Physio and psych trauma/stress impact on health outcomes Flashcards
Four major pathways people look to when explaining the link between psych trauma/stress and chronic illness
HPA axis
sympathetic nervous system
inflammatory processes
injury sustained during the trauma
Foour major/common classes of chronic illness linked to exp of psych stress/trauma
cardiovascular disease
diabetes
GI conditions
cancer
In addition to trauma-based psych tx’s what are three adduct treatments that can help to down regulate the inflammatory response?
long-chain omega 3 fatty acids
sleep interventions
exercise interventions
In a nutshell, how do trauma expo’s impact the inflammatory system
trauma/stress primes the inflammatory response such that it is more likely to be engaged throughout the lifetime; lowers the threshold for activation
Researchers first noticed the connection between trauma and health outcomes related to what kinds of health conditions? when?
chronic pain syndroms
in the 1980’s
(this isn’t a new idea)
the relationship between trauma and negative health outcomes seems dose dependent; true or false?
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)
It is just childhood trauma that seems linked to negative health outcomes? true or false
False
there are studies that looked at both childhood experiences as well as trauma experiences in adulthood
What kinds of trauma seem linked to neg health outcomes?
All
Name the three, interrelated components of the stress response
release of catecholamines
HPA axis
and the immune response
what are the three catecholamines?
epinephrine
norepinephrine
dopamine
release of catecholamines triggers what?
activation of the HPA axis
Activation of the HPA axis causes what?
a chemical cascade (ultimately resulting tin the release of cortisol)
Hypothalamus –> CRH
Pituitary –> ACTH
Adrenal cortex –> cortisol
What kind of chemical is cortisol
glucocorticoid
Chronic activation/dysregulation of the HPA axis and sympathetic nervous system leads to
increased allostatic load (i.e. body “wear and tear”)
Whats the overarching conceptual model we use to think about the connection between trauma/PTSD and the stress response
Allostatis (McEwan, 1998)
Increased activation of the sympathetic nervous system and the HPA axis is commonly referred to as what?
the F-F-F response
in resp to both physio and psych stress, What does the immune system do to try to protect the body ?
realease proinfammatory cytokines
cytokines are meant to _______, but in excess they _____
heal wounds and fight infection
leave the body vulnerable to disease
in addition increased inflammation how else might stress and trauma be related to heart health?
increased trauma/stress can increased coagulation which can lead to MI, athersclerosis, etc.
over and above trauma and stress, what other psychological variables are robust predictorsof negative health outcomes?
depression and high trait hostility
the connection between stress/trauma/PTSD/depression and health outcomes is both ______ and ______
direct (i.e. SNS, HPA axis, immune response (inflam/coag)
indirect (risk taking, substance use, homelessness, increased service utilization)
What kind and how much of supplement could people take to prevent depression
200-400 mg DHA
What ind sof supplment (and how much) could people take to treat depression and other affective disorder?
1000 mg EPA
generally recognized as safe levels omega 3 fatty acids?
3000 mg of EPA/DHA combined
1500 mg of
both fish oil supplements and exercise do what?
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)
general and health-related LOC is a one dimensional concept. True or false?
False. We conceptualize it as having three dimensions
- internal
- powerful others
- chance
Whats the difference between LOC and self-efficacy
LOC is a generalized expectancy of ability; S-E has to do with a specific area of performance
When assessing “stress” it is important to
understand the unique context of each clients stressful events and their responses to them
Define response theories of stress
early theories
focus on the physic response (fff), i.e. initial hyper arousal in response to stressor and eventual return to homeostasis
define the interactional theories
Person x environment interactions are emphasized
e.g. Person variables (cog appraisal/assigned meaning, hx, personality, and resources)
Coping strats that are available
which do we think are more true? reap vs. interactional theories.
interactional
Examples of personality variables interacting with stressful events
- 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
How many levels of appraisal (according to Lazarus and Folkman)
two; primary and secondary
Define primary appraisal
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)
define secondary appraisal
determine ones coping abilities and resources, and whether they’re sufficient tot meet the harm, threat o challenge
What kinds of responses does the the secondary appraisal involve?
physio (SAM and HPA systems)
cog (beliefs about cause, controllability and distractibility)
emotional (fear, excitement, stoicism, denial)
behavioral (FFF)
Perception of the threat occurs in the ________, and sets of a chain of reactions mediated by _________.
cerebral cortex; appraisals
From the cerebral cortex, where’s it going?
the hypothalamus, setting off the HPA axis
Symp nerv sys arousal stimulates what part of the brain?
the medulla and the adrenal glands
What physio changes occurs with the release of catecholamines
BP ries, heart rates increase, sweating, vasoconstriction
what does cortisol do for you?
increase arousal
conserve carbs stored
reduces inflammation (when regulated)
Are these stress response systems bad?
No, they’re necessary for survival; its an issue when then systems are chronically activated and, hence, dysregulated
Does everyone react the same way to threat?
No. Indiviudal differences depending on: genes leanring hx (influence appraisals [mediators]) modeling by other social support threshold of stress response
in addition to physio consequences of stress/trauma/threat, what other general bx or mood consequences
Bx: sleep cycle, eating dysregulation
Mood: increased depression, anxiety, PTSD, phobias
outbursts of anger and hostility
Aside from god appraisal, what are other mediators/moderators
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
PA, NA: flip side of same coin?
No; two different dimensions
