Psychology Past Paper: Health and Stress - PDF

CH 12: Health and Stress - Stress is used to refer to a wide range of concepts from external environmental stimuli to internal experiences and bodily responses. - Stressors are external circumstances and stimuli that represent a perceived potential for harm, loss, damage, cha...

CH 12: Health and Stress - Stress is used to refer to a wide range of concepts from external environmental stimuli to internal experiences and bodily responses. - Stressors are external circumstances and stimuli that represent a perceived potential for harm, loss, damage, challenge, or other deviations from a balance state. - Stress responses are internal integrated psychological (cognitive) and biological responses to stressors that then work to restore a balanced state. Different types of Stress - Types of stressors can be defined by Duration (chronic, acute, traumatic) and Severity (how severs is it) 1. Acute Stressors: short-term circumstances, lasting minutes to hours and have the potential for harm, loss, damage, or challenge 2. Chronic Stressors: Enduring circumstances, lasting weeks to years, with the potential for harm, loss, damage, or challenge 3. Traumatic Stressors: most severe stressors involving threat to your own or another’s life or physical integrity. Hans Selye, the “Father of Stress Research” believed that stress isn’t bad in moderation. Stress responses can be hugely beneficial – “eustress” He came up with General Adaptation Syndrome: The normal process when we encounter stress. 3 Steps of working through. Used rate for this experiment. - An alarm reaction is initiated when a stressor is first perceived and identified. - When stressors are prolonged, Selye suggests we enter a stage of resistance. During this stage, we continue to experience ongoing stress, which requires us to adapt and cope as well as possible. - If stressors are severe and last long enough, a person might reach Selye’s exhaustion stage. Strength and energy drop to very low levels. The exhaustion stage has much in common with the criteria for major depressive disorder. When a person is in exhaustion, they are susceptible to stress-related illnesses. In extreme cases, exhaustion can even lead to death. Origins of the Adverse Childhood Experiences (ACEs) – found the exposure to early adversity, especially in the absence of protective factors (e.g., supportive family environments and social networks), can result in a host of harmful outcomes immediately and throughout the life course. - Include child maltreatment (i.e., child abuse and neglect) and household challenges (i.e., witnessing intimate partner violence, parental separation or divorce, mental illness in the household, substance abuse in the household, or parental incarceration) that happen during the first 18 years of life. Research demonstrates that ACEs are prevalent, and exposure to ACEs has been linked to underdeveloped executive functioning and altered physiological stress responses, mental health problems, chronic health conditions,  health risk behaviors, decreased life opportunities (e.g., education and income), and decreased life expectancy. These linkages highlight the critical association between childhood experiences and ill health and subsequently the importance of preventing ACEs. HIGH ACE? NOW WHAT? Early identification and intervention is critical Increase safe, stable, and nurturing relationships Oxytocin(natural hormones that release when a mother nurses child) research – may regulate the HPA function Exercise – helps stress response reset itself and recalibrate Helps metabolize stress hormones and release endorphins Stabilizes mood and immune functions. Increases production of and releases BDNF (like miracle grow for the brain) – makes new connections. Mindfulness – stimulates the parasympathetic NS (a network of nerves that helps the body relax and conserve energy), being present in time The Stress Response serves to protect us from harm and restore balance to the body. - Homeostasis: the state of balance that is upset by stressors and then restored by the stress response.  Neurobiological Response: Studied by exposing people to short-term stressful situations while brain activity is being measured using electroencephalography (EEG) or functional magnetic resonance imaging (fMRI) Earliest stress responses typically occur in the amygdala Hippocampus and the prefrontal cortex also important Hippocampus (long-term memory) important in learning and memory Prefrontal cortex (problem-solving, making decision) important in higher-order processing of stimuli. Biological Response: Once the brain registers a stressor, the autonomic nervous system (ANS) and the hypothalamic pituitary adrenal (HPA) axis are rapidly activated The ANS includes two major branches, the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS). The SNS elicits the fight-or-flight response, which is involved in preparing the body to fight or to flee in response to stressors (Cannon, 1939) activation and regulation are key to understanding the stress response. The Immune System: Research has shown that everyday acute stressors promote an inflammatory response. - When encountering acute psychological stressors, the body increases levels of proteins called cytokines that regulate