Pg3-30 Flashcards
Fight or flight syndrome
A syndrome of physical symptoms that result from an individual’s real or perceived notion that harm or danger is imminent
Define general adaptation syndrome and three stages
The general biological reaction of the body to a stressful situation, as described by Hans Selye. It occurs in three stages: the alarm reaction stage, the stage of resistance, and the stage of exhaustion.
Alarm reaction stage: during this stage,the physiological responses of the fight or flight syndrome are initiated.
Stage of resistance: the individual uses the physiological responses of the stage as a defense in the attempt to adapt to the stressor. If adaptation occurs, the third stage is prevented or delayed. Physiological symptoms may disappear.
Stage of exhaustion: this stage occurs when there is prolonged exposure to the stressor to which the body has become adjusted. The adaptive energy is depleted, and the individual can no longer draw from the resources for adaptation described in the first two stages. Diseases of adaptation (headaches, mental disorders, coronary artery disease, ulcers, colitis) May occur. Without intervention for reversal, exhaustion, and in some cases even death, ensues.
Stressor
A biological, psychological, social, or chemical factor that causes physical or emotional tension and maybe a factor in the etiology of certain illnesses.
Core concept: adaptation
Adaptation is set to occur when an individual’s physical or behavioral response to any change in his or her internal or external environment results in preservation of individual integrity or timely return to equilibrium.
What are the three concepts of stress
Stress as a biological response, stress as an environmental event, and stress as a transaction between the individual and the environment
What LCU score indicates a high level of recent life stress
500
Can stress be From something positive
Yes
Why have life changes questionnaires been criticized
They do not consider the individuals perception of the event, It fails to consider the individuals coping strategies and available support system at the time when the life change occurs
Precipitating event
A precipitating event is a stimulus arising from the internal or external environment and is perceived by the individual in a specific manner
Cognitive appraisal
And individuals evaluation of the personal significance of the event or occurrence
Cognitive response
Consists of a primary appraisal and a secondary appraisal
Three types of primary appraisal and define all
Irrelevant, benign-positive stressful
Irrelevant: when the outcome holds no significance for the individual
Benign-positives: outcome is one that is perceived as producing pleasure for the individual
Stress: appraisals include harm/loss, threat, and challenge. Harm/loss appraisals refer to damage or loss already experienced by the individual, Threatening appraisals are perceived as anticipated harms or losses, challenging appraisals are when the individual focuses on potential for gain or growth, rather then on risks associated with the event.
What happens when stress is produced in response to harm/loss, threat, or challenge?
A secondary appraisal is made by the individual
What is a secondary appraisal
An assessment of skills, resources, and knowledge that the person possesses to deal with the situation
What are predisposing factors
A variety of elements that influence how individual perceives and response to a stressful event. Types of predisposing factors include genetic influences, past experiences, existing conditions.
What are genetic factors
Circumstances of an individual’s life that are acquired through heredity. examples: family history of physical and psychological conditions, both strengths and weaknesses, and temperament – behavioral characteristics present at birth that involved with development
What are past experiences
Occurrences that result in learned patterns That can influence individuals adaptation response. Including- previous exposure to the stressor or other stressors, learned coping responses, and the degree of adaptation to previous stressors
What are existing conditions
Incorporate vulnerability that influence the adequacy of the individuals physical, psychological, and social resources for dealing with adaptive demands. Examples include current health status, motivation, developmental maturity, severity and duration of the stressor, financial and educational resources, age, existing coping strategies, and a support system of caring others.
When are coping strategies adaptive?
When they protect the individual from harm or strengthen the individuals ability to meet challenging situations.
What do adaptive responses help restore and what do they in impede?
To restore homeostasis and impede the development of diseases of adaptation
When are coping strategies considered maladaptive?
When the conflict being experienced goes under unresolved or intensifies.
What are the results of maladaptation
Energy resources become depleted as the body struggles to compensate for the chronic physiological and psychological arousal being experienced. Effect is a significant vulnerability to physical and psychological illness.
What is maladaptation
It occurs when an individual’s physical or behavioral responses to any change in his or her internal or external environment results in disruption of individual integrity or persistent disequilibrium
Name seven adaptive coping strategies
Awareness, relaxation, meditation, interpersonal communication with a caring other, problem-solving, pets, music.
