Stress as bodily response Define stress Describe the pituitary adrenal system Describe the sympathomedullary pathway Demonstrate

an understanding of the link between stress-related illnesses and the effects of the immune system. Describe and evaluate research into the effects of stress on the immune system.

Stress is the response to the demands placed upon an individual. It is physical, psychological strain which threatens the individuals ability to go on coping. It results when there is a lack of fit between the perceived demands and perceived ability to cope.

You MUST be able to describe the bodys response to stress, including the pituitary adrenal system (HPA) and the sympathomedullary pathway (SAM). HPA: SAM: Hypothalamus activates the ANS (autonomic nervous system) which has 2 divisions: o The sympathetic nervous system (SNS): prepares the body for fight or flight. Sympathetic arousal causes heart rate, respiration rate and blood pressure to increase. Sugars and fatty acids are released into the blood stream to help energize the muscles, and the digestive system is slowed down. The adrenal medulla is stimulated to produce adrenaline (epinephrine) and noradrenaline (norepinephrine), which acts as arousal hormones supporting and reinforcing the SNS response. o The parasympathetic nervous system (PNS): this acts to return the body to a state of normality following a period sympathetic arousal. This pathway is very good for immediate and acute stress, but cannot maintain the level of functioning for long. This response is designed for short term. Stimulated by the hypothalamus. Sends corticotrophic releasing factor to the pituitary gland. Pituitary gland sends adrenocorticotrophic hormone (ACTH) to the adrenal cortex. This stimulates the release of corticosteroids such as cortisol into the blood stream. Helps the body produce more energy. Helps body combat chronic stress by maintaining energy levels. It is designed to work long term.

GAS: The general adaptation syndrome The reaction of the body to chronic stress, universal physical reaction that occurs over a period of weeks and this is called GAS. Three stages:

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Alarm stage the HPA and SAM both activated. Resistance stage the body does not display outward signs of stress but continues to work hard to maintain energy so it is resistant to stress is maintained as much as possible. Exhaustion stage long lasting stress could exhaust hormone reserves so much that the body would be able to maintain its resistance. At this stage, stress-related illnesses such as high blood pressure, ulcers, and mental health problems may manifest themselves.

Explain that stress is associated with illness and is thought to have a negative effect on the immune system. Brief procedure, findings and 2 criticisms of two research studies examining the relationship between stress and immune system functioning (e.g. Kiecolt-Glaser et al medical students, Cohen cold virus) Blood samples taken from first year med students one month before exams, on the day of exams they were analysed for lymphocyte activity. Questionnaires were also given assessing psychiatric symptoms, loneliness and life events. FINDINGS: natural killer cell activity had reduced. Immune response was weakest in those who scored high on the questionnaires.

Kiecolt-Glaser found support for their conclusions in carers of people with Alzheimers disease and in women going through divorce.

Cohen showed that couples in conflict that had lasted for more than a month were especially vulnerable to succumbing to infection when exposed to infectious agent. Kiecolt-Glaser supported the idea that the immune responses are reduced by showing that blisters on the arms of couples healed more slowly after conflicting discussions compared to after supportive ones.

Kiecolt-Glaser et al. found that long term care on a dependent relative was associated with lower levels of killer cell activity and poor resistance to viral infection in caregivers compared with matched non-caregivers.

Explain why stress appears to have a negative impact on the immune system by discussing the role of cortisol. Directly Indirectly Reduces the bodys ability to fight illness. leads the individual to adopt an unhealthy Cortisol and immunosuppression stress lifestyle e.g. increased smoking and drinking , impairs the immune system as cortisol directly lack of sleep, poor diet, less exercise etc. supresses the immune system. Cortisol decrease the production of cells that identify and destroy foreign bodies (such as viruses) Endocrine system and immunosuppression the link between stress and illness may be due to the effect of endorphins. Endorphins are the bodys natural painkillers released at times of pain and anxiety. These decrease pain but also suppress the activity in immune system. Include another study e.g. Kiecolt-Glaser et al on wound healing in carers. Procedure: female caregivers looking after a relative with Alzheimers disease and control group who were matched in age and family income. Caregivers scored higher on stress scale. Punch biopsies in forearm. o FINDINGS: caregivers took 48.7 days to heal whereas the non-caregivers took 39.3. caregivers has larger wounds.

Include Evans et al to show how acute stress can have a positive impact so the effect of stress depends on the type of stressor. Evans et al looked at the activity of one particular antibody, sigA which coats the mucous surfaces of the mouth, lungs and stomach and helps prevent infection. They arranged for students to give talks to other students (mild but acute stress). These students showed an increase in sigA, whereas levels of sigA decreased during examination periods that stretched over several weeks. Evan et al propose that stress appears to have two effects on the immune system: up-regulation for very short term acute stress and down regulation for chronic stress. This fits with the SAM/HPA distinction and the essence of the GAS model.