Download - Stress, Coping, and the Anxiety Response
Stress, Coping, and the Anxiety Response
Stress, Coping, and the Anxiety Response
When we view a stressor as threatening, the natural reaction is arousal and fear
Stress reactions, and the fear they produce, are often at play in psychological disorders
Stress, Coping, and the Anxiety Response
Stress and psychological disorders Acute stress disorder Posttraumatic stress disorder (PTSD) The DSM-5 lists these as “trauma and stressor-related
disorders” Stress and physical (psychophysiological)
disorders These disorders are listed in the DSM-5 under
“psychological factors affecting medical condition”
Stress and Arousal: The Fight-or-Flight Response
The features of arousal and fear are set in motion by the hypothalamus Two important systems are activated:
Autonomic nervous system (ANS) An extensive network of nerve fibers that connect the central
nervous system (the brain and spinal cord) to all other organs of the body
Endocrine system A network of glands throughout the body that release hormones
Stress and Arousal: The Fight-or-Flight Response
There are two pathways, or routes, by which the ANS and the endocrine system produce arousal and fear reactions: Sympathetic nervous system pathway Hypothalamic-pituitary-adrenal pathway
Hypothalamus signals the pituitary gland, which stimulates the adrenal cortex to release corticosteroids – stress hormones – into the bloodstream
The Autonomic Nervous System
The Endocrine System
Pathways of Arousal and Fear
The Psychological Stress Disorders
Acute stress disorder Symptoms begin within four weeks of event and last for
less than one month Posttraumatic stress disorder (PTSD)
Symptoms may begin either shortly after the event, or months or years afterward As many as 80% of all cases of acute stress disorder develop
into PTSD
The Psychological Stress Disorders
Aside from the differences in onset and duration, the symptoms of acute stress disorders and PTSD are almost identical: Reexperiencing the traumatic event Avoidance Reduced responsiveness Increased arousal, anxiety, and guilt
What Triggers a Psychological Stress Disorder?
What Triggers a Psychological Stress Disorder?
Combat and stress disorders Called “shell shock” or “combat fatigue” Post-Vietnam War clinicians discovered
that soldiers also experienced psychological distress after combat
As many as 29% of Vietnam combat veterans suffered acute or posttraumatic stress disorders An additional 22% had some stress
symptoms 10% still experiencing problems
A similar pattern is currently unfolding among veterans of wars in Afghanistan and Iraq
What Triggers a Psychological Stress Disorder?
Disasters and stress disorders Acute or posttraumatic stress disorders may also follow
natural and accidental disasters Types of disasters include earthquakes, floods, tornadoes, fires,
airplane crashes, and serious car accidents Because they occur more often, civilian traumas have been
implicated in stress disorders at least 10 times as often as combat traumas
What Triggers a Psychological Stress Disorder?
Victimization and stress disorders People who have been abused or victimized often
experience lingering stress symptoms Research suggests that more than one-third of all victims of
physical or sexual assault develop PTSD
Terrorism and torture The experience of terrorism or the threat of terrorism
often leads to posttraumatic stress symptoms, as does the experience of torture
Why Do People Develop a Psychological Stress Disorder?
Clearly, extraordinary trauma can cause a stress disorder However, the event alone may not be the entire
explanation
Why Do People Develop a Psychological Stress Disorder?
Biological and genetic factors Traumatic events trigger physical changes in the brain
and body that may lead to severe stress reactions and, in some cases, to stress disorders
Why Do People Develop a Psychological Stress Disorder?
Personality factors Some studies suggest that people with certain
personalities, attitudes, and coping styles are particularly likely to develop stress disorders Risk factors include:
Preexisting high anxiety Negative worldview
A set of positive attitudes (called resiliency or hardiness) is protective against developing stress disorders
Why Do People Develop a Psychological Stress Disorder?
Childhood experiences Researchers have found that certain childhood
experiences increase risk for later stress disorders Risk factors include:
An impoverished childhood Psychological disorders in the family The experience of assault, abuse, or catastrophe at an early age Being younger than 10 years old when parents separated or
divorced
Why Do People Develop a Psychological Stress Disorder?
