Quality Stress Management Course

The Well Being Way Stress Management Program

What you'll learn in the book is as follows: The Secret Formula I use every day to gain maximum happiness. Over 101 Ways To Reduce Stress. How To Use Your Body to Maximise Your Happiness. The one thing I did in 2010 which made a huge difference to my life which I didn't use for the 2 previous years. How To Deal With Challenging Emotions. The key to building a Joyful Life that if you implement will make huge changes. How To Turn Stressful Situations Around When Things Arent Going Your Way. Revealed. The best Spiritual Advice I've Ever Received. Affirmations. How To Make Affirmations Work For You. The Cornerstone of Maintaining Joy In Your Life. The One Technique To Cope With Huge Workloads in An American Fortune 500 Company. The 2 things that you need to start doing to overcome modern day stress in your life. Read more...

The Well Being Way Stress Management Program Summary

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Stress Management in the Health Care Field A Pilot Program for Staff in a Nursing Home Unit for Patients With

Summary This journal article describes a pilot stress management program developed for staff in a nursing home unit for patients with Alzheimer's disease. A survey of the nursing unit staff was conducted to determine how much work related stress the staff was experiencing, the sources of this stress, and how staff members were dealing with the stress. The results were used to develop a stress management program to meet the specific needs of the staff members. A series of weekly, half hour, voluntary stress management classes were implemented. The techniques varied from week to week and often utilized music therapy methods. These interventions included gentle stretching to music, guided imagery with music, and massage therapy with music. Although attendance remained low throughout the program, the majority of staff indicated they liked the program. It was often difficult for staff to attend at the scheduled time during a shift, yet they were not willing to use their own time before or...

Coping With Caregiving Stress Management for Caregivers of the Elderly

Summary This article describes a study of stress management approaches to benefit caregivers of family members with Alzheimer's or other dementias. The study hypothesized that stress management training would promote more effective coping and more greatly reduce caregiving burdens in caregivers than a support group intervention. Results of the study suggest that specific stress management techniques adapted to meet the needs of caregivers can improve ways in which caregivers cope with frustrations more significantly than participation in support groups. However, the study did not show the ability of either support groups or the stress management program to alter the sense of burden caregivers experience. 35 references.

Stressful Events

Stressful life events may be a risk factor for developing AN. Studies investigating the relationship between sexual abuse and eating disorders have produced highly discrepant results (Connors & Morse, 1993). Alow rate of sexual abuse has been reported among anorectic restrictors relative to either bulimic anorectics or to normal-weight bulimics (Waller, Halek, & Crisp, 1993).

The Combined Health Information Database

The Combined Health Information Database summarizes studies across numerous federal agencies. To limit your investigation to research studies and stress management, you will need to use the advanced search options. First, go to http chid.nih.gov index.html. From there, select the Detailed Search option (or go directly to that page with the following hyperlink The trick in extracting studies is found in the drop boxes at the bottom of the search page where You may refine your search by. Select the dates and language you prefer, and the format option Journal Article. At the top of the search form, select the number of records you would like to see (we recommend 100) and check the box to display whole records. We recommend that you type stress management (or synonyms) into the For these words box. Consider using the option anywhere in record to make your search as broad as possible. If you want to limit the search to only a particular field, such as the title of the journal, then select...

Search the Crisp Web site at httpcrispcitnihgovcrispcrispquerygeneratescreen

You will have the option to perform targeted searches by various criteria, including geography, date, and topics related to stress management. For most of the studies, the agencies reporting into CRISP provide summaries or abstracts. As opposed to clinical trial research using patients, many federally funded studies use animals or simulated models to explore stress management. The following is typical of the type of information found when searching the CRISP database for stress management

Project Title A Cdrom Workplace Stress And Mood Management Program

Treatment of these problems are available, a large proportion of the work force - perhaps a majority of those afflicted - do not seek interventions for their problems, largely because of the stigma attached to the mental disorders, coupled with a lack of exposure to available interventions. The goal of this project is to develop and test an interactive, multi-media computer-based stress and mood management program for the workplace. By presenting topics of depression, anxiety and substance abuse within a program of stress management - a relatively non-stigmatized topic -- working adults can acquire the necessary awareness, skills and motivation to prevent, or seek treatment for, these costly disorders. In Phase I, a prototype CD-ROM stress and mood management program will be developed and tested in focus groups of working adults, and interviews will be conducted with human resource managers and workplace health professionals to assess the feasibility and commercial viability of the...

Acknowledgements

The collective knowledge generated from academic and applied research summarized in various references has been critical in the creation of this book which is best viewed as a comprehensive compilation and collection of information prepared by various official agencies which produce publications on stress management. Books in this series draw from various agencies and institutions associated with the United States Department of Health and Human Services, and in particular, the Office of the Secretary of Health and Human Services (OS), the Administration for Children and Families (ACF), the Administration on Aging (AOA), the Agency for Healthcare Research and Quality (AHRQ), the Agency for Toxic Substances and Disease Registry (ATSDR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the Healthcare Financing Administration (HCFA), the Health Resources and Services Administration (HRSA), the Indian Health Service (IHS), the institutions of...

Forward

Studies on Stress Federally Funded Research on Stress Chapter 2. Nutrition and Stress Finding Nutrition Studies on Stress Chapter 3. Alternative Medicine and Stress Chapter 4. Dissertations on Stress Dissertations on Stress Chapter 5. Clinical Trials and Stress Recent Trials on Stress Chapter 6. Patents on Stress Patents on Stress Patent Applications on Stress Chapter 7. Books on Stress Chapters on Stress Chapter 8. Multimedia on Stress Bibliography Multimedia on Stress Chapter 9. Periodicals and News on Stress Academic Periodicals covering Stress

Index249

In March 2001, the National Institutes of Health issued the following warning The number of Web sites offering health-related resources grows every day. Many sites provide valuable information, while others may have information that is unreliable or misleading. 1 Furthermore, because of the rapid increase in Internet-based information, many hours can be wasted searching, selecting, and printing. Since only the smallest fraction of information dealing with stress management is indexed in search engines, such as www.google.com or others, a non-systematic approach to Internet research can be not only time consuming, but also incomplete. This book was created for medical professionals, students, and members of the general public who want to know as much as possible about stress management, using the most advanced research tools available and spending the least amount of time doing so. In addition to offering a structured and comprehensive bibliography, the pages that follow will tell you...

Alcohol And Depression

Similar relationships between depressed mood and alcohol abuse have been reported in adolescents. In a prospective study of over 1000 adolescents, those with depressive symptoms and heavy drinking were more likely to have low levels of functioning, high levels of childhood externalizing problems and stressful life events, low levels of family social support, and high levels of delinquency (34). Alpert et al. (35) found that childhood and adolescent onsets of depression were risk factors in the development of alcohol dependence and abuse in adulthood. King et al. (36) noted that depressed male adolescents had increased risk of later alcohol and drug abuse.

Stimulus Theories and Research

Remaining consistent with the usage of the term 'stress' described in physics, some investigators have focused on stress as a stimulus. Most notable among researchers employing this approach were Holmes and Rahe (1967). These investigators devised a list of major life events known as the Social Readjustment Rating Scale. Intuitively selecting 'death of a spouse' as the barometer of the most stressful life event, this instrument consisted of 43 items measuring distinct life changes that were self-reported over a specified period of time, typically one year. Each item was assigned what Holmes and Rahe called a Life Change Unit score based upon the item's relative severity with reference to 'death of a spouse.' Research employing the Social Readjustment Rating Scale has demonstrated an association between the number of significant stressful life events and incidence of a number of psychological disorders and medical diseases (Brown and Harris, 1989 Horowitz et al., 1977). Elliott and...

