l19@psychneuro

Question 1

draw a diagram reflecting the models that affect the biological immune mechanisms

Answer 1

Outside- Social model (support)

Psychological model - (stress, depression, humour, coping, appraisal)

Inside- Biological- (immune system)

Question 2

what is the PNI

Answer 2

psychoneuroimmunology ​- how links between emotions and health were part of the pre-modern thought: humoural medicine

(the study of the effect of the mind on health and resistance to disease.)

Question 3

give evidence of PNI

Answer 3

1)classic early study found decreased phagocyte activity in tuberculosis patients when they were emotionally agitated ​(Ishigami, 1919)​
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2)substantial empirical evidence to demonstrate and explain links between psychological states and immune function

(two major areas of interest are stress and depression​
+ more recent interest in positive emotions​)​
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3)links between immunity (PNI) and endocrinology (PNE)​

4)increasing evidence of pathogenic involvement in diseases not previously thought to involve infection and inflammatory processes

(H.pylori implicated in stomach ulcers and MI​)
​

Question 4

expand on humoural immunity

Answer 4

the 4 humours - blood, yellow bile, black bile, phlegm - imbalances in these were not just influenced by diseas, but also the emotions​

• the sanguine personality is named after the latin for blood ​
• the melancholic personality is named after the latin words for black and bitter bile​

Question 5

describe the general adaptation syndrome

Answer 5

consists of 3 phases:

• alarm
• resistance
• exhaustion

alarms- body is mobilised against the stressor​

Resistance-arousal stays high as body defends / adapts

exhaustion-​
resources are​
depleted, ​
resistance ​
may collapse​

Question 6

what is the relationship between stress and immunity

Answer 6

Stress and immunity- when body is threatened body is rapidly aroused and motivated by sympathetic nervous system (SNS) and HPA

​

Question 7

can the alarm phase be stitched

Answer 7

yes-Alarm can be switched on and off depending on how large stressor is ​
If stress is longer, resistance occurs to try and prolong response ​

Until the exhaustion phase comes in which occurs when resources are depleted

Due to different stressors in present ie money, exams, climate change, the stressors are longer- it isn’t an appropriate response to our psychological stressors ​

Question 8

is stress good or bad for the immune system

Answer 8

yes- depending on its duration stress can be good or bad, ​
​
Prolonged exposure to stress can be bad- due to exhaustion and depletion of resources ​
​
Cortisol production goes up due to HPA axis, causing immune function to go down ​

Question 9

why is prolonged stress harmful

Answer 9

it increases the allostatic load

short term: protects -acute

can harm in the long term- chronic

Question 10

what is the allostatic load

Answer 10

allostatic load refers to the physiological costs of prolonged exposure to fluctuating or elevated neural or endocrine responses​

measures of allostatic load include ​

• decreased cell-mediated immunity​
• inability to shut off cortisol in response to stress​
• elevated epinephrine levels​
• reduces hippocampus volume​

Question 11

what exactly is stress

Answer 11

stress is a negative experience accompanied by predictable changes aimed at altering the stressful event and/or accommodating its effects :​

• biochemical
• cognitive​

-physiological
-behavioural​
​

Question 12

what is stress a response to

Answer 12

a stressor and therefore appraisal of stressor is important

Question 13

evidence for negative effects of stress

Answer 13

-among school children, cortisol levels were generally higher on test days, but they were highest in some children - the ones who care about the test

therefore Response to stress is important and different for everyone depending on outlook on situation ​

Question 14

what is the transactional model

Answer 14

there is not a particular leap between stress and stressors

it goes: stressors- primary appraisal- secondary appraisal - stress

Primary appraisal :(outlook)

• positive / negative / neutral?​
• harmful / threatening / challenging?​

secondary appraisal : (resources)-can coping abilities/resources meet ​the harm, threat, or challenge?

secondary - can be in a social context

if resources insufficient then it leads to stress ​

Question 15

what is the perception/expectation and experience (Keller et al., 2012)​ model

Answer 15

high amounts of stress and the perception that stress harms health are both associated with poor health and mental health.​

• individuals who perceived that stress affects their health and reported a large amount of stress had a significantly increased risk of premature death​
  ​

Question 16

what does reactivity refer to

Answer 16

Reactivity refers to autonomic, neuroendocrine, and/or immune responses to stress ​
- It is thought to reflect a genetically-based disposition.

