Health Psychology Quiz 1

lymphatic system, lymph, lymph glands/nodes, thymus, spleen, bone marrow

* Immune System: Defense against 'foreign agents' (i.e., antigens) • Structure: "lymphatic organs" assist development / deployment of lymphocytes (white blood cells) • Bone marrow: origin of lymphocytes • Thymus: Gland where lymphocytes mature. • Lymph nodes: glands throughout body, capture antigens and house lymphocytes ~ Nodes networked via lymph vessels (carry 'lymph'), which dump into bloodstream. • Spleen: lymphocytes and antigens in blood filtered by the spleen (big lymph node that carries blood).

2. In the context of our discussion of correlational analyses, we discussed the notion that "correlation does not imply causation." What does this mean specifically? Be prepared to describe what information a correlation coefficient can tell you.

*Correlation does not mean causation because one variable does not affect the other in any way. There can be a relationship between the 2 variables do the more stress you have the more you smoke (positive correlation)...one does not cause the other.

6. What does it mean that the circulatory system is "closed"? Please describe blood pressure and describe the factors that influence it.

A Closed System: Blood does not contact tissue and cells directly -> transferred across membranes

psychological control

Ability to control thoughts, and emotions...which, in turn, would help to control and regulates one's behavior and the way in which they choose to cope.

4. Describe the differences between an experimental design and a quasi-experimental design. Please note when you or a researcher might choose one over the other.

Quasi-Experimental Designs are used when it is unethical to put individuals into different control and experimental groups. *Usually these studies are related to the healthcare system because it is unethical to subject or keep kids from getting medical treatments. *Have to use naturally occurring groups...not able to manipulate variables because in most cases it would be unethical...Cannot control extraneous variables because the groups start with differences...Measuring academic achievement for individuals who have a sedentary lifestyle vs. those who are very athletic.

3. Describe the basic factors that compose an experimental approach. In your answer, please give an example that you believe demonstrates appropriate use of an experimental design.

Random assignment...a control and experimental group...independent and dependent variables...different levels of the independent variable...Looking for Cause and effect *Does CBT for depression reduce smoking? *Variables: Independent: CBT or No CBT... Dependent: Amount of cigarettes smoked

allostatic load, tend-and-befriend theory

~ Allostatic load: The wear and tear on the body" which grows over time when the individual is exposed to repeated or chronic stress. ~ Tend-and-befriend: A behavior exhibited by some animals, including humans, in response to a threat. It refers to protection of offspring (tending) and seeking out the social group for mutual defense (befriending).

2. Health has often been defined as an absence of sickness. In what ways might this definition be correct? In what ways is only partly true? What is a definition of health that is more inclusive? (One that considers health on a continuum from death on one end to optimal functioning on the other.)

~It is correct because health is a balance of all aspects of ourselves. When we are ill there is not balance in our lives. An aspect is going to be thrown out of wack. ~It's only partly true because it only focuses on one aspect of health and wellbeing, and that is the absence of illness. One can be absent of illness, but can be unhealthy because they smoke. ~Inclusive definition: Positive state of physical, social and mental well-being *Health exists on a continuum (death on the left...optimal health and wellness on the right)...can fall within the continuum based on health in various different categories.

3. Stress exerts negative effects on health in a variety of ways - be prepared to talk about direct and indirect effects of stress on health.

• Direct effects Hypothesis: SAM and HPA activation, immune 'soldiers' affected directly ~ Cells have receptors for corticosteroids (T- & B-cells) and catecholamines (lymphocytes) ~ Binding of cortisol and NE and E suppress immune system "soldiers", or immunosuppression over the long term ~ Ulcers may be related to repeated suppression and activation of the digestive system ~ Hypertension is caused by consistently raised blood pressure ~ Cholesterol is increased in blood stream by effect of N and NE on release of free fatty acids in the blood stream • Indirect Effect Hypothesis: Stress' effects on illness are mediated by behavior. ~ One might sleep poorly or smoke and drink excessively to mediate stress (i.e., to 'cope') ~ These behaviors impact immune function

explanatory style, pessimism (internal, stable and global attribution), optimism

* Explanatory Style: Our dispositional tendencies regarding attribution predict coping & health * Pessimism: a tendency toward negativity Failure/difficulty attributed to causes that are: ~ Internal (i.e., I'm to blame) ~ Stable (i.e., "Things won't change") ~ Global (i.e., "I can't do anything right") -- This negativity predicts mortality... * Pessimists: Disengage from problems ~ Rumination on negative experiences and possible tendency toward hostility ~ Consider the interpersonal environment * Optimists: Tend to engage active, problem-focused coping ~ Faced with potential stress, less likely to appraise threat.

