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Title: You make me sick! - or is it my hormones?

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Assignment Goals
Source Material
Student Instructions
Guiding Questions
Writing Prompt
Calibrations, Average Word Count, and Answer Keys

Assignment Goals

This activity requires you to apply the following concepts in thinking about the consequences of issues such as social isolation, exam stress, and child abuse:

This goal will be achieved by reading primary research abstracts. Study the abstracts to extract commonalities, to make recommendations, and to identify unresolved questions.

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Source Material

Abstracts of primary research articles provide data that relates stressors to hormone responses. These abstracts are available through PubMed. (Click on each title to link to the abstract)

Relate the knowledge gained through assigned readings and classroom lecture materials to the data in these abstracts.

A glossary of terms used in the last two abstracts is available under Source Material Resources.

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Source Material Resources:
Human Physiology, by Silverthorn - This links to search engines for more information on hormones.
URL: http://cw.prenhall.com/silverthorn/chapter7/deluxe.html
Glossary for abstracts - assignment resource
URL: http://cpr.molsci.ucla.edu/cpr/data/institutions/300010/001001400288/003004500585/perm/resources/res3/file/Glossarystress.doc
limbic system - Figure 9-9, Human Physiology by Silverthorn
URL: http://cpr.molsci.ucla.edu/cpr/data/institutions/300010/001001400288/003004500585/perm/resources/res4/file/Fg09_09.gif
hypothalamus and pituitary - Figure 9-7, Human Physiology by Silverthorn
URL: http://cpr.molsci.ucla.edu/cpr/data/institutions/300010/001001400288/003004500585/perm/resources/res5/file/Fg09_07.gif

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Student Instructions

A variety of disease states are associated with hypersecretion or hyposecretion of hormones. Changes can result from abnormal hormone release or they can result from abnormal target tissue response. We frequently know about changes that correlate with disease long before we can identify the precise cause and effect relationships.

Many people believe that social problems such as stress and abuse put them at greater risk for disease and infections. (Justifying the response, "You make me sick!") Some current research supports the hypothesis that altered activity of the hypothalamic-pituitary-adrenal axis links stress to immunosuppression, yet more research is needed. It is difficult to perform experiments on humans, so scientists assume that many of the hormones that are active in humans are also found in other vertebrate animals and the experiments are performed on animals.

This assignment requires you to read some current research on both humans and animals to find out what we know so that you can then make recommendations for future research.

Start by using your assigned readings and class lecture materials to learn about the hormone activity of the hypothalamic-pituitary-adrenal axis. The diagram of the relationships between these hormone responses, Figure 7-15 on p. 190 in your textbook, may be helpful.

Study the primary research abstracts listed under Source Materials. Make a list of hormone responses to stress that are reported in each of the research abstracts. The abstracts agree on some of the hormone responses, but for other hormones, there is disagreement.

Finally, use the Guiding Questions to organize your ideas. Then write a paragraph to explain what we know, list the points of disagreement, and state your recommendation for a future research project.

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Guiding Questions

For full credit, you must address each of the following questions:

  1. What hormone level changes in response to stress?
  2. How does the hypothalamic-pituitary-adrenal axis control the levels of this hormone?
  3. What hormonal or psychobiological changes result as a consequence of this altered hormone level?
  4. How do levels of this hormone correlate with T-lymphocyte proliferation?
  5. Cite specific data from each research abstract to support your statements.
  6. To conclude your paragraph, identify a question about the link between stress and immunosuppression that you think scientists should answer next.

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Writing Prompt

     Write a paragraph explaining to social workers the significance of the glucocorticoid system for their work. Start the paragraph with this value claim (no need to put this item in quotes, because you are being instructed to do this): "For the health of children, social relationships may be more important than socioeconomic status." State why this value claim can be made, and correctly cite a research study whose knowledge claim supports your reason. Qualify the validity of this study by giving its limitations and suggesting what the researchers need to do to make their knowledge claim more applicable to our society. Then, explain the role of the glucocorticoid system. Be sure to include a description of the role of the hypothalamic-pituitary-adrenal axis in the psychobiological response to stress. Compare and contrast the data from primary research paper abstracts. Describe one hormone response to a variety of stress stimuli that has been reported in several studies. Describe other hormone responses to stress stimuli that are reported in some studies, but not others. Describe relationships between these hormone responses. Include all steps and details reviewed by the guiding questions. Conclude with a therapy you might develop for a child, correctly cite the study to justify your recommendations, and identify unresolved issues that should be addressed in future research studies to confirm your suggested therapy.

