Psych Exam 3 - Health and Wellbeing

Stress

• any circumstance that threatens or is perceived to threaten one’s well being

• stress has both psychological and physiological components

Coping Response

• any attempt made to avoid, escape from, or minimize a stressor

Stressors fall into three categories:

• Major life stressors

• chronic stress

• daily hassle

Major life stressors

• changes or disruptions that strain central areas of people’s lives, such as having your first child

Chronic stress

• ongoing challenges often linked to long-term illness, poverty, or caregiving

Daily hassles

• small, day-to-day irritations and annoyances, such as driving in heavy traffic, dealing with difficult people, or waiting in line

Frustrations

• the pursuit of a goal is prevented

Conflict

• two or more competing and incompatible goals

Approach-approach conflicts

• a choice must be made between two desirable goals

• the least stressful type of conflict

Avoidance-avoidance conflict

• a choice must be made between two unattractive goals

Approach-avoidance conflict

• a choice must be made about achieving a goal which has both positive and negative attributes

Change

• any notable difference in one’s life that requires adaptation

• both positive and negative life changes can be stressful

• Holmes and Rahe Social Adjustment Scale:

  • Eustress: the stress of positive events

  • Distress: the stress of negative events

• Higher rates of stressful life events are associated with greater risk for health challenges

Pressure

• expectations or demands that one behave in a particular manner

General Adaptation Syndrome

• all types of stressful situations lead to a similar stress response consisting of three stages

  • Alarm: the body releases adrenal hormones, sympathetic nervous system is activated

  • Resistance: body is on “high alert”

  • Exhaustion: increased physiological vulnerability to stress

HPA Axis

• a few seconds after a fearful stimulus is perceived, the hypothalamus activates the pituitary gland to release adrenocorticotropic hormone (ACTH).

• the ACTH then travels through the bloodstream to activate the adrenal glands to release catecholamines and cortisol, which energize the fight-or-flight response

Allostatic Load

• the cumulative “wear and tear” on biological systems, including the stress, digestive, immune, cardiovascular, and hormonal systems, among others, after repeated or chronic stressful events

  • Over time, these experiences can cause the system to become “stuck” in certain states and less responsive to changing conditions in the world

  • one way of understanding why experiencing frequent stress in early life is a risk factor for developing psychological disorders later in life

Primary appraisal

• interpretation of a stimulus as stressful or not

Secondary appraisal

• determination of whether the stressor is something that can be handled or not

Threat

• stressor that you believe might not be overcome

Challenge

• stressor you feel fairly confident you can control

• the body responds differently to a threat (negative appraisal) than a challenge (positive appraisal)

Kanner

• also studied stress in terms of daily hassles: the total sum of mundane life tasks that combine to create significant levels of stress

Stressors

• specific events or chronic pressures that place demands on a person and/or threatens well-being

Stress is associated with many health impairing behaviors

• additional health issues associated with stress

  • smoking

  • poor nutritional habits

  • lack of exercise

  • alcohol/drug use

  • risky behaviors

Smoking and Health

• smokers have a significantly shorter life expectancy than non-smokers

• lung cancer, heart disease as well as other cancers, hypertension and emphysema are all smoking-related illnesses

• smokers underestimate health risks

• smokers overestimate their ability to quit

• according to CDC report, just under 1 in 7 American adults are current smokers

  • smoking is blamed for more than 480,000 deaths per year in the Untied States and decreases the typical smoker’s life by more than 12 years

Stress and Health

• Stress in general lowers/decreases the body’s immune response

• short-term stress boosts the immune system; chronic stress weakens it

• healthy volunteers had cold viruses swabbed into their noses

  • those who reported the highest levels of stress prior to exposure developed worse cold symptoms than those who reported being less stressed

• stress and personality style interact with health: heart and circulatory system sensitive to stress

Type A behavior pattern

• a pattern of behavior characterized by competitiveness, achievement orientation, aggressiveness, hostility, restlessness, impatience with others, and inability to react

Type A personality

• a strong predictor of heart disease as is high blood pressure, high cholesterol, or smoking

