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Medicine Unit 3 > Psychological factors in health and illness > Flashcards

Psychological factors in health and illness Flashcards

1
Q

stress definition

A

refers to experiencing events or situations that are perceived as endangering ones physical and or psychological wellbeing

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2
Q

models of stress

A

stress as a stimulus
stress as a response
stress as an interaction

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3
Q

what is the stimulus model of stress

A

what are the causes of stress
focus on stressors
may be acute e.g. catastrophes, life events
or chronic: occupational stress, conflict, prolonged circumstances

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4
Q

how may stresses be measured

A

scales and questionnaire
daily hassles scale
social readjustment rating scale

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5
Q

daily hassles scale

A

irritating frustrating distressing demands that characterise everyday transactions with the environment
rating 0 to 5 for how often each factor causes you stress

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6
Q

social readjustment rating scale

A

major life events
tick the events experienced in the last year

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7
Q

use of the social readjustment rating scale

A

participants scored LCUs over 1 year
positive correlation with the probability of illness in the subsequent year
scores greater than 300= subsequent ill health in 70% of the sample

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8
Q

limitations of the SRRS

A

item selection is culturally specific
individual differences in significance events
duration
confounded by illness
moderating factors such as coping
shows correlation rather than a cause

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9
Q

what is the response model of stress

A

physiological/biological models:
-fight or flight
-general adaptation syndrome aka stress response-stress reactivity

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10
Q

stress response and consequences of prolonged stress

A

components of the stress response and possible pathological consequences

mobilisation of energy -> fatigue, muscle wasting
suppression of immunity -> reduced disease resistance
analgesia -> apathy

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11
Q

what are the 2 pathways of physiological response

A

neuroendocrine immune pathway
sympathetic nervous pathway

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12
Q

neuroendocrine immune pathway

A

HPA

stressor
hypothalamus (CRH)
pituitary gland (ACTH)
adrenal glands- cortex (corticosteroids)
immune system down

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13
Q

sympathetic nervous system pathway

A

stressor
hypothalamus
ANS-SNS
adrenal glands- medulla (adrenaline and noradrenaline)
increased blood pressure

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14
Q

sympathetic adrenal medullary

A

threat trigger an instantaneous hormonal change and physiological reponsr to ready for action- cascade effect
hypothalamus activates the SNS via the ANS to the adrenal glands, produces adrenaline and noradrenaline
HPA axis activated to keep the body on high alert through cortisol release
threat passes, cortisol decreases and Pin is activated

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15
Q

neuroendocrine immune pathway (HPA axis)

A

HPA axis activated to keep the body on high alert through cortisol release
immune system decreases
associated with chronic stress

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16
Q

response model: measurement

A

endocrine system- ACTH, cortisol
cardiovascular system- cardiac output, BP
skin conductance- sweat glands controlled by SNS
immune system- leukocytes, antibodies
little correlation between the measures

17
Q

what role does stress play in the immune response

A

appears to be a neurophysiological basis (increased stress, increased cortisol, decreased immune function)
pathways aren’t fully understood

18
Q

chronic stress

A

stress-induced increased cortisol prolonged secretion is detrimental physically and psychologically
down-regulation or resistance of the glucocorticoid receptor that blocks cortisol binding, similar to mechanism of type 1 diabetes

19
Q

normal cortisol breakdown

A

cortisol binds to the glucocorticoid receptor GR
acts as an anti-inflammatory

20
Q

experimenting the stress and cold

A

increased stress exposed volunteers were more likely to develop colds than decreased stress
stress related to immune function

21
Q

evidence of stress and wound healing

A

students received skin wounds
those who received prior to exams took longer to heal
high stress and worry impaired wound healing

22
Q

evidence based between stress and immune function

A

link between psychological factors and susceptibility to infectious diseases and wound healing

supported by life event research e.g. autoimmune diseases, cancer, CHD

23
Q

life event research

A

explores possible links between (potentially stressful) life events and ill health

24
Q

summary of infection, inflammation and immunity

A

endocrine pathway through HPA axis where brain communicates with target cells through hormone production
adrenal cortex responds to stimulation of ACTH by producing glucocorticoids such as cortisol and DHEA (dehydrepiandrosterone)
effects are beneficial or detrimental

25
Q

what is DHEA function

A

balance T-helper cell production

26
Q

acute stress and immune function

A

provides improvements

27
Q

chronic stress and immune function

A

the HPA axis suppresses immune activity through the production of cortisol (anti-inflammatory effect)
reducing the number of white blood cells and release of cytokines

28
Q

limitations of the response model

A

not specific to the stressor
other responses: cognitive, emotional and behavioural
individual differences in stress reactivity, stress recovery time, allostatic load, stress resistance

29
Q

toxic stress- adverse childhood experiences

A

potentially traumatic events that occur in ages 0-17
seen to contribute to: deep sense of overwhelming feeling, feeling of intense fear and terror, helplessness, loss of safety control and fear of annihilation
serves stress in later life

30
Q

what is an ACE

A

adverse childhoodexpeirences

31
Q

ACE’s impact on health

A

linked to chronic health conditions
mental illness substance misuse in adulthood
negatively impact education and job opportunities

32
Q

types of ACE’s

A

presence of mother alters and reduces the offsprings physiological responses to stress

types could be: abuse, neglect and household disfunction

33
Q

household dysfunction

A

mental illness
incarcerated relative
mother treated violently
substance abuse
divorce

34
Q

different immune responses to stressors (children)

A

dandelion children
orchid children

35
Q

transactional model

A

stress is the response which occurs when a person believes the demands on them (external) outweigh their capacity to meet those demands (internal)

focus on individuals characteristics and stress appraisals
emphasis on interaction between perceived stressor and perceived ability to come

36
Q

primary appraisal

A

nature and magnitude of the threat

37
Q

secondary appraisal

A

what resources do I have available to me

Medicine Unit 3 (28 decks)

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