3. Be prepared to identify the functions associated with the major brain structures and regions discussed in class and in the text. ( Lower level structures...Limbic system...Cerebral Corext)

1. The lower Level structures: Mediate vital reflexes, "the basics" ~Medulla: Breathing, HR, BP, Salivation, Coughing, Sneezing ~Pon: Breathing, Sleeping, Swallowing, Bladder Control, Posture and Equilibrium ~Reticular Formation: Neural pathways regulating arousal and alertness ~Thallumas: Relays sensory information to auditory, gustatory and touch centers ~Cerebellum: Coordination and large Muscle movement (alcohol affects this as well as getting hit in the back of the head) 2. Limbic System: Structures between the cortex and brainstem, linked to emotion, memory and pain. ~Amygdala: Rage, aggression, fear...Defending something (body, family...most salient memories involve fear) ~Hippocampus: Memory long term, learning, orientation in space (Clive Wearing damaged hippo severe amnesia)...learning is crucial to survival and well-being. ~ Hypothalamus: Control of Behaviors that maintain equilibrium or satisfy needs...(drives hunger and thirst, body temp regulation, and sexual behaviors) 3. Cerebral Cortex: Left and right Hemispheres; billions of neurons mediating cognitive functioning (80% of brain) ~3 mm thick outer layer of the cerebrum ~4 lobes 1. Occipital: Info from eyes 2. Parietal: Info from body and skin (primary sensory cortex) 3. Temporal: Memory, auditory processing 4. Frontal: Movement, higher order reasoning, and planning (primary motor cortex)

1. Please be prepared to provide a definition of health psychology.

Subfield of psychology ~Principles and research methods applied to health enhancement and illness prevention *Psychs contribution to wellness and healthcare.

6. In his 1977 challenge to biomedicine, George Engel presented the basic arguments for a biopsychosocial view of health. Please be able to provide a description of what it means to view health as a biopsychosocial process. Be prepared to describe an example.

~Engle acknowledged that health is multifactorial...he emphasized the connection between the mind and body...different cultures define illness differently ~Psychological factors contribute to patienthood and shape how we view illness (if people ar treated well in hospital they might not get better because they are being reinforced) ~Biopsychosocial perspective: Mind/body integration *understand disease and arrive at rational treatments...the treatment must incorporate the patient, social context and societal system in which is occur (medicine still very much separate different fields have different practices rather than incorporating all of them together for a very complete treatment.

5. Since 1900, the leading causes of death in the US shifted dramatically. Please describe this shift and be able to discuss why this contributed to the development of health psychology as a discipline.

~Life expectancy skyrocketed (mostly due to vaccinations, antimicrobials, antibiotics all helped to shape picture of morality) *Shift in cause of death due to life habits...people were living longer which meant people had the ability to live long enough to die from cancers and other illness that can be brought on later in life. ~Contemporary morality linked to lifestyle and behavior more clearly than ever *Health was redefined as multifactorial The goals were to study etiology...promote health...prevent and treat illness...and promote public health policy.

5. Please provide a very basic description of the path blood takes through the body, starting with its delivery to the heart in an oxygen-depleted state.

