Psych of Stress Exam 1 (chapters 1,3,4,5)

Stress and the Growth Process

-Growth requires calcium to build bones, amino acids for protein synthesis and fatty acids to build cell walls. -Thyroid hormone promotes growth hormone release. -Estrogen promotes growth of long bones and promotes growth hormone secretion. -Testosterone promotes growth of long bones. (Growth hormone works on fat cells to provide energy for growth) Stress inhibits secretion of somatomedins, which promote cell division. Glucocorticoids inhibit growth of new bone, blocks uptake of dietary calcium & increase excretion of calcium by the kidney. If bones dump too much of their calcium into the blood, they become prone to fracture(fragile) and excess circulating calcium can form kidney stones. (So chronic stress can increase the risk of osteoporosis and skeletal atrophy) (Stress decreases testosterone secretion.)

Social Readjustment Rating Scale:Holmes and Rahe (1967)

A questionnaire used for identifying major stressful life events. Each one of the 43 stressful life events was awarded a Life Change Unit depending on how traumatic it was felt to be by a large sample of participants.

Five Factor Model: Agreeableness

Agreeableness is associated with trust, altruism, compliance, modesty and straightforwardness. Its opposite is antagonism.

What are Stressors?

Anything that causes the release of stress hormones. There are three broad categories of stressors: -Behavioral -Psychological -Physiological

Types of Stress Responses

Behavioral Action oriented psychological Phisological

How does prolonged stress disrupt hippocampal memory?

By glucorticoids disrupting long term potentiation. The amygdala gets activated during major stressors and sends projections to the hippocampus. Hippocampal neural networks get disconnected or weakened, although regrowth can occur at the end of the major stressor period. Birth of new neurons in the hippocampus is inhibited as well. If the stress goes on for a long time delivery of glucose to the brain is noticeably inhibited and this is due to the glucocorticoids. An energy crisis occurs. ( Now hippocampal neurons become endangered and die). Excess glutamate increase calcium inflow to the cells and oxygen radicals. Glucocorticoids associated with neural insult can increase inflammatory cytokines and that contributes to neuron death. People with PTSD have smaller hippocampi. There are elevated levels of glucocorticoids in lots of people with major depression and you see a smaller hippocampus. You can get steroid dementia from high levels of long term use of steroids.

Glucocorticoid

CORTISOL and other similar hormones produced by the outer zone (cortex) of the adrenal gland. The glucocorticoids suppress inflammation and convert AMINO ACIDS from protein breakdown into glucose, thus raising the blood sugar levels. Their effect is thus antagonistic to that of INSULIN.

Optimism

Carver and Scheier are expectancy value theorists, so this construct relates to confidence in goal attainment. Optimists persist in goal directed coping in response to disruptions or difficulties. Pessimism leads people into self-defeating patterns of behavior. Pessimists experience more negative feelings of anxiety, anger, despair and sadness. Optimism is associated with decreased interpersonal stressor exposure and increased levels of social support over time. Optimism relates to ways of coping and approaching problems. They appear to use more problem focused and proactive coping approaches. They make appropriate goal directed plans and seek relevant information . Research has shown optimists cope better following surgical procedures like bypass surgery and experience greater life satisfaction. They demonstrate less disruption of social activities following treatment for breast cancer. Optimism predicted later college adjustment and development of friendship networks. Optimism is associated with physical well being and minimization of health risks. Optimism has been measured with the Life Orientation Test Revised.

Glucocorticoids :

Cause shrinking of the thymus and formation of lymphocytes there. Inhibit release of messengers like interleukins and interferon. Cause lymphocytes to be stored in immune tissues. Disrupt mostly cellular but also antibody mediated immunity. Can kill lymphocytes

Impact of Trauma in someones life

Cognitive formulations of PTSD have proposed that the consequences of the trauma has a profound impact on the person's attitudes and beliefs including: Issues of: security, control, predictability, competence, worthiness of the self, guilt, shame, vulnerability, trust, and violation of assumptions regarding an orderly and just world. Individuals may organize their lives around not feeling or participating in life on an emotional level or plunge into work where they feel less vulnerable. Some may become dependent and seek reassurance. Years after the trauma, victims will claim that their reliving experiences are as vivid as when the trauma first occurred. What is meant by reenactment behaviors? Why do many abused victims stay in their relationships? Ever hear of the Stockholm syndrome? Identification with the aggressor?

Who was Walter Cannon?

Coined the "fight or flight response" (how quickly we react to something) Wrote: "wisdom of the body" Video: killer stress (on youtube) Discussed that strain, cold, lack of oxygen, is caused by stress

Five Factor Model: Conscientiousness

Conscientiousness is associated with achievement striving, dutifulness, self-discipline and deliberation. Its opposite is unreliability. Individual differences in executive functioning may play a role in associations between conscientiousness and reduced stress exposure. These people override emotions and impulses, stay on task, stay organized, and meet goals. So they are less likely to experience stressors. Conscientiousness is related to educational attainment, career success, lower rates of divorce. Individuals with poor executive functioning may struggle with substance abuse, impulsivity, risk taking, time management , planning and organization - all of which generate stressors.

Life event questionnaires:

Developed to address concerns of specialized subgroups like adolescents, college students etc. Questionnaires have been developed to address hassles uplifts and ongoing strains.

