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PSYC*3390 Ch 5.doc

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University of Guelph
PSYC 3390
Mary Manson

Thursday, October 4, 2012 Chapter 5: Stress and Adjustment Disorders What Is Stress? - adjustive demands placed on an organism and to the organism’s internal biological and psychological response to such demands Stressors - adjustive demands and the effect they create within an organism is stress Coping Strategies - efforts to deal with stress - stress is a by-product of poor and inadequate coping Eustress - positive stress (wedding) Distress - negative stress (funeral) - the DSM-IV has 3 Axis I categories: adjustment disorder, acute stress disorder, and posttraumatic stress disorder - these disorders involve patterns of physiological and behavioural disturbances that oc- cur in response to identifiable stressors - the key differences among them lie in the severity of the disturbances but also the na- ture of the stressors and the time frame during which they occur - stressors supposedly can be identified as causal factors and specified on Axis IV Categories of Stressors - 3 basic categories: 1. Frustrations - obstacles both external and internal - environmental = prejudice and discrimination, death of a loved one - personal limitations = physical handicaps, limited ability to perform tasks, loneliness - often lead to self-devaluation, making the person feel like a failure and incompetent 2. Conflicts - simultaneous occurrence of 2 or more incompatible needs or motives - conflicts may be approach-avoidance (approach and avoid the same goal), double-ap- proach (choosing between 2 or more desirable goals), and double-avoidance (choices are between undesirable alternatives) 3. Pressures - pressures to achieve specific goals or to behave in particular ways - pressures force us to speed up, redouble our effect, or change the direction of goal-ori- ented behaviour, which can seriously tax our coping resources or even lead to maladap- tive behaviour Thursday, October 4, 2012 - pressure can originate from both external and internal sources Factors Predisposing a Person to Stress - the severity of stress is gauged by the degree to which it disrupts functioning - depends on the stressors characteristics, a person’s resources for meeting Th. de- mands and the relationship between the 2 The Nature of the Stressor - stressors that involve important aspects of a person’s life (death of a loved one, di- vorce, a job loss, or a serious illness) tend to be highly stressful for more people - the longer a stressor operates, the more severe its effects - stressors often appear to have a cumulative effect - sometimes key stressors centre on a continuing difficult life situation, these stressors are considered chronic - 1/3 of Canadian workers feel “quite a bit” or “extremely” stressed most days at work - shift workers especially regard their jobs as highly stressful - when stressors occur at the same time, the stress will be more severe than if they oc- curred separately - the symptoms of stress intensify when a person is more closely involved in an immedi- ate traumatic situation The Experience of Crisis - crisis refers to times when a stressful situation approaches or exceeds the adaptive ca- pacities of a person or group - if the crisis leads to a person to develop an effective new method of coping they they may emerge even better adjusted than before - but if the crisis impairs the person’s ability to cope with similar stressors in the future because of an expectation of failure, then his or her overall adjustment will suffer Life Changes - life changes (good or bad) place new demands on us and may be stressful - our psychosocial environments can play a significant role in causing disorders or pre- cipitating their onset, even in strongly biological disorders like bipolar - the Social Readjustment Rating Scale is an objective method for measuring the cumu- lative stress to which a person that has been exposed over a period of time - this scale measures life stress in terms of life change units (LCU) - death rates 100, divorce rates 73 and vacation rates 13 - people with LCU scores of 300 or more for recent months were at significant risk for getting a major illness within the next 2 years Thursday, October 4, 2012 - the Impact of Event Scale measures a persons reaction to a stressful situation by first identifying the stressor and then posing a series of questions to determine symptoms - there have been criticisms of both methods such as the items selected for different scales, the subjectivity of the scoring, the failure to take into account the relevance of items for the populations studied and the relevance on subjects’ memory of events - another limitation is that many of the life event scales measure chronic problems rather than reactions to specific environmental events - most problematic aspect is that they serve only as a general indicator of distress and do not provide useful information about specific types of disorders - another approach involves a semistructured interview that places the life event rating variables in a clearly defined context in order to increase interrater reliability A Person’s Perception of the Stressor - the different reactions people have to environmental stress has to do in part with the way they perceive (appraise) the situation - there are 2 types of appraisals: primary appraisal (is this a threat) and secondary ap- praisal (can I cope) - new adjustive demands that have not been anticipated will place a person under se- vere stress - perceiving some benefit from a disaster, such as growing closer to your family because of a tragedy, can moderate the effects of a trauma - trauma always leaves a person transformed in some way and one natural outcome of the stress process is adaptation and growth The Individual’s Stress Tolerance - people who do not handle changing life circumstances well may be particularly vulner- able to the slightest frustration or pressure - stress tolerance refers to a person’s ability to withstand stress without becoming seri- ously impaired - early traumatic experiences can leave a person especially vulnerable to or especially well equipped to handle certain stressors A Lack of External Resources and Social Supports - positive social and family relationships can moderate the effects of stress on a person - lack of external