~Right Atrium: receives O2 depleted blood from the body; contraction pumps the blood to the.... ~Right Ventricle: contraction pumps blood through the pulmonary artery to the lungs... *CO2 and O2 transferred in capillaries of the lungs; blood returns to heart via pulmonary vein ~ Left Atrium: Receives O2 rich blood; contraction sends blood to the... ~ Left Ventricle: Contraction sends blood to the body via the aorta

4. What is "hardiness"? Be prepared to explain the concept and identify an example. (control, commitment, Challenge)

* Hardiness: three stress-buffering traits - Cross-sectional/Longitudinal study of illness burden among business executives ~ Control: A sense of power/efficacy ~ Commitment: Connection to values & meaning ~ Challenge: Events represent opportunity * High hardiness people react to stress by increasing their interaction with it (Maddi, 1999) ~ Stress is associated with illness; People with high hardiness have lower levels of illness because they have the coping mechanisms to deal with stress.

6. Please provide a basic description of the research method of meta-analysis. Why is this technique so informative for health psychology?

*Looking at the results from multiple studies that have been conducted using the same type of study and measurement...Capitalizes on combined samples *Effect Size: how much of difference does treatment make

belief bias, expectancy effects

BB: Your beliefs based on the outcomes of a situation rather than your own thoughts and opinions EE: What you expect to happen effects what does happen.

7. Be prepared to briefly describe the findings of Sapolsky's research with baboons and the Whitehall Study of British Civil Service employees relative to findings regarding stress, health, and social order.

Individuals who hold lower positions, have more stress hormones than those who are in higher positions... Those in lower positions are more likely to call in ill, than those who have more control over their postions.

8. Consider the issue of role strain/overload and discuss the scarcity and enhancement hypotheses regarding the potential effects of multiple roles.

• Overload and role strain: • Overload: when demands exceed capacity * We're overcommitted; health behavior suffers, accidents happen, chronic SNS arousal, Cardiovascular problems *Role Strain/Overload: ~ Enhancement hypothesis: Multiple roles = more sources of self-esteem/satisfaction/competence ~ Scarcity hypothesis: Multiple roles confer overcommitment/conflict -Generally, enhancement wins out; in women, number of roles less important than quality

3. Discuss the link between SES and problem-focused coping and perceived behavioral control. What role does self-efficacy play in this relationship?

* Coping efforts and control: Links with SES Use of problem-focused coping varies with psychological control ~ Perceived ability to engage in behavior to bring about particular outcomes - Note link to efficacy & outcome expectancy...If someone is used to experiencing stress and has had positive outcomes using P-F coping then they are more likely to engage in it, because they know they are efficient in it and can get the job done (Efficacy) * Socioeconomic status (SES): indexed via income and education ~ Why might this be? Repetitive stressful events, ~ Efficacy theory: belief in behavioral competence predicts behavior

7. Contrast specific (acquired) and non-specific immunity. Be able to describe the major 'soldiers' or defenses of each type of immunity, outlining some basic information about what they do.

* Nonspecific Immunity: several defenses that attack any antigen, including new ones. • First line of defense: Skin & other exterior defenses • Keep infectious agents from penetrating the body. • Second line of defense: • Lymphocytes and the process of phagocytosis 1. Prowling phagocytes (large lymphocytes) scour bloodstream for antigens 2. Macrophages present at infections Yummy! 3. Natural Killer Cells (NK) à smaller lymphocytes that attack diseased cells (Cancer and viral) • Secrete interferon, a protein that disrupts viral replication. * Specific Immunity: we develop 'memory' for previously encountered antigens ("Acquired") • Strongest line of defense; involves 2 more lymphocytes (T- and B-cells) o Antibody-Mediated Immunity o B-cells produce antibodies (immunoglobulins) à suppress toxic effects of bacteria & viruses ~ When activated by an antigen, B-cells divide into plasma and memory cells ~ Plasma cells generate antibody molecules & live a few days ~ Memory cells live for life à thus, a stronger response on re-exposure. * Cell-Mediated Immunity: 3 types of T-cells 1. Cytotoxic (Killer) cells: Specific receptors latch onto antigens, inject a toxin Regulatory cells à serve a moderating function via chemical secretion (lymphokines) 2. Helper cells: Encounter antigens; recruit killer, B-Cells, phagocytes chemically 3. Suppressor cells: Suppress immune responding • Wounds and the inflammatory response (nonspecific). *Cells release histamine, which increases blood flow and attracts phagocytes *Phagocytes consume invading antigens (bacteria, etc.) *Histamine also causes regional heat, which can disable bacteria.

