Psychology Responses to Injury & Illness

The Biopsychosocial Crisis thoery The intrusiveness of the condition= the intrusiveness of the psychological symptoms and overall health. Does it disrupt their roles and hence their sense of self? Cognitive Behavioral The Triad – cognitive, affective and behavioral

Stress process models and coping theory Lazarus & Folkman thory of coping and adaptation Illness or injury can be perceived as stressors leading to a DYNAMIC and temporarily ONGOING process of cognitive appraisals, affecting emotional responses and leading to behavioral choices. Primary perceptions affect secondary or subsequent appraisals of the resources avialable for the demands. e.g. back pain This leads to coping strategies IN order to adapt or adjust - recreate homeostasis The professional can make a difference (e.g. chronic fatigue patient doing less to conserve energy) E.g. physical therapist (paul and rich)

Stress process models and coping theory Immediate- unconscious, subconscious, instinct Response – involves a cognitive appraisal, longer times Adjustment

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Stress and Coping Coping depends on the physical & mental resources, culture and personality. By successfully coping with something a patient is able to better manage and have a more favorable response. Lazarus’s model – transactional model Emphasizes the appraisal process

Stress and Coping Primary appraisal = perception of an event as being either mainly harmful or harmless. Secondary appraisal = individual’s perception of their self efficacy in dealing with the potential stressor. Therefore, if a person views something stressful and not having self efficacy in being able to handle it = full blown stress.

Stress and Coping Eight identified coping strategies Escape avoidance Avoid the problem by day dreaming, drinking, or workaholic Distancing Humour, metaphors Positive reappraisal Finding good in bad, reframing Self controlling Keep feelings and controlled internally Seeking social support Sharing problems instead of bottling. A problem shared is a problem halved.

Stress and Coping Planful problem solving Strategically find a way to plan their way out of a problem Accepting responsibilty When one is responsible or the case reduces a sense of victim mentality Confronting Dealing with the cause of the problem head on. People tend to use more than one style

Stress and Coping Certain strategies may make someone effective in dealing with certain stressors. However, those same strategies may much less effective with other stressors. Certain strategies that are “higher order” maybe comprised of a number of the previously mentioned. For example, Intellectualisation Distanicng, positive reappraisal, confronting

Stress and Coping Emotion focused Centered on the emotional reaction Self control Escape avoidance Accepting responsibility Distancing Seeking support Ruminators Problem focused Centered on dealing with the problem Confronting Planful problem solving Seeking support Nonruminators

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Social Support & Family Appraisal support Appraisal support Enabled or encouraged to evaluate their own state Emotional support Emotional support Being loved, cared for, listened to, etc Esteem support Esteem support Feeling that your valued Information support Information support Advice or information that can facilitate coping Instrumental support Instrumental support Practical behavioral or resource based assistance.

Stress and Coping Berkman & Syme (1979) Classic study –followed thousands of people Those that had the most social support were least likely to die during the nine years. Social support becomes like an opportunity to charge the system of the person with more energy.

Self perception and grieving Malingering