inflammation  These include interleukin-6 (IL-6), tumor necrosis factor (TNF) and acute phase protein C-reactive protein (CRP) Helps the body to deal with any injuries and/or infection (through any wounds) that may occur Stress Appraisals and Coping - Primary Appraisals: are based on your perceptions of the stressor characteristics, how much demand it represents, and its relevance for you - Secondary Appraisals: based on your perceptions of the resources available for coping for a specific stressor - Internal factors: e.g. personality and personal abilities - External factors: e.g. social support or financial resources Challenge and Threat Theory: - Challenges - defined as situations in which resources exceed the demands of the situation The potential for positive outcomes and gain are more likely to be perceived as challenges - Threats - defined as situations in which demands exceed the resources available for coping Danger, uncertainty, uncontrollability, novelty, and high levels of effort all have higher “demands” and are more likely to be perceived as threats Coping with Stress– Approaches n Problem-focused coping: aimed at controlling or altering the environment that is causing the stress. One benefit of either of these problem-focused coping strategies would be elimination of the perceived stressor. At the same time, you benefit by experiencing more control over your environment, which may also enhance your self-esteem. However, it is also possible that you have misdiagnosed the problem, which is a cost of problem-focused coping. Generally, problem-focused coping tends to be most useful when we feel that we can do something about a situation. Under these circumstances, problem-focused coping is more likely to lead to a more positive health outcome. However, when we do not feel that a situation is controllable, we often rely more on emotion-focused coping strategies.  n Emotion-focused coping: aimed at controlling your internal, subjective, emotional reactions to stress. You either express your emotions or alter the way you feel or think to reduce stress. Stressors activate a variety of emotions, including anxiety, worry, guilt, shame, jealousy, envy, and anger. Because these emotions are usually experienced as unpleasant, we are motivated to release, reduce, or avoid them. We attempt to lessen the effects of these negative emotions in two ways: by engaging in cognitive reappraisal and by using psychological defense mechanisms. - Cognitive reappraisal is an active and conscious process in which we alter our interpretation of the stressful event. - Cognitive reappraisal can be an emotionally constructive way of coping with a stressful event. Diathesis-Stress Model: “Theory that mental and physical disorders develop from a genetic or biological predisposition for that illness (diathesis) combined with stressful conditions that play a precipitating or facilitating role.” Healthy Behaviors - Physical activity: maintaining a physically active lifestyle is one of the best things to do for mental and physical health - Maintain a healthy sleep schedule - Choose a healthy diet - Healthy social connection Social Brain Hypothesis propose that humans and other primates evolved relatively large and metabolically expensive brains in order to navigate the complex social networks in which we operate. - Emotional support refers to expressions of empathy, love, and care when someone is experiencing stressors or high levels of perceived  CH:13 Personality n Bandura’s Reciprocal Determinism: how cognitive factors, environment, behavior affect each other. - Self-System: set of cognitions, used to observe and evaluate external stimuli, helps regulate behavior in different situation. - Albert Bandura speculates that personality is the product of three interacting forces: environment, behavior, and thoughts. - Bandura called the constant interaction among these three factors reciprocal determinism. - We choose to place ourselves in certain environments, and these environments then influence our behavior and the way we think. - However, the way we think—our attributions, goals, values, and perceptions—may guide which environments we choose to be in as well as the behavior we exhibit. - Our behavior, in turn, may change the environment as well as the way we think. - All three variables influence each other in a reciprocal manner. - A critical cognitive element in this interplay is what Bandura termed self-efficacy, or one’s expectation of success in each situation. - Self-efficacy can differ among different domains in one’s life. - People with high self-efficacy in a certain domain believe that they will be successful in that domain. - Approaching a situation with this belief is more likely to result in actual success. - In contrast, people with low self-efficacy in a particular domain are more likely to approach a task believing that they won’t succeed at it. - This mindset then decreases their chance of succeeding by causing them to give up too easily or to not even really try in the first place. - Self-efficacy, however, must be tempered by realistic evaluations of one’s skills. - If your beliefs don’t line up with your actual abilities, having a high level of self-efficacy won’t necessarily lead to success. Defense Mechanisms: sublimation, reaction