Stress And Disease Lecture Slides PDF

NURS 7053 STRESS AND DISEASE Overview A condition in which a demand exceeds a person’s coping abilities, resulting in disturbances of cognition, emotion and behavior Stress Overview Psychological stress is a cause or precipita...

NURS 7053 STRESS AND DISEASE Overview A condition in which a demand exceeds a person’s coping abilities, resulting in disturbances of cognition, emotion and behavior Stress Overview Psychological stress is a cause or precipitating factor in many diseases, including mental illness (see Table 11-1 on page 328) Psychological stress may exacerbate symptoms and outcomes of many diseases Severe emotional stress has been linked to poor cardiac disease outcomes Stressful events can cause insomnia, appetite changes and physical illness Stress Overview Chronic stress accelerates the aging process in the brain, causing a reduction in synaptic function and brain atrophy (especially in the hippocampus, leading to memory loss) Chronic stress at a young age can cause lifelong alterations in a person’s physiological, psychological and behavioral response to stress Animal research shows that brain changes due to chronic stress are irreversible Stress Overview Fear, anxiety, anger Major life events Lack of sleep, insomnia Trauma, abuse, violence Malnutrition Daily hassles, school/work Prolonged exertion Relationships, caregiving Noise Disease, illness (physical or mental), infection, pain, surgery Extreme temperatures Medications, alcohol, other drugs Stress Categories of Stressors A person’s perception of stress is the critical factor Acute stressors Chronic stressors Microstressors Stress Concept of Allostatic Load Wear and tear on the body due to chronic or repeated stress Caused by: – Exposure to multiple novel stressors over time (acute, chronic or microstressors) – Failure to habituate to repeated stressors – Delayed shutdown of the stress response – Inadequate stress response that leads to compensation from other mediators Stress Concept of Allostatic Load Wear and tear on the body due to chronic or repeated stress Results in constant exposure of cells and tissues to stress hormones which can alter immune function, accelerate disease processes and alter brain structure and function. Stress STRESS RESPONSE 9 Categories of Stress Response Reactive: The physiological response from stressors Anticipatory: The physical responses that occur in anticipation of a stressor Conditional: A learned response to specific stimuli (danger) and the anticipatory physiological response it produces Stress Response Categories of Stress Response Post traumatic stress disorder: Develops after an event that caused harm or the threat of harm; stress response occurs due to flashback memories Stress Response Central Stress Response Perceived in brain regions that receive sensory information - cerebral cortex Stress Response Central Stress Response Information relayed to the limbic system (amygdala, hippocampus, and hypothalamus) Stress Response Central Stress Response Amygdyla – Registers fear (also involved in other emotional reactions, memory and decision making) Stress Response Central Stress Response Hippocampus – Involved primarily in memory, located near amygdala Stress Response Central Stress Response Hypothalamic-Pituitary Axis – Receives information from amygdala and hippocampus, registers stress and pain Stimulation of hypothalamus results in release of CRH, ACTH, and then cortisol Stress Response Central Stress Response Hypothalamic-Pituitary Axis – Receives information from amygdala and hippocampus, registers stress and pain Stress Response Central Stress Response Hypothalamic-Pituitary Axis – Stressor and CRH also activate the sympathetic nervous system causing the release of norepinephrine and epinephrine Stress Response Central Stress Response Hypothalamic-Pituitary Axis – Stimulation of the hypothalamus results in the secretion of TSH and then T3/T4 Stress Response Central Stress Response Hypothalamic-Pituitary Axis – Stimulation of neurons in paraventricular nucleus of the hypothalamus results in the release of ADH and oxytocin from the posterior pituitary Stress Response Central Stress Response Brainstem – Locus ceruleus neurons (of the pons) release norepinephrine which enhances brain activity and contributes to the generalize sympathetic effect of stress Stress Response Negative Effects of Increased Cortisol Elevation of blood glucose levels – Associated disease states: Insulin resistance Metabolic syndrome Type 2 DM Stress Response Negative Effects of Increased Cortisol Inhibition of the immune and inflammatory response – Associated disease states: Immunosuppression Infection Cancer Sepsis Stress Response Negative Effects of Increased Cortisol Reduction in wound healing (Christian, Graham, Padgett, Glaser, & Kiecolt-Glaser, 2007) Stress Response Negative Effects of Increased Cortisol Development of truncal obesity (lipogenesis) and weight gain – Associated disease states: Diabetes mellitus Cardiovascular disease – Atherosclerosis – CAD – MI Hepatic Steatosis Stress Response Negative Effects of Increased Cortisol Inhibition of LH, estradiol, and testosterone production – Associated disease states: Infertility Osteoporosis Stress Response Negative Effects of Increased Cortisol Increased SNS activity – Associated disease states: Hypertension Heart failure Kidney disease Atherosclerosis Stress Response Negative Effects of Increased Cortisol Reduction in serotonin levels in the brain – Associated disease states: Depression Anxiety Stress Response Negative Effects of Increased Cortisol Promotion of gastric secretion of acid and enzymes – Associated disease states: Peptic ulcers GERD Stress Response Negative Effects of Increased Cortisol Enhanced renal excretion of calcium – Associated disease states: Kidney stones Stress Response Negative Effects of Increased Cortisol Interferes with sleep cycle – Associated disease states: Insomnia Stress Response Negative Effects of  Catecholamines Elevated heart rate and strength of myocardial contraction, myocardial remodeling – Associated disease states: Heart failure Stress Response Negative Effects of  Catecholamines Peripheral artery vasoconstriction – Associated disease states: Hypertension Stress Response Negative Effects of  Catecholamines Peripheral arteriole vasoconstriction leading to reduced blood flow to tissues – Associated disease states: GI ischemia, ulcers, constipation, bowel obstructions Skin ulcerations Stress Response Negative Effects of  Catecholamines Elevation in Blood Glucose Levels – Associated disease states: Insulin resistance Metabolic Syndrome Type 2 DM Stress Response Negative Effects of  Catecholamines Increased lipolysis leading to an increase in free fatty acid and cholesterol levels in the blood – Associated disease states: Atherosclerosis Stress Response Negative Effects of  Catecholamines Inhibition of general smooth muscle contraction in the GI tract and increases GI sphincter tone – Associated disease states: Constipation Bowel obstruction Stress Response Negative Effects of  Catecholamines Inhibition of immune and inflammatory responses – Associated disease states: Immunosuppression Infection Cancer Sepsis Stress Response