Stress and the Digestive System

During stress, stored proteins get moved into circulation as amino acids. Excess carbs and sugars are stored as glycogen in liver & muscles and gets moved in circulation as glucose ( gluconeogenesis). Fatty acids and glycerol are stored as triglycerides and mobilized as fatty acids and glycerol. The reversal of the storage process occurs thru the stress hormones( glucocorticoids, glucagon, epinephrine and norepinephrine).

Immunity, Stress, and Disease

During the first 30 min. or so after onset of an infectious challenge, physical or psychological stressor, immunity ( especially innate)...Glucocorticoids kill off older lymphocytes and divert other lymphocytes to the infection site along with epinephrine. By the 1 hr mark, a suppression process begins. It is with major stressors of longer duration that the immune system plummets into an immunosuppressing phase. Such stressors will suppress formation of new lymphocytes, inhibit manufacturing of antibodies, disrupt lymphocyte communication, inhibit innate immune response, suppressing inflammation. (Now stress can worsen autoimmune diseases like multiple sclerosis, rheumatoid arthiritis , ulcerative colitis, inflammatory bowel disease, and asthma.)

Prenatal Stress

Dutch Hunger Winter (famine) occurred near the end of WWII. Consequences for surviving fetuses was (a group of ppl around the same age) of adults with thrifty metabolisms and increased risk of Metabolic Syndrome 50 years later. Prenatally stressed rats grow into adults with elevated glucocorticoid levels. (The suggestion is that there are fewer glucocorticoid receptors in the brain available to turn off CRH release.) It seems that glucocorticoid secretion by the stressed pregnant female rat is the culprit. (You also see the metabolic syndrome in the adult rat. The stressed pregnant female rat produces a demasculized male.) Stress as pregnant rat and it's offspring will grow up to be anxious and with memory impairments especially as they age.

Socioeconomic status

Economic & sociological combined total measure of a person's work experience and of an individual's or family's economic and social position in relation to others, based on income, education, and occupation. Lower SES is associated with fewer resources, less ability to manage stress and increase vulnerability to negative cognitions and emotions. i.e. those who were poorer were less likely to be resilient in the face of Katrina. The worse off the neighborhood, the higher incidence of heart disease. Social support is positively associated with resliency resources including self-efficacy, optimism, and social skills. (Families play an important role here.) Sufficient resources are essential if people are to effectively engage their environment and deal with stressors and challenges. Individuals may conserve resources by interpreting threats as challenges and focusing on potential gains or reevaluation of resources that are threatened or have been lost.

Importance of Control `

Give a rat the same series of shocks but allow it to press a lever to avoid a shock. Take away the lever and the rat develops a massive stress response including ulceration. Can you think of situations where lack of control is stressful for you? What if you think you have significantly more control or less control than you actually do? Can you think of examples and their consequences?

John Henryism

Having an illusory sense of control is illustrative It is a belief that any and all demands can be vanquished if you work hard enough or outcomes can be regulated with enough effort and determination. This view becomes pathological in a world of people born into poverty, of limited educational opportunities, of prejudice and racism. Such people have a marked risk of hypertension and CHD. An overabundance of information can be stressful too. It can limit controllability. Think of trying to prepare for the GRE. Think of the "orange alerts in the post 9/11 world when we received information that told us little. We also get hung up on "rare events" and elevate their importance e.g., school shootings and calls for cops to patrol schools.

Who was Claude Bernard?

He came up with homeostasis: (body temp regulation, heart rate regulation, keeping things in balance in the body) trying to maintain this in our bodies (keeping things in check)

Trauma in Children

In children you might see regression in developmental expectations. You may see problems in attention and concentration. There will be problems in ignoring what is unimportant and selecting what is relevant. Intrusions are relevant here. Trivial cues associated with the trauma are seen as threats. You see impulsivity. Life is a matter of avoiding elements associated with the trauma- feelings and activities OR challenging it in some way. You may see a withdrawal from everyday life events that make it worth living- its pleasures and learning opportunities. PTSD has a high comorbidity with mood, dissociative, anxiety disorders, substance abuse, and ADHD. Similarly, most victims of trauma develop disorders like depression, panic disorder, and/or generalized anxiety disorder in addition to PTSD. Physical injuries and treatment effects create additional problems. Childhood trauma sets state for various psychiatric disorders like borderline personality disorder, somatization disorder, dissociative disorder, self-mutilation, eating disorders, and substance abuse. Interpersonal traumas are more significant than impersonal ones. Children exposed to physical abuse, especially sexual abuse report among the highest levels of PTSD that may persist, especially in females. In formerly abused children you see later on poorly modulated affect and impulse control,( includes risk taking), insecurity in relationships, trust issues and problems in social settings that may include withdrawal , aggression, and acting out behaviors. The adverse effects of early traumatic stress may well extend into adulthood. Adolescents are particularly at risk for being victimized, involved in incidents outside the home and suffering physical injuries. Lack of self-regulation may also manifest as attentional problems: ADHD Out of body experiences Having dissociative experiences at the moment of trauma is a major predictor of PTSD

Sex and Reproduction

In the male the hypothalamus stimulates the pituitary to release LH and FSH that stimulates testosterone and sperm production, respectively. Injury, illness, starvation, surgery and psychological ( say rank lowering in a primate) stressors inhibits this system. Stress initiated endorphins and enkephalins block LHRH which activates the pituitary. Prolactin , also released during stress decreases sensitivity to the pituitary to LHRH. Glucocorticoids block the testes' response to LH. In females, LH stimulates ovaries to synthesize estrogen while FSH stimulates the ovaries to release eggs. Following ovulation, progesterone made in the corpus luteum of the ovary facilitates development of the embryo. Stress does a similar number on this system with the same players involved. (Net result is lowered secretion of LH, FSH, and estrogen and lowering likelihood of ovulation.) We know the importance of estrogen for protection against osteoporosis. Stress also disrupts sex drive ( e.g., social subodination in monkeys). Serious stress can cause miscarriages. Epinephrine and norepinephrine decrease blood flow to the uterus.