Interaction Transactional Theories and Research

Regardless of whether researchers approach their field of study from a stimulus, response, or transactional perspective, there is a general recognition that individual differences exist in how individuals respond to stressful situations (Lazarus and Folkman, 1984 McEwen,

Modifiable Psychological Variables

Know people who seem to possess the ability to cope with life's most challenging stressors (like becoming quadriplegic or losing the family home in a hurricane) without apparent distress we also know others who experience extreme distress if they are five minutes late for an appointment. Clearly, these individuals differ regarding the sorts of coping skills they have learned throughout life. Lazurus and Folkman (1984) used the term 'coping' to refer to the cognitive and behavioral efforts that a person made to manage the specific stressors that were appraised as taxing or exceeding their resources. They categorized these groups of skills into two types emotion-focused coping and problem-focused coping. Problem-focused coping involves cognitive and behavioral efforts on the part of the person to deal directly with the source of the stress. For example, a person with considerable job-related stress might generate strategies to become more efficient on the job or make suggestions to the...

Child And Adolescent Depression

Although the cause of depression is not yet determined, it is thought that depression is most likely to occur when a number of risk factors come together. Biological vulnerability is one of these factors Children whose parents have had significant depression are at a markedly increased risk for depression as well as other behavioral and emotional problems. Children may inherit a genetic risk for depression or temperamental qualities such as sensitivity to negative emotions, or they may learn depressive coping styles from their parents. Both adults and young people who are depressed share a depressive or negative way of thinking that leads them to view themselves, the world, and their future in a negative way. This is frequently described as seeing the cup as half empty, while others can look at the same situation and see the cup as half full. Many times depressed individuals come to see all failures as due to their own inherent faults but any success as pure chance or a fluke. This is...

Shared Underlying Pathophysiology Between Schizophrenia and Substance Abuse

Stress is important to the etiology of schizophrenia as well as craving for abused substances. Studies examining cumulative non-illness-related stressors have reported increased number of stressors a few weeks or months prior to the onset of relapse in schizophrenia, as well as in other psychiatric disorders (73-75). However, Norman and Malla (73) reported that the number of stressful life events in schizophrenia within the defined study period was not different from that in other psychiatric patients. Several clinical and preclinical studies suggest enhanced sensitivity to stress in schizophrenia. For example, patients with schizophrenia have been reported to have enhanced plasma homovanillic acid (HVA) (76), the major metabolite of DA, and greater adrenocorticotropine hormone (ACTH) (77) responses following metabolic stress compared to normal controls. Furthermore, various studies indicate abnormal regulation of the hypothalomic-pituitary-adrenal (HPA) axis in schizophrenia....

The Acute Cognitive Stress Response

Measuring acute cognitive responses to stress, retrospective recall of thoughts and think-aloud procedures. The former involves requesting individuals to report thought content associated with a given stressful situation after the stress has dissipated, and the latter involves training respondents to state their thoughts aloud into a recorder for later scoring during the given stressful situation. Both possess obvious problems. Retrospective reports of cognitive activity are contaminated by problems of inaccurate and selective recall. While some thoughts are going to be lost because they were not properly coded into memory, others are selectively recalled, often based upon the participant's perception of task performance or situation outcome. For example, if a participant who was engaged in a serial subtraction task performed poorly, retrospective reports of his or her thoughts that occurred during the task may yield an overestimate of self-deprecating thoughts. One advantage of the...

Aging Stress and Mental Disorders

Aging is associated with increased risk for a number of important stressful life events and chronic strains, including declines in health, death of spouse or significant others, and caregiving for impaired family members. However, common conceptions of late-life as generally stressful or unpleasant are incorrect. For example, recent studies of retirement show no negative effects on health or psychological functioning once preretirement physical and emotional functioning are considered. Older adults have lower rates of some stressful life events than younger persons because of their retirement status. Older persons are also often found to cope as successfully with problems as younger persons, and in some cases better, in part due to their prior experience with adversity and the fact that certain problems (such as spousal bereavement) are normative in late life.

Precipitating factors

Seventy-five per cent of those with chronic insomnia link the onset of their sleep disorder to a stressful event. This may be a difficulty in a close relationship, bereavement, a change in school or employment, or the onset of a medical disorder. The stress leads to both physiological and psychological arousal, which is more likely to precipitate insomnia if the predisposing factors listed above are present. If they are absent, or if the patient adapts to the stress, insomnia may only be transient.

Psychological Health

While friendships and peer acceptance are related to socio-emotional adjustment. Children adapt better to stressful situations when in the presence of friends or familiar peers. Peer victimization exists when children are exposed to abusive processes that promote cognitive-affective states such as insecurity, mistrust, or fearfulness. Peer victimization involves aggressors and their victims, and is linked with a number of adjustment difficulties during childhood, including anxiety, loneliness, depression, and school maladaptation.

Assessment and Treatment of PTSD

A comprehensive clinical assessment of PTSD should include administration of structured diagnostic interviews, self-report psychometrics, and an evaluation of trauma across the lifespan. Several structured interviews are available and the Clinician-Administered PTSD Scale for the DSM-IV and PTSD module of the Structured Clinical Interview for the DSM-IV have become standards in the field. Self-report instruments can also assist in diagnosis or provide efficient, low-cost assessment methods for research and screening purposes. Of these, several were constructed specifically for assessing PTSD (e.g., Mississippi Scale for Combat-related PTSD PTSD Checklist PTSD Diagnostic Scale). Others were derived from the existing items of major inventories such as the Minnesota Multiphasic Personality Inventory and the Symptom Checklist-90. Finally, instruments such as the Potential Stressful Events Interview and the Traumatic Stress Schedule are used to evaluate trauma across the lifespan.

Lifestyle Interventions

The effectiveness of weight loss has also been shown to be superior to other non-pharmacologic interventions aimed at preventing hypertension. Data from over 2000 participants in the first phase of the Trials of Hypertension Prevention (TOHP) study showed that while weight loss and sodium reduction were associated with significant reductions of both SBP and DBP after 18 months, stress management or dietary supplements with calcium, potassium, magnesium, or fish oil failed to exhibit any demonstrable reduction in blood pressure (Whelton et al., 1997). In the second phase of this large-scale trial, both weight loss and sodium reduction were shown to reduce incidence of essential hypertension over a three-to-four-year follow-up period when compared with a usual care control group (Trials of Hypertension Collaborative Research Group, 1997). Therefore, weight loss has been shown to be an effective strategy both for lowering blood pressures of hypertensive patients and for preventing onset...

Balance of Ground and Flight Investigations

Consistent with Strategy report recommendations, the Countermeasures Task Force recommended that high priority be given to a critical review of analogue studies to identify psychological characteristics of successful individuals and crews, the natural history of psychosocial adaptation to extreme environments, identification of the types of problems that occur during deployment, and outcomes of attempted intervention and prevention measures (NASA, 1997b). Only three of the behavior and performance studies listed in the FY 1998 Task Book are in accordance with this recommendation. The Strategy report and the Countermeasures Task Force report also recommended that priority be given to reviewing the Russian experience with screening and selection, training and support, in-flight monitoring and support, and postflight monitoring and interventions. None of the current NASA-funded research projects address this recommendation. Also recommended in the Countermeasures Task Force report was a...

