Chapter 6 Book Notes
Chapter 6 Book Notes psy 240
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This 10 page Class Notes was uploaded by Alicia Rinaldi on Tuesday September 8, 2015. The Class Notes belongs to psy 240 at University of Miami taught by Dr. Parlade in Fall 2014. Since its upload, it has received 54 views. For similar materials see abnormal psychology in Psychlogy at University of Miami.
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Date Created: 09/08/15
Chapter 6 Stress Disorders l Preface A We feel some degree of stress whenever we are faced with demands or opportunities that require us to change in some manner Stressor the event that creates the demands Stress response the person s reactions to the demands Key stress disorders 1 Acute stress disorder 2 Posttraumatic stress disorder ll Stress and Arousal The Fightor Flight Response A Hypothalamus the brain area that sets arousal and fear in motion B Hypothalamus activates 1 Autonomic nervous system ANS the network of nerve bers that connect the central nervous system to all the other organs of the body a Controls involuntary activities of organs 2 Endocrine system the system of glands located throughout the body that help control important activities such as growth and sexual activity a Releases hormones into the bloodstreamorgans 3 Systems often overlap responsibilities C 2 pathways above systems use to produce arousal and fear reactions 1 sympathetic nervous system the nerve bers of the autonomic nervous system that quicken the heartbeat and produce other changes experienced as arousal and fear a may directly or indirectly cause changes b indirectly stimulating adrenal glands adrenal medulla which causes them to release epinephrine adrenaline and norepinephrine noradrenaline which travels to organs amp muscles to further produce arousal and fear c parasympathetic nervous system the nerve bers of the autonomic nervous system that help return bodily processes to normal 2 hypothalamicpituitaryadrenal HPA pathway one route by which the brain and body produce arousal and fear a when faced by stressors hypothalamus signals pituitary gland to secrete adrenocorticotropic 00w hormone ACTH aka the body s quotmajor stress hormonequot b ACTH triggers the release of corticosteroids a group of hormones including cortisol released by the adrenal glands at times of stress D Fightor ight response is our body s response to danger E Trait anxiety is a person s general level of arousal and anxiety and these differences appear soon after birth F State anxiety is the situations that cause fear or anxiety for a speci c person The Psychological Stress Disorders Acute and Posttraumatic Stress Disorders A Preface 1 For most people stress reactions subside as soon as the danger passes but for others the symptoms of anxiety and depression persist 2 A traumatic event is one in which individuals are exposed to actual or threatened death serious injury or sexual violation 3 Acute stress disorder a disorder in which fear and related symptoms are experienced soon after a traumatic event and last less than a month 4 Posttraumatic stress disorder PTSD a disorder in which fear and related symptoms continue to be experienced long after a traumatic event 5 Acute stress disorder becomes PTSD after a month 80 of all cases symptoms a Reexperiencing the traumatic event vivid recurring thoughts memories or nightmares b Avoidance people avoid activities that remind them of a traumatic event c Reduced responsiveness people feel detached from other people or lose interest in activities they used to enjoy d lncrease arousal negative emotions and guilt B What Triggers a Psychological Stress Disorder 1 Can occur at any age affect all aspects of someone s life and may incur symptoms of depression another anxiety disorder suicidal thoughts or substance abuse 2 35 of people per year 79 lifetime 23 seek treatment women are 2x more likely than men 3 Combat and Stress Disorders a quotshell shockquot and quotcombat fatiguequot refer to the symptoms of anxiety and depression developed during war b many veterans from VietnamAfghanistanlraq have PTSD or acute stress disorder 4 Disasters and Stress Disorders a Acute amp PTSD may follow natural amp accidental disaster such as earthquakes oods tornadoes res airplane crashes and serious car accidents b More likely to see triggers because these events are relatively common 5 Victimization and Stress Disorders a Sexual assault Rape forced sexual intercourse or another sexual act committed against a nonconsenting person or intercourse with an underage person Rape victims are often young women and 70 are raped by family members Most victims develop acute stress disorder but some develop PTSD Victims continue to have higher than average levels of anxiety suspiciousness depression selfesteem problems selfblame ashbacks sleep problems and sexual dysfunction b Terrorism People who are victims of terrorism who live under the threat of terrorism often experience posttraumatic stress symptoms c Torture the use of brutal degrading and disorienting strategies to reduce victims to a state of utter helplessness vi Usually done by gov tauthority order to force persons to yield information We don t know the numbers because many gov ts keep torture a secret Physical torture beatings waterboarding electrocution Psychological torture threats of death mock executions verbal abuse degradations Sexual torture rape violence to the genitals sexual humiliation Torture through deprivation sleep sensory social nutritional medical or hygiene deprivation vii Victims often experience physical pain but the mental scarring is usually worse viii Even those who do not develop a disorder 50 may still have