Motohiro: Stress and Coping Flashcards
What is stress?
Stimulus (stressor/event)>
Process (interactions between the two)>
Response (strain)
“A physical or emotional factor that causes bodily or mental tension, and may lead to disease causation”
What is a physical stress?
a DIRECT physical threat to one’s well-being
Ex:
Cold, heat, infection, extended exercise etc.
What is physiological stress?
an event that is PERCEIVED as negative (not physically threatening–> TOP- DOWN)
Ex:
Loss of a loved one
Major personal disappointment
Unemployment
What are the two systems that stress activates in the brain?
The Sympathetic-Adrenal-Medulla (SAM) axis
The Hypothalamus-Pituitary-Adrenal (HPA) axis
What are the two components of SAM and how do they regulate autonomic balance?
Sympathetic–prepares body to respond to emergencies (secretion of EPI/NE from adrenal medulla> increased BP and HR)
Parasympathetic–controls organs under normal conditions (decreases HR)
What does the Hypothalamus release when it’s under stress?
CRH> anterior pituitary> ACTH> adrenal cortex> Cortisol> IS/Liver/Muscle/Adipose> IS suppressed, gluconeogenesis, protein catabolism, lipolysis
SAM activation acts on the adrenal MEDULLA to secrete…
NE and EPI
HPA acts on the adrenal CORTEX to secrete…
steroids (cortisol)
How does cortisol inhibit immune functions?
Decreased macrophage cell ingestion
Decreased IL-1 production by macrophages
What is allostasis?
More focused on active processes to maintain homeostasis
*brain detects non-optimal states and compensates = homeostasis
What is the flight or fight response?
Increases chance of survival
Incorporates powerful EMOTIONAL (anxiety, fear, anger), NEUROENDOCRINE and AUTONOMIC changes to increase chance of survival.
What are the 3 components of General Adaptation Syndrome (GAS)?
- ALARM RXN where the body detects the external stimulus
- ADAPTATION where the body engages in defensive countermeasures against the stressor
- EXHAUSTION where the body begins to run out of defenses (results from long-term exposure to the stress)
* LINKED stress and illness
What is coping?
Dynamic process/internal effort to manage demands that are seen as taxing or exceeding the resources of the person
What are coping behavioral techniques?
Relaxation Cognitive strategies Stress inoculation Exercise Social support Pharmacological interventions (benzos- Cl channel and beta blockers)
Why is stress good for you?
It’s a centrally mediated process to help the organism adapt to the environmental demand
*best at MODERATE levels of stress
Chronic/excessive stress can lead to….
development/progression of illness
What are type A coping behaviors?
Time urgency Impatience Competitiveness Hostility--most associated with Coronary heart disease May not cope well with stress
What are the steps in the process of coping?
- environmental event
- primary appraisal
- secondary appraisal
- coping behaviors
- coping outcomes (biological, psychological, behavioral)
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.”
Tend to perform poorly to similar stressful situation later even if they have coping skills
What is psychological hardiness?
Perceive stressful events as CHALLENGES rather than threats
Believing that you have CONTROL over aversive events
Related variable is OPTIMISM
What is the cardiovascular response to stress?
Exaggerated cardiovascular reactivity to stress is associated with CHD.
Cardiovascular responses is related to the development of HTN
Activation of HPA system is also associated w/ development of CVD.
The combination of cortisol and cholesterol diet for 52 weeks 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 is a RF for the 1st and recurrent cardiac events?
depression
5 odd ratio for MI in those with history of major depression
What emotions contribut to increased risk for CVD?
anxiety, anger, hostility
What unhealthy behaviors are ppl more likely to engage in under stressful circumstances?
Tobacco use
Excessive alcohol use
Poor dietary habits
Sedentary lifestyle
*problems when used as regular coping strategies b/c they don’t help
What are physical disorders caused by or exacerbated by stress?
Diabetes Hypertension Cardiovascular disorders Cancer Ulcers Migraine and tension headaches Asthma Arthritis Colitis Muscle tension problems
How may stress effect the doctor-pt relationship?
Lower compliance w/ medical regimens
drug seeking behaviors
What are the similarities and differences btwn stress and exercise?
Both activate SNS
Good for you as long as it doesn’t exceed your capacity
Emotional outcome is different
Length of time
