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Clinical + Mental Illness (Midterm II) > Stress (Acute stress disorder, PTSD and Adjustment Disorders) > Flashcards

Stress (Acute stress disorder, PTSD and Adjustment Disorders) Flashcards

1
Q

What does research show about the health status of students?

A

Research shows college/university students do not rate themselves as having better health even compared with older populations.

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2
Q

What are the predictors of less positive health status in students?

A
  • Poorer child-parent relationship
  • Low interest and achievement in school;
  • Lower self-esteem
  • Women reported more health problems than men students
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3
Q

What are the top health problems in students?

A

Allergy (47.9%), back pain (41.6%), sinus infection (30.7%), depression (17.0%), strep throat (13.8%)

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4
Q

What are the top five factors interfering with academic performance?

A
  • Stress (33.9%), cold/flu/sore throat (28.2%), sleep difficulties (25.6%), concern for troubled friend/family member (18.8%), Internet use/computer games (16.9%)
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5
Q

What is a stressor?

A

Any event that triggers coping adjustment.

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6
Q

What is strain?

A

The physical and emotional wear and tear reaction of a person attempting to cope with a stressor.

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7
Q

What is stress?

A

The process by which we perceive and respond to events (stressors)

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8
Q

What are the 3 research focuses of stress?

A
  1. The environment: stress as a stimulus (stressors)
  2. Reaction to stress: stress as a response (distress)
  3. Stress as a process that includes stressors and strains, but includes relationship between person and the environment (coping).
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9
Q

What is the physiology of stress?

A

When we sense danger we experience an:

  • Increase in: Adrenaline, Heart rate, breathing, blood pressure… etc., Cortisol
  • Reduced blood flow to the kidneys, skin and gut + organs/processes that are not immediately needed
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10
Q

What is the role of the endocrine system in the physiology of stress?

A
  • Hypothalamus orders the pituitary to secrete adrenocorticotropic hormone (ACTH) which is taken up by the adrenal glands.
  • Adrenal glands: Mediates most of our physiological responses to stress. Releases cortisol, epinephrine, and norepinephrine.
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11
Q

What are the two parts of the adrenal glands?

A

1) Adrenal Medulla
- fast-acting
- secretes epinephrine, and norepinephrine (which increases HR, respiration, perspiration, blood to muscles, metabolism, mental activity)
2) Adrenal Cortex
- delayed response that restores body to homeostasis
- Cortisol influences… immune function, metabolism, heart rate, blood to muscles, memory

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12
Q

What is the general adaptation syndrome?

A
  • Experience a perceived stressor
    1) Alarm reaction (fight or flight is activated)
    2) Resistance (arousal high as body tries to defend and adapt
    3) Exhaustion (limited physical resources; resistance decreases; if stress continues, death
  • Hans Selye’s theory was objective and biological. The same event may be stressful for one person and not another, its about how we perceive the event. This is a limitation of this theory. Selye did not consider cognition/beliefs important (i.e., limitation)
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13
Q

What is the somatic weakness theory?

A
  • Weakness in a specific body organ exists.
  • Weaknesses become exacerbated by stress.
  • Example: congenitally weak respiratory system might
    predispose the individual to asthma
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14
Q

What is the specific reaction theory

A

Individual response to stress is idiosyncratic (response to stress varies)

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15
Q

What is the prolonged exposure to stress hormones biological theory?

A
  • Activation of CNS and HPA axis

- prolonged exposure to stress will change the way your body reacts to stress, by making you more sensitive.

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16
Q

What is the stress and immune system biological theory?

A
  • Stress impact the ANS, hormone levels, brain activity
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17
Q

What is stress as a transaction?

A

“…the circumstance in which transactions lead a person to perceive a discrepancy between the physical or psychological demands of a situation and the resources of his or her biological, psychological, or social systems”

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18
Q

What is the transactional model?

A

1) encounter a potentially stressful event or situation
2) cognitive appraisals
- primary appraisal: is this event positive, neutral or negative? and if negative, how bad?
- secondary appraisal: do I have the resources or skills to handle the event/demand?
- if no, then distress

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19
Q

What are the psychological aspects of stress?

A
  • Stress can affect cognitive performance.
    • Vicious cycle of rumination and/or worrying
  • Stress can affect our emotions.
    • Fear and anxiety!
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20
Q

What is cognitive vulnerability?

A

“A person’s perception of himself as subject to internal or external dangers over which his control is lacking or is insufficient to afford him a sense of safety. In clinical syndromes, the sense of vulnerability is magnified by certain dysfunctional cognitive processes”

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21
Q

What are dysfunctional cognitive processes?

