Stress

What is included in the SAM pathway?

Adrenal Medulla - Adrenalin - Fight or Flight

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What is included in the HPA Axis?

Hypothalamus - CRF - Pituitary Gland - ACTH - Adrenal Cortex - Corticosteroids/Cortisol

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What are the risks of the HPA Axis?

Myocardial infarction, stroke, atheroschlerosis and immunosuppression.

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How did Cohen et al test the effects of stress on the immune system?

394 pts completed questionnaire on stressful life events in previous year, rated degree of stress and negative emotion - giving a 'stress index.' When exposed to cold virus, 82% developed a cold, correlating with their stress index score.

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What is wrong with Cohen et al's study?

Protection of pts, not a direct measure of the immune system, correlational (no cause and effect), need fully informed consent.

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How were naturalistic stressors tested against immunity?

75 med students had NK cell activity measured before and during exam period and completed life event and social isolation questionnaire. NK cell activity decreased in high stress, even greater with social isolation.

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What was wrong with Klecolt-Glasar et al's study?

Limited sample, NK cells are part of a complex system, no manipulation of the IV, need fully informed consent.

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How is stress measured?

Using the Social Readjustment Rating Scale (Holmes and Rahe).

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How was the SRRS made?

Hospital patients (many with CHD) reported life events the life before. Patients asked to compare life events to marriage in terms of degree of adjustment needed. The rating (Life Change Units) equate to amount of stress.

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What is wrong with the SRRS?

Conducted in the USA (ethnocentric), no OBJECTIVE assessment, life events are only one source of stress.

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What are characteristics of Type A behaviour?

Time pressured, unhappy doing nothing, competitive, hostile, easily irritated.

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How did Friedman and Rosenman test personality and stress?

Middle aged men were classed type A or B personality through interview where behaviour was observed and then followed up for 8.5 years. Out of 257 heart attacks, 69% were type A.

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What is wrong with Friedman and Rosenhan's study?

Longitudinal (risk of attrition), sample was US men, no control of extraneous variables, correlation, failed to be replicated.

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How does hardiness relate to stress?

It acts as a resistance to stress - those who are high in hardiness are less likely to suffer stress related illness.

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What 4 features contribute to workplace stress?

physical environment, home-work interface, workload, and control.

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How did Marmot et al investigate the relationship between workplace stress and health?

analysed data from 7000 London civil servants and followed up for 5 years.Low paid workers had twice as much illness and 1.5x more heart problems. Decision latitude is most important factor for health.

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What is wrong with Mermot et al's study?

self report questionnaires can be bias, only civil servants, relationship (no cause and effect), would be difficult to test directly.

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What are the 2 types of approaches used when coping with stress?

Emotion focused and problem focused.

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How did Tennon et al test the effectiveness of the two approaches of coping?

Pts completed 'Coping style questionnaire' and assessed level of pain daily. Found that strategies were used simultaneously. EFC was used 4.4x more when PFC was also used. We try preferred method first, if this does not work we alter the approach.

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A psychological stress management is Stress Inoculation Training - how does this work?

Identify source of stress and reach more realistic views of stressor, teaching coping skills/relaxation techniques, follow up while using the skills.

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Advantages and disadvantages of SIT?

reduces mismatch between demand and resources, effective in a wide range of settings, time consuming, needs commitment.

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A physiological coping resource is BZs - how do these work?

Increases the action of GABA, a calming neurotransmitter, also decreases noradrenaline and serotonin, treats stress associated with anxiety.

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Evaluate BZs.

Safe in overdose, there are side effects, risk of dependency, only treat the symptoms, effective in combination with therapy.

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Social support is an alternative method - how does this work?

This could be emotional, practical, informational or a general network. It can protect against damaging effects of stress.

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Evaluate social support as stress management.

In a meta-analysis done on social support and physiological processes, 28 shows social support reduces BP, 19 show link between support and immune system. There is a file drawer problem however.

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Stress

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