Motohiro: Stress and Coping

Question 1

What is stress?

Answer 1

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”

Question 2

What is a physical stress?

Answer 2

a DIRECT physical threat to one’s well-being

Ex:
Cold, heat, infection, extended exercise etc.

Question 3

What is physiological stress?

Answer 3

an event that is PERCEIVED as negative (not physically threatening–> TOP- DOWN)

Ex:
Loss of a loved one
Major personal disappointment
Unemployment

Question 4

What are the two systems that stress activates in the brain?

Answer 4

The Sympathetic-Adrenal-Medulla (SAM) axis

The Hypothalamus-Pituitary-Adrenal (HPA) axis

Question 5

What are the two components of SAM and how do they regulate autonomic balance?

Answer 5

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)

Question 6

What does the Hypothalamus release when it’s under stress?

Answer 6

CRH>
anterior pituitary>
ACTH>
adrenal cortex>
Cortisol>
IS/Liver/Muscle/Adipose>
IS suppressed, gluconeogenesis, protein catabolism, lipolysis

Question 7

SAM activation acts on the adrenal MEDULLA to secrete…

Answer 7

NE and EPI

Question 8

HPA acts on the adrenal CORTEX to secrete…

Answer 8

steroids (cortisol)

Question 9

How does cortisol inhibit immune functions?

Answer 9

Decreased macrophage cell ingestion

Decreased IL-1 production by macrophages

Question 10

What is allostasis?

Answer 10

More focused on active processes to maintain homeostasis

*brain detects non-optimal states and compensates = homeostasis

Question 11

What is the flight or fight response?

Answer 11

Increases chance of survival

Incorporates powerful EMOTIONAL (anxiety, fear, anger), NEUROENDOCRINE and AUTONOMIC changes to increase chance of survival.

Question 12

What are the 3 components of General Adaptation Syndrome (GAS)?

Answer 12

1. ALARM RXN where the body detects the external stimulus
2. ADAPTATION where the body engages in defensive countermeasures against the stressor
3. EXHAUSTION where the body begins to run out of defenses (results from long-term exposure to the stress)
   * LINKED stress and illness

Question 13

What is coping?

Answer 13

Dynamic process/internal effort to manage demands that are seen as taxing or exceeding the resources of the person

Question 14

What are coping behavioral techniques?

Answer 14

Relaxation
Cognitive strategies
Stress inoculation
Exercise
Social support
Pharmacological interventions (benzos- Cl channel and beta blockers)

Question 15

Why is stress good for you?

Answer 15

It’s a centrally mediated process to help the organism adapt to the environmental demand

*best at MODERATE levels of stress

Question 16

Chronic/excessive stress can lead to….

Answer 16

development/progression of illness

Question 17

What are type A coping behaviors?

Answer 17

Time urgency
Impatience
Competitiveness 
Hostility--most associated with Coronary heart disease
May not cope well with stress

Question 18

What are the steps in the process of coping?

Answer 18

1. environmental event
2. primary appraisal
3. secondary appraisal
4. coping behaviors
5. coping outcomes (biological, psychological, behavioral)

Question 19

What is learned helplessness?

Answer 19

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

Question 20

What is psychological hardiness?

Answer 20

Perceive stressful events as CHALLENGES rather than threats

Believing that you have CONTROL over aversive events

Related variable is OPTIMISM

Question 21

What is the cardiovascular response to stress?

Answer 21

Exaggerated cardiovascular reactivity to stress is associated with CHD.

Cardiovascular responses is related to the development of HTN

Question 22

Activation of HPA system is also associated w/ development of CVD.

Answer 22

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.

Question 23

What is a RF for the 1st and recurrent cardiac events?

Answer 23

depression

5 odd ratio for MI in those with history of major depression

Question 24

What emotions contribut to increased risk for CVD?

Answer 24

anxiety, anger, hostility

Question 25

What unhealthy behaviors are ppl more likely to engage in under stressful circumstances?

Answer 25

Tobacco use
Excessive alcohol use
Poor dietary habits
Sedentary lifestyle

*problems when used as regular coping strategies b/c they don’t help

Question 26

What are physical disorders caused by or exacerbated by stress?

Answer 26

Diabetes
Hypertension 
Cardiovascular disorders
Cancer 
Ulcers
Migraine and tension headaches 
Asthma
Arthritis 
Colitis 
Muscle tension problems

Question 27

How may stress effect the doctor-pt relationship?

Answer 27

Lower compliance w/ medical regimens

drug seeking behaviors

Question 28

What are the similarities and differences btwn stress and exercise?

Answer 28

Both activate SNS
Good for you as long as it doesn’t exceed your capacity

Emotional outcome is different
Length of time