Stress & PTSD Flashcards

1
Q

Stress

A

A real or interpreted threat to the physiological or psychological integrity of an individual
Results in physiological and/or behavioural responses
We all perceive stress differently

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2
Q

Hooke’s law

A

Wear & tear of everyday life

How long until the spring snaps

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3
Q

Cannon(1932): homeostasis, fight or flight

A

Homeostasis; biological self-regulation, enables an organism to adapt to life’s demands, we’re built to prepare to fight or flight

Stressor; stimulus resulting in imbalance threatening homeostasis

Stress response; response of an organism to maintain or re-establish homeostasis

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4
Q

General adaptation syndrome; Selye (1956)

A

3 stage model of chronic stress

1) alarm; immediate response
2) resistance; bodies ability to cope with higher level of stress
3) exhaustion; need a break from stress or exhaustion occurs, rush if developing other conditions, reduced immune system

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5
Q

Cognitive effects of stress

A

Loss of concentration
Memory loss
Reduced decision-making ability

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6
Q

Behavioural effects of stress

A
Over eating
Under eating 
Reduced work performance
Reduced time management 
Arguments
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7
Q

Physiological effects of stress

A

Increased heart rate
Increased blood pressure
Increased galvanic skin response

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8
Q

Emotional effects of stress

A

Anxiety
Anger
Low motivation
Increased jealously/insecurity

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9
Q

Sympathetic-adrenal-medulla (SAM) axis

A

Sympathetic nervous system
Immediate stress response/fight or flight

Norepinephrine (in brain)
Epinephrine (in blood)

Generates more energy, conserving every, more blood & oxygen to brain, heart & muscles, decreased blood loss after injury

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10
Q

Hypothalamic-pituitary-adrenal (HPA) axis

A

Hormone mediated
Slower response
1) stress
2) corticotropin releasing hormone
3) adrenocorticotropin hormone
4) cortisol
Negative feedback loop
Short term release of cortisol is protective
Adaptive long term release can lead to immunosuppression, CVD & hypertension
Early life stress can lead to high cortisol releasing hormone & altered cortisol

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11
Q

Measuring acute stress

A

High salivary amylase

High norepinephrine in blood

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12
Q

Measuring chronic stress

A

Diurnal (daily) curve of cortisol response
Cortisol awakening response; natural rise in morning, prepares people for day
Altered in mental health disorders

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13
Q

Life events as stressors

A

Stress exposure significantly associated with depression
Increased cortisol awakening response in men who have experienced early life stress compared to men who have not
Still an effect even if no MH disorder
If experienced trauma; higher CAR
low parental care; increased CAR
CAR higher in patients with psychosis

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15
Q

Ways to measure life events as stressors

A

Social readjustment rating scale; Holmes & Rae (1967)

College life inventory (Renner & Macklin, 1998); gives value to different events

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16
Q

Childhood trauma/adversity

A

Frequent in people with psychosis
Increase in the likelihood of developing psychotic symptoms in adulthood if having experienced childhood adversity
Childhood adversity associated with the severity of symptoms & cause of schizophrenia
Has an effect on cognition (memory, executive functioning, cognitive performance)

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17
Q

Importance of appraisal

A

Lazarus; influential stress theorist & researcher
Perceived stressors
Transactional model
Appraisal; 15 core relational themes
Some stressors can be positive if we believe we can cope

18
Q

Risk factors

A

neuroticism
external locus of control
type A personality (exaggerated sense of time urgency, competitive, hostility & drive, linked to 2x increased risk of CHD, type D personality?

19
Q

Protective factors

A
Conscientious 
Extra version 
C+E= resilience 
Openness to experience 
Agreeableness 
Dispositional optimism
Internal locus of control
20
Q

Influence of stress on mental health

A

Yerkes-Dodson law; optimal stress=high performance

Higher sense of control, more likely to experience stress as excitement rather than depression or anxiety

21
Q

Salutogenic model

A

Anyonvosky, medical sociologist
Health is on a continuum defined by how a person manages stress
Generalised resistance resources, conprehensibility, manageability , meaningfulness & sense of coherence (confidence that environment is predictable & that things will work out)

22
Q

Erickson & Lindstrom (2005)

