1、Chapter 5 Stress and Adjustment Disorder,Alice Cheng, Ph.D. University of Hartford,Stress, Psychological Factors, and Health,Stress - A demand made on an organism to adapt or adjust.Stressor - A source of stress.,What Is Stress?,Stress refers to both The adjustive demands placed on an organism (a.k.
2、a. stressors) The organisms internal biological and psychological responses to such demands Both eustress (positive stress) and distress (negative stress) tax a persons coping skills,3,0,Types of Stress: Distress,“A condition characterized by emotional upset and/or physical strain.” Distress appears
3、 to be the type of stress most people refer to in everyday conversation. “Im stressed out.”,0,Types of Stress: Eustress,“Pleasurable stress although physical and mental stress is placed on the body, it seems to have a positive effect.” Brisk exercise Successful completion of a large task.,0,Categori
4、es of Stressors,6,0,Factors Predisposing a Person to Stress,The nature of the stressor The experience of crisis Life changes A persons perception of the stressor The individuals stress tolerance A lack of external resources and social supports,7,0,Stress and the Endocrine System,Endocrine system The
5、 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. The endocrine system consists of glands distributed throughout the body.,Stress and the Immune System,Immu
6、ne system The bodys 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,
7、called antigens, literally antibody generators.,Copyright (c) 2011 Pearson Education. All rights reserved.,Adjustment Disorder: Reactions to Common Life Stressors,A person is said to have an adjustment disorder if the persons response to a common stressor is maladaptive occurs within 3 months of the
8、 stressor Stressors that typically cause adjustment disorder include unemployment bereavement divorce or separation,11,0,Adjustment disorders,Adjustment disorder - A maladaptive reaction to an identified stressor, characterized by impaired functioning or emotional distress that exceeds what would no
9、rmally 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
10、 population vary widely (5-20%).,Subtypes of Adjustment disorders,14,The Effects of Severe Stress,The effects of severe stress include: Lowered efficacy Depletion of adaptive resources Wear and tear on the biological system Severe personality and physical deterioration Death,0,Stress and illness,Psy
11、chological 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 relation
12、ships between psychological factors, especially stress, and the workings of the endocrine system, the immune system, and the nervous system,The General Adaptation Syndrome,General adaptation syndrome (GAS) - The bodys three-stage response to states of prolonged or intense stress.Alarm reaction - The
13、 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.,The General Adaptation Syndrome,Resistance stage - The second stage of the GAS, involving the bodys attempt to withstand prol
14、onged stress and preserve resources.Exhaustion stage - The third stage of the GAS, characterized by lowered resistance, increased parasympathetic activity, and eventual physical deterioration.The exhaustion stage is characterized by dominance of the parasympathetic branch of the ANS.,Acculturative S
15、tress: 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 min
16、ority 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.,Acculturative Stress: Making It in America,Research with Hispanic (Latino) Americans that highlight psychological ri
17、sks associated with acculturation:Increased risk of heavy drinking among women.Increased risk of delinquency, smoking, and sexual intercourse among adolescents.Increased risk of disturbed eating behaviors.,Psychological Factors That Moderate Stress,Stress may be a fact of life, but the ways in which
18、 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 c
19、ouples desire for a child and their readiness to care for one.,Styles of Coping,Emotion-focused coping - A coping style that attempts to minimize emotional responsiveness rather than deal with the stressor directly.Problem-focused coping - A coping style that attempts to confront the stressor direct
20、ly.Self-efficacy expectancies - Beliefs in ones ability to accomplish particular tasks.,Coping with Stress,22,0,Coping with Stress,23,0,Psychological Hardiness,Psychological hardiness - A cluster of stress-buffering traits characterized by commitment, challenge, and control.Three key traits distingu
21、ished the psychologically hardy executives :1. Commitment. 2. Challenge. 3. Control over their lives,Optimism,Among heart disease patients, optimistic attitudes are associated with less emotional distress.Among cancer patients, optimism is associated with lower levels of emotional distress, better p
22、sychological adjustment, and lower levels of reported pain.Among pregnant women, it is linked to better birth outcomes, such as higher infant birth weights.,Optimism,Positive psychology - A growing contemporary movement within psychology that focuses on the positive attributes of human behavior.The
23、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.,Social Support,The role of social support
24、as a buffer against stress is well documented .In one study, having a broad network of social contacts was associated with greater resistance to developing an infection following exposure to a common cold virus.The investigators believe that having a wide range of social contacts may help protect th
25、e bodys immune system by serving as a buffer against stress.,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
26、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.Ethnic identity is associated with perceptions of a better quality of life among African Americans and appears to be mo