A
  • Stress arises or is augmented by faulty or irrational ways of thinking:
  • Catastrophizing – “It is the end of the world if I get turned down when I ask for a date.”
  • Overgeneralizing – “I didn’t get a good grade on this test. I can’t get anything right.”
  • Selective abstraction – Only seeing specific details of the situation (e.g., Seeing the negatives but missing the positive details).
22
Q

What is the diathesis stress model?

A
  • Diathesis: some predisposition that increases the risk/susceptibility for developing a disorder
    • Diatheses can be either biological (genetic coding for the functioning of a particular neurotransmitter system; teratogens during gestation) or psychological (childhood abuse; cultural pressures; cognitive style)
  • Stress: the predisposition will not necessarily lead to the development of a disorder without some stress to act as a trigger
  • Stressors can be biological (a physical illness), psychological. (relationship stress, or mourning the loss of a loved one), or social (cultural pressure to meet certain standards)
23
Q

What are the physiological measures of stress?

A

Galvanic Skin Response (GSR)

  • Measure of skin’s resistance to electricity
  • Polygraph
24
Q

What are 2 studies that used performance measures of stress?

A

One way of examining stress is looking at performance under stress
Glass and Singer (1972)
- Under stress people perform differently
- They placed ppl in a noisy environment and told them either they could control the noise with a switch or had no control over the noise. The group with control over the noise did not use the switch as often. They were then asked to engage in some task, like a cognitive performance task, people who had control over the switch did better than those who had no control. Used random assignment.
- Proposed that noise is a source of stress and uncontrollable stress leads to feelings of helplessnes
Driskel et al. (1999)
- Naval cadets assigned to one of two conditions: a group that had to work together to locate enemies on a radar and another group was that they did it on their own. And each of these groups either experienced noise or no noise.
- Found that groups do better, especially in the no noise condition. When there was noise however, they did no better than the individual.

25
Q

What is the social facilitation effect?

A
  • A performance measure of stress
  • Social facilitation effect (good stress):
  • Any increment of individual activity resulting from the presence of another individual (e.g., good pool players perform much better in front of an audience, than poor players with the same audience)
  • Creates arousal, thus enhancing the dominant response
26
Q

Is there an optimal level of arousal?

A
  • yerkes dodson law
  • there is an optimal level of arousal and performance
  • performance can become impaired with too much arousal and anxiety
27
Q

What is the social readjustment rating scale?

A
  • Holmes & Rahe came up with a list of events from clinical experience and asked people (with various backgrounds) to report the amount of adjustment that each event would need (from 1-100)
  • Then assigned each event a value in life change units (to reflect the amount of change that was necessary)
  • Compiled a chart of life’s most stressful events with an impact score that indicates how stressful that experience is (100 = most stressful)
  • An important advance in the literature because it connected our lives to the experience of stress, despite limitations (e.g., limitation associated with self-report).
28
Q

What is acute stress?

A

Sudden, typically short-lived, threatening event (e.g., robbery, giving a speech)

29
Q

What is chronic stress?

A

Ongoing environmental demand (e.g., marital conflict, work stress)

30
Q

What are daily hassles?

A

Experiences and conditions of daily living that have been appraised as salient and harmful or threatening (e.g., concerns about weight, health of a family member)

31
Q

What are uplifts?

A

Experiences & conditions of daily living that have been appraised as salient & positive or favourable (e.g., completing a task, relating well to friends)

32
Q

What are the 3 categories of job stress?

A

A) Work Overload – Work too long & too hard
B) Role Overload – Balance several different jobs at once
C) Burnout – Physical and psychological exhaustion

33
Q

What is environmental stress?

A

Natural disasters, accidents, terrorism, and war

34
Q

How does stress affect health?

A
  • Physiological effects: Hormones, decreased immunity, increased blood pressure
  • Unhealthy habits and poor coping: Increased smoking, drugs and alcohol
  • Health behaviour: decreased compliance, delay in care seeking
35
Q

Heart Disease is the ______ leading cause of death in Canada, accounting for 1 in ______ deaths

A

Second; 5

36
Q

What is essential hypertension?

A
  • Hypertension without identified biological cause
  • Sometimes called: Primary hypertension
  • Known as the silent killer (may go undetected for years)
37
Q

What is coronary heart disease?

A
  • Narrowing of blood vessels supplying O2 and blood to heart

- Two diseases involving heart and blood-circulation system appear to be adversely affected by stress.

38
Q

What are the genetics, biology and psychology of cardiovascular disorders and BP?

