1. Chapter 5 Stress and Physical and Mental Health
ABNORMAL PSYCHOLOGY SIXTEENTH EDITION James N. Butcher/ Jill M. Hooley/ Susan Mineka
Chapter 5
Stress and Physical and Mental Health
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2. What Is Stress? Stress External demands placed on an organism
Organism’s internal biological and psychological responses to such demands
Stress is a by-product of poor or inadequate coping
Both positive stress and negative stress (distress) tax a person’s coping skills
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3. Stress and the DSM Stress and DSM
Significant component of multiple DSM diagnostic categories
DSM-5: Trauma- and stressor-related disorders
Stress is a significant component of multiple DSM diagnostic categories
PTSD
Adjustment disorder
Acute stress disorder
All part of new category of disorders: trauma- and stressor-related disorders which occur in response to identifiable stressors.
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4. Factors Creating Predisposition to Stress
Nature of stressor
Experience of crisis
Life changes
Individual perception of stressor
Individual stress tolerance
Lack of external resources and social supports
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5. Characteristics of Stressors
Key characteristics of stress involve:
Severity
Chronicity
Timing
Degree of impact
Level of expectation
Controllability
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6. Characteristics of Stressors
Crises
Life changes
Perception of benefits
Crises are especially stressful because the stressors are so potent that typical coping techniques are overwhelmed
Life changes, positive or negative, can increase stress
Perceiving benefit from a disaster, such as personal growth, can lessen the experience of stress
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7. Stress and the Stress Response
Two of body’s systems respond when stressor is perceived
Sympathetic-adrenomedullary (SAM) system
Hypothalamic-pituitary adrenocortical (HPA)
Sympathetic-adrenomedullary (SAM) system prepares fight-or-flight response
Hypothalamic-pituitary adrenocortical (HPA) produces cortisol, which is helpful in emergencies
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8. Figure 5.1: The Hypothalamic-Pituitary-Adrenal (HPA) Axis
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9. Biological Costs of Stress
Allostasis
Is process of adaptation or achieving stability through change
Results in wear and tear on body
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10. The Mind-Body Connection
Psychoneuroimmunology
Study of interaction between nervous system and immune system
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11. The Mind-Body Connection
True or False?
Stress may cause overall vulnerability to disease.
True
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12. Understanding the Immune System
Protects body from such things as viruses and bacteria
Provides leukocytes: front lines of defense
Communicates with brain via cytokines
Immune system is like the body’s “police force,” protecting it from such things as viruses and bacteria
Leukocytes are the front lines of defense, and there are two types:
B-cells: produce antibodies to specific antigens (foreign invaders, tumors, cancer cells)
T-cells: Helper cells. Help destroy antigens after activation from a microphage
Cytokines mediate inflammatory and immune response and send signals to the brain about infection and injury. Also stimulate the HPA axis which creates a negative feedback loop.
Progression from HIV to AIDS illustrates impact of stress on immune functioning
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13. Figure 5.2: Immune System Responses to a Bacterial Infection
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14. Stress, Depression, and the Immune System
Associated with compromised immune function beyond stressors that precipitated depression
This is especially true when the depression is chronic
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15. Stress and Physical Health
Many psychological factors can affect relationship between stress and health
Optimism
Negative affect
Optimism contributes to better physical health
Negative affect such as chronic anger and hostility contribute to poor physical health
Positive psychology is a growing movement that emphasizes characteristics that enhance health
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16. Cardiovascular Disease
Study in this area includes:
Hypertension
Coronary heart disease
Risk and causal factors
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17. Hypertension
Hypertension involves persisting systolic and diastolic blood pressure
Chronic hypertension and disease
Hypertension and ethnicity
Hypertension and anger management
Hypertension involves:
Persisting systolic blood pressure of 140 or more
Diastolic blood pressure of 90 or more
Chronic hypertension can contribute to a wide range of diseases
Hypertension is especially high in African-Americans, and in people who don’t express anger constructively
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18. Figure 5.3: Defining Hypertension
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19. Coronary Heart Disease
How would you define coronary heart disease?