ashbacks repressed memories anger sadness etc C Why Do People Develop a Psychological Stress Disorder 1 Anyone who experiences trauma will be affected by it but not everyone will develop a stress disorder 2 Biological and genetic factors a Researchers found abnormal activity of hormone cortisol and neurotransmitterhormone norepinephrine in urine blood saliva of soldiers rape victims etc b Once a stress disorder sets in individuals experience further biochemical arousal that may damage key brain areas c Dysfunctional hippocampus produces intrusive memories amp constant arousal d Dysfunctional amygdala may help produce repeated emotional symptoms and strong emotional memories e PTSD leads to transmission of biochemical abnormalities to children of people with PTSD 3 Personality a Studies suggest that people with certain personalities attitudes and coping styles are particularly likely to develop acute and PTSD b Ex anxious people are more likely to get PTSD after a storm 4 Childhood experiences a Researchers found that certain childhood experiences seem to leave people at risk for acute and PTSD b Ex people who grew up in poverty or whose family members have been assaulted 5 Social support a People with weak support systems are more likely to develop acute or PTSD 6 Multicultural factors a Hispanics have higher rates of acute and PTSD than other racial groups b Part of their cultural belief system views traumatic events as inevitable amp unalterable 7 Severity of trauma a Generally the more severe the trauma and the more direct exposure the greater the likelihood of developing a stress disorder D How Do Clinicians Treat the Psychological Stress Disorders 1 Treatment procedures vary according to type of trauma but all therapies try to help survivors put an end to their stress reactions gain perspective and return to living 2 Treatment for Combat Veterans a e Most common i Drug therapy antianxiety drugs amp antidepressants ii Behavioral exposure techniques ooding and relaxation training may be most helpful iii lnsight family amp group therapy helps others amp veteran react in better ways iv Usually approaches are combined Eye movement desensitization and reprocessing EMDR an exposure treatment in which clients move their eyes in a rhythmic manner from side to side while ooding their minds with images of objects and situations they ordinarily avoid Said to help with PTSD Cognitive therapy helps veterans change dysfunctional attitudes Rap group a group that meets to talk about and explore members problems in an atmosphere of mutual support Veterans Outreach Centers provide treatment for veterans and their families 3 Psychological debrie ng aka critical incident stress debde ng a A form of crisis intervention in which victims are helped to talk about their feelings and reactions to traumatic events People traumatized by disasters victimization or accidents pro t from the same treatments veterans use ln psychological debrie ng sessions counselors guide individuals to describe details of trauma to relive emotions and then guide them through stress management Sessions often applied to trauma victims who haven t yet shown signs of stress as a precaution e Many communities get debrie ngtrained counselors after a traumatic event for free debrie ng sessions 4 Does Psychological Debrie ng Work a Research once supported PD but has been questionable recently b Some clinicians worry early intervention encourages victims to dwell on traumatic events some say it suggests certain problems to victims The Physical Stress Disorders Psychophysiological Disorders A B C Stress can impact our physical functioning and can contribute to medical problems Mindbody dualism the belief that the mind or soul is separate from the body Psychophysiological disorders aka psychological factors affecting medical condition stressinduced disorders in which biological psychological and sociocultural factors interact to cause or worsen a physical illness 1 Bring about actual damage and are different from apparent physical illnesses like factitious disorder conversion disorder illness anxiety disorder Traditional Psychophysiological Disorders 1 Clinicians used to believe that very few illnesses were psychophysiological but now they know that many other illnesses may be caused by an interaction of psychosocial and physical factors 2 Ulcer a lesion that forms in the wall of the stomach or of the duodenum a Stress factors environmental pressure anger anxiety b Physiological factors bacteria 3 Asthma a medical problem marked by narrowing of the trachea and bronchi which results in shortness of breath wheezing coughing and a choking sensann a 70 of cases caused by interaction of stress factors with physiological factors b stress factors environmental pressures anxiety c physiological factors allergies slow nervous system weakened respiratory system 4 insomnia difficulty falling or staying asleep a psychosocial factors anxiety or depression b physiological problems overactive arousal system or certain medical ailments 5 chronic headaches a muscle contraction tension headaches a headache caused by a narrowing of muscles surrounding the skull b migraine headache a very severe headache that occurs on one side of the head often preceded by a warning sensation and sometimes accompanied by a dizziness nausea or vomiting i blood vessels in the brain narrow ow of blood slows ii blood vessels later expand rapid ow of blood c stress factors environmental pressure helplessness anger anxiety depression d physiological factors abnormal activity of serotonin vascular problems muscle weakness 6 hypertension chronic high blood pressure a essential hypertension hypertension that results from a combo of