Conclusions and Future Directions

Just what should be done with a patient like Franklin Although his case may appear quite complicated, involving multiple etiologic factors including exposure to a stressful job, a genetic propensity for developing hypertension, and an array of lifestyle factors that may increase his risk, it is really a fairly typical case of essential hypertension. Most individuals with hypertension are exposed to some degree of environmental stress and exhibit a wide range of lifestyle behaviors that may be linked to increased risk for developing it. However, these characteristics are common among most normotensive individuals as well. Therefore, it is quite difficult to ascertain which etiologic factors are operative in a single case of essential hypertension. In particular, because psychological stress has been inconsistently defined and measured throughout decades of research and theorizing, answers to questions concerning the relation between stress and hypertension have been even more elusive...

Therapies Involving Life Force Energy

Today, Western medicine concentrates on the corporeal body and doesn't recognize that we have a life force. However, in non-Western, ancient healing, it's thought that the life force is what heals the corporeal body. One of the most ancient forms of healing is energy healing, which can involve therapeutic touch or healing touch. Technically, these techniques are considered forms of biofield therapy. An energy healer will use his or her hands to help guide your life force energy. The hands may rest on the body, or just close to the body without actually touching it. Energy healing is used to reduce pain and inflammation, improve sleep patterns and appetite, and reduce stress. Energy healing, supported by the American Holistic Nurses Association, has been incorporated into conventional nursing techniques with good results. Typically, the healer will move loosely cupped hands in a symmetric fashion on your body, sensing cold, heat, or vibration. The healer will then place his or her...

Preclinical Models of Depression and Relationship with 5HT

One approach to understanding the behavioral effects and mechanism of action of SSRIs involves study of animal models of human psychopathology. An established and valid animal model of depression, extensively studied by our laboratory, is 'learned helplessness' which is a stress-induced behavioral depression. The basic paradigm involves an exposure, usually of rats, to uncontrollable, inescapable stress followed by a subsequent test, usually involving a task in which the stress can be terminated by the animal. An attractive aspect of the learned helplessness model is that not all animals develop learned helplessness after inescapable stress (just as not all humans become depressed following stressful life events). This variability in outcome after stress, considered a possible model for 'coping,' allows comparisons to be made between animals that receive identical stress but have different behavioral reactions to stress helpless versus non-helpless. Animals with learned helplessness...

Association with Alcohol and Drug Abuse

A key factor in the association between accidents and TBI is alcohol abuse, since it places individuals at greater risk for head injury than any other factor examined, including age and occupation (5). Other studies have provided additional support for the connection between alcohol intoxication and head trauma (6-13). A host of factors contribute to this association, including the physiological effect of an increased blood alcohol concentration on trauma-avoidance behaviors, psychopathology, and acute stressful life events (14,15). Drugs other than alcohol can also result in significant perceptual disturbances in association with intoxication or withdrawal states (16), thereby contributing to TBI. In DSM-IV the nosology of substance-induced perceptual problems is divided into substance intoxication with perceptual disturbances, substance withdrawal with perceptual disturbances, and substance-induced psychotic disorder with hallucinations (2). Compared to alcohol, there are fewer...

Transcendental Meditation

Meditation as an important part of their religious and spiritual enrichment (e.g., Zen, yoga). More recently, the West has taken an interest in the practice of transcendental meditation (TM) as taught by Maharishi Mahesh Yogi. It is promoted as a means to help increase energy, reduce stress, and have a positive effect on mental and physical health. The actual practice of TM involves sitting upright, with the eyes closed, and silently repeating a mantra whenever thoughts occur. The meditation is said to be effortless, enjoyable, and relaxing. The individual is instructed to meditate for 20 minutes in the morning before breakfast and 20 minutes in the evening.

Major Life Events and Blood Pressure

Some stressful life events are more chronic in nature. For example, the amount of stress experienced in an individual's residential neighborhood is endured on a daily basis, often for periods of years or even decades. Some neighborhoods are characterized by stable single family dwellings, good school systems, and low crime rates, while others are much less stable and have higher crime rates. To examine the effects of living in stressful residential neighborhoods on blood pressure, Harburg et al. (1973) contrasted blood pressures among black and white adults in various neighborhood areas in Detroit characterized as either high or low stress according to various domains like home ownership and crime rate. Young black males living in high stress neighborhoods exhibited higher blood pressures than those living in low stress areas. Similar relations between blood pressure and stressful living environments have been reported among pregnant women living in areas prone to terrorist attacks...

Animal Research Linking Stress to Hypertension

Ethically, experimental studies on the effect of intensive prolonged stress upon levels of blood pressure cannot be conducted on humans. Recognizing the unpleasant impact of chronic stress and potential health consequences, we simply cannot expose humans to experimental stress conditions voluntarily. As seen above, life events commonly occur that present humans with stressful situations to which they will respond, but we do not purposefully expose humans to natural stressors like tornados, hurricanes, and floods, nor do we expose them intentionally to manmade disasters like Three Mile Island and the World Trade Center collapse. However, when these events unfortunately occur, we can learn a great deal regarding the human stress response by measuring various aspects of acute and chronic stress responses among individuals exposed to them.

Does Stress Cause Essential Hypertension

The evidence examined in this book shows that there is indeed an association between stress and essential hypertension. As initially depicted in Figure 4.1, exposure to environmental stressors represented the stimulus in this model, and onset of the underlying pathology associated with hypertension represented the consequence. Based upon empirical evidence presented in Chapter 4, stressful life events, engaging in high-strain jobs, and even living in stressful industrialized nations have each been related to higher blood pressures. Findings linking stress to hypertension have also been strongly supported by animal research that has consistently shown that animals exposed to a variety of stressful environments exhibit higher blood pressures than animals in less stressful environments. Yet, despite these commonly observed associations, demonstrating a causal role for stress in the etiology of hypertension requires much more evidence than what is currently available. Because most...

Constitutional and Lifestyle Factors

Although acute physiological responses to stress are likely candidates for mediating the stress-hypertension link, it is obvious that individual differences in physiological responses to stress exist and need to be considered in any model of hypertension. For example, exposure to stressful life events, jobs, or cultures leads to acute elevations in blood pressure among some individuals, whereas other individuals exposed to identical stressful life events, jobs, or cultures maintain normal blood pressure responses. A wide array of individual difference variables has been examined that have been hypothesized to influence the magnitude and pattern of physiological stress responding, including constitutional parameters (like gender or ethnicity) and psychosocial characteristics (like coping skills, personality, and social support). These variables cannot technically be considered candidates for mediating the stress-hypertension relation in the model presented in Figure 4.1, because they...

Primary Secondary And Tertiary Gains And Secondary Losses

A second strategy involves the reduction of stress. Here relationships become more complex. Stress takes many forms. Reducing stress requires changes in the physical and social environment. Environmental stress situations involve a whole complex of interacting variables. Some

Assertiveness Training

Recent AT research has focused on reducing anxiety in psychiatric patients, providing stress management training, using AT in school settings to reduce aggressive behavior, enhancing social skills training, developing sex education programs, and increasing self-confidence in college students. Assertiveness training is also being used in Behavioral Health and Behavioral Medicine programs for lowering blood pressure, smoking cessation, and anger control.

