short answer questions

GERO 508 Spring 2021
Week 2
The Mind & Body Connection
Timothy Lu Office Hours: By Appointment Email: [email protected]

Dr Paul Nash CPsychol, AFBPsS, FHEA
Office: GERO 231E
Office Hours: Thurs 09.00-12.00
(OR AGREED APPOINTMENT)
Email: [email protected]

Gillian Fennell
Email: [email protected]

Questions about assessments?

2

The session in brief

Biological – What is stress?
Biological consequences of stress
Biological models of stress
Measuring biological stress

What does stress look like?
The meaning of sex
Psychological approaches to stress
Environmental approaches to stress
Specific models of stress
Bio-Psycho-Social models of stress
Measuring psychological components of stress

3

What forms can stress take?

4

Stress – The overview

Actual Stress
– See a predator / See a car coming towards you
5
Perceived Stress
– In a situation where something may or may not happen
Which do you think happens with humans? Why?

Humans exhibit the anticipatory stress response, well done us!! Turn on stress response for psychological reasons
– memory, emotions, thoughts
NOT what stress was designed for which leads to potential for chronic stress
Essentially the aim of the stress response is to return us to the homeostatic equilibrium we are in.

Acute or Chronic?

6

The meaning of sex

7

Fight or Flight
Tend and Befriend
Evolutionary
Protection of self and offspring
Nurturing offspring under stressful situation
Protect from harm (tend)
Create / join social groups to maximize resource and protection (befriend)
Evolutionary
Protection of self
Fight a stressor
Escape a stressor
Short lived
Few mins – Alive or dead
Most research based on males until the tend / befriend hypothesis produced. Mainly due to different cyclical variation in hormones and endocrine responses making research with women less predictable.
Not the whole story and we have biological and psychological differences later in the course!

Stress – The psychological approach

8
Stress as a response
The ways in which we respond to a stressor
Storm and stress approach
Coping & resilience
Effects of prolonged stress

Stress as a stimulus
Views stress as a significant life event or change that demands response, adjustment, or adaptation
Sees change as inherently stressful
Stress is dealt with uniformly across populations
Illness outcome thresholds are uniform

Stress as a transaction
Stress is a product of the human – environment transaction
Hardiness, resilience, locus of control and self-efficacy are important constructs
Duration of transaction (Episodic, Acute, Chronic)

Environmental stressors

9
Suboptimal environmental conditions pose demands that may exceed an individuals ability to cope
The imbalance between environmental demands and response capabilities is called…..?
…Stress

Environmental stressors include:
Chronic
Noise when living by a freeway
Acute
Noise when in a tunnel

Which is more impactful?
Chronic is more impactful and more likely as individuals have less ability to escape from them: Worked example, Airports

Some environmental stressors affecting YOU in LA

10
Noise
Intensity (decibel); Frequency (pitch); Periodicity (continuous or not); Duration (acute or not)

Noise is more than sound. Characteristics affecting this are:
Intensity
Unpredictability
Uncontrollability

But what can chronic noise actually impact?
Psychological stress (Ising and Kruppa, 2007)
Increased noradrenaline levels and BP in children (Evans et al., 1998)
Increased BP in high noise work environments (Tomei et al., 2010) Reduced reading ability in children (Bronzaft, 1981)
Attention and task discrimination (Evans & Hygge, 2007) Memory (Cohen et al., 1986)
When there was control, the effects were mitigated

Some environmental stressors affecting YOU in LA

Poor neighborhood quality
Quality of municipal & retail services; recreational opportunity; traffic; transportation links; noise; crowding; community transience; healthcare; education opportunity

Similar to the others, there is a lifespan effect

But what can a poor environment actually impact?
Greater psychological distress for children in poorer environments (Gifford & Lacombe, 2006) Similar trends both longitudinally (Dalgard & Tambs, 1997) and cross-sectionally (Gary et al., 2007)
Increased physiological stress in adults and children (Hill et al., 2005; McGrath et al., 2006) Effects of community are experienced irrespective of household SES (Evans, 2004)
What can be done to improve poorer environments to reduce stress?

