Stress, Crisis, Trauma, and Grief Flashcards
_____ ______ are effective behaviors used to respond to or avoid sources of stress
Coping Skills
_______ _______ can be described as behavioral and personality patterns used to adjust or adapt to environmental pressures without giving up one’s goals or purposes
Coping mechanisms
What is the difference between a coping a strategy and an ego defense mechanism?
difference focuses on the degree to which the person’s response is under his conscious and voluntary control and whether reality distortion and self-deception are involved.
Coping Strategy is a relatively deliberate and conscious effort to solve a problem or handle personal distress.
Ego Defense mechanism is a habitual or unconscious problem-solving maneuver.
____ occurs when an internal and/or environmental demand challenges or exceeds an individual’s adaptive resources.
Stress
Responses to stress may include
physiological reactions (ulcers, high blood pressure, etc) psychological reactions (avoidance of a stressful event) and more serious mental conditions (learned helplessness, anxiety disorders, dissociative disorders)
People under stress confront 2 primary challenges
- the need to manage their emotional and cognitive responses
- the need to determine what they should do in response to the stress or stressor.
_______-________ coping is used to reduce one’s emotional response to the stress
Emotion-focused coping
_______-______ (task-focused coping) coping uses strategies to deal directly with the source of the stress
Problem-focused coping
Usually a person must first deal with his/her _______ reactions before moving on to _____-_____.
emotional
problem-solving
but emotion-focused and task-focused coping often occur simultaneously.
_______ hypothesis shows that the subjective perception of social support is actually more critical than actual support, not only for alleviating feelings of loneliness but also for reducing the effects of stress and the risk for coronary heart disease.
buffering hypothesis
the _____-______ theory proposes that a person’s belief about his/her own ability is the most significant mediator of his adjustment.
self-efficacy
______ _____ __ ____ is a belief they have a degree of control over the causes or consequences of stress
Internal locus of control
_______ is sometimes used to refer what can be considered “good” stress and can motivate people to continue engaging in and enjoying activities and events that require effort but ultimately promote physical and emotional well-being. Give examples of _____
Eustress
physical exercise, completing coursework to graduate, having a baby, pursuing and attaining a desirable job.
_____ is a state of acute emotional upset that includes a temporary inability to cope by means of one’s usual problem-solving methods.
Crisis
A typical crisis lasts for no more than ___ to ___ weeks because a person cannot remain for too long in a state of acute emotional upset. At the end of a crisis, the person’s subjective discomfort diminshes.
6 to 8 weeks
Events alone do not activate crisis. Instead, crisis occurs when a person’s _______ of the event and available coping methods and social resources produce tension so severe that the person cannot find relief.
interpretation
Key determining factors that contribute to stress are
person’s cultural values related to the event, previous problem-solving ability, and current levels of social, material, and other support
List the 5 stages of crisis
- Hazardous Event
- Vulnerable State
- Precipitating Factor
- Active Crisis State
- Restoration of Equilibrium
______ _____ is an initial shock that disrupts a person’s equilibrium and initiates a series of reactions that may culminate in a crisis. It may be anticipated or unanticipated
Hazardous Event
_______ _____ is a person’s subjective response to stressful events in his/her life.
vulnerable state
The vulnerable state is marked by an increase in _____, which the person attempts to relieve by using his customary coping strategies. If these are unsuccessful, the person’s _______ continues to rise and, eventually, he is unable to function effectively.
anxiety
tension
The _________ ______ is the final stressful event in a series of events that moves a person from a state of acute vulnerability into crisis.
