Maria is a 21-year-old single mother. On the way to work, she drops off her 3-EEyear-old daughter at ...

Psychological stress is a contributing factor to the development of physical illness. While the exact mechanisms are not known, immune suppression is a result of a series of endocrine-immunological interactions that include the following:
Hormone receptors on lymphocytes: suppression of lymphocyte activity occurs under the influence of a variety of CNS-controlled hormones.
Catecholamine release: the SNS innervates lymph nodes, thymus, and spleen. A synergistic relationship between epinephrine, CRF, and cortisol act to suppress the function of lymphatic structures.
Alteration of T-cell production: stress hormones stimulate the proliferation of particular subtypes of T-lymphocyte helper cells. This creates a physiologically altered immune response.

Conditioning factors contribute to an individual's response to a stressor. Some factors affecting Maria's ability to cope might include the following suggestions:
Time: students might identify the illness of her daughter, loss of sleep, and lack of food within a short length of time to be factors in Maria's adaptive abilities.
Age: it may be indicated by some students that she is a young mother and therefore less able to cope with daily stressors
Nutrition: there is indication that food security has been a problem in the household.
Sleep-wake cycles: decreased sleep disrupts both immunologic and psychological functioning.
Hardiness: while not addressed specifically in the case study, some students may suggest that Maria's sense of control of her life is limited by her circumstances.
Psychosocial factors: social support mechanisms and personal relationships are limited in this situation.

The individual with posttraumatic stress disorder presents with the following triad:
Intrusion: flashbacks and nightmares recounting the traumatic event
Avoidance: emotional numbing and withdrawal from relationships. There are also feelings of guilt and depression following the event.
Hyperarousal: There is increased emotional irritability, anxiety, decreased concentration, hypervigilance, and strong concern for safety. The patient will also demonstrate sleeping difficulties and an increased startle reflex.