2. Be prepared to discuss the differences between problem-focused and emotion-focused coping. When might each approach might be most helpful?

* Problem-focused: Address the source of the stress; ~Very straight forward address the root problem, go to someone who has caused you stress and talk to them directly. ~Most helpful ~ Can be used when an individual has the resources available to use this form of coping *When the situation seems controllable * Emotion-focused: Address the affective impact of stress ~ Used when situation is perceived to be uncontrollable & resources are in doubt Note... reference to perception ~ Research examines if coping strategies vary with demographic variables and personality - Choice of one v. other is related to health!

red blood cells, leukocytes, platelets, plasma, arteries, veins, capillaries, diastole, systole.

* Red Blood Cells: Contain hemoglobin; attaches to oxygen, carries it through the body * Leukocytes: White blood cells; protective functions * Platelets: Granular fragments; prevent blood loss (coagulation) * Plasma: 50% of blood mass * Arteries: Carry blood from the heart to organs (incl. the heart) and tissues • Narrow gradually to arterioles and then... * Capillaries: Smallest vessels; point of transfer between vasculature and cells/tissues. * Veins: Return blood (fr. capillaries & lungs) to heart. * Blood pressure: Force exerted by blood on vessel walls. • Function of blood volume & viscosity, peripheral resistance, and cardiac output • Highest during systole, as heart muscle contracts; lowest during diastole, muscle relaxes

social support: buffering hypothesis, direct effect hypothesis...instrumental social support, emotional social support, regulatory control

*Buffering Hypothesis: theory that social support produces its stress-busting effects indirectly, by helping the individual cope more effectively. *Direct Effects Hypothesis: Theory that social support produces its beneficial effects during both stressful and nonstressful times bu enhancing the body's physical responses to challenging situations. *Social Support: Companionship from others that conveys emotional concern, material assistance, or honest feedback about situations. *Instrumental Social Support: refers to the various types of tangible help that others may provide (e.g., help with childcare/housekeeping, provision of transportation or money). *Emotional Social Support: Support that is emotionally based, not something that is an actual item. Something like verbal support. *Regulatory Control: The various ways in which we modulate our thinking, emotions, and behavior over time and across changing circumstances.

2. Several divisions exist in the nervous system. Please describe and distinguish between the central and peripheral nervous systems, the autonomic and somatic nervous systems, and the sympathetic and parasympathetic divisions of the autonomic nervous systems. In addition, please contrast the physiological effects of sympathetic and parasympathetic 'arousal'.

*Central Nervous system: Brain and the spinal cord. *Peripheral Nervous System: ~Afferent (ascending sensory ) nerves...access the spinal cord ~Efferent (descending motor) nerves...exit the spinal cord 1. Somatic Nervous System: Voluntary (nerves linking sense organs, muscles, and glands with Central Nervous system) 2. Autonomic Nervous System: Involuntary/Automatic (Nerves linking CNS with internal organs that we don't control consciously (digestion, heart rate) A. Sympathetic Nervous System: Arouses body; mobilizes it for action, especially when stressed (fast reactive response from Spine)...increase HR, breathing, blood flow, etc. B. Parasympathetic Nervous System: Counteracts arousal often leading to effects opposite to SNS...comes from the brain longer way to travel (promotes nonemergency functions... PNS: constrict bronchi, pupils contract...SNS: Relaxes bronchi and dilates pupils)

3. Views of health and illness have changed a lot over the ages. Please be prepared to outline the major historical developments in descriptions of health and illness discussed in class and the text. (Ancient times, Hippocrates/Galen, Fall of Roman Empire, Renaissance, Cartesian Dualism, and Biomedical Model)

1. Ancient times: Health was not seen as a biological issue, but rather as a spiritual issue...There was no bio basis to illness. 2. Hippocrates: looks at both body and biological issues/imbalances (imbalance in the 4 humors)...Galen (studied anatomy via animal dissection) took a deeper look at the four humors and found their qualities determined disease state...developed a system of pharmacology. (Goal: keep physical and mental states in balance) 3. The church digresses and goes back to spiritual beliefs about medicine (Rome also fell) 4. Renaissance: Plague occurred (thought angry God) Large cultural change shift in science/scientific methods...body was thought of as a machine...not only God or higher power had control, but the mind also played a role. 5. Cartesian dualism ("I think therefore I am")...mind and body are separate entities 6. Biomedical model: there is now the thought that mind and body are connected (Sigmund)...illness has a biological cause...increased life expectancy, sanitation, and public health measures.