supports can make a stressor more potent - men who lose a spouse are often more depressed than women who had done so - the reason why is unclear but it could be that women have a closer network of friends Coping with Stress Thursday, October 4, 2012 - inner factors such as a person’s far-off reference, motives, competencies or stress tol- erance play a dominant role in coping strategies - some people create stress rather than coping (intensified beliefs/interpretations) - there are 3 interacting levels of coping with stress: (1) biological level, there are im- munological defences and damage-repair mechanisms (2) on a psychological and inter- personal level, there are learned coping patterns, self-defences, and support from family and friends (3) on a sociocultural level, there are group resources such as labour unions, religious organizations and law enforcement agencies - the failure of coping on any of these levels may increase a person’s vulnerability - in coping with stress, a person is faced with 2 challenges: (1) meeting the require- ments of the stressor and (2) protecting himself or herself from psychological or physical damage and disorganization Task-Oriented Coping - a task-oriented response may involve making changes in one’s self, one’s surround- ings, or both, depending on the situation - e.g. showing a spouse more affection, lowering one’s level of aspiration - action may involve retreating from the problem, attacking it directly, or trying to find a workable compromise Defence-Oriented Coping - defence-oriented response occurs when a person’s feeling of adequacy are seriously threatened by a stressor, behaviour is directed at protecting oneself rather than resolv- ing the situation - there are 2 common types of defence-oriented responses: (1) responses such as cry- ing, repetitive talking and mourning that seem to function as psychological damage-re- pair mechanisms and (2) ego-defence or self-defence mechanisms such as denial and repression - relieve tension and anxiety and protect form hurt and devaluation - ego-defence mechanisms protect themselves in the following ways: (1) by denying, distorting, or restricting a person’s experience, (2) by reducing emotional or self-involve- ment and/or (3) by counteracting threat or damage - defence mechanisms are used in combination and also with task-oriented behaviour - Greve and Strobl view adaptation to stressors in terms of 3 models: defensive, proac- tive (task-oriented) and accommodative reactions (re-evaluate the situation) The Effects of Severe Stress - when stressors are sustained or severe, a person may experience a lowering of adap- tive functioning which is called personality or psychological decompensation Thursday, October 4, 2012 - stress can be damaging if certain demands are too severe for our coping resources or if we believe they are and act as though they are - severe stress can cause lowered efficiency, depletion of adaptive resources, wear and tear on the biological system, and severe personality and physical deterioration - when an organism is stressed, it is thrown out of homeostatic balance - another phenomenon is Allostasis - the process of adaptation or achieving stability through change - in order to deal with stress the body activates adrenaline, but under prolonged stress these body systems are activated on a continuing basis and fail to shut down - the frequent mobilization of these systems under stress is the Allostatic Load - sustained stress can lower biological resistance to disease - prolonged stress may lead either to pathological overresponsiveness (the last straw) or pathological insensitive to stressors (loss of hope, extreme apathy) Biological Effects of Stress General Adaptation Syndrome - the body’s reaction to sustained and excessive stress typically occurs in 3 major phases: (1) an alarm reaction, the body’s defensive forces are activated by the autonomic nervous system, (2) a stage of resistance, biological adaptation is at the maximal level in terms of bodily resources used, and (3) exhaustion, bodily resources are depleted and the organism loses its ability to resist Stress and the Sympathetic Nervous System - when an organism is faced with danger, the sympathetic nervous system discharges adrenaline to prepare the organism for “flight or fight” as follow: (1) the heart rate and blood flow (and blood pressure) to the large muscles increase to provide the organism with the capability of reacting to physical threats (2) the pupils dilate so that more light enters the eye (3) the skin constructs to limit blood loss in the event of energy (4) blood sugar increases to provide more ready energy - our biology is more geared to escape wild animals than modern-day activities - once the stress response has been activated over long period or in an extreme man- ner, it becomes more difficult to return to homeostasis - any employment of the stress response inflicts a degree of wear and tear on the body - each exposure leave an indelible scar, in that it uses up reserves of adaptability which cannot be replaced - rest can restore us to ALMOST the original level of fitness - even a minute deficit of adaptation every day adds up to what we call aging Stress and the Immune System Thursday, October 4, 2012 - stress can also act through the hypothalamus-pituitary-adrenal glands to produce a se- rious endocrine imbalance that takes a major toll on a person’s immune system - the hypothalamus releases hormones that stimulate the pituitary to release other hor- mones that regulate many bodily functions such as tissue and bone growth - stress can result in suppression of the immune system, making people vulnerable to diseases to which they would normally be immune - psychneuroimmunology focuses on the effects of stressors on the immune system - the organs and cells associated with the immune system provide the body’s major de- fence against foreign organisms and other potential dangers Psychological Effects of Long-Term Stress 1. Alarm and Mobilization - first a person’s resources for coping with trauma are alerted and mobilized - anxiety, tension, emotional arousal 2. Resistance - if trauma continues, a person is often able to find some means of deal- ing with it and thus to maintain some adjustment to life - resistance may be achieved temporarily by concerted, task-oriented coping measures 3.
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