• at greater risk compared to those who may exhibit different personality styles

• especially the “most toxic” variable of hostility is one of the best predictors of heart disease (more than cholesterol, caloric intake or smoking)

• hot-tempered people who are frequently angry, cynical, and combative are much more likely to die at an early age from heart disease

• multiple studies conclude that hostile, angry people are at greater risk for serious diseases and earlier death than those with more optimistic and happier personalities

Type B personalities

• noncompetitive, relaxed, and easygoing

• less quick to anger

Burnout

• physical, emotional, and mental exhaustion caused by long-term exposure to demands associated with lower performance and motivation

Well-being

• a positive state that includes striving for optimal health and life satisfaction

Coping

• strategies you use to buffer against the stress cycle

• active efforts to master, reduce, or accept the demands created by stress

• uses humor, social support, religious or spiritual practice

  • humor: the use of humor can help cope with stress; it can also diffuse some situations such as bullying to reduce stress/stressors

  • social support: presence of social supports provide adaptive coping/release from pressures

    • longitudinal research demonstrates the positive benefits of meaningful relationships and their association with health and wellbeing

Biopsychosocial model

• a model of health that integrates the effects of biological, behavioral, and social factors on health and illness

• contrasts with the traditional medical model that views the individual as passive recipient of both disease and treatment

Maladaptive coping strategies

• Displaced aggression

  • harmful act to someone verbally or physically, who is not actually the true “object” of the hostility

• Catharsis

  • release of emotional tension

• Self-Indulgence

  • compensate for deprived/frustrated feelings by trying to promote a feeling of satisfaction in another area

Constructive/Adaptive Coping Strategies

• health efforts to deal with a stressful event making one more resilient to the stressor(s)

• problem focused coping

  • how to change the situation

• emotion focused coping

  • how to change perceptions/reactions to the situation

Optimism

• people with more positive outlooks handle stress better

• a protective variable against Alzheimer’s disease (nun study)

Predictors of Happiness

• research shows that there are many variables that impact the subjective experience of happiness

• strong predictors: close friendships, religion, genetic factors

• moderate predictors: health, love and marriage, work satisfaction

• weak predictors/not predictive: money, age, parenthood, intelligence, attractiveness

• research indicates the stress reduction benefits of dogs as a source of companionship, connection with others, and its association with exercise

  • stress and dogs

Conscientiousness

• been associated with positive physical health and higher rates of longevity (Terman’s sample)

• May gravitate toward healthier environments

• Less reactivity towards stress

• Less likely to exhibit unhealthy habits like smoking, drinking, risk taking

Coping strategies that focus on managing the body and its physiological reactions and responses to stress

• relaxation

• meditation

• aerobic exercise

Relaxation

• reduces tension by relaxing muscles in body, slowing cortical activity, heart rate, respiration and blood pressure

Meditation

• intentional process, historically associated with religious rituals, but also practiced outside religious contexts

• Clear the mind of thoughts

• Concentration on breathing with or without a mantra

• Many report the experience is both restful and restorative

• For some the experience transforms consciousness

Exercise

• the more people exercise, the better their physical and mental health

• people feel good because they know exercise is good for them; it builds self-confidence; helps in coping with stress; and also enhances the growth of new neurons and the production of synaptic connections

• at least 30 minutes of daily exercise is associated with the most positive mental state

• those with better fitness in middle age are:

  • likely to enjoy much longer lives

  • less likely to have heart problems

  • at much lower risk for most types of cancer

• a meta-analysis found that exercise is as effective as medications for preventing diabetes or heart disease or promoting recovery following heart attacks

• it is never too late to start exercising and receiving its positive benefits

• researchers have concluded that exercise reduces cognitive decline in older adults with moderate memory problems

Mind management coping

• involves ways to change how we think about stressors

• three strategies can help people use positive thoughts to deal with stress:

  • positive reappraisal: focusing on possible good things in one’s current situation

    • aka. the silver lining

  • downward comparisons: comparing oneself to those who are worse off

  • creation of positive events: a strategy of giving positive meaning to ordinary events

