CH 5 Stress Flashcards

1
Q

What is PE

A

Prolonged Exposure Therapy, a PTSD treatment

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2
Q

Who coined the term “stress”?

A

Hans Selye

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3
Q

Define “stress”

A

External demands placed on an organism lead to the organism’s internal biological and physiological responses

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4
Q

How is stress involved with the DSM and how has this changed over time?

A

Stress is a component of multiple DSM diagnostic categories

DSM-4 and before: Classified under anxiety disorders

DSM-5: PTSD, Acute stress disorder, and Adjustment disorder are in their own category (trauma and stressor-related disorders)

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5
Q

List the Trauma- and Stressor-related disorders classified in the DSM-5

A

PTSD, Acute Stress Disorder, Adjustment Disorder

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6
Q

List characteristics of stressors (factors in the intensity of stress)

A

Severity
Chronicity
Timing
Degree of impact
Level of expectation
Controllability
Age
Social support available
Isolation

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7
Q

What factors are linked to high resilience?

A

Being older
High income
More life experience
Higher education
Positive life outlook
Self-confidence
Ability to focus on the present

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8
Q

Allostatic load

A

Biological cost of adapting to stress

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9
Q

High allostatic load = _____(high/low) stress

A

high

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10
Q

What are some physical illnesses associated with high levels of stress?
(9 answers)

A

Heart disease
stroke
asthma
diabetes
obesity
GI issues
Cancer
Alzheimer’s disease
High blood pressure

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11
Q

Sympathetic adrenomedullary system SAM (What it does & Pathway)

A

The body’s response to short-term stressors

Fight or flight

  1. The hypothalamus stimulates the sympathetic nervous system
  2. Inner portion of adrenal glands secrete adrenaline (epinephrine) and noradrenaline (norepinephrine)
  3. These circulate in the blood and lead to an increase in heart rate & glucose metabolization
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12
Q

Hypothalamus-pituitary-adrenal system HPA
(What it does & Pathway)

A
  1. The hypothalamus releases corticotropin-releasing hormone
  2. The pituitary gland is stimulated and releases the adrenocorticotropic hormone
  3. The adrenal cortex is stimulated to release cortisol
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13
Q

The hypothalamus releases _______, which causes the pituitary gland to release _______, which causes the adrenal glands to release _______.

A

corticotropin-releasing hormone
adrenocorticotropic hormone
cortisol

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14
Q

Leukocytes

A

White blood cells involved in immune protection

FIRST LINE OF DEFENSE

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15
Q

T Cells

A

Leukocytes

Recognizes specific antigens when activated

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16
Q

B Cells

A

Leukocytes

Produce antibodies that respond to specific antigens

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17
Q

Cortisol

A

Human stress hormone released by adrenal glands

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18
Q

Immune System

A

Protects body from viruses and bacteria

Provides leukocytes, the front line of defense

Communicates with brain via cytokines

19
Q

Stress is linked to immune system _______ (improvement, suppression)

A

suppression

20
Q

What 2 personality types are associated with high stress and increased risk for heart disease?

A

Type A
Type D

21
Q

Type A behavior pattern

A

Hostile, committed to work, impatient, competitive

22
Q

Type D behavior pattern

A

Distressed personality type

Experience mostly negative emotions, insecurity, anxiety

23
Q

Forgiveness is linked with _______(increased/decreased) stress.

A

decreased

24
Q

What is the goal of biological interventions in chronically stressed patients?

A

Lower cholesterol or reduce risk of blood clots

25
Q

What are some biological interventions for chronically stressed patients?

A

Surgeries, lipid-lowering medications, aspirin or other anticoagulants, antidepressants

26
Q

What are some psychological interventions for chronically stressed clients?

A

Emotional disclosure (journaling), biofeedback, relaxation and meditation, CBT

27
Q

Biofeedback

A

The technique of gaining greater awareness of the physiological functions of one’s own body

Uses electronic or other instruments

Goal: being able to manipulate the body’s systems at will

28
Q

What is the difference between Adjustment Disorder and PTSD?

A

AD: Common Stressor, mild symptoms
PTSD: Traumatic stressor, severe symptoms

29
Q

Adjustment Disorder
(Common causes, typical timeline, and general definition)

A

One of the mildest DSM diagnoses

A common stressor leads to a psychological response

Within 3 months of the stressor

Symptoms disappear when the stressor ends OR the person adapts

Common causes: unemployment, death of loved one, moving, divorce

30
Q

Posttraumatic Stress Disorder
(Common causes and clinical description)

A

Trauma and stressor-related disorder

Common causes: Combat, rape, concentration camp, natural disaster

Clinical Description: Trauma memory inexperienced involuntarily with same emotional force for at LEAST 1 month

31
Q

DSM-5 Criteria for PTSD
(Criteria A-E)

A

1 month or longer

A. Stressor (1 required)
1. A person is exposed to death, serious injury, or sexual violence (actual or threatened) in the following ways: direct exposure, witnessing, learning that a close person was exposed to the trauma
2. Indirect exposure to aversive details of the trauma (first responders, medics)

B. Intrusion symptoms (1 required)
Unwanted upsetting memories
Nightmares
Flashbacks
Emotional distress
Physical reactivity
MUST BE PERSISTENT

C. Avoidance (1 required)
Trauma-related thoughts or feelings
Trauma-related external reminders

D. Negative alterations in cognitions & mood (begin or worsen AFTER trauma)
(2 required)
Inability to recall key features of the trauma
Overly negative thoughts & assumptions about oneself or the world
Exaggerated blame of self/others for causing trauma
Negative affect
Anhedonia
Feeling isolated
Difficulty experiencing positive affect

E. Alterations in arousal and reactivity (2 required)
Irritability or aggression
Risky or destructive behavior
Hypervigilance
Heightened startle reaction
Difficulty concentrating
Difficulty sleeping

32
Q

Describe the prevalence of PTSD

A

Trauma is more common in men and PTSD diagnoses are more common in women

6.8% lifetime prevalence

33
Q

Why is PTSD difficult to diagnose?

A

Comorbidity with other conditions
(Depression, substance abuse)

34
Q

Acute Stress Disorder

A

Symptoms develop shortly after traumatic event and last for AT LEAST 2 days

Can receive treatment immediately

Diagnosis CAN change to PTSD if symptoms persist (1 month or longer)

35
Q

Biological factors in PTSD
(Gender, genetics, brain)

A

Gender: Higher baseline cortisol levels in females with PTSD (women are more likely to experience chronic stress)

Genetics: 5-HTTLPR

Brain: Reduced size of hippocampus

36
Q

Which gene is associated with trauma exposure and low levels of social support?

A

5-HTTLPR

37
Q

5-HTTLPER

A

Gene associated with trauma exposure and low levels of social support

38
Q

Sociocultural risk factors for PTSD include _______.

A

Minority group
Negative and unsupportive social environment
Less than a college education
Poverty

39
Q

PTSD Prevention

A

Reduce exposure to traumatic events
Advanced preparation (ex. proper military training)

40
Q

PTSD Treatment

A

Hotlines, crisis intervention, psychological debriefing, medications, CBTs

41
Q

What medications are used to treat PTSD?

A

SSRIs (Prozac, Paxil, and Effexor)

42
Q

Golden treatments for PTSD

A
  1. Prolonged Exposure PE
  2. Cognitive Processing Therapy CPT
  3. Eye Movement Desensitization and Reprocessing EMDR
43
Q

Prolonged Exposure PE

A

PTSD Treatment involves building up exposure to stressors over 9-12 90-minute sessions through use of imaginal and in vivo exposure