Chapter 5 Stress

The diagnosis of PTSD requires that symptoms must last for at least

1 month

The DSM-5 recognizes 20 symptoms for PTSD but the 4 main areas of concern are:

1. Intrusion. 2. Avoidance. 3. Negative alterations in cognitions and mood. 4. Arousal and reactivity.

Production of antibodies take

5 days or more

________ is a psychological response to a common stressor (e.g., divorce, death of a loved one, loss of a job) that results in clinically significant behavioral or emotional symptoms.

Adjustment disorder

Which disorders are precipitated by exposure to stress

Adjustment disorder, PTSD and acute stress disorder.

_______ produces specific antibodies that are designed to respond to specific antigens.

B- Cell(because it matures in the bone marrow),

Why does Selye state that stress can occur in positive and negative situations

Both tax a person's resources and coping skills Distress is more damaging.

Jayden is a black male who works as a lawyer. Since childhood, he has experienced discrimination and unfair treatment because of his race. He recently found out that he has high blood pressure and early signs of cardiovascular disease despite exercising regularly and being relatively young. Building on preliminary research by Lewis and colleagues, Jayden would likely show higher levels of __________ in his liver.

C-reactive protein (CRP)

_______ can augment or enhance an immune system response or cause immunosuppression, depending on the specific type that is released.

Cytokines

_________ are small protein molecules that are an important component of the immune system,. They serve as chemical messengers and allow immune cells to communicate with each other.

Cytokines

_______ are risk factors for the development of CHD

Depression, hostility and anxiety

____ or bad stress has the potential to do the most damage

Distress

Which of the following most accurately describes how early life stressors affect the perception of stress later in life? (People who are depressed see stressors as less stressful because they do not care as much about things going on around them. Experiencing stress early in life always helps people to learn how to cope with it later. Early life stressors may make us more sensitive to stress later on, and the effects of stress can be cumulative. Genetics are not related at all to how stress is perceived._

Early life stressors may make us more sensitive to stress later on, and the effects of stress can be cumulative.

PTSD: Avoidance

Efforts to avoid thoughts, feelings or reminders of trauma

PTSD: Negative alterations in cognitions and mood

Feelings of detachment, negative emotional states e.g. shame or anger, distorted blame of oneself or others

Gene's husband died suddenly in an unexpected car accident with a large truck. After learning about the accident, Gene was extremely upset and for the following 4 months experienced symptoms of PTSD that were extremely distressing and interfered with his daily functioning. When asked, however, Gene reported that he did not experience feelings of fear, helplessness, or horror when learning of the event. Which of the following statements is true?

Gene's symptoms qualify for PTSD as defined by DSM-5 but not DSM-IV.

Depression is most commonly linked with what other health problem?

Heart disease

Why do doctors test for the presence of C-reactive protein, a molecule produced in the liver in response to IL-6, when assessing risk for heart disease?

Heart disease is related to chronic inflammation. Chronic inflammation is caused by the body's impaired ability to turn off cytokine production

Research by Chida & Steptoe (2009) and Wong et al. (2013) found that a Type A behavior pattern component correlated with coronary artery deterioration. Which of the following was the behavioral correlate noted?

Hostility

PTSD: Arousal and reactivity

Hypervigilance, excessive response when startled, aggression, and reckless behavior.

______ is cytokine given to patients with cancer, multiple sclerosis and hepatitis C.

Interferon

Stress can occur in more than one form. What does this mean?

It can occur from a single event but can also occur as a continuous force that exceeds our ability to handle it.

With people who work during the weekdays, heart attacks are most likely to occur on __________ due to __________.

Monday; stress associated with returning to work after the weekend

________ are white blood cells that identify and destroy tumors and cells infected by viruses.

Natural killer (NK) cells

Which of the following most accurately describes some of the research on hippocampal volume and PTSD? ( Hippocampal volumes are unrelated to PTSD. Reduced hippocampal volumes are only a risk factor of PTSD. Reduced hippocampal volumes may be both a risk factor for and consequence of PTSD. Reduced hippocampal volumes are only a consequence of PTSD. )

Reduced hippocampal volumes may be both a risk factor for and consequence of PTSD.

_________a variable that increases the statistical risk of something negative happening

Risk factor

_______circulate through the blood and lymph systems in an inactive form

T-Cells

_______ is a type of white blood cell that can recognize specific antigens. Plays an important role in the immune system

T-cell

_____ have receptors on its surface that recognize one specific type of antigen but cannot recognize antigens by themselves.

T-cells

The presence of what protects the genes close to them from being damaged and truncated during cell division.

Telomeres

______ are the protective ends of our chromosomes

Telomeres

_______ are made up of repeated sequences of DNA.

Telomeres

_____ shorten as we age, stress also reduces the length

Telomeres.

What makes one stressor more serious than another?

