Lesson 2 - Stress Disorders

What is Stress?

“Stress is physical, mental or emotional distress.”

How does the body react to stress?

Stress is the body's natural response to changes or challenges, triggering both physical and mental reactions. It helps individuals adapt to difficult situations but can become harmful if prolonged or overwhelming.

What is a stressor?

An event that repeatedly causes distress or difficulty for a person.

______ describes the three types of stress. What are they?

• Hans Selye

  1. Psychological Stress

  2. Biological Stress

  3. Environmental Stress

What is the Social Readjustment Rating Scale (SRRS)?

It is an important tool for measuring how life changes impact stress levels. It helps assess the connection between major life events and a person’s ability to adapt socially and emotionally.

Who developed the Social Readjustment Rating System (SRRS)?

Developed by Holmes and Rahe in 1967

How many major life events did Holmes and Rahe identify?

43 major life events

What are the main stresses people face with day-to-day life?

• Frustration 

• Conflicts

• Pressure

• Sexual abuse

• Daily Hassles

What stressors affect stress which can be discussed under several specific categories?

• Physical Stressors

• Mental Stressors

• Job related stressors

• Environment Stressors

• Family-related Stressors

• Social Stressors

The effects of stress can be discussed in two parts.

What are they?

1. Physical effect 

2. Psychological effect

What is Physical Effect?

The body’s autonomic nervous system controls your heart rate, breathing, vision changes and more. Its stress response is the “flight-or-fight response.” Some examples,

• High heart rate

• Headache

• Immaturity

• Disorders in the menstrual cycle in women

What are the Mental Effect?

• Anxiety

• Depression

• Cognitive impairment

• Irritability

Who wrote the The Stress of Life (1956)?

Hans Selye, a psychologist who has done extensive research on stress.

According to the book The Stress of Life (1956) , there are ___ main stages in a person's stress.

What are they?

Three

1. Alert phase

2. Coping phase

3. Energy degradation phase

What happens during the alert phase in a person’s stress?

• The body’s immune system is stimulated during this stage.

• The nervous system gets activated in a way that gives the body instant energy during a stressful situation.

What happens during the coping phase in a person’s stress?

• The person is experiencing stress.

• On the other hand, it can be a struggle with stress or adaptation stress.

What happens during the energy degradation phase in a person’s stress?

• This stage is the most severe stage of stress.

• This stage issue to prolonged stress.

• The physical and mental strength of a person is cope with stress is declining.

If the stress symptoms persist for approximately two days after a traumatic event, it can be identified as ____

Acute Stress Disorder

 What are the factors that can lead to Acute Stress Disorder (ASD)?

1. Exposure to actual or threatened death, serious injury, or sexual violation

2. The presence of nine or more symptoms from any of the five categories—intrusion, negative mood, dissociation, avoidance, and arousal

3.  Duration of the disturbance (symptoms in Criterion B) is 3 days to 1 month after trauma exposure.

4. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

5. The disturbance is not attributable to the physiological effects of a substance or another medical condition and is not better explained by brief psychotic disorder.

What are the ways that ASD can take place by exposure to actual or threatened death, serious injury, or sexual violation?

1. Directly experiencing the traumatic event(s). 

2. Witnessing, in person, the event(s) as it occurred to others. 

3. Learning that the event(s) occurred to a close family member or close friend. Note: In cases of actual or threatened death of a family member or friend, the event(s) must have been violent or accidental. 

4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s) (e.g., first responders collecting human remains, police officers repeatedly exposed to details of child abuse)

Presence of Intrusive symptoms in ASD

• Upsetting memories that keep coming back about something scary that happened.
  For kids: This might show up as playing the same scary scene over and over again.

• Bad dreams about the scary event.
  For kids: These dreams might not make sense but still feel frightening.

• Feeling like the scary event is happening again (flashbacks).
  Sometimes, people forget where they are because it feels so real.
  For kids: They might act out the scary event while playing.

