CH 5 Stress

Question 1

What is PE

Answer 1

Prolonged Exposure Therapy, a PTSD treatment

Question 2

Who coined the term “stress”?

Answer 2

Hans Selye

Question 3

Define “stress”

Answer 3

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

Question 4

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

Answer 4

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)

Question 5

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

Answer 5

PTSD, Acute Stress Disorder, Adjustment Disorder

Question 6

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

Answer 6

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

Question 7

What factors are linked to high resilience?

Answer 7

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

Question 8

Allostatic load

Answer 8

Biological cost of adapting to stress

Question 9

High allostatic load = _____(high/low) stress

Answer 9

high

Question 10

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

Answer 10

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

Question 11

Sympathetic adrenomedullary system SAM (What it does & Pathway)

Answer 11

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

Question 12

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

Answer 12

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

Question 13

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

Answer 13

corticotropin-releasing hormone
adrenocorticotropic hormone
cortisol

Question 14

Leukocytes

Answer 14

White blood cells involved in immune protection

FIRST LINE OF DEFENSE

Question 15

T Cells

Answer 15

Leukocytes

Recognizes specific antigens when activated

Question 16

B Cells

Answer 16

Leukocytes

Produce antibodies that respond to specific antigens

Question 17

Cortisol

Answer 17

Human stress hormone released by adrenal glands

Question 18

Immune System

Answer 18

Protects body from viruses and bacteria

Provides leukocytes, the front line of defense

Communicates with brain via cytokines

Question 19

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

Answer 19

suppression

Question 20

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

Answer 20

Type A
Type D

Question 21

Type A behavior pattern

Answer 21

Hostile, committed to work, impatient, competitive

Question 22

Type D behavior pattern

Answer 22

Distressed personality type

Experience mostly negative emotions, insecurity, anxiety

Question 23

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

Answer 23

decreased

Question 24

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

Answer 24

Lower cholesterol or reduce risk of blood clots

Question 25

What are some biological interventions for chronically stressed patients?

Answer 25

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

Question 26

What are some psychological interventions for chronically stressed clients?

Answer 26

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

Question 27

Biofeedback

Answer 27

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

Question 28

What is the difference between Adjustment Disorder and PTSD?

Answer 28

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

Question 29

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

Answer 29

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

Question 30

Posttraumatic Stress Disorder (Common causes and clinical description)

Answer 30

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

Question 31

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

Answer 31

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

Question 32

Describe the prevalence of PTSD

Answer 32

Trauma is more common in men and PTSD diagnoses are more common in women 6.8% lifetime prevalence

Question 33

Why is PTSD difficult to diagnose?

Answer 33

Comorbidity with other conditions (Depression, substance abuse)

Question 34

Acute Stress Disorder

Answer 34

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)

Question 35

Biological factors in PTSD (Gender, genetics, brain)

Answer 35

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

Question 36

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

Answer 36

5-HTTLPR

Question 37

5-HTTLPER

Answer 37

Gene associated with trauma exposure and low levels of social support

Question 38

Sociocultural risk factors for PTSD include _______.

Answer 38

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

Question 39

PTSD Prevention

Answer 39

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

Question 40

PTSD Treatment

Answer 40

Hotlines, crisis intervention, psychological debriefing, medications, CBTs

Question 41

What medications are used to treat PTSD?

Answer 41

SSRIs (Prozac, Paxil, and Effexor)

Question 42

Golden treatments for PTSD

Answer 42

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

Question 43

Prolonged Exposure PE

Answer 43

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