1. Chapter 4 Stress-Related Disorders
ABNORMAL PSYCHOLOGY IN A CHANGING WORLD, NINTH EDITION Jeffrey S. Nevid/Spenver A. Rathus/Beverly Greene
Chapter 4
Stress-Related Disorders
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2. Stress and Health
Health psychologist – A psychologist who studies the interrelationships between psychological factors in physical illness.
Stress – A demand made on an organism to adapt or adjust.
Stressor – A source of stress.
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3. Stress and Health
Psychological sources of stress not only diminish our capacity for adjustment, but also may adversely affect our health.
Stress is associated with an increased risk of various types of physical illness, ranging from digestive disorders to heart disease.
The field of psychoneuroimmunology studies relationships between psychological factors, especially stress, and the workings of the immune system.
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4. Stress and the Endocrine System
Stress has a domino effect on the endocrine system.
Several endocrine glands are involved in the body’s response to stress.
Endocrine system – The system of ductless glands that secrete hormones directly into the bloodstream.
Hormones – Substances secreted by endocrine glands that regulate body functions and promote growth and development.
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5. Major Glands of the Endocrine System
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6. Stress and the Immune System
Prolonged stress can eventually weaken the body’s immune system (Fan et al., 2009; Kemeny, 2003).
Immune system – The body’s system of defense against disease.
Leukocytes are white blood cells that systematically envelop and kill pathogens such as bacteria, viruses, and fungi, worn-out body cells, and cells that have become cancerous.
Leukocytes recognize invading pathogens by their surface fragments, called antigens, literally antibody generators.
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7. Writing about Stress and Trauma as a Coping Response
Expressing our emotions in the form of writing about stressful or traumatic events in our lives is a positive coping response that can have positive effects on both psychological and physical health (Frattaroli, 2006).
Some previous research studies have shown that participants assigned to an expressive writing program reported fewer psychological and physical symptoms than control participants (e.g., Low, Stanton, & Danoff-Burg, 2006; Sloan, Marx, & Epstein, 2005; Sloan et al., 2007).
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8. Terrorism-Related Trauma
The September 11, 2001 terrorist attacks on America changed everything.
Before 9/11 we may have felt secure in our homes, offices, and other public places from the threat of terrorism.
But now, terrorism looms as a constant threat to our safety and sense of security.
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9. The General Adaptation Syndrome
General adaptation syndrome (GAS) – The body’s three-stage response to states of prolonged or excessive stress.
Alarm reaction – The first stage of the GAS, characterized by heightened sympathetic activity.
Fight-or-flight reaction – The inborn tendency to respond to a threat by either fighting or fleeing.
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11. The General Adaptation Syndrome
Resistance stage – The second stage of the GAS, in which endocrine and sympathetic nervous system responses remain at high levels, but not quite as high as during the alarm reaction.
Exhaustion stage – The third stage of the GAS, characterized by lowered resistance, increased parasympathetic activity, and eventual physical deterioration.
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12. Stress and Life Changes
Researchers have investigated the stress–illness connection by quantifying life stress in terms of life changes (also called life events).
Life changes are sources of stress because they force us to adjust.
They include both positive events (such as getting married) and negative events (such as the death of a loved one).
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13. Acculturative Stress: Making It in America
One of the primary sources of stress imposed on immigrant groups, or on native groups living in the larger mainstream culture, is the need to adapt to a new culture.
We can define acculturation as the process of adaptation by which immigrants, native groups, and ethnic minority groups adjust to the new culture or majority culture through making behavioral and attitudinal changes.
Acculturative stress – Pressure to adjust to a host or mainstream culture.
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14. Acculturative Stress: Making It in America
Research with Hispanic (Latino) Americans that highlight psychological risks associated with acculturation:
Increased risk of heavy drinking among women.
Increased risk of smoking and sexual intercourse among adolescents.
Increased risk of disturbed eating behaviors.
The erosion of traditional family networks and traditional values that may accompany acculturation among immigrant groups might increase the risk of psychological problems.
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15. Psychological Factors That Moderate Stress
Stress may be a fact of life, but the ways in which we handle stress help determine our ability to cope with it.
Individuals react differently to stress depending on psychological factors such as the meaning they ascribe to stressful events.
For example, whether a major life event, such as pregnancy, is a positive or negative stressor depends on a couple’s desire for a child and their confidence in their ability to care for one.
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16. Styles of Coping
Emotion-focused coping – A coping style that involves reducing the impact of a stressor by ignoring or escaping it rather than dealing with it directly.
Problem-focused coping – A coping style that involves confronting a stressor directly.
Self-efficacy expectancies – Beliefs in one’s ability to cope with challenges and to accomplish particular tasks.
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17. Psychological Hardiness
Psychological hardiness – A cluster of stress-buffering traits characterized by commitment, challenge, and control.
Three key traits distinguished the psychologically hardy executives:
1. Commitment
2. Challenge
3. Control over their lives
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18. Coping with stress
Psychologically hardy people appear to cope more effectively with stress by adopting active, problem solving approaches and by perceiving themselves as choosing high-stress situations.