formation, displacement, rationalization, repression - To mask feelings of anxiety and disguise the source of the tension, as well as to keep them from being expressed (e.g., screaming out loud), individuals unconsciously employ a variety of defense mechanisms (ways to avert the expression of id impulses without conscious awareness) - Repression: characterized by the individual’s ego simply removing (e.g., ignoring, trying to forget) the threatening impulse from conscious awareness. - Sublimation: transformation inappropriate impulses and motives into socially acceptable and even valuable expressions. (e.g., developing a career as a scientist studying deviant sexual behavior to satisfy one’s own atypical sexual desires) - Reaction Formation: Unacceptable thoughts and desire in the unconscious are expressed as their opposite in consciousness. (e.g., speaking out against homosexual behavioral while fantasizing about having sex with the same-sex individuals) - Displacement: shifting the expression of an unwanted impulse from a threating person to a less threatening one. (e.g., instead of expressing his anger at his boss for humiliating him in a meeting, an office manager yells at his child when arriving home) - Rationalization: creating an acceptable and local explanation to replace a true but threating cause of behavior. (e.g., instead of admitting to being a thief, an employee justifies stealing supplies from work as compensation for what is perceived as an unfair salary) Id/Ego/Superego - Id: the core component of personality and is located completely in the unconscious mind. Without any direct contact with the external world or conscious awareness, operates on the pleasure principle (the driving force of id, where the focus is on the fulfillment of all sexual urges and aggressive impulse. It takes care of basic human needs for survival and self-preservation (e.g., eating, drinking) in addition to satisfying primal urges, such as sexual impulses (Eros)and unrestrained aggression (Thanatos). - Ego: the component of the mind that can subdue the id’s sexual and aggressive impulses to wait for the “right time and right place.” It operates on the reality principle. - Superego: one’s moral compass of what is right and wrong. This is learned through people. Regulated by ego ideal and conscience. Exists at all levels of conscious awareness. Objective vs. Projective Personality assessment - Projective hypothesis: when people attempt to understand an ambiguous or vague stimulus, their interpretation of that stimulus reflects their needs, feelings, experiences, prior conditioning, thought processes and so forth. (give something that doesn’t have true answer, it’s based on their answers, more or less sociopath) - Objective self-report techniques: Assess personality by comparing responses to standard, fixed-format questions. From the Eysenck’s Trait Theory, there are the big five personality areas. - Openness - Variation in the expression of creativity, intelligence, diversity of interests, and conformity. The degree to which one is thoughtful and rational in considering new ideas. n People who score high in openness tend to be imaginative, creative, and curious and to prefer variety; those who score low in openness prefer routine and are more narrow- minded in their ideas and experiences. - Conscientiousness - Variation in the expression of being careless, orderly, and responsible. The degree to which one is aware of and attentive to other people, to the details of a task, or to both. n People who are high in conscientiousness tend to be hardworking, ambitious, reliable, and self-controlled, whereas individuals low on this dimension are more often described as unreliable, lazy, and spontaneous. - Extraversion - Variation in the expression of being adventurous, assertive, and social. the degree to which one’s energy is directed inward or outward. n People high in extraversion are talkative and sociable and prefer to be around others. At the other end of the continuum are people low in extraversion (introverts), who are quiet, reserved, and more comfortable on their own. - Agreeableness - Variation in the expression of being friendly, cooperative, and kind. the degree to which one gets along well with others. Being easygoing and trusting are traits characteristic of one high in agreeableness. n At the other end of the spectrum are people who are unfriendly, antagonistic, and suspicious (low agreeableness). - Neuroticism - Variation in the expression of being calm, stable, and anxious. the degree to which one is emotionally stable or unstable. n People high in neuroticism are temperamental, worrisome, and pessimistic. People who score low on this factor tend to be more even-tempered and calmer. Humanistic Theories; Carl Rogers - Human thrives toward self-actualization - Congruence vs. incongruence - Congruence: The therapist is genuine and authentic. It is important that the therapist’s body language matches the words the therapist says. For example, saying “I’m sorry to hear that” while smiling is incongruent. Rotter’s Social Learning Perspective - Internal locus of control n The generalized belief that we do have considerable influence over the events in our live n Better adjusted - External locus of control n The generalized belief