Personal Characteristic/ Skills & Traits

Includes: skills & traits. -Skill resources (occupational skills, social skills, leadership ability) -Traits may (self-esteem, self-efficacy optimism, trust, &hope)

Suggestions for Reducing Insomnia

Increase physical activity in the day. Do not use hypnotics. Watch caffeine intake Use a regular sleep and wake routine. Do not have a clock visible and keep the bedroom dark. Use the bed for sleep, sex. Do not worry or watch stimulating programs while in bed. Meditate or relax prior to sleep. Avoid daily naps. Avoid alcohol, a meal and physical exercise within two hours of bedtime. If you cannot go to sleep, go to another room and come back when you are sleepy.

What happens to sleep during stress?

Insomnia. CRH and sympathetic activation occur, of course and arousal pathways are activated. Most cases of insomnia are triggered by a major stressor. Poor sleepers have higher levels of glucocorticoids in the blood. Psychologically the person will be fatigued, of course; moody; show sensorimotor and cognitive performance decrements ( you don't want to be asleep at the switch) especially in tasks requiring sustained concentration and shifting attention; lack of motivation. Work performance suffers. Long term health consequences include hypertension, obesity, and cardiovascular disease.

Modulation of the Stress Response: What Animal Research tells us

Jay Weiss exposed rats to mild electric shocks and observed ulceration development. Ulceration levels dropped when rats could gnaw on wood after each shock. Importance of outlet for frustration. Other outlets included letting the rat drink, eat, run on a running wheel. Displaced aggression works too. What do people do? Distraction is one feature but another is the reminder that there is more to life than whatever is bothering you now.

Stress and GI Disorders

Major stressors correlate with these disorders and traumatic stressors that happen early in your life can increase the risk. ex. irritable bowel syndrome Contractions of the colon increase in IBS patients more than controls in response to lab stressors like a cold pressor task or participating in a pressured interview.

A perception of things improving

Male baboons whose ranks are dropping have elevated glucocorticoid levels, while males whose ranks are rising do not show this. Context is always relevant when we make judgments about events and outcomes. Our sense of optimism and confidence takes context ( the perception of change in a condition over time) into account and therefore affects perceived stress. Can you think of pertinent examples?

Postnatal Stress

Maternal deprivation causes similar consequences in a rat as prenatal stress. When you look at children who had been adopted more than a year out from Romanian orphanages, (the longer the child spent in the orphanage, the higher the glucocorticoid levels.) Similarly, abused children have elevated glucocorticoid levels and decreased size and activity in the frontal cortex. Deprivation( psychosocial) dwarfism: You see children years behind in expected height and mental development. (You have low growth hormone levels.) --It is not a problem of insufficient food. There is overactivity of the SNS. (Some kids have elevated glucocorticoid levels.) SNS activity halts release of digestive enzymes, stops muscular contractions of the stomach & intestinal walls and blocks nutrient absorption. Handling and stroking rap pups facilitate growth. Tiffany Field went to neonatal wards and touched babies 15 min. 3X/day. Kids grew faster, were more alert, active and got out of hospital earlier than controls. Harry Harlow and the wire and terry cloth mothers. What is love?

Mediators vs Moderators

Mediators are activated by the current stressful experience and account for the relations between stressors and psychopathology. For example, hostile, rejecting parenting and inconsistent discipline may mediate the relation between economic stressors and psychological symptoms in children and adolescents. When we look at evidence for prospective relationships between stressors and psychological symptoms, we need to be aware of the influence of moderators and mediators. Moderators are conceptualized as diatheses or protective factors as they represent preexisting characteristics ( i.e., in existence prior to the stressor) that increase or decrease the likelihood that stressors will lead to psychopathology. Potential moderating variables include demographics ( age, gender, SES), social factors( social support, parental atmosphere, neighborhood and school context), temperament, personality, attributional and coping styles. Some examples: Boys are more likely to exhibit externalizing symptoms while girls are more likely to exhibit internalizing symptoms in response to stressors.