Beyond Stage Theories The Search for Unifying Frameworks

Generational perspective, and consider the intersections of individual and family change processes. For example, T. Laszloffy recently articulated a systemic family development (SFD) model, which integrates family crisis theory and family systems theory in conceptualizing families' and individuals' responses to stressful life events and transitions. According to SFD, common processes that all families experience are external and internal stressors that challenge family members to change their roles and interactional patterns in order to cope effectively. In accordance with H. McCubbin's family crisis theory, families cope adap-tively (i.e., make the necessary changes) or maladaptively (i.e., get stuck and experience a crisis) depending on an interaction of family members' individual and collective coping resources as well as their interpretations of the stressful events. Apileup of stressors (i.e., multiple stressors occurring within a short period of time) presents a greater...

Job Stress and Strain and Blood Pressure

The prevalence of hypertension was higher among air traffic controllers than second-class airmen, but also that the rates of hypertension increased among air traffic controllers in proportion to the density of air traffic at their work location. Associations between a stressful job environment and increased rate of hypertension have been observed in many other samples as well, including blue-collar factory workers (Matthews et al., 1987), pregnant women with high-status jobs (Lands-bergis and Hatch, 1996), transit vehicle operators (Ragland et al., 1997), and workers in electrical factories (Kawakami, Haratini, and Araki, 1998). Not all studies that have examined the relation between job stress or job strain and prevalence of hypertension have revealed significant associations. Albright et al. (1992) found an inverse relation between job stress and prevalence of hypertension among bus drivers, and Tarumi, Hagihara, and Morimoto (1993) found a similar inverse relation among...

Alternative Treatments

Relaxation therapy is a core technique used in many comprehensive behavioral and stress management interventions. The goal of relaxation therapy is to reduce arousal in both the central nervous system and autonomic nervous system in order to sustain psychological and physical health this is done through abdominal breathing exercises, progressive muscle relaxation, or visual imagery (Jacobson 1938). Relaxation therapy, which aims to reduce muscle tension, seemingly contradicts the goal of behavioral therapy, which aims to increase physiological arousal to promote habituation to anxiety. However, behavioral therapists often use relaxation techniques between exposure exercises to decrease residual anxiety. Patients are encouraged to practice relaxation during the absence of immediate stressors rather than when they are in the throes of anxiety. Relaxation therapy is cost-effective and relatively risk free. In a controlled study, behavioral stress management therapy using progressive...

Severity Of Psychosocial Stressors Scale

The Severity of Psychosocial Stressors Scale was developed for Axis Iv of the third edition and revised third edition of the Diagnostic and Statistical Manual of Mental Disorders. The scale assessed precipitating stressors in mental disorders in the year prior to evaluation and formed part of the multiaxial system of modern diagnosis designed to improve the view of patients'background, symptoms, and functioning. The Severity Scale was founded on research on stressors that took place in the 1960s and 1970s, particularly the Holmes-Rahe Scale, which rated stressful life events along a hierarchy of severity. In terms of etiology, research on most mental disorders suggests that many factors may be involved as influences or causes. These factors may include social (external) events in combination with biologic or genetic (internal) dispositions. According to current diathesis-stress or vulnerability models of pathology, an inherent or biological vulnerability (diathesis) in an individual...

Sources of Self Efficacy

People's beliefs about their efficacy are constructed from four principal sources of information. The most effective way of instilling a strong sense of efficacy is through mastery experiences. Successes build a robust belief in one's personal efficacy. Failures undermine it, especially if frequent failures occur in early phases in the development of competencies. Development of resilient self-efficacy requires experiences in overcoming obstacles through perseverant effort. The second method is by social modeling. Models serve as sources of competencies and motivation. Seeing people similar to oneself succeed by perseverant effort raises observers'beliefs in their own capabilities. Social persuasion is the third mode of influence. Realistic boosts in efficacy can lead people to exert greater effort, which increases their chances of success. People also rely partly on their physiological and mood states in judging their capabilities. The fourth way of altering self-efficacy beliefs is...

Loss of Arousal Regulation

Subjects who did not develop PTSD exhibited significant autonomic responses to a reminder of their trauma, while PTSD patients showed almost no autonomic response to the recounting of the triggering stressful event. Interestingly, the PTSD patients demonstrated a comparable degree of autonomic dysregulation at rest as the control subjects' reaction to a personal stressor They reacted to ordinary stimuli the way others reacted to reminders of traumatic incidents. One possible explanation for this phenomenon is that PTSD patients experience so great a degree of autonomic hyper-activation at rest that they are unable to marshal a further stress response to reminders of their trauma (Cohen et al., 1998). A recent study found that the HRV parameters that indicate autonomic dysregulation, which characterize PTSD patients at rest, are normalized in responding patients by use of selective serotonin reuptake inhibitors (SSRIs) (Cohen et al., 2000a).

Rationale for a General Theory of Relaxation 11 Introduction

Relaxation is an important element of many psychological processes. It is applied by psychotherapists using different psychotherapeutic approaches and in counseling and stress management. However, in spite of the fact that relaxation techniques are commonly employed, altered states of consciousness in relaxation, as such, are hardly studied in psychology. What exists are mainly descriptions of techniques and changes in psychophysiological parameters during relaxation. Relaxation techniques are based on an assumption concerning reciprocal connections between three factors psychic tension, functional state of the vegetative nervous system and the muscle tension. As the tonus of the skeletal muscles may be voluntarily changed, it enables an application of muscle relaxation for the achievement of psychic relaxation as well as for an influence on the functions of organs controlled by the vegetative nervous system (Kratochvil, 1978, p. 253).

Dilemma Of Psychiatric Diagnostics Dsms And Beyond

Some mental disorders arise through stressful life circumstances. Others emerge more from constitutional infirmities. Nature-nurture arguments do not help us much in unraveling such intertwined complexities, unless discrete genetic differences can be discovered, as in fragile X and Williams syndrome (Chapter 14). Ultimately psychiatric thought must continue to be guided by a careful appreciation of the evolving stories of selves in action on the stage of life. Neither the brainless psychiatry of the middle of the 20th century, nor the mindless variety of the past 30 years should be taken to represent the most we can achieve. The future should yield a synthesis. However, since we have been unable to unambiguously link most mental functions to brain functions and have only been able to pinpoint biological causes for a few rare genetic disorders, we have been left no other option than to categorize mental disorders on the basis of outward symptoms. Hopefully brain imaging and new...

Separation Distressanxiety

Studies that examine comorbidity of psychiatric disorders indicate that children and adolescents with SAD are commonly diagnosed with other disorders as well. One half of children with SAD are diagnosed with other anxiety disorders, and one third are diagnosed with depression. It has been suggested that children with SAD may have become overly dependent on the attachment figure, often after a stressful life event such as illness or the loss of a loved one (Erickson, 1998). SAD occurs in approximately 2 to 4 of children and adolescents, and those with this disorder may be at increased risk for psychopathology in adulthood. Current treatment approaches to SAD include behavioral interventions, psychotherapy, and family interventions as well as psychopharmacological treatments.