A blockage of arteries that supply blood to the heart muscle
Can lead to cardiac arrest
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20. Risk and Causal Factors in Cardiovascular Disease
Certain personality patterns are linked
Type A
Type D
Type A: Excessive drive, hostility, impatience. Hostility presents greatest risk for heart disease
Type D: Distressed; tendency to experience negative emotions
Chronic and acute stress can contribute to cardiovascular disease
Depression, anxiety, and social isolation are also linked to cardiovascular disease
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21. Treatment of Stress-Related Physical Disorders
Biological interventions
Psychological interventions
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22. Biological Interventions
Surgical procedures
Lipid-lowering medications
Aspirin or other anticoagulants
Antidepressant medications
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23. Psychological Interventions
Emotional disclosure
Biofeedback
Relaxation and meditation
Cognitive-behavior therapy
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24. Stress and Mental Health
Some DSM disorders are triggered by exposure to stress
Adjustment disorder
Posttraumatic stress disorder
Adjustment disorder
Reaction to a common stressor
Posttraumatic stress disorder
Reaction to a traumatic stressor
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25. Stress and Mental Health
Adjustment Disorder
Maladaptive response to common stressor within 3 months of stressor
Symptoms disappear when stressor ends or person adapts
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26. Posttraumatic Stress Disorder
Definition
Causes
Clinical description
Severe psychological and physical symptoms resulting from sudden, unexpected environmental crises
Trauma causing PTSD varies
If briefer, correct diagnosis may instead be acute stress disorder
Recurrent re-experiencing of the traumatic event through nightmares or intrusive memories
Avoidance of stimuli associated with the trauma and emotional numbing
Negative cognitions and mood including feeling detached or excessive blaming of self or others
Increased arousal, which may involve insomnia, the inability to tolerate noise, and excessive response when startled
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27. Prevalence of PTSD in General Population
Lifetime prevalence rate in the U.S. is 6.8%
Higher rates in women despite finding that men are more likely to be exposed to traumatic events
What contributes to this gender difference?
In women, 9.7%
In men, 3.6%
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28. Rates of PTSD After Traumatic Experiences
Military combat
Prisoner of war, concentration camp, and torture experience
Traumas caused by human intent
Accidents or natural disasters
Military combat can be especially traumatic
Creation of the PTSD diagnostic category was stimulated by combat experience
Prisoner of war, concentration camp, and torture experience are all recognized traumas that can lead to PTSD
Traumas caused by human intent are more likely to cause PTSD than accidents or natural disasters
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29. Causal Factors in Posttraumatic Stress Disorder
True or false? Not everyone exposed to a trauma will develop PTSD!
True
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30. Causal Factors in Posttraumatic Stress Disorder
Causal factors may include:
Nature of trauma
Individual risk factors
Sociocultural risk factors
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31. Individual Risk Factors
How many can you name?
Being female
Low levels of social support
Neuroticism
Preexisting anxiety or depression
Family history of anxiety or depression
Substance abuse
Appraisals soon after trauma
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32. Individual Risk Factors
High cognitive ability (IQ) may lower risk of PTSD
Biological differences may play a role in likelihood of developing PTSD
Biological differences may play a role in likelihood of developing PTSD
Hormone levels
Genetics
Size of hippocampus
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33. Sociocultural Factors
In combat-related trauma:
Justification for combat
Identification with combat unit
Esprit de corps
Quality of leadership
PTSD symptoms can appear after delay, such as when a soldier returns home
Overreaction to minor stresses easily handled before
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34. Prevention and Treatment of Stress Disorders
Psychological debriefing
Challenges in studying crisis victims
Trauma and physical health
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35. Advanced preparation of stressor
Prevention
Advanced preparation of stressor
Military service
Medical procedures
Relationship termination
Attempts to prepare a person in advance of a stressor has met with success in the military
This approach is now being used with people facing events such as major surgery or the breakup of a relationship
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36. Treatment for Stress Disorders
Approaches to treatment include:
Telephone hotlines
Psychological first aid
Crisis intervention
Crisis intervention (e.g., with airline disasters)
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37. Psychological Debriefing
Strategies for relief of PTSD symptoms
Critical Incident Stress Debriefing
Medications
Cognitive-behavioral treatments
Allow people involved in disaster to discuss their experiences shortly after trauma has subsided
Critical Incident Stress Debriefing is a specific type of psychological debriefing
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38. Challenges in Studying Crisis Victims
Traumatic events cannot be predicted or controlled by researchers
Variables of interest are difficult to assess
Funding can be difficult to obtain
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39. Trauma and Physical Health
Relatively new area for physical research
Studies indicate that trauma is bad for body as well as mind
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40. Unresolved Issues The motivation for studying trauma stress
The role of advocacy for trauma victims in trauma stress studies
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