Stress, Emotions, and Motivation in Psychiatry

Stress, Emotions, and Motivation

• Stress is a change that challenges adaptability, measured by the Holmes & Rahe scale.
• Short-term effects of stress include sympathetic over-activity, while long-term effects include increased cortisol.
• Life events that can cause stress include loss, humiliation, and entrapment.

Factors Determining the Effect of Stress

• Individual factors: physical, emotional state, and mental expectations (prepared mental set by antecedents).
• Stress factors: type, severity, frequency, and duration.

Coping with Stress

• Problem-solving, but impaired by cognitive errors (table 1).
• Emotional coping (defensive mechanisms) and impaired by pathological defenses (table 2).
• Failure to cope can lead to mental and psychosomatic illnesses, such as angina, cerebrovascular insufficiency, spastic colon, bronchial asthma, urticaria, and rheumatoid arthritis.

Cognitive Errors

• Perfectionism: assumes everything should be perfect, leading to obsessive traits.
• Black & white thinking: assumes things are all good or all bad, leading to borderline traits.
• Catastrophization: assumes a negative catastrophe, leading to depressive traits.
• Personalization: assumes events are related to oneself, leading to paranoid traits.

Defensive Mechanisms

• Denial: don't see problems, leading to poor reality testing.
• Distortion: problems seen as distorted.
• Projection: sees own problems in others.
• Identification: imitates significant others, leading to imitating parents or stars.
• Projective identification: provokes others to assume a role in one's mind.
• Act out: impulsive expression of unconscious wishes.
• Passive aggression: expression of aggression by being passive.
• Somatization: somatic symptoms symbolic to psychic state.
• Blocking affect: transient repression of emotions.
• Turning against oneself: blames oneself instead of the aggressor.
• Fantasy: imagines better conditions.
• Regression: behaves as in earlier stages, leading to childish behaviors.

Pathological Defensive Mechanisms

• Repression: excludes conflicts from awareness, leading to neurotic disorders.
• Dissociation: transient amnesia to an event or identity, leading to dissociative disorders.
• Isolate/split affect/intellectualize: avoids emotionality and focuses on intellectual details.
• Inhibition-undo: consciously limits impulse conflicting with another.
• Controlling: regulates environment to relieve inner chaos.
• Displacement: directs unaccepted emotion from high-rank person to a weaker or lower rank one.
• Reaction formation: expresses the opposite of an unaccepted emotion.
• Rationalization: justifies criminal behaviors.
• Sexualization: gives sexual meaning to non-sexual objects.

Disorders of Emotions

• Expression as a physical symptom, as in conversion and somatization.
• Experience: reactivity of emotions is exaggerated, as in affective disorders.
• Quality of emotion is incongruent to the situation, as in psychotic disorders.
• Quantity of emotions is blunt or even flat, as in psychotic disorders.

Motivation

• Initiating, guiding, and maintaining goal-oriented behavior.
• Maslow's hierarchy of needs: basic needs at the bottom and higher-level needs above.
• Yerkes-Dodson Law: inverted U-shaped curve relating performance and arousal.

Motivators

• Instincts: universal inborn programmed behavioral patterns.
• Drives reduction of Hull: internal tension relieved by desired behavior.
• Incentives: external rewards.
• Needs: the humanist Maslow designed a hierarchy of needs.

Disorders of Motivation

• Addiction: craving to seek pleasurable experience, even if destructive due to neurotoxicity.
• Amotivation syndrome: burnout of the brain reward system due to recurrent neurotoxic dopamine surges or degeneration.

Clinical Psychology

• Uses psychology in assessment, understanding, preventing, and managing psychological distress in clinical settings.
• Psychometrics and neuropsychology: standardized tests, including intelligence quotient, personality assessment, and structured interview.
• Psychotherapies and counseling: approaches include psychodynamic, cognitive-behavioral, and humanistic schools.
• Psychosomatics: the study of mind-body relation.

Mind-Body Relation

• Stress model: psychological stress renders a person liable for bodily disorders, affecting the sympathetic nervous system, endocrinal and immune systems.
• Somatoform & Pain model: perception of bodily symptoms is affected by psychological state.
• Placebo effect: treatment effects, side effects, and placebo elicit the effect expected by the patient through autosuggestion.

Body-Mind Relation

• The body's health influences the brain where mentation processes occur.
• Coping with disabilities, chronic & terminal illnesses: stages include denial, anger, bargaining, depression, and acceptance.
• Hospitalization and invasive maneuvers: disrupt daily life routine, loss of privacy, and familiarity with the surrounding environment.

This quiz covers the concept of stress, its effects on the body, and factors that influence its impact. It also touches on emotions and motivation in the context of psychiatry.