PSY240H5 Chapter Notes - Chapter 5: Posttraumatic Stress Disorder, Acute Stress Reaction, Pre-Medical

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Published on 29 Nov 2011
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CHAPTER 5: STRESS AND ADJUSTMENT DISORDERS
WHAT IS STRESS?
stressors – refer to adjustive demands and the effect the create is called stress
Axis IV scale is particularly useful in relation to 3 Axis I categories: adjustment
disorder, acute stress disorder and posttraumatic stress disorder
Categories of Stressors
3 categories – frustrations, conflicts and pressures
Frustrations
a wide range of obstacles, both external and internal can lead to frustration
can stem from the env. – ex. death of a loved one, discrimination, etc.
can be based on personal limitations – ex. loneliness, physical handicaps, etc.
often leads to a self-devaluation, making one feel that he/she has failed in some
way/is somehow incompetent
Conflicts
often stress results from simultaneous occurrence of 2/more incompatible
needs/motives
3 types
oapproach-avoidance conflicts
odouble-approach conflicts
odouble-avoidance conflicts
various combos of the above are possible as well
Pressure
pressures to achieve specific goals/to behave in particular ways
pressures force us to speed up, redouble our effort, or change the direction of goal-
oriented behaviour, which can cause stress
can originate from external/internal sources
Case Study Dejected Premed Student
premed student received rejection letters
felt depressed
conflict – over what his next steps should be
pressure – from family and friends to try again
frustration over his failure
this shows that a situation can involve all 3 types of stressors
Factors Predisposing a Person to Stress
The Nature of the Stressor
the longer a stress occurs, the more severe its effects
stressors often appear to have a cumulative effect
research reveals that 1/3rd of Canadian workers feel quite a bit/extremely stressed
most days at work
oshift workers more likely than regular schedule workers to regard their jobs as
stressful
encountering several stressors at the same time as opposed to separately has a bigger
impact
symptoms of stress intensify when a person is more closely involved in an
immediately traumatic situation
study – of children’s symptoms and behaviour one month after a shooting in
schoolyard
oone child killed, several wounded
odepending on where the children were during the shooting, they experienced
diff. stress level (most severe for those closest and those who weren’t at
school experienced no symptoms)
The Experience of Crisis
crisis – refers to times when a stressful situation approaches/exceeds the adaptive
capacities of a person/group
ocan occur as a result of:
natural disaster
aftermath of an injury/disease that forces difficult readjustments in a
person’s self concept and way of life
outcome of such crises has a profound influence on a person’s subsequent adjustment
oespecially if crisis impairs person’s ability to cope b/c of an expectation of
failure
ounless the person has developed a new method of coping such as joining a
support group
crisis intervention – providing psychological help in times of severe and special
stress – has been widely used
Life Changes
even pos. life changes can be stressful
Social Readjustment Rating Scale
oobjective way to measure cumulative stress that a person has been exposed to
over time
omeasures life stress in terms of life change units (LCU)
odeath of a spouse = 100 LCU, divorce = 73 LCU, vacation = 13 LCU
criticism of life event scales in the assessment of stress due to
oitems selected for diff scales
osubjectivity of scoring
ofailure to take into account relevance of items for the populations studied
oreliance on subject’s memory of events
omany of the scales measure chronic probs rather than reaction to specific
events
omood can affect the scale’s rating of how stressful something is
odo not provide useful info about specific types of disorders
another approach to the assessment of significant life events
oLife Event and Difficulty Schedule
involves a semistructured interview
possible to assess the meaning of the event to the individual more
direcly
labour intensive and costly
results considered more reliable than other life event approaches’
A Person’s Perception of the Stressor
diff ppl perceive (appraise) situations differently
2 types of appraisals when evaluating environmental events
oprimary appraisal – is this a threat?
osecondary appraisal – can I cope?
research shows that it is not simply poverty that is stressful but also who the person
appraises the situation
often new adjustive demands that have not been anticipated (and for which no ready
made coping strategies are available) will place a person under severe stress
understanding the nature of a stressful situation, preparing for it and knowing how
long it will last all lessen the severity of the 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 somewhat and make
adjustment easier
some theorists have pointed out that trauma always leaves the person transformed in
some way and that one natural outcome of the stress process is adaptation and growth
study – found that one’s ability to perceive some benefit in adapting to the
consequences of a disaster depended in part on the nature of the disaster
The Individual’s Stress Tolerance
children are particularly vulnerable to severe stressors
people who are generally unsure of their adequacy and self worth are much more
likely to experience threat than those who feel confident and secure
stress tolerance – person’s ability to withstand stress w/o being seriously impaired
study – suggests that stress tolerance is due to a combination of genetic factors and
environmental experiences
A Lack of External Resources and Social Supports
pos. social and family relationships can moderate the effects of stress on a person
lack of external resources and social supports can make a stressor more potent and
weaken a person’s capacity to cope with it
nationwide survey of stressful life events in mainland China found that probs w/
interpersonal relationships were the most commonly reported stressors in daily life
a person may be adversely affected by family members who are experiencing probs
often a culture offers specific rituals/courses of action that support people as they
attempt to deal with certain types of stress such as the loss of a loved one
Coping with Stress
sometimes inner factors such as a person’s frame of reference, motives, competencies
or stress tolerance play the dominant role in determine his/her coping strategies
at other times environmental conditions are of primary importance
any stress reaction involves the interplay of inner strategies and outer conditions