that we do not have considerable influence the events in our lives n Learned helplessness (have no control) Chapter 14: Psychological Disorders The study of psychological disorders is called abnormal psychology. Word Choices: Person-first rather than disability first language (this person has this disorder) except autistic person Models 2 of psychopathology: medical model vs. bio-psycho-social-spiritual Biopsychosocial model: balancing the three aspects Dissociative Identity Disorder (personality disorder) n Dissociative disorders are marked by a disruption in a person’s memory, identity, emotion, perception, or behavior. Positive dissociative symptoms include depersonalization and derealization, as well as identity fragmentation, while negative symptoms include memory loss or impaired mental functioning. n Charactered by the presence of two or more distinct identities and extensive memory loss. The condition reflects a fragmentation or splitting of identity that results in alternate personality states that may have distinct names, ages, genders, attitudes, outlooks, and personal preferences. n Involve disruption in an individual’s memory, identity, emotion, perception, and behavior. Can affect physical sensations and motor control. n From of dissociation, whether spacing out while driving down highway or getting so wrapped up in reading a book that you lose track of time. n Positive dissociative symptoms: feeling of disconnection from one’s body (depersonalization), feelings that one’s surroundings are not real (derealization), or fragmentation of identity. n Negative dissociative symptoms: experienced as loss of memory or mental function. Experienced as inability to recall personal information, important life events, or significant people in one’s life. These disorders are largely marked by unawareness of this lost time or information. Social Anxiety Disorder n Anxiety is related to thoughts of future danger, cautious or avoidant behaviors, ad muscle tension. Bipolar I vs. Bipolar II Disorder: The term bipolar describes these highs of mania and lows of depression. Bipolar means two opposite extreme, such as freezing and scorching or greedy and generous. - Bipolar and related disorders are characterized by mood shifts in two directions, but more importantly, by the presence of a manic episode in which impulsiveness or productive behavior increase to abnormally high levels. - A manic episode describes a distinct period of increased energy and activity and may include psychotic symptoms. An individual may demonstrate impaired judgement by engaging in risking or dangerous activates, such as gambling, extravagant shopping sprees, or sexual escapades. Some individuals report feeling extremely productive during a manic episode, as another symptom is increased goal-directly activity. - Opposite of manic episode is a depressive episode, marked by sad mood or loss of interest or pleasure. n Mania, a distinct period of high energy and increased activity, is the defining feature of disorders. (impulsively hitchhiking to burning man) n Bipolar II Disorder - Hypomania is a less intense experience of mania that features the same increased energy and activity levels without the same impairment in functioning. Schizophrenia – positive and negative symptoms - Heterogeneous clinical syndrome: there are many different ways the disorder presents. For example, in a group of three people diagnosed with schizophrenia, there may be overlap in the primary symptoms they exhibit. May also experience cognitive symptom that is subtle and are often undetectable without neuropsychological testing. - Executive functioning: describes the mental skills we use to make decisions based on the information we are presented with. For example, sustained attention helps us to focus and concentrate on the task of driving and our working memory helps us to remember that we should apply our breaks when we see a red traffic light. In schizophrenia, these skills may be impaired, which can lead to confusion and poor decision making. n Interferes with daily activities n Diminished sustained attention n Many end up homeless n Positive symptoms: behaviors that were not present before the onset of a psychotic disorder. These symptoms start to appear during the psychotic disorder and are not typically seen in healthy individuals. - Delusions are strong beliefs that are not founded in reality. - Hallucinations: sensory experiences that do not have a source. While auditory hallucinations are most common, hallucinations can also be visual, olfactory, gustatory, or tactile (i.e., seen, smelled, tasted, or felt). - Disorganized thinking: discerned from a person’s speech and may entail switching from one topic to another in nonsensical way or speaking in a jumbled, incoherent fashion. - Abnormal motor behaviors: range from excessive and agitated movements to complete stillness and rigidity of the body. n Negative symptoms: behavior typically observed in healthy individual that an individual experiencing psychosis does not do. - Diminished emotional expression, also known as flat affect, is reduced expression of emotions through facial expressions, tone of voice, or body language. - Avolitation: decreased motivation to start or follow through on activities such as school, work, or