Patho- Stress and Coping

stress

a physical or psychological tension that threatens homeostasis or a persons psychological equilibrium that necessitates change or adaptation

stress is a

response to an event, the response can be psychologic and physiologic

what does stress often apply to

perceived threat or challenge

coping

psychologic and behavioral measure aimed at handling stress demands

what is adaptation

a physiologic and psychologic processed used in response to stress

what is how we cope often directly linked to

our adaptation to the situation and how we are going to adapt (more individualized)

what populations are at risk for stress

• those who already have a chronic illness or disease they are managing

• children exposed to something traumatic early in life→ can change their brain structures

• older adults because decreased immune system → more prone to getting ill or an infection

• adolescence→ hormonal interactions= ineffective coping

acute stress

most common and typically occurs for a short period of time is usally occurs in reaction to a real or perceived demand or threat and then it resolves quickly

episodic acute stress/ self-inflicted stress

when people take on unrealistic assignments beyond what is typically or reasonably expected

• stress that can be controlled by the person as long as they understand their own boundaries and limitations

chronic stress

stress that represents a perpetual or sustained demand threat or pressure

• it can wear on our body system out long term which can lead to issues like inability or decreased immune system

stress signs and symptoms/ reactive response

psychological + emotional

physiological: muscle tension, high bp and hr, stomach ache

behavioral

general adaptation syndrome stress model

• been around a long time and was made by hans selig has 3 stages

• breaks down what physically happens in the body during stress response

• also describes what happens in body when stress is not alleviated

general adaptation syndrome stage 1

alarm stage

when does the alarm stage begin

when a stressor activates the hypothalamus and sympathetic nervous system

what happens in the alarm stage

the hypothalamus is triggered to release cortical releasing hormone ans sympathetic nervous system is trigered to release catchoolamines (epi/noepi)

• the cortical triggering releasing hormone will cause an increase release of cortisol by the adrenal cortex which increases blood sugar and glucose in the body so cells have more nutrients

• epi/no epi is secreted from adrenal medulla contributes to high bp, hr, rr to help stimulate the body during response

general adaptation syndrome stage 2

stage of resistance

when does the stage of resistance begin

with the actions of the adrenal hormones cortisol, norepinephrine and epinephrine

what should we see during the resistance stage

we are still seeing the activation but we should start to see a change back to homeostasis

general adaptation syndrome stage 3

stage of exhaustion

when does the exhaustion stage occur

if stress continues and adaptation is unsuccessful

what will the exhaustion stage ultimately cause

an impairment of the immune response and organ failure eventually leading to death

stress as a stimulus model

-looks at the stimulus itself that promoting the stress/ situation

-helps explain why not every person has the same stressful experience as someone else

-stressful situations are individualized

stress as a stimulus says that how the event is interpreted leads to the

physiologic response

stress as a transaction model

individual appraisal of the event

in the stress as a transaction model what does the response depends on

how situation interacts with the individual coping resources and perceived meaning of event

what does the hypothalamus secrete

corticotropin-releasing hormone (CRH)

what does the corticotropin-releasing hormone (CRH) do

binds to specific receptors on anterior pituitary cells

after CRH binds to pituitary cells what is produced

Adrenocorticotropic hormone (ACTH) and is transported through the blood to the adrenal glands

what happens after ACTH is transported

Glucocorticoid hormones are released – primarily cortisol

what functions do Glucocorticosteroids regulate

many functions of the CNS including arousal, cognition, memory, mood, sleep, metabolism, maintenance of cardiovascular tone, the immune and inflammatory reaction, growth and reproduction

Cortisol’s action of carbohydrate metabolism results in i

increased blood glucose levels thereby energizing the body to combat the stressor

what does cortisol effect

protein metabolism

Cortisol secretion during stress exerts

beneficial effects by inhibiting the initial inflammatory effects

LC/NE System

group of neurons lecated in the pons portion of the brain connected to the hypothalmus and thalamus

Circulating catecholamines stimulates

sympathetic nervous system

what do Catecholamines include

Epinephrine and Norepinephrine

what do catecholamines stimulate

α-adrenergic (α1 and α2) and β-adrenergic

receptors (β1 and β2)

what does Norepinephrine do

Regulates blood pressure, promotes arousal and increases vigilance, anxiety and other protective emotional responses

what does norepinephrine binds with

primarily with alpha receptors

what does Epinephrine do

influences cardiac action

how does epi influence cardiac action

enhancing myocardial contractility, increasing heart rate and increasing venous return to the heart, ultimately increasing both cardiac output and blood pressure

what does Epinephrine dialate

blood vessels supplying skeletal muscles allowing for greater oxygenation

what does epi cause and decrease

causes transient hyperglycemia

decreases insulin release from the pancreas

what does epi mobilizes

fatty acids and cholesterol

what does epi binds with

both α and β receptors

patients that have chronic inflammatory response or diseases leads to

sickness behavior or more generalized symptoms that they don’t feel good

homeostasis

presence of an internal stage of balance (our goal to achieve after being stress)

allostasis

the continual state of fluctuation our body is in

Stress-Age Syndrome

▪ Set of neurohormonal and immune alterations, as well as tissue and cellular changes, develops

▪ Alterations in the limbic system and homeostasis

▪ ↑ in catecholamines, ADH, ACTH and cortisol

▪ Immuno-depression and chronic inflammation

Physiologic Stress examples: acute

▪ Acute Renal Failure

▪ Myocardial Infarction

▪ Respiratory Failure

▪ Sepsis

▪ Trauma

▪ Acute Pain

physiologic stress examples: Chronic

▪ Cancer

▪ Chronic Obstructive Pulmonary Disease

▪ Chronic Kidney Disease

▪ Dementia

▪ Diabetes

▪ Heart Failure

▪ Obesity

▪ Chronic Pain

Psychologic/Emotional stress examples

▪ Death/end of life (family, friend or pet)

▪ Divorce

▪ Loss of Job

▪ Loss of Home

▪ Change in Personal

▪ Finances

Behavioral stress examples

▪ Alcohol Addiction

▪ Drug Addiction

▪ Gambling Addiction

▪ Substance Abuse

▪ Tobacco Addiction

coping

making an effort to manage physical and psychological stress

Coping – Mediating Factors

▪ Age/ developmental level

▪ Socioeconomic Status

▪ Social Support

▪ Religious or Spiritual Preferences

▪ Personality

▪ Self-esteem

▪ Genetics

▪ Past Experiences

▪ Current Health Status

poor coping is related to

▪ Inability to accurately assess the stressor

▪ Denial or avoidance of the stressor

▪ An actual or perceived lack of control over the situation

▪ An actual or perceived lack of support

▪ No experience or poor past experiences handling stressful situations