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Lecture 6

Lecture 6 For those of you who missed class, these notes have all the lecture slides and my own notes taken integrated together in one neat word document. Great for last minute studying!

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University of Toronto Mississauga
Ayesha Khan

Chapter 5: Stress and Adjustment Disorders What Is Stress?  Stress refers to both o The adjustive demands  Regular stressors (ex. Getting to class on time, any change in your life that’s important to you)  “Adjusting” your behaviour o Internal responses to such demands  Biological/physiological  Psychological  Stress is a by-product of poor or inadequate coping o Too much stress = a by-product of poor/inadequate coping o Don’t have enough skills to curve what’s happening internally  Both eustress and distress tax a person’s coping skills o Eustress: positive stress, ex. associated w/ starting a new job, wedding planning, vacation, we need stress in our life to make us function o Distress: negative stress, ex. Associated w/ losing a loved one, relationship troubles, etc, This is typically what we think of when we say stress. Categories of Stressors  Frustrations o Arise when we have a certain set of obstacles in the way o Normal aspect of everyone’s life  Conflicts: simultaneous needs that have to be resolved  Approach-avoidance o A strong tendency to approach the goal, but at the same time avoid the goal. o Ex. You have a great job but your ex is working at the same company  Double-approach conflicts o Two desirable goals o Ex. You get into two really good med schools and have to pick one.  Double-avoidance conflicts o Not a win-win situation any way you look at it o Ex. The only job available is crappy AND your ex is there  Pressures o Forces you to work, change the direction you’re heading in, move things forward o Not all pressures, conflicts, stressors are bad, we NEED them to get us going o It’s the extent of the stress Factors Predisposing a Person to Stress  Nature of the stressor: o Characterize the stressor. Is it chronic/constant? Or is it just associated with a single event? Short term stress? How many stressors do you have at one time?  The experience of crisis: o Crisis = the ultimate form of stress, when it exceeds your coping/adaptive ability to handle.  Life Changes: o Everything that gets you to change your behaviour = a stressor, could be good or bad. o Ex. Getting married, starting university  Perception of Stress: o We all deal w/ challenges differently.  Tolerance: Chapter 5: Stress and Adjustment Disorders o How much you can handle.  Lack of external resources and social supports: o The one friend that helps you with stress. Ex. Alexis! Life Changes  Social Readjustment Rating Scale o Cumulative stress o Life change units (LCU)  Number that is calculated o LCU: death of a spouse >> divorce o LCU: 300 or more (major illness)  high number=very risky/dangerous  Impact of Event Scale o Better than ^, more thorough and look at the stressor and try to relate symptoms o Identification of the stressor o Stress-related symptoms  Sometimes these scales ignore the acute stressors, tend to focus on chronic/ongoing changes. o Critics of stress: o Assess how anxiety affects stress, pay attn to person’s memory Coping with Stress Three interacting levels: 1. Biological o Body has ability to deal with stressful situations o Fight/flight internal/intrinsic ways of dealing o Rest/digest slowing down to help recover 2. Psychological o Social support at a psychological level 3. Sociocultural o Institutional societys set up to help us deal w/ stress o Ex. Religion, police A task-oriented response involves  Making changes in one’s self, one’s surrounding, or both  Overt (everyone can see) or covert (talking to yourself, thinking in your mind) action  Retreating, attacking, or compromising A defense-oriented response may involve  Protecting yourself  Psychological damage repair mechanisms o Ex. Crying (letting it all out), repetitive talking  Ego-defense mechanisms o Ex. Depression, repression, denial, etc! The Effects of Severe Stress • Extreme or prolonged stress can bring about extensive physical and psychological problems – Stress can affect the sympathetic nervous system • Fight/flight responses – Stress can affect the immune system Chapter 5: Stress and Adjustment Disorders • When you stressed, you get sick. The effects of severe stress include:  Lowered efficacy o Ability to handle things goes down  Depletion of adaptive resources o Physically not there  Wear and tear on the biological system o Don’t have the same kind of energy  Severe personality and physical deterioration  Death  What happens when you have chronic stress in your life?  Changes of function in time (ex. Wearing pjs to class)  wear and tear in your life Homeostasis  a “balanced” state when basic biological needs are being met o Body will always try to bring you back to state of normality  do we really??  Allostasis o the process of adaptation or achieving stability through change o Allostatic load results in wear and tear on the body  occurs when we experience the stress o Adrenaline released when faced with a situation General Adaptation Syndrome Personality decompensation appears to involve the following biological responses:  Alarm and mobilization o Allostatic load  Resistance o Maximum amount body can handle  Exhaustion o When the stress is beyond the point of resistance Phase 1: resistance starts to build up, getting what you need to get up Phase 2: there’s a max amount, shouldn’t be here, most of us don’t get to this stage Phase 3: period of exhaustion, normal level or resistance drops, crisis mode/leads to premature death  physiological systems are failing Chapter 5: Stress and Adjustment Disorders Stress and Physiology  “Fight or flight” o Increased heart rate & blood flow o Pupils dilate o Skin constricts o Blood sugar increases  After our SNS (sympathetic NS) is activated and is biologically ready for physical combat, what happens after the threat vanishes? o What happens after we go through the exhaustic stage? o Depends on how we handle the stress Adjustment Disorder: Reactions to Common Life Stressors  A person is said to have an adjustment disorder if the person’s response to a common stressor o Is maladaptive
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