(Traumatic Stress) Physical Health Outcomes

Most people are likely to be exposed to a traumatic event in their lifetime and a significant group experiences symptoms of distress many years after the event. It is an event that poses significant risk of death or serious injury. Think of responders at the World Trade Center who have experienced respiratory disorders. Some had lower gray matter volume in various brain regions. Pregnant women exposed to trauma at WTC were at greater risk of giving birth to infants with lower birth weights and smaller head circumferences. Pregnant women with Posttraumatic Stress Disorder( PTSD) reported engaging in substance use like alcohol and tobacco and not taking proper care of themselves. Environmental hazards and illnesses affected a number of Katrina victims and responders. Trauma victims have been shown to be more likely to seek medical care. They tend to attribute a variety of symptoms to the trauma. When communities are affected with a major drain on available resources there can be serious disruptions in accessing care. (This is particularly problematic for underinsured persons and those with chronic health conditions.) Decreasesed immune functioning after a trauma have been associated with greater reports of illness symptoms. Trauma victims who experience open wounds, crowded conditions,and unsanitary environments will be more likely to be exposed to pathogens and get infected. Patients with HIV experience faster progression of the disease. A number have difficulty obtaining antiretroviral meds creating adherence issues. (Among elderly persons with cardiovascular disease, exposure to trauma has been associated with elevations in blood pressure and more frequent episodes of arrhythmias.) Researchers have documented a positive relationship between exposure to earthquake trauma and MI. Changes in health behaviors following a trauma like increases in smoking, drinking, alterations in sleep, poor nutrition and lack of exercise may contribute to and exacerbate diabetes.

Internal/ external Validity

Most research we will examine will not involve experimental manipulations but retrospective, cross-sectional, and longitudinal investigations. Statistically speaking findings will often be based on correlational research and regression analysis. Manipulated or isolated potentially causal variables are the independent variables and the outcome variables are the dependent variables in an investigation. Literature reviews of a topic will often cite meta-analyses, which are based on combining results of lots of studies on the same topic in order, in theory, to maximize internal and external validity. Effect sizes reported give us an indication of relationship strength between the independent and dependent variables of interest.

Some Human Coping Examples

Norwegian soldiers learning to parachute were monitored over the course of training. Glucocorticoids and epinephrine levels were elevated hours before and after the jump initially but with time they were no longer turning on the stress response like this. Give postsurgical patients in the hospital control and predictability over administering pain medication, and they wind up taking less medication. Alleviating the uncertainty of relief was important. If you give nursing home residents opportunities for decision making and control, their tendency toward withdrawal and passivity diminishes and their mood and health improves. Quality social contact is important. Data on glucocorticoid and immune function support this.

Types of Resources : Object vs Condition

Object: a house, diamonds. (They are linked to survival value or status and self-esteem) (matieral things) Condition: health, employment, marriage, seniority. (They lay foundation for access to other resources)

Testing the Stress-Disease Link

One research area has focused on social isolation. For the same illness, people with the fewest social connections have 2.5 times as much chance of dying as those with the most connections after controlling for age, gender and health status. Infect monkeys with SIV and the more socially isolated animals have higher glucocorticoid levels, fewer antibodies against the virus and greater mortality rate. Bereavement: ( e.g., loss of a child) increases the risk of dying among those who have an additional physiological or psychological risk factor like being widowed or divorced. Then there is the stress-cold connection. Sheldon Cohen et. al.'s work cited in the text is important because of the control for lifestyle confounds, and the dose-dependent relationship with level of stress . Work with HIV patients seem supportive. Starting with the same amount of HIV, a faster decline in immune function and higher mortality rate occur among people with minimal social support and more stressors, especially bereavement. Elevated SNS plays a role. What about cancer? The rate at which transplanted tumors grow in mice can be affected by stressors like noisy cages or by rotating the cage on a platform. Glucocorticoids can facilitate growth thru angiogenesis and cancer cells are good at absorbing glucose. NK cells are suppressed as well. What about people? If you do a retrospective study where you rely on a history of verifiable stressors ( e.g, divorce, death of a family member, loss of a job), you do see a link with onset of colon cancer years later. Prospective studies have not provided solid evidence for a stress-cancer following the direct immune system changes route. When we look at the role of stress and disease like cancer we have to realize that such a disease has risk factors that can be independent of or indirectly associated with stress e.g., carcinogen exposure, diet, alcohol, smoking, family history, depletion of melatonin( night shift work).

Five Factor Model: Openness

Openness to experience is associated with less sympathetic activation in response to stressors and its opposite pole, closed mindedness, shows the reverse. Highly open persons are more flexible and adaptive in coping with stressors.

pessimistic explanatory style

People who generally tend to blame themselves for negative events, believe that such events will continue indefinitely, and let such events affect many aspects of their lives display what is called a pessimistic explanatory style.

Stress and Drug Use

Pleasurable activities release dopamine. Think roller coasters. (The projection begins at the ventral tegmentum, goes to n. accumbens, and from there to frontal cortex, anterior cingulate and amygdala.) Addictive substances all cause this release of dopamine in this pathway. Glucocorticoids trigger release of dopamine. Experience severe and prolonged glucocorticoid exposure ( as with severe or chronic stress) and you get dopamine depletion and depression. Drugs of abuse make one feel less stressed. The person reports less anxiety and negative moods. Stressors increase relapse in those who had been addicted especially unpredictable and uncontrollable ones. The frontal cortex is likely impaired as it is supposed to play a role in restraining the need for gratification and in making proper decisions. When rats are deprived of a drug they are addicted to , there is a large increase in CRH especially in pathways mediating fear and anxiety like the amygdala. Glucocorticoid secretion then is constantly elevated in withdrawal where it depletes dopamine. Stimulants may be used to increase of maintain performance while stressed ( focus attention, decrease distraction, maintain energy level). Drug use may increase social interactions that could buffer stress. Of course drug use may increase stress. Think withdrawal and craving.

