Psychosocial Coping Flashcards
what is stress?
Complex process that alters our psychological and physiological systems.
Actual or potential threat to homeostasis
May lead to physiological or psychological health issues
Part of life
Unique person-to-person
Eustress =
good stress
what is appraisal related to stress?
Initial reaction to POTENTIAL stress.
-Interpretation of situation and determination if it is a stressor.
what is coping?
Managing stress. Coping can mitigate or reduce the cause of stress or emotion it causes.
what is adaptation?
Outcome of coping. When a person SUCCESSFULLY adjusts or adapts to stress.
If a person is unable to adapt, pathological manifestations may occur.
How does the body maintain homeostasis?
KEEPING balance of: Blood pressure Glucose regulation Temperature regulation Acid-base balance All vital processes
what is allostasis?
Process of RESTORING homeostasis in response to stress.
Allostatic response occurs through physiological mediators:
Baroreceptors in aortic arch
Secretion of insulin
Hypothalamus
Respiratory response
individualized
What is the allostatic load?
= allostasis is sustained and homeostasis is not achieved. aka sustained allostatic state
-Cumulative burden of adaptation to stress
what can a sustained allostatic state lead to?
disease
what happens if stress is repetitive in relation to allostatic load?
If stress stimuli are excessive and repetitive, recovery to the original homeostatic levels may be incomplete
-As a result, the body adapts to anticipate the stress and creates “new” baseline for homeostasis.
example of new baseline due to repetitive allostatis?
An allostatic response may be increase in glucose level from a stressor, persistent allostasis will cause the body to adapt and allow a higher glucose level.
2 divisions of autonomic nervous system?
sympathetic
parasympathetic
what does sympathetic nervous system do?
Secretion of neurohormone norepinephrine and epinephrine. This can be excitatory or inhibitory.
Stressor–>pupil dilation, tachycardic (excitatory) but also slow down GI motility (inhibitory).
what does parasympthathic nervous system do?
- Secretion of acetylcholine.
- Following stress event, the PNS activates to return back to homeostasis.
- Example: Pupil constriction, reduce HR,…
systems involved in ANS?
Cardiovascular Respiratory GI Renal Endocrine
Neurotransmitters secreted by the sympathetic nervous system?
Norepinephrine and epinephrine
Excitatory actions?
Pupil dilation, increased heart rate, bronchial dilation, increased glucose
Inhibitory actions?
Decrease digestive function, inhibit insulin secretion, prevent urination
Major neurotransmitter for the parasympathetic nervous system?
Acetylcholine
most common glucocorticoid?
cortisol
where does cortisol come from
Cortisol is a stress hormone that is from the adrenal glands. These are located on top of your kidneys.
What does cortisol impact? (2 physiological effects)
1.metabolism - glucose
2.immune system
acute response- cortisol is protective
chronic stress- cortisol is damaging
when are glucocorticoids released?
When the body is under stress glucocorticoids are released.
Stimulation of glucocorticoids comes after the initial SNS response.
which steroid prepares body for fight or flight?
cortisol
What does prolonged stress lead to?
Anxiety, depression, and other alterations in health
fight or flight: neuro repsonse:
pupils dilate
fight or flight response: cardiac
tachy, HTN, angina, dysrhythmia
fight or flight response: resp:
increase RR, hyperventilate
fight or flight response: GI:
loss of appetite, n/v, increase HCl acid prdxn
fight or flight response: skin:
diaphoresis, contraction of arrector pili muscles
fight or flight response: musculoskeletal
increased muscle tension in large muscles, tremor/shakiness in smaller
2 major types of coping?
problem focused
emotion focused
what are coping mechanisms?
Coping mechanisms are an individual’s level of resistance, resilience, and vulnerability.
*Not all coping mechanisms are positive.
what is resistance?
adaptability to adversity
what is resilience?
ability to move forward despite adversity
what is vulnerability?
increase in resiliency and resistance from experiencing and evolving from the past.
Newborn infant coping
Dependent on care of others to survive.
Stressors are typically quickly resolved
Good stress – nurturing environment
Bad stress – sensory stimuli from neonatal unit
Toddler/preschooler coping
Still dependent on adults.
Social and familial interactions and behavior impact coping.
Stressful issues are perceived more intensely at this age in comparison to adults.
School age coping
- Social environment begins to expand.
- Coping is influenced by a balance of home support and an internal sense of self-worth.
- Younger school aged children may have a hard time distinguishing reality from imaginative thinking.
- Adolescent children are capable of rationalization and are able to utilize more coping mechanisms, but also may use negative coping skills.
Adult-Older Adult
coping
-In adulthood the ability to cope with stress is partly dependent upon how coping developed through the formative years.
-Life changes and physiological changes compound and add to stress.
*Coping for this age includes self-talk, cognitive reframing, …
This age group may begin to display negative coping skills….
Where is the line drawn for when a legal substance becomes a maladaptive coping pattern?
The line is drawn when cognitive status is altered and the use of the substance is consistent to get that alteration in cognitive function.
Defense mechanisms:
denial, projection, rationalization, suppression, repression
Refusing to believe or accept something =
denial
Attributing one’s own thoughts onto another=
projection
Concealing the motive for behavior by giving a socially acceptable reason for the action=
rationalization
Consciously dismissing something from the mind and thoughts =
suppression
Immersing something in the subconscious or unconscious level of thought =
repression
Diagnostic tests for stress
-labs (epi, norepi, cortisol), although cannot be exclusively related to stress
Measurement Tools
Everyday Hassles Scale/Coping self-efficacy scale
interventions for stress
Visualization Imagery Affirmations Mediation Biofeedback Therapeutic Touch Massage Yoga Deep Breathing* - taught easily Journaling
Stress management for nurses
Establish a regular program of exercise
Eliminate or restrict mood-altering substances
Learn to accept failure and turn it into a constructive experience
Difficult to do!
Develop assertiveness to have more personal control
Develop and bolster support systems
Work to believe that most people do the best they can
Can also be difficult
