Stress and Distress -Martin and Sweeny

Question 1

What are the differences between the mechanist and the vitalist ideas about the causes of behavior?

Answer 1

Vitalist: there is a spirit force that is behind us and is being expressed through our bodies.

Mechanist: CNS is made of neurons and glia. Incoming sensory info comes in and tells you there is something in the environment that you want. then the CNS send info to the PNS to obtain it.

Question 2

What was BF Skinner’s opinion about free will?

Answer 2

there is no free-will and that people are continually influenced by things around them

(Skinner established operant conditioning==> animals do behavior that are more rewarding)

Question 3

What is a proximate cause of behavior? What is an example?

Answer 3

• Proximate=the stimulus that causes/initiates a particular behavior
• immediate stimulus
• developmental –> ex: language development. necessary functions

Question 4

What is an ultimate cause of behavior? What are some examples?

Answer 4

• Ultimate: all things in the past (ancestors and natural selection) that allow for the development of behavior
• include adaptation
  ex: scared reflex: developed as an adaptation to increase survival

Question 5

What is stress?

What are some origins of stress?

Answer 5

Perceived or un-perceived difficulties in responding to the physical, biological or social environment.

origins of stress:

• mismatch with evolutionary adaptations
• proximate uncontrollable events

Question 6

How does a diet high in fiber affect glucose and insulin levels?

Answer 6

High fiber diet reduces both plasma glucose and insulin levels–> even more than the American Diabetes Association diet.

Question 7

What does a diet high in omega 6 fatty acids result in?

Answer 7

interferes between inflammatory and anti-inflammatory actions of immune cells–> can lead to increased inflammation and interfere with incorporation of phospholipids into nerve cell membranes.

Question 8

How does acute stress affect the body?

Answer 8

stress triggers the release of NTs (NE, ACh, 5HT, GABA)–> hypothalamus (paraventricular nucleus)–> release of corticotropin releasing hormone–> stimulate release of ACTH from anterior pituitary–> stimulate release of glucocorticoids from adrenal cortex–> blood–> through lipid membrane–> regulation of glucocorticoid receptor genes at the nucleus level

both the hypothalamicpituitaryadrenocortical (HPA) (hormonal response) and the sympathoadrenomedullary (SA) (neural response) systems are activated by stress

Question 9

What is chronic stress?

Answer 9

-Chronic stress which is inescapable stress lasting over weeks or months eventually leads to physiological damage

Question 10

What was found in combat veterans with PTSD?

What does this indicate about the cause-effect relationship of stress on the brain?

Answer 10

• lower hippocampus volume
• can’t be certain of the cause-effect relationship but there is a correlation between chronic stress and lower hippocampus volume

Question 11

How does the hippocampus volume of a person with Cushing’s syndrome compare to normal?

What about a depressed person?

Answer 11

• Cushing’s =excessive secretion of cortisol from the adrenal cortex
• BOTH cushing’s and depressed have LOWER hippocampal volume

Question 12

What was found in children of mothers who had high cortisol levels?

Answer 12

• female children had increased amygdalae and more affective problems
• male children did not

Question 13

What types of things can lead to alterations in the developing fetus brain?

Answer 13

maternal stress, glucocorticoids, exogenous CRH, infection, inflammation, prenatal drug exposure, maternal and fetal genotype

these can all lead to psychopathological/developmental disorders such as: autism, ADHD, schizophrenia, depression, anxiety, and dementia

Question 14

What is pre-pregnancy BMI associated with? How is this thought to work?

Answer 14

elevated pre-pregnancy BMI is associated with ADHD

maternal obesity increases the inflammatory environment in pregnancy and can lead to neurodevelopmental deficits

Question 15

How can early life infections (maternal infections) affect individuals later in life?

Answer 15

• prenatal stressors can combine with stressors in early adulthood to cause inflammatory responses and immune dysfunction
• these individuals can be sensitized to later peripupertal stressors leading to psychopathology or behavior disorders in adulthood.