Methodological Considerations in Assessing Stress

Questionnaires: Social Readjustment Rating Scale was the main stress scale that initially moved the field of human stress research forward. (It was used to predict stress related symptoms.) Problems include: - Issues surrounding retrospective reporting such as reliance on long term memory. -Confounding of life events with current health conditions -Current mood states and personality biasing the reports ( e.g., negative affectivity)

Positive Outcomes Following Trauma

Resilience is not uncommon. A significant number of people can handle crises effectively and feel that they are better off. Prisoners of war have reported benefitting from their experience. Some have written books, taken political action, and helped others. Importance of preparation for potential trauma in training procedures. BFG Some researchers urge caution in accepting these reports at face value. There is the matter of social desirability. Validity of questionnaires that address BFG are called into question, for example the Benefit Finding Scale. "As a result of experiencing...I have become more respectful of others." "I am more compassionate toward others." In responding the individual must evaluate his or her current standing on the dimension described in the item, recall the previous standing on the same dimension, compare current and previous standings, assess degree of change and determine how much of the change can be attributed to the traumatic event or stressful encounter. BFG interventions have the potential to contribute to a tyranny of positive thinking, once popularized by Bernie Siegel, author of Love, Medicine and Miracles. From him people got the idea that cancer patients caused their own cancer by not being positive enough - not having enough love, courage etc. and should feel positive even if they felt otherwise. So this brings up the idea of perceived control. In the case of trauma, more often than not the victim could not have done more to prevent the bad outcome.

Resource Loss

Resource loss is disproportionately more important than resource gain. People who lack resources are most vulnerable to additional losses & less capable of achieving resource gain vs. those who possess resources are more capable of gain Caravan passageways are environmental conditions that support and enrich resources of persons and organizations or do the exact opposite. Consider physical safety, quality of schools, safe leisure activities, money, availability of good employment and medical care, crowding, pollution etc. Caravan passageways are created and preserved thru inheritance and by means of cultural capital- access to certain social circles, clubs etc. These passageways clearly influence physical and mental health.

Explain People who are Hot Reactors

Robert Eliot in the 80s discovered people who were hot reactors. They reacted to everyday irritations as if they were fighting saber toothed tigers. As he put it "as if they were burning a dollar's worth of energy for a dime's worth of trouble." He noted that the trait correlated with a bunch of cardiovascular risk factors including elevated blood pressure. He tested its presence in the lab with computer game challenges, cold pressor, serial 7 tasks. They show an exaggerated cardiovascular response to psychological stress. He discovered that excessive catecholamine release over time can cause myocardial damage in the form of lesions that can trigger rhythm disturbances and sudden death. We know that a high degree of hostility predicts coronary disease, stroke and associated mortality. Friedman thinks that the core of hostility relates to time pressure and the core of that is insecurity. Various forms of hostility are bad news. James Gross showed volunteers a film clip that evoked disgust. You get SNS activity. Now you show other volunteers the same clip ( leg amputation) and tell them to suppress their emotions and the SNS reaction is greater.

Animal Personality and Stress

Robert Sapolsky has studied baboons in the Serengeti in Africa. He sees that the animals differ in such behaviors as how readily males form coalitions with other males, how much they groom females, whether they play with kids or whether they sulk after losing a fight or just take it out on a smaller animal. Animals vary in their ease of getting agitated. Those that do have higher resting glucocorticoid levels.

Cardiovascular Stress Response

SNS (Sympathetic Nervous System) dilates arteries leading to the muscles...the coronary arteries constrict. Decrease in blood flow to digestive tract & skin with a shift in blood flow to brain. Blood flow is reduced to kidneys & water is reabsorbed into the circulatory system via vasopressin keeping blood pressure up. SNS increases blood pressure but makes blood thick and sticky (viscous) Inflammatory response basis for atherosclerosis. Epinephrine makes platelets more likely to clump together. Stress increases LDL levels. Proinflammatory cytokines may promote plaque instability.

Importance of Social Support

Sapolsky has shown that glucocorticoids are elevated in low ranking baboons and among the group if the dominance hierarchy is unstable or if a new aggressive male has joined the group. If you are a male baboon with lots of friends and grooming opportunities glucocorticoid levels are lower than males of the same rank who do not have these outlets.

Stress and Memory

Short term stressors of mild to moderate severity enhance cognition and lower sense thresholds Major or prolonged, intense stressors are disruptive and executive function is disrupted. Synapses in the hippocampus and cortex disproportionately make use of an excitatory transmitter, glutamate. Cahill and McGaugh's experiment and importance of sympathetic stimulation for emotional memory enhancement. Glucocorticoid levels increase in this situation and facilitate long term potentiation in the hippocampus. Cushingoid Dementia -tumors result lots of glucocorticoid secretion. You see impaired explicit memory and decrease in the volume of the hippocampus. Synthetic glucocorticoids given in prolonged treatment for autoimmune or inflammatory disorders are associated with explicit memory problems.