12

General Adaptation Syndrome (GAS)

The Alarm Phase

The alarm reaction stage refers to the initial symptoms the body experiences when under stress.
The “fight-or-flight” response – the physiological response to stress. This natural reaction prepares you to either flee or protect yourself in dangerous situations. Heart rate increases, Adrenal gland releases cortisol (a stress hormone), and you receive a boost of adrenaline, which increases energy.
Selye, 1936
13

General Adaption Syndrome (GAS)

The Resistance Stage

After the initial shock of a stressful event and having a fight-or-flight response, the body begins to repair itself. It releases a lower amount of cortisol, and your heart rate and blood pressure begin to normalize. Although your body enters this recovery phase, it remains on high alert for a while. If you overcome stress and the situation is no longer an issue, your body continues to repair itself until your hormone levels, heart rate, and blood pressure reach a pre-stress state.
Some stressful situations continue for extended periods of time. If you don’t resolve the stress and your body remains on high alert, it eventually adapts and learns how to live with a higher stress level. In this stage, the body goes through changes that you’re unaware of in an attempt to cope with stress.
Your body continues to secrete the stress hormone and your blood pressure remains elevated. You may think you’re managing stress well, but your body’s physical response tells a different story. If the resistance stage continues for too long of a period without pauses to offset the effects of stress, this can lead to the exhaustion stage.
Signs of the resistance stage include: irritability
frustration

poor concentration
14

General Adaption Syndrome (GAS)

The Exhaustion Stage

This stage is the result of prolonged or chronic stress. Struggling with stress for long periods can drain your physical, emotional, and mental resources to the point where your body no longer has strength to fight stress. You may give up or feel your situation is hopeless. Signs of exhaustion include:
fatigue
burnout
depression
anxiety
decreased stress tolerance

The physical effects of this stage also weaken your immune system and put you at risk for stress-related
illnesses.
15

Diathesis Stress model

Diathesis
Predisposition (genetic, psych, bio, environmental, situational, personality type)
Stress
Events resulting in the disruption of the psychological equilibrium

Nature v Nurture

Disorders linked with this model:
Alcoholism; Schizophrenia; Anxiety; Depression

What do you think are the protective factors?
Social support; Network typology; Environment; Self-esteem

Expanded into the ‘Differential Susceptibility Hypothesis’ (Belsky et al., 2007) – Look it up!!
16

A stage model of stress

‘Events appraised as stressful are viewed as triggering affective states that in turn engender behavioral and biological responses having possible downstream implications for disease’
(Cohen, Gianaros & Manuck, 2016)
Combines:
Epidemiology
Defining which circumstances and experiences are deemed stressful on the basis of consensual agreement that they constitute threats to social or physical well-being

Individuals’ perceptions of the stress presented by life events on the basis of their appraisals of the threats posed and the availability of effective coping resources

Biology
Brain-based perturbations of physiological systems that are otherwise essential for normal homeostatic regulation and metabolic control

17

A stage model of stress – more detail

Stressors trigger a brain-based perceptual appraisal which in turn triggers an affective response (stress / anxiety)

Affective responses change the way both HPA( hypothalamic– pituitary–adrenal system) & SAM (sympatho-adrenal- medullary mediators) function.

Affective responses also impact emotional responses and behavioural outcomes / health risk behaviours like drinking and smoking

Appraisals of stress and their affective sequelae can influence interpretations of physiological sensations, such as defining sensations as symptoms and symptom clusters as diseases that in turn influence health-care seeking, and adherence to medical regimens
18

A stage model of stress – Keep in mind

Common criticisms include:

Too Sequential
However, although the model is sequential, emphasizing the proximal predictive nature of each stage, this is demonstrative of the integration of the Biological, Environmental and Psychological constructs. Further, the authors repost that other mechanisms can be at play rendering some stages obsolete in different situations

Unidirectional Model
Feedback loops (e.g. depression in final stage can feed into negative appraisals) mean that the model has Omni- directionality
19

Next time…

20

Week 3
02/04/2021 Stress and genetics
(Lu/Nash) SEE BB Week 2 Discussion

GERO 508 Spring 2020
Week 2
Biological Aspects of Stress
The Mind & Body Connection

