Externalizing Behaviors: Stress Flashcards
Stress: General (3)
- A mentally or emotionally disruptive or upsetting condition occurring in response to adverse external influences
- A state of extreme difficulty, pressure, or strain
Definition:
- Stress is a function of three elements:
i. Demand of the situation as they present themselves
ii. Reaction of the person and how they relate to the situation
iii. Individual’s ability to cope with the challenge and adapt to the situation
Common childhood stressors (6)
- School stressors
a. Grades, being a “failure”, disappointing teachers - Parent/family stressors
a. Disappointing family, anxiety over parental worries (finances, etc.) - Sibling stressors
- Interpersonal stressors
a. Being liked/fitting in, problems with friends - Personal stressors
a. Looks/appearance, being overweight, desire to excel at activities - Environmental stressors
a. Disturbing media reports, unsafe neighborhoods
i. Ex: nuclear war
Susceptibility to stress (4)
- Gender: No gender difference in terms of social adequacy, academics, economics
* Girls are more worried about family, personal appearance, the future, classmates and personal health - Temperament: Easy versus difficult
- Development
- Age: Children in middle/late childhood and early adolescence have greater stress levels
Behavioral symptoms of stress (8)
- Short-term behavioral problems (mood swings, bedwetting, changes in sleep pattern)
- Depression
- Defying authority or bullying other children
- Self-punishment behaviors (i.e. head-banging)
- Changes in academic performance
- Overreactions to minor problems or hysterical behavior
- Emotional eating
- Low self-esteem
Manifestations of Stress: Somatic Symptoms (6)
- Chronic, recurrent abdominal pain
- Tension-type headaches
- Encopresis
- Nocturnal enuresis
- Recurrent backaches or neck pain
- Increased risk of contracting common illnesses
Consequences of Chronic Stress and Poor Coping: Physical Effects (2)
- Increased risk for immunological deficits
2. Increased problems with chronic and recurrent pain
Consequences of Chronic Stress and Poor Coping: Mental Effects (4)
- Increased risk of developing behavior problems
- Higher risk of psychological pathology in late adolescence/ adulthood
- More adjustment problems
- Decreased ability to concentrate in school
Toxic Stress (3)
- Frequent activation of stress without the buffering protection of an adult
a. Child abuse
b. Maternal or paternal depression
c. Parental drug use - MRI showed changes in brain architecture that occurred in impoverished children with depression but not those without impoverishment
- Chronically elevated glucocorticoid levels
a. May help explain difficult to treat asthma and URI
b. Leads to hypertension, hyperglycemia and obesity in adolescents
Overcoming stress (2)
- Whitehall study demonstrated that low social class contributed in poor health outcomes and was not mitigated if you were wealthy as an adult
- Studies suggest that need to intervene before age 3 year or even in utero to prevent brain changes
Trauma and Stressor-Related Disorders (5)
DSM-5 brings together anxiety disorders that are preceded by a distressing or traumatic event
- Reactive Attachment Disorder
- Disinhibited Social Engagement Disorder (new)
- PTSD (includes PTSD for children 6 years and younger)
- Acute Stress Disorder
- Adjustment Disorders
PTSD Symptoms in Children (5)
- Re-experience trauma via play
- Loss of recent acquired developmental growth
- Believe future is limited
- Omen formation - predict events
- Separation Issues, anxiety, fearfulness
PTSD Prevalence (4)
- Afflicts 7.8% of overall population
- Affects about 7.7 million American adults
- Can occur at any age, including childhood
- Previously thought more common in women
DSM V Criteria for Post Traumatic Stress Disorder (>6 years): Definition of traumatic events (5)
- Serious threat to integrity and/or life
- Serious injury - self / others
- Sudden loss
- Physical / Sexual violence/abuse
- Disasters
DSM V Criteria for Post Traumatic Stress Disorder (>6 years)
- Exposed to an actual or threatened death, serious injury or sexual violence
a. The person experienced, witnessed or was confronted with an event that involved actual or threatened death or serious injury, or a threat to the physical integrity of others.
b. Learning that a traumatic event occurred to a close family member or friend that even must be accidental or violent
c. Experiencing repeated or extreme exposure to aversive details of traumatic event - Presents of one or more of the following intrusions symptoms associated with the traumatic event.
a. Traumatic event is persistently re-experienced in one (or more) of the following:
i. Recurrent and intrusive distressing memories of the event, including images, thoughts or perceptions
ii. Recurrent distressing dreams of the event
iii. Dissociative reactions (flashbacks)
iv. Intense or prolonged psychological distress at exposure to internal or external cues
v. Marked physiological reactions - Persistent avoidance of stimuli associated with traumatic events
a. Avoidance of or efforts to avoid distressing memories, thoughts, or feeling about traumatic event
b. Avoidance of or effort to avoid external reminders associated with event - Negative alterations in cognition and mood associated with the traumatic event or worse after the traumatic event
a. Inability to remember an important aspect of the traumatic event.
b. Persistent and exaggerated negative beliefs - Marked alterations in arousal or reactivity associated with traumatic event
a. Irritable behavior and angry outburst
b. Hypervigilance
c. Reckless or self destructive behavior
d. Exaggerated startle response
e. Problems with concentration
f. Sleep disturbance
PTSD Treatment (5)
- Psychotherapy with focus on mastery
- Psychotherapy with focus on control
- Play Therapy
- Family Therapy
- Medications
a. NONE approved for use
b. Beta Blockers
c. SSRIs