3 - stress and illness

Question 1

examples of common stressors

Answer 1

small daily hassles e.g. missing the bus
academic or work related concerns e.g. exams
relationship issues
financial problems 
loss of control over goals

Question 2

factors that make an event stressful

Answer 2

perceived as negative
lack of control
long-lasting
cannot be dealt with using current resources
amiguity
relevant to important life domains/aspects of self

Question 3

transactional theory (Lazarus and Folkman)

Answer 3

define stress as..
“a relationship between the person and environment that is perceived by the person as taxing or exceeding his or her resources and endangering his or her wellbeing”

Question 4

factors affecting how stressful an event is for an individual

Answer 4

appraisal differences (perception of the stress)
psychological differences
coping mechanisms --> strategies to deal with the stress

Question 5

example of a way to measure stress

Answer 5

the social readjustment rating scale (Holmes and Rahe)

records how people rate different types of stress

measures daily hassles and uplifts

Question 6

what are daily hassles

Answer 6

small difficulties during the day that may add up and create unmanageable demands
e.g. rising prices, noisy neighbours, too many responsibilties

Question 7

what are daily uplifts

Answer 7

positive occurrences that may offset the daily hassles and reduce the perceived demand

e.g. good weather, getting on well with friends

Question 8

how are hassles and uplifts measured in the social readjustment scale (Holmes & Rahe)

Answer 8

factors are rated on a scale of 0-3 of perception as a hassle or an uplift

examples included children, parents, partner, weather, news

Question 9

results from social readjustment scale (Holmes and Rahe)

Answer 9

ratings of factors from hassles to uplifts varied from day to day

more hassles were associated with lower social wellbeing
daily uplifts made little difference

hassles were found to be good indicators of stress

Question 10

how does stress directly effect your health

Answer 10

affects functioning of the cv and immune system
due to cortisol entering the bloodstream
chronic stress undermines general system functioning

Question 11

how does stress indirectly affect your health

Answer 11

increases health risk behaviours e.g. smoking, alcohol use, drug use –> negative health consequences

decreases health promoting behaviours e.g. physical activity, good sleep, good diet
–> secondary consequences such as tiredness affecting eating habits, physical activity etc.

Question 12

evidence to show that stress affects speed of wound healing

Answer 12

small biopsy wound in hard palate of dental students
taken once in summer holidays and once before major exams

healing resonse was measured as much longer for those in exam condition

Question 13

physical effects of moderate/severe stress

Answer 13

dry mouth
perspiration
headaches
high BP
GI problems
lower back pain

Question 14

emotional effects of moderate/severe stress

Answer 14

anxiety
depression
fatigue
irritability
impulsiveness
hypervigilance

Question 15

cognitive effects of moderate/severe stress

Answer 15

inability to concentrate

memory problems

Question 16

behavioural effects of moderate to severe stress

Answer 16

teeth grinding
crying
disrupted eating
aggression
sexual problems

Question 17

how is stress induced by the nervous system

Answer 17

sympathetic nervous system
adrenal medulla releases catecholamines e.g. adrenaline to induce stress response
cortisol is released into the blood stream

Question 18

physiological responses to sympathetic nervous system

Answer 18

bronchiole dilation
increased breathing rate
increased heart rate
increased BP
increased blood glucose
decreased metabolism
decreased digestion
decreased immune activity and pain perception

Question 19

physiological responses to the parasympathetic nervous system

Answer 19

reduces adrenalin secretion
reduces heart rate and blood pressure
reduces breathing rate
reduces perspiration 
increases salivation
body returns to homeostasis
promotes relaxation
facilitates energy storage

Question 20

adrenal glands

Answer 20

sit on top of kidneys
pyramid shapes
made up of cortex and medulla

Question 21

adrenal medulla

Answer 21

secretes catecholamines e.g. adrenaline, noradrenaline

Question 22

adrenal cortex

Answer 22

outer section of adrenal gland
produces glucocorticoids
e.g. cortisol

Question 23

2 nervous and endocrine mechanisms of stress response

Answer 23

sympathetic adrenal medullary (SAM) system

hypothalamic pituitary adrenal (HPA) axis

Question 24

what does SAM stand for

Answer 24

sympathetic adrenal medullary system

Question 25

what is the SAM system

Answer 25

initial response to stress (fast and moderate) hypothalamus in midbrain releases corticotropin releasing hormone (CRH) CRH enters blood stream and stimulates adrenal medulla to release adrenalin

