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Behavioural & Social Sciences > Physiological Factors in Health & Illness > Flashcards

Physiological Factors in Health & Illness Flashcards

1
Q

What is stress?

A

Stress refers to experiencing events or situations that are perceived as endangering one’s physical and/or psychological wellbeing
-Perceptions of threat = subjective (unique) - when ext demands exceed int capacities
-When pressure exceeds load bearing

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2
Q

Problems with initiating a stress response?

A

A repeated & often unnecessarily over-activated response to stressors in modern Western society can = damaging effects on physiological stress response systems & physical health

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3
Q

Problems with not initiating a stress response?

A

-Inability to mount a stress response can = -ve consequences for health
-People who’ve experienced severe life stressors & diagnosed w/ PTSD may show this lack of response (or under response)

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4
Q

What is a healthy stress response?

A

Mount sufficient response but able to efficiently adapt & recover after stressful event has ended & can adapt to repeated stressors

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5
Q

How do the 3 models of stress each perceive stress?

A

-Stress as a stimulus - think of stressor “I’m under pressure” - causes us to do something
-Stress as a response - physiological, psychological, beh responses to being stressed “I am stressed out” = defence mechanism - what we do
-Stress as an interaction - between stressor (= stressful) & response (= demanding) “I can’t cope with the pressures on me” - can cope to do anything else when stressed

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6
Q

What might come under the stressors focussed on in the stimulus model of stress?

A

*Acute:
-Catastrophes
-Life events
-Daily hassles
*Chronic:
-Conflict
-Occupational stress
-Prolonged circumstances - poverty, illness, disability

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7
Q

What happens in the stimulus model of stress?

A

-Stressors (acute or chronic) = cause stress

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8
Q

How can stressors (stimulus model) be measured?

A

On scales or using questionnaires
-Daily Hassles Scale
-Social Readjustment Rating Scale

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9
Q

Is there a link between stress & ill health?

A

-Increase risks for secondary/indirect disease consequences
-Physiological bod link
-But also linked to good health - need adrenaline in normal functioning

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10
Q

What is the structure of the Daily Hassles Scale?

A

-Measures irritating frustrating, distressing demands - part of everyday life
-117 items (Qs)
-Rate on scale 0-5 (e.g., 0 = never, 5 = extremely often)

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11
Q

What is the Social Readjustment Rating Scale?

A

-Measures major life events stressors (that you have to adapt to)
-43 items (Qs)
-Ps score life changing units (LCUs) over 1yr & correlate w/ probability of illness next yr
-Scores>300 = 70% sample had ill health subsequently

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12
Q

Limitations of Social Readjustment Rating Scale?

A

-Item selection - culturally specific
-Individual differences in significance of events
-Duration, e.g. divorce drawn out
-Confounded by illness
-Moderating factors? e.g., coping resources, social support
-Shows correlation rather than cause - are we measuring stress or just stress perceptions- doesn’t tell us if they are actually stressed (but perceptions can = stress)

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13
Q

What are the responses that fall under the response model of stress?

A

-Physiological
-Psychological - cognitive appraisal
-Behavioural - coping style

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14
Q

What is the response model of stress?

A

How the body responds to stress
-Physiological/bio models = fight or flight & stress response-stress reactivity
-Can show links between stress & illness

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15
Q

What can the response model of stress a basic example of?

A

Cause & effect (with emphasis on effects)
–> studied rat’s responses - can’t generalise to humans (fewer mediators influencing stress - most of rats showed similar responses - not seen in humans)

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16
Q

What are some further examples of stress response components & pathological consequences?

A
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17
Q

Name the 2 physiological stress response pathways.

A

-Sympathetic NS pathway (SAM sympathetic adrenal medullary)
-Neuroendocrine Immune Pathway

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18
Q

What is the process of the Sympathetic NS pathway (SAM sympathetic adrenal medullary) pathway?

A

Stressor
–>
Hypothalamus – activates…
–>
Autonomic NS – activates…
–>
Sympathetic NS
–>
Adrenal glands – medulla – releases adrenaline & noradrenaline*
–> to target cells
BP increased

Activate HPA axis – keep body on high alert

Once stressor (stimuli) gone = cortisol levels decrease = activates Parasympathetic NS = rest & digest

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19
Q

What is the process of the Noradrenaline Immune Pathway?

A

Stressor
–>
H ypothalamus – releases CRH (Corticotropic Releasing Hormone)
–>
P ituitary gland – releases ACTH (Adreno Corticotropic hormone) – through blood
–>
A drenal glands - cortex – releases glucocorticoids/corticosteroids e.g., cortisol
–> to target cells
Decrease immune function, raise blood sugar, increases metabolic rate throughout body

HPA axis = activated when stimulus of stress doesn’t go away – to keep body on high alert (cortisol)
-linked to chronic stress

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20
Q

How do he Sympathetic NS pathway (SAM sympathetic adrenal medullary) pathway and the Neuroendocrine Immune Pathway link?

