Stress
what is cortisol?
a glucocorticoid hormone
what is hypochondriasis?
Excessive worry about illness
what is somatisation?
Physical expression of emotional distress
state a personality factor that can increase risk of addiction?
Those who are:
- Thrill seeking
- Impulsive
- Lack of self control
What neurotransmitter plays a role in addiction to substances?
dopamine
How can stress affect existing physical illness?
Relapse of condition, poor control/management of illness.
Name some common presentations of medically unexplained symptoms?
Chronic fatigue
Chest, pelvic, muscle, joint, abdominal and facial pain
Headaches and palpitations
What are MUS?
Physical symptoms not explained by organic disease, which cause distress and impair function. There must be evidence/strong assumptions that the symptoms are linked to psychological factors, like stress.
2 ways alcohol can negatively impact an individual?
Absences: Results in more sick leave
Work accidents: In Great Britain, up to 25% of workplace accidents and around 60% of fatal accidents at work may be linked to alcohol
Productivity: Heavy drinking at work may reduce productivity
Unemployment: Heavy drinking or alcohol abuse may lead to unemployment
addiction vs dependence?
Addiction is a mental/behavioural disorder characterised by continued repetition of a behaviour despite adverse consequences, whereas dependence is the presence of symptoms of tolerance/withdrawal
name 3 coping mechanisms for stress?
1. appraisal-focused (adaptive cognitive) - changing the way you think
2. problem-focused (adaptive behavioural)
3. emotion-focused
4. occupation-focused coping
What are 3 ways of diagnosing MUS?
Symptoms don’t fit known disease models
patient is unable to give a clear description of symptoms
Physical problems related to stressful life events
patient s are overly anxious → feel pain in multiple locations and have multiple symptoms
Outline a reason that make people more vulnerable to MUS?
Reinforcement and modelling in childhood - For example, if your mother only pays attention to you when you’re ill or in pain, then having physical symptoms becomes a way for you to gain support.
Briefly describe neurobiology of alcohol dependence
Increased effect on GABA receptors, resulting in suppression of the CNS. Leads to reduced anxiety and induces a euphoric feeling.
3 stages of addiction?
- preoccupation/anticipation
- binge/intoxication
- withdrawal/negative affect.
what can stress lead to?
panic attacks
problems sleeping
Stress can lead to structural changes to the heart.
Stress can lead to depression.
Stress can affect pre-existing physical illness.
What are some reasons for people to present with MUS?
Reduces the stigma of having mental illness
Adopt the sick role and the lack of responsibility that comes with it.
A way to release internal emotional conflict/distress
What factors affect how people respond to stress?
Mental state, childhood trauma or abuse, prior experience of illness and personality temperament.
3 criteria stated on ICD 11 for alcohol dependence (requires at least 2)?
- impaired control over alcohol use
- increasing precedence of alcohol use over other areas of life e.g maintenance of health, exercise, hobbies despite occurrence of harm to health
- physiological features indicative of neuroadaptation e.g tolerance, withdrawal
3 principles of Motivational interviewing
Any of:
- Expressing empathy through reflective learning
- Develop discrepancy through client’s goals and their current behaviour
- Avoid argument and direct confrontation
- Adjust to client resistance rather than opposing it directly
- Support self-efficacy and optimism
describe long term stress
Cerebral cortex → hypothalamus → pituitary gland → adrenal cortex → glucocorticoids such as cortisol.
Name 4 ways in which you can manage MUS?
Explanation is the key
Symptoms management - analgesics (non-opioids), laxatives, antispasmodics, exercise, acupuncture and physiotherapy.
Psychotherapist - attention is directed away from the symptoms to the problem that has provoked the MUS.
Promote self-efficacy
Initiate treatment for depression/anxiety if present
describe short term stress
Cerebral cortex → hypothalamus → activation of the sympathetic nervous system →adrenal medulla → catecholamines
The 6 stages of the states of change model
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Termination/relapse
Name 4 commonalities in addiction
Salience (prominent in life)
Mood modification (usually negative)
Tolerance
Withdrawal
Conflict: Neglect of other activities
Relapse