Precipitating Factor
The precipitating factor is often a _____ event, but it can assume catastrophic proportions in the context of other stressful events and the person’s _______ to use his usual problem-solving strategies. The precipitating factor can produce a range of responses, from a strong desire to seek ___ to a _____ attempt.
minor
inability
help; suicide
The ____ _____ ____ always includes disequilibrium, or disorganization, and normally involves 3 stages which are:
Active Crisis Stage
- physical & psychological agitation
- preoccupation with the events that led to the crisis
- gradual return to a state of equilibrium
During the active state stage of crisis, a person usually recognizes that his/her coping mechanisms are inadequate and, therefore, may be highly motivated to _____ and ____ help.
seek; accept
______ __ ______ is the successful reintegration following a crisis and depends on several factors including (2)
Restoration of Equilibrium
person’s ability to objectively evaluate the crisis situation
the development and use of adaptive coping strategies
In a _______ crisis, the crisis origin is a sudden random, shocking, and often catastrophic event that cannot be anticipated or controlled.
Situational
Factors that determine whether a person will experience a situational event as a crisis include his _______ or ______ of the event and available _____ ______ & _______ _____.
perception or interpretation
coping mechanisms; social supports
A situational crisis leads to emotional and psychological _______ when the stressful event shatters the person’s sense of security and makes him/her feel helpless and vulnerable.
Trauma
List the 7 sources of situational crisis:
- physical illness & injury
- Unexpected or untimely death of a loved one
- Crime, including for victimes and offenders
- Natural and man-made disasters
- War and related acts
- Other unexpected social or interpersonal events, such as divorce
- Other material or environmental losses or events, such as job
With a _______ crisis, the crisis origin is embedded in maturational process–struggle from one life stage (or role) to another. B/c these transitions are a part of normal development, they can be anticipated.
Maturational (Developmental)
In maturational crisis, transitional states may be either universal or non-universal. Explain the difference
Universal consist of normal life cycle passages from one developmental stage to the next.
Non-universal transitional states are transitions that not all people experience during the course of normal development.
Give examples of non-universal transition states
changes in social status, such as a shift from student to worker or from worker to retiree Like universal developmental transitions, non-universal transitions are usually anticipated and can be prepared for.
List the main transition issues, tasks and possible crisis events associated with childhood.
tasks center on socialization, relationship with parents, friendships, and success/failure in school.
Potential crisis events include peer conflict, loss of friends through moving, conflict with parents, school difficulties, and, in early childhood, entering school
List the primary transition issues, tasks and possible crisis events associated with adolescence.
Identity issues dominate.
Potential crisis events include success/failure in academics or athletics, graduation from high school, going to college, conflict with parents over personal habits and lifestyle, breakup with boy/girlfriend, unwanted pregnancy, career indecision, and difficulty on the first job.
List the primary transition issues, tasks, and possible crisis events associated with young adulthood (18-34).
transition issues: intimacy, parenthood, and getting started in a career or occupation.
Potential crisis events include rejection by boy/girlfriend, an extramarital affair, separation/divorce, unwanted pregnancy, birth of a child, inability to have children, illness in a child, discipline problems with children, inability to manage the demands of parenthood, academic difficulties, job dissatisfaction, poor performance in a chosen career, financial difficulties, conflict between career and family goals, and the “age 30 transition”
List the primary transition issues, tasks associated with middle adulthood (35-50).
Transition issues include reworking previous developmental issues and confronting new issues and challenges–the person evaluates what he has accomplished personally and professionally.
List the potential crisis events of middle adulthood (35-50).
awareness of physical decline, chronic illness (self or spouse), rejection by adolescent children, decisions about caring for an elderly parent, death or prolonged illness of parents, career setback, conflicts at work, financial concerns, moving associated with a job promotion, unemployment, sense of discrepancy between life goals and life achievements, dissatisfaction with goals achieved, regret over past decisions related to marrying/not marrying or having children/not having children, marital problems, return to work after raising children, and death of friends
List the primary transition issues, tasks and potential crisis events associated with Maturity (ages 50-65):
Transitions include consolidating one’s experience and resources and reorienting one’s life toward later years.
Potential crisis events include health problems, decisions related to retirement, resistance to retirement, changes in physical living arrangements, conflict with grown children, adjusting to an “empty nest”, death of a spouse, divorce, and conflict with parents
List the primary transition issues, tasks, and potential crisis events associated with old age (retirement until death)
Transition issues involve sharing wisdom from life experiences, evaluating the past, and achieving a sense of satisfaction with his life.
