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Psychology applied to health > Stress And Illness > Flashcards

Stress And Illness Flashcards

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1
Q

__________ is an important negative outcome of stress.

A

Anxiety

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2
Q

Give six examples of common stressors.

A

Small daily hassles, work/academic concerns, relationships, goal conflict, role conflict and finances.

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3
Q

Who developed the transactional theory of stress?

A

Lazarus and Folkman (1984)

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4
Q

Define the transactional theory of stress (ref?)

A

A relationship between the person and the environment that is perceived by the person as taxing or exceeding resources and endangering wellbeing (Lazarus & Folkman, 1984)

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5
Q

According to the transactional theory of stress, two people faced with the same ___________ demands may react _______________ because they differ in _________ and ___________.

A

Objective/differently/perception of demand/perception of resources.

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6
Q

Stress can be easily defined in terms of objective environmental stimuli. True or false?

A

False, appraisal and coping are critical to the stress transaction.

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7
Q

According to the transactional theory of stress: Understanding stress requires measures of….

A

Environmental inputs, individual differences, appraisal differences, psychological responses and coping responses.

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8
Q

In 2013/14, stress accounted for what percentage of acute work related illness in the uk?

A

39%

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9
Q

Stress is the most common cause of long term sick leave, how many days are lost per year in the uk because of this?

A

> 10 million

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10
Q

Give examples of how high demand jobs affect physical and mental health.

A

Cardiovascular disease, anxiety and depression.

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11
Q

Name the six characteristics of stressful events.

A

Negative (not always), uncontrollable (key characteristic), long lasting, cannot be dealt with using current resources, ambiguous, relevant to important life domains.

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12
Q

Measuring stress: Who developed the social readjustment rating scale?

A

Holmes & Rahe (1967)

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13
Q

Measuring stress: Describe the social readjustment rating scaled identify its limitations.

A

An extensive list of life events (pos & neg) which are each given a life change unit score e.g. Divorce 73, personal illness 53, Christmas 11. Scores reflect the extent to which the event affects daily routines and the idea is to give a LCU for the past year. However whilst they all broadly cause stress, individual differences would mean that scores would differ a lot for different people. This measure only takes into account objective demand on the system.

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14
Q

Measuring stress: Who developed the daily hassles scale?

A

Canner et al (1981)

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15
Q

How many items are there on the daily hassle scale? (Canner et al 1981), and give a few examples.

A

117 items e.g. Rising prices, noisy neighbours, bad weather and feeling lonely etc.

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16
Q

Daily hassles may seem like nothing, but can add up to __________ and so create __________ (ref?).

A

Undermine resources and Unmanagable demands (ref) Canner et al (1981).

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17
Q

Research suggests that experiencing more daily hassles leads to _________.

A

Increased stress and less psychological wellbeing.

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18
Q

While the daily hassles scale can be used to add smaller hassles to bigger life events, what is its main limitation?

A

Things which could be positive to one person, may be neg to another. As with social readjustment scale individual differences are not accounted for (Canner et al, 1981).

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19
Q

Alongside the daily hassles scale the _________ was developed by ________.

A

Daily uplift scale (Canner et al, 1981).

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20
Q

Give some examples of daily uplifts.

A

Good weather, good neighbours, having a laugh, completing tasks.

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21
Q

Measuring stress: Who developed the daily hassles and uplifts scale?

A

Delongis (1982, 1988).

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22
Q

Describe the daily hassles and uplift scale Delongis (1982, 1988), and describe its advantages.

A

53 item scale for which you give a rating from 0 = None, and up to 3 = Great Deal, as to how much of a hassle and how much of an uplift each item was for you ‘Today’. This scale has advantages over the other scales because it classifies areas of demand and acknowledges not only that they seem pos or neg, but also that may seen as both pos and neg i.e. This scale acknowledges individual differences in demand perception.

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23
Q

Give example of items on the daily hassle and uplift scale (ref).

A

Your children, parent/in laws and the weather (Delongis 1982, 1988).

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24
Q

How does stress directly affect cardiovascular and immune functioning?

A

Wear and tear undermine system functioning.