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Calibrations and Answer Keys

Average Calibration Word Count = 334
High Quality Calibration
Social interactions such as stress and abuse may depress the immune system response that protects us from disease by increasing blood levels of the hormone, cortisol. Flinn and England (1997) showed that unstable family relationships rather than socioeconomic status were more likely to increase cortisol levels and promote illness in children. Their study was limited to a rural village in the Caribbean, so they would need to see if they would get the same results in a place like New York City to make their research more valid. One child from the study was 16-year old Sonya, who lived in improved housing and had a healthful diet. Her father divorced her mother and had a different woman staying over every week. Every time Sonya saw her father with other women her heart would race and she would feel very unsettled over the many years this had been going. She never seemed to get over a nagging cough and flu-like symptoms. Cortisol levels are regulated by the hypothalamic-pituitary-adrenal axis. The hypothalamus releases corticotropin-releasing hormone (CRH) that stimulates the pituitary to release corticotropin (adrenocorticotropic hormone, or ACTH). One target for ACTH is the adrenal cortex, that responds by releasing the "stress" hormone, cortisol. The four abstracts agree in listing hypersecretion of cortisol as a response to stress. Kaufman et al found that depressed abused children release more ACTH in response to a given level of CRH than normal or depressed non-abused children, suggesting that the pituitary of abused children responds differently. Increased ACTH would cause the adrenal cortex to release more cortisol. In contrast, a study in squirrel monkeys shows that isolated monkeys had increased cortisol in spite of reduced ACTH, suggesting that in these monkeys, a difference in the adrenal responsiveness is the cause of high cortisol levels. Another study in cynomolgus monkeys who were made subordinate suggests that increased cortisol requires suppression of negative feedback mechanisms, and may result in ovarian dysfunction and lower fertility. In humans, medical students were found to have increased cortisol levels immediately before a final exam, and they also had lower T lymphocyte proliferation that presumably would affect their immune responses. I think it would be important to identify the signal for increased cortisol levels in response to stress so that we can protect susceptible individuals from reduced fertility and problems with their immune responses in times of stress. Komori et al. (1995) found that citrus fragrance, which they called a comforting stimulus, lowered cortisol levels in depressed patients and improved their immunity. We could give a child a supply of candles with her favorite fragrance and have her enjoy this fragrance whenever she felt particularly distressed. This therapy would decrease infections by lowering cortisol levels. But I think it is important to confirm the link between perceived stress and cortisol, to determine whether there is a cause/effect relationship between increased or decreased CRH and/or ACTH levels and cortisol levels, before we can be confident that our behavioral recommendations have biological consequences.

1. Does the essay have any mechanical errors (that is, mistakes in spelling, grammar, and punctuation)?
None
Some (1 or 2)
Many (more than 2)
Answer: None
Feedback : none
2. Are any ideas disorganized or scattered, or do they jump from one to another in an unconnected manner?
None
Some (1 or 2)
Many (more than 2)
Answer: Some (1 or 2)
Feedback : Social interactions such as stress and abuse may depress the immune system response that protects us from disease by
3. Does the essay waste words by discussing irrelevant material?
None
Some (1 or 2)
Many (more than 2)
Answer: None
Feedback : none
4. Is data from the abstracts used to support conclusions or inferences?

Yes
No

Answer: Yes
Feedback : Social interactions such as stress and abuse may depress the immune system response that protects us from disease by
5. The cortisol level increases in response to stress. Does this essay explain that all the abstracts show an increase in cortisol in response to stress?

Yes
No

Answer: Yes
Feedback : Social interactions such as stress and abuse may depress the immune system response that protects us from disease by
6. The pituitary releases ACTH to control the levels of cortisol. Does this essay explain that the release of ACTH from the pituitary regulates levels of cortisol?

Yes
No

Answer: Yes
Feedback : Social interactions such as stress and abuse may depress the immune system response that protects us from disease by
7. One abstract reports that abused children have increased ACTH. In contrast, another abstract reports that social separation of monkeys causes depressed ACTH levels. Does this essay contrast these ACTH level responses according to both of these studies?

Yes
No

Answer: Yes
Feedback : Social interactions such as stress and abuse may depress the immune system response that protects us from disease by
8. Does this essay list a hormonal or psychobiological change such as infertility or immunosuppression that occurs as a consequence of increased cortisol levels?

