Stress and health

Question 1

Outliers

Answer 1

A town in Pennsylvania made up of Italian immigrants. They had a significantly lower death rate in typical causes: CD, cancer, etc. Generally healthier. Why?
- No differences from surrounding towns by the standard metrics of diet or exercise. Rather, they had an exceptional sense of community. The neighborhood had really close ties with one another, multi generational households, and strong support systems. Very interconnected.

Question 2

What is health psych?

Answer 2

Applying psychological principles and research to the enhancement of health and the treatment/prevention of illness
- why we are so concerned with messaging
- 4 purposes: etiology (cause of disease), promote health, prevent and treat illness, promote public health policy and improve healthcare system.

Question 3

How have understanding of health and medicine changed over time?

Answer 3

At first, illness was seen as spiritual and related to humors—→ then came biomedical/biopsychosocial model
- In developed countries, people are far less likely to die from communicable diseases and generally live longer than we did. Now, we are more likely to die from lifestyle related disorders (cancer, stroke, HD)

Question 4

Biopsychosocial Model

Answer 4

The biopsychosocial model is our current model of health psych that takes into account how biological, psychological, and social contexts influence our health and interact with one another. All health behaviors are explained through these contexts.

Question 5

Biological

Answer 5

Biological: our “nature”: genetic predispositions, our body systems and how they react. Every thought, mood, and urge is a biological event (ie. dopamine is being released in your brain, causing your feelings of pleasure and happiness). Our behaviors are a result of evolutionary adaptations. Also sees our health through the perspective of time and age (age related illness).

Question 6

Psychological

Answer 6

Psychological: how we cope with stressors, our attitudes, positive psychology (how can we thrive?), psychological interventions (CBT)

• Can influence the biological! CBT can teach reappraisal of certain stressors as challenges vs threats, and actually decrease the intensity of our stress response (amount of cortisol and how activated our SNS becomes).
• We can use psychological techniques, like meditation and mindfulness, to activate our PNS and relax our bodies.
• Perception of control

Question 7

Social context

Answer 7

• The ways we think about, influence, and relate to one another and our environment.
• Cultural views, SES, race
  
  • microaggressions: all day, essentially inescapable stressors that compound over time and take physical tolls (wear and tear). Oxidative stress on our cells.
• Social support
  
  • Readings: Social support from people we are close to can lower the intensity of our stress response on a neuronal level as well as perceptually (hand holding study).
  • Discover 2020 article: people who are lonely and socially isolate tend to have greater risk of HD and stroke, cancer, disturbed sleep, altered immune system, and greater inflammation. Social interactions can strengthen our vagus nerve, which is often a good sign of health!
    
    • High vagal tone is associated with negative emotional arousal and more constructive coping.
  • Cacioppo study: cancer risk is increased with lonliness.
  • Cole study: even our immune cells are impacted by loneliness

Each of these factors in the model are in constant communication with one another to create our health behaviors.

Question 8

Epidemiology

Answer 8

The study of the FRECUENCY, DISTRIBUTION, and CAUSES of a particular disease

• John Snow, an English physician in the 1800s, sort of founded this when he figured out that more people were dying of cholera in areas with polluted water. He cut off the water supply and deaths dropped! Distribution and causes!

Question 9

Vector

Answer 9

any agent that carries and transmits an infectious pathogen into another organism

Question 10

Morbidity

Answer 10

The number of health issues in a given group of people at a given group of time.

Question 11

Mortality

Answer 11

Number of deaths due to a specific cause

Question 12

Incidence

Answer 12

of diagnosed cases of a disease or condition that exists at a given time

Question 13

Etiology

Answer 13

The causes/origins of a disease

Question 14

Retrospective study

Answer 14

Longitudinal study that looks back at a history of a group of people.

Question 15

Case-control study

Answer 15

A retrospective study where people with the condition are compared to people without.

