The human spirit is more powerful than any drug. It needs to be nourished with work, play, friendship, love. The simplest things. The things we have forgotten.” from the movie “Awakenings

Stress & Coping Primary Situational Appraisals*** * Harm/Loss – * Threat – * Challenge – Threats create greater response than challenges

Primary Appraisals (cont’d) Depend on the situation and how one interprets the stimulus Negative appraisals, heighten the physical arousal Positive appraisals, decrease physical arousal

Stress Factors Hassles - daily, irritating events vs Uplifts - satisfying daily events contribute or detract from risk of depression

Conflict Patterns*** Approach – approach: Avoidance –avoidance: Approach-avoidance:

Stress Factors Social Readjustment Rating Scale ( 490) + / - situations experienced in past 6 mos. (> 300) and past year (> 500) Doesn’t address appraisals***

Stress on the System Fight or flight response – Appraisal of event – Hypothalamus – activated by threats Sympathetic – speeds up responses Parasympathetic – slows down / calms

Stress on the System*** Psychosomatic symptoms – Examples – stomach, muscle pains, fatigue, eating probs, skin rashes, insomnia, asthma, blood pressure incr.

Mind-body Connection Thoughts, emotions & beliefs … Mind – body Therapy: Psychoneuroimmunology - relationship between CNS, endocrine system and psychosocial factors

Personal & Social Factors Resiliency Locus of Control – external vs internal Optimism / Pessimism –  Social Support –

Coping Secondary Appraisal – deciding to deal with the stressor Emotion-focused: seeking comfort, sympathy Problem-focused: Seeking information Control elements -> Combination is best

Stress Management Techniques Challenge appraisals Positive Self-Statements Biofeedback Progressive Relaxation Meditation Social-cognitive counseling / intervention

Disorders Definitions of Abnormality Statistical frequency- Social norms – Maladaptive –

Diagnosis Clinical interview: Personality tests: Neurological tests: DSM-IV (297) :

Frequency - % reporting Any disorder – 48% Substance Use – 27% Anxiety Disorder – 25% Mood Disorder – 20-25%

Mood Disorders Major Depression 2 weeks or more Low mood, low interest, low pleasure Problems with 4 of these: eating, sleeping, thinking, concentration, guilt, making decisions, energy level, suicidal thoughts

Mood Disorders Biological Theory – genetic, neurological factors Psychosocial Theory – personality traits Cognitive Theory – automatic negative thoughts

Mood Disorders Bipolar disorder – extremes variable self-esteem, sleep patterns rapid, frequent speech / little speech racing thoughts / depressed affect

Bipolar – PET Scans

Mood Disorders - Interventions Social skills – Social support – Thought substitution –

Mood Disorders - Treatments Antidepressants – SRI’s (Serotonin Reuptake Inhibitors) (Prozac) Lithium- mineral salt (for Bipolar I) ECT (Electroconvulsive therapy)

Personality Disorders Antisocial -> Violates rights of others without guilt or remorse Delinquent : stealing, fire- setting, forgery, law-breaking Psychopathic: human victimizers

Personality Disorders Psychopaths * Chemical * Environmental Treatment Drugs to raise serotonin levels 2/3rds – no long-term improvement

Personality Disorders – other examples Paranoid – Schizotypical – Histrionic – Obsessive-compulsive – Dependent –

Schizophrenia Affects thought, attention, perception, motor functions & emotions Identifiable gene directly linked on Chromosome # 6 ( 48-83% in twins)

Schizophrenia Type I: + symptoms -> Type II: Neurology – biological basis Ventricles – larger–> Thalamus – smaller -> Frontal Lobe – PET scan data Diathesis Theory – Combination of genetic predisposition interacting with life stressors

Dissociative Disorders Dissociative Identity Disorder – formerly known as “Multiple Personality”