Potential crisis include illness and disability, death of a spouse/friend, financial difficulties, interpersonal conflicts w/children/peers in new living arrangements, neglect by adult children, difficulty in adjusting to retirement, and awareness of loneliness
Whether or not a transition state activates an emotional crisis depends on several factors. Name some of them
when someone does not or cannot prepare for one of these changes.
lack of needed skills/knowledge, unable to take risks, or is socially disadvantaged
co-occurrence of negotiating a key developmental task and an unanticipated traumatic event
perceives life event or situation is inconsistent with society’s expectations for his/her age group
A crisis may stem from various __________/_______ factors operating in the larger society. Job loss, for example, may be due to discrimination rather than poor job performance.
social/cultural factors
List the possible positive outcomes for a person in crisis:
- Problem-solving efforts are successful, and the person returns to precrisis state.
- Person returns to precrisis state and also grows from the crisis experience b/c he discovers new ways of solving problems and new resources.
List the possible negative outcomes for a person in crisis:
- crisis produces severe affective, cognitive, and/or behavioral malfunctioning
- a state of equilibrium is regained and person erroneously feels the crisis has resolved but it has only subsided has not resolved.
List some of the severe affective, cognitive, and/or behavioral malfunctioning related to possible negative outcomes:
depression, withdrawn, suspicious, impulsivity that produce only temporary solutions that are destructive (alcohol, drugs), suicide, homocide
A ____________ ______ occurs when the crisis event is buried below the person’s awareness, and when new stressors occur, it resurfaces and quickly triggers a new crisis. People in this state function at a minimal level & are at increased risk b/c any single stressor may send them back into crisis.
Transcrisis State
What are the three potential effects of Crisis on a Person’s Functioning?
Affective (emotional) Functioning
Cognitive Functioning
Behavioral Functioning
Affective (emotional) Functioning
As in a noncrisis situation, a person’s feelings during a crisis are usually consistent with his/her _________ of the situation.
perception
Name 6 affective (emotional) functioning clues that someone may be in crisis.
impaired affect high degree anxiety/tension
sense of loss or emptiness hopelessness/helplessness
fear of losing control; failure to understand why he/she is acting in a certain way
anger directed at self/others
Name 2 cognitive functions that may be impaired during a crisis.
Altered Cognitive Process (concentration, intrusive thoughts)
Interpretation of events (reality, irrational beliefs)
Cognitive Functioning
Interpretation of events may be affectedby
socialization processess
value systems
Behavioral Functioning
A person’s behavior is generally determined by what he _____ and _______, including his/her interpretation of events.
feels
thinks
Name 7 behavioral indicators associated with crisis.
diminished ability work/school difficulty handling responsibility
change in social behavior Impulsive behavior
Atypical behavior (driving while drunk)
behavior inconsistent with thoughts & feelings
Rejection of help offered by friends/family
An individual’s personal and social resources can affect both the origin and resolution of the crisis. In particular, a person’s ability to cope with recent stressful events can be affected by (5)
family’s response to & interpretation of the events
personal, social, & institutional strengths or supports available.
view of family & other supports as assets or liabilities
Personal, social, financial, vocational,etc. obstacles to progress
success or failure in obtaining resources
______ & ______ affect how people both perceive and respond to life events, including traumatic ones.
Culture; socialization
various _____, _____, & _______ groups attach different meanings to and have distinct patterns of response to events such as death, physical illness, divorce, pregnancy outside of marriage, etc.
cultural, ethnic & religious
Various _____, ______ & ______ groups also have differing role expectations for males/husbands and females/wives. Thus job loss would be more traumatic for an adult male if males in his ______ are expected to provide for the family’s material needs.
cultural, ethnic, & religious
culture
Change, whether expected or unexpected, requires transformation in the organization of a family system and may result in _________, ____ ________, and _______ ________ within the family.