What is awareness
The initial step in managing stress.. to become aware of the factors that create stress and the feelings associated with a stressful response. Stress can be controlled only when one recognizes that is that it is being experienced. As one becomes aware of stressors he or she can omit, avoid, or accept them.
How often should a person meditate to produce a lasting reduction in blood pressure and other stress – related symptoms
20 minutes once or twice daily
What could someone do if they didn’t feel they had someone they could talk to (Interpersonal communication with caring other)
Write in a journal or diary
What are the eight steps of problem-solving
- Assess the facts of the situation.
- formulate goals for resolution of the successful situation.
- study the alternatives for dealing with the situation
- determine the risks and benefits of each alternative.
- Select an alternative
- implement the alternative selected.
- Evaluate the outcome Of the alternative implemented.
- If the first choice is ineffective, select and implement the second option.
What do studies show that those who care for pet, especially dogs, are better able to cope with
Stressors of life
What did studies show about per owners who had heart attacks
They had 1/5 the death rate of those who did not have pets
What happens when individuals remain in a state of aroused response to stress for an extended period of time?
They become susceptible to diseases of adaptation, some examples of which include headaches, mental disorders, coronary artery disease, ulcers and colitis.
Name 3 limitations of this concept of stress
Failure to consider the individuals perception of the event, coping strategies, and available support systems at the time when life change occurs
Sondra, who lives in Maine, hears on the evening news that 25 people’s were killed in a tornado in south Texas. Sondra experiences no anxiety upon hearing of this stressful situation. This is most likely because Sondra:
A. Is selfish and doesn’t care what happens to other people
B. appraises the event as irrelevant to her own situation
C. Assesses that she has the skills to cope with the stressful situation
D. Uses suppression as her primary defense mechanism
B
Cindy regularly develops nausea and vomiting when she is faced with a stressful situation. Which of the following is most likely a predisposing factor to the maladaptive response by Cindy?
A.cindy inherited her mother’s nervous stomach
B. Cindy is fixed in a lower level of development
C. Cindy has never been motivated to achieve success
D. When Cindy was a child, her mother pampered her and kept her home from school when she was ill
D
When an individuals stress response is situated over a long period, the endocrine system involvement results in which of the following: A. Decreased resistance to disease B. increased libido C. Decreased blood pressure D. Increased inflammatory response
A
Management of stress is extremely important in today’s society because:
A.evolution has diminished human capability for fight or flight
B. the stressors of today tend to be ongoing, resulting in sustained response
C. We have stress disorders that did not exist in the days of our ancestors
D. One never knows when one will have to face a grizzly bear or saber-toothed tiger in today’s society
B
Nancy has just received a promotion on her job. She is very happy and excited about moving up in her company, but she has been experiencing anxiety since receiving the news. Her primary appraisal is that she most likely views the situation as which of the following? A. Benign-positive B. irrelevant C.challenging D. Threatening
C
Precipitating stressors, past experiences, existing conditions, and genetic influences are components of the transactional model of stress adaptation, and influence an individuals response to stress identify each of these conditions in the following examples: A. Precipitating stressors B. past experience C. Existing conditions D. Genetic influences
____ mr t is on a lower level of development
____ mr t’s father has diabetes mellitus
____ mr t has been fired from his last five jobs
____ mr t’s baby was stillborn last month
C, d, b, a
Mental health
The successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate incongruent with local and cultural norms.
Mental illness
Maladaptive responses to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms, and interfere with the individuals social, occupational, and/or physical functioning.
When did psychiatric care plant it’s roots
In ancient times, when etiology was based in superstition and ideas related to the supernatural.
Describe primitive psychological treatment
Brutal beings, starvation, or other torturous means
Who began the movement of psychiatric care away from the belief in the supernatural?