Reappraisals as a coping response/Rational Coping

• Acceptance

  • accepting that stressors exist and understanding the bodies response

• Exposure

  • attending to or seeking out the stressor

• Understanding

  • working to find the meaning stressors hold in one’s life

• Reappraisals

  • reappraising one’s own stress response as adaptive reduces the negative effects of stress, in effect making the response more adaptive

Reframing

• ways to promote the ability to find a new or creative way to think about a stressor that reduces a threat

  • Stress inoculation training (SIT): Reframing technique that helps people cope with stressful situations by developing positive ways to think about situations

  • Writing about your deepest thoughts and feelings has been shown to have a range of beneficial health effects

  • research has shown using third-person self-talk may decrease depressed affect and worry and increase emotion regulation

Positive Psychology

• promote higher rates of happiness and a greater sense of well-being

• across multiple studies and types of measures, positive emotions are related to considerable health benefits

  • higher levels of hope and curiosity are associated with reduced risk of disease

  • positive emotional states, or a generally positive outlook on life, have multiple beneficial effects on the immune system

Personality

• a distinctive pattern of behavior, thoughts, motives, and emotions that are consistent in an individual over time

Personality inventories

• sensitive to self-report bias

• Minnesota multi phasic personality inventory (MMPI); rosenberg, self-esteem, locus of control

Projective tests

• sensitive to interpreter bias

• rorschach, TAT, DAP

Technological Measurements

• EAR (electronic activated recorder)

• ESP (experience sampling method)

Idiographic approaches

• person-centered approaches to studying personality

• focus on individual lives and how various characteristics are integrated into unique persons

Personality traits

• long-term disposition to behave in a particular way in a variety of situations

Cattel’s Theory of Personality

• studied traits using factor analysis

• developed the 16 personality factors

• questionnaire

• examples: reserved-outgoing; relaxed-tense; trusting-suspicious

McRae and Costa

• developed the “Big Five” personality traits; believe most personality traits fall under these categories

  • Openness to Experience

  • Conscientiousness

  • Extraversion

  • Agreeableness

  • Neuroticism

Big 5 traits appear to be universal

• used in many research settings showing validity

• people high in extraversion like to spend more time with people and look them more in the eye

• people high in conscientiousness perform well at work and live longer

• people low in conscientiousness and agreeableness more likely to be “juvenile delinquents”

• Generally stable over the lifespan with increase of conscientiousness in 20s, more agreeable in 30s, and neuroticism decreases in women as they age

Trait Theory and Gender

• research on traits show that in general:

  • overall men and women seem to be more similar in personality than different

  • women tend to be higher than men on agreeableness, neuroticism, and conscientiousness

  • men have been found to report being more assertive, self-esteem, and sensation seeking

  • research shows that personality differences by gender are more pronounced in adolescence cross culturally

• cross cultural research on the big 5 has shown that the Big 5 personality traits are valid across all the countries

• however, some note that the Big 5 omits dimensions of personality that feature prominently in other cultures, such as modesty and humility, but are less valued in the West

Eysenck’s Theory

• personality is determined by a large extent to one’s genes

• all of personality emerges from 3 higher order traits that are biologically based (ex. differences in cortical levels of arousal). hierarchal with specific behavioral tendencies associated with a higher-order trait

• extraversion: being sociable, assertive, and lively

• neuroticism: anxious, tense, moody, low self-esteem

• psychoticism (constraint): egocentric, cold, impulsive

• eysenck believed that differences in arousal produce the behavioral differences between extraverts and introverts

  • proposed that the resting levels of the system that regulates arousal are higher for introverts than extroverts

  • introverts are typically above their optimal level, so they do not want any additional arousal

Freud’s Psychoanalytic Theory

• focus on influences of early childhood

• emphasis on unconscious motives/conflicts

• primary focus on sexual and aggressive urges

• Primary focus on sexual and aggressive urges

• your textbook states that Freud’s ideas of unconscious forces determining personality have been abandoned by modern psychological science because they are difficult to test with data.