Question 16

Prospective study:

Answer 16

Begins with a group of disease free participants and follows them overtime to determine whether a certain condition or behavior is related to later health conditions.

Question 17

Randomized clinical trial

Answer 17

True experiment, can really determine cause and effect.

• tests treatments
• placebo

Question 18

Nunn + Azrin study (Nunn’s nails!! nail polish study)

Answer 18

• Problematic for many reasons.
• Vague procedure
• Sample: included anyone who had bitten their nails for 8 years, 20 max. Ages 11-38, responded to an ad. Mostly women, VERY small sample.
• IV: counseling interventions (immediate or waitlisted)
• DV: nail biting habits
• Only checked after 1 month
• Results: claimed it worked great and all behaviors were eliminated after 1 week.
• Measured through photos of hands
• 2 counselors, one used more than the other.

Question 19

Eukaryotic

Answer 19

Contain nuclei and other organelles

Question 20

Prokaryotic

Answer 20

Do not contain nuclei and organelles but make bacteria and other single cell organisms.

Question 21

Neurons

Answer 21

Electrical impulses travel down the axon. If the charge is strong enough, it will trigger the release of neurotransmitters into the synapse, the space between two neurons. The NTs travel across the synapse and dock to receptors on the receiving neuron. This allows other charged atoms to travel into the cell, potentially triggering another action potential. A relay race!

Question 22

Important NTs

Answer 22

Glutamate, GABA, acetlycholine, dopamine, serotonin, norepinephrine

Question 23

What are the biological responses to stress?

Answer 23

HPA axis
- slow acting stress response
- hypothalamus releases CRH to the pituitary gland, which then releases ACTH, which tells the adrenal cortex to release cortisol and other stress hormones. These travel through the bloodstream.
- returns to homeostasis through a feedback loop with the hippocampus
- impacts the immune system and raises blood sugar.

SAM axis
- hypothalamus tells adrenal medulla to release neurotransmitters norepinephrine and epinephrine
- sympathetic nervous system
- fast acting/fight or flight
- raises HR, BP, effects organs

Question 24

Endocrine system—hormones!

Answer 24

Controlled by hypothalamus
- The pituitary gland secretes hormones that influence growth, sexual development, reproduction, kidney functioning, and aging. Other glands in our endocrine system help regulate heart rate and BP (adrenal medulla), growth and metabolism (thyroid), blood glucose levels (pancreas), and reduce inflammation (adrenal cortex).
- travel through bloodstream and are slower acting and longer lasting than neurotransmitters

Question 25

Pituitary gland's role in endocrine system?

Answer 25

The hypothalamus receives input from the outside world, tells the pituitary to jump into action and activate the endocrine system. The pituitary releases an activating hormone to whatever gland its targeting which tells the gland to start producing it’s hormones. The pituitary keeps an eye on hormone levels and stops releasing its activating factor if hormone levels get too high.

Question 26

Lymphocytes

Answer 26

White blood cells produced by lymph nodes. Different types include T cells, B cells, and natural killer cells

Question 27

Phagocytes

Answer 27

destroy pathogens by engulfing and digesting them

Question 28

Macrophages

Answer 28

patrol for worn out cells and antigens

Question 29

Natural killer cells

Answer 29

destroy viruses and tumor cells by injecting them with lethal chemicals

Question 30

T cells

Answer 30

Your T cells help kill infected cells and control your body’s immune response to foreign substances. Most of your T cells need the help of another immune cell to become activated. After your T cells are activated, they multiply and specialize into different types of T cells. These types include: Cytotoxic (killer) T cells: Cytotoxic T cells attach to antigens on infected or abnormal cells. Then, they kill the infected cells by making holes in their cell membranes and inserting enzymes into the cells. Helper T cells: Helper T cells help your other immune cells. Some helper T cells help B cells make antibodies against foreign invaders. Others help activate cytotoxic T cells. Regulatory (suppressor) T cells: Regulatory T cells make substances that help end your immune system’s response to an attack. Sometimes, they prevent harmful responses from occurring.