Hippocrates
What did Hippocrates associate insanity with
An irregularity in the interaction of the 4 body fluids– blood, blac bile, yellow bile, and phlegm
How would Hippocrates treat insanity
Induction of vomiting and diarrhea with potent cathartic drugs
Ship of fools
The term given during the middle ages to sailing boats filled with severely mentally ill people who were sent out to sea with little guidance and in search of their lost rationality
Was the father of American psychiatry
Benjamin Rush
For the first people to consider mentally ill patients actually ill
Middle eastern Islamic countries
What did Benjamin Rush do
He was a doctor in the first hospital to admit mentally ill clients in Philadelphia. Initiated the provision of humanistic treatment and care for the mentally ill, including kindness, exercise, and socialization, he also employed harsher methods such as bloodletting, purging, various types of physical restraints, and extremes of temperatures, reflecting the medical therapies of that era
Who is Dorothea Dix
19th-century New England schoolteacher who lobbied on behalf of of the mentally ill population bringing about the establishment of a system of state asylums
When did the emergence of psychiatric nursing begin
1873
Who is the first American psychiatric nurse
Linda Richards from the nursing program at the New England Hospital for women and children in Boston
When and where was the first school psychiatric nursing
The McLean Asylum in Waverly Massachusetts in 1882
How did Maslow describe self-actualization
Psychologically healthy, fully human, highly evolved, and fully mature.
List the six indicators that suggests a reflection of mental health per Jahoda
A positive attitude toward self, growth development and the ability to achieve self actualization, integration, autonomy, perception of reality, environmental mastery.
Certain elements are associated with individuals perceptions of mental illness. Identify 2 of these elements
Incomprehensibility and cultural relativity
Incomprehensibility
Relates to the inability of the general population to understand the motivation behind the behavior
Cultural relativity
Considers that the rules, conventions, and understandings used to interpret behavior are conceived within ones culture
Anxiety
A diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness
Name 4 levels of anxiety
Mild, moderate, severe, and panic
Describe mild anxiety
Associated with the tension experienced in response to the events of day to day living. Seldom a problem for the individual. Prepares people for action. Sharpens the senses, increases motivation productivity, increases the perceptual field, and results in heightened awareness. Learning is enhanced. Functioning is at optimal level.
Describe moderate anxiety
Moderately anxious individual is less alert to events occurring in the environment. Individuals attention span and ability to concentrate decrease. Assistance with problem-solving may be required. Increased muscular tension and restlessness are evident.
Describe severe anxiety
Perceptual field is so greatly diminished concentration centers on one particular detail only or on many extraneous details. Attention span extremely limited. Difficulty completing even the simplest task. Physical symptoms include headaches, palpitations, insomnia. Emotional symptoms consist of confusion, dread, and horror. Discomfort experienced to the degree that virtually all overt behavior is aimed at relieving anxiety.
Describe panic anxiety
Unable to focus on even one detail in the environment. Misperceptions are common, loss of contact with reality may occur. May experience hallucinations or delusions. Characterized by wild desperate actions or extreme withdrawal. Functioning and communication with others is ineffective. Associated with a feeling of terror. Individuals make it be convinced that they have a life-threatening illness or fear that they are going crazy or losing control. Prolonged panic anxiety can lead to physical and emotional exhaustion. Can be a life-threatening situation.
Behavioral adaptation responses to mild anxiety
Sleeping, eating, yawning, drinking, physical exercise, smoking, crying, pacing, foot swinging, fidgeting, daydreaming, laughing, cursing, nailbiting, finger tapping, talking to someone with whom one feels comfortable.
behavioral adaptation responses for mild to moderate anxiety
Ego defense mechanisms
What are defense mechanisms used as
A protective device for the ego in an effort to relieve mild to moderate anxiety. Become maladaptive when they are used by individual to such a degree that there is interference with the ability to deal with reality, with effective interpersonal relations, or with occupational performance.
What does maladaptive use of defense mechanisms promote
Disintegration of the ego
Name the 15 defense mechanisms
Compensation, denial, displacement, identification, intellectualization, introjection, rationalization, reaction formation, regression, depression, subordination, depression, isolation, projection, undoing
Compensation
Covering up a real or perceived weakness by emphasizing the trait one considers more desirable
Example: a physically handicapped boy is unable to participate in football, so we compensates by becoming a great scholar
Denial
Refusing to acknowledge the existence of a real situation or the feelings associated with it
Example: woman drinks alcohol every day and cannot stop, failing to acknowledge that she has a problem.
Displacement
The transfer of feelings from one target to another that is considered less threatening or that is neutral
Example: client is angry with his physician, but does not express it, because verbally abusive with the nurse.
