Psych Exam 2 ch5-6

factors that make ppl more stress sensitive

challenges to phys or emo well-being exceed coping abilities, linked to coping skills and resources, kids are esp vulnerable, s/s genotype of serotonin promoter are more stress sensitive, past experiences of stress

characteristics of stressors that make them hardest to cope with

severity, duration, timing, how much impact on everyday life, how expected it was, and how much ctrl one has over the stressor

how the body responds to stress

autonomic nervous system responds in variety of ways: hypothalamus stimulates sympathetic nervous system and epinephrine (adrenaline) and norepinephrine are released of adrenal medulla which prep for fight or flight, heart rate incr, body metabolizes more glucose to provide energy

allostatic load

wear and tear on mind and body that results from either too much stress or ineff mgmt of stress 

what psychoneuroimmunology aims to study

interactions between nervous system and immune system

stress-induced immunosuppression

too much stress disrupts cytokine production (protein molecules) which dampen immune response

the role emotions play in phys health

neg emo states like dep, hostility, anger, loneliness are linked to dvlpmt of cardiovascular disease bc neg emos are source of stress

helpful emotions

positivity, optimistic, forgiving

harmful emotions

anger, sadness, loneliness

psychological interventions used to reduce stress and treat stress-related disorders

expressive writing allows venting and reframing, biofeedback (awareness of internal bio activity like heart rate and blood pressure), relaxation training, meditation, cognitive-bhvrl therapy

adjustment disorder

• response to common stressor is maladaptive and occurs w/in 3 mths of stressor 

• Stressor can be single event or have multiple stressors involved 

• Symptoms lessen or dissappear when strssor ends or person learns to adapt, if cont then diagnosis changes 

PTSD

• Exposure to actual or threatened death, srs injury, or sexual violence 

• Presence of 1 or more intrusive symptoms assoc’d w traumatic event starting after it occurred 

• Persistent avoidance of stim assoc’d w traumatic event starting after it occurred 

• Neg alterations in cognitions and mood assoc’d w event 

• Marked alterations in arousal and reactivity assoc’d w event 

• Duration of disturbance is more than 1 mth 

• Disturbance causes clinically significant distress or impairment in soc, occupational, or other important areas of functioning 

• Disturbance is not attributable to phys effects of substance or other med cond 

acute stress disorder

• disorder that occurs w/in 4 wks after a traumatic event and lasts for min of 2 days and max 4 wks 

• Symptoms dvlp shortly after event, if lasts longer diagnosis moves to PTSD 

similarities between adjustment disorder, PTSD, acute stress disorder

result from stress, similar symptoms, natural recovery w time

differences between adjustment disorder, PTSD, acute stress disorder

severity of stressor and duration of symptoms

risk factors of PTSD

experiencing traumatic event, degree of direct exposure to event, hi lvls of neuroticism, dep and anx, fam history of dep and anx and drug abuse, low lvls of soc support

treatment approaches for PTSD

• Psychological debriefing (talking it out as a form of counseling, grp therapy) 

• Soc support 

• Meds like SSRIs 

• Cognitive-bhvrl treatmt like prolonged exposure 

fear

alarm reaction in response to immediate danger, source of danger is obvious

anxiety

general feeling of apprehension about possible future danger, unspec danger

essential features of anxiety disorders

• cognitive: neg mood, worry abt future threats, self-preoccupation

• phys: state of tension and chronic overarousal

• bhvrl: tendency to avoid sitches where danger may be encountered

unrealistic, irratl fear/anx of disabling intensity

clinical features of specific phobias

• Marked fear or anx abt spec object or sitch 

• Obj/sitch always provokes immediate fear/anx 

• Actively avoid object/sitch 

• Fear is disproportionate to sitch 

• Fear/anx/avoidance is persistant, lasts 6+ mths 

• Causes clinically significant distress and impairment 

clinical features of social anxiety (soc phobia)

• Marked fear or nax abt 1 or more soc sitches where one is exposed to possible scrutiny by other 

• One fears that they will act in a way or show anx symtpoms that will be neg eval’d (embarrassing) 