Stress and a Good Night's Sleep

Stress is a leading cause of insomnia & insomnia is a frequent cause of stress. If one is deprived of sleep, glucocorticoid levels increase and the SNS is activated. Levels of growth and sex hormones decrease. Learning and memory are lousy when one is sleep deprived. Poor sleep quality may be associated with a smaller volume in the hippocampal region and insomnia is associated with less gray matter in the brain. Night or shift work increases risk of CHD and gastrointestinal disorders. There is immune suppression and evidence of elevation of free radical production and inflammation ( C reactive protein levels are elevated).

Stress and Food Consumption

Stress makes most people have an abnormally increased appetite. (Stress induced release of cortisol may underlie effects of stress on eating behavior. ) Emotinal eating is higher in women Glucocorticoids stimulate appetite for fat, starchy, and sugary foods and blunts leptin's satiation signal. Glucocorticoids stimulate fat deposition in the abdomen. (Note that fat released from cells there readily find their way to the liver and is converted to glucose, setting one up for elevated blood sugar and insulin resistance.) Kaplan argued that some obese ppl do not learn to distinguish between hunger and anxiety. Some researchers have found that situations involving potential negative evaluation or task failure or stress encourages disinhibition in restrained eaters or dieters. (Michaud found that on test days, school children increased overall calorie intake and fat intake.)

Negative Stress Response consequences...

Stress response hinges on mobilization of energy and inhibition of further storage. (HeartRate, BloodPreassure, & respiration increase) Digestion, growth, reproduction are shortenend and tissue repair decreases. Immunity and pain perception are weakend. Hormones: Epinephrine(Adrenalin) Norepinephrine (Noradrenalin )are released by adrenal medulla Epinephrine causes constriction of blood vessels in skin and viscera while dilating arterioles of skeletal muscles. (Metabolic rate is increased) Hypothalamus secretes corticotropin releasing hormone triggering pituitary to release ACTH causing secretion of glucocorticoids from adrenal cortex. (They facilitate SNS(Sympathetic Nervous System) arousal and enhance effects of epinephrine and norepinephrine in raising blood pressure.) The pancreas releases glucagon, elevating blood sugar as well. Prolactin suppresses reproduction. Pituitary also secretes vasopressin ( antidiuretic hormone) and oxytocin. (Oxytocin facilitates maternal behavior and milk production. "Tend and befriend behavior") Secretion of endorphins and enkephalins blunting pain perception during stress.

Psychosocial Stress and Coronary Heart Disease

Stressors such as exercise, mental stress and sexual activity can induce MI or malignant arrhythmias. Stress may influence cardiac thru health impairing habits and undermining regular physical activity and sleep. Another way stress is linked to cardiac outcomes involves delay behavior, and nonadherence. Chronic stress is related to weight gain, especially abdominal obesity. (Obesity is associated with Type II diabetes). Diabetes increases risk for coronary artery disease. Stress promotes smoking. Bernin et.al.(2001) showed that workers exposed to a highly controlled and socially isolated work environment had higher serum lipids than those who felt social support at work. Chronic stress contributes to hypertension. (Hypertension is a risk factor for coronary artery disease, stroke, and kidney disease. Elevated blood pressure promotes plaque formation.) Individuals with depression, hostility or work stress have increased platelet aggregation ( more clotting). (Depression and hostility are correlated ith unhealthy behaviors like overeating and smoking). Feelings of low control are associated with high levels of fibrinogen, a blood clotting factor that predicts cardiovascular disease. Proinflammatory cytokines are released in response to mental stress and facilitate atherosclerotic lesions. Studies of natural disasters show associations with MI.

PTSD

Substance abuse is commonly comorbid with PTSD. Trauma victims may experience increased likelihood of exposure to injury and disease not only by means of drug taking and impulsive behavior but thru decrements in ability to perform required tasks ( inattention, concentration deficits). Symptoms: : intrusive thoughts, dissociation of the traumatic memories, numbing of emotional responsiveness, avoidant behaviors that may include drug taking, withdrawal from salient activities of every day life, hypervigilance, exaggerated startle, irritability, flashbacks and nightmares, insomnia , intense emotions, and interpersonal reenactments in situations reminiscent of the trauma.

Stress Reactivity

The capacity or tendency to respond to a stressor. It is a disposition that underlies individual differences in responses to stressors and is assumed to be a vulnerability factor for the development of diseases.

Hans Selye (psychiatrist)

The father of stress Made up the "general adaptation syndrome" (response of alarm, resistance and exhaustion) Injected rats with something, chased them around, examined the rats... (peptic ulcers and large adrenal glands, shrunken immune tissues (from general unpleasantness (stress) = stress causes physiological consequences!!!! Selye recognized that stressors could be positive ( Eustress)

Treatment for Trauma

The overarching goal is to gain control over emotional responses and place the trauma in the larger perspective of life as a historical event that is unlikely to recur when the person takes charge of his or her own life. Consider feeling strong and capable (This requires active engagement in challenges and involvement with others.) External validation about the reality of the traumatic experience in a safe, supportive context. It is important to bring up trauma details and deal with issues such as what happened and what the client did and how much control he or she had in the sequence of events. Importance of social and community support structures. Master physiological stress reactions to traumatic reminders. Address secondary adversities. (Consider the returning veteran, for example. There have been issues regarding delayed treatment for veterans at VA facilities and nursing homes. There have been concerns about homelessness.) Finally research on expressive writing involving emotional disclosure (Pennebaker paradigm) has found that people may gain health benefits when they find positive aspects of the traumatic experience e.g., ways in which they have personally grown. Lestideau and Levallee (2007) suggested that when writing about a stressful situation, developing a plan for dealing with it boosts the health benefits of expressive writing.