self-care - Alogia: reduction in speech output. In conversation, an individual will reply sparsely, if at all. PTSD – post-traumatic stress disorder: Trauma and stressor-related disorders are psychological disorders that occur in response to experiencing or witnessing a traumatic event or in response to chronic stress (such as an abusive childhood). Post-traumatic stress disorder (PTSD) is the most well-known of trauma and stressor-related disorders. n Develop as the result of an individual experiencing or witnessing a traumatic event. n The symptoms of PTSD usually set in within three months of exposure to a traumatic event. n Re-experiencing symptoms: flashback (reliving the trauma over and over), nightmares, or involuntary disturbing thoughts about the traumatic events. n Avoidance symptoms: staying away from people, places, situations, or objects that serve as reminders of the traumatic event. n Cognitive and mood symptoms: inability to remember important features of the traumatic event; negative thoughts about oneself, others, or the world; persistent fear, horror, anger, guilt, or shame; inability to feel happy, satisfied, or loved. n Arousal and reactivity symptoms: constantly feeling tense or edgy; being easily startled; irritable behavior and angry outbursts; difficulty sleeping. Major Depressive Disorder n Includes suicidal behavior, thoughts, plans, and attempts n Characterized by either sad mood or loss of interest or pleasure in activities that were one enjoyable. Other symptoms include significant increase or decreases in weight (without trying), appetite, or sleep patterns. n Physical symptoms, such as headaches, digestive problems, agitation, and lethargy, are also common. n Depressive disorders are characterized by physical symptoms and negative thoughts that significantly impair an individual’s daily functioning. Suicidal thoughts and behaviors are frequently associated with depressive disorders, and any and all suicidal comments should be taken seriously. Generalized Anxiety Disorder  n Anxiety disorders are a group of psychological disorders marked by excessive fear and anxiety; this group of disorders includes phobias, social anxiety, agoraphobia, panic disorder, and generalized anxiety disorder, among others. Anxiety is a normal emotion. Can be adaptive in many ways. Phobia: fear that would change daily life. Like fear of dogs make you avoid certain places and must change path) Panic attack: intense fear about something (sudden onset and don’t know why) Agoraphobia: an anxiety disorder in which an individual fears or avoids certain places or situations. “Fear of the marketplace” n Women are twice as likely as men to experience agoraphobia. n Diagnosis of this condition requires fear of avoidance of at least two of: using public transportation, being in open spaces, being in enclosed places, standing in line or being in  a crowd, or being outside of the home alone. The individual may report feeling trapped, helpless, or embarrassed, which amplifies their anxiety. n Leads to the experience of panic symptoms, such as shakiness, chest pain, nausea, dizziness, and shortness of breath, as well as fear of “going crazy” or dying. What kinds of behaviors show an elevated risk of suicide? n Suicidal behaviors can include thoughts, plans, and attempts to end one’s life. Motivations for suicide may include a desire to end intense emotional suffering, feeling overwhelmed with the stressors of life, or a wish to not be a burden to others. Autism Spectrum Disorder (ASD): significant social, emotional, behavioral impairments. Repetitive movement (rocking the body back and forth), insistence on a routine (eating the same food every day, distress when the schedule is not followed), intense preoccupation with a particular interest (fixation on a specific topic, like dinosaurs), and hyper-reactivity to sensory input (adverse response to specific sounds or smells, excessive touching of objects.) Autism spectrum disorders (ASD) are a class of disorders of varying levels of impairments to social, emotional, and behavioral processes and communication. Antisocial Personality Disorder Somatic Symptom Disorders: Somatic symptoms and related disorders are psychological disorders related to the body, such as an intense preoccupation with symptoms related to physical illness or pain. Physical symptoms caused by somatic disorders are real but have no traditional medical explanation. n Something that is specifically related to the body and not the mind. Intense focus on symptoms of physical illness or pain. n Factitious disorder: faking illness for attentions OCD – obsessions and compulsions: Obsessive-compulsive and related disorders are characterized by obsessions (unwanted and intrusive thoughts, fears, urges, or images) and compulsions (behaviors a person feels driven to perform in response to an obsession); rituals are frequent in these disorders to reduce anxiety related to the obsessions and compulsions. n Obsessions are recurrent unwanted and intrusive thoughts, fears, urges, or images. (e.g., Fear of germs) n Compulsions are behaviors in response to an obsession. (e.g., repetitive handwashing) n Hoarding Disorder: difficulty getting rid of useless things. Results in excessive accumulation. Conversion Disorder  Eating Disorders