A
  • Genetics – still little success in identifying specific genes
  • Biology – heightened cardiovascular reactivity in response to exposure to stressors
  • Psychology – acute stress such as anger episodes and physical exertion can trigger myocardial infarction
  • Chronic stress (marital conflict, financial worries) activates immune system and contributes to inflammation, which, in turn, produces coronary heart disease
39
Q

What are the risk factors for CHD?

A
  • Age
  • Sex (males are at greater risk)
  • Cigarette smoking
  • Elevated blood pressure
  • Elevated serum cholesterol
  • increase in size of the left ventricle in heart
  • Obesity
  • A long-standing pattern of physical inactivity
  • Excessive use of alcohol
  • Diabetes
40
Q

What are the psychological diatheses (predispositions) of CHD?

A

Type A behaviour pattern:
- Intense and competitive drive for achievement and advancement;
- Exaggerated sense of the urgency;
- Aggressiveness and hostility toward others
Type D (distressed) personality:
- Negative affectivity + social inhibition, including the inhibition of anger, anxiety and depression

41
Q

What are the therapies for psychophysiological disorders?

A
  • Treating hypertension through decreasing CHD risk factors
    • Decrease anxiety, depression, or anger is best way to decrease psychophysiological disorders
    • Also decrease smoking, obesity, alcohol consumption, salt intake
    • Increase exercise
  • Drugs can be used to decrease cholesterol levels
  • Biofeedback
    • Effectiveness of biofeedback has only modest empirical support
  • Cardiac Rehabilitation
    • Support and counseling aimed at decreasing stress
    • Known effectiveness shown in meta-analyses
    • However, concerns about barriers to access programs:
    • lack of physician referral
    • long travel time and distance to available rehab
42
Q

What are the diagnostic criteria for adjustment disorder?

A

A. the development of emotional behavioural symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor
B. these symptoms or behaviours are clinically significant, as evidenced by one or both of the following
1. marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and cultural factors that might influence symptom severity and presentation
2. significant impairment in social, occupational or other important areas of functioning
C. Stress related disturbance does not meet criteria for another mental disorder
D. the symptoms do not represent normal bereavement
E. Once the stressor or it’s consequences have terminated, the symptoms do not persist for more than an additional 6 months

43
Q

What are the diagnostic criteria for acute stress disorder?

A

A. Exposure to actual or threatened death, serious injury, or sexual violation in one (or more) of the following
1. directly experiencing the traumatic events
2. witnessing, in person, the event(s) as it occurred to others
3. Learning that the events occurred to a close family member or close friend (violent or accidental in nature)
4. experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains)
B. Presence of nine or more of the following symptoms from any of the five categories of intrustion, negative mood, dissociation, avoidance and arousal, beginning or worsening after the traumatic event occurred
C. duration of the disturbance is 3 days to 1 month after trauma exposure
D and E the same

44
Q

Who was James miller?

A
  • Military
  • almost shot his wife because of his PTSD, they are no longer together, and he lives in a trailer in his fathers backyard
45
Q

What is post traumatic stress disorder?

A

1) Threatened with death

2) Response involves fear and helplessness

46
Q

What does trauma stand for/

A 
T = traumatic event
R = re-experience
A = avoidance
U= unable to function
M= Month at least
A= Arousal
47
Q

What are the risk factors of PTSD?

A
  • Exposure to trauma and severity of trauma
  • Gender (more females)
  • Perceived threat to life
  • Family history of psychiatric disorders
  • Presence of pre-existing psychiatric disorders
  • Early separation from parents
  • Previous exposure to traumas
  • Dissociative symptoms (including amnesia and out-of-body experiences) at the time of the trauma
  • Trying to push memories of the trauma out of one’s mind
  • Tendency to take personal responsibility for failures
  • Coping with stress by focusing on emotions (“I wish I could change how I feel”)
  • Attachment style (insecure attachment style)
48
Q

What are the psychological theories of PTSD?

A
  • PTSD arises from a classical conditioning of fear avoidances are built up, and they are negatively reinforced by the reduction of fear that comes from not being in the presence of the CS.
  • Anxiety sensitivity
49
Q

What are the cognitive theories of PTSD?

A
  • characterize PTSD as a disorder of memory.
  • The hallmark feature being the constant involuntary recollection of the traumatic event
  • It has been shown across several studies that PTSD is associated with impaired memory of emotionally neutral stimuli.
  • There is a robust association between PTSD and memory impairment and this tendency is stronger for verbal memory than visual memory
50
Q

What do all 3 DSM-5 Stress disorders have in common?

A
  • they involve a prolonged, maladaptive reaction to stress

Clinical + Mental Illness (Midterm II) (9 decks)

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