PSYCH 223 Exam 2

stressor

event that creates demands

stress response

person’s reactions to the demands

• influenced by how we appraise both the event and our capacity to react to the event effectively

• appraise a stressor as threatening cause cause a natural reaction of fear

sympathetic nervous system

the fight response

increases everything in your body (ex. dilates pupils, release bladder, increase HB, release bronchi)

parasympathetic nervous system

flight response

everything in the body goes back to normal (ex. contract pupils, contract bladder, slow HB, contracts bronchi)

stress and arousal: fight or flight order

1. hypothalamus

2. pituitary gland

3. secretion of ACTH

4. adrenal cortex

5. corticosteroids

acute stress disorder

symptoms begin within four weeks of event and last for less than one month

post traumatic stress disorder (PTSD)

symptoms may begin either shortly after the event, or months or years afterward

what triggers a psychological stress disorder

• combat/military experience

• natural/accidental disasters

• victimization

  • ongoing family abuse

  • terrorism

  • torture

  • SA

additional considerations in stress disorder research

• survivor biological processes

• personalities

• childhood experiences

• social support systems/cultural backgrounds

• severity of the traumas

biological and genetic factors

traumatic events trigger physical changes in the brain and body that may lead to SD

personality factors

some studies suggest that people with certain personality profiles, attitudes, and coping styles are particularly likely to develop stress disorders

personality risk factors

• preexisting high anxiety

• a history of psychological problems

• negative worldview

resiliency/hardiness

a set of positive attitudes

protective against developing stress disorders

childhood experiences

researchers have found certain childhood experiences increase risk for later SD

risk factors of childhood experiences

• an impoverished childhood

• psychological disorders in the family

• experience of assault, abuse, or catastrophe at an early age

• being younger than 10 years old when parents separated or divorced

social support

people with weak social support systems are more likely to develop a stress disorder after a traumatic event

multicultural factors

cultural differences have an occurrence of PTSD

• hispanic americans are more vulnerable to PTSD than other ethnic groups

severity of the trauma

the more severe the trauma and more direct a person’s exposure is to it, the greater the likelihood of developing a stress disorder

risky:

• mutilation and severe injury; witnessing the injury or death of others

treatment procedures goals

1. end lingering stress reactions

2. gain perspective on painful experiences

3. return to constructive living

drug therapy

antianxiety and antidepressant medications are most common

behavior exposure techniques

• reduce specific symptoms, increase overall adjustment

• use flooding and relaxation training

• use eye movement desensitization and reprocessing (EMDR)

insight therapy

• bring out deep-seated feelings, create acceptance, lessen guilt

• often use family or group therapy formats

psychophysiological disorders (physical stress disorders)

resulted from an interaction of biological, psychological, and sociocultural factors

Psychophysiological Disorders effects

ulcers, asthma, insomnia, chronic headaches, high BP, coronary heart disease

Traditional Psychophysiological Disorders: biological factors

ANS reactivity, weak Gl system

Traditional Psychophysiological Disorders: psychological factors

needs, attitudes, coping strategies, personality styles

Traditional Psychophysiological Disorders: sociocultural factors

poverty, social support styles

Psychoneuroimmunology

stress can interfere with the activity of lymphocytes, slowing them down and increasing a person’s susceptibility to viral bacterial infections

Psychoneuroimmunology influence

biochemical activity, behavior changes, personality style, degree of social support

Psychoneuroimmunology behavior changes

poor sleep patterns, poor eating, lack of exercise, increase in smoking and/or drinking

that indirectly affect the immune system

Psychoneuroimmunology personality style

changes personality style including their level of optimism, constructive coping strategies, and resilience

also plays a role in how much the immune system is slowed down by stress

Psychoneuroimmunology Biochemical activity

1. stress increases sympathetic nervous system

2. releases norepinephrine

3. slows functioning of immune system

4. endocrine glands reduce immune system functioning during stress nad release corticosteroids

Psychoneuroimmunology Social support

people with few social supports and feel lonely display poorer immune functioning

Physical disorders treatments: behavior medicine

relaxation training, biofeedback training, meditation, hypnosis, cognitive therapy, insight therapy, and support groups

depression

low sad state in life which seems dark and its challenges overwhelming

mania

state of breathless euphoria or frenzied energy

clinical depression

can bring severe and long lasting psychological pain that may intensify over time

symptoms of depression

1. emotional symptoms: feeling miserable, empty, humiliated; experiencing little pleasure

2. motivational symptoms: lacking drive, initiative, spontaneity; between 6% and 15% of those with severe depression commit suicide

3. behavioral symptoms: less active. less productive

4. cognitive symptoms: hold negative views of themselves, blame themselves for unfortunate events, pessimism

