18. Stress and Mental Health Flashcards
describes the dynamic regulatory process that maintains homeostasis through a process of adaptation
allostasis
When is physiologic stability achieved
when the autonomic nervous system, the HPA, CV, metabolic, and immune systems respond to internal and external stimuli
characteristics of acute stress
- reaction to a threatening event
- time limited but can occur repeatedly
- associated w/ the “fight or flight” response
ongoing physiologic reaction to events that results in “wear and tear” on the body and negatively impacts health and well-being; “fight and flight” becomes maladaptive
chronic stress
3 stages of Seyle’s general adaptation syndrome (GAS)
- alarm: threat is perceived and body response physiologicically
- resistance: coping mechanisms are used to try and reestablish homeostasis
- exhaustion: occurs if homeostasis is not achieved
What hormone in excess contributes to dysregulation of the ANS
cortisol
increase in the number of abnormal biological parameters as a consequence of wear and tear on the body and brain
allostatic load
What is allostatic load associated with?
Poor health (greater state of chronic stress)
Allostatic load indicators
- BP
- waist to hip ratios
- Glucose (HgbA1C)
- immune system values (CBC)
- Cortisol and NE levels
What type of people are known to have increased allostatic load
- lower socioeconomic status
- racial & ethnic groups
- older adults
- PTSD
- depression
- suicide
- chronic pain
examples of acute stress
- new challenge
- presentation at work
- intermittent fasting
- running sprints
examples of chronic stress
- annoying boss
- bad work schedule
- difficult spouse
- poor sleep habits
- negative friends
a genetic predisposition increases susceptibility to developing a disorder
diathesis
2 factors that determine if a person experiences a stress response
- person-environment relationship
- appraisal of events
personality: competitive, aggressive, ambitious, impatient, alert, tense, and restless; think, speak, and act at an accelerated pace and reflect time-urgent style of living (increased arousal)
Type A
personality: relaxed, easygoing, and easily satisfied; use problem solving skills for major problems and usually don’t try to accomplish too much at any one time
Type B
personality: introverted, respectful, conforming, compliant, and eager to please; avoid conflict and respond to stress w/ depression and hopelessness
Type C
personality: increased negative emotions (depressed), pessimism, and non sharing of emotions
Type D
consists of linkages among defined set of people with whom an individual has personal contacts
social networks
consists of 6-12 people with whom a person has close contact
Level I social network
consists of a larger number of contacts, generally 30-40 people whom the person sees regularly
Level II social network
consists of a large number of people with whom the person has direct contact such as a cashier or mail man; can represent several hundred people
Level III social network
ideal characteristics for a social network
- fairly dense and interconnected (people connected to each other)
- balance between intense and less intense relationships
- opportunities to give and take from network members
positive interpersonal interactions provided by a social network that varies with new life events and health status
social support
3 functions of social support
- emotional support contributes to person’s feelings of being cared for and loved
- tangible support provides person w/ resources
- Informational support helps person view situation in new way
complex process that includes demands, constraints, resources, and personal goals and beliefs; critical factor is risk of event
appraisal
evaluation of events as a threat, harm, or challenge
primary appraisal
What is determined during primary appraisal
- the goal is relevant
- the goal is consistent w/ his or her values and beliefs
- if a personal commitment is present
explanation of outcome of events; may be blame or credit given for outcome
secondary appraisal
2 parts of a stress response
- physiologic response
- emotional response
emotions that occur when there is a threat to, delay in, or thwarting of a goal or a conflict between goals
negative emotions
examples of negative emotions
- anger
- fright
- anxiety
- guilt
- shame
- sadness
- envy
- jealousy
- disgust
emotions that occur when there is a movement toward or attainment of a goal
positive emotions
examples of positive emotions
- happiness
- pride
- relief
- love
emotional that are somewhat ambiguous
- hope
- compassion
- empathy
- sympathy
- contentment
group of emotional reactions but are too ambiguous to fit into an emotional category
nonemotions
examples of nonemotions
- confidence
- awe
- confusion
- excitement
deliberate planned and psychological activity to manage stressful demands
coping
coping where the person attacks the source of stress and solves the problem; changes the person-environment relationship
problem focused coping
coping where the person reduces the stress by reinterpreting the situation to change its meaning
emotion focused coping
same thing as appraisal but occurs after coping -> provides feedback about the outcomes and allows for continual adjustment to new info
reappraisal
person’s capacity to survive and flourish
adaptation
3 areas affected by adaptation
- healthy coping (or ineffective coping)
- psychological well-being (or unsatisfactory outcomes)
- social functioning (or impaired)
overall goals for nursing management of stress
- resolve stressful person-environment situations
- reduce stress response
- develop positive coping skills
goals for those at high risk for stress
- recognize potential for stressful situations
- strengthen positive coping skills
nursing assessment for stress
- physical: ROS, physical functioning, pharmacology
- psychosocial: emotions with severity, and coping strategies
- social network assessment
nursing interventions for stress
- nutrition
- exercise
- relaxation techniques
- referral for hypnosis or biofeedback
alternate coping strategies - facilitation of family functioning
- expand social network
- parent education
- family therapy
