STRESS, COPING, AND MALADAPTIVE BEHAVIOR CHAPTER 4 STRESS, COPING, AND MALADAPTIVE BEHAVIOR

STRESS AND COPING Stress Stress and Coping Coping Skills Emotional response to behavioral, biochemical, physiological changes related to acute or chronic challenges known as stressors. Stress and Coping Ability to cope depends on individual vulnerability and resilience. Coping Skills Characteristic ways of dealing with difficulties. Coping Processes Seek pertinent information Share concerns with others. Redefine situation to make it more solvable. Consider alternatives and examine consequences. Use humor to defuse situation.

STRESS AND VULNERABILITY

TYPES OF DENIAL OF STRESS

THE COPING PROCESS

AIDS TO BEHAVIORAL COPING

SOME PSYCHOLOGICAL, BODILY, AND BEHAVIORAL REACTIONS TO STRESS

TWO EXAMPLES OF TASK-ORIENTED COPING

STRESSFUL SITUATIONS AND LIFE TRANSITIONS Unexpected situations Accidents and natural disasters Personal crises Bereavement and grief Life Transitions Birth and child development Adolescence Going to college Entry into the workforce Marriage Bearing and raising children Establishing a new residence Children’s milestones Retirement

FACTORS THAT HEIGHTEN RISK FOR POOR OUTCOME OF BEREAVEMENT

BEHAVIORAL AND PHYSIOLOGICAL ASPECTS OF BEREAVEMENT Crying Agitation, restlessness Preoccupation with deceased Social withdrawal Decreased concentration Depressed mood Anxiety Physiological Muscular weakness Sighing Sleep disturbance Immunological changes Endocrine changes Cardiovascular changes Decreased body weight

CLINICAL REACTIONS TO STRESS Adjustment Disorder Acute Stress Disorder Dissociative Disorders Dissociative Amnesia Localized amnesia Selective amnesia Generalized amnesia Continuous amnesia Systemized amnesia Dissociative Fugue Dissociative Identity Disorder Depersonalization

NORMAL AND ABNORMAL RESPONSES TO STRESS

INFORMATION NEEDED IN MAKING A DIAGNOSIS OF ADJUSTMENT DISORDER Time of onset and duration of stressor Symptoms must develop within 3 months after onset. Duration of symptoms Usually less than 6 months Depressed mood, and/or anxiety, and/or inappropriate or antisocial conduct

DIAGNOSTIC CRITERIA FOR ACUTE STRESS DISORDER Exposure to an extreme event that evokes fear, helplessness, or horror Dissociative symptoms Persistent reexperiencing of the event Marked avoidance of stimuli associated with the traumatic event Marked anxiety and arousal Clinically significant symptoms that last for a minimum of 2 days and a maximum of 4 weeks, and emerge within 4 weeks of the traumatic event, and are not due to the effect of a substance or general medical condition.

MAJOR FEATURES OF DISSOCIATIVE DISORDERS

TREATING STRESS-RELATED DISORDERS Supportive Therapy Medications Relaxation Training Systematic Desensitization Cognitive Modification Social Intervention