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PSYC 3604
Connie Kristiansen

PSYC3604 March 3 This is the beginning of the final exam material Goals for today’s class… • Chapter 6: Stress Disorders & Health Psychology • Stress • Psychoneuroimmunology & the role of social support in maintaining health • DSM: Sleep-Wake Disorders – Insomnia, Hypersomnolence, Narcolepsy, Non-Rapid Eye Movement Sleep Arousal Disorder, Nightmare Disorder • Treatments for Insomnia From the text… • Chapter 6: Stress Disorders & Health Psychology – How do we respond to stressors? Physical, social, cognitive, behavioural responses. – How is the stress response related to illness? – How does stress impact sleep? And how does this affect our health? – How is personality a factor in stress and health? – How might we improve health? What is Stress? • Two perspectives… • The stress response: → Response to a stressor • What is a stressor? → It somthing that disrupts the normal functioning of our physiology → Or an event that leads one to feel stress → What makes us feel stressed • What is stress: → Its an imbalance of the body’s functioning → It a feeling that you perceived uncontrollable and threatening in response to a stressor/event/stimulus • Stress: (1) An imbalance in the body’s functioning, OR, (2) A subjective feeling produced by events perceived as uncontrollable and threatening (stressors). • Stressors: (1) Anything that disrupts physiological balance, OR, (2) Events that lead to feelings of stress. • The Stress Response: (1) The body’s adaptations designed to reestablish the balance, OR, (2) A response to the perceived demands of the situation Stress: Theories & Models • Hans Selye – neurological approach – General Adaptation Syndrome – Focused on body’s physiological reaction to stress – Fight-or-flight response is engaged too long – Alarm stage: when we accounter an event, initiate the fight or flight response – its very adaptive and necessary for our survival, the issue is that someone of stress is chronic, thus we keep being stressed thus move in to stage 2 – Stage 2: resistant: still maintaining the active stress response thus use too much of our body resources – but the body kinda of adapts to it because used to using resources at a high rate – Thus we hit stage 3: exhaustion : the things that we need to fuel the body is gone thus system that needs energy are starved: such as the immune system ( uses lots of body resources) • Lazurus & Folkman – describe stress as a relationship between a person & the environment that is appraised by the person as taxing or exceeding her/his resources and endangering his/her well being The Role of Perception & Interpretation • Lazarus & Folkman (1988) “Stress itself is not a simple variable but a system of interdependent processes, including appraisal & coping, which mediate the frequency, intensity, duration, and type of psychological and somatic response.”- so it’s the appraisal part that makes you feel stressed Primary & Secondary Appraisal • Stress is the subjective reaction of a person to potential stressors • According to Folkman & Lazarus, in order for stress to be evoked, two cognitive events must occur…- We all go through the primary and seconday appraisal – Primary appraisal: Person perceives an event as a threat to goals – Does it threaten my goal ? Then we move on to Secondary appraisal. Ex: does this threaten my studies? – Secondary appraisal: Person concludes they do not have resources to cope with demands of threatening event- Do have the resources to cope with this stressor?- we don’t need to see something a stressful in each of theses appraisal EX; Well I go do this, wake up sleep a lil bit less – so here Okay I can do it, but have no time to take care of the exams thus you will be very stressed out – (at either stage, event could be perceived as non-stressful) What happens if stress is prolonged? Psychoneuroimmunology - combine psychology and neuroscience side, and look the factors that influence the immune system • Robert Ader – the father of PNI ( founded psychoneuroimmunlogy) • Defines PNI as the study of the connection between the brain and the immune system • Psychological experiences (i.e. stress) can influence immune functioning • PNI is the study of the interaction among emotions, the brain, and the immune system Psycho-oncology and cancer: Psychoneuroimmunology and cancer J.K. Kiecolt-Glaser, T. F. Robles, K. L. Heffner, T. J. Loving, & R. Glaser (2003). Annals of Oncology, 13 (Supplement 4) Kiecolt-Glaser et al. : • Suggest that behavioural and psychological factors have an impact on cellular immune response – ultimately affecting the occurrence and progression of certain tumors • The growth of tumour that is not controlled Social Support • Study of Alzheimer’s caregivers • poor NK response to cytokines correlated with less social support, less emotional closeness, and more physician visits • Social support is a great buffer against stress • It can help with problem solving • It can help to share emotions • The subject are caregivers that are looking after a loved one dealing with Alzheimer • For the patients who had a good amount of social support their immune system was still functioning quite well, those with less social support had immune system deficit • The NK ( natural killer cells- part of the immune system)- they kill antigen ( virus, foregein particle) – they go after