2 Stress and Mental Health Flashcards
What is stress?
External demands placed on an organism - organism’s internal biol. and psych. responses to demands
Distress (Selye - 1974)
Damaging or unpleasant stress (exam, breakup etc)
Eustress (Selye - 1979)
Positive stress resulting in pleasurable or satisfying experience (marriage, winning lotto)
- Alarm stage of GAS (4)
- Appearance of stressor -
- Release of hormones - blood glucose levels high
- Flight or fight
- Continued stress = next stage
Hormones released during alarm stage
Epinephrine (adrenaline) and Cortisol
- Resistance stage of GAS
- ANS returns to an above average normal functioning
- Exhaustion stage of GAS
- Physical defences breakdown (i.e. immunological suppression
- Resistance drops to below normal levels of resistance
3 categories of stress
Frustrations - conflicts and pressures
Frustrations
Caused by a wide range of obstacles
Conflicts
Result from the simultaneous occurrence of two or more needs or motives
Pressures
Force us to speed up or change the direction of goal-oriented behav.
Nature of a stressor can be
- major stressor - catastrophe - daily hassles - acculturative stress (living in a diff. culture)
Stressor can be perceived as
changeable or fixed
acute vs chronic
Factors creating predisposition to stress (6)
- Nature of stressor
- experience of crisis
- life changes
- individual perception of stressor
- individual stress tolerance
- lack of external resources and social supports
Factors predisposing a person to stress (2)
- past experiences of stress
- Individual characteristics
Egs of past experiences of stress
History of life stressors
Effects of cumulative stress
past coping patterns
Individual characteristics of those who are able to deal with stress effectively (5)
- sense of control
- self-esteem
- optimism
- hardiness
- social support
Key characteristics of stress (6)
Severity Chronicity Timing Degree of impact level of expectation controllability
Effects of stress on behaviour (3)
- drug abuse (smoking alcohol)
Eating habits get worse
Tendencies towards violence
Effects of stress on the nervous and endocrine systems (2)
- blood pressure and heart rate
- lipids and sugar levels
Effects of severe stress (5)
- lowered efficacy
- depletion of adaptive resources
- wear and tear on biol. system
- Severe personality and physical deterioration
- death
Stress and DSM-1 (1952)
Gross stress reaction - became PTSD in DSM-III
Role stress plays in psychopathology
- Specific stressors are identified at the time just preceding psychopathology
- stress can exacerbate psychological conditions.
- Stress can maintain psychological conditions
DSM-5 disorders and stress (3)
- Adjustment disorders
- Acute stress disorder
- post traumatic stress disorder
Psychological Trauma
Caused by an external event that affects internal psychological phenomena at multiple levels - consciously and unconsciously
- Person’s assumptions about the world have been shattered and must be rebuilt
Adjustment Disorder DSM-5 Diag. categories
- Symptoms within 3 months of a clear stressor
- Once stressor has been terminated symptoms do not persist for more than 6-months
- Can specify anxiety, depression, mixed etc (predominance)
Accute Stress Disorder (ASD) DSM-5
- Duration of symptoms 3 days to 4 weeks within 4 weeks of cessation of stressor
- greater emphasis of dissociation
- If symptoms last longer - PTSD
Post-traumatic Stress Disorder (PTSD)
- duration longer than 1 month
Criteria for AD (A)
a) The development of emotional or behav. symptoms in response to an identifiable stressor occurring within 3 months of the onset of the stressor(s)
Clinical significance component of criteria for AD (2)
1 - Marked distress out of proportion to the severity or intensity of stress (taking into account external context and cultural factors)
2 - Significant impairment in social, occupational or other areas of functioning
What must AD not be
bereavement or another mental disorder or exacerbation of mental disorder
Stressors typically causing AD
Unemployment
divorce or separation
Female vs male likelihood of AD (adulthood)
females twice as likely to get AD diagnosis - not true for childhood and adolescent pops
Prevalence rate of AD in child, adolescent and elderly pops
2 - 8 %
AD prevalence outpatient hosp. settings
10 - 30 %
AD prevalence in specialised pops (following cardiac surgery etc)
> 50 %
Prevalence of ASD in individuals who have experienced severe trauma
14 - 33 %
What is the prev. of ASD in gen. pop?
Not known
a) DSM criteria for ASD
a) exposure to actual or threatened death, serious injury or sexual violation in one or more ways
ASD exposure can occur (4)
- through direct experience of traumatic events
- witnessing the events occurring to others
- learning that events occurred to close family member or friend (must have been violent or accidental)
- Experience repeated or extreme exposure to adverse events
ASD symptom categories (5)
Intrusion, negative mood, dissociation, avoidance and arousal
ASD/PTSD : How many symptoms from the categories must be present
9 or more
Depersonalisation
Seeing oneself from another’s perspective
Problems with original PTSD criteria
1) Trauma not as rare as though (60 % of men and 50 % women experience situations pot. traumatic
ASD and PTSD Stressors in DSM-5
Direct/ witnessed: military combat, injuries etc
Incidents with highest lifetime prevalence PTSD (4)
- Massive catastrophic trauma (combat etc)
- Sexual assault
- Interpersonal assault violence
- sudden loss of a loved one
Lifetime prevalence rate of PTSD in the US
6.8 %
Women vs men prevalence PTSD
Higher rates in women despite men being more likely to be exposed (to traumatic events)
Prevention of Stress Disorders
- preparation of individual prior to stressor (success in military)
Treatment strategies for stress disorders
- psychoeducation - anger management
