1. alarm (defense force called to arms) automatic nervous system

2. resistance- max level in body resources used (biological adaptation)

3.exhaustion- resources depleted (at this time your body could lead to stress illness)

Body's response to fear (CNS-central nervous system)

1.sympathetic nervous system activated when danger is sensed (fight or flight)

2. hypothalamus (in the brain) triggers a series of reaction response to arousal and fear (2 systems activated)

a.) autonomic-(involuntary) sympathetic and parasympathetic (calming)

b.)endocrine system

network of fibers connects organs to body

-regulates involuntary actions (heartbeat, breathing, blood pressure, perspiration)

-you'll get physically ill if this goes on too long

-norepinephrine, seratonin, dopamine

ex. trauma related ques can activate this. brain responds as if trauma if happening again

HPA axis (endocrine system)

Hypothalamic-pituitary-adrenal axis

1. confronted by stressor

2. Hypothalamus signals pit. gland to secrete the major stress hormone ACTH

3. Adrenal glands are stimulated, triggering release of stress hormones, called corticosteroids (adrenaline)

4. this can have long term impact on immune functioning (constant ACTH lowers immune functioning)

Psychological Effects on Stress

personality, decompensation

1. Alarm (more alert for self-control), resources

2. Resistance-coping skills (praying, talk to someone,drink)

3. exhaustion-resources depleted (possibly begin to fail)

Adjustment Disorder

clinically significant emotional or behavioral symtoms in response to identifiable stressor causes more problems than to be expected

-if you have MDD or no other axis 1 disorder than you get adjustment disorder

-has to occur within 3mo. of stressor

-disorder goes away when you learn to cope

Trauma

(normal responses)

(after trauma it's normal to develop disaster syndrome)

1. shock-stunned, dazed

2. suggestive stage-passive and willing to take orders from professionals

3. recovery-tense, anxiety, slowly gain equilibrium (some ppl can develop PTSD here)

PTSD

post traumatic stress disorder

*only disorder in DSM that has to have an extreme traumatic event occur

-somthing witnesses or experienced that involved, threatened injury or death to self or someone else

-learned about unexpected death or violent death or serious harm to family member or friend

-elicits reaction of intense fear, helplessness, or horror

-persistent reexperiencing of trauma (intrusive and distressing recollections)

-persistent avoidance of stimuli associated with the trauma,(try to forget)can include reduced responsiveness (don't feel anymore)

-persistent hyperarousal-difficulty going to sleep and staying asleep, overly vigilant (exaggerated startled responses)

PTSD

time, associated features, prevelance rate, course

time=have to have symtoms for at least a month, most ppl develop within 3mo. (acute)of event (after 6 mo. delayed onset)

assoc. features=survivor guilt, impulsive behavior, somatic complaints, dissociative symptoms, hostility, social withdrawl

prev rate= 50% of adults will experience trauma, 9-10% exper. PTSD; 2x's more in women

course=3mo.; 1/2 remint in yr. & get better

*most common cause of PTSD

-not always reported 200,000/yr.

-20% anonymous report unwanted sexual experience

1. stranger rape- physical harm and death reaction

2. acquaintence rape- guilty, responsible for what happened

(with children and teens this leads to confusion about sex. don't encourage to "forget it"

1. anticipatory stage-begins before rape(uh-oh this isn't good)

2. impact-during(fear for life=fear of death paralyzing)

3. post-traumatic recoil-immediately after rape(feel guilty here)*expressed-visibly upset,*controlled-looks super-calm

4. reconstitution-put life back together, nightmare common

Reasons whether rape victim will experience getting better:

-past coping skills, social support

-ppl who blame themselves are slower to recover

-if their control over life is good

-disclosed rapes have more positive and fewer negative reactions

-right away 12% symptoms PTSD, 6mo. later 17% get symptoms

-reservists immediately 13%, 6mo. later 25%

*community support helpful

*rates increase insignificantly in deployments, marital problems, divorce

*physically wounded show less symptoms than those not physically wounded

PTSD military combat

causal factors

-personality & maturity level

-how close goals are to person-connected to what your doing is good

-quality of leadership

-idenify to unit

-how people react when you get home

Biological & Genetic factors causing PTSD

-traumatic events trigger changes in the brain and body

-childhood experiences-previous child abuse

-lack of social support

-severity of trauma-more severe & direct (proximity) exposure

-those who react more physical symptoms of anxiety have higher risk of PTSD

-60% recovered with treatment

-26% without treatment

-approaches to treatment include:  debriefing sessions (actually harmful), telephone hotlines, direct exposure therapy-ed. slowly build up to deal with triggers (trauma cues)

1. imaginative exposure (visualize it)

2. in vivo exposure (get out & deal)

meds-antidepressants with antianxiety, virtual reality (promising)

Anxiety

mental strategy used to avoid future danger (cognitive)

-can be helpful and help us prepare

1. Physiological arousal- sympathetic nervous system (fight or flight)

2. Attentionial shifts-attention narrow to threat cues

3. Behavioral responses- fight, flee (escape/avoidance)

-when normal anxiety goes away

-uncontrollable, can be less realistic concerns

1. Obsessions- repetitive, unwanted, intrusive, anxiety-provoking cognitions

2. Compulsions-repetitive behaviors used to reduce anxiety; feels uncontrollable

3. Phobias

4. Panic Attacks

specific phobia-7

ocd-19

panic disorder-24

sad-13

agoraphobia w/o panic-20

gad-31

any anxiety disorder-11

*1/3 all people have any anxiety disorder 

*women are more likely to experience all anxiety disorders except OCD (equal)

*women have more relapse

*women may be more vulnerable to substance misuse

*focus on anxiety can be dictated by cultural concerns (koro-offend someone)

*expression, may be affected by cultural norms

-high comorbidity among anxiety disorder

-high rates of comorbidity with depression

-both are characterized by high levels of neg. emotion, but depression is also characterized by low positive emotion whereas anxiety is not.