Importance of Predictability

The rats get a series of shocks but rats that get a warning bell before the shock get fewer ulcers. Another variation relates to habituation. Consider a rat getting food delivered to its cage at measured intervals. -Now change the food delivery pattern over the hour so that it is random....up go glucocorticoids. For us: Predictive information has to be timely and useful for coping purposes. Can a lack of predictability be a good thing? Can an overabundance of predictability be unpleasant?

Why is hostility bad for your heart?

Then there are repressors. They say there aren't depressed or anxious and describe themselves as happy, successful and socially interactive. Yet you see chronically activated stress responses in them. Coronary disease patients who are repressors are more vulnerable to cardiac complications. These people describe themselves as planners who don't like surprises and live structured, rule-bound lives. They keep a tight lid on emotions and inhibit negative affect. Have a high need for social conformity.

Five Factor Model

This model is useful in clarifying which aspects of personality influence stress. Extraversion, Agreeableness, Conscientiousness, Neuroticism (sometimes named by its polar opposite, Emotional Stability), and Openness to Experience (sometimes named Intellect.

(Animals) Do they act passively or aggressively in a potentially "interpersonal threatening situation"?

Those that are passive, have higher glucocorticoid levels. Males who spend the most time grooming females and are groomed by them most frequently, who spend more time playing with the young have lower glucocorticoid levels and are most capable of developing friendships. Stephen Suomi has found that one of five rhesus monkeys is a hot reactor. (Put one in a novel environment and the monkey reacts with fear and you see high glucocorticoid levels...put the monkey with a new peer and it becomes shy and withdrawn). Separate the monkey from a loved one and it becomes depressed, again with excessive glucocorticoid levels, excessive SNS activation and immunosuppression.

Pennebaker's Expressive Writing Paradigm

We know that people often have a need to talk to others after a distressing event but we have seen it can be difficult for some experiences. Freud talked about catharsis in psychoanalytic therapy. Zeigarnik noted that people tend to ruminate, talk, and dream about unresolved tasks. Distressing nature of intrusive ruminations produces anxiety. Pennebaker had undergraduates write about thoughts and feelings associated with traumatic experiences. There were positive stress reducing effects including reduced number of physician visits, and even better grades. Pennebaker emphasized importance of meaning, control and predictability in our lives. We know that trauma has a disrupting influence. Why did the trauma occur and how do we restore what was changed? Inhibition associated with suppression is a stressor that can lead to health problems. One tenet of psychotherapy is having clients confront anxieties and problems by creating a story to explain and understand past and current life concerns. The story provides resolution that gives a sense of predictability and control over their lives. The benefit of forming a narrative is communicability to others that can bring about social integration and social support. Confiding traumas reduces arousal associated with inhibition and increases one's ability to understand and integrate the experience. Analysis of writing samples of those whose health improved were judged to be more self-reflective, emotionally open, with more causal and insight words. They used a lot of positive and moderate use of negative emotion words. Frattaroli's (2006) meta-analysis showed that expressive writing produced benefits on distress, depression, medical visits and physical health.

Irritable Bowel Syndrome( spastic colon)

You get abdominal pain after a meal relieved by defecating. You see diarrhea, constipation, passage of mucous, bloating and abdominal distention.

How many items do you include on the checklists to get a picture of stressors experienced?

You need to determine the affective quality and level of intensity of the life event. Was the event neutral, positive, negative?

Stress Induced Analgesia

You see this in jocks, rats who have been stressed, and triggered even by someone playing a competitive video game. Stress triggers beta-endorphin from the pituitary gland. Enkephalins are mobilized from brain and spine. Surgery, a cold, spinal taps, acupuncture and childbirth all produce similar effects. Oxytocin also stops pain responsiveness. Stress Induced Hyperalgesia involves emotional reactivity to pain. Antianxiety drugs block this. People high on neuroticism are prone to this response.

learned helplessness

a condition in which a person suffers from a sense of powerlessness, arising from a traumatic event or persistent failure to succeed. It is thought to be one of the underlying causes of depression.

Ulcer

a hole in the wall of an organ (Types include peptic, gastric and esophageal. )

Neuroticism

a long-term tendency to be in a negative emotional state. People with neuroticism tend to: -have more depressed moods -suffer from feelings of guilt, envy, anger, & anxiety more frequently and more severely than others -Their use of emotion focused coping strategies may exacerbate stress. Neuroticism has been associated with activation of the amygdala and anterior cingulate cortex. They tend to carry over a negative mood following a negative event. You see poorer sleep and greater sleep disruption in them. They take longer to recover following a lab stressor.

Biopsychosocial Model

a newer model of health that assumes health is a product of biological, psychological and social influences.

Voodoo Death

a term coined by Walter Cannon The phenomenon of sudden death brough on by a strong emotional shock, such as fear.

social desirability

bias is a social science research term that describes a type of response bias that is the tendency of survey respondents to answer questions in a manner that will be viewed favorably by others. It can take the form of over-reporting "good behavior" or under-reporting "bad", or undesirable behavior. Validity of questionnaires that address BFG are called into question, for example the Benefit Finding Scale. "As a result of experiencing...I have become more respectful of others." "I am more compassionate toward others."