• Feeling really upset or nervous when something reminds them of the scary event.
  This could be a smell, sound, or place that makes them remember what happened.

Presence of Negative Mood in ASD

• Persistent inability to experience positive emotions (e.g., inability to experience happiness, satisfaction, or loving feelings). 

Presence of Dissociative Symptoms in ASD

1. An altered sense of the reality of one’s surroundings or oneself (e.g., seeing oneself from another’s perspective, being in a daze, time slowing). 

2. Inability to remember an important aspect of the traumatic event(s) (typically due to dissociative amnesia and not to other factors such as head injury, alcohol, or drugs). 

Presence of Avoidance Symptoms in ASD

1. Efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). 

2. Efforts to avoid external reminders (people, places, conversations, activities, objects, situations) that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

Presence of Arousal Symptoms on ASD

1. Sleep disturbance (e.g., difficulty falling or staying asleep, restless sleep). 

2. Irritable behavior and angry outbursts (with little or no provocation), typically expressed as verbal or physical aggression toward people or objects. 

3. Hypervigilance. 

4. Problems with concentration. 

5. Exaggerated startle response

How is ASD treated?

1. Psychotherapy

2. Medication

3. Combination of psychotherapy and medication.

What are the factors that can lead to PTSD?

A. Exposure to actual or threatened death, serious injury, or sexual violence

B. Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred

C. Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred

D. Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred

E. Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred

F. Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month. 

G.The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

H.The disturbance is not attributable to the physiological effects of a substance (e.g., medication, alcohol) or another medical condition.

How can exposure to actual or threatened death, serious injury, or sexual violence lead to PTSD?

1. Directly experiencing the traumatic event(s). 

2. Witnessing, in person, the event(s) as it occurred to others. 

3. Learning that the traumatic event(s) occurred to a close family member or close friend. 

4. Experiencing repeated or extreme exposure to aversive details of the traumatic event(s)

Presence of one (or more) of the following intrusion symptoms associated with the traumatic event(s), beginning after the traumatic event(s) occurred are : (PTSD)

• Unwanted and upsetting memories of the traumatic event that keep coming back.

• Repeated nightmares related to the trauma.

• Flashbacks, where a person feels like they are reliving the traumatic event.

• Strong emotional distress when reminded of the trauma by certain sights, sounds, or situations.

• Physical reactions, such as a racing heart or sweating, when faced with reminders of the traumatic event.

Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the traumatic event(s) occurred are : (PTSD)

1. Avoidance of or efforts to avoid distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s). 

2. Avoidance of or efforts to avoid external reminders that arouse distressing memories, thoughts, or feelings about or closely associated with the traumatic event(s).

Negative alterations in cognitions and mood associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred are : (PTSD)

1. Inability to remember an important aspect of the traumatic event(s) 

2. Persistent and exaggerated negative beliefs or expectations about oneself, others, or the world. 

3. Persistent, distorted cognitions about the cause or consequences of the traumatic event(s) that lead the individual to blame himself/herself or others.

4. Persistent negative emotional state 

5. Markedly diminished interest or participation in significant activities. 

6. Feelings of detachment or estrangement from others. 

7. Persistent inability to experience positive emotions.

Marked alterations in arousal and reactivity associated with the traumatic event(s), beginning or worsening after the traumatic event(s) occurred are : (PTSD)

1. Irritable behavior and angry outbursts. 

2. Reckless or self-destructive behavior. 

3. Hypervigilance. 

4. Exaggerated startle response. 

5. Problems with concentration. 

6. Sleep disturbance

What is the difference between ASD and PTSD?

The length of symptoms.

Acute stress disorder involves stress reactions occurring between three days and four weeks after a traumatic event.

PTSD is diagnosed if the stress reactions persist after 1 month

Some Ways to Avoid Stress

• Breathing exercises

• Engage in yoga or meditation

• Exercising regularly

• Jogging

• Reading newspapers