Physio and psych trauma/stress impact on health outcomes Flashcards

1
Q

Four major pathways people look to when explaining the link between psych trauma/stress and chronic illness

A

HPA axis
sympathetic nervous system
inflammatory processes
injury sustained during the trauma

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2
Q

Foour major/common classes of chronic illness linked to exp of psych stress/trauma

A

cardiovascular disease
diabetes
GI conditions
cancer

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3
Q

In addition to trauma-based psych tx’s what are three adduct treatments that can help to down regulate the inflammatory response?

A

long-chain omega 3 fatty acids
sleep interventions
exercise interventions

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4
Q

In a nutshell, how do trauma expo’s impact the inflammatory system

A

trauma/stress primes the inflammatory response such that it is more likely to be engaged throughout the lifetime; lowers the threshold for activation

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5
Q

Researchers first noticed the connection between trauma and health outcomes related to what kinds of health conditions? when?

A

chronic pain syndroms
in the 1980’s
(this isn’t a new idea)

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6
Q

the relationship between trauma and negative health outcomes seems dose dependent; true or false?

A

true
(e.g. In one study w/ women with PTSD and GI/chronic pain; the more severe the trauma the more severe the reported symptoms)

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7
Q

It is just childhood trauma that seems linked to negative health outcomes? true or false

A

False

there are studies that looked at both childhood experiences as well as trauma experiences in adulthood

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8
Q

What kinds of trauma seem linked to neg health outcomes?

A

All

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9
Q

Name the three, interrelated components of the stress response

A

release of catecholamines
HPA axis
and the immune response

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10
Q

what are the three catecholamines?

A

epinephrine
norepinephrine
dopamine

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11
Q

release of catecholamines triggers what?

A

activation of the HPA axis

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12
Q

Activation of the HPA axis causes what?

A

a chemical cascade (ultimately resulting tin the release of cortisol)
Hypothalamus –> CRH
Pituitary –> ACTH
Adrenal cortex –> cortisol

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13
Q

What kind of chemical is cortisol

A

glucocorticoid

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14
Q

Chronic activation/dysregulation of the HPA axis and sympathetic nervous system leads to

A

increased allostatic load (i.e. body “wear and tear”)

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15
Q

Whats the overarching conceptual model we use to think about the connection between trauma/PTSD and the stress response

A

Allostatis (McEwan, 1998)

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16
Q

Increased activation of the sympathetic nervous system and the HPA axis is commonly referred to as what?

A

the F-F-F response

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17
Q

in resp to both physio and psych stress, What does the immune system do to try to protect the body ?

A

realease proinfammatory cytokines

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18
Q

cytokines are meant to _______, but in excess they _____

A

heal wounds and fight infection

leave the body vulnerable to disease

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19
Q

in addition increased inflammation how else might stress and trauma be related to heart health?

A

increased trauma/stress can increased coagulation which can lead to MI, athersclerosis, etc.

20
Q

over and above trauma and stress, what other psychological variables are robust predictorsof negative health outcomes?

A

depression and high trait hostility

21
Q

the connection between stress/trauma/PTSD/depression and health outcomes is both ______ and ______

A

direct (i.e. SNS, HPA axis, immune response (inflam/coag)

indirect (risk taking, substance use, homelessness, increased service utilization)

22
Q

What kind and how much of supplement could people take to prevent depression

A

200-400 mg DHA

23
Q

What ind sof supplment (and how much) could people take to treat depression and other affective disorder?

A

1000 mg EPA

24
Q

generally recognized as safe levels omega 3 fatty acids?

A

3000 mg of EPA/DHA combined

1500 mg of

25
Q

both fish oil supplements and exercise do what?

A

down regulate the stress response and are inversely related to the levels of proinfammatory cytokines in the body (high level of these chemicals are strongly correlated with mutple forms of disease)

26
Q

general and health-related LOC is a one dimensional concept. True or false?

A

False. We conceptualize it as having three dimensions

  1. internal
  2. powerful others
  3. chance
27
Q

Whats the difference between LOC and self-efficacy

A

LOC is a generalized expectancy of ability; S-E has to do with a specific area of performance

28
Q

When assessing “stress” it is important to

A

understand the unique context of each clients stressful events and their responses to them

29
Q

Define response theories of stress

A

early theories
focus on the physic response (fff), i.e. initial hyper arousal in response to stressor and eventual return to homeostasis

30
Q

define the interactional theories

A

Person x environment interactions are emphasized
e.g. Person variables (cog appraisal/assigned meaning, hx, personality, and resources)
Coping strats that are available

31
Q

which do we think are more true? reap vs. interactional theories.

A

interactional

32
Q

Examples of personality variables interacting with stressful events

A
  • approach vs. avoidance tendencies (similar to fff; which way do you tend to go?)
  • perfectionistic tendencies
  • dependent tendencies (self sufficient or rely on social supports)
  • antisocial/schizoid (may not be as stressed by interpersonal stressors
33
Q

How many levels of appraisal (according to Lazarus and Folkman)

A

two; primary and secondary

34
Q

Define primary appraisal

A

determines the the meaning of the event for potential:
harm (damage already done)
threat (potential harm or vuln for the future)
challenge (potential to overcome, poss to profit)

35
Q

define secondary appraisal

A

determine ones coping abilities and resources, and whether they’re sufficient tot meet the harm, threat o challenge

36
Q

What kinds of responses does the the secondary appraisal involve?

A

physio (SAM and HPA systems)
cog (beliefs about cause, controllability and distractibility)
emotional (fear, excitement, stoicism, denial)
behavioral (FFF)

37
Q

Perception of the threat occurs in the ________, and sets of a chain of reactions mediated by _________.

A

cerebral cortex; appraisals

38
Q

From the cerebral cortex, where’s it going?

A

the hypothalamus, setting off the HPA axis

39
Q

Symp nerv sys arousal stimulates what part of the brain?

A

the medulla and the adrenal glands

40
Q

What physio changes occurs with the release of catecholamines

A

BP ries, heart rates increase, sweating, vasoconstriction

41
Q

what does cortisol do for you?

A

increase arousal
conserve carbs stored
reduces inflammation (when regulated)

42
Q

Are these stress response systems bad?

A

No, they’re necessary for survival; its an issue when then systems are chronically activated and, hence, dysregulated

43
Q

Does everyone react the same way to threat?

A
No. Indiviudal differences depending on:
genes
leanring hx (influence appraisals [mediators])
modeling by other
social support
threshold of stress response
44
Q

in addition to physio consequences of stress/trauma/threat, what other general bx or mood consequences

A

Bx: sleep cycle, eating dysregulation
Mood: increased depression, anxiety, PTSD, phobias
outbursts of anger and hostility

45
Q

Aside from god appraisal, what are other mediators/moderators

A
Affect (PA and NA)
Trait optimism
personal control (i.e., LOC and self-efficacy; hopefulness; acceptance)
benefit finding (cog re-appraisal)
social support
existing coping skills
46
Q

PA, NA: flip side of same coin?

A

No; two different dimensions