• Soc sitches almost always provoke fear/anx 

• Soc sitches are avoided or endured w intense fear/anx 

• Fear/anx/avoidance persistent, 6+ mths 

• Fear/anx/avoidance causes clincally significant distress or impairment 

clinical features of panic disorder

• Reccurent unexpected panic attk (surge of intense fear that reaches a peak and 4+ of following symptoms happen: incr heart rate, sweating, shaking, shortness of breath, chest pain, nausea, dizziness, tingling, derealization/depersonalization, fear of dying, etc) 

• Avoidance or persistent concern abt having another attk 

clinical features of GAD

• Excessive anx and worry (apprehensive expectation) occurring more days than not, for at least 6 mths, abt a number of events 

• Difficult to ctrl the worry 

• Anx/worry are assoc’d w 3+ of following symptoms 

• 1. Restlessness or feeling keyed up or on edge. 

• 2. Being easily fatigued. 

• 3. Difficulty concentrating or mind going blank. 

• 4. Irritability. 

• 5. Muscle tension. 

• 6. Sleep disturbance 

• Causes clincially sig distress or impairment in soc, occupational or other important areas of functioning 

clinical features of OCD

• Presence of obsessions, compulsions, or both 

• Obs and comps are time-consuming or cause clinically sig distress or impairmt 

• The person must recognize that the obs is product of their own mind rather than imposed from without (like in schizo) 

• Thoughts are excessive and persistent and interfere w everyday life 

• Obs/comps must take at least 1 hr/day 

treatment for OCD

• Exposure and response prevention: bhvrl treatmt in which ppl w OCD are exposed to stim that provoke their obs and then the response is refraining from engaging in their rituals (starts out small in fear hierarchy) 

• Bhvrl work gets better response than meds 

• OCD responds best to meds that affect sero syst 

• Some psychiatrists have tried surgical methods to treat OCD (destroying brain tissue in one of the areas implicated in OCD) 

main bio causal factors of OCD

• Genetics: hi concordance rate for OCD in twins, moderate genetic heritability 

• Abnormalities in brain: cortical and subcortical structures like basal ganglia, linked at amgydala to limbic syst which ctrls emo bhvrs, abnormally hi lvlvs of activity in frontal cortex which also linked to limbic syst 

• Abnormalities in serotonin activity 

cultural differences in sources of worry

• LatAms, esp PR, have hi rates of variant of panic disorder called ataque de nervios (same symptoms as panic attk but also includes bursting into tears, anger, unctrlable shouting, shakiness, aggression, dissociative, fainting episodes), common in kids and adolescents 

• Yoruba culture in Nigeria has 3 primary clusters of symptoms w GAD: worry, dreams, bodily complaints, Nigerians w this symptoms fear malevolent attk by witch craft 

• India, more worries abt possessed by spirits and abt sexual inadequacy 

• Koro, syndrome common in China and SEA: men fear penis is retracting into body and will die after, women fear nipples are retracting and breasts are shrinking, occurs in epidemics 
  

4 P’s

• Predisposing: genetic vulnerability, toxic expose in utero, DV, poverty, home life, personality traits, insecurities, attachmt style 

• Precipitating (happens more closely to being brought into clinic): poor sleep, substance abuse, recent loss/stress, school stressors, loss of sig relationship, loss of home 

• Perpetuating (will make it harder to pt in therapy, enables the damaging bhvr): poor response to meds, chronic illness/pain, coping mechanisms, belief of self, others, and world, role of stigma to access treatmt, poor finance, ongoing transition 

• Protective: adequate diet and sleep, good genes, phys exercise, resilience, intelligence, insightful bhvr strat, coping skills, community, family, faith, financial support 

How to Make Stress your Friend

• changing how you think abt stress can make you healthier by changing body’s response to stress

• rethink stress response as helpful for a performance, now less stressed, less anx, more confidence, blood vessels stay relaxed

• stress can make you social

• oxytocin is a stress hormone but also a social hormone, encourages you to seek out others for support when stressed

• oxy keeps blood vessels relaxed and anti-inflammatory, helps heart cells regenerate and heal

• caring for others can create resilience