Yes
No

Answer: Yes
Feedback : Social interactions such as stress and abuse may depress the immune system response that protects us from disease by
9. Increased cortisol levels correlate with decreased T-lymphocyte proliferation. Does this essay describe this relationship?

Yes
No

Answer: Yes
Feedback : Social interactions such as stress and abuse may depress the immune system response that protects us from disease by
10. This assignment requires students to find ambiguities in the link between stress and immunosuppression. Does this essay identify an unresolved issue that should be addressed in future research studies?

Yes
No

Answer: Yes
Feedback : Social interactions such as stress and abuse may depress the immune system response that protects us from disease by
11. How would you rate this text?
10 Highest
9
8
7
6
5
4
3
2
1 Lowest
Rating: 9
Feedback : none

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Mid Quality Calibration
Two hormones increase in response to stress: cortisol and ACTH. The hypothalamus controls the levels of these hormones by releasing CRH. Stress causes more CRH to release more cortisol from the adrenal glands and more ACTH from the pituitary gland. The four abstracts agree on the fact that stress causes this increase, but the kind of stress used in each case was different. Depressed abused children released more stress hormones than depressed children who were not currently being abused (by marital violence, poverty or emotional abuse, for example). In another experiment, cynomolgus monkeys hypersecreted stress hormones when they spent more time alone and were made subordinate so they received aggression from other monkeys, and these monkeys were depressed. A third study caused depression in squirrel monkeys by isolating and not allowing them companionship with other monkeys. These monkeys were depressed and released more stress hormone when they were removed from social contact. Medical students were like the stressed monkeys and abused children because they had more cortisol before a stressful exam than after activities with moderate stress or after summer vacations and the students had more T-lymphocyte proliferation and one abstract suggests that this means they will be immunosuppressed. Are we really more prone to disease when stressed than not stressed individuals? We also need to know if hormone changes are really similar in monkeys and in humans. Do premature babies that are removed from their mothers to be placed in an incubator have higher levels of stress hormones just like baby monkeys that are taken from their mothers?

1. Does the essay have any mechanical errors (that is, mistakes in spelling, grammar, and punctuation)?
None
Some (1 or 2)
Many (more than 2)
Answer: None
Feedback : none
2. Are any ideas disorganized or scattered, or do they jump from one to another in an unconnected manner?
None
Some (1 or 2)
Many (more than 2)
Answer: None
Feedback : none
3. Does the essay waste words by discussing irrelevant material?
None
Some (1 or 2)
Many (more than 2)
Answer: None
Feedback : none
4. Is data from the abstracts used to support conclusions or inferences?

Yes
No

Answer: Yes
Feedback : Two hormones increase in response to stress: cortisol and ACTH. The hypothalamus controls the levels of these hormones by
5. The cortisol level increases in response to stress. Does this essay explain that all the abstracts show an increase in cortisol in response to stress?

Yes
No

Answer: Yes
Feedback : Two hormones increase in response to stress: cortisol and ACTH. The hypothalamus controls the levels of these hormones by
6. The pituitary releases ACTH to control the levels of cortisol. Does this essay explain that the release of ACTH from the pituitary regulates levels of cortisol?

Yes
No

Answer: No
Feedback : Two hormones increase in response to stress: cortisol and ACTH. The hypothalamus controls the levels of these hormones by
7. One abstract reports that abused children have increased ACTH. In contrast, another abstract reports that social separation of monkeys causes depressed ACTH levels. Does this essay contrast these ACTH level responses according to both of these studies?

Yes
No

Answer: No
Feedback : Two hormones increase in response to stress: cortisol and ACTH. The hypothalamus controls the levels of these hormones by
8. Does this essay list a hormonal or psychobiological change such as infertility or immunosuppression that occurs as a consequence of increased cortisol levels?

Yes
No

Answer: Yes
Feedback : Two hormones increase in response to stress: cortisol and ACTH. The hypothalamus controls the levels of these hormones by
9. Increased cortisol levels correlate with decreased T-lymphocyte proliferation. Does this essay describe this relationship?

Yes
No

Answer: No
Feedback : Two hormones increase in response to stress: cortisol and ACTH. The hypothalamus controls the levels of these hormones by
10. This assignment requires students to find ambiguities in the link between stress and immunosuppression. Does this essay identify an unresolved issue that should be addressed in future research studies?