Timothy Lu
Office: Virtual
Office Hours: By Appointment
Email: [email protected]
Dr Paul Nash CPsychol, AFBPsS, FHEA
Office: GERO 231E
Office Hours: Weds 09.00-12.00
(OR AGREED APPOINTMENT)
Email: [email protected]
Gillian Fennell
Email: [email protected]

Biological Aspects of Stress
22
What are the main biological components involved in stress?
How does the brain react?
How the brain triggers the body to respond
How does acute stress differ from chronic stress?
What diseases may manifest from chronic stress? (which we’ll talk more about in future lectures)

First, a disclaimer:
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The stress response itself is not harmful
Stress response (in general) is adaptive
It allows us to respond to threats accordingly!
Why then, does stress become an issue with us humans?

What is stress?
24
Stress is the body’s method of reacting to a condition perceived as dangerous and/or harmful, including threats, challenges and physical or psychological barriers
The body reacts to stress via the fight-or-flight response: a psychophysiological reaction in response to a perceived harmful event, attack or threat to survival
This response is regulated by the autonomic nervous system, a division of the peripheral nervous system which acts largely unconsciously to regulate bodily functions

The agents of stress are stressors, which may be internal or external. Key to stress is some amount of (perceived) loss of control over physical or psychological safety.

Physical triggers
25
Animate triggers from other species: predators, infectious agents
Inanimate triggers: floods, earthquakes, fires, avalanches, storms, hurricanes, riptides, other natural calamities
Humans and many other species can also experience stress induced by interactions with members of their own communities

Psychological/social triggers
26
Concerns about one’s place in the universe
Providing for the necessities of life
Security (physical, social, psychological)
Social achievement
Social hierarchy advancement
Relationship with peers
Concerns about the environment
Conditions which threaten homeostasis
Crisis & unrest
Many stress triggers observed in animal societies have parallels in human society

Neurons – Components of the Brain
27
Dendrites receive signals.
As neuron gets activated by incoming signals, the “summed signals” from many inputs goes to cell body.
Cell body integrates and makes decision on the importance of the signal (s).
If signals are important enough the cell body/hillock discharges and the receiving cell sends its own signal out the axon to next neuron in the sequence.
In the cell body we have the nucleus. Activity on the neuron will influence the nucleus to make proteins based on the needs of the nerve cells (using DNA expression and RNA recipes).

Neuronal Communication
28
The connection between two neurons is a space known as a synapse
Generally, this connection is chemical (although sometimes it is electrical)
Important this signal is uninterrupted
We have excitatory/inhibitory signals

What might happen if this connection is interrupted?
What is the importance of inhibitory signals?
28

Important Brain Anatomy to Know
29
Frontal Lobe – executive functions
Parietal Lobe – processing of somatosensory information
Occipital Lobe – processing of visual information
Temporal Lobe – processing of auditory information

The frontal lobe is going to be the primary decision maker – this lobe is responsible for your entire existence (from your speech decisions, motor movements, and other life choices you’ve made) and as such is a critical part of the stress response in terms of ASSESSING stressors or even being a part of them!

Frontal Brain Importance
30
Impaired function: Clinical depression, ADHD, anxiety, overactive stress response, addiction, etc;

Important Brain Anatomy for Stress Modulation
31
Amygdala – primary stress response
Basal nuclei – movement
Hippocampus – memories 
Hypothalamus – bodily integration
Thalamus – sensory information gateway
Pituitary glands – hormonal release

The amygdala is the primary structure involved in the stress response. It triggers the activation of the hypothalamus to communicate with the pituitary gland and send out hormones that are important to the stress response. The hippocampus stores memories that can relate to the stress response and trigger it (such as in PTSD)

Hormones and their function
32
A hormone is any member of a class of signaling molecules produced by endocrine glands and transported by the circulatory system to target organs, where they modulate physiology and behavior
A corticosteroid is a type of hormone secreted by the adrenal glands
Adrenaline (epinephrine) increases blood flow and blood sugar levels
An important class of corticosteroids are the glucocorticoids, which regulate glucose (blood sugar) and modulate the stress response, immunity, inflammation and behavior
Cortisol increases blood glucose and suppresses immunity and inflammation