Interviews and ratings

can be used to generate a list of stressful events, level of threat, severity of impact and conditions surrounding them including: What happened? When? Who was(were) involved? Duration? Consequences? Interviews have been criticized as less likely to elicit information that may be embarrassing or have potential negative consequences if reported. (This is of particular concern with child and adolescent samples) Pragmatism is on the side of the checklists. You have to consider cost, time and effort.

Explanatory Style

construct proposed by Martin Seligman. Construct has to do with attributions for bad events. Does one makes internal, stable, global attributions or external, unstable or specific attributions? The Attributional Style Questionnaire measures these attributions. Optimists underestimate likelihood of future bad events and believe they can forestall such events by their own actions. Prior experience with controllable events facilitates enhanced persistence at difficult or unsolvable tasks. So how do you think all of this relates to experienced stress and ability to cope with stress?

Jay Weiss

exposed rats to mild electric shocks and observed ulceration development.

Five Factor Model: Neuroticism

facets include anxiety( worry, rumination), angry hostility, self-conscientiousness, impulsiveness and vulnerability. The opposite pole is emotional stability. It is consistently associated with increased stressor exposure in the form of major life events, hassles, and chronic stressors like conflict in close relationships. Hostility is associated with social isolation, marital conflict, higher blood pressure and delayed recovery of cardiovascular responses to stress.

SNS hormones, beta endorphin, and CRH

facilitate immunosuppression During infections the immune system releases interleukin-1, which stimulates the hypothalamus to release CRH( with the consequence of release of glucocorticoids and immune suppression). Note that glucocorticoids are used to treat autoimmune diseases.

Fight or flight Response

how quickly we react to something

Energies:

i.e. time, money, knowledge. (They derive value from their ability to be exchanged for resources in the other categories.) They can be invested or retained in order to enhance resource acquisition, protect against resource loss or combat loss cycles. ((Note that in this model change, transitions and challenges aren't of themselves stressful))

Five Factor Model: Extraversion

is associated with warmth-gregariousness; assertiveness, activity, excitement seeking and positive emotions. The opposite pole is introversion.

Metabolic Syndrome

is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes (insulin resistance) obesity, high blood pressure and stroke. ( They collectively predict mortality rates.) The term "metabolic" refers to the biochemical processes involved in the body's normal functioning. Risk factors are traits, conditions, or habits that increase your chance of developing a disease.

Neuroticism or negative affectivity

is thought to derive from a behavioral inhibition system that increases sensitivity to signs of threat or punishment. It can lead to defensiveness, anticipatory anxiety and rumination.

Parasympathetic Division of ANS

mediates conservation of energy, relaxation, vegetative activities, and growth.

Sympathetic Division of ANS

mediates the four Fs( fright, flight, fight and sex). You are expending energy and the hypothalamus is the major mediator.

Stephan Hobfall: on the definition of stress

people strive to obtain, retain, protect & build resources & what is threatening to them and want to protect and enhance the self( e.g., gain or maintain status). We may lean toward prevention of resource loss when we are ill equipped to gain resources or are vulnerable. Psychological stress occurs when there is threat of a loss of resources or lack of resource gain following investment of resources.

Alexithymia

problems in using semantic constructs to identify somatic states.

General Adaptation Syndrome

proposed by Hans Selye three stage modelof chronic stress alarm stage, resistance stage & exhaustion stage. (Today we use the term "Allostatic Load") Symptoms include: included enlarged adrenals, peptic ulcers, shrunken immune tissues -found this out by chasing rats around

BFG

refer to the constellation of positive changes that are frequently reported following trauma, illness or major stressful life events. Examples include developing a healthy life style, spending more time with family and friends, an increased sense of self-reliance, greater appreciation of life, becoming more altruistic, sensitive and compassionate, changes in priorities, new openness to religious experiences and development of new interests and skills.

Posttraumatic growth

refers to sustained positive changes in major commitments and goals involving active processing of the meaning of the loss. Goals may involve devotion to a cause that gives them meaning.

Lazarus and Folkman: on the definition of stress

stress seen as a relationship between the person & environment that is appraised by the person as taxing or exceeding his or her resources and endangering their well being

Patrick Mc Grath (psychologist): on the definition of stress

stress seen as substantial imbalance between environmental demand & response capability of the organism. Imbalance could be an overload or underload.

Janoff-Bulman

suggested that one model of growth centers on changes in self-understanding that emerges from suffering. Another centers on changes in worldview-where one realizes that assumptions about control, just world, and benevolence of others and order need revision. A third centers on meaning making, reprioritizing, revaluing life and spiritual change.

Stress Induced Hyperalgesia

super sensitive to pain

interpersonal circumplex model

the interpersonal circle or interpersonal circumplex is a model for conceptualizing, organizing, and assessing interpersonal behavior, traits, and motives (Wiggins, 2003).

Predictors of PTSD:

when the trauma occurred( age of victim) extent of physical injury degree of life threat and duration prior traumatic exposures level of preparation and training level of social support level of mental health prior to exposure negative parenting behavior or early separation from parents: unresponsive, abusive and parental psychopathology level of education level of mental health and personality structure Member of ethnic minority