5. physical symptoms: headaches, dizzy spells, general pain

Diagnosing Unipolar Depression: Criteria 1

major depressive episode

marked by 5 or more symptoms lasting 2 or more weeks

symptoms: psychotic, hallucinations, delusions

Diagnosing Unipolar Depression: Criteria 2

no history of mania

Major depressive disorder

criteria 1 and 2 are met

dysthymic disorder

symptoms are mild by chronic

• depression is long lasting but less disabling

• consistent symptoms for at least 2 years

double depression

when dysthymic disorder leads to major depressive disorder

biological model

stress (the trigger and number of stressful events)

genetic factors

biochemical factors: serotonin and norepinephrine, cortisol

brain anatomy/circuitry

psychodynamic model

introjection, identification

behavior model

rewards, punishments

sociocultural model

gender/age, cultural background, family-social structure

cognitive model (beck)

negative thinking, maladaptive attitudes

cognitive triad

self, experiences, future

biopolar disorders

people with it experience both the lows of depression and the highs of mania

state of mania

people in this state typically experience dramatic and inappropriate rises in mood

many describe their lives as an emotional rollercoaster

symptoms of mania 1

emotional symptoms: active, powerful emotions in search of outlet

symptoms of mania 2

motivational symptoms: need for constant excitement, involvement, companionship

symptoms of mania 3

behavior symptoms: very active- move quickly; talk loudly or rapidly

flamboyance is not uncommon

symptoms of mania 4

cognitive symptoms: show poor judgement or planning

symptoms of mania 5

physical symptoms: high energy level- often in the presence of little or no rest

bipolar disorder criteria 1

manic episode: three or more symptoms of mania lasting 1 week or more

(extreme cases symptoms are psychotic)

bipolar disorder criteria 2

history of mania: if currently experiencing hypomania or depression

biopolar I disorder

full manic and major depressive episodes

bipolar II disorder

hypomanic episodes and major depressive episodes

Biopolar disorders without treatment

mood episodes tend to recur for both types of bipolar disorders

if people experience four or more episodes within a 1 year period, their disorder is further classified as rapid cycling

causes of bipolar disorder: biological model

NT- serotonin and norepinephrine

permissive theory

low serotonin + low norepinephrine = depression

low serotonin + high norepinephrine + mania

causes of bipolar disorder: ion activity

irregularities in cellular ion transport may cause neurons to fire too easily (mania) or to resist firing (depression)

causes of bipolar disorder: brain structure

basal ganglia and cerebellum, among others

causes of bipolar disorder: genetic factors

family pedigree studies indicate that people inherit a biological predisposition to develop bipolar disorders

• when one twin/sibling has bipolar disorder, the likelihood for the other twin/sibling increases:

  • identical (MZ) twins: 40% likelihood

  • fraternal (DZ) twins and siblings: 5% to 10% likelihood

  • general population = 1 to 2.6% likelihood

mood disorders

as painful and disabling as they tend to be - respond more successfully to more kinds of treatments than do most other forms of psychological dysfunction

treatments for unipolar depression: psychodynamic

widely used despite no strong research evidence of its effectiveness

treatments for unipolar depression: brhavioral

primarily used for mild or moderate depression but practiced less than in past decades

treatments for unipolar depression: cognitive

has performed so well in research that it has a large and growling clinical following

psychodynamic therapy

unipolar depression results from unconscious grief over real or imagined losses; psychodynamic therapists seek to bring these issues into consciousness and work through them

psychodynamic therapists procedure

free association, therapist interpretation, review of past events and feelings

two features may be particularly limiting

depressed clients may be too passive or weary to fully participate in clinical discussions

depressed clients may become discouraged and end treatment too early when treatment is unable to provide quick relief

behavioral therapy Lewinsohn

• reintroduced clients to pleasurable activities and events, often using a weekly schedule

• appropriately reinforce their depressive and nondepressive behaviors

• help them improve their social skills

• works best when used in combination with cognitive techniques

Beck’s cognitive therapy

designed to help clients recognize and their change their negative cognitive processes

• addresses maladaptive attitudes and illogical thinking

phases of becks cognitive therapy

1. increasing activities and elevating mood

2. challenging automatic thoughts

3. identifying negative thinking and biases

4. changing primary attitudes

Interpersonal therapy (IPT)

holds 4 IPT may lead to depression and must be addressed:

1. interpersonal loss

2. interpersonal role dispute

3. interpersonal role transition

4. interpersonal deficits

it is very effective as cognitive therapy for treating depression

couple therapy

main type is behavior marital therapy (BMT)

focuses on developing specific communication and problem solving skills

anti depressant drugs

monoamine oxidase inhibitors (MAO inhibitors)

second generation anti depressants

anti depressant drugs (MAO inhibitors)

drugs made people happier

works biochemically by slowing down the body’s production of MAO

MAO inhibitors risks

BP may rise to a fatal level if one eats foods with tyramine (cheese, bananas, wine) while taking MAOIs

Antidepressant drugs: tricyclics

medications for schizophrenia; it lessened depressive symptoms

Tricyclics risks

when patient stops taking them when they have relief, the relapse within one year

• patients who take tricyclics for five additional months (continuation therapy) have a high decreased risk of relapse

• maintenance therapy decreases risk even more

second generation antidepressant drugs

only act on serotonin (fluoxetine/prozac and sertraline/zoloft)

second generation antidepressant drugs risks/benefits

no dietary restrictions

it is harder to overdose

these drugs may have their own side effects like reduction in sex drive

Electroconvulsive therapy (ECT)

targeted for brain seizures

now frequently used because it is effective and fast acting

Lithium and other mood stabilizers

lithium is very effective in treating bipolar disorders and mania

determine the correct dosage for a patient is a delicate process

• too low = no effect

• too high = lithium intoxication (poisoning)