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current topics 2 > L4: stress & resilience > Flashcards

L4: stress & resilience Flashcards

1
Q

is stress a new phenomenon? (3)

A

no! it came under different words tho and was treated differently (nerves/zenuwden treated w barbiturates)

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2
Q

what is everyones unique stress profile made up of? (5)

A

environment (childhood trauma, life events, social environment)
+ psych (coping, stress performance, optimisim, neuroticism aka our inner world!)
+ biology (cortisol, adrenaline, brain activity, (epi) genetics))
-> resilience
-> psychiatric symptoms

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3
Q

how do we differ in stress? (1)

A

every person has a unique tipping point when stres exceeds resilience

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4
Q

what is the psychometric approach in defining resilience? (2)

A
  • measures resilience using questionnaire or survey
  • aka considers resilience a directly observable trait
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5
Q

What is the effect modification approach to defining resilience? (2)

A
  • looks at how various factors modify the impact of adversity by identifying buffering facotrs (psych, social, physical resources).
  • aka want to determine what factors protect ppl from harmful effects of stress/trauma
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6
Q

What is the a priori approach to defining resilience? (3)

A
  • research defined “resilience” before data collection
  • researchers pre-select or categorize individuals they believe are resilient based on certain characterstics
  • they then study these individuals to understand their resilience
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7
Q

What is the clustering approach to defining resilience? (4)

A
  • data driven technique
  • uses stats to identify patterns of resilience within populations
  • can find clusters or groups of individuals who show similar resilence patterns without predefined categories
  • exploratory method
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8
Q

What is the residual approach to defining resilience? (3)

A
  • identifies resilience as a deviation from the expected outcome
  • researchers build stat models (like regression lines) to predict typical responses to adversity
  • if someone does better than expected, this difference is considered a sign of resilience, or a “residual’ that explains their exceptional performance
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9
Q

What is the complex system approach to defining resilience? (3)

A
  • sees resilience as a dynamic process
  • so systems can show resilience through their ability to adapt & recover from disturbances
  • “critical slowing down”: resilient systems may experience delays or slow recovery before bouncing back, reflecting resilience over time
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10
Q

what are the 6 approaches to defining resilience?

A
  1. Psychometric approach
  2. Effect modification approach
  3. A priori approach
  4. Clustering approach
  5. Residual approach
  6. Complex system approach
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11
Q

how can an organization increase resilience to stress including burnout? (4)

A

through
1. Early proactive detection of stress with integral stress signals
2. Collaborative dialogue between employers and employees.
3. Customization and context
4. Attention to both individual and organizational solutions

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12
Q

what was found about reward processing after stress? (2)

A

increased ventral striatum and orbitofrontal cortex responses to positive task feedback post-stress

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13
Q

what was found about emotion processing after stress? (2)

A

suppression of default mode network and salience network activity post-stress

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14
Q

what are the molecular markers of stress in the brain? (4)

A
  • 216 differentially expressed genes in stress vulnerability related regions
  • genes associated w stress related psychiatric conditions
  • genes associated w stress and glucocorticoid responsiveness
  • specific neural populations & neurotransmitter receptors related to stress
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15
Q

is resilience always determined by the individual? (2)

A

no theres also
income, financial problems, environmental problems, work environment etc

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16
Q

how is childhood trauma related to resilience? (4)

A
  • CT reported by 40% of depressed patients
  • around 50% of childhood onset psychiatric disorders and 1/3 of all psychiatric disorders are related to CT
  • CT is arguably the most potent predictor of poor (mental) health across the life span
17
Q

why is it so important to target CT from a treatment perspective? (3)

A
  • depression severity & other mental health outcomes can be majorly reduced by treatment even in ppl w CT
  • CT is very common
18
Q

how does childhood trauma lead to disease manifestations (mental or physical)? (2->4, 1->3, 2->7, 3->7)

A
  • personality & cognition: higher neurotocism & negative self associations, lower extraversion & optimisim
  • bio stress systems: slightly elevated cortisol levlels, inflammation,cumulative stress systems’ markers
  • brain structure & function: reduced mPFC & amygdala volumes, amygdala hyperresponsivity, mPFC hypoactivity, connecitivty reductions in limbic/salience/defaullt mode networks
  • bio aging,lifestyle, somatic health: advanced epigenetic aging, accelerated telomere shortening, higher rates of smoking and BMI, increased metabolic syndrome, arterial stiffness, muscoskeletal pain
19
Q

what 3 levels need to be integrated in the approach to treating childhood trauma? (1->3, 1->11, 1)

