Stress, Emotions, and Motivation in Psychiatry

Study Notes

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.

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

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.

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.

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.

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.

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.

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.

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.

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.

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.