Question 31

B cells

Answer 31

Primary immune response: When an antigen attaches to a receptor, your B cells are stimulated. Some B cells change into memory cells. Other B cells change into plasma cells. Plasma cells make an antibody specific to the particular antigen that stimulated it. Production of enough of that specific antibody can take several days. Secondary immune response: If your B cells encounter that antigen again, the memory cells remember it and multiply. They change into plasma cells and quickly produce the correct antibody.

Question 32

How does stress make you sick?

Answer 32

Suppressed T cells Activate ANS fibers that descend from brain to immune tissues. Triggers the secretion of hormones that bind to white blood cells and alter functioning. Induce immunosuppressing behaviors (poor diet, sub abuse, lack of exercise).

Question 33

Allostatic load

Answer 33

The cumulative long-term effects of the body's physiological responses of stress. High allostatic load from chronic stress, unpredictable, uncontrollable scenarios can decrease immunity, increase epinephrine activity, and decrease hippocampal size and function! The hippocampus is especially concerning because it is involved in helping the body return to homeostasis after HPA activation.

Question 34

Glucocorticoid receptor resistance model

Answer 34

Chronic stress disrupts the sensitivity of receptors to glucocorticoid hormones which normally turn off the inflammatory response. The extra inflammation can promote the development and progression of diseases.

Question 35

Selye's general adaptation model

Answer 35

The body's reaction to stress is consistent and predictable (nonspecific to the demand). Goes through stages. Alarm: mobilize coping resources, the extent of response will be consistent with the degree of threat the stressor is perceived as. Resistance : Continue coping with stressor. ability to cope with everyday events and hassles decreases. Exhaustion: Resources depleted. Energy reserves are gone/ Hypocorticolism (depletion of cortisol).Continued stress puts individual at risk for disease or death.

Question 36

Transactional Model of Stress

Answer 36

The experience of stress depends as much on individual's cognitive appraisal of a potential stressor's impact as it does on the event of the situation itself. This means different people may have entirely different responses to the same stressor (public speaking in front of judgey scientists). When confronted with a stressor we go through: Primary appraisal: Assessing the scenario for a threat Secondary appraisal: assessing our own ability to cope with the stressor. If we can cope, we might not have any stress at all. If we feel we can't cope, stress occurs. Reappraisal: checking in and adapting

Question 37

Threat vs Challenge

Answer 37

Threat: the stressor is threatening and harmful. Challenge: Situation is demanding but ultimately beneficial and achievable.

Question 38

Diathesis Stress Model

Answer 38

Predisposition (diathesis) + Environmental factors = development of disorder

Question 39

TSST

Answer 39

Trier Social Stress Test. Have participants read a speech in front of judgey scientists and then do mental arithmetic. Measure cortisol response.

Question 40

Immune response from specialized lymphocytes

Answer 40

1. virus enters body and cells begin to display viral antibodies (signs that they have been infected). 2. Macrophages notice these antibodies and engulfs the virus 3. The macrophage activates T cells and B cells. 4. The helper t cells begin organizing a response. They activate the cytotoxic t-cells which destroy infected cells and regulatory. They also activate B cells. The regulatory t-cells ensure that the immune response doesn't become too activated and overblown. 5. B cells form plasma and memory b cells. Plasma b cells make antibodies that bind to viral antigens and signal to other cells that it needs to be destroyed. B memory cells store the memory of the virus's receptors so that it can identify it more quickly next time.

Question 41

DNA Methylation

Answer 41

One of the modifications of epigenetics. A methyl group gets added directly to a cytosine residue. This generally turns the gene off, as it causes the chromosome to be so tightly wrapped it cannot be transcribes (hypermethylation).

Question 42

Histone modification

Answer 42

This is when an acetyl group is added to the histone tail causing the chromatin to unfurl, exposing it to transcription. This turns a gene ON.