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25
What are the indirect affects of stress on health?
Increased health risk behaviour (Smoking and alcohol/drugs) and decreased health promoting behaviours (Sleep, diet, help seeking).
26
Who studied exam stress and wound healing?
Marucha (1998)
27
Describe Marucha et al's (1998) study on exam stress and wound healing (PICO).
``` P = Dental students. I = 3.5mm punch biopsy wound on hard palate 3 days before a major exam. C = Same wound during summer holidays O = Daily photos and foaming responses to hydrogen peroxide. Result - At exam time healing was 3 days (40% longer). Implication - this study directly shows exam stress on immune system functioning. ```
28
The affects of stress on wound healing had clear implications for _________.
Surgery recovery.
29
___________ moderated the affects of stress on wound healing in Marucha et all (1998) study.
Social support i.e Students with better support and both reduced stress during exam time and faster wound healing. The reverse was true for lonely students.
30
Effects of moderate sever stress: Physical symptoms.
Dry mouth, excessive perspiration, headaches, frequent infections, pounding heart, HBP, asthma, arthritis, back and chest pain, muscle tension.
31
Effects of moderate sever stress: Emotional symptoms.
Anxiety and worry which prolonged can lead to depression, fatigue, hypervigilance, impulsiveness and irritability.
32
Effects of moderate sever stress: Cognitive symptoms.
Poor memory and poor concentration (implications for academic performance).
33
Effects of moderate sever stress: Behavioural symptoms (Apart from health related behaviours).
Teeth grinding, crying, disruptive eating/sleeping, aggression and sexual problems.
34
What is the autonomic nervous system?
The body system which keeps the body functioning but is not consciously controlled.
35
The ANS consist of two halves the ________ and the _________.
The sympathetic and the parasympathetic nervous system.
36
The sympathetic ANS and the parasympatheitc ANS are _________ and ________ distinct.
Anatomically and functionally.
37
The sympathetic nervous system is responsible for _________.
The fight or flight response to threat, mobilising, arousing and activating the body.
38
The parasympathetic nervous system is responsible for _________.
The rest and digest response, calming and restoring energy.
39
The sympathetic and the parasympathetic nervous systems are _________.
Antagonistic, they have opposite effects and work together to maintain balance and optimal functioning (Homeostasis).
40
The sympathetic NS initiates the fight or flight response via the ________ which releases ________.
Adrenal Medulla which releases catecholamines including adrenaline and noradrenaline.
41
Describe the affects of adrenaline.
Increases: Heart rate, blood pressure, blood glucose, blood flow to skeletal muscles Decreases: Blood flow to organs, inhibits digestive function and leads to bronchiole dilation and therefore increased breathing rate. These effects cause immune system suppression, reduced pain perception and reduced salivation = Max speed and power. Our bodies have evolved to do this but it is not what we want to happen when we read an email.
42
The Parasympathetic NS uses _________ the close fight or flight down.
Noradrenaline.
43
Describe the affects of the rest and digest response.
Calms the body to conserve and maintain energy, reduces heart rate BP and blood glucose. Reduces blood flow to skeletal muscles and increases to organs. Accelerates digestion, promotes relations, facilitates energy storage and body regeneration and returns the body to homeostasis.
44
People who are stressed benefit from mindfulness techniques and relaxation because ___________.
They activate the parasympathetic NS.
45
One of the main problems with stress is ________ of the symp NS and _________ of the para NS, leading to e.g. __________.
Increased activation and Deregulation. | Poor sleep.
46
The adrenal glands are ______ at the top of the kidneys?
Pyramid shaped glands.
47
The central core of the adrenal glands is called the ________ and is involved in the _______ responses?
Adrenal medulla and the Symp adrenal medullary system response (SAM).
48
Outer section of the adrenal glands is called the ________ and is involved in the _______ response?
Adrenal cortex and Hypothalamic Pertuitary adrenal axis (HPA).
49
The adrenal cortex produces ________ e.g. ________?
Glucocorticoids e.g. Cortisol.
50
Like adrenaline, cortisol ________ to allow immediate energy expenditure and reduces ________.
Increases blood glucose and reduces immune responses.
51
Describe the SAM.
The first response to threat which has fast and relatively moderate effects via the release of adrenaline (lighting a match).
52
Describe the HPA axis.
Second response to prolonged threat. | It is slower but more extensive effects via release of cortisol (Like lighting a fire).
53
Describe how the SAM and the HPA interact in the stress response.
See card 1.
54
Cortisol levels can be used as an _________ of stress?
Objective measure.
55
The HPA is activated more readily for some people and less for others, this may help to explain ________.
Individual differences in the experience of stress.
56
Stress and CVD: Chronic stress leads to the continual release of _______ which can cause the heart to _______.
