work in response to stress?
- Sympathetic-Adrenal-Medulla (SAM) axis
2. Hypothalamus-Pituitary-Adrenal (HPA) axis
What happens in the Sympathetic-Adrenal-Medulla axis in response to stress?
- Prepares organ to respond to state of emergency
2. Adrenal medulla secretes catecholamines (NE and EPI)
What happens in the Hypothalamus-Pituitary-Adrenal (HPA) axis in response to stress?
- Corticotropin-Releasing Hormone (CRH)
- Goes to anterior portion of pituitary gland
- Releases ACTH (Adrenocorticotropic Homrone)
- Adrenal cortex produces cortisol (glucocorticoid hormone)
- Normal metabolic functions and efficiency under state of emergency (energy utilization)
What does the diagram of the HPA axis show?
- Circadian Rhythm disruptions or Stress cause the release of…
- CRH which leads to the release of…
- ACTH which leads to the release of…
- Cortisol
What are the functions of Cortisol from the HPA diagram?
- Negative feedback upon ACTH and CRH
- Suppresses immune system function
- Causes gluconeogenesis in the liver (producing glucose)
- Causes protein catabolism in the muscle (producing a.a.)
- Causes lipolysis in the adipose tissue (producing fat particles)
How can cortisone inhibit immune functions?
- Dec. macrophage response to IL-2 or interferon-g –> Dec. macrophage cell ingestion
- Dec. IL-1 production by macrophages –> Dec. IL-2 production by T cells
- Dec. production of CD4 cells
- Dec. activity of B lymphocytes –> Dec. activity of NK cells
What three main things did Walter Cannon describe (1871-1945)?
- Homeostasis
- Allostasis
- Fight-Flight Response
What is Homeostasis?
The collective process of maintaining the internal physiology stability in the face of environmental change
What is Allostasis?
(Refinement of homeostasis): the compensation that an organism does to achieve homeostasis successfully
- -> Brain is able to detect non-optimal internal states & it can use lots of mechanisms to compensate correctly
- -> Failure to meet such challenges of homeostasis can result in tissue damage or death
What is homeostasis a dynamic balance between?
The autonomic branches
- Stress –> sympathetic activity dominants –> fight or flight
- Normal resting condition –> parasympathetic activity dominates –> rest and digest
What is the Fight-Flight Response?
- Organisms better equipped to defend themselves would have a survival & evolutionary advantage over those less equipped
- The term “fight-flight response” is used in reference to this loosely defined constellation of survival functions
- Fight-flight response is a prototype stress response
- Fight-flight response incorporates powerful emotional (anxiety, fear, anger), neuroendocrine and autonomic changes to increase chance of survival
What was Hans Selye’s contribution?
He proposed a general model of stress reactivity which described physiological mechanisms for the stress-illness relationship
What is General Adaptation Syndrome (GAS)?
- Alarm Reaction
- Adaptation
- Exhaustion
What is the Alarm Reaction?
Body detects the external stimulus
What is Adaptation?
Body engages in defensive countermeasures against the stressor
What is Exhaustion?
Body begins to run out of defenses (results from long-term exposure to the stress)
What is the Limitation of Hans Selye’s work?
Lack of psychological and social influences
What are Psychological Stressors?
Do not pose a direct physical threat
What are examples of Psychological Stressors?
Familial issues (ex: divorce), social issues (ex: job strain)
What did Richard Lazarus come up with (1922-2002)?
COPING!
What is coping?
The process of managing demands that are appraised as taxing or exceeding the resources of the person
–>Includes efforts (action-oriented or emotion-focused) to manage environmental demand
How do we describe the relationship between coping and a stressful event?
Dynamic (not a one-time action). The relationship between coping and a stressful event is dynamic.
–Encompasses a wide variety of actions to stressful situations
Describe the process of coping:
- Environmental Effect
- Primary Appraisal (Assessment of situation)
- Secondary Appraisal (Assessment of resource(s) that are available)
- Coping Behaviors
- Coping Outcome (Biological -Autonomic, Endocrine, Immune Systems) (Psychological - Cognitions) (Behavioral)
What are some behavioral coping techniques?
- Relaxation - ex. progressive muscle relaxation
- Cognitive strategies - problem-focused or emotion-focused coping
- Stress inoculation - systematic assessment in which healthcare professional supply clients with sets of cognitive and behavioral skills to use during stressful situations
- Exercise - just make sure you don’t exceed your limit
- Social support - quantity vs. quality (quality more important)
- Pharmacological interventions (Benzodiazepines, beta-blockers reduce stress-related anxiety)
- Biofeedback
Can Stress be good for you?
- Stress response is a centrally mediated process to make the organisms adaptive to the environmental demand
- Quality of functioning is best at moderate (or optimal) levels of stress
- Performance peaks at moderate stress level (remember performance vs. stress bell curve)
- ->Moderate, short-lived stress -> coping mechanisms -> better adaptability -> better performance
- Chronic and excessive stress could lead to the development or progression of illness
- ->Happens with people suffering from chronic diseases
What is Type A Behavior?
Time urgency, impatience, competitiveness, self-critical –> may not cope well with stress
- Hostility/anger –> exaggerated CV response to stress –> coronary heart disease
- Also have more interpersonal conflict –> reduced social support
What is the sense of control for stressed people?
Tendency to perceive stressors as uncontrollable
What is Learned Helplessness?
Repeated efforts to exert control in situations that fail to achieve an organism’s desired effects lead to a sense of “helplessness”
–> Once individuals learn that they do not have control over a stressful situation, they tend to perform poorly to a similar stressful situation later even if they are provided with coping skills
What is Psychological Hardiness?
- Believing that you have control over aversive events.
- Related variable is optimism - do better (when realistic) but may be harmful if it is excessive (underestimate impact of stress, use negative coping strategies)
What do Psychologically Hardy people do?
Perceive stressful events as challenges rather than threats
How does Stress relate to Cardiovascular Reactivity?
- Exaggerated cardiovascular reactivity to stress is associated with CHD
- Research has shown that CV responses to acute laboratory stress (public speaking) is related to development of HTN
How does Stress relate to the Endocrine System?
- Chronic activation of HPA system is associated with the development of cardiovascular disease
- -> Combo of cortisol and cholesterol diet for 52 wks produced significant atherosclerotic injuries in the aortic intimal surface in monkeys
- ->There is a positive association between plasma levels of cortisol and early atherosclerosis in humans as documented by coronary angiography
What type of association is there between chronic activation of the HPA system and the development of cardiovascular disease?
Positive association – correlation not causation
What is a major risk factor of the 1st and recurrent cardiac events?
Depression
What is the Odd Ratio for MI in those with a history of major depression?
5
What contributes to increased risk for CVD?
Intense anxiety, anger, and hostility
What unhealthy behaviors do people engage in under stressful circumstances?
- Tobacco use - cigarettes produce cortisol –> stimulates stress patterns
- Excessive alcohol use
- Poor dietary habits
- Sedentary lifestyle
What are other issues related to stress?
- Stress is linked with lower compliance with medical regimens
- Stress may increase care-seeking behavior for minor sx but may decrease care-seeking for serious ones
- These may influence disease progression
What are some physical disorders caused by or exacerbated by stress?
- Hypertension
- Cardiovascular disorders
- Cancer
- Ulcers
- Migraine and tension headaches
- Asthma
- Arthritis
- Colitis
- Muscle tension problems
