Models for stress: Know what each model says about stress (e.g., Cannon’s, Selye’s, etc.)
Stress & the Immune system – Acute vs. prolonged stress & illness; Physiology of stress & immune system functioning -SAM System- Sympathetic adrenomedullary system. Results in release of catecholamines. -HPA System- Hypothalamic-Pituitary-Adrenocortical system. Results in release of corticosteroids-cortisol. Chronically elecated levels-compromises the immune system. Destruction of hippocampal neurons. Increase in storage of centripetal fat. PTSD & Acute Stress Disorder (How are they similar? How different? Symptoms? Subtypes?, etc.) -PTSD- Post Traumatic Stress Disorder-Related to trauma. Subtypes: Acute PTSD-Symptoms develop within 6 months of trauma-Prognosis: good with treatment. Delayed PTSD-Symptoms develop after 6 months from trauma. Prognosis: Poorer. Symptoms: Hyperarousal and vigilance, flashbacks of event (cued or uncued), difficulty concentrating, sleep problems, psychic numbing-dissociative states, irritability, intimacy problems, substance abuse (“dual diagnosis”)-often go hand in hand, avoidance of anything related to trauma, increased arousal-exaggerated startle response. -Higher rates of Coronary Heart Disease, diabetes, hypertension, muscloskeletal disorders. Combat PTSD- 12-20% of returning soldiers are diagnosed, ~30% of wounded receive a diagnosis, Many do not seek help-delay in seeking help-poorer outcomes. Direct link between aggression in PTSD and re-experiencing the event. Acute Stress Disorder- “A normal reaction to abnormal circumstances” Symptoms-Same as PTSD- EXCEPT symptoms typically begin within the first 4 weeks. DSM-Symptoms must last at least a day but not more than30 days. Important points from the Rosen et al. article on PTSD from quiz section
Adjustment Disorder – What is it? Symptoms? Controversy over the diagnosis? -Most common stress related disorder diagnosed amongst college students. -Source-Difficulty adjusting to one or more stressors-Reaction is out of proportion to the stressor. -Prognosis-Typically good. Symptoms often do not exceed 6 months after the stressors. -Typical Symptoms-Depression OR anxiety OR both, with anxiety, with depressed mood, with disturbance of conduct, with mixed anxiety and depressed mood, with mixed disturbance of emotions and conduct-“acting out”. Social withdrawal, decrease in performance, conduct disturbances, sleep problems, physical (somatic) complaints. *Somewhat controversial disorder-Up to 30% of people seeking treatment are given this diagnosis. Vulnerability to Stress Disorders – what are the factors?
-Biological and Genetic Factors: Cardiovascular. Reactivity- “Hot reactors”- very strong cardiovascular response to stress and take longer to return to baseline. May be inborn and may be acquired. Inhibited vs. Disinhibited. -Personality: Neuroticism-nervous, worrier-more vulnerable. Perceived lack of control over life. Chronic negative affectivity. -Background Factors: History of poverty and/or early trauma or abuse. Family history of psychological disorders. History of divorce of parents prior to age 10 years. History of family upheaval. -Social Support: Lack of social support.
-Severity of Trauma: Very severe trauma can affect those without background factors or vulnerabilities. Characteristics of Psychophysiological Disorders & How DSM-IV designates them Previously called “Psychosomatic”-mind/body interactions. -Psychological factors affecting medical conditions-Axis I
Protocol: specify which psychological factor is affecting which medical condition Important: In diagnosis, when diagnosing, must put medical condition on Axis III. Conditions affected by psychological factors: Headaches, asthma, skin conditions, stomach ulcers, hypertension, coronary heart disease, progression of several illnesses. Anxiety vs. Fear: Differences? Similarities?