it may vary depending on the nature of stressors

with a higher reactivity related to worse health outcomes: assessed physiological reactivity (cardiac or immune)​

• looked at numbers of stressful events over next 12 weeks (reported by parents)​
• correlated with illness rates during same period.​
• kids who were more reactive were more likely become ill in response to stress​​

Question 17

stress aetiology

Answer 17

men show more reactivity to stress than women ​
men tend to take longer for their physiological arousal to return to baseline levels once the stressor has ceased​
​
men’s and women’s reactivity varies depending on the type of stressor​
- men more reactive when competence is challenged​
- women more reactive when friendship/love is challenged (Smith et al. 1998)​

Question 18

what is coping

Answer 18

actions people take to reduce stress. ​

= processes used to manage perceived discrepancies ​
between the demands of a situation and their perceived resources

(not all coping mechanisms are directed at solving the problem-some are directed at avoiding the problem )

Question 19

what are the 2 major models of coping

Answer 19

emotion-focused: includes behavioural and cognitive

problem focused: aimed at: reducing demands of situation and/or ​
increasing resources to deal with stressful situation​

different strategies are better suited for different stressors

Question 20

what is the problem focused model

Answer 20

e.g. devising (and sticking to) a study schedule, negotiating an extension on bill payment​
We tend to use problem-focused coping for situations that are more controllable ​
​
Seeking social support can be both emotion-focused and problem focused. Given the range of types of social support, it is clear that social networks can be valuable for coping​

Question 21

what is the emotional focused model

Answer 21

behavioural - e.g. alcohol/drug use, seeking emotional support from friends, engaging in activities that distract attention from the stressful situation (e.g. watching TV)​

cognitive - e.g. thinking differently about stressful situations (e.g. I’m better off without him; this experience has helped me to re-evaluate my goals/values) ​

We tend to use emotion-focused in uncontrollable situations - death of loved one ​

Question 22

describe different coping mechanisms and the model they express and effects

Answer 22

emotional :expressive writing-
emotional disclosure enhances mood, immune function, and health

relaxation / self-hypnosis / guided imagery- emotions​-
self-hypnosis / guided imagery​-
may mute effects of stress on immune system

problem solving and stress management -problem + emotions​-
can reduce effects of stress on immune function

physical activity​
can reduce effects of stress on cortisol

Question 23

describe the effects of a social support network

Answer 23

​
e.g. increased sociability associated in a linear fashion with a decreased ​
risk of developing cold (Cohen et al., 2003)​
​
high levels of loneliness and small social networks linked to lowest ​
antibody response to a flu vaccination

Question 24

effects of social support categorised

Answer 24

direct effects ​-
via psychosocial influences on endocrine and immune function - i.e. people feel less stressed​
​
indirect effects​-
people with better social support are more likely to adhere to medication and more likely to use health services​

Question 25

explain the relationship between depression and immunity

Answer 25

negative emotions - loneliness, pessimism, depression - impair immune function (Herbert & Cohen, 1993; Kiecolt-Glaser & Glaser, 2002)​
​
= greater susceptibility to infections​
​
= slower wound healing​
​
= altered immune function​
reduced number and function of lymphocytes ​
reduced number and function of NK cells​
changes in pro-inflammatory cytokines ​
increases in interleukin-6 (mediator of fever + inflammation)

Question 26

what is the dose-response effect

Answer 26

dose-response’ effect - more severe depression is related to greater immune effects​

Question 27

what can depression lead to

Answer 27

more rapid progression of disease- aids and cancer

Question 28

categorise the effects of depression

Answer 28

direct: effect on immune function​
indirect: unhealthy behaviour / lower adherence

Question 29

what can help with depression

Answer 29

psychological interventions to treat depression can affect course of immune disorders​

interventions that improve psychological well-being lead to improved ​
immune function

Question 30

what is the relationship between positive mood and immunity

Answer 30

• increasing evidence that positive moods and personalities are related to enhanced immune function
• positive events and moods may have longer-lasting effects on immune function than negative events

-ote: evidence less strong than for impact of negative emotions​
​
implications for interventions​

-based of modifiability

Question 31

describe some factors of positive mood and immunity and their modifiability

Answer 31

personality [hard to modify]​-
optimism, emotional expressiveness, extraversion associated with: NK cell cytotoxicity; proliferation of helper T lymphocytes

mood [modifiable]​-
watching comedy videos leads to increases in immune function