Catecholamines and Corticosteroids which cause heart beat erraticaly.
57
Chronically high levels of Cats and Corts causes the build up of _______ in the ________.
Plaques in the arteries.
58
_________ refers to the build of plaques made from ______, _______ and ________ which limit blood supply through arteries which lead to the _______ or ______.
Atherosclerosis Cholesterol, Fat and Smooth muscle cells. Heart or Brain.
59
In atherosclerosis ________ get narrower and _______ rises so it is harder for your heart to pump ______ around your body.
Arteries and BP | Oxygenated blood.
60
Atherosclerosis is a key problem with high levels of ________, making the ______ response so potentially dangerous.
Cortisol and HPA axis.
61
When plaques rupture this leads to _______, which is large enough can stop _______.
Blood clots, Blood supply.
62
If a blood clot stops the blood supply in a cardiac artery this leads to _______.
Death of a part of the heart muscle (Myocardial infarction).
63
If a blood clot stops the blood supply in a brain artery this leads to _______.
Death of brain cells (Stroke).
64
Who studied whether penalty shoot outs cause heart attacks?
Carroll et al (2002)
65
Describe the background to Carroll et al's (2002) study on pens and heart attacks.
50% of MI survivors say there was a triggering event. In 1994 there was an earthquake in California and an associated 35% increase in MI admission compared to prev. week. On 30th June 1998 England were knocked out football world cup in pen shoot out. It was the most watched programme that year (24 million viewers).
66
Who examined hospital records on the day and the day after the Eng world cup pen shoot out of 1998?
Carroll et al (2002).
67
What were the findings from Carroll et al's (2002) study?
MI admissions increased by 25% on the day and 2 days after the shoot out. This effect was slightly higher in men and no increase in any other diagnosis.
68
What were the conclusions drawn Carroll et al's (2002) study?
Some MI's may have just been brought forward by this 'triggering event' however this does not account for the overall effect. there could have been some role played by increased smoking and drinking.
69
What does the immune system do?
It identifies non self material in the body.
70
Auto immune diseases occur when ________?
When the body identifies self material as non self.
71
After identifying non self material what does the immune system do?
It mounts an innate natural non-specific response to pathogens -> Learns to recognise pathogens based on markers known as antigens -> mounts pathogen specific attacks -> remembers and destroys pathogens.
72
We are subjected to thousands of viruses everyday, it is only a problem when ________?
There is a new virus that our bodies cannot protect against.
73
The immune response: What are phagocytes and what do they do?
They are immune system cells which move from the blood stream to the site of an infection/inflammation and consume pathogens (this is the first line non specific immunity which can happen within hours.
74
How do phagocytes initiate specific immune response?
They advertise what kind of thing they have attacked by displaying antigens on their cell walls.
75
What do B and T cells do?
They are lymphocytes which respond to antigens. A human body has up to 100 thousand different receptors, but we have to generate a new one designed for specific antigens that will match specific pathogens. This happens through B/T cell multiplication which takes days.
76
Why do you feel fatigued when you are ill?
Because your immune system needs to shut you down so it can produce new cells to fight pathogens.
77
Cell mediated immunity: What do killer T cells (natural killer cells) do?
They directly attack specific antigens and secrete toxins, they then approach pathogens and poison them.
78
What is the most important function of NK cells?
They are key in the routine destruction of our cells when they go wrong e.g. cancer. The question is why do some cancer cells escape identification.
79
What do Helper T cells do?
They stimulate other specific T or B cells to multiply and secrete cytokines which help regulate the immune system.
80
Many B cells become _______ which produce ______.
Plasma cells, Antibodies.
81
Antibody mediated immunity: B cells attach themselves to pathogens and produce antibodies. How do antibodies kill directly?
Cause microorganisms to burst, swell as slowing and marking pathogens, so other cells can more easily kill them.
82
As the infection is destroyed _______ cells slow and stop the immune response.
T suppressor cells.
83
The immune system can be under or over active, both of these effects can be caused by ________.
Stress
84
Activation of the SAM _______ the immune response.
Suppresses.
85
What effect does over-activation of the HPA response have on the immune response system?
Can cause the immune system to continue to work after it is needed.
86
Outline a few ways of measuring immune function.
Counting cells (T B/NK-Antiretrovirals), speed to T cell proliferation, how quickly NK cells destroy foreign cells or cancer, how much antibody the body contains to common antigens (Epstein-Barr), the production of antibodies in response to an ingested substance that produces antigens (Direct test of antibody mediated immunity).