Question 26

what does HPA stand for

Answer 26

hypothalamic pituitary adrenal axis

Question 27

features of the HPA axis

Answer 27

secondary stress response slower with longer, more extensive effects cortisol secretion into the blood

Question 28

mechanism of HPA axis

Answer 28

hypothalamus releases CRH CRH travels in blood stream to pituitary gland adrenocorticotrophic hormone (ACTH) released ACTH stimulates adrenal cortex to release corticoids and cortisol

Question 29

effects of cortisol

Answer 29

increased protein and fat mobilisation increased access to energy storage decreased immune response decreased inflammation

Question 30

how does chronic stress cause illness

Answer 30

increased risk of viral infection triggers histamines which lead to bronchoconstriction --> exacerbates asthma increases risk of diabetes mellitus alters acid concentration in stomach --> leads to pepti ulcers, ulcerative colitis arterial plaque build up (atherosclerosis) psychiatric illness e.g. depression, anxiety, schizophrenia tumour development and NK cell suppression --> metastasis no longer prevented

Question 31

how does chronic stress cause cardiovascular disease

Answer 31

leads to the continual release of catecholamines and corticosteroids increases HR increases BP increased force on heart muscle walls and circulatory system increased platelet count increased growth of plaques

Question 32

how does stress cause damage to the heart

Answer 32

heart muscle walls become enlarged and damaged particularly left ventricle (main pumping chamber) --> LV hypertrophy muscles lose elasticity --> cant pump with sufficient force

Question 33

effects of damage to the heart caused by stress

Answer 33

``` shortness of breath fatigue chest pain heart palpatations dizziness increased risk of heart attack and stroke ```

Question 34

effect of chronic stress on circulation

Answer 34

blood vessels and arteries become distended/inflamed due to increased blood flow vessels become rigid (wrapped with more muscle) fat and cholesterol attracted and forms plaques which can rupture causing blood clots

Question 35

what happens in plaques formed on blood vessels rupture

Answer 35

stroke if occurs in the brain myocardial infarction if occurs in the heart blood clot if anywhere else

Question 36

how can chronic stress lead to depression

Answer 36

high cortisol levels makes brain more susceptible to depression when stressed

Question 37

evidence that stress is linked to depression

Answer 37

daily cortisol measured from 3 groups --> depressed group had higher morning cortisol levels and higher net secretion of cortisol in response to stressful task

Question 38

what is autoimmunity

Answer 38

when the immune system attacks self-cells

Question 39

what do vaccines take advantage of

Answer 39

the natural, non-specific response to pathogens

Question 40

function of immune system

Answer 40

to recognise and destroy pathogens based on markers on their cell walls (antigens)

Question 41

features of innate immune response

Answer 41

immediate fast general phagocytes migrate from bloodstream to site of infection and consume pathogens display pathogens on walls (antigen presentation)

Question 42

features of adaptive immune response

Answer 42

secondary specific slow B and T cells respond to the displayed antigens antigen specific receptors required through cell multiplication

Question 43

outline cell-mediated immunity

Answer 43

NK cells directly attack via toxin secretion helper T cells and T cells secrete cytokines to stimulate other immune cells B cells become plasma cells which produce antibodies

Question 44

outline antibody mediated immunity

Answer 44

B cells attach themselves to a pathogen and produce specific antibodies antibodies bind to pathogen receptors - cause them to burst - OR mark pathogen for other immune cells to kill antibodies assist in formation of memory B cells T helper cells produce B-cell growth factors casing B cell proliferation and inreased antibody production

Question 45

effect of stress on immune system

Answer 45

initial effect - activates immune system e..g acute stressor such as a wound to avoid potential infection chronic stress - glucocorticoid shrinks thymus gland decreasing cell-mediated immunity

Question 46

importance of thymus gland in immunity

Answer 46

T and B cells formed there

Question 47

how can you measure immune function

Answer 47

count B, T and NK cells in blood samples - examine how rapidly cells proliferate measure how much antibody our body cotrains against common antigens measure production of antibody in response to ingested substance that produces antigens

Question 48

main man in measuring immune function what did he find

Answer 48

Glaser collected blood from med students 1 month and 1 day before exams found NK cell activity much lower 1 day before exams

Question 49

overall effect of stress on illness

Answer 49

stress increases cortisol which causes immunosuppression increasing risk of illness

Question 50

rhinovirus study to show stressful life events increases risk of illness

Answer 50

17 subjects exposed to rhinovirus symptoms measured over 5 days recent stressful life events recorded greater number of stressful recent life events had occurred in those that developed colds