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19. Optimism
Seeing the proverbial glass as half full rather than half empty is linked to better physical health and emotional well-being.
One recent research study links greater optimism in women to lower rates of heart disease and greater longevity (Tindle et al., 2009).
Pain patients who express more pessimistic thoughts during flare-ups tend to report more severe pain and distress (Gil et al., 1990).
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20. Optimism
Positive psychology – A growing contemporary movement within psychology that focuses on the positive attributes of human behavior.
The developers of this movement believe that psychology should focus more of its efforts on the positive aspects of the human experience, rather than just the deficit side of the human equation, such as problems of emotional disorders, drug abuse, and violence.
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21. Social Support
The role of social support as a buffer against stress is well documented.
People with a broad network of social relationships not only show greater resistance to fending off the common cold but also tend to live longer.
The investigators believe that having a wide range of social contacts may help protect the body’s immune system by serving as a buffer against stress.
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22. Ethnic Identity
African Americans, on the average, stand a greater risk than Euro Americans of suffering chronic health problems, such as obesity, hypertension, heart disease, diabetes, and certain types of cancer.
The particular stressors that African Americans often face, such as racism, poverty, violence, and overcrowded living conditions, may contribute to their heightened risks of serious health-related problems.
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23. Ethnic Identity
Ethnic identity is associated with perceptions of a better quality of life and appears to be more strongly related to psychological well-being among African Americans than among White Americans.
Evidence links perceived discrimination among ethnic minorities to poorer mental and physical health and to higher rates of substance abuse.
African Americans and other ethnic minorities who become alienated from their culture or ethnic identity may be more vulnerable to the effects of stress, which in turn may increase risks of physical and mental health problems.
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24. Adjustment Disorders
Adjustment disorder – A maladaptive reaction to an identified stressor, characterized by impaired functioning or emotional distress that exceeds what would normally be expected.
According to the DSM, the maladaptive reaction is characterized by significant impairment in social, occupational, or academic functioning or by states of emotional distress that exceed those normally induced by the stressor.
Prevalence estimates of the rates of the disorder in the population vary widely.
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25. Adjustment Disorders
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26. Traumatic Stress Disorders
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27. Acute Stress Disorder and Posttraumatic Stress Disorder
Traumatic experiences can lead to the development of traumatic stress disorders, which are characterized by maladaptive patterns of behavior in response to trauma that involve marked personal distress or significant impairment of functioning.
Acute stress disorder (ASD) – A traumatic stress reaction in which the person shows a maladaptive pattern of behavior for a period of three days to one month following exposure to a traumatic event.
Posttraumatic stress disorder (PTSD) – A prolonged maladaptive reaction to a traumatic event.
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28. Acute Stress Disorder and Posttraumatic Stress Disorder
People with acute stress disorder may feel they are “in a daze” or that the world seems like a dreamlike or unreal place.
Acute stress disorder may occur in response to battlefield trauma or exposure to natural or technological disasters.
Stronger or more persistent symptoms of dissociation around the time of the trauma is associated with a greater likelihood of later development of PTSD.
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29. Common Features of Traumatic Stress Disorders
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30. Acute Stress Disorder And Posttraumatic Stress Disorder
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31. Acute Stress Disorder and Posttraumatic Stress Disorder
PTSD presents with a similar symptom profile as acute stress disorder, but may persist for months, years, or even decades, and may not develop until many months or even years after the traumatic event.
Although exposure to combat or terrorist attacks may be the types of trauma the public most strongly links to PTSD (Pitman, 2006), the traumatic experiences most commonly associated with PTSD are serious motor vehicle accidents (Blanchard & Hickling, 2004).
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32. Theoretical Perspectives
The major conceptual understanding of PTSD derives from the behavioral or learning perspective.
Within a classical conditioning framework, traumatic experiences are unconditioned stimuli that become paired with neutral (conditioned) stimuli such as the sights, sounds, and even smells associated with the trauma—for example, the battlefield or the neighborhood in which a person has been raped or assaulted.
Consequently, anxiety becomes a conditioned response that is elicited by exposure to trauma-related stimuli.
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33. Treatment Approaches
Cognitive-behavioral therapy has produced impressive results in treating PTSD.
The basic treatment component is repeated exposure to cues and emotions associated with the trauma.
In CBT, the person gradually reexperiences the anxiety associated with the traumatic event in a safe setting, thereby allowing extinction to take its course.
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34. Treatment Approaches
Therapists may use a more intense form of exposure called prolonged exposure, in which the person repeatedly reexperiences the traumatic event in imagination or in real life without seeking to escape from the anxiety.
Treatment with antidepressant drugs, such as sertraline (Zoloft) or paroxetine (Paxil), may help reduce the anxiety components of PTSD (Schneier et al., 2012).
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35. Treatment Approaches
Eye movement desensitization and reprocessing (EMDR) – A controversial form of therapy for PTSD that involves eye tracking of a visual target while holding images of the traumatic experience in mind.
Evidence from controlled studies demonstrates the therapeutic benefits of EMDR in treating PTSD.
Researchers lack a compelling theoretical model explaining why rapid eye movements would relieve symptoms of PTSD.
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36. The End
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