87
What is Epstein Barr?
It is a herpes virus with which 90% of people are infected by 30. It is a life long latent infection. Increased antibody response indicates reactivation.
88
Some people's antibody response after vaccination is stronger this is explained in part by ________.
Stress
89
Who looked at academic stress and the immune response?
Kiecolt-Glaser et al (1984)
90
PICO Kiecolt-Glaser et al's (1984) study on academic stress and the immune response?
P = First year medical students I = Blood sample taken on the first day of exams. C = Blood samples taken a month before first exam O = Natural killer activity. Results -> NK activity was lower on the first day of exams, this effect was moderated by recent stressful life events and loneliness.
91
What are the implications of Kiecolt-Glaser et al's (1984) study on academic stress and the immune response?
Physical measures of immunological functioning are affected by stress and life events.
92
Who summarised 20 years of stress and infection research?
Cohen (2005)
93
What did Cohen (2005) conclude about 20 years of stress and infection research?
Psychological stress inc. risk of resp illness as a result of exposure to cold virus. Higher 24hr urinary adrenaline and noradrenaline is associated with greater susceptibility to cold but these were not mediators. Behaviour e.g. not smoking and regular exercise were associated with dec. susceptibility but were not mediators. Longer stress duration and stress resulting from interpersonal problems was the most strongly associated with illness (Perhaps because interpersonal stress is a marker for inc. cortisol levels).
94
Who looked at stress IL6 and infection?
Cohen (2003) and Kiecolt-Glaser (2003)
95
What is IL6?
IL6 is a cytokine released by T cells which regulate inflammation.
96
What are the effects of long lasting stress on IL6?
Reduces immune systems capacity to turn off IL6 which leads to prolonged cold symptoms.
97
High IL6 is associated with ________ and _______.
Depression and Inc. inflammation (Immune system is doing things it doesn't need to).
98
What did Cohen (2003) discover about IL6 levels and stress?
IL6 levels are mediated by psychological stress.
99
What conclusion can be drawn from Cohen's (2003) findings?
Stress-illness associations may not only be due to stress elicited suppression of immune function, but also failure to suppress immune responses once optimum levels are reached.
100
PICO Kiecolt-Glaser et al's (2003) study on stress IL6 and infection.
P = Dementia spouse carers/controls (mean age 70) I = IL6 levels over 6 years O = Mean annual changes in IL6 Results -> Mean annual change in IL6 amongst care givers was greater than non care givers. Mean annual change in IL6 amongst former care givers was no different from current care givers, even several yrs after spouse death.
101
What are the implications of Kiecolt-Glaser et al's (2003) study on stress IL6 and infection?
Care giving has chronic effects on IL6 levels.
102
What is the overproduction if IL6 associated with?
CVD, osteoporosis, arthritis, type 2 diabetes and certain cancers.
103
2500 teachers in schools and uni's suffered from clinical levels of stress in 2014 (ref?)
Evidently Cochrane (2014)
104
Mindfulness based stress reduction has been shown to reduce stress in both clinical and non populations (ref?)
Grossman et al (2004)
105
Who wrote the review on stressful early life experiences and immune dysregulation across the lifespan?
Fagundes et al (2013)
106
Early stress (abuse, neglect and low SES) leads to increased likelihood of ______, ______ and _______ even when controlling for ________ (ref?).
CVD, T2DM and Cancer Poor health behaviours Miller et al (2011)
107
Inflammation is associated with ______, ______ and ______ (ref?).
CVD, T2DM and arthritis. | Libby (2007)
108
What is CRP?
A blood test marker for inflammation
109
Who did a longitudinal study on inflammation and neglect? (ref)
Danese et al (2007)
110
PICO Danese et al (2007) longitudinal study on inflammation and neglect?
P = 866 adults neglected in their first decade O = CRP levels at 32 yrs Results -> those neglected in their first decade had higher CRP levels at 32 yrs old and more than 10% of adult low grade inflammation was attributable to childhood stress.
111
Links between childhood EA and inflammation persist across cultures, who showed this and how did they show it? (ref)
Slowpen (2010), showed that higher IL6 levels in adulthood were associated with EA in African American but not White people.
112
Links between EA and inflammation persist into older adulthood (ref?)
Kiecolt-Glaser (2007)
113
PICO Describe Dougherty's 2004 study on the effects of EA on adulthood.
P = 97 outpatients with early onset dysthymia IV = EA and chronic stress DV = Symptoms at 30 month intervals over 7.5 yrs Results -> EA moderated the associated between stress and dysthymia symptoms. This shows that EA leads to pyscho stress sensitivity.
114
Describe the findings of Heim et al's (2000) study on EA and physiological sensitivity to stress.
N = 49 Hyperactivity of the HPA axis and ANS in women who were sexually and physically abused in childhood, compared to those who were not.

Psychology applied to health (6 decks)

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