The severity, chronicity, and timing, of the stressor. Additionally, how it close it affects our own lives and how expected and controllable it is.

______is designed to mobilize resources and prepare for a fight-or-flight response.

The sympathetic-adrenomedullary (SAM) system

Danny, age 40, has been described by others as being prone to negative emotions. He is also insecure and anxious. Which personality type best fits the description of Danny's behaviors?

Type D

Stressors for an adjustment disorder can be

a single event, such as going away to college, or involve multiple stressors, such as a business failure and marital problems.

Which of the following traumatic events would be most likely to produce PTSD for someone?

a terrorist attack in a shopping mall

The hypothalamic-pituitary-adrenal (HPA) system, where the hypothalamus releases a hormone called corticotropin-releasing hormone (CRH). This travels through the blood and stimulates the pituitary gland. This now secretes

adrenocorticotropic hormone (ACTH)

In the SAM system, the stress response begins in the hypothalamus and stimulates the sympathetic nervous system. This causes the inner portion of the adrenal glands )adrenal medulla) to secrete adrenaline (epinephrine) and noradrenaline (norepinephrine). As this circulates through the blood this causes

an increase in heart rate. body metabolizes glucose rapidly.

_______are foreign bodies such as viruses and bacteria, as well as internal invaders such as tumors and cancer cells.

antigens

Individuals who experience prolonged unemployment are at a greater risk for __________.

attempting or dying by suicide

Situations that require adjustment can _____

be potentially stressful

_____ is concerned with psychological factors that may predispose an individual to medical problems

behavioral medicine

B-cells are leukocytes that mature in

bone marrow

Proinflammatory cytokines such as interleukin-1 (IL-1), IL-6, or tumor necrosis factor (TNF) help us deal with challenges to our immune system by _______

by augmenting the immune response

Chronic inflammation is a risk factor for a range of health problems such as

cardiovascular disease, type 2 diabetes, asthma, osteoporosis, rheumatoid arthritis, and many other

Stress tends to aggravate and maintain _____

certain disorders such as migraines, arthritis and others

_____ are efforts to deal with stress

coping strategies

The hostility component of the Type A construct (including anger, contempt, scorn, cynicism, and mistrust) that is most closely correlated with

coronary artery deterioration

The hypothalamic-pituitary-adrenal (HPA) system, where the hypothalamus releases a hormone called

corticotropin-releasing hormone (CRH)

The brain has receptors to detect cortisol. When these are activated, they send a feedback message that is designed to dampen the activity of the glands involved in the stress response. But if the stressor remains, the HPA axis stays active and

cortisol release continues

HPA System. Hypothalamus -> CRH -> Pituitary gland -> ACTH -> Adrenal Cortex ->

cortisol.

Prolonged stress leads to secretion of the adrenal hormone ______, which elevates blood sugar and increases metabolism. These changes help the body sustain prolonged activity but at the expense of decreased ______.

cortisol; immune system activity

When a B-cell recognizes an antigen, it begins to divide and to produce antibodies that circulate in the blood. This process is facilitated by _______ that are released by T-Cells

cytokines like interleukin-1

anti-inflammatory cytokines such as IL-4, IL-10, and IL-13 ________.

decrease or dampen the response that the immune system makes. Sometimes they accomplish this by blocking the synthesis of other cytokine

Knowing what to expect going into a stressful situation such as surgery has proven to ____

decrease overall stress and increase recovery time

Like stress, ______ is associated with disrupted immune function

depression

PTSD is not in the anxiety disorders section. It is in the

diagnostic category called trauma and stressor related disorders. This is because experience of major stress is central to the development.

Although depression is a greater risk factor than medical factors are in predicting mortality for patients who have already had a heart attack, many physicians fail to treat depression. This oversight has been attributed to the physician's tendency to __________.

dismiss the depression as an issue because it is perceived to be merely a consequence of having had a life-threatening medical event

When a B-cell recognizes an antigen, it begins to _______

divide and to produce antibodies that circulate in the blood

Men with CHD with type D personality, who scored high on measures of chronic emotional distress were more likely to have

fatal heart attacks

PTSD: Intrusion

flashbacks and nightmares, physiological reactivity to reminders of trauma.

Stress tends to reduce our immune system's ability to

function properly, so that higher stress generally leads to greater incidence of physical illness.

Under conditions of stress, the production of proinflammatory cytokines is disrupted. This affects the

healing of wounds

___ is the study of The effects of stress and other psychological factors in the development and maintenance of physical problems

health psychology

An overactive HPA axis would produce

high levels of circulating cortisol, problematic

The second system involved in stress response is the

hypothalamic-pituitary-adrenal (HPA) system

In the SAM system, the stress response begins in the

hypothalamus

a person's behavior and psychological state can affect

immune functioning.

glucocorticoids can cause stress-induced

immunosuppresion

Hans Selye stated that stress occurs

in positive and negative situations.