Identification
An attempt to increase self-worth by acquiring certain attributes and characteristics of an individual one admires
Example: a teenager who required lengthy rehabilitation after an accident decides to become a physical therapist as a result of his experiences
Intellectualization
An attempt to avoid expressing actual emotions associated with a stressful situation but using the intellectual process of logic, reasoning, and analysis
Example: a patient’s husband is being transferred with his job to the city far away from her parents. She hides anxiety by explaining to her parents the advantages associated with the move.
Introjection
Integrating the beliefs and values of another individual into one’s own ego structure
Rationalization
Attempting to make excuses Or formulate logical reasons to justify unacceptable feelings or behaviors
Example: John tells the rehab nurse I drink because it’s the only way I can deal with my bad marriage and my worse job
Reaction formation
Preventing unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or types of behavior
Example: Jane hates nursing. She attended nursing school to please her parents. During career day, she speaks to prospective students about the excellence of nursing as a career.
Regression
Retreating in response to stress to an earlier level of development and the comfort measures associated with that level of functioning
Example: when 2-year-old Jay is hospitalized for tonsillitis he will drink only from a bottle, even though his mom states he’s been drinking from a cup for six months.
Repression
Involuntarily blocking unpleasant feelings and experiences from one’s awareness
Example: an accident victim can remember nothing about his accident
Sublimination
Rechanneling of drives or impulses that are personally or socially unacceptable into activities that are constructive
Example: a mother whose son was killed by drunk driver channels her anger and energy into being the president of the local chapter of MADD
Suppression
The voluntary blocking of unpleasant feelings and experiences from one’s awareness
Example: Scarlett O’Hara says ‘ I don’t want to think about that now. I’ll think about that tomorrow. ‘
Isolation
Separating a thought or memory from the feeling tone, or emotion associated with it
Example: a young woman describes being raped with no emotion
Projection
Attributing feelings or impulses unacceptable to one’s self to another person
Example: Sue feels a strong sexual attraction to her track coach and tells her friend he’s coming on to her
Undoing
Symbolically negating or canceling out an experience that one finds intolerable
Example: Joe is nervous about his new job and yells at his wife. On his way home he stops and buys her some flowers.
Behavioral adaptation responses to moderate to severe anxiety
Can contribute to a number of physiological disorders if left unresolved over an extended period of time. Psychological and behavioral factors may affect the course of almost every major category of disease, including cardiovascular conditions, dermatological conditions, endocrinological conditions, gastrointestinal conditions, neoplastic conditions, neurological conditions, pulmonary conditions, renal conditions, and rheumatological conditions.
Behavioral adaptation responses to severe anxiety
Can result in psychoneurotic patterns of behaving. The following disorders are examples of psychoneurotic responses to severe anxiety: Anxiety disorders, somatoform disorders, dissociative disorders
Define anxiety disorders
Disorders in which the characteristic features are symptoms of anxiety and avoidance behavior. Examples are: phobias, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, posttraumatic stress disorder.
Define somatoform disorders
Disorders in which the characteristic features are physical symptoms for which there is no demonstratable original pathology. Psychological factors are judged to play significant role in the onset, severity, exacerbation, or maintenance of the symptoms. Symptoms include: hypochondriasis, conversion disorder, somatization disorder, pain disorder.
Describe dissociative disorders
Disorders in which the characteristic feature is a disruption in the usual integrated functions of consciousness, memory, identity, or perception of the environment. Examples include – dissociative amnesia, dissociative fugue, dissociative identity disorder, and depersonalization disorder.
Psychosis
A loss of ego boundaries or gross impairment in reality testing. Psychoses are seriously psychiatric disturbances characterized by the presence of delusions or hallucinations in the impairment of interpersonal functioning in relationship to the external world.
At what level of anxiety would you find psychosis
Panic anxiety
What are examples of psychotic responses to anxiety
Schizophrenic, schizoaffective, and delusional disorders
Grief
Grief is a subjective state of emotional, physical, and social responses to the loss of valued entity
Describe the normal mourning process
It is adaptive and characterized by feelings of sadness, guilt, anger, helplessness, hopelessness, and despair
Is it normal to experience mourning after a loss
Yes. An absence of mourning after a loss maybe considered maladaptive
What did Kubler Ross identify
The five stages of feelings and behaviors that individuals experience in response to a real, perceived, or anticipated loss
List the five stages of grief
Denial, anger, bargaining, Depression, acceptance
Do individuals need to experience the stages of grief in a particular order
No. In fact not all individuals experience each of the stages of grief in response to loss.