7. When performing actual experiments is not possible, epidemiologists and health psychologists occasionally make cautious causal statements regarding a link between a risk factor and an illness. However, they tend to do so only when certain conditions are met in the understanding of that illness. Please be prepared to describe those conditions that, if met, might lead to a cautious causal inference. (Evidence, Cause, Risk, Relationship pattern, Relative Risk, Prevalence/Incidence)

1. Evidence base consistently supports the relationship; findings regarding risk are replicated 2. Supposed cause precedes the illness/disease 3. Risk-disease relationship is plausible 4. Relationship follows a dose-response pattern (increase in negative activity = increased risk) 5. Strength of the association (relative risk) suggests causality *Relative risk: Likelihood of illness given exposure vs. likelihood of getting illness when not exposed 6. The prevalence and incidence drops when risk factor (cause) is removed

6. In the film we watched during class, Sapolsky argued that baboon tribes and the British Civil Service were excellent laboratories for researching links between health and stress. In this case, why are these two populations excellent study groups?

Because in the BCS you are able to see how individuals are affected based on just the difference in rankings, where they stand on the power level (how it affects their health...there is no need to conduct an experiment) With Baboons you can see the same thing...but you are able to test blood samples, and how the constant fear of being beaten can affect a baboons health.

2. You should be able to describe the acute phase response (APR: as described in the text) and means by which cytokines communicate with the brain.

Brain-Immune system connections: stress and the Acute Phase Response ('sickness') * APR = systemic: including inflammation, fever, ↓ activity, ↓ food/H20 intake, ↑ anxiety • Saves energy, targets resources to fight infection • Accompanies nonspecific immune response. * Macrophages release chemical messengers 'cytokines' upon infection... • Proinflammatory cytokines (interleukin-1 & -6) bind to vagus nerve à activates limbic system • Brain releases own interleukin-1, triggers APR and further activates immune cells. Stress also activates the APR o Laboratory animals held in isolation (Maier) demonstrate elevated interleukin-1 in hippocampus • "Stress and infection activate overlapping neural circuits" involving interleukin-1 (Maier: cited in Azar, 2001) • In lab animals, stress invokes similar response seen in infection • "Stress is another form of infection" (Maier) o Pro-inflammatory cytokine production in periphery invokes cytokine production centrally (CNS) • There are cytokine receptors in hippocampus and hypothalamus -> BOTTOM LINE: Stress and immune system are linked!

bronchi, bronchioles, alveoli

Bronchi: Are the main passageway into the lungs Bronchioles: Any of the minute branches into which a bronchus divides Alveoli: Are the terminal ends of the respiratory tree, which outcrop from either alveolar sacs or alveolar ducts, which are both sites of gas exchange with the blood as well.

5. Cross-sectional and longitudinal research designs allow some insight into changes in health over time. Describe the difference between these approaches and highlight each approach's particular strengths and weaknesses.

CS Study: look at a certain characteristic, illness, etc. at in different age groups at the same time. *cohort effect: diff. results because of what people experienced (diff wars, and economic times) LS: Follow the same individuals over the course of their life *The advantage is the ability to address confounds related to cohorts because subjects are tested repeatedly. *disadvantages: costly...complex...attrition over time

5. Be prepared to provide an example of stress from your life and describe it from the perspective of the transactional model.

Car breaks down in the middle of Spokane...I am not from Spokane so I don't know the area...I have to appraise my situation, I am okay, the car is broken, I don't know where I am, I don't have money to get a new car, I have my phone so I can call my dad...Stressed dad will get mad...realize it's better than not having the phone. In the end I have the resources to try to fix my problem.