The adrenal glands – Stress hormone releaser
33
The adrenal glands are located above the kidneys and secrete two very important hormones: adrenaline and cortisol
An adrenal gland consists of two distinct anatomic divisions: the cortex and the medulla
The cortex produces steroid hormones like glucocorticoids (cortisol is only one example)
The medulla produces adrenaline

Memory and Emotions
34
Amygdala closely related to hippocampus – strong relation to memory centers
This means stressful/fear-inducing events become greatly attached to our memory
Alzheimer’s is an age-related disease that leads to the degradation of memory centers
Chronic stress can induce damage to these memory areas
Emotional events in general tend to be deeply ingrained in our memory!

What do you think could occur with stress induced memory loss?
Why do you think emotions are so important to our memory?
34

What can the brain do to impact the body?
35

Brain to body interaction for stress
36

Sympathetic Nervous system (Fast)
Slow response (hormonal):
1. Second wave of energy
2. Shut off unnecessary physiology
3. Shut off stress response via negative feedback

Brain to body interaction for stress
37

Under conditions when a subject feels alert, safe and interested, phasic release of catecholamines (adrenaline and dopamine) strengthens the higher cognitive functioning of the PFC, thus allowing top-down regulation of thought, action and emotion. In primates, the PFC is topographically organized, with the dorsal and lateral surfaces mediating attention, thought and action while the ventral and medial aspects mediate emotion (tells the amygdala to SHUT UP – it inhibits the amygdala).
During stress exposure, high levels of catecholamines (adrenaline) take the PFC ‘off-line’ while strengthening the functions of more primitive circuits—for example, the conditioned emotional responses of the amygdala and the habitual actions of the basal ganglia. The amygdala activates brainstem stress systems, which in turn activate the sympathetic nervous system.
Stress weakens prefrontal networks: molecular insults to higher cognition

http://www.nature.com/neuro/journal/v18/n10/full/nn.4087.html?WT.ec_id=NEURO-201510&spMailingID=49632583&spUserID=ODkwMTM2NjI1OAS2&spJobID=763426042&spReportId=NzYzNDI2MDQyS0

Focus on the SYMPATHETIC (stress) response
38

How does this all work together?
39
HPA Axis and the feedback loop

The hypothalamic-pituitary-adrenal (HPA) axis is the loop of our stress response.

The hypothalamus sends corticotropin releasing hormone (CRH) to the pituitary gland. The pituitary releases adrenocorticotropic hormone (ACTH) to the kidneys, specifically the adrenal glands on top of the kidneys. The adrenal glands then release cortisol (shown as corticosterone for rats) which affects the body. This cortisol creates a negative feedback loop which shuts itself off.

What we will learn is that this is not always the case in chronic stress. We will talk more about the effects of cortisol on the body.
39

Stress, socioeconomic status and ethnicity
40
Low social rank is associated with more stress across human societies
Studies indicate that this is the case even when accounting for factors like financial security, access to healthcare, education and other factors
Because more stress is associated with higher inflammation, this suggests that individuals who are members of disadvantaged social groups can be at higher risk for cardiovascular disease, neurodegenerative disorders, anxiety and depression
Members of social groups who are at higher risk for discrimination can be more likely to experience prolonged stress and its consequences
These considerations are not yet properly understood scientifically but there are substantial efforts now underway to clarify and alleviate socioeconomic and ethnic disparities in stress-related morbidity and mortality

Biological Measures of Stress
41
Measuring stress biologically comes in many forms, what do each of these tell us?
We can look at stress hormones: cortisol
We can look at other biomarkers that come from the stress response:
blood urates – byproduct of protein degradation (neuronal)
Lysozymes – antibacterial enzyme (decreases)
CRP – elevated marker of inflammation/stress
miRNAs – influence biological systems
heat shock proteins – induced by short-term stress (anti-inflammatory)
Measured in the blood and saliva

https://www.frontiersin.org/articles/10.3389/fmolb.2019.00091/full

41

Stress effects upon neural cells and brain structure
42
The hippocampus is a brain structure which plays a central role in memory formation
In stressed mice, neurons have fewer dendrites and the hippocampus is smaller
Chronic stress changes brain circuits such that we slowly lose the ability to remember things
This is the hallmark of Alzheimer’s disease