Id

• impulses/dominated by pleasure/avoid pain

Ego

• voice of reason, mediator of id/superego, helps find compromises

Superego

• moral component of personality; rigid standards

Psychosexual stages

• progress through stages

• fixations or regressions can occur

Defense mechanisms

• responses to anxiety that are caused by internal conflicts

• attempts to reduce distress of anxiety/guilt

• ex) displacement, reaction formation, compensation (overcompensation)

Social Cognitive Theory of Personality

• Bandura argued that three factors influence how a person acts

• 1. the person’s environment

• 2. multiple person factors (personal/cognitive factors) which include the person’s characteristics, self-confidence, and expectations

• 3. behavior

Bandura’s Reciprocal Determinism

• the theory that how personality is expressed can be explained by the interaction of environment, person factors, and behavior itself

• Personality reflects how we think about the situations we encounter and that determines our behavioral response

  • reinforcement history (environment) interacts with cognition and influences behavior

  • we may see what we expect to see

  • we may place ourselves in places that will confirm our beliefs

Self-esteem

• the extent to which an individual likes, values, and accepts the self

• people high in self-esteem live happier, healthier lives

• people low in self-esteem tend to perceive rejection in ambiguous feedback

Self-concept

• explicit knowledge of one’s own behaviors, traits, ad characteristics

• self-concept develops and is maintained in relationship to others

• social comparison plays a role here

• increased stability over time

• self-verification: we look for evidence to confirm our self-concept

• self-confidence may affect our behaviors and decision making

Self-efficacy

• belief one can set out to accomplish tasks/goals

• acquired from 4 sources

  • mastery of new skills, overcome obstacles

  • successful and competent role models

  • positive feedback and encouragement

  • awareness of feelings/manage responses

Locus of Control (Rotter)

• the degree to which people perceive the control of rewards as internal to the self or external to the environment

Internal Locus of Control

• people believe they are responsible for what happens to them

External Locus of Control

• people believe their lives are controlled by luck, fate, or other people

Situations

• have a significant impact determining behavior

• people behave inconsistently across situations, showing a limitation of a strict trait theory

• Mischel proposed a cognitive affective processing system, suggesting that people react in predictable ways to specific conditions

  • people will exhibit stable behavior if they find themselves in similar situations over time

  • circumstances may be more likely to determine shyness, honesty, cheating, or breaking the rules versus being trait determined

Humanistic Perspective

• humanistic approaches to personality emphasize personal experience, belief systems, the uniqueness of the narrative of each human life, and the inherent goodness of each person

• focus on the inner experience of one’s personality and development

• unique human qualities

• free will and the potential for human growth

• optimistic view of human nature: can control impulses, not based on irrational needs and conflicts

• explores the healthy choices that form our personalities

Carl Rogers’ person-centered approach

• emphasized the importance of people’s subjective understandings of their lives

• encouraged parents to raise their children with unconditional positive regard so that they might become fully functioning people

• according to Rogers,a. child raised with unconditional positive regard would develop a healthy sense of self-esteem and would become a full functioning person

• scientists have developed training interventions that can be completed across a few months to help parents express unconditional positive regard and other positive practices, such as warmth and responsitivity

• Csikszentamihalyi introduced the concept of flow to the humanistic perspective

  • flow reflects the achievement of one’s potential

  • tasks that are below our abilities cause bordeom

  • tasks that are too challenging cause anxiety

  • tasks that are “just right” lead to the ideal feeling of being in “the zone” or an optimal state he calls flow

Mental Disorder

• any behavior or emotional state that causes distress or suffering, is maladaptive, and disturbs relationships and the greater community

• key component is the level of subjective distress and whether it interferes with the ability to successfully function in everday life

Legal Standards

• competency may be determined by whether a person is or is not in control of their behavior and aware of the consequences of their actions

Classifying Mental Disorders

• standard reference book for disorders is current the DSM 5-TR (2022)