Anxiolytics Tranquilizers

Many illnesses are accompanied by anxiety, a worried state during which a syndrome characterized by feelings of helplessness, despair, dark premonitions, and asthenia begins to develop. It can be accompanied by headaches, increased perspiration, nausea, tachycardia, dry mouth, etc. A state of anxiety can originate from neurological reasons, and can also be of a somatopsychic nature, which is associated with pathological development in diseases of the cardiovascular system, neoplasms, hypertonia, and diseases of the gastrointestinal tract. Drugs used for relieving anxiety, stress, worry, and fear that do not detract attention from or affect psychomotor activity of the patient are called anxiolytics or tranquilizers. Most of them have sedative and hypnotic action, and in high doses their effects are in many ways similar to barbiturate action. However, the primary advantage of this group over barbiturates lies in their significantly increased value in terms of the ratio of sedative...

Quasiexperiments casecontrol studies and cohort studies

To confirm the relationship between severely stressful life experiences and relapse of breast cancer found in a previous case-control study. Overall the researchers found no increased risk of recurrence in women who had one or more severely stressful life experiences in the year before diagnosis compared with women who did not, and of those who had stressful experiences since diagnosis the results demonstrated a lower risk of recurrence, hence confirming that stressful events did not lead to increased risk of recurrence.

Quantitative Research

To confirm the relationship between severely stressful life experiences and relapse of breast cancer found in a previous case-control study. Overall, the researchers found no increased risk of recurrence in women who had one or more severely stressful life experiences in the year before diagnosis compared with women who did not, and of those who had had stressful experiences since diagnosis the results demonstrated a lower risk of recurrence, confirming that stressful events did not lead to increased risk of recurrence.

Suicidal Behavior Among Youth Epidemiology

Stressful Life Events Early negative life events are associated with later suicidal-ity in youth (Yang & Clum, 2000). Adolescent suicide at-tempters report higher rates of stressful life events 12 months prior to the attempt (Davidson & Linnoila, 1991). Specific life stresses include fights with parents, breakups with a romantic partner, loss of a parent due to death or divorce, and legal or disciplinary problems (Gould & Kramer, 2001).

The Buffering Model of Social Support

The term buffering (sometimes called moderating) suggests that the impacts of noxious stimuli or stresses are attenuated by the availability of social support absence of support, according to the buffering hypothesis, is linked to experiencing of the full consequences of stressful situations (Cobb, 1976 Kaplan, Cassel, & Gore, 1977 LaRocco, House, & French, 1980). The stress-buffering effect is more likely to occur when the social network is perceived as ready to provide assistance. The buffering model has also been extended to social network ties by specifying that they may lessen the adverse psychological consequences of stress (Friis & Nanjundappa, 1989). The buffering role of social support is attractive to practitioners, who view social relationships as more amenable to change than are the conditions in which adversity arises. Theorists posit that social support buffers some stressors more effectively than others, depending on the nature of the stressor. For example, a person who...

Primary Prevention Of Psychopathology

An area of major research investigation in recent years has been the relationship between stressful life events and the onset of both physical illness and mental disturbance. Studies report correlations between severity of life stresses and the probability of the appearance of specific illnesses in the future. Statistically significant relationships have been found between the stresses of life change and diseases such as tuberculosis, heart attacks, accidents, leukemia, and diabetes. High life stress has been associated repeatedly with subsequent mental and emotional disturbances. Being part of a strong support network reduces the risk of exposure to stress.

Psychological Approaches to Blood Pressure Reduction

Because of the perceived importance of the sympathetic nervous system in the etiology of essential hypertension, the vast majority of studies examining psychological interventions aimed at lowering blood pressure have focused on interventions that were thought to alter sympathetic nervous system functioning. These include studies employing various relaxation and meditation strategies as well as more direct methods of physiological control obtained via biofeedback. The most recent psychological intervention efforts have added cognitive behavioral stress management components to the more commonly used relaxation strategies to optimize stress-reducing components of these psychological interventions. Let's examine each of these types of psychological intervention and supporting empirical work. Combination Stress Management Programs Given that no single psychological intervention has received uniform empirical support for its use in treating essential hypertension, several investigators...

Initial Aspects of Treatment Establishment of Trust

The therapist should attempt to identify any environmental, social, or biological factors that could be maintaining the illness-related fears. A cognitive therapist would emphasize variables that are maintaining the anxiety, whereas a psychodynamic psychotherapist would spend more time exploring experiences that might relate to the patient's current distress. To evaluate a patient's reactions to stressful situations, cognitive therapists may use guided imagery to re-create a real-life difficulty. A therapist can ask the patient to conjure up an image of going to a doctor's office and ask him or her to articulate any fears that come to mind. Self-report instruments, such as diaries in which to express illness fears and write down somatic symptoms, can help the patient observe the waxing and waning of symptoms as stressful events occur. These instruments can also help the therapist objectively assess the severity and complexity of the problem in order to set properly targeted goals....

Use of Individualized Patient Assessment in Optimizing Treatment Outcome

For the most part, intervention studies examining both pharmacologic and non-pharmacologic approaches have selected patients on the basis of pre-treatment blood pressure without reference to other constitutional or psychosocial characteristics that may influence treatment outcome. For example, studies of the effect of sodium restriction programs on blood pressure reduction rarely have selected patients on the basis of their sodium sensitivity, and studies of stress management programs on lowering blood pressure have typically used samples of hypertensives without regard to the quality of their pre-treatment stress management skills (like the inclusion of patients already equipped with a broad array of stress management skills). Presumably, for many interventions that are matched with important individual characteristics, outcomes for treatment as well as prevention programs could be enhanced. From this perspective, reductions in blood pressure might not be expected for an obese...

Friendship and Gender

Friendships develop more often between members of the same gender than between males and females. Other-sex friendships are particularly infrequent during the elementary school years, accounting for less than 20 of friendships during this time. These friendships occur less commonly because of structural barriers and cultural norms. Differences also exist in the typical nature of friendships of males and females. For instance, female friendships tend to be characterized by more intimacy and self-disclosure than male friendships, and this distinction becomes particularly notable in adolescence. Closeness in male friendships may occur through shared activities sometimes experiencing a very stressful event together can also foster closeness. During childhood and adolescence, girls tend to be more exclusive in their friendships than boys are.

Physiological effects

These abnormalities may be detectable even before insomnia has become established. In subjects who undergo polysomnography and who subsequently develop insomnia, there is raised sympathetic activity with, for instance, an increased heart rate. This suggests that there is a trait to respond in this way to stressful situations.

Hormonal Responses to Emotional Stress

GAS may be brought about by any stressful situation, including chronic physical stress (e.g., from exposure to extreme cold or in times of real physical danger), but it also may occur as a result of continual psychological stress. As originally described by Selye, the physical correlates of GAS include enlarged adrenal glands, with a marked increased in size of the adrenal cortex as its cells respond to the actions of ACTH and attempt to produce ever larger quantities of the glucocorticoids, as well as a shrunken thymus, weight loss, and gastric ulcers. Gastric ulcers are caused by chronic decrease in blood flow to the gut. Substantial rates of blood flow are necessary for maintenance of the mucosal lining that protects the stomach from the digestive acids. As a consequence of chronic activation of the body's stress response, the gut's blood flow is so decreased that its mucosal lining deteriorates, and the stomach's hydrochloric acid produces ulcers.