A

Reviewed 458 publications of salutogenic model

Found that sense of coherence promoted resilience & positive health

23
Q

Van der Hal-van Raalte et al (2008)

A

203 holocaust survivors

Strong sense of coherence protects from PTSD even in old age compared to survivors with weak SOC

24
Q

Trauma & stress-related disorders

A

Separate in DSM-5 from anxiety disorders
Major diagnostic category is PTSD
primary precipitating cause is traumatic experience
Can be diagnosed even if you have just witnessed an event

25
Q

PTSD

A

Intrusive symptoms e.g. disturbing dreams
Avoidance responding
Negative changes in cognition & mood
Increased arousal & reactivity
Symptoms began at event or after & lasted for at least 1 month

26
Q

Acute stress disorder

A

Similar to PTSD
much shorter duration
Begins within 3 days-1 month after event
Lasts for 3 days-1 month

Prescribe of PTSD? Actually a disorder?

27
Q

Effects of military service on mental health; Hoge et al (2004)

A
2530 studied before Iraq deployment 
1709 studied after return 
PTSD before; 9.4%
PTSD after; 18%
Demographics of pp were similar to those of the general, deployed non-officer pop in Iraq
28
Q

PTSD triggers

A
Rape; 90% chance 
Torture; 70-90% chance 
Prisoners of war; <50%
Flood &amp; earthquake survivors; 20-25%
Motor vehicle accident victims; 15%
Overall US prevelance rate; 1%
29
Q

Conditioning theory

A

symptoms associated with PTSD due to classical conditioning

Trauma (UCS) associated with other cues (CS)

Conditioned fear response does not extinguish due to avoidance responses

30
Q

Conditioning theory doesn’t explain;

A

Individual nature of responses to trauma

Range if symptoms specific to PTSD e.g. dissociative experiences & flashbacks

31
Q

Why only some people?

A

Pre-existing personality factors
Possible genetic disposition
Key appears to be the fear reaction to the experience

32
Q

Biological factors

A

30% heritability
Genetically wired heightened startle response & endocrine system response
Reduced hippocampul volume
Vebtrimedial frontal cortex; amygdala circuitry

33
Q

Other factors

A

Tendency to take responsibility for the traumatic event & the misfortunes of others involved in the event
Developmental factors
Family history of PTSD
Existing high levels of anxiety or pre-existing psychological disorder
Low IQ, link to coping strategies?
Types of experiences reported at time of event

34
Q

Mental defeat

A

Individual vulnerability in increased in those who see themselves as a victim
Loss of individual autonomy
All info about trauma is processed negatively & person views themselves as unacceptable to act effectively
Perceived lack of control prevents processing of the memory

35
Q

Avoidance & dissociation

A

Avoidance coping more likely to lead to PTSD
Dissisociation as an avoidant strategy; dissociation used to allow person to detach & distance themselves from the trauma
Individuals who show dissociative symptoms at the time of trauma more likely to develop PTSD

36
Q

Emotional processing theory

A

Information processing model
1) Representation of memory becomes strongly associated with other contextual details due to intense nature of trauma
2) leads to formation of representations & associations in memory different to those formed from everyday experience
3) previous assumptions about how safe the world is leads to a sensitisation in terms of the threshold to display fear response
People with fixed ideas of self & world prior to trauma more susceptible to PTSD

37
Q

Dual representation theory; Brewin (1996)

A

Trauma memories are represented in a more fundamentally distinct way

Re-experiencing arises when trauma memories become dissociated from the ordinary memory system

Recovery involves transforming them into ordinary or narrative memories

38
Q

Memory model

A

Verbally accessible memories (VAM) vs situationally accessible memories (SAM)

39
Q

Verbally accessible memories

A

Memories consciously processed at time of trauma
Contain info before, during & after traumatic event; temporal context is encoded
Can be deliberately retrieved
Integrates with personal context comprising past, present & future
Hippocampus involvement

40
Q

Situationally accessible memories

A

Perceptual processing (sights, sounds, touch)
Stores info about bodily response
Memories difficult to communicate to others
Responsible for flashbacks
Amygdala involvement
Triggered involuntarily by situational reminders