Abnormal Psychology

06/07 February 2017

 STRESS-RELATED DISORDERS
Introduction
 Ano ang nakaka-stress sayo?
 What is STRESS?
Refers to the pressures or demands placed on organisms to
adapt or adjust
 STRESSORS (or stresses) is a source of stress
a.) psychological factors:
Ex. Exams in school, problems in social relationships, and
life changes (death of loved one, separation, losing a job)
 STRESS-RELATED DISORDERS
Introduction (continued)

b.) physical environmental factors:

Ex.Traffic jams, exposure to extreme temperatures or
noise levels
 Is stress good or bad?
STRESS & HEALTH
GAS (General Adaptation Syndrome): Hans Selye 1976:

I. Alarm reaction stage: mobilizes the body to

prepare for challenge or stress.
: activation of the sympathetic nervous system
which increases bodily arousal and triggers of
stress hormones by the endocrine system.
: fight-or-flight reaction (W. Cannon)
STRESS & HEALTH
GAS (General Adaptation Syndrome): Hans Selye 1976:

II. Resistance stage (or adaptation stage ):

Endocrine and sympathetic nervous system
responses (e.g., release of stress hormones) remain
at high levels.
STRESS & HEALTH
GAS (General Adaptation Syndrome): Hans Selye 1976:
III. Exhaustion stage: characterized by the
dominance of the parasympathetic branch of the
ANS.
 Normal cycle: goes back to equilibrium ( back to
normal state)
 Ancestors’ time vs now
 “diseases of adaptation”: from allergic reaction to
heart disease, even death.
STRESS & HEALTH
Stress-Related Changes in the Body
Associated with the Alarm Reaction
Corticosteroids are released.
Epinephrine and norepinephrine are released.
Heart rate, respiration rate, and blood pressure increase.
Muscles tense.
Blood shifts from the internal organs to the skeletal
muscles.
Digestion is inhibited.
Sugar is released by the liver.
Blood-clotting ability is increased.
STRESS & HEALTH
 The Endocrine System
STRESS & HEALTH
 “Domino effect” of Stress:

Hypothalamus
hormone
pituitary gland
ACTH
adrenal glands
corticosteriods
 epinephrine (adrenaline)
norepiphrine
STRESS & HEALTH
 Effects on the immune system:
Immune system
: body’s system of defense against diseases.
: leukocytes (white blood cells)
- “frontliners/soldiers”
- produce antibodies
STRESS & HEALTH
 Effects on the Immune System (continued)
Persistent /chronic stress can eventually
weakened the immune system
Weakened immune system increases susceptibility
to many illness
Examples of stress that can weaken immune
system: final exam week, marital conflict,
separation, unemployment, traumatic stress (e.g.,
natural disasters, terror attacks)
STRESS & HEALTH
 Effects on the Immune System (continued)

Inflammation seemed to be the cause how stress

leads to health problems (Cohen et al., 2012;
Gouin et al., 2012)
-normally, immune system regulates the body’s
inflammatory response to infection or injury.
STRESS & HEALTH
-under stress, it becomes less capable of toning
down inflammatory response, leading to persistent
inflammation that may contribute to development
of physical disorders like cardiovascular diseases,
asthma, arthritis, diabetes, even cancer.
-continuous secretion of the cortical steroids
weakens the immune system by disrupting the
production of antibodies, which increase
vulnerability to colds and other infections.
PSYCHOLOGICAL FACTORS THAT
MODERATE STRESS
COPING STYLES:
 Emotion-focused coping
Examples:
o Denial
o Displacement (blaming)
o Avoidance
o Intellectualization / rationalization (sour-graping)
PSYCHOLOGICAL FACTORS THAT
MODERATE STRESS
COPING STYLES:
 Problem-focused coping
Examples:
o Practical ways to solve the problem (solution-
focused; future oriented)
o Confrontation
o Learning the lesson from a failure
SELF-EFFICACY EXPECTANCIES
 Self-efficacy expectancies: one’s expectation
regarding his/her abilities to cope with the
challenges; to perform certain behaviors skillfully,
and to produce positive changes in his/her life
(Bandura, 1986).

