Chapter 5 – Stress And Physical And Mental Health Flashcards
What are some key factors that make one stress or more serious than another?
The severity of the stressor, its chronicity, it’s timing, how closely it affects our own lives, how expected it is, and how controllable it is.
Characterize the DSM – IV diagnosis of adjustment disorder and describe three major stressors and the consequences that increase the risk of adjustment disorder
And adjustment disorder is a psychological response to a common stressor such as divorce, death of a loved one, loss of a job, that results in clinically significant behavioural or emotional symptoms. The symptoms must begin within three months of the onset of the stressor, and the person must experience more distress than would be expected given the circumstances or be unable to function as usual.
List the diagnostic criteria for post dramatic stress disorder or PTSD
A. The person has been exposed to a dramatic event in which both of the following were present:
- The person experienced, witnessed, or was confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of self or others
2. The person’s response involved intense fear, helplessness, or horror
B. The traumatic event is persistently reexperienced in one or more of the following ways:
1. Recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions 2. Recurrent distressing dreams of the event 3. Acting were feeling as if the traumatic event were recurring 4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event 5. Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness, as indicated by three or more of the following:
- Efforts to avoid thoughts, feelings, or conversations associated with the trauma
- Efforts to avoid activities, places, or people that arouse recollections of the trauma
- Inability to recall an important aspect of the trauma
- Markedly diminished interest or participation in significant activities
- Feeling of detachment or estrangement from others
- Restricted range of affect
- Sense of a foreshortened future
D. Persistent symptoms of increased arousal, as indicated by two or more of the following:
- Difficulty falling or staying asleep
- Irritability or outbursts of anger
- Difficulty concentrating
- Hypervigilance
- Exaggerated startle response
E. Duration of the disturbance is more than one month
F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning
Compare and contrast acute stress disorder and posttraumatic stress disorder
The diagnosis of PTSD requires that symptoms must last for at least one month. Acute stress disorder or is a diagnostic category that can be used when symptoms develop shortly after experiencing a traumatic event and last for at least two days. The existence of this diagnosis means that people with symptoms do not have to wait a whole month to be diagnosed with PTSD and instead can receive treatment as soon as they experience symptoms. If the symptoms persist beyond four weeks, the diagnosis can be changed from acute stress disorder to post traumatic stress disorder.
Summarize what is known about the major features of reactions to catastrophic events
Traumatic events that result from human intent, such as rape, are more likely to cause PTSD then events such as accidents and natural disasters that are not personal in nature. Personal events destroyed the sense of safety we often assume comes from being a member of a rule abiding and lawful social group
Another factor that is important to the development of PTSD is the degree of direct exposure to the traumatic event.
Differences may also be linked to the way that PTSD is defined in the manner in which it is assessed
Characterize the phenomenon of combat-related stress end of PTSD in connection with battlefield stress
In a combat situation, with the continual threat of injury or death and repeated narrow escape’s, the persons ordinary coping methods are relatively useless. Combat brings with it constant fear, unpredictability, many uncontrollable circumstances, and the necessity of killing. Other stressors include separations from loved ones, reductions and personal freedom, sleep deprivation, extreme and harsh climate conditions, and increased risk for disease.
During World War I, traumatic reactions to combat conditions were known as “shell shock” which regarded these reactions as organic conditions produced by minute brain haemorrhages. However, most victims were suffering instead from the general comment situation, with its physical fatigue, ever present threat of death or mutilation, and severe psychological shocks
During World War II, traumatic reactions to combat were known as operational fatigue and war neuroses, before finally being termed combat fatigue or combat exhaustion in the Korean and Vietnam wars. These terms implied that physical exhaustion played a more important role then was usually the case.
The hypervalent of mental disorders in men and women returning from Iraq and Afghanistan may be a consequence of longer and more frequent deployments. Other factors may be that military psychiatrist had been sending mentally unfit servicemembers into combat.
List and illustrate the long-term effects of being a prisoner of war or in a concentration camp and note the methodological problems associated with biased sampling
Many survivors of Nazi concentration camp sustained residual organic and psychological damage, along with a lower tolerance to stress of any kind. Symptoms commonly included anxiety, depression, insomnia, headaches, irritability, nightmares, impaired sexual potency, and diarrhoea.
Survivors of prisoner-of-war camps commonly showed impaired resistance to physical illness, low frustration tolerance, dependence on alcohol and drugs, irritability, and other indications of emotional instability.
Methodological problems associated with biased sampling may occur due to the availability of only retrospective data
Describe the psychological problems associated with being tortured, with being a refugee, and with being held hostage
Those acknowledging being tortured had more PTSD and higher rates of lifetime mood and generalized anxiety disorder’s.
Other symptoms experienced after torture include physical symptoms such as pain, nervousness, insomnia, tremors, weakness, fainting, sweating, and diarrhea. Psychological symptoms include night terrors and nightmares, depression, suspiciousness, social withdrawal and alienation, irritability, and aggressiveness. Cognitive impairments such as trouble concentrating, disorientation, confusion, and memory deficits. Disturbed behaviours such as aggressiveness, impulsivity, and suicidal attempts
Outline the factors that appear to influence combat-related stress problems
Combat-related stress problems may be related to feelings of responsibility associated with killing as well as feelings of guilt for having survived when friends and unit peers did not.
Summarize The approaches that have been used to treat or to prevent stress disorders and evaluate their effectiveness
Prevention: reduce the frequency of traumatic events. Prevent maladaptive responses to stress by preparing people in advance and providing them with information and coping skills. Using cognitive-behavioral techniques to help people manage potentially stressful situations or difficult events, this preventative strategy is often referred to as stress-inoculation training, which prepares people to tolerate anticipated struck by changing the things they say to themselves before or during a stressful event.
Treatment: telephone hotline’s, crisis intervention – focusses on the immediate problem with which an individual or family is having difficulty, psychological debriefing – designed to help and speed up the healing process in people who have experienced disasters or been exposed to other traumatic situations; victims are provided with emotional support and encourage to talk about their experiences during the crisis.
Medications
Cognitive-behavioral treatments such as prolonged expose her-the patient is asked to vividly recount the Trumatic event over and over until there is a decrease in his or her emotional responses
Cognitive therapy designed to modify excessively negative appraisals of the Chama or its consequences, decreased the threat that patients experience when they have memories of the Trumatic event, and remove problematic cognitive and behavioural strategies. Very effective
Virtual-reality exposure therapy – customized to reflect the individual soldiers traumatic experience
What are factors that increase or decrease a persons vulnerability to stress
Coping skills and the presence of particular resources may be linked to vulnerabilities to stress.
Children are particularly phone herbal to severe stressors such as war and terrorism, adolescents with depressed parents are far more sensitive to stressful events and are more likely to have problems with depression themselves after experiencing stressful life events.
Individual characteristics that improve a persons ability to handle stress include higher levels of optimism, greater psychological control or mastery, increased self-esteem, and better social support.
Differences in coping styles may be linked to underline genetic differences.
The amount of stress experienced early in life may make a person more sensitive to stress later on. The effects of stress maybe cumulative, with each stressful experience serving to make the system more reactive.
Stressful experiences may also create a self-perpetuating cycle by changing how we think about, or appraise, the things that happen to us. Stressful situations may be related to or intensified by a persons cognitions.