Bethany five years old four years afier my relapse

Children's defence mechanisms will vary as much as those of their parents. One child may deal with a parent's cancer by using denial, another by displacement of anxiety and another by rationalization. These defences will vary over time and with maturity It may be that, during particularly stressful times, a child will revert to denial, seeming to know nothing about an illness that has been previously acknowledged. It may emerge that children of survivors seek to explain illness of a parent in the same way as a survivor and are drawn to caring professions and cancer causes. Parenting as a survivor is not all about stressful situations. The concept of post-traumatic growth includes enhanced enjoyment of life and this can impact positively upon a survivor's children. The enhanced pleasure at seeing children grow up must surely be a two-way process with a consequent greater appreciation of family for the child. Living with the chronic illness of a parent may encourage offspring to become...

Mental Health In Late Life

Stressful life events and hassles, medical illness, physical and functional decline, and decreasing social activity are all associated with causing or worsening a wide variety of mental disorders among older adults. When mental disorders, medical illness, and functional decline co-occur, older adults face a greatly increased risk of hospitalization and placement in long-term care facilities. It is important to note, however, that older adults vary substantially in terms of their mental and physical health, physical abilities, level of cognition (e.g., memory skills), independent living skills, community functioning, family and social relationships, and overall well-being. some older adults are relatively healthy and active well into their 80s and 90s.

Mechanism of Cardioprotection by Ethanol

As shown in Table 1, the proposed mechanisms for the cardioprotective effect of moderate alcohol consumption include decreased plasma fibrinogen, increased serum high-density lipoprotein (HDL), decreased oxidation of low-density lipoprotein (LDL), decreased platelet activity, and stress reduction (12-22). Other possible mechanisms of reduction of coronary artery disease in the moderate or light alcohol user include antithrombotic actions and stress reduction. With regard to the former, fibrinogen levels are lowered in alco- Inhibition of oxidation of low-density lipoprotein (LDL) Increasing levels of high-density lipoprotein (HDL) Decreasing levels of fibrinogen Decreased platelet activity Stress reduction

Lifespan Development

Anumber of stage-crisis theories have been developed to explain the change adults undergo, the best known being Erikson's theory and, in the popular literature, Gail Sheehy's Passages. Many theorists and researchers, however, have not been satisfied with the stage-crisis approaches to adult development. To obtain a more accurate view of adult development, many experts believe that the study of life events adds valuable information. Hultsch and Deutsch point out that our lives are punctuated by transitions defined by various events. Particular emphasis is placed on the stressful nature of these events. Events typically thought of as positive (marriage or being promoted at work), as well as events usually perceived as negative (death of spouse, being fired from work), are potentially stressful. Factors that can mediate such stressful life events include internal resources (physical health, intellectual abilities) and external resources (income, social sup But while adults are likely to...

Diathesisstress Models

Exposure to stressful life events has been recognized as an important promoter of major psychiatric illness for many years (i.e., the classic diathesis-stress model). This belief stems from observations that episodes of psychiatric illness are more frequently observed shortly after major life stressors and that clinical symptoms of many psychiatric illnesses worsen during times of stress (Mazure and Druss, 1995). Indeed, the role of life stressors as determinants for the onset and severity of many major psychiatric conditions has been common parlance in psychiatric settings for decades. Stress has been reported to promote symptomology in diverse psychiatric conditions ranging from personality disorders, to affective disorders, to dissociative disorders, and to somatic disorders. With such a wide range of conditions affected by exposure to stressors, it is clearly of interest to understand the organization and function of stress responsive systems in the brain that might serve as...

Degenerative Muscular Disorders

Bregman has outlined strategies families can employ to result in more effective management of the childhood neuromuscular disorders (1) maintaining a regular schedule of activities for both the affected child and other family members, (2) providing interesting activities appropriate to the degree of disability that enhance the affected child's experiences, (3) assisting the affected child in setting realistic goals, (4) encouraging as much independence as possible in the affected child, (5) employing stress reduction strategies, (6) including all family members in decision making, and (7) maintaining active relationships with the primary physician and support groups in the community.y

Properties of CNS in Relation to Behavior

According to Nebylitsyn (1972a), the role of temperament in human behavior is particularly pronounced when the balance between organism and environment is disturbed, which occurs in stressful situations. Gurevich (1970 Gurevich & Matveyev, 1966) conducted a field study that exemplifies this line of thinking. The authors demonstrated an interrelation between CNS strength as measured by laboratory methods and performance efficacy of operators during a breakdown in a power plant. Under these conditions, which may be characterized as extreme stress, the behavior of operators representing a weak type of CNS was disorganized, especially as regards perception, memory, and thinking. On the other hand subjects with a strong CNS displayed considerable endurance in the face of stress.

The Autonomic Nervous System

The autonomic nervous system, which controls many vegetative and involuntary body functions, has two major divisions differently organized, namely, the sympathetic and the parasympathetic branches. Most organs innervated by the ANS are under the control of both branches, but in opposite relationships. In general, the parasympathetic NS is concerned with the storage and preservation of energy in the body it tends to reduce the level of functioning. The sympathetic NS, on the other hand, is active during energy release, especially in situations demanding high concentration of energy mobilization, when the individual acts under stressful situations. The sympathetic NS, also responsible for the manifestation of emotions, tends to increase the level ofthe organism's functioning.

Psychosocial Factors

Bipolar disorder is affected by psychosocial stress. Two domains have been studied negative affective relationships within the patient's family, and stressful life events. Regarding the former, prospective studies indicate that bipolar patients who, following an acute illness episode, return to family or marital environments that are high in expressed emotion (containing relatives who are highly critical, hostile, or emotionally overinvolved) are more likely to relapse at 9-month or 1-year follow-up than patients who return to low-key family environments (for a review, see Miklowitz, Wendel, & Simoneau, 1998). It is not clear whether stress within the family is a primary eliciting factor for symptoms, whether bipolar symptoms in patients evoke family conflicts, or whether patients' symptoms and family conflicts are both traceable to third variables such as a shared genetic vulnerability to mood disorder.

Buffering Hypothesis

An important theoretical task in clarifying the buffering hypothesis is the integration of the many possible variables into a model explaining why social support works. Cohen has presented a transactional model that includes core concepts about social networks, stressful events, and personality factors, including perceived social support, stress appraisal, and support behaviors ultimately affecting the development of a disorder. Basing his conclusion on several studies, Cohen indicates that one personality feature that seems particularly important to include in addition to social support is the sense of internalized control or self-efficacy (a person's sense of capability and effectiveness). Coping styles and genetic predispositions are other psychological variables that need to be included in an integrated theory of the relation between stress and disorder surrounding the buffering hypothesis.

Psychotherapy

Primary care clinics at the Harvard Health Plan have established brief group therapy programs specifically for somatizing patients. Some of these programs have been remarkably effective in improving function and reducing distress. The sessions (8 to 16) combine general advice on topics such as stress management, problem solving, and social skills training, with specific interventions targeted at the mechanism of amplification and the need to be sick that underlies somatization. In a study of a 6-week group cognitive-behavioral intervention (n 171), McLeod and Budd (1997) determined that patients experienced a decrease in emotional and physical distress, an increase in functional status, and a decrease in medical services utilization up to 12 months later. An inclusion criterion was unexplained somatic complaints, although not necessarily somatization disorder per se.