Ex. People who believe they can cope with their

problems are less likely to feel nervous
PSCYHOLOGICAL HARDINESS
 Psychological hardiness : a cluster of traits that
may help people manage stress (Kobasa et al.,
1982):
1. Commitment. Very involved in their tasks.
They believe in what they’re doing.
2. Challenge. They welcome change.
3. Control over their lives. They have an
internal locus of control.
 Hardy people also appear to use problem-solving
approaches.
OPTIMISM
 Recent study shows the link between greater
optimism in women to lower rates of heart disease
and greater longevity (Tindle et al., 2009)
 Positive psychology movement
 The magic ratio
SOCIAL SUPPORT
 People with a broad network of social relationships
(spouse, having close family members and friends,
and belonging to a social organizations) not only
show greater resistance to fending off common
cold but also tend to live longer (Cohen et al.,
2009; Cohen et al., 2003).
 Social support helps protect the body’s immune
system by serving as a buffer against stress.
ADJUSTMENT DISORDERS
 Classified in the DSM-5 within the category of
Trauma-and Stressor-Related Disorders
 Adjustment disorders are among the mildest
 Adjustment disorder: is a maladaptive reaction
to a distressing life event or stressor that develops
within 3 months of the onset of the stressor.
 Stressor: either traumatic experience or non-
traumatic life event
ADJUSTMENT DISORDERS
 DSM: characterized by significant impairment in
social, occupational, or other important area of
functioning or marked by emotional distress
exceeding what would normally be expected in
coping with stressor.
Examples: break up  failing grades
: after separation  feeling down, pessimistic
: ___________  vandalizing on school
walls or showing sings of disturbed conduct
Specific Types of Adjustment Disorders
Disorder Chief Features
Adjustment disorder Sadness, crying, and feelings
with depressed mood of hopelessness.
Adjustment disorder Worrying, nervousness, and
with anxiety jitters (or in children, fear of
separation from primary
attachment figures).
Adjustment disorder A combination of anxiety and
with mixed anxiety depression.
and depressed mood
Specific Types of Adjustment Disorders
Disorder Chief Features
Adjustment disorder Violation of the rights of
with disturbance of others or violation of social
conduct norms appropriate for one’s
age;
sample behaviors include
vandalism, truancy, fighting,
reckless driving, and
defaulting
on legal obligations (e.g.,
stopping alimony payments).
Specific Types of Adjustment Disorders
Disorder Chief Features
Adjustment disorder Both emotional disturbance,
with mixed such as depression or anxiety,
disturbance of and conduct disturbance (as
emotion and conduct described above).
Adjustment disorder A residual category that
unspecified applies to people not
classifiable in one of the other
subtypes.
Source: Based on the DSM-5 (American Psychological Association, 2013).
ADJUSTMENT DISORDERS
 it is difficult to distinguish features of adjustment
disorders that are distinct from other disorders
such as depression (Casey et al., 2006)
TRAUMATIC STRESS DISORDERS
 characterized by maladaptive patterns of behavior
in response to trauma that involve marked
personal distress or significant impairment of
functioning.
TRAUMATIC STRESS DISORDERS
Acute Stress Disorder
 person shows a maladaptive pattern of behavior
for a period of 3 days to 1 month following
exposure to a traumatic event.
 Traumatic event: exposure to either actual or
threatened death, serious accident, or a sexual
violation
TRAUMATIC STRESS DISORDERS
Acute Stress Disorder
 Exposure: direct exposure, witness other people
experience, learned about a violent or accidental
traumatic event experienced by a close friend or
family member. First responders in traumatic
events may also develop acute stress disorder.
TRAUMATIC STRESS DISORDERS
Acute Stress Disorder
 Symptoms may vary but includes: disturbing,
intrusive memories or dreams about the trauma
: re-experiencing the trauma in the form of
flashbacks
: feelings of unreality or detachment (dissociation)
from one’s surroundings or from oneself – higher
likelihood of PTSD
: avoidance of external reminders of the trauma
TRAUMATIC STRESS DISORDERS
Acute Stress Disorder

: problems sleeping
: development or irritable or aggressive behavior
: exaggerated startle response to sudden noises
POSTTRAUMATIC STRESS
DISORDER (PTSD)
 Compared to acute stress disorder (up to several
weeks following traumatic event), PTSD is a
prolonged maladaptive reaction that lasts longer
than one month after the traumatic event.
 PTSD has similar symptoms with acute stress
disorder but may persist for months, years, or
even decades
 Symptoms may also not develop until months or
even years after the event.
POSTTRAUMATIC STRESS
DISORDER (PTSD)
THEORETICAL PERSPECTIVES
 Derived from behavioral perspective: classical
conditioning
 Traumatic experiences (unconditioned stimuli) paired
with neutral stimuli (e.g., sights, sounds, smell
associated with trauma) conditioned response (e.g.
anxiety)
 The person may learn to avoid contact with the
trauma-related stimuli and is reinforced by the relief
from anxiety
 Avoidance however may fail to overcome the
underlying fear
TREATMENT APPROACHES
 Cognitive-Behavior Therapy (CBT) produced
impressive result in the treatment of PTSD (Ehlers
et al., 2010; Henslee & Coffey, 2010; Resick et
al., 2012)
 Basic treatment
: repeated exposure to cues and emotions
associated with the trauma.
: gradual re-experiencing the anxiety associated
with the traumatic event in a safe setting, thereby
allowing extinction to take its course.
TREATMENT APPROACHES
: re-experiencing can either be imagined or in vivo
: retelling of the experience
: expressive therapies
END OF CLASS