disequilibrium, role confusion and heightened conflict
Symptoms in one or more family members are especially likely to occur during periods of _______, indicating that the family is having difficulty negotiating the transition.
change
Name 3 family events with crisis potential
normal transition points that require a change in roles (retirement)
unexpected traumatic events including those that disrupt the expected course of the family’s development
loss of family morale and family unity
Whether a traumatic event leads to a family crisis or not depends on the family’s ______, _____, & _______ resources for handling the event, including their ability to engage in effective _________ efforts to cope with the difficulties, and on how they _____ & _____ the event
personal, social, & material
collaborative
perceive; define
____ refers to intense emotional suffering brought on by the loss of or separation from someone or something that is deeply loved.
Grief
Grief may be expressed both _______ & ________.
Emotionally; physiologically
Emotional expressions of grief include
sadness, anger, self-reproach, anxiety, loneliness, helplessness, numbness, and sometimes, relief or a sense of freedom.
Physiological expressions of grief include
emptiness in the pit of the stomach, shortness of breath, tightness in the throat, muscle weakness & fatigue, sensitivity to noise, and dry mouth.
Despite emotional and physiological expressions, grief is considered to be a _______ reaction in response to a significant loss.
normal
When using the DSM, _________ is recorded when an individual is having a normal or expectable reaction to the death of a loved one.
bereavement
________ ______ refers to the reaction that occurs at the time of the loss, such as a parent’s immediate reaction to his child being killed in an accident.
Acute grief
Acute grief typically occurs in response to a _______ and _____ loss.
sudden & unexpected
________ _______ is triggered by the realization that a significant loss will occur in the near future. The diagnosis of a terminal illness may precipitate ________ _______.
Anticipatory Grief
Anticipatory Grief
________ ______/_____ occurs when grief returns as a result of remembering a previous loss (e.g. a person feels sad each year during the month when his/her spouse died).
Anniversary Reaction/grief
________ ______ are additional losses that stem from a primary, or initial, loss, and can be a significant source of grief. For example, following his parents’ divorce, a child may lose not only his two-parent family, but also have to move to a new neighborhood and change schools.
Secondary Losses
Name types of losses that may precipitate a grief reaction
death of a loved one, separation or divorce of one’s parents, receiving a terminal diagnosis, having a planned or spontaneous abortion, delivering a stillborn child, placing one’s child in foster care, voluntarily relinquishing one’s parental rights, experiencing a decline in one’s physical/mental functioning, retiring/losing a job, losing a pet, and facing the loss or destruction of one’s personal belongings in a robbery, house fire, or natural disaster
Expressions of grief are affected by the person’s ______ to the lost person or object, _____, _____, _______ _____, ________ ______, _____ _____, _______ or ______ of loss or death the person has experienced.
relationship; age, gender, developmental stage, cultural background, person’s coping patterns, suddenness or type
List 4 phases of grief reaction to a death of a loved one
Numbness
Longing (yearning)
Despair and Disorganization
Recovery and Reorganization
For many people, intense grief diminishes in ____ _____ to a _____, but the process of grieving can take from ______ to ____ years or even longer.
six months to a year
three to five
The _____ ______ ______ ___ _____ with grief suggests that grieving takes place on two levels.
dual process model of coping
List and explain the 2 levels of grieving in the dual process model of coping.
Loss-oriented coping (focuses on negative feelings; early in bereavement process)
restoration-oriented coping (focuses on distractions from grief, such as finding new roles and relationships; predominates later in the bereavement process)
Describe the typical reactions and needs of children up to 2 years old experiencing the death of a parent
doesn’t understand death; senses feelings of adults around him; won’t remember parent
Common symptoms: general distress, sleeplessness, shock, despair & protest, nervousness, frequent sickness, rebellious behavior, hyperactivity,nightmares, depression, compulsive behavior, excessive anger, excessive dependency.