Chronic stress appears to impair the body's ability to respond to the signals that will terminate immune system reactivity. The result of this impairment is __________.

inflammation

Chronic stress impairs the body's ability to respond to the negative feedback signals set off by cytokines production. This results in

inflammation.

Evidence is growing that inflammation—increased levels of proinflammatory cytokines—is increased in people who are under prolonged stress. This is because long-term stress seems to ______

interfere with the body's ability to turn off cytokine production.

To activate the T-cells, the macrophages release a chemical known as

interleukin-1

______ are produced in the bone marrow and then stored in various places throughout the body, such as the spleen and the lymph nodes

leukocytes, lymphocytes

Which of the following experiences is likely to produce the most stress? ( going through a breakup losing one's home in an unexpected hurricane-related flood watching a film about what to expect during and after hip surgery before undergoing surgery talking with the dentist about what to expect with a dental implant procedure)

losing one's home in an unexpected hurricane-related flood

When we are relaxed and not stressed our allostatic load is

low

general term for white blood cells involved in immune protection

lymphocyte or leukocytes

T-cells are unable to recognize antigens by themselves. They become activated when immune cells called ______ (the word means "big eater") detect antigens and start to engulf and digest them.

macrophages

The protective activity of the B- and T-cells is supported and reinforced by other specialized components of the system, the natural killer cells _____ and _____

macrophages and granulocytes

Demetrius is an Iraq War veteran diagnosed with PTSD who, while in Iraq, witnessed an army personnel carrier transporting U.S. soldiers explode. Since returning to the United States, Demetrius's wife, Shania, notes that her husband seems detached and blames himself for every mishap that occurs in the family. In which of the four PTSD symptom categories do the behaviors described by Shania fall?

negative alterations in cognitions and mood

In cases of PTSD the stress symptoms fail to abate even when the traumatic event has passed and the danger is over. This makes PTSD a disorder of

nonrecovery

In PTSD a traumatic event is thought to cause a __________ ________ that is a t the center of the characteristic clinical symptoms associated with the disorder?

pathological memory

Rather than conceptualizing PTSD as a normal response to an abnormal stressor, the DSM 5 views PTSD as a

pathological response to an extreme form of stress

The hypothalamic-pituitary-adrenal (HPA) system, where the hypothalamus releases a hormone called corticotropin-releasing hormone (CRH). This travels through the blood and stimulates the

pituitary gland

Cytokines play an important role in mediating the inflammatory and immune response. They can be divided into two main categories:

proinflammatory and anti-inflammatory cytokines

Katrina, a police officer, has PTSD. She is working with a therapist who has her vividly recount the traumatic event she experienced on duty over and over at each therapy session. What type of treatment is Katrina participating in? ( stress inoculation training prolonged exposure cognitive restructuring systematic desensitization )

prolonged exposure

Which of the following treatments would likely have the highest rates of treatment dropout? ( cognitive therapy for PTSD virtual reality exposure therapy psychological debriefing prolonged exposure for PTSD)

prolonged exposure for PTSD

IL-1 and other cytokines stimulate the HPA axis, leading to an increase in cortisol. Cortisol is suppose to regulate or turn off cytokine production. In other words, cytokine production under normal conditions is suppose to

set off a negative feedback loop designed to prevent excessive or exaggerated immune or inflammatory response.

____ is the effect that stressors create within an organism

stress

____ are external demands

stressors

Prolonged unemployment increases risk for ______ in adults and _______ for children

suicide; repeating a grade

In the SAM system, the stress response begins in the hypothalamus and stimulates the

sympathetic nervous system

Telomere length is maintained by an enzyme called ______. Cortisol can reduced the activity of this enzyme.

telomerase

In the SAM system, the stress response begins in the hypothalamus and stimulates the sympathetic nervous system. This causes

the inner portion of the adrenal glands )adrenal medulla) to secrete adrenaline and noradrenaline.

The longer a stressor operates

the more severe its effects

The hypothalamic-pituitary-adrenal (HPA) system, where the hypothalamus releases a hormone called corticotropin-releasing hormone (CRH). This travels through the blood and stimulates the pituitary gland. This now secretes ACTH. And the adrenal cortex (outer portion of the adrenal gland) produces

the stress hormone, glucocorticoids. In humans, called cortisol.

T-cells are leukocytes that mature in the

thymus, an important endocrine gland

PTSD symptoms that do not last for the required month are considered

to be acute stress disorder

stress slows the healing of wounds by as much as 24 to 40 percent because

tress is linked to suppression of the immune system

The function of releasing hormones is to

trigger the release of other substances

How you view problems and cope with challenges, and even your temperament, may directly affect

underlying physical health.

A B-Cell is a form of

white blood cells. or leukocytes/lymphocytes