Stress effects upon brain circuitry
43
Stress/glucocorticoid excess have been linked to
Decreases in the connectivity of the hippocampus and frontal cortex
Increases in the connectivity of the amygdala, a structure involved in the processing of emotions and affect
Brain networks can be very susceptible to hormonal imbalances, such that abnormal levels of inter-connectivity between regions can be linked to anxiety and depression
Connections between the limbic system and prefrontal cortex are often affected substantially

Stress effects upon neurotransmission
44
Behavior and affect are intimately linked to the chemistry of the brain
When a neurotransmitter called dopamine is released at the synapse, it binds to receptors signaling pleasure in anticipation of a reward
Dopamine is released not when the reward arrives, but when it is anticipated: “Success is a journey, not a destination”
Positron emission tomography (PET) is an imaging technique which can be used to investigate dopamine receptor binding
PET can also be used to investigate the concentration of glucose in the brain and to study how the metabolic needs of neurons are correlated with stress

Impact of stress on the brain and body
45
Increased stress leads to decreased response to dopamine
This decrease in dopamine leads to a decreased feeling of reward
Increased stress also affects metabolism which may lead to obesity
During the semester we will explore the impact of stress on different bodily systems

More on exercise in a later lecture
45

Stress and the heart
46

Stress and atherosclerosis
47
Because stress and the resulting flood of hormones increase blood pressure, the cardiovascular system is subjected to mechanical stress associated with higher blood pressure and pulse rate
High blood pressure damages artery walls
Damaged artery walls become repositories for plaque
Plaque restricts blood flow and increases the risk of heart attack
Atherosclerosis is a condition where the interior of arteries becomes narrower because of plaque

https://www.youtube.com/watch?v=1rv7GbUPXC4

Other Diseases Caused by Stress
48
Stress can greatly impact the body and lead to various diseases such as…
Diabetes
Atherosclerosis
Cardiovascular issues
Weakened immune response
Obesity

General Adaptation Syndrome (GAS) – RECAP

Selye, 1936
49

Diathesis Stress model – Recap

Diathesis
Predisposition (genetic, psych, bio, environmental, situational, personality type)
Stress
Events resulting in the disruption of the psychological equilibrium

Nature v Nurture

Disorders linked with this model:
Alcoholism; Schizophrenia; Anxiety; Depression

What do you think are the protective factors?
Social support; Network typology; Environment; Self-esteem

Expanded into the ‘Differential Susceptibility Hypothesis’ (Belsky et al., 2007) – Look it up!!
50

A stage model of stress – Recap
51

‘Events appraised as stressful are viewed as triggering affective states that in turn engender behavioral and biological responses having possible downstream implications for disease’
(Cohen, Gianaros & Manuck, 2016)
Combines:
Epidemiology
Defining which circumstances and experiences are deemed stressful on the basis of consensual agreement that they constitute threats to social or physical well-being

Individuals’ perceptions of the stress presented by life events on the basis of their appraisals of the threats posed and the availability of effective coping resources

Biology
Brain-based perturbations of physiological systems that are otherwise essential for normal homeostatic regulation and metabolic control

Bio-Psycho-Social Model
52

Back to your roots
Fight or flight today – Same as evolution indented?

Some bosses may be predators but essentially, no. But we have similar physiological if not behavioural responses

Something to consider:
What do you think the impact of social hierarchy is?

Primates, as with humans, who are higher up the social hierarchy have fewer stress hormones
Less stress
Less sickness

Bio-Psycho-Social Model
53

Take a lifecourse perspective
– People who are susceptible to high stress often have a background being bullied or abused

Back to the monkeys:
Primates have 1 alpha per pack but impossible to have a global alpha so much postulating and social domineering esp in workplaces

Removing the alphas reduces status play, harassment and increased socialization.
Can this be done with humans?
Reduce fiscal inequality; reduce vertical management hierarchy and increase autonomy in decision making; increase individual control

Bio-Psycho-Social Model
54

Which is better, the whole pizza of just the base?
Easier to allow a dominator hierarchy to form (pizza base) which controls and suppresses other aspects of personality and responses
‘Core Transformation’ suggests embracing all aspects of self, integrating not repressing
Similar principles to adjusting primate behaviour