n Binge eating disorder: recent but most common eating disorder n Cants stop eating and consume large amounts of food Alzheimer’s Disease: it takes a while to start off Chapter 15: Treatment of Psychological Disorders  Be able to explain one type of therapy treatment and what type of disorder it might be helpful with and what you would do/target in that therapy Gestalt Therapy: not interesting in changing but in knowing. Look at the whole pictures. (listen and look at body action) (Empty chair technique: ongoing conversation with someone who is actually not there) More direct and far less gentle. Patients are encouraged and sometimes actively pushed to express their feeling openly. Cognitive Behavioral Therapy: time sensitive and structure talk therapy that specifically tailor for the need of each individual client. Cognitive means thinking. Focus on solving client current problems and teaching them skills to change their thinking and behavior. Help client become their own therapist by teaching technique to use for the rest of their life. Short-termed, action-oriented, and problem-focused approach. Psychoanalysis is based on the assumption that psychological disorders arise from unconscious anxiety. Person-centered and Gestalt humanistic therapy assumes that each person has the tools needed to achieve mental health. Cognitive therapies assume that irrational beliefs and maladaptive thoughts are the source of psychological disordered outcomes. Person-centered therapists use unconditional positive regard toward their clients. Dr. Khislavsky requires his clients to keep extensive records of intrusive thoughts and emotions. They work together to come up with solutions to these thoughts. This form of psychotherapy is Cognitive Therapy. Psychodynamic Therapy: psychoanalysis Humanistic Therapy/Client-Centered: a therapeutic modality that focuses on the client’s individual characteristics with a primary goal of helping them develop a stronger, healthier sense of identity to better understand the meaning of life. n Active Listening n Unconditional Positive Regard: The therapist is accepting, respectful, and caring toward the patient. Even when the therapist does not agree with the patients’ views or behaviors, they should demonstrate that they believe the patient is doing the best he or she can. Systematic Desensitization vs. flooding  - Systematic Desensitization: A treatment which aims to replace anxious response to stimulus with a relaxation response. Used by behavior therapists to treat patients whose experience of anxiety is so overwhelming that it interferes with day-today life. Ellania is experiencing crippling test anxiety. Her school therapist suggests she try learning relaxation skills and then practice relaxing when she thinks of exams, during quizzes and then finally during exams. Ellania’s therapist is suggesting a technique known as Systematic Desensitization. - Flooding: A therapeutic technique in which the client is exposed to an anxiety-provoking stimulus and not allowed to escape until they are able to relax. Psychiatrist vs. psychologist vs. psychiatric nurse practitioner vs. master’s level therapist vs. clinical social worker. - Psychologist: A doctoral-level professional who is trained to assess and treat psychological disorders. They often provide psychotherapy; do not typically prescribe medication. They are “scientist-practitioners” meaning they are trained to conduct and consume research as well as provide psychotherapy. n Clinical psychologists: typically treat individuals with more severe mental health concerns. n Counseling psychologists: work with individuals who currently find difficult to cope with and adjust to life crises and stressors. n School psychologist: work with individuals who currently find it difficult to cope with and adjust to life crises and stressors. - Psychiatrist: a medical doctor who is trained to assess and treat psychological disorder. Often prescribe and manage psychiatric medication and refer to other mental health providers for psychotherapy. (work clinical hours) - Psychiatric nurse practitioners: nurses with advanced training and education (i.e. a master’s degree or doctorate) who, in many states, can prescribe and manage psychiatric medication. - Clinical social worker: complete a master’s degree in social work (M.S.W.) and provide mental health care to a variety of populations in many different settings. Provide more than the 60% of all mental health services in the United States. Work to create practical solutions for problems that may make mental health concerns harder to treat (e.g., access to health care, food and housing subsidies, medical disability compensation) - Mental health counselors: complete a master’s degree; typically, a Master of Arts (M.A.) or a Master of Science (M.S.) and provide diagnostic assessment and counseling to individual across the lifespan. - Therapist: broad term that can describe a number of master’s-level mental health professionals. Trained in the assessment and treatment of psychological disorders and practice in a variety of setting.  Using a thought record to help with cognitive restructuring: patients learn to identify their cognitive distortions, dispute the negative thoughts, and develop alternate, more positive, and rational thoughts.