Question 43

How are the prevalence and morbidity of asthma in the United States related to socioeconomic status?

Answer 43

Asthma is highest in children in low SES in the US. One Discover article (Dr. Nadeau) linked this to an exposure to more pollution and allergens which trigger asthma. Pollution has been found to cause epigenetic changes that impact genes which control the body’s immune response. One of these epigenetic changes is on a gene that determines how many cells turn into Th2 cells (t cells in the immune reaction) and Th1 cells (regulatory t cells which suppress the immune response). If there are too few T-regs, asthma is more likely.

Question 44

Weaver's rats

Answer 44

Rats that were nurtured by their mothers as pups had a more robust stress response and were more relaxed. The nurturing was causing an epigenetic effect on their GR gene. Hippocampal glucocorticoid receptors are GR receptors are in our hippocampus and are an important part of our negative feedback loop in the HPA axis. When cortisol is released, it travels to the hippocampus and binds to the HC glucocorticoid receptors. When enough have bound, the hippocampus tells the hypothalamus to begin shutting down the stress response and return to homeostasis. When the GR gene is turned on, it makes more GR proteins and is quicker at shutting down the stress response. Rats that were not nurtured did not have their GR gene activated, so they were more sensitive to their environment and anxious. This could be reversed by injecting them with a drug that removed their methyl groups.

Question 45

Allostasis

Answer 45

The process of achieving stability or homeostasis through psych or behavioral change. Carried out by the ANS, HPA axis, and cytokines. Can be done in ANTICIPATION of a stressor as well as after.

Question 46

Allostatic load

Answer 46

The wear and tear that the body experiences due to repeated cycles of allostasis as well as the inefficient turning-on or shutting off of these responses.

Question 47

How do we measure stress and AL?

Answer 47

- time of day matters because our cortisol levels have a daily pattern. - Many measures: cortisol levels, neuroendocrine, immune, metabolic, anthropometric (surveys). - We do many measures to see overall changes in the body due to AL and chronic stress.

Question 48

Minority Stress Model

Answer 48

Stressors from our environment like discrimination, stigma, and rejection can negatively impact mental and physical health. Having multiple minority statuses increases likelihood of feelings of rejection and isolation and heightened risk of sub. abuse and high risk coping. - health disparities within populations can be explained with this model. - Racial Discrimination and Perceived Discrimination vary by race and are compounded by poverty.

Question 49

Adverse Childhood Experiences and Prenatal Stress

Answer 49

Exposure to early life stress can have adverse impacts throughout the lifespan. - adverse childhood experiences are linked with developing chronic diseases in adulthood.

Question 50

Protective Factors

Answer 50

- social support - undoing harm - resilience - cog therapy - maternal responsiveness

Question 51

Coping

Answer 51

The cognitive, behavioral, and emotional ways in which we manage stressful situations

Question 52

Disengagement (avoidance coping)

Answer 52

A coping strategy aimed at distancing oneself from a stressful situation

Question 53

Problem focused coping

Answer 53

A coping strategy for dealing directly with a stressor.

Question 54

Emotion focused coping

Answer 54

A coping strategy in which we try to control our emotional response to a stressor.

Question 55

Emotional-approach coping

Answer 55

The process of working through, clarifying, and understanding the emotions triggered by a stressor.

Question 56

Repressive Coping

Answer 56

- An emotion focused coping style in which we attempt to inhibit our emotional responses, especially in social situations, so we view ourselves as imperturbable. - Not very healthy: it activates the SNS and leads to greater cortisol reactivity in people with CDs. - Also correlated with the development of cancer, asthma, and diabetes. Repressors tend to have higher white bloods called called esinophiles.