Social support People whose social support systems are weak are
more likely to develop a stress disorder after a traumatic event
Why Do People Develop a Psychological Stress Disorder?
Multicultural factors There is a growing suspicion among clinical
researchers that the rates of PTSD may differ among ethnic groups in the US It seems that Hispanic Americans might be more vulnerable to
PTSD than other cultural groups Possible explanations include cultural beliefs systems about trauma
and the cultural emphasis on social relationships and social support
Why Do People Develop a Psychological Stress Disorder?
Severity of the trauma Generally, the more severe the trauma and the more
direct one's exposure to it, the greater the likelihood of developing a stress disorder Especially risky: Mutilation and severe injury; witnessing the
injury or death of others
How Do Clinicians Treat the Psychological Stress Disorders?
About half of all cases of PTSD improve within 6 months; the remainder may persist for years
Treatment procedures vary depending on type of trauma General goals:
End lingering stress reactions Gain perspective on painful experiences Return to constructive living
How Do Clinicians Treat the Psychological Stress Disorders?
How Do Clinicians Treat the Psychological Stress Disorders?
Psychological debriefing A form of crisis intervention that has victims of trauma
talk extensively about their feelings and reactions within days of the critical incident Four-stage approach:
Normalize responses to the disaster Encourage expressions of anxiety, anger, and frustration Teach self-help skills Provide referrals
The Physical Stress Disorders: Psychophysiological Disorders
In addition to affecting psychological functioning, stress can also have great impact on physical functioning
The Physical Stress Disorders: Psychophysiological Disorders
Psychophysiological (psychosomatic) disorders: disorders in which biological, psychological, and sociocultural factors interact to cause or worsen a physical illness.
Early versions of the DSM labeled these illnesses psychophysiological, or psychosomatic, disorders DSM-5 also labels them as psychological factors
affecting medical condition
Psychological Factors Affecting Medical Condition
Psychological Factors Affecting Medical Condition
Traditional Psychophysiological Disorders
Traditional Psychophysiological Disorders
Traditional Psychophysiological Disorders
Traditional Psychophysiological Disorders
A number of variables contribute to the development of psychophysiological disorders, including: Biological factors Psychological factors Sociocultural factors
Traditional Psychophysiological Disorders
New Psychophysiological Disorders
Since the 1960s, researchers have found many links between psychosocial stress and a wide range of physical illnesses
In recent years, more and more illnesses have been added to the list of psychophysiological disorders
New Psychophysiological Disorders
Are physical illnesses related to stress? The development of the Social Adjustment Rating Scale
in 1967 enabled researchers to examine the relationship between life stress and the onset of illness
Using the Social Adjustment Rating Scale, studies have linked stressors of various kinds to a wide range of physical conditions
Overall, the greater the amount of life stress, the greater the likelihood of illness
Social Adjustment Rating Scale does not take into consideration the particular stress reactions within specific populations
Psychoneuroimmunology
Psychoneuroimmunology
The immune system identifies and destroys antigens (foreign invaders, such as bacteria) and cancer cells Lymphocytes - white blood
cells that circulate through the lymph system and the bloodstream, attacking invaders Helper T-cells, natural killer T-
cells, and B-cells
Psychoneuroimmunology
Psychoneuroimmunology
Psychological Treatments for Physical Disorders
Behavioral medicine - the field of treatment that combines psychological and physical interventions to treat or prevent medical problems
Psychological Treatments for Physical Disorders
Psychological Treatments for Physical Disorders
Psychological Treatments for Physical Disorders
Psychological Treatments for Physical Disorders
Psychological Treatments for Physical Disorders
Psychological Treatments for Physical Disorders
Psychological Treatments for Physical Disorders
Combination approaches Studies have found that the various psychological
interventions for physical problems tend to be equal in effectiveness Psychological treatments are often of greatest help when they
are combined and used with medical treatment