Need affection and reassurance from adults; if lost mx needs a consistent nurturing figure to take her place
Describe the reactions to and understanding of the death of a parent of a child age 2-5 years
understands death as temporary or reversible; will understand that something significant has happened. May no remember the deceased parent.
symptoms: confusion, behavioral and/or emotional regression, frightening dreams, short period of sadness. some children appear unaffected by the loss
Describe the response and needs of a child 2-5 years after the death of a parent
May ask questions, attach quickly to “substitute” people, experience loss as punishment, escape from loss through play, fear that no one will take care of him, fear of losing remaining parent and become clingy
needs adults to communicate in a simple & honest way; reassurance, secure & loving environment, and daily routine and structure. S/b included in funeral rituals
Describe a child age 5-8 years old understanding and symptoms experienced with the death of a parent
beginning understanding of finality of death & may fear death of others
symptoms: anger, blame self, difficulty expressing feelings in words, expresses feelings in behavior, identify with deceased parent as way of hanging on to them; denial, sorrow, general distress, disorientation, and confusion; some behave as though nothing has happened
Describe response and needs of a 5-8 year old’s in relation to death of parent
may ask many questions
needs adults to communicate in simple/honest way; reassurance about the future. May benefit from physical activity as an outlet for his feelings. S/B included in funeral rituals
Describe an 8-12 year old’s understanding of death and possible symptoms in response to the death of a parent
understands finality of death and worry about his own death
symptoms: anxiety, including phobic behavior and intense of fear of the future; physical complaints; angry, develop strong interest in the morbid, & may question religious beliefs
Describe the response and needs of an 8-12 year old in relation to the death of a parent
likely to ask many questions about the death (what happened to the body)
needs adults to communicate directly & honestly and encouraged to talk about feelings; reassurance about the future; physical activity as a regular basis as outlet for feelings; s/b included in funeral plans & rituals
Describe the understanding/symptoms of an adolescent to the death of a parent
may react similarly to an adult but have fewer coping mechanisms
exhibit denial (not want to talk); intense fear of future, hide feelings from others, repress feelings of anger, sadness, become depressed; physical complaints; question religious beliefs, exhibit aggression or withdrawal
Describe the response/needs of adolescents who experienced death of parent
may feel vulnerable, may want to talk about feelings, allowed/encouraged to talk about feelings; peer support; reading about grief
needs supportive adults and a consistent environment; s/b included in both funeral plans/rituals
Children directly impacted by a disaster are at higher risk risk for developing longterm _____ problems than those who are impacted indirectly.
emotional
List 2 common reactions of children exposed to disaster, whether directly or indirectly
Emotional Reactions
Post traumatic Stress Disorder (PTSD)
Children directly or indirectly exposed to disaster may experience an emotional reaction. List 6 emotional reactions they may experience
fear, Loss of Control, Anger, Loss of Stability
Confusion, Isolation
Child directly or indirectly exposed to disaster may experience PTSD. Name typical PTSD symptoms in children.
difficulty sleeping, nightmares, increased aggression, increased clinging, crying or sadness, appetite changes, social withdrawal, obsessive play, hyperactivity, and increased physical complaints (stomachs, headaches)
Although rape occurs predominantly to women, men who are raped by men may suffer traumatic and long-term consequences, particularly b/c they never thought of themselves as potential _____ ______.
rape victims
_______ _____ occurs when a woman is raped by someone she knows. ____ ____ occurs when she is raped by someone she is dating
Acquaintance rape
date rape
Only about ____ % of all rapes are committed by strangers.
20
In date rape, a woman is forced to have sexual intercourse with her date w/out her consent, and this includes cases in which a woman is too _______ to consent. Even men who admit to forcing a woman to have intercourse on a date ___ ___ perceive this act as rape.
intoxicated
may not
Women who are raped experience a ______ __ ____, which can result in overwhelming feelings of fear and stress.
loss of control
Common fears following rape include
fear of being alone, fear of men, inability to trust a dating partner
feelings include depression, anger, guilt, shame and anxiety
Rape trauma syndrome may include ___ phases.
List them
3
Disorganization Phase
Controlled Reaction
Reorganization Phase