Conclusion

Numerous options exist for treating hypochondriasis. Although researchers have not yet identified the exact mechanism of efficacy of various treatments nor which treatments work best for particular patients, it is clear that many patients with hypochondriasis can benefit from serotonergic pharmacotherapy and cognitive-behavioral psychotherapy. Controlled research has demonstrated that cognitive-behavioral therapy is significantly more effective than stress management therapy at short-term assessment. Stress management therapy or explanatory supportive therapy without response-prevention behavioral therapy may also be helpful, but may be less effective than cognitive-behavioral therapy. The role of exploratory psychodynamic psychotherapy will be determined only after controlled inquiry into its effectiveness for treatment of hypochondriasis. No controlled studies that demonstrate either the efficacy or inefficacy of a medication over placebo have been published yet. Although...

Classification

The modern conception of mood disorders emerged in the 19th and 20th centuries. As the scientific method began to influence the methodological approaches used to understand mental disorders, anecdotal and impressionistic work began to be replaced by more observational and longitudinal approaches. The work of Emil Kraepelin is one of the most notable in this regard (Kraepelin, 1921). Through meticulous longitudinal observation, Kraepelin proposed that recurrent affective illnesses were distinct from other mental disorders and could be conceptualized as manic-depressive insanity, now referred to as bipolar disorder. In part due to the influence of psychoanalytic theories, in the 1950s and 1960s depressions were grouped based on whether they were thought to have been caused by a stressful life event as opposed to having emerged spontaneously, presumably due to a chemical imbalance. The shift from a brainless view of mental illness in the 1950s to a mindless view of mental illness in the...

Occupational Stress

Despite researchers'efforts to identify various stressors and strains, several factors contribute to the difficulty in understanding and predicting individuals' reactions to a particular stressor. First, individuals may differ both in their likelihood of encountering certain stressful situations and in their reactions to the same objective stimuli. Therefore, consideration of various characteristics of the individual as well as those in the objective environment is necessary. In particular, the personality trait of neuroticism (or negative affectivity) influences workers' reports of occupational stressors and strains. Although researchers continue to debate the precise mechanisms underlying the role of such individual differences, findings indicate that these traits impact individuals' susceptibility to, perceptions and appraisals of, reactions to, and ability to cope with objective stimuli.

Childhood Pain

The KIDCOPE developed by Spirito, Stark, and Williams is a questionnaire that has been designed specifically to assess coping strategies used by children to deal with stressful situations. The child identifies a recent stressful event to provide a context for responding to the coping strategy items. Given that pain is a common problem identified by children with medical problems, the KIDCOPE can be a useful instrument to assess pain coping strategies, especially because it is relatively brief and simple to complete.

Beyond metaphors

In any situation in which the integrated mapping process would be prevented, two consequences are expected from our model. The sketch itself loses its inner (spatial) coherence or configuration. Different sketches will not be interrelated, which might break the continuity rule. As matter of fact, anyone having experienced a stressful event might understand what is meant by this disruption.

Acupuncture

Acupuncture is an ancient Chinese healing art, which aims to restore the smooth flow of life energy (qi) to the body. Acupuncturists believe that your qi can be accessed from various points on your body, such as your ear. Each point is associated with a specific organ. Depending on your physical health, an acupuncturist will use a fine needle on a very specific point to restore qi to various organs. Each of the roughly two thousand points on your body has a specific therapeutic effect when stimulated. Acupuncture can relieve many of the physical symptoms and ailments caused by stress it's now believed that acupuncture stimulates the release of endorphins, which is why it's effective in reducing stress, anxiety, pain, and so forth.

Concluding Remarks

As noted in Chapter 8, Franklin's blood pressures declined somewhat following his participation in the anger management training program. Unfortunately, most physicians rely solely on pharmacologic interventions for regulating blood pressure, and the opportunity to participate in this type of intervention trial is not available in most primary care settings. In Franklin's case, this non-pharmacologic approach clearly served as a helpful adjunctive treatment. Certainly, not all patients with essential hypertension would benefit from this type of stress management intervention, but with continued research, it is likely that we will be able to better elucidate the characteristics of patients for whom such an approach would be worthwhile. In this regard, patients like Franklin will be able to lower their blood pressures using lower doses of antihypertensive medications, if any are used at all.

Social Neuroscience

The notion of a social neuroscience is not as oxymoronic as it might first seem. Evolutionary forces operating over thousands of years have sculpted the human genome to be sensitive to and succoring of relationships with others. Affiliation and nurturant social relationships, for instance, are essential for physical and psychological well-being across the lifespan (Cacioppo, Berntson, Sheridan, & Mc-Clintock, 2000). Disruptions of social connections, whether through ridicule, separation, divorce, or bereavement, are among the most stressful events that people endure (Gardner, Gabriel, & Diekman, 2000), and social isolation is as large a risk factor for broad-based morbidity and mortality as are high blood pressure, obesity, and sedentary lifestyles even after statistically controlling for known biological risk factors, social status, and baseline measures of health (House, Landis, & Umberson, 1988). The case of Phineas Gage in the late 1800s vividly established the importance of the...

Stress Consequences

One of the fundamental, and most frequently examined, physiological responses elicited by stressors is the activation of the hypothalamic-pituitary-adrenal (HPA) axis. This system is readily stimulated not only by psychological or physical stressors but also by systemic stressors (e.g., immune activation), although they may do so by activation of a different neural circuit. Ordinarily, when a stressor is encountered, the paraventricular nucleus of the hypothalamus is activated, giving rise to the release of corticotropin-releasing hormone (CRH) from terminals located at the median eminence. This hormone stimulates the anterior pituitary, promoting the release of ACTH into circulation, which in turn stimulates the release of cortisol (or cortico-sterone) from the adrenal cortex. Cortisol is thought to play an integral role in facilitating adequate responses to stressful events and may serve to prevent overshoot of immune reactions. In addition to the immediate effects, stressful events...

Amygdala

Memory for emotional events is superior to memory of nonemotional events. This phenomenon may be due, at least in part, to hormones that are released in response to stress that modulate effects on memory by binding to receptors in the amygdala. Stress hormones, such as epi-nephrine and corticosterone, produce a dose-dependent enhancement of memory when given after training. Posttraining administration corresponds to the time at which these hormones are naturally released in response to a stressful event and at which consolidation of the memory for the event occurs. Amygdala lesions abolish the memory-enhancing effects of these hormones, and direct injection of the hormones into the amygdala produces memory-

Other Hypotheses

Cells such as those that are infected or malignant (Young and Elliott, 1989) Although self-cpn60-related protein is constitutively expressed on the surface of human cells (Jarjour et al., 1990), interferon-- stimulates the expression of a surface-localized form of cpn60 on murine bone marrow macrophages (Kaufmann et al., 1990). In areas of inflammation, such as multiple sclerosis brain lesions, there is colocalization of y8 T cells and cpn60-expressing oligodendrocytes (Selmaj et al., 1991). In addition, heat shock proteins and heat shock can regulate the expression of the murine class lb molecules that may be the antigen-presenting molecules for yS T cells (Imani and Soloski, 1991). This evidence supports the idea that chaperonins are upregulated in stressful situations such as inflammation. The possibility that yS T cells eliminate cpn60-expressing cells is supported by the finding that cpn60-related surface protein is recognized by T cell clones that specifically lyse...