psychosocial and physiological factors 90 of cases b psychosocial factors danger stress anger depression c physiological factors obesity smoking poor kidney function high collagen in blood vessels 7 coronary heart disease illness of the heart caused by a blockage in the coronary arteries a myocardial infarction a heart attack b psychosocial factors job stress anger depression c physiological factors high cholesterol obesity hypertension smoking lack of exercise 8 biological factors a brain activates body organs through the autonomic nervous system defects contribute to psychophysiological disorders b some people are biologically prone to certain disorders 9 psychological factors a needs attitudes emotions or coping styles may cause people to overreact to stressors and increase chance of psychophysiological disorders b a person with a repressive coping style has a reluctance to express discomfort anger or hostility and experiences a sharp rise in blood pressure amp heart rate when stressed c type A personality style a personality pattern characterized by hostility cynicism drivenness impatience competitiveness and ambition i linked to coronary heart disease ii not necessarily having a type A personality is linked to heart disease but characteristics of a type A like hostility and time urgency d type B personality style a personality pattern in which persons are more relaxed less aggressive and less concerned about time 10 Sociocultural Factors The Multicultural Perspective a Adverse social conditions trigger and interact with biological and personality factors and can cause psychophysiological disorders poverty is strongest b African Americans have higher rates than whites due to dangerous living conditions bad jobs racism and poverty c Hispanics unexpectedly have less psychophysiological problems than whites and African Americans probably because of their emphasis on family and religion E New Psychophysiological Disorders 1 Are Physical lllnesses Related to Stress a Holmes and Rahe developed a Social Adjustment Rating Scale to rank big stressors in someone s life such as death of a spouse or sending a kid to college b Found that overall the greater amount of life stress the greater the likelihood of illness c SAR scale doesn t take into consideration the particular life stress reactions of speci c populations such as African Americans vs whites or adults vs college students 2 Psychoneuroimmunology the study of the connections between stress the body s immune system and illness a Immune system the body s network of activities and cells that identify and destroy antigens and cancer cells Antigen a foreign invader of the body such as a bacterium or virus Lymphocytes white blood cells that circulate through the lymph system and bloodstream helping the body identify and destroy antigens and cancer cells i Helper Tcells a group of lymphocytes that identi es antigens and then multiplies and triggers production of immune cells ii Natural killer Tcells destroys body cells that have been infected by viruses iii Bcells produce antibodies protein molecules that recognize and bind to antigens to prevent the from causing infection Stress slows down activities of lymphocytes so people are more susceptible to virusesbacterial infections Biochemical activity I excessive norepinephrine contributes to slowdowns of the immune system ii corticosteroids contribute to poorer immune system functioning by producing cytokines which leads to chronic in ammation throughout body behavioral changes people becoming anxious or depressed are more likely to sleep badly eat poorly exercise less and other activities that slow the immune system personal style people who generally respond to lie stress with optimism constructive coping and resilience experience better immune functioning social support people with more social support likely have better immune systems than those who lack social support F Psychological Treatments for Physical Disorders 1 Behavioral medicine a eld that combines psychological and physical interventions to treat or prevent medical problems Relaxation Training a People can be taught to relax their muscles at will which can help prevent or treat medical illnesses related to stress b Used in combo with medicine to treat headaches insomnia asthma diabetes etc 3 Biofeedback a People are connected to machinery that gives them continuous readings about involuntary body activities 4 Meditation a A technique of turning one s concentration inward achieving a slightly changed state of consciousness and temporarily ignoring all stressors b Used to help manage pain and treat high blood pressure heart problems asthma skin disorders etc c Mindfulness meditation meditators pay attention to the feelings thoughts and sensations that are owing through their minds during meditation with detachment and objectivity and without judgment 5 Hypnosis a People are guided by a hypnotist into a sleeplike suggestible state during which they can be directed to do certain things b used to treat many physical conditions 6 Cognitive Interventions a Selfinstruction training or stress inoculation training helps patients cope with severe pain by ridding themselves of unpleasant thoughts that keep emerging during pain episodes b Replace negative thoughts with coping self statements like quotI can do thisquot 7 Emotion Expression and Support Groups a Discussingwriting down emotions helps improve a person s health b Bene cial for patients with HIV or cancer 8 Combination Approaches a Various psychological interventions for physical problems tend to be equal in effectiveness b Helpful in changing Type A patterns amp reducing risk of coronary heart disease among people who display these patterns