27、re strongly related to psychological well-being among African Americans than among White Americans.,Psychological Factors and Physical,Psychosomatic is defined as pertaining to a physical disorder in which psychological factors play a causal or contributing role. The term psychosomatic is derived fr
28、om the Greek roots psyche, meaning “soul” or “intellect,” and soma which means “body.” The field of psychosomatic medicine explores the health-related connections between the mind and the body.,Headaches,Headaches are symptoms of many medical disorders.When they occur in the absence of other symptom
29、s, however, they may be classified as stress-related. By far the most frequent kind of headache is the tension headache.,Cardiovascular Disease,Cardiovascular disease A disease or disorder of the cardiovascular system, such as coronary heart disease or hypertension. Coronary heart disease (CHD) is t
30、he major form of cardiovascular disease, accounting for about 500,000 deaths annually, mostly from heart attacks. CHD is the leading cause of death for both men and women, claiming even more womens lives than breast cancer.,Negative Emotions,Frequent emotional distress in the form of anger, anxiety,
31、 and depression can have damaging effects on the cardiovascular system. Type A behavior pattern (TABP) A behavior pattern characterized by a sense of time urgency, competitiveness, and hostility. Evidence indicates that episodes of acute anger can actually trigger heart attacks and sudden cardiac de
32、ath in some people with established heart disease.,Social Environmental Stress,Social environmental stress also appears to heighten the risk of CHD. Such factors as overtime work, assembly-line labor, and exposure to conflicting demands are linked to increased risk of CHD. Researchers in Sweden find
33、 that among women, marital stress triples the risk of recurrent cardiac events, including heart attacks and cardiac death.,Ethnicity and CHD,Coronary heart disease is not an equal opportunity destroyer. European Americans (non-Hispanic Whites) and African Americans (non-Hispanic Blacks) have the hig
34、hest rates of death due to coronary heart disease. Factors such as obesity, smoking, diabetes, and hypertension play important roles in determining relative risks of CHD and the rate of CHD-related deaths.,Coronary heart disease death rates in relation to race and ethnicity,Copyright (c) 2011 Pearso
35、n Education. All rights reserved.,Asthma,Asthma is a respiratory disorder in which the main tubes of the windpipethe bronchiconstrict and become inflamed, and large amounts of mucus are secreted. During asthma attacks, people wheeze, cough, and struggle to breathe in enough air. According to the Cen
36、ters for Disease Control (CDC, 2009b), an estimated 16 million adults and 7 million children in the United States are affected by asthma.,Theoretical Perspectives,Many causal factors are implicated in asthma, including allergic reactions; exposure to environmental pollutants, including cigarette smo
37、ke and smog; and genetic and immunological factors.Asthmatic reactions in susceptible people can be triggered by exposure to allergens such as pollen, mold spores, and animal dander; by cold, dry air; and by emotional responses such as anger or even laughing too hard. Psychological factors such as s
38、tress, anxiety, and depression can increase susceptibility to asthmatic attacks.,Cancer,The word cancer is arguably the most feared word in the English language, and rightly so: One of every four deaths in the United States is caused by cancer. Cancer claims about half a million lives in the United
39、States annually, one every 90 seconds or so. Men have a one in two chance of developing cancer at some point in their lives; for women the odds are one in three.,Cancer,Cancer involves the development of aberrant, or mutant, cells that form growths (tumors) that spread to healthy tissue. Cancerous c
40、ells can take root anywherethe blood, the bones, lungs, digestive tract, and reproductive organs. When it is not contained early, cancer may metastasize, or establish colonies throughout the body, leading to death.,Stress and Cancer,A weakened or compromised immune system may increase susceptibility
41、 to cancer. It remains to be seen whether psychological interventions actually increase the length of survival of patients suffering from cancer. Cancer patients may benefit from training programs that focus on developing coping skills, such as relaxation, stress management, and coping thoughts, to
42、help relieve the stress and pain of coping with cancer.,Acquired Immunodeficiency Syndrome (AIDS),Acquired immunodeficiency syndrome (AIDS) is a disease caused by the human immunodeficiency virus (HIV). HIV attacks the immune system, leaving it helpless to fend off diseases it normally would hold in
43、 check. HIV/AIDS is one of historys worst epidemics.,Adjustment of People with HIV and AIDS,Coping-skills training and cognitive-behavioral therapy can help improve psychological functioning, ability to handle stress, and quality of life among patients with HIV/AIDS and reduce their feelings of depr
44、ession and anxiety. Treatment may incorporate training in stress-management techniques, such as self-relaxation and positive mental imagery, and cognitive strategies to control intrusive negative thoughts and preoccupations. The importance of stress management skills is highlighted by findings that
45、stressful life events and passive coping (use of denial) were associated with faster progression to AIDS in HIV infected men.,Psychological Interventions to Reduce Risky Behaviors,Providing information about risk reduction alone is not sufficient to induce widespread changes in sexual behavior. Psychological interventions are effective in helping people alter these risky behaviors. These programs raise peoples awareness about risky behaviors and help them develop more adaptive behaviors, such as learning how to refuse invitations.,Stress reduction,Progressive muscle relaxation: http:/ END,