Question 57

Dispositional Affect

Answer 57

- Person’s coping style or personality dimension consisting of a tendency toward chronic negative emotions and distress (negative affectivity), or positive emotions and subjective well-being (positive affectivity). - General approach to life - how we tend to respond to situations. - Positive affectivity: happy, cheerful, optimistic, and energetic. tends to predict better mental and physical health and lower stress hormones. Stronger immune response to environmental challenges. - Negative affectivity: insecure, jealous, hostile, and less emotionally stable. Tend to have a higher allostatic load and tend to have poorer health.

Question 58

Optimism

Answer 58

- Optimistic people tend to cope more effectively with stress and tend to lead healthier, longer, lives. - Associated with reduced levels of cortisol, lower BP, lower inflammation. > “By shortening the duration of negative emotional arousal, positive emotions such as optimism may stave off stress related elevations in hypertension, inflammation, immunosuppression, and other disease promoting processes. > - Learned optimism: A of consciously cultivated habits that entail viewing life’s setbacks and misfortunes as external (due to forces or influences outside of oneself).

Question 59

Resilience

Answer 59

The quality that allows some people to bounce back from difficult events that might otherwise disrupt their well-being.

Question 60

Hardiness

Answer 60

Someone with a strong sense of challenge, control, and commitment. Commitment: - tendency to see the world as interesting and meaningful (committed to life!) Challenge: - Seeing change and new experiences as exciting opportunities to learn and develop Control - Belief in one’s own ability to control or influence events Hardy people tend to be mroe resilient and cope better with stress. What influences hardiness? - childhood experiences - CBT - Disposition and personality - Discrimination

Question 61

Personal control and choice

Answer 61

The belief that we make our own decisions and determine what we do or what others for to us (can also be influenced by minority status). Learned Helplessness: When we feel like what we do doesn’t matter→ nothing is in our control. We stop searching for solutions and accept what is happening, even when there actually are things we could be controlling. - Finding small areas of control can make a big difference in our response to stress.

Question 62

Pet therapy!

Answer 62

- lowers blood pressure - decrease heart rate - decrease stress levels - increase energy level - decrease in pain - reduction in cortisol when petting a dog - gave participants the TSST

Question 63

Social support and stress coping

Answer 63

How does social support effect our ability to cope with stress? - Vagus Nerve: a communication pathway from our brain to our body. Effects our organs and BP. Associated with our stress response. - Social interactions helps strengthen our vagal tone. - High vagal tone is associated with negative emotional arousal and more constructive coping. - Social isolation - increased heart attack, risk of stroke, disrupted sleep, higher inflammation, poor immune system - Cacioppo: cancer risk increased with loneliness - Cole: immune cells are altered by loneliness

Question 64

**Coan et al - handholding**

Answer 64

Took different types of couples (platonic, married, cohabiting) Put them in an MRI and gave them a shock, could be holding hands with a stranger, familiar partner, or stranger. **Results** Partner handholding - increased valence - lowered activity in neural threat network If you were familiar with someone, it didn’t really matter who they were. They still got the benefits

Question 65

Personal Control and choice

Answer 65

The belief that we make our own decisions and determine what we do or what others for to us (can also be influenced by minority status). Learned Helplessness: When we feel like what we do doesn’t matter→ nothing is in our control. We stop searching for solutions and accept what is happening, even when there actually are things we could be controlling. - Finding small areas of control can make a big difference in our response to stress.

Question 66

Psychological influences on stress coping

Answer 66

Writing/journaling (study where they had people write for 20 minutes for 4 days about a traumatic experience) - continuous exposure decreases arousal Exercising Relaxation/mediation (literally increases hippocampus size--> v important for negative feedback loop), also increases telomerase activity CBT (appraisal)

Question 67

Vagal tone and coping

Answer 67

High vagal tone is associated with negative emotional arousal and constructive coping.

Question 68

Alomeda health study— Health Behaviors and death rate

Answer 68

- Across age groups, people with fewer health behaviors died than those with more health behaviors. Strongest in older groups - Healthy behaviors: eating breakfast, balanced diet, no smoking, moderate use of alcohol, sleep 7-8 hours, regular physical exercise, not eating between meals.