A

-Symp = initial stress response - immediate - after experinece stressor = adrenaline + noradrenaline
-Neuroend = HPA axis within this is activated if stressor doesn’t go away (prolonged stress) - keeps body on high alert (cortisol)

–> these 2 systems work together

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21
Q

What is the sympathetic NS a cause of?

A

Fight or flight response

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22
Q

What happens in the physiological responses to stress once stressor/threat has passed?

A

PNS activated (by decreased cortisol) - rest & digest - to relax

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23
Q

What is the Neuroendocrine Immune Pathway linked to?

A

Chronic stress

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24
Q

Which part of NS forms basis of stress response & in what way?

A

Autonomic NS - governs:
-Cardiac & smooth muscles
-Digestive & sweat glands
-Certain endocrine organs - not under conscious voluntary control

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25
Q

Summarise the HPA axis.

A

= cascade of endocrine hormones - producing cortisol - peak around 20mins acute stressor onset

-ve feedback loop signalling to the pituitary & hypothalamus, enabling the cortisol response to be switched off after the stressor has terminate (this then activates PNS)

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26
Q

Importance of cortisol?

A

= vital catabolic hormone
-Secreted by adrenal cortex of kidney

-Glucose production for energy (cortisol maintains glu levels)
-Regulation of blood pressure
-Downregulation of inflamm processes - cortisol prevents widespread tissue & nerve damage due to inflamm

27
Q

How are stress responses measured (response model)?

A

-Endocrine system = ACTH, cortisol
-Cardiovascular system = cardiac output, BP
-Skin conductance (sweat glands, controlled by SNS)
-Imm system = leukocytes, antibodies
(But little correlation between measures)

28
Q

Role of stress in immune response (response model)?

A

Indirect relationship between stress & ill health
–> neurophysiological: inc stress = inc cortisol = dec imm function

29
Q

How is cortisol linked to decreased immune response?

A

Prepares body for flight:
-Reducing protein demand by the imm system
= reduces no. lymphocytes produced
(also reduced cytokine productuion)
-Fewer lymphocytes:
*more susceptible to acute illnesses
*wounds take longer to heal

30
Q

What is chronic stress?

A

When have excessive/prolonged cortisol secretion as:
-cortisol should bind to glucocorticoid rec (GR) to be an anti-inflamm BUT ex/prolon = resistance of GR - blocks cortisol binding

31
Q

What can chronic stress lead to & why?

A

Inflammatory bowel disease amongst other inflammatory conditions.

32
Q

Study - stress & common cold - findings?

A

-Inc stress predisposed ps to common cold (higher stress rates in people w/ common cold) –> used questionnaire & measured neuroendocrine imm function
–> shows stress related to immune function

33
Q

Study - stress & wound healing - findings?

A

High stress & worry impaired wound healing after hernia surgery

34
Q

Study - stress & influenza vaccine - findings?

A

-People w/ more stressful life events linked to lower antibody levels after influenza vaccine than people w/ less stressful life events
–> levels of stress predicted antibody response

35
Q

Summarise the evidence shown to link physiological factors & imm function & so ill health?

A

-Infectious diseases - common cold, HIV progression to AIDS
-Wound healing

36
Q

How does the adrenal cortex respond to stress?

A

-Responds to ACTH stimulation - produces glucocorticoids e.g., cortisol & DHEA (dehydroepiandrosterone)
-DHEA = balances Th cell pop

37
Q

What determines the effects of stress - either being beneficial or detrimental?

A

Duration of stress

38
Q

How does acute stress influence immune response?

A

Produces improvements in imm resp

39
Q

Problems with the response model of stress?

A

-Not specific to stressor - depend on novelty, controllability, predictability of stressor
-Other responses - cognitive, emotional, behavioural
-Ind diffs in:
*Stress reactivity (physiological responsiveness to stress)
*Stress recovery time - time to recover to baseline
*Allostatic load (physiological consequences of long-term exposure to fluctuating or heightened neural or neuroendocrine responses to stress) - wear and tear on body
*Stress resistance - ability to deal w/ stress

40
Q

What is Psychoneuroimmunology (PNI)?

A

= study of interaction between psychological processes & NS & imm systs of body
An area which can prove link between psychological states & imm function

41
Q

What are Adverse Childhood Experiences (ACEs)?

A

= potentially traumatic events in childhood
-Disrupts normal childhood development
-Divorce
-Parent death
-Abuse

42
Q

What are ACEs linked to causing?

A

-Felling overwhelmed
-Feelings of intense fear & terror
-Helplessness
-Loss of safety, loss of control & fear of annihilation

43
Q

How does ACEs link to ill health, & how may this affect a child in later life?

A

-Link to chronic health conditions:
Mental illness
Substance misuse
–> can -vely impact education & job opportunities

44
Q

Types of ACEs?

A
45
Q

What studies how shown that stress reactivity is linked to ACES?

