objective 6 Flashcards
the body’s reaction to any change that requires a response
stress
psychological or physical stimuli that are incompatible with current functioning and require adaptation
stressor
a way the mind responds to events that are challenging or threatening
coping
ability of human being to percieve reality and respond to it
adaptation
ineffective coping
maladaptation
what are the physiological sources of stress?
Environmental conditions such as cold, trauma, excessive heat
* Physical conditions such as infection, hemorrhage, hunger, or pain
what are the psychological sources of stress?
Exemplified by divorce, job loss, unmanageable debt, death of a
loved one, retirement, marriage, unexpected success
what are the mediators of stress response
stressors
perception
personality
social support
culture
spirituality and religious beliefs
what are Selye’s 3 stages of reaction to stress
alarm or acute stress stage
resistance or adaptation stage
exhaustion stage
body prepares for situation that individual perceives as threat
alarm or acute stress stage
person continues to use sources of energy to adapt to the stressor
resistance or adaptation stage
total expenditure of energy
exhaustion stage
Walter Cannon
* Body prepares for situation that individual perceives as threat to survival
* New research indicates that men and women have different neural responses
to stress
flight-or-flight response
Serotonin synthesis more active
* May impair serotonin receptor sites and brain’s ability to use serotonin
neurotransmitter stress response
Interaction between nervous system and immune system during alarm phase of GAS
* Negatively affects body’s ability to produce protective factors
immune stress response
what are the approaches to stress management?
measuring stress
assessing coping stress
Tools i.e. Recent Life Changes Questionnaire (Table 5.2) or Perceived
Stress Scale (Figure 5.4)
measuring stress
Social readjustment rating scale (Holmes and Rahe, 1967, 1978, 1997)
* Measures level of positive and negative stressful life events over a 1-
year period
assessing coping styles
how do you manage stress through relaxation techniques?
Deep breathing exercises (Box 5.4)
* Progressive muscle relaxation
* Relaxation response (Box 5.2)
* Reduction of caffeine
* Meditation
* Guided imagery (Box 5.3)
Biofeedback
* Physical exercise and outdoor activity
* Mindfulness
* Cognitive reframing
* Journaling
* Humour
Profound disruption of normal psychological homeostasis
* Normal coping mechanisms fail
* Results in inability to function as usual
* Acute and time-limited
crisis
what do outcomes of crisis depend on?
Realistic perception of the event
* Adequate situational supports
* Crisis intervention
* Adequate coping mechanisms
New developmental stage is reached
* Old coping skills no longer effective
* Leads to increased tension and anxiety
maturational crisis
Arise from events that are
* Extraordinary
* External
* Often unanticipated
situational crisis
Unplanned and accidental
* Natural disaster
* National disaster
* Crime of violence
adventitious crisis
Conflict or problem
* Self-concept threatened
* Increased anxiety
* Use of problem-solving techniques and defense mechanisms
* Resolve conflict or problem
* Reduce anxiety
phase 1 (crisis)
Defense mechanisms fail
* Threat persists
* Anxiety increases
* Feelings of extreme discomfort
* Functioning disorganized
* Trial-and-error attempt to solve problem and restore normal
balance
phase 2 (crisis)
Trial-and-error attempts fail
* Anxiety can escalate to severe level or panic
* Automatic relief behaviours mobilized (i.e., withdrawal and flight)
* Some form of resolution may be devised
(i.e., compromising needs or redefining situation)
phase 3 (crisis)
Problem is unsolved and coping skills are ineffective
* Overwhelming anxiety
* Possible serious personality disorganization, depression,
confusion, violence against others, or suicidal behaviour
phase 4 (crisis)
General assessment
* Assess the patient’s potential for suicide/homicide
* Assess the patient’s perception of precipitating event
* Assess the patient’s situational supports
* Assess the patient’s personal coping skills
* Self-assessment
assessment
ineffective coping, risk for suicide
diagnosis
Crisis intervention i.e. mobile crisis units, victim outreach, crisis
line, etc
planning
Basic level
* Patient safety
* Anxiety reduction
implementation
Primary care
* Secondary care
* Tertiary care
psychotherapeutic crisis intervention