• Descriptive and provides a set criteria for diagnosis

• problems with a diagnostic classification system such as the DSM

  • the danger of overdiagnosis

  • the power of diagnostic labels

  • many of the symptoms are based on subjective not objective measures

  • some categories have political/social/cultural implications

• DSM 5 and 5-TR significant shifts and changes from previous editions

• Diagnostic categories take a developmental/lifespan approach beginning with disorders that appear in infancy/childhood through those most likely to occur in adulthood

Autism Spectrum Disorders

• A. Deficits in social communication and social interactions as manifested by all of the following

  • 1. no back and forth conversation

  • 2. lack of eye contact, gestures

  • 3. deficit in social relationships

• B. Restricted in repetitive patterns of behaviors or activities

  • 1. Repetitive speech or use of objects

  • 2. Excessive need for routines/rituals including verbal

  • 3. Restricted interests and preoccupations

  • 4. Sensory senstivity (hyp or hyper reactivity)

• All 3 required in criterion A and 2 of 4 in B for the diagnosis

Attention Deficit Hyperactivity Disorder (ADHD)

• Inattention: fails to attend to details, difficulty organizing tasks, loses things, forgetful

• Impulsivity and/or hyperactivity: fidgets, “on the go”, interrupts, runs and climbs inappropriately

  • behavior is inappropriate for a child’s particular developmental age

• Several inattentive of hyperactive-imulsive symptoms (6+) present prior to age 12 years

• several inattentive or hyperactive-impulsive symptoms are present in two or more settings

• there is clear evidence that the symptoms interefere with, or reduce the quality of social, academic, or occupational functioning

• Diagnosis is made as:

  • ADHD predominantly inattentive presentation

  • ADHD predominately hyperactive/impuslive presentaion

  • ADHD combined presentation

• Severity Specifier

  • Mild: few symptoms in excess, minor impairment in social/occupational functionig

  • Moderate: impairment between mild/severe

  • Severe: several symptoms in excess of what is required for a diagnosis, or several severe symptoms, or severe impairment in functioning

• Genetic link/runs in families

• Multimodal treatment approach: drugs and behavioral interventions

• ADHD is more frequent in males than in females in the general population

• Females are more likely than males to present primarily with inattentive features. Sex differences in ADHD symptom severity may be due to differing genetic and cognitive liabilities between sexes

Conduct Disorder

• a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated

  • aggression to people and animals

  • destruction of property

  • deceitfulness or theft

  • serious violation of rules

  • specify if with limited prosocial emotions: lacks remorse, callous, unconcerned about performance, shallow or deficient affect

• may be a precursor to antisocial personality

Tourette’s Disorder

• both multiple motor and one or more vocal tics

• occur many times a day nearly every day or intermittently over a period of more than 1 year

• onset before age 18

• does NOT need to interfere with functioning for diagnosis

Generalized Anxiety Disorder (GAD)

• Continuous feelings of worry, anxiety dread/foreboding

• Restlessness

• Difficulty concentrating

• Irritability

• Muscle tension

• Sleep disturbance

Panic Disorder

• the spontaneous and unexpected occurrence of panic attacks

• recurring attack of intensive fear or panic accompanied by feelings of impending doom or death

• symptoms include:  trembling, shaking, dizziness, chest pain, sweating, heart palpitations, hot/cold flashes, sense of losing control

• panic attacks must be associated with longer than 1 month of subsequent persistent worry about having another attack or consequences of the attack, or significant maladaptive behavioral changes relatled to the attack

Anxiety and Phobias

• exaggerated fear of a specific situation, activity, or thing

Social Anxiety Disorder (Social Phobia)

• fear or anxiety about one or more social situations in which the individual is exposed to possible scrutiny by others

Agoraphobia

•  fear of being alone in public places from which escape might be difficult or help will be unavailable; at its worst one doesn’t leave his/her home

Specific Phobias

• ex) spiders, squirrels, dogs

Obsessive-Compulsive Disorder (OCD)

• Obsession: a recurrent, persistent and unwished for thought

• Examples: contamination; need for orderliness, aggressive impulses or thoughts, obsessive worry about an accident happening

• Compulsion: repetitive ritualized behavior in which people feel a lack of control over it.