Yes
No

Answer: Yes
Feedback : Two hormones increase in response to stress: cortisol and ACTH. The hypothalamus controls the levels of these hormones by
11. How would you rate this text?
10 Highest
9
8
7
6
5
4
3
2
1 Lowest
Rating: 6
Feedback : This essay is grammatically correct, but does not display clear unserstanding of the hypothalamic-pituitary-adrenal axis. The statement that stress results in increased CRH release is not supported by data from the abstracts. The essay makes at least two errors showing incorrect relationships between changes in the variables - (1) The essay does NOT state that increased cortisol happens in spite of depressed ACTH in one study, and (2) that lymphocyte proliferation declines with exam stress and increases in cortisol.

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Low Quality Calibration
The hypothalamus, pituitary, and adrenal hormones are out of balance in depressed children with a history of abuse. Thirteen depressed abused children had more corticotropin-releasing hormone (CRH) than 13 depressed nonabused and 13 normal control children. Blood samples had more adrenocorticotropic hormone and (ACTH) and cortisol levels when compared to depressed nonabused and normal control children. Increased hormone secretion was only observed in depressed abused children experiencing ongoing chronic adversity (marital violence, emotional abuse, poverty, lack of supports). The pattern of findings of the depressed abused children experiencing ongoing adversity is just like that reported in animal studies of chronic stress, but I do not believe in testing on animals. It is cruel to subjest monkeys to trauma and adversity that would cause the monkeys to experience depression. I am a vegetarian and I think we should not be experimenting with cynomolgus monkeys or squirrel monkeys, especially if separating monkeys from companionship with other monkeys makes them feel stressed. The brains of monkeys may not even react to stress like human brains, becuase humans can think more clearly about stressful situations, but monkeys do not understand why they are being stressed. I think the next experiment that scientists should do is to see if students just before an exam are stressed just like abused children, and to see how this affects the life and health of the students and of the abused children. All of these studies should be done in humans, and not in animals.

1. Does the essay have any mechanical errors (that is, mistakes in spelling, grammar, and punctuation)?
None
Some (1 or 2)
Many (more than 2)
Answer: Some (1 or 2)
Feedback : The hypothalamus, pituitary, and adrenal hormones are out of balance in depressed children with a history of abuse. Thirteen
2. Are any ideas disorganized or scattered, or do they jump from one to another in an unconnected manner?
None
Some (1 or 2)
Many (more than 2)
Answer: Some (1 or 2)
Feedback : This essay shows plagiarism - some phrases are copied from an abstract.
3. Does the essay waste words by discussing irrelevant material?
None
Some (1 or 2)
Many (more than 2)
Answer: Many (more than 2)
Feedback : The hypothalamus, pituitary, and adrenal hormones are out of balance in depressed children with a history of abuse. Thirteen
4. Is data from the abstracts used to support conclusions or inferences?

Yes
No

Answer: No
Feedback : Only data from one abstract has been included.
5. The cortisol level increases in response to stress. Does this essay explain that all the abstracts show an increase in cortisol in response to stress?

Yes
No

Answer: No
Feedback : Note that only data from one abstract has been used. The hypothalamus, pituitary, and adrenal hormones are out of balance in depressed children with a history of abuse. Thirteen
6. The pituitary releases ACTH to control the levels of cortisol. Does this essay explain that the release of ACTH from the pituitary regulates levels of cortisol?

Yes
No

Answer: No
Feedback : The hypothalamus, pituitary, and adrenal hormones are out of balance in depressed children with a history of abuse. Thirteen
7. One abstract reports that abused children have increased ACTH. In contrast, another abstract reports that social separation of monkeys causes depressed ACTH levels. Does this essay contrast these ACTH level responses according to both of these studies?

Yes
No

Answer: No
Feedback : none
8. Does this essay list a hormonal or psychobiological change such as infertility or immunosuppression that occurs as a consequence of increased cortisol levels?

Yes
No

Answer: No
Feedback : none
9. Increased cortisol levels correlate with decreased T-lymphocyte proliferation. Does this essay describe this relationship?

Yes
No

Answer: No
Feedback : none
10. This assignment requires students to find ambiguities in the link between stress and immunosuppression. Does this essay identify an unresolved issue that should be addressed in future research studies?

Yes
No

Answer: No
Feedback : The hypothalamus, pituitary, and adrenal hormones are out of balance in depressed children with a history of abuse. Thirteen
11. How would you rate this text?
10 Highest
9
8
7
6
5
4
3
2
1 Lowest
Rating: 2
Feedback : This essay does not address all the Guiding Questions. Data used comes only from one of the abstracts.

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