Cyclothymic Disorder

Recent evidence suggests that the extreme mood swings observed among cyclothymic and other bipolar individuals may be attributable to both a behavioral and a biological hypersensitivity to stress. Alloy and colleagues (1999) and Reilly-Harrington, Alloy, Fresco, and Whitehouse (1999) found that cyclothymic and bipolar individuals' dysfunctional attitudes and negative attributional styles interacted with stressful life events to predict longitudinally depressive and hypomanic mood swings. Specifically, cy- clothymic and bipolar participants with negative cognitive styles were the most likely to experience depressive and hypomanic mood swings in response to stressful events. Similarly, Depue and colleagues (Depue, Kleiman, Davis, Hutchinson, & Krauss, 1985 Goplerud & Depue, 1985) found that cyclothymics showed slower behavioral recovery following a stressful life event and slower recovery of cortisol secretion following a laboratory stressor than did normal controls.

Obesity

Psychological factors may contribute to obesity in some people. For example, people often gain large amounts of weight during or after stressful situations, such as the death of a parent, a severe illness, or even mental depression. It seems that eating can be a means of releasing tension.

Impact on Children

Crossman and Adams (1980) described two social-psychological theories that can be used to understand the potential negative effects of divorce on children. Crises theory suggests that divorce is an undesirable and stressful event that can have adverse consequences for a family member. According to crisis theory, children who are the most sensitive to the stressors associated with divorce tend to experience the most problems.

Clinical Features

When the course is chronic, hypochondriasis may appear similar to lifetime obsessive-compulsive disorder (OCD) or a personality disorder. When the course is intermittent (Barsky et al. 1990) or of new onset, the physician should search for predisposing stressful life events as the cause (e.g., the sudden death of a loved one). Henry Maudsley, the great British anatomist of the 19th century, referred to this type of grief-induced hypochondria in poetic terms The sorrow that has no vent in tears makes other organs weep.

Mindfulness

The social recognition of mindfulness is due to the successful research on a mindfulness-based stress reduction (MBSR) program introduced by Kabat-Zinn in 1979 (1990, 2003). The authors of a meta-analysis of the empirical research on mindfulness (Grossmean et al., 2004) found that of 64 reports, 20 met methodological criteria for metaanalysis. These results indicated that MBSR may help a broad range of individuals to cope with their clinical and nonclinical problems MBRS is a program of group training. It lasts 8-10 weeks and consists of weekly 2.5-hour sessions, 45 minutes of homework daily, and one all-day session on a weekend. It covers a variety of topics related to mindfulness, including different forms of meditation, yoga positions, and practicing mindfulness in stressful situations and social interactions.

Pharmacotherapy

Whiteley Index, Illness Attitude Scale), and a measure of functional status (Medical Outcomes Study 36-Item Short-Form Health Survey SF-36 ) before treatment with fluvoxamine, which was increased gradually to 300 mg day. In this study, 4 (22 ) of 18 patients were excluded during the placebo run-in phase either because of marked improvement or noncompliance with the medication or study visits. Three patients discontinued treatment before 6 weeks. Eight (73 ) of 11 patients who completed the minimum treatment of at least 6 weeks responded to treatment and 8 (57 ) of 14 patients given active fluvoxamine responded. Even though these results suggest that fluvoxamine may be effective for treating hypochondriasis, the greater than 25 dropout rate in active treatment suggests that pharmaco-therapy may be less acceptable to patients than psychotherapy. This suggestion is supported by a 4.6 dropout rate reported by Clark et al. (1998) in their study of cognitive therapy and behavioral stress...

History

Postulated that hysteria resulted from stressful events that acted on the affective part of the brain In the early 19th century, Paul Briquet (1796-1881) published what is considered the first general work of real value in hysteria , which prepared the way for the contemporary studies (Janet 1907). Briquet (1859) developed the modern concept of hysteria as a chronic polysymptomatic disorder and provided the first known systematic description of its characteristics. Briquet attributed the phenomena of hysteria to a dysfunction of the nervous system and postulated that the disorder was the result of stressful events that acted on the affective part of the brain of vulnerable individuals. Closely following Briquet's ideas are those of Reynolds (1869), who eloquently described clinical cases in which he attributed pain or loss of function to an idea that the patient had about his or her body. It was Reynolds who first described illness behavior dependent on an idea.

Raynauds Disease

It is important to discuss with patients the role of behavior modification. Conservative approaches to treatment include warm socks or mittens and cold avoidance. Patients are encouraged to stop smoking and to avoid vasoconstrictive drugs, such as amphetamines, cocaine, and over-the-counter decongestants. Caffeine may also exacerbate symptoms by causing a rebound vasoconstriction after an initial vasodilatation. In patients with vasospasm associated with emotional stress, relaxation and stress management strategies have also been helpful.

School Adjustment

The school environment and the children's experiences inside and outside of school impact school adjustment. Concurrent physical and cognitive development, as well as stressful life events, peer relationship problems, and family relationships, impinge on children's school adjustment, as does the changing school environment. Within and across schools, considerable variability exists in terms of educational resources, academic and behavioral expectations, teacher and parent involvement, extracurricular ac

Book

The Canadian Type 2 Diabetes Sourcebook (1st edition, 2002 2nd edition, 2005) Women Managing Stress (2002) The Hypothyroid Sourcebook (2002) 50 Ways to Prevent Colon Cancer (2000) 50 Ways Women Can Prevent Heart Disease (2000) 50 Ways to Manage Ulcer, Heartburn and Reflux (2001) 50 Ways to Prevent and Manage Stress (2001) 50 Ways to Prevent Depression Without Drugs (2001)

Sport Psychology

In addition to imagery and mental rehearsal, modern sport psychology encompasses a broad range of interventions directed at improving performance. Amajor focus of these efforts has been on athletes' ability to manage arousal and anxiety. Many interventions include an anxiety management component intended to allow athletes to modify their level of arousal to match the demands of competition. These interventions mirror the clinical anxiety reduction, stress management, and problem-solving motivational work prevalent with clients experiencing anxiety or depression.

Summary

Stress has long been associated with the condition of essential hypertension. However, the relation between stress and hypertension is probably not direct, but rather involves various intervening variables depicted in Figure 4.1. Considerable empirical work has examined the relation between environmental stress and the etiology of essential hypertension, including research on stressful life events, job stress, comparisons of blood pressure across cultures, and research using rats and mice with experimentally induced high blood pressures. Findings from research on the relation of stressful life events and hypertension are mixed, with some demonstrating elevations in blood pressure following traumatic or chronic stressful events (Baum, 1999 Kario et al., 2001) and others showing no relation (Melamed et al., 1997 Suter et al., 1997). Among studies supporting a relation between stressful life events and hypertension, it is unclear whether these alterations in blood pressure persist for...

Trauma

Trauma is a specific term referring to unusual psychological and physiological reactions to major losses, such as the death of close others. Traumatic reactions may be so severe as to constitute Posttraumatic Stress Disorder (PTSD), which is a particular diagnostic category in psychology and psychiatry. The field that now is called traumatology began with an ancient Egyptian physician's reports of hysterical reactions that were published in 1900 b.c. in Kunyus Papyrus (quoted in Figley, 1993, p. 3) and that became one of the first medical texts. Traumatology may be defined as the investigation and application of knowledge about the immediate and long-term psychosocial consequences of highly stressful events and the factors that affect those consequences. This field evolved mainly within the last 2 decades, with foci both on research and therapy and application. The onslaught of studies of PTSD after the Vietnam War was a major factor in contributing to development and refinements of...

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