• Examples: Cleaning, Checking and Hoarding; Creates anxiety to not have things a certain way

• considered a disorder when it interferes with everyday life

Hoarding Disorder

• persistent difficulty discarding items, even those with no or little value

• due to a perceived need to save the items and associated distress with discarding

• difficulty discarding the items results in clutter and inability to use living space

• Severity is related to levels of insight into the disorder and its disruptions

• Multiple factors associated with individuals who develop Hoarding Disorder (e.g., Steketee, et al 2015 )

  • Being raised in a chaotic home

  • Challenges with decision making and problem solving;

  • ADHD (overwhelmed with organization/task)

  • Anxiety and/or depression

  • Guilt about waste

  • Effort to “protect” and comfort with objects/items

  • Reminder to respect the intensity of the symptoms and support the individual for where they are in the process

Post Traumatic Stress Disorder (PTSD)

• trauma or stress related disorder following exposure to death, threatened death, actual or threatened serious injury, or actual or threatened sexual violence. Reflects change from previous functioning

• reexperiencing symptoms: spontaneous intrusions of traumatic memory in the form of images or nightmares

• avoidance symptoms: avoiding places and reminders of the traumatic event

• hyperarousal symptoms: insomnia, irritability, impaired concentration, hypervigilance, and increased startle response

Mood Disorders

• Depression (major depressive disorder, persistent depressive disorder, premenstrual dysphoric disorder, prolonger grief and unspecified mood disorder)

• sadness: lethargy, inactivity, and feelings of helplessness and hopelessness

• behavioral changes: ex) slower motor reactions

• cognitive changes: ex) cognitive distortions

• physical changes: ex) alters immune functioning

Bi-polar Disorder (previously Manic-Depression)

• Bipolar I Disorder: characterized by at least 1 manic episode or mixed episode (manic and depressive features in the same episode)

• Biopolar II Disorder: 1 or more major depressive episodes, together with at least 1 hypomanic episode

  • cyclical nature of this disorder

  • responsive to lithium and other mood stabilizers

  • challenges with treatment compliance

  • can be adaptive, healthy, and contributing members of society

Mania/Hypomania as part of the Bi-Polar Diagnosis

• Inflated self-esteem or grandiosity.

• Decreased need for sleep

• Pressured speech

• Flight of ideas or subjective experience that thoughts are racing.

• Distractibility

• Increase in goal-directed activity

• Excessive involvement in activities that have a high potential for painful consequences (e.g., buying sprees, sexual indiscretions, or poor business investments)

Mania of Bipolar I

• mood is iextremely abnormal and is also combined with i increased activity or energy that is also abnormal

Hypomania of bipolar II

• sustained mood that is elevated (heightened), expansive (grand, superior), or irritable

• this mood has to be noticeably different from his or her (their) normal mood when not depressed

• mild: if only minimum symptom criteria are met

• moderate: if there is a significant increase in activity or impairment in judgement

• severe: if almost continual spervision is required

Somatic Symptom Disorder

• history of diverse physical complaints which are psychological in origin and result in disruption in daily life

Illness Anxiety Disorder

• excessive preoccupation with health concerns/worry about developing illnesses. Used to be called hypochondria

Functional Neurological Symptom Disorder (formerly Conversion disorder)

• loss of motor or sensory function with no organic basis, usually a specific area or system affected

Personality Disorders

• rigid, maladaptive traits that cause great distress or lead to an inability to get along with others, or to function well in the world

• pattern is inflexible, pervasive, and of long duration

• some question the validity of the category

• clusters identified in your text:

  • odd/eccentric: paranoid, schizoid, schizotypal

  • dramatic/erratic: antisocial, borderline, histrionic, narcissistic

  • anxious/inhibited: ocpd, dependent, avoidant

Schizophrenia

• psychosis or condition involving distorted perceptions of reality and an inability to function in most aspects of life

• Typical age of onset: 17-25

• Strong genetic component

Positive Symptoms

•  Presence of a distortion or bizarre behavioral symptom

• Bizarre delusions

• Hallucinations

• Grossly disorganized speech

• Grossly disorganized behavior