Lecture Four

SAM system

• Prep for flight-or-fight

• Brain talks to sympathetic nervous system which communicates with adrenal gland which release hormones (adrenaline and noradrenaline)→increased heart rate, respiration, etc.

cortisol

• cortisol is good in an emergency because preps body for flight-or-fight, inhibits immune response so can focus on escape

• chronic activation can increase levels too much and lead to brain damage over time

• can be measured through saliva samples after an acute stressor

vulnerability factors for stress

• increased risk of negative mental health outcomes

• children

• adolescents with depressed parents

• early life stress

• negative cognitive style

protective factors for stress

• decreased risk of negative health outcomes

• optimism

• psychological control or mastery (feeling in control of life and emotions)

• higher self-esteem

• social support

characteristics of stressors that influence impact on health

• severity of the stressor

• chronicity (how long does it last)

• timing (does it occur at the same time as other stressors)

• how closely it affects you

• how expected it is

• how controllable it is (do you have control over it)

allostatic load

• the biological strain on our body as the result of exposure to stress

• high allostatic load aggravates physical health problems

stress and the DSM

not a specific disorder in the DSM, but stress increases risk for many forms of psychopathology (especially early life stress→trauma disorders, mood disorders, anxiety disorders, substance use disorders, and more)

stress inoculation effect

• mild stressors early in life allow you to cope with stressors later in life

• not just exposure but positive and adaptive response to mild stressor

PTSD risk factors

• type of trauma (intentional human acts higher than natural disasters)

• degree of exposure (direct vs. indirect)

• risk for exposure to trauma (occupation, male, race)

• female gender (despite higher rates of traumatic events in males)

• minority group membership

• pre-existing anxiety/depression

• family history of anxiety, depression, substance use

• low social support (cause or consequence is unclear)

DSM-5 PTSD

• trauma

• intrusive/re-experiencing symptoms

• avoidance

• negative alterations in cognition and mood

• hyperarousal

• duration of symptoms >1 month

• clinically significant distress or impairment

• not due to substance or other medical conditions

acute stress disorder

• same symptoms as PTSD but duration is 3 days to one month after trauma

• some can go on to develop PTSD, others do not

adjustment disorder

• reaction to non-traumatic stressor (e.g., divorce, loss of loved one, loss of job)

• marked distress starting within 3 months of the stressor that is out of proportion to the stressor

• must be within 6 months of the stressor ending

• cannot be due to normal bereavement

• “mild” diagnosis; temporary; frequently assigned

structural changes with PTSD

• smaller hippocampi (important area of the brain for memory)

• biological vulnerability and consequence of PTSD

• risk factor for future development of depression