1. Psychoneuroimmunology (PNI)
    • Mind, brain, and immune system are connected
    • Mind can somewhat heal virally induced infections (i.e. warts)
  2. Stress
    • Stressor - very individualized
    • Most of time stress is a useful, good response
    • There are negative feedback loops that turn the stress off
    • HPA (hypothalamus-pituitary adrenal cortex) - more likely to be active during chronic stress; incr cortisol levels in stress and depression
    • SNS - fight or flight response; epinephrine
    • PNS - opposes SNS; involved w/ release of oxytocin
    • Acute stress - activation of immune system
    • Chronic stress - suppression of immune system (poverty, chronic diseases, people w/ terrible marriages, etc); incr risk of infection, cancer, allergies, autoimmune diseases
    • Reactivity - react to environment; always on edge to world around us; causes acute blips of stress
    • Some people can't launch an adequate stress response (inadequate cortisol response)
  3. Models and theories of stress
    • Life stress model - more negative life events you have the more stress you have
    • Lazarus and Folkman model - used today; stress is in your head, it is how you perceive it
    • Allostasis model - new model; perception of stress and physiologic response, but we pay a price for those responses (allostatic load; risk for disease)
  4. Examples of allostasis
    • Role of catecholamines in promoting adaptation by adjusting HR, BP to sleeping, waking, and physical exertion (can accelerate atherosclerosis, Type II diabetes)
    • Lewis rat: incr susceptibility to inflammatory and autoimmune disturbances is related to inadequate levels of cortisol
  5. Physical vs. psychological stress
    • Top-down stress activation - self talk about what is going on; threats vs. challenges; negative vs. positive
    • Bottom-up stress activation - outside things that cause brain to react w/ stress response
    • Classes of stress responses - defense vs. defeat (often leads to learned helplessness)
    • Learned helplessness - learn that you can't change anything; hopeless
  6. Mirror stress
    • Mirror your stress onto someone else
    • Stress you respond with will be mirrored in someone else
  7. Social interactions
    • Most positive social interactions seem to buffer stress and even improve immune function when stressed
    • Negative life events produce their strongest effect on health when social support is low
    • Marriage benefit - those who marry even if get divorced, live longer than single people
    • Personality needs to be considered (A, B, C personalities; depression; pessimism)
    • Type A - time driven, can't wait, hostile, multi-tasker, talk fast
    • Type B - relaxed, easy-going, lack sense of urgency, disengaged
    • Type C - more likely to get autoimmune disease or cancer, won't allow themselves to feel emotion
    • It is the perception not the actual amount or type of social support that makes a difference
  8. Humor
    Laughter decreases cortisol and improves immunity
  9. Exercise
    • Can be a stress buffer
    • For those who like to exercise it improves immune function
    • Elite athletes immune system suffers and they appear to be chronically stressed
    • Older people who rate themselves as physically active have better health (fewer infections) and improved immune function
  10. Depression
    • Known relationship with depression and poor health
    • Pt's with CV disease who are depressed have two times the mortality
    • Sleep disturbances in depression may contribute to mortality and may be through immune mechanisms
    • CRH brain levels incr in depression
    • Brain regulation of peripheral immunity through CRH mediated regulatory autonomic nervous system pathways
    • HPA is dysregulated in depression (hypercortisol)
    • Vegetative symptoms of depression are similar to the behaviors assoc with sickness (fatigue, social isolation, decr appetite, lack of interest)
    • Antidepressant drugs decr pro-inflammatory cytokine expression
    • Other influences: smoking, alcohol, lack of exercise, sleep disturbances
  11. Cytokine hypothesis
    • CNS responds to peripheral blood levels of cytokines
    • Cytokines do not appear to be able to cross blood brain barrier
    • Cytokines in blood may produce a corresponding incr in neurological synthesis of cytokines and changes firing in certain parts of brain
Card Set
Psych Exam 3 - PNI