A

-Animal studies - children w/ nurturing mothers have reduced HPA axis responses (parents less stress reactive - child in secure env - so stress resp system not always on high alert)
-Presence of mother alters & reduces offspring’s physiological responses to stress

46
Q

What are dandelion child ren & orchid children in relation to immune responsivity to stressors?

A

–> Temperament - emotional dispositions of children (not just env child is in or if env they are in isn’t a good fit for child’s temperament - instead focussing on child’s emotional dispositions)
Dandelion = more robust - hard to destroy
Orchid = need tender care, more sensitive

47
Q

How can we say -ve emotions link to reduced immune response?

A

*Conditions e.g., depression - associated w/ impaired imm function - imm syst = dysregulated
-Depressive symptoms linked to rapid progression of HIV/AIDS & heart disease
-Psychotherapy - can affect course of imm disorders - improve psychological wellbeing

48
Q

What are the implications of linking psychological factors to illness progression & recovery?

A

-Patient management - shown to help & improve outcomes
-Psych interventions - improve outcomes

–> how & why = unknown

49
Q

Why are stress responses different between people?

A

-Because is subjective view - when ext demands exceed int capacities –> transactional model accounts for this

-Ind diffs - unique subjective experience of social world- may have experienced adverse experiences, daily hassles, life altering events (stressors may not be same so stress response not same either)

50
Q

What is the transactional model?

A

-Focuses on unique/individual’s appraisals of stress (as stress = result of when person’s perception pf ext demands outweigh int capacity)
-Interaction of perceived stressor & perceived ability to cope
-May be real or imagined (perceived signif threat)
–> perceptions trigger stress resp even when (e.g., exam failure not occurred yet)

51
Q

How is Transactional model measured?

A

Self-report scales - Perceived Stress Scale

52
Q

What are the 2 types of appraisal?

A

-Primary
-Secondary

53
Q

What is primary appraisal?

A

Nature & magnitude of threat
-Am I harmed?
-Is there a threat or a challenge?
–> initially primes stress response

54
Q

What is secondary appraisal?

A

What resources do I have available to me?
How well am I coping?
Resources can be int or ext
–> may be your temperament, social support, helpful coping
–> occurs after primary (after appraise as threat or challenge) & then how appraise our ability to cope
-Maladaptive coping

55
Q

Why are appraisals a key part of the stress?

A

-Exaggerated psych responses (e.g., catastrophizing) after maladaptive cognitive appraisals of potential stressors as threatening may exacerbate cortisol secretion & facilitate the consolidation of fear-based memories of pain or non–pain-related stressors - but: coping, cognitive reappraisal, or confrontation of stressors can minimise cortisol secretion & prevent chronic, recurrent pain

56
Q

Outline Lazarus’ Transactional model of stress.

A

-Event = important exam
-Appraisal = show my knowledge, opportunity to develop, threat to me - will harm me
-Coping = put solution in place, breathing exercises, avoidance
-Outcomes = impacts how much activation we have in the 2 stress pathways
-Stable/dispositional factors & sit factors = all impact each stage - affect int & ext demands - effects coping
-Adversity in childhood, economic challenge

57
Q

What is eustress?

A

+ve form of stress - has beneficial effect on health, motivation, performance, and emotional well-being

58
Q

How might a threat be +vely percieved?

A

As a challenge - eustress (= +ve emotions not distress - -ve) - can help us to meet a challenge
-Uses physiological stress response to your advantage –> doesn’t tell us how this may be triggered

59
Q

What is the vulnerability-stress model (diathesis-stress model)?

A

-Proposes that stress triggers an underlying predisposition to illness/disease (may have been lying dormant & then activated by stress)
-So stress response set up by lived experiences, disposition, previous lived adversity - as biological systems develop to support a continual stress response e.g., lack of imm response - imm system

60
Q

What is diathesis?

A

A person’s predisposition/vulnerability to a medical condition, which can be a psychological or physical disorder

61
Q

What does the model show?

A

Link between psychology & biology

62
Q

What does this psychobiological reactivity diagram show?

A

-Stress appraisal (+ve/-ve) –> based upon internal perceptions of external demands results in a stress response which leads to internal resources being utilise.
-This stress response ultimately has consequences (x4 boxes at bottom - affect a range of area)

63
Q

How can stress be summarised - causes up to outcomes?

A

-Causes - an ext demand which exceeds our int capacities - defines stress (also ACEs)
-Mediators - how we appraise & cope - what we have in ext world (social support/circumstances) how do we cope (avoid or problem solve)
-Outcomes - stress response (on 3 levels)

-Avoidance -if view stressor as a threat

64
Q

What are mediators of stress?

A

Resources to deal with stress - e.g., coping
-Internal = dispositional (personality), how you think about something - do you catastrophise?
-External = social support, social situation, education

–> either int/ext used may be problem-focussed or emotion-focused or avoidance (based on how individual perceived the stressor - threat or challenge?)

Behavioural & Social Sciences (16 decks)

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