Stress

In the acute stress response, which pathway is activated first to produce the rapid 'fight or flight' reaction?

• AThe hypothalamic-pituitary-adrenal (HPA) axis releasing cortisol
• BThe parasympathetic branch releasing acetylcholine to calm the body
• CThe sympathomedullary pathway (SAM), via the sympathetic nervous system and adrenal medulla releasing adrenaline✓
• DThe pituitary gland releasing growth hormone

Answer: Acute stressors trigger the sympathomedullary (SAM) pathway: the sympathetic branch of the autonomic nervous system stimulates the adrenal medulla to release adrenaline (and noradrenaline), producing the rapid fight-or-flight changes. The HPA axis governs the slower, chronic response.

Which sequence correctly describes the pituitary-adrenal (HPA) response to chronic stress?

• AAdrenal medulla to ACTH to hypothalamus to cortisol
• BPituitary releases adrenaline, which stimulates the hypothalamus to release CRH
• CAdrenal cortex releases CRH, which triggers the pituitary to release noradrenaline
• DHypothalamus releases CRH, which stimulates the anterior pituitary to release ACTH, which stimulates the adrenal cortex to release cortisol✓

Answer: In the HPA axis the hypothalamus secretes CRH, prompting the anterior pituitary to release ACTH, which acts on the adrenal cortex to release cortisol. Cortisol then feeds back to regulate the system. The other options scramble the glands and hormones.

Prolonged elevation of cortisol during chronic stress is associated with which effect relevant to health?

• AEnhanced immune function and faster wound healing
• BSuppression of the immune system, increasing vulnerability to illness✓
• CPermanent removal of the fight-or-flight response
• DIncreased production of adrenaline by the pituitary

Answer: Chronically high cortisol suppresses immune activity (e.g. reducing the action of lymphocytes), leaving the individual more susceptible to infection and illness. Short-term cortisol can mobilise resources, but sustained elevation is immunosuppressive.

Kiecolt-Glaser et al.'s (1984) study of medical students taking exams supported a link between stress and the immune system because:

• ANatural killer cell activity was higher during the exam period than a month before
• BCortisol had no measurable effect on immune cells
• CNatural killer cell activity was lower in the high-stress exam period than in a lower-stress baseline taken a month earlier✓
• DOnly participants with Type B personality showed immune change

Answer: Kiecolt-Glaser et al. found natural killer (NK) cell activity was significantly reduced during the stressful examination period compared with a baseline sample taken about a month earlier. This natural-experiment evidence indicates that acute stress can lower immune functioning.

Holmes and Rahe's Social Readjustment Rating Scale (SRRS) measures stress from life changes using which unit?

• ALife change units (LCUs)✓
• BDaily hassles points
• CGalvanic skin response scores
• DCortisol micrograms per decilitre

Answer: The SRRS rates 43 life events in life change units (LCUs), with higher totals reflecting greater required readjustment and higher predicted stress-related illness risk. Daily hassles are measured by a different scale, and the other options are physiological measures, not the SRRS.

What is the central claim of the 'daily hassles' approach to sources of stress?

• AOnly major catastrophic life events cause stress-related illness
• BHassles reduce stress by distracting people from larger problems
• CThe minor, everyday irritations and demands of daily life accumulate and can be a better predictor of stress and ill health than major life events✓
• DHassles only matter for people over the age of 65

Answer: The daily hassles approach (e.g. Kanner et al.) argues that accumulated minor stressors of everyday life have a measurable, often greater, impact on wellbeing than infrequent major life events, with uplifts potentially buffering their effect.

Marmot et al.'s Whitehall studies of British civil servants found that workplace stress and cardiovascular risk were most strongly linked to:

• AHigh job demands alone, regardless of seniority
• BWorking too few hours per week
• CHaving a Type B personality
• DLow job control (low decision latitude), with lower-grade staff showing higher illness rates✓

Answer: The Whitehall research found that lower-status civil servants, who had less control (low decision latitude) over their work, had higher rates of stress-related cardiovascular disease. Low job control, rather than demand by itself, was the key factor in this job-strain model.

Friedman and Rosenman characterised the Type A behaviour pattern, linked to coronary heart disease, as involving:

• ARelaxed, patient and easy-going behaviour
• BCompetitiveness, time urgency and hostility✓
• CHigh openness and creativity
• DLow arousal and indifference to deadlines

Answer: Friedman and Rosenman described Type A individuals as competitive, hostile and time-pressured; their large prospective study linked this pattern to a raised risk of coronary heart disease. Type B individuals are the relaxed, easy-going contrast. Hostility is now seen as the most cardiotoxic component.

Kobasa's concept of 'hardiness' as a moderator of stress comprises which three components?

• ACortisol, adrenaline and ACTH
• BCommitment, challenge and control (the 3 Cs)✓
• CCompetitiveness, hostility and urgency
• DCompliance, conformity and obedience

Answer: Kobasa proposed that hardiness, an individual difference buffering the effects of stress, consists of commitment (involvement in life), challenge (seeing change as opportunity) and control (belief in influencing events). The other options confuse hardiness with stress hormones, Type A traits or social-influence terms.

Meichenbaum's Stress Inoculation Training (SIT) is best described as a cognitive-behavioural technique with which three phases?

• AAlarm, resistance and exhaustion
• BPrecontemplation, contemplation and action
• CSensitisation, generalisation and extinction
• DConceptualisation, skills acquisition (and rehearsal), and application (real-life follow-through)✓

Answer: SIT proceeds through conceptualisation (understanding the stressor), skills acquisition and rehearsal (learning and practising coping strategies such as positive self-talk and relaxation), and application/follow-through (using the skills in real situations). 'Alarm, resistance, exhaustion' are Selye's GAS stages, not SIT.