1. We discussed several different descriptive research methods in class. Please be prepared to identify an example of each (i.e., case study, survey, correlational/observational studies) and to describe what sets these types of methods apart from experimental methods.

Case Study: is an intensive study about one individual...interview, health history etc. *there is not manipulation of variables...not control, experimental group, and not independent/dependent variables. Surveys: Self-report (interviews, questionnaires, etc.) examines attitudes and beliefs...(impact of depression ads on individuals with depression)...again no diff groups, random assignment, independent or dependent variables. Observational studies: Structured and unstructured observations of behaviors...no variables are manipulated...and no random assignment (example watching people in their natural environment) Correlational Study: Examine relation between 2 variables *Correlation coefficient (r) = an index of the strength and direction of a relationship (no random assignment...or control experimental groups) Exper

germ theory, anatomical theory, cellular theory

Cell theory: Disease results when cells die Germ Theory: Bacteria and viruses invade the body

1. What is coping?

Coping: Successful and unsuccessful attempts to manage stress effects * Coping efforts unfold over time in concert with events and changing perceptions of stress

epidemiology, morbidity, mortality, prevalence, incidence, case-control, heritability, randomized clinical trial

Epidemiology: Study the reach, spread, impact, cause and treatment of the illness *Case Control: Experience of new cases (people with the illness) contrasted against controls (people without the illness) Morbidity: Unfavorable outcomes (pain, hospital visits...etc.) Mortality: How many people have died from the illness Prevalence: Frequency of illness...how many cases exist at a given time Incidence: Onset of new cases in a given period Heredibility: How much of an illness is due to genes and predispositions. RCT: Experiments used to test whether or not treatment works.

4. Two endocrine pathways (the HPA axis and the SAM system) were discussed in class. Please be prepared to describe the hormonal processes that occur in these pathways and the effects that they have on the body.

HPA Axis: Hypothalamic-Pituitary-Adrenocortical *Feedback system among the hypothalamus, pituitary and adrenal glands ~controls "long duration" stress reactions ~ regulates many other bodily processes *e.g. digestion, immune system, mood, energy expenditure all affected *When stressed hypothalamus releases corticotropin-releasing hormone (CRH) -> Pituitary gland *Adrenal Cortex secretes cortisol ~"Stress Hormone" ~Cortisol: raises glucose (energy) impact metabolism decrease inflammation ~Cortisol (when high) feeds back to hippocampus and hypothalamus (decrease ACH) SAM: Sympathetic- Adreno- Medullary System ~A faster stress response system implanting the adrenal glands ~Adrenocorticotropic hormone (ACTH) activates sympathetic division of ANS *Adrenal Medullae-> Epinephrine/norepinephrine -bind to receptors on heart and blood vessels -fight/flight response: HR/BP increases, blood flow increases in respiration, more blood to activate muscles, etc.

1. We discussed four major physiological systems in class, the nervous system, the endocrine system, the cardiovascular system and the immune system. Please be prepared to describe the major structures and functions of these systems.

Nervous System: *The main components: the brain, spinal cord, ascending and descending nerves...send and receive information Endocrine System: Bodies slow chemical comm. system...a set of glands that secrete hormones into the blood stream (HPA axis...SAM axis...thyroid...spleen...pituitary gland Cardiovascular system: (Heart, blood, and vasculate)...The primary transportation system for nutrient/oxygen delivery and waste removal. Immune System: Defense against antigens (foreign objects) within the body...lymphcytes, bone marrow, lymph nodes

4. Compare and contrast Selye's model of stress with the transactional model proposed by Lazarus and Folkman. What is the primary differences between the two? (GAS...Alarm Reaction, Resistance, Exhaustion)...(Transaction model...Primary...Secondary)