Question 16

What is Sweeny’s definition of stress?

What is distress?

What is an example of positive stress?

Answer 16

• stress: Life events, or stressors, that have the force to alter the expected course of an individual’s goals, employment, relationships, and health.
• distress-unpleasant stress
• positive stress: a promotion that carries a lot of stress but is considered a good thing

Question 17

What is behavioral medicine?

Answer 17

an interdisciplinary field combining both medicine and psychology and is concerned with the integration of knowledge in the biological, behavioral, psychological and social sciences relevant to health and illness

Question 18

What was Dr. Cannon responsible for?

Answer 18

establishing the first correlation between stress (ANS) and physiological changes or disease (BP, HR, CO)

Question 19

Who described “conversion hysteria” as psychological symptoms with deep psychic meaning which manifested (converted) to somatic (physical) illness?

What is this approach called now?

Answer 19

Freud

Psychoanalytic approach

Question 20

Who came up with the theory that “psychosomatic symptoms” were due to prolonged autonomic system arousal linked to repressed psychic conflict?

Answer 20

Dr. Franz Alexander

Question 21

Who came up with the idea of general adaptation syndrome?

Answer 21

Dr. Hans Selve

he described the human stress response in relation to adrenocortical hormones –> organism responds to external stress

Question 22

What scale is used to qualify stress?

What score puts you at risk for illness in the following year?

Answer 22

Rahe Holmes Social Readjustment Rating Scale

300+= at risk of illness in the following year
150-299=risk of illness is moderate
<150=slight risk

Question 23

What psychoneuroimmunological changes take place under acute stress?

Answer 23

Corticosteroids:
-immunosuppressive effects on lymphoreticular system & marked antiallergic and & anti-inflammatory effects
       *catecholamines
       *opiates
       *growth hormone &
         prolactin – initially are
         immuno-enhancing

Question 24

What two things become inhibited in chronic stress?

What overall changes happen to the immune system?

Answer 24

growth hormone and prolactin are inhibited in chronic stress–> stress dwarfism

==> dysregulation of the immune system from elevated corticosteroids, catechols and opiates, along with the gh/prolactin inhibition

Question 25

What percent of pts visiting primary care have stress-related disorders?

Answer 25

50%!!

Question 26

What does major depressive disorder often present as?

Answer 26

fatigue, backache, HA, pain

Question 27

What does generalized anxiety disorder present as?

Answer 27

CP, SOB

Question 28

What are the 3 variables to modulate stress response?

Answer 28

1. outlets for frustration
2. social support is highly protective
3. predictability==> coping strategies

Question 29

What are the 3 individual differences that help you in psychological stress?

Answer 29

1. commitment to self
2. sense of control over one’s life
3. ability to see change as a challenge
4. ? coherence. accept that one’s internal and external environments are predictable and things will work out as expected.

Question 30

What are some ways to reduce stress? (10)

Answer 30

1. . Improve time management (balance between work/exercise/play.
2. Improve sense of humor
3. Perspective: meaning and purpose of life
4. Cultivate spiritual activities: (prayer, mindfulness, *meditation)
5. Increase emotional self-disclosure
6. Short-term psychotherapy
7. *Social support network
8. Increase assertiveness
9. Reduce exposure to unnecessary stressors
10. Monitor sensory input (introvert v extrovert)

Question 31

How is depression related to cardiac issues?

Answer 31

there is double the risk for MI, revascularization procedures for unstable angina related to depression

-depression=risk factor for ischemic heart disease&raquo_space; standard cardiac variables (left ventricular ejection fraction)

Question 32

What is the “toxic core” of type A personalities? What do high levels of this emotion correspond with?

Answer 32

hostility

high hostility=linked with coronary events, lipid accumulation, increased BP and HR

type A also tend to be smokers, drinkers, and have higher BMIs

Question 33

What musculoskeletal system problems are often associated with psych consults?

Answer 33

Rheumatoid arthritis: stress, depression, SLE, low back pain, fibromyalgia, HA