The human spirit is more powerful than any drug. It needs to be nourished with work, play, friendship, love. The simplest things. The things we have forgotten.”from the movie “Awakenings

Stress & Coping

Primary Situational Appraisals**** Harm/Loss – * Threat – * Challenge –

Threats create greater response than challenges

Primary Appraisals (cont’d)

Depend on the situation and how one interprets the stimulus

Negative appraisals, heighten the physical arousal Positive appraisals, decrease physical arousal

Stress Factors

Hassles - daily, irritating events vs Uplifts - satisfying daily events

contribute or detract from risk of depression

Conflict Patterns***

Approach – approach:

Avoidance –avoidance:

Approach-avoidance:

Stress Factors

Social Readjustment Rating Scale (490)

+ / - situations experienced in past 6 mos. (> 300) and past year (> 500)

Doesn’t address appraisals***

Stress on the System

Fight or flight response – Appraisal of event –

Hypothalamus – activated by threats Sympathetic – speeds up responses Parasympathetic – slows down / calms

Stress on the System***

Psychosomatic symptoms –

Examples – stomach, muscle pains, fatigue, eating probs, skin rashes, insomnia, asthma, blood pressure incr.

Mind-body Connection

Thoughts, emotions & beliefs …

Mind – body Therapy:

Psychoneuroimmunology - relationship between CNS,

endocrine system and psychosocial factors

Personal & Social Factors

Resiliency

Locus of Control – external vs internal

Optimism / Pessimism –

Social Support –

Coping

Secondary Appraisal – deciding to deal with the stressor

Emotion-focused: seeking comfort, sympathy

Problem-focused: Seeking information

Control elements -> Combination is best

Stress Management Techniques

Challenge appraisals Positive Self-Statements Biofeedback Progressive Relaxation Meditation Social-cognitive counseling / intervention

Disorders

Definitions of Abnormality

Statistical frequency- Social norms – Maladaptive –

Diagnosis

Clinical interview: Personality tests: Neurological tests: DSM-IV (297) :

Frequency - % reporting

Any disorder – 48%

Substance Use – 27%

Anxiety Disorder – 25%

Mood Disorder – 20-25%

Mood DisordersMajor Depression

2 weeks or more

Low mood, low interest, low pleasure

Problems with 4 of these: eating, sleeping, thinking, concentration, guilt, making decisions, energy level, suicidal thoughts

Mood Disorders

Biological Theory – genetic, neurological factors Psychosocial Theory – personality traits

Cognitive Theory – automatic negative thoughts

Mood Disorders

Bipolar disorder – extremes variable self-esteem, sleep patterns rapid, frequent speech / little speech racing thoughts / depressed affect

Bipolar – PET Scans

Mood Disorders - Interventions

Social skills –

Social support –

Thought substitution –

Mood Disorders - Treatments

Antidepressants – SRI’s (Serotonin Reuptake Inhibitors)

(Prozac) Lithium- mineral salt (for Bipolar I)

ECT (Electroconvulsive therapy)

Personality Disorders

Antisocial -> Violates rights of others without guilt or remorse Delinquent : stealing, fire-setting, forgery, law-breaking

Psychopathic: human victimizers

Personality Disorders

Psychopaths

* Chemical

* EnvironmentalTreatment

Drugs to raise serotonin levels 2/3rds – no long-term improvement

Personality Disorders – other examples

Paranoid – Schizotypical –

Histrionic – Obsessive-compulsive – Dependent –

Schizophrenia

Affects thought, attention, perception, motor functions & emotions

Identifiable gene directly linked on Chromosome # 6 ( 48-83% in twins)

Schizophrenia Type I: + symptoms ->Type II:

Neurology – biological basis

Ventricles – larger–> Thalamus – smaller -> Frontal Lobe – PET scan data

Diathesis Theory – Combination of genetic predisposition interacting with life stressors

Dissociative Disorders

Dissociative Identity Disorder – formerly known as “Multiple Personality”