Lecture 6 Psychological Medicine (Stress and Coping)

Question 1

What is stress? There are three components to it - what are they?

Answer 1

1. An event or situation occurs (stressor) or thought bout a possible stressor
2. Psychological/emotional reaction whereby the individual ‘feels stressed’ - influenced by many factors (the event, personality, childhood adversities, support)
3. Physiological stress response.

Question 2

The physiological stress response
So, stress starts in the brain with a psychological stimulus (after the event, it’s your psychological reaction). Then there is a physiological response that involves two main pathways:

What are the two pathways and what hormones are related and from where?

Answer 2

So there are two pathways - one is the Sympathetic branch of the autonomic nervous system and then there is the HPA axis.

The SNS branch of ANS causes the release of noradrenalin and adrenalin (catecholamine hormones) from adrenal glands and elsewhere.

The HPA axis (Hypothalamic-pituitary-adrenocortical) causes the release of cortisol from adrenal glands (which is a corticosteroid hormone)

The integrated action of SNS and HPA (the three hormones) is termed “fight or flight response”

Question 3

Fight or flight response:

1. What happens to your breathing, heart rate, BP and why?
2. What happens to arteries going to muscles and where is the blood flow directed?
3. What happens to the glucose and fats from storage in body cells?
4. What happens to the consistency of blood?
5. What happens to the immune system?
6. What happens if these processes are chronic?

Answer 3

1. The three increase to deliver oxygen and blood to the muscles
2. -

Question 4

1. So after the stressor is gone, what kicks in to calm you down? Is your body damaged by the stress?
2. What is stress like nowadays? Do we get stressed by bears often? What else can maintain our stress these days?
3. What are we often not aware about with the chronic stress that’s happening?

Answer 4

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Question 5

Effects of chronic stress on heart:

1. What happens to the BP? What does this put on the vessel walls and esp where?
2. There is the initiation of the ______ response and also will attract ____ (cholesterol)
3. There can be a build up of _____ plaques, risk of clots and ____ (restricted blood supply to heart) and this _______ _____
4. Does this suggest that stress is the only cause of high BP and high BP is the only cause of atheroscleoriss

Answer 5

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Question 6

Effects of chronic stress on metabolism:

1. What do the stress hormones in fight or flight response do to the storage forms of glucose, fats and protein?
2. What happens to insulin production? What message does the body get about what it should make cells?
3. With chronic stress, what are there chronically elevated levels of in the blood stream? What is there a tendency towards?
4. This contributes to what syndrome and risk of what major disease?

Answer 6

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Question 7

Name a few physical conditions that stress is associated with.

What is it definitely not associated with it?

Answer 7

CV, diabetes, MSK problems and chronic pain esp (get stressed about it and then stress makes pain worse)

Question 8

Roles stress plays in disease:

1. Is stress the primary causal factor of organic disease? Wha is it then? What does stress act in combination with to increase susceptibility to a specific disease
2. What can influence the disease risk and is to do with stress?
3. So stress is linked with most physical conditions and diseases, one way or another - why?

Answer 8

Stress is an exacerbator (never a primary causal factor for organic disease) meaning it acts in combination with a cause factor or with pre-existing biological vulnerability

Question 9

Explain in your own words the example of how stress can influence disease susceptibility? (peptic ulcers)

Answer 9

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Question 10

Stress also increases risk of mental disorders:

1. What are well-established risk factors for the development of major depressive disorders and some anxiety disorders? (3)
2. What are the psychological mechanisms and biological mechanisms that come to play here?
3. Around 50% of people with recurring depression have been found to have abnormal what?

Answer 10

. If feel stress, you feel overwhelmed like you cant cope.
o Cortisol seemed to affect functioning of neuro in depress – can also damage hippo (memory function)
o HPA functioning – elevated level of stress hormones in response to stimulus affects

Question 11

Some stress is inevitable. How we cope with it is key though.

1. How we cope with stress determines how frequently the _____ _____ response is turned on and how _____ it lasts
2. If we have good coping strategies, we develop ___ in our abilities to cope with similar situations and so don’t perceive them so stressful

Answer 11

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Question 12

There are two ways of coping

1. Problem-focussed coping: what do you focus on here? What do you do? (2)
2. Emotion-focused coping: what do you focus on here? What do you control?

Answer 12

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Question 13

Problem-focused coping:

1. What four things can you do?

Answer 13

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Question 14

Emotion-focused coping:

1. What are the three things you can do here?

Answer 14

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