their foreign things • Cytokines are chemical messenger in the body – they pretty much communicate to the body saying hey look there is antigen here, thus Natural killer cells usually response to the cytokines but ppl with poor social support, less emotional closeness to their social support ( they were sick more often, thus visited doctor more often) well their natural killer cells do not respond well to cytokines Indirect effect of Stress - its the review of 3 studies which demonstrated the indirect effect of stress and cancer, because the stress if acting up to the immune system thus immune system response less to cancer in the body • Bereaved spouses had elevated cortisol and decreased NK cell activity- people who lossed their spouses they had high levels of cortisols and decreased activity in their natural killer cells • Spouses of cancer patients – social support positively correlated with NK cell activity- the subject of studies spouses that are looking after someone is sick with cancer ( well their spouses) here the better the social support was their Natural killer cell activity was also good • Inciting an argument among newlyweds – the amount of negativity or hostility in the argument was negatively correlated with NK cell activity 24 hours later – here incite arguments with newlyweds here the more the argument was hostile or negative their Natural killer cells activity (became bad 24 hours later) Direct effect of Stress – stress acts directly to the production of tumour/ abnormal cells/damaged cells • Most carcinogens appear to induce tumors by damaging cellular DNA – producing abnormal cells- If we are overally stressed it makes it hard for our DNA to repair itself – thus cannot repair damaged cells • The body defends against this by attacking the carcinogen, repairing the DNA, and destroying the abnormal cells Direct effect of Stress • Patients with emotional stress exhibited poorer ability to repair damaged cellular DNA (relative to controls) – older population diagnosed with a stress anxiety disorder, thus if too stressed thus have a hard time repairing their damage cells/DNA • Contrasting findings – medical students’ perceived stress was positively associated with DRC – second study here they look into med students, this study contrast the 1 study,st but here higher stressed thus better the functioning of the immune system thus body is able to repair the damaged cells/DNA. Different findings is that they are using two different type of population and their can see stress differently and med students have chosen to be in this high stressed thus can escape this, differences it chronic or acute stress, older pop undergoes more chronic stressed while med students undergoes acute stress • DRC = DNA Repair Capacity Kiecolt-Glaser et al. (1985) • Study of 45 healthy adults – randomly assigned to receive one of three treatment protocols: relaxation training, social contact, or no intervention. • After 1 month – relaxation subjects showed a significant enhancement in NK cell activity, with concomitant decreases in distress-related symptomatology – in comparison with non-significant changes in the other two groups. • Here look at healthy adults and there are randomly assigned to: relaxation training, social contact ( its not really social support- just with contact with ppl) or no intervention ( control gr) • After one month: they have found that the relaxation training: they improved their immune system functioning : thus NK active was good and distressed related symptoms were reduced thus this was not found in the other two Fawzy & colleagues • Evaluated the immediate and longer term effects of a 6-week structured group intervention (health education, problem solving training, stress management techniques, social support) • Treatment condition subjects – increased NK cell number and NK cytotoxic activity • Here look into the 6 week structure group ( ppl had gone through a major event, thus here they did under went therapy for 6 weeks in which : health education- like healthy life styles, problem solving training ( how to solve problems when your stressed), stress management techniques ( such as relaxation), social support – different from social contact because develop a healthy social network • Those who underwent the treatment their immune system functioning did improve, they had a good relation with the Natural killer and the cytokines and the had lots of natural killer cells • And 6 years later they were less likely to have their old symptoms back and less likely to have died Conclusions…? • The research suggests mechanisms whereby psychosocial stressors could play a role in the immunological and cellular processes that underpin tumour development. • Evidence from healthy populations as well as from individuals with cancer suggest a link between psychological stress and immune function. • Currently – social therapies (relaxation training, social support, health education) appear to have an important impact upon the immune functioning that is necessary for successful disease progression. • See a big connect with psychological stressors and the immune system and its development of cancer – • Social therapies are really have big positive impact in the functioning of the immune system DSM • Trauma- and Stressor-Related Disorders – already talked about this – Reactive Atta
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