A
  • context (socio cultural, community, interpersonal)
  • levels of funcitoning (endocrine, inflammatory, brain structure & function, cognitive, emotional, behavioural, social, quality of life, health, wellbeing)
  • time dynamics
20
Q

how does childhood trauma lead to psychopathology? (4)

A

childhood trauma -> reduced stress dynamics due to high cortisol levels -> more stress sensitivity -> psychopathology

21
Q

what is childhood trauma connected with in terms of somatic disease? (4)

A
  • cardiometabolic disease w/o depression
  • deprssion w/o cardiometaboloic disease
  • comorbidity between both conditions
    -> CT clinically relevant indicator connecting poor mental & somatic health
22
Q

how does CT affect stress reactivity? (4)

A
  • through epigenetics (DNA methytlation markers)
    CT -> DNA methytlation in the KITLG gene -> cortisol stress reactivity
23
Q

what are the brain changes in preterm infants? (1->1->4)

A

their higher stress levels impaired structural connectivity growth, including amygdala, insula, hippocampus, and PCC

24
Q

what does the MR CA haplotype (mineralocorticoid receptor) do? (1)

A

protects women but not men from the detrimental effects of childhood trauma

25
Q

through what 2 approaches can the effects of childhood trauma be reversed?

A
  1. biological approach w brief GR blocker mifepristone
  2. psych appraoch w psych trauma treatment for CT
26
Q

according to the RESET study, how did a brief GR blockade w mifepristone affect CT? (4)

A

it showed reversal effect of early life stress (ELS)
- reduced freezing behaviour
- restored post synaptic hippocampal transmission
working hypothesis: restores epigenetic regulation after ELS

27
Q

how well did mifeprisotne (GR bllocker) work in PTSD patients? (2)

A
  • in pilot study all 4 ptsd patients in mifepristone group achieved clinical response
  • used as open label treatment in the netherlands for treatment resistant ptsd
28
Q

can cortisol prevent PTSD? (4)

A
  • 3 meta analyses support hydrocortisone as an early intervention to prevent PTSD
  • cortisol released during traumatic experiences is powerful mnemonic modulator
  • but also supports memory integration & contextualization while suppressing new memory encoding & retrieval - processes that potentially interfere w consolidation
    -> disease interception by interfering w the posttraumatic hyperconsolidation that takes place in the first days after trauma
29
Q

what is “reset” psychotherapy? (3)

A

REStoring mood after Early life Trauma (therapy to target CT)
- through EMDR (for CT w predominant abuse/violence)
- through imagery rescripting (CT w predominant neglect)

30
Q

how reliable is the diagnosis “burnout”? (5)

A
  • theres no diagnotic interview
  • its not in the DSM
  • theres no goldens tandard for it
  • lots of overlap w depression / anxiety (77%)
    -> no clear definition so hard to diagnose clearly
31
Q

according to the research paradigm, what should mental health research focus on? (2)

A

resilience aka stress related disease prevention
rather than focusing on treating disorders after onset

32
Q

what is resilience research? (2)

A

research into understanding why some individuals maintain mental health despite significant stressors, so as to enhance prevention strategies

33
Q

what is a challenge in resiience? (4)

A
  • lack of consensus on how to define & measure it.
  • some see it as an ability, process, or collection of skills, while others consider it a stable trait
  • makes comparisons between studies hard & doesnt help the field advance
34
Q

why do we need dynamic, process oriented research? (3)

A
  • resilience cannot be understood as a fixed characteristic, its an ongoing dynamic adapatation to adversity.
  • so requires prospecctive longitudinal studies that track mental health over time in response to stresors
  • current reliance on cross sectional studies & resilience questionnaires is not dynamic enough
35
Q

how can we operationalize resilience? 3)

A

based on outcomes - specifically: stable or quickly recovering mental health folllowing adversity
resilience factors, like cognitive emotion regulation or social support, can factilitate these adaptive processes, but resilience itselff cant be predicted or measured before it occurs

36
Q

what are the 4 key proposals for future research in resililence?

A
  1. Resilience is a dynamic process of adaptation to stressors.
  2. Resilience is not a trait or stable personality profile but is influenced by various factors.
  3. Resilience should be measured after exposure to stressors based on mental health outcomes.
  4. More prospective longitudinal studies are needed to understand resilience mechanisms and predictors.
37
Q

why is resilience research so hard? (5)

A
  • expensive
  • time consumiing
  • complex
  • stressors exposure is often unpredictable
  • in many studies only a minority develop mental health problems

current topics 2 (6 decks)

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