Why do we ‘pizza base’?
Ease / laziness; Social norms; Dislike of aspects of personality; Self-presentational bias; Maintaining social standing

Just how well do you fair?
55

Holmes Social Readjustment Rating Scale

Take a pen and paper
Write down the values for each event that is relevant to you (within last 12 months)
Total your score
Reflect

Life Event Point Value

Death of spouse 100

Divorce 73

Marital separation 65

Jail term 63

Death of close family member 63

Personal injury or illness 53

Marriage 50

56

Fired from job 47

Marital reconciliation 45

Retirement 45

Change in health of family member 44

Pregnancy 40

Sex difficulties 39

Gain of new family member 39

readjustment 39

57

Change in financial state 38

Death of a close friend 37

Change to different line of work 36

Change in number of arguments with spouse 35

Mortgage over $10,000 31

Foreclosure of mortgage or loan 30

Change in responsibilities at work 29

Son or daughter leaving home 29

Trouble with in-laws 29

58

Nearly there…
59

Outstanding personal achievement 28

Spouse begins or stops work 26

Begin or end school 26

Change in living conditions 25

Revision of personal habits 24

Trouble with boss 23

Change in work hours or conditions 20

Change in residence 20

Change in schools 20

Change in recreation 19

Change in church activities 19

Change in social activities 18

Mortgage or loan less than $10,000 17

Change in sleeping habits 16

Change in number of family get-togethers 15

Change in eating habits 15

Vacation 13

Christmas 12

Minor Violations of the law 11

60

Totting it up
61

150 points and below: It implies you are less likely to experience a health breakdown.

151-300 points: It implies you have a 50% chance of a major health-breakdown in the next two years.

301 points and above: It implies you have an 80% chance of a major health breakdown in the next two years.

Is it that straight forward?
62

Issues with the HSRR:

SR model
Assumes that all events have same stress value for everyone
Assumes that the anchoring is accurate
Not age-rated (all stresses have the same values at all points in the life span)
Some stress is positive

Thoughts?!?

Additional Reading
63

Social vs environmental stress https://www.sciencedirect.com/science/article/pii/S0924977X12001459

Animal models of social stress https://www.tandfonline.com/doi/full/10.1080/10253890.2018.1462327?scrol

l=top&needAccess=true

Social stress models https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4901160/

GERO 508 Spring 2021
Week 3
The Mind & Body Connection
Timothy Lu Office Hours: By Appointment Email: [email protected]

Dr Paul Nash CPsychol, AFBPsS, FHEA
Office: GERO 231E
Office Hours: Thurs 09.00-12.00
(OR AGREED APPOINTMENT)
Email: [email protected]

Gillian Fennell
Email: [email protected]

The session in brief
65

Nature v nurture?
Influences factors for genetic predisposition
Influence of personality types
Coping mechanisms
Appraisal models
Integrated approach to genetic predisposition

Nature vs Nurture?
66

https://www.khanacademy.org/test-prep/mcat/behavior/behavior-and-

genetics/v/gene-environment-interaction

Revisiting the Diathesis Stress model
67

Diathesis
Predisposition (genetic, psych, bio, environmental, situational, personality type)

Stress
Events resulting in the disruption of the psychological equilibrium

Nature via Nurture

Factors that affect the genetic predisposition

20
What are the factors that can influence genetic predisposition?

Culture: Food Tradition Expectation Religion Others?

Intrapersonal / Interpersonal:
Internal concerns
(health, money, future etc) Communication with others

Social Network: Friends
Family
Civic engagement Confidant?

Gender:
Roles
Expectation / opportunity

Modern Life: Work hours Tech reliance
24 / 7 immersion Unhealthy lifestyle Drink / substances

Factors that affect the genetic predisposition

21

S.E.S.:
Income Education
Access to services Type of work
Leisure time / activity

Built Environment: Neighborhood type Housing stock
Green spaces / urban planning Urban vs rural
Transportation Visible incivilities Crime

Personality types: State / Trait Attitude
Locus of Control

Type …