Selye's General Adaptation Syndrome (GAS) 1. Alarm Reaction: Mobilization stage 2. Resistance: w/ continued stress, arousal remains elevated • Increased resistance to illness 3. Exhaustion: Prolonged arousal depletes resources • Ability to resist disease becomes limited. • With continued stress, stress-related illness likely. * Selye's GAS provided a conceptual model linking stress and illness • Model was general: same stages occur regardless of the individual or type of stress • Recall our definition: perception, interpretation, psychological... The transactional model of stress Lazarus & Folkman (1984) * Stress experience stems from transactions between us and our circumstance, environmental & psychological • An interactionist view: • Our experiences are not solely functions of circumstances/situations... • By our constructions and actions, situations are functions of us * Stress transactions involve appraisal regarding: 1. A demand's degree of threat . 2. Resources • Stress is a process with high inter-individual specificity... Steps in the appraisal process: • Primary Appraisal: What does this mean? Will I be okay? 1. It's negligible/doesn't matter (irrelevant) 2. It's good (benign-positive) 3. It's a problem (stressful) • Harm-loss: Damage has occurred • Threat: Expectation of future harm • Challenge: There's a possibility of growth, mastery * Secondary Appraisal: What are my resources? ~ "I can't handle this; No time; I'm too tired" ~ "I can fix this, but it will take effort" ~ "I can try one approach first; if it fails, I'll try something else" - Essentially: Are resources adequate to address the threat or ameliorate the harm? • Coping: We may address the stressor directly or its emotional effects • Reappraisal: We continually monitor our progress and status... Key implications of the transactional Model: • Situations aren't inherently stressful or not • Appraisals shift with changes in mood, health, motivation * Stress depends on 'individual differences' variables * Physiological response centrally-mediated via cognition * Stress response is similar, whether an event occurs or is simply symbolized

1. Be prepared to describe the HPA/SAM stress responses in detail, including relevant hormones and the structures involved in the production of those hormones.

Stress Physiology • Reticular formation: Brainstem nerve bundle alerts brain to threat. • Thalamus à to cortex & hypothalamus • Corticotropin Releasing Hormone (CRH) • Pituary releases Adrenocorticotropic hormone (ACTH) Activates two pathways: 1. Sympathetic-adreno-medullary (SAM): SNS: Adrenal medullae dump catecholamines (epinephrine & norepinephrine) • Fight-or-flight 2. Hypothalamic-Pituitary-Adrenocortical (HPA) ~ ACTH also activates the adrenal cortices ~ Secrete corticosteroids (e.g., cortisol)... * Anti-inflammatory hormones; mobilize energy stores ~ Response regulated by negative feedback; cortisol to hippocampus / hypothalamus ~ Chronic activation can damage the hippocampus.

4. The work of Freud/Brewer/Franz Alexander and other psychoanalytic theorists played an important role in our current view of health as an integrated model of mind/body. How did theorists' work shed light on the limitations of strictly biomedical conceptions of health?

~Biomedical took away they thought that the mind and our mental states can also play a role in our health and wellbeing. *Freud and Brewer came up with psychoanalysis and the talking cure (talked about repression and how that could affect an individual) ~Franz Alexander: Psychosomatic medicine (look at psych processes for the diagnosis and treatment of mental illness): thought repressed energy was directed inward...illness results from specific conflict...inability to express inner turmoil could lead to illness. ~All of these thoughts and beliefs set the stage for psychology to receive a second glance.

9. Describe the pioneering work of Holmes and Rahe in the area of major life events and stress.

• Life events: The quantitative approach (Holmes & Rahe) * "Life change units" (LCUs) ~Derived for major life events (e.g., divorce, new job, new child, etc.) ~ Developed the Social Readjustment Rating Scale (SRRS) ~ First attempt to link 'magnitude of stress' to health ~ Limitations to design, but results showed: • Increased stress to increased likelihood of illness • Stress is complicated, affects people differently * Hassles and uplifts: Daily annoyances and pleasures • Relation with health depends on frequency, durability/ duration, and severity • Uplifts are protective; may mitigate stress but hassles emerge as better predictors of health * Work: Work-related stress is highly prevalent and high impact (absenteeism/presenteeism) • High perceptions of work stress elevate risk for mental health concerns (Szeto & Dobson, 2013) * Why is work stressful? • Work ranks high among life goals... • Vocational Identity for some, " what you do determines who you are" • Between 18-27, average US worker has 8 jobs • Social evaluative threat: Negative evaluation from others impacts affliative/achievement motives, linked to SNS arousal ~Lack of Control...