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| Diagnostic and Statistic Manual of Mental Disorders, Text Revision Four |
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the successful adaptation to stressor from the internal or external environment, evidenced by thoughts, feelings and behaviors that are age appropriate and congruent with local and cultural norms.
state of being that is relative not absolute |
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hierarchy of needs
-individual's motivation in the continuous quest for self actualization.
-first physiological needs then safety--love/belonging--self-esteem and that of others-- then self actualization |
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-maladaptive responses to stressors (internal or external)
-evidenced by thoughts, feelings and behaviors that are not congruent with the local and cultural norms
-interfere with individuals social, occupational and physical functioning. |
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cultural influences on how ppl view mental health
-incomprehensibility
-cultural relativity |
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the inability of the general population to understand the motivation behind the behavior.
unable to find meaning for the behavior, will label as ill |
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| how a behavior can be "normal" in one culture and "abnormal" in another. |
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physical responses to stress
Stress is "the state manifested by a specific syndrome which consists of all the nonspecifically induced changes within a biologic system".
this is called fight or flight . - general adaptation syndrome |
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| Selye's General Adaptation Syndrome Stages |
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Alarm Reaction stage
Stage of Resistance
Stage of Exhaustion |
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Selye's General Adaptation Syndrome Stages
Alarm Reaction Stage |
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initiation of physiological responses
-fight or flight |
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Selye's General Adaptation Syndrome Stages
Resistance Stage |
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| use of physiological responses from first stage as defense in attempt to adapt to stressor |
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Selye's General Adaptation Syndrome Stages
Exhaustion |
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| prolonged exposure to stressors = adaptive energy is depleted |
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Fight or Flight "Syndrome"
initial response |
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| stimulation of SNS by hypothalamus |
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Fight or Flight "Syndrome"
sustained response |
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stimulation of pit gland by hypothalamus
release of hormones |
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| what are the two major response patterns to stress? |
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determined by the
-extent to which the thoughts, feelings and behaviors interfere with an individual's functioning |
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diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness
-extremely common in our society |
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Peplau's Four levels of anxiety
mild |
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seldom a problem
-adaptive and can provide motivation for survival |
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Peplau's Four levels of anxiety
moderate |
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-perceptual field diminishes
-person is less alert to events occurring within the environment.
-dec concentration, muscle rigidity and restlessness evident |
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Peplau's Four levels of anxiety
severe |
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-perceptual field is so diminished that concentration centers on one detail only or on many extraneous details
-very dec concentration even for simple tasks,
-headache, palpitations, insomnia, confusion, dread and horror
- all behavior targeted at relief of anxiety |
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Peplau's Four levels of anxiety
painc |
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most intense state
-unable to focus on one detail of environment
-loss of contact with reality (hallucinations or delusions)
-wild desperate actions and social withdrawal
-could be life threatening |
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adaptation responses to
mild stress |
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Definition
| eating, drinking, sleeping, exercise, smoking, crying, laughing, pacing, foot swinging, nail biting, finger tapping, taking to friend |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
Acting out |
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Definition
internal or external stressors cause emotional conflict
-this is an action rather than reflection
ie punching a hole in a wall |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
affiliation |
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emotional conflict (external or internal cause)
-turning to others for help/support without trying to make the other person responsible for him or herself.
--ie moving back home to be with family to support you not care for you. |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
Altruism |
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response to stress
-dedication to meeting the needs of others,
gratification without self sacrifice (different from reaction formation)
--- ie nurse that serve for unselfish reasons |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
Anticipation |
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dealing with emotional stress by
-experiencing emotional reaction in advance of, or anticipating the consequences of, possible future events and considering realistic alternative responses or solutions
---ie preparing for an interview |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
autistic fantasy |
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| excessive day dreaming as a substitute for human relationships, more effective action or problem solving |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
compensation |
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| covering up a real or perceived weakness by emphasizing a trait one considers desirable |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
Denial |
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| refusing to acknowledge the existence of a real situation or the feelings associated with it |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
devaluation |
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dealing with emotional stress by attributing exaggerated negative qualities to self or others
--ie failing algebra test and calling self stupid and unable to learn even though you are on the honors roll |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
displacement |
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| transfer of feelings from one target to another that is considered less threatening or that is neutral |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
dissociation |
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dealing with emotional stress by
-breaking down in functions of consciousness, memory, perception of self or the environment or sensory/motor behavior
---ie losing track of time or having no memory of an event but finds self in another location. |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
help-rejecting complaining |
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dealing with emotional stress by
-complaining or making repetitious requests for help that disguise covert feelings of hostility or reproach toward others, which are then expressed by rejecting the suggestions of advice or help that others offer.
-- ie complaining, receiving help then rejecting the offer. |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
humor |
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| dealing with emotional stress by emphasizing the amusing or ironic aspect of conflict/stressor |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
idealization |
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dealing with stress by
-attributing exaggerated positive qualities to others
--ie when stressed for an exam i focus on how well others always do |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
identification |
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an attempt to increase self-worth by acquiring certain attributes and characteristics of an individual one admires
-- deciding to become a nurse after a long rehabilitation |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
intellectualization |
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an attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual process of logic, reasoning and analysis
--ie having to move away from family and explaining the benefits of the move to avoid the sadness associated with the move |
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adaptation responses
ego defense mechanisms for
mild to moderate stressadaptation responses
Introjection |
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Definition
integrating the beliefs and values of another individual into one's own ego structure
--ie kid integrate parent's values by saying "dont cheat. its wrong" |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
Isolation |
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Definition
separating a thought or memory from feeling tome or emotion associated with it
--ie: with out emotion explaining a rape or attack |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
omnipotence |
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Definition
dealing with emotional stress by
-acting as if she possesses special powers or abilities and is superior to others
-- ie can life more than others when challenged |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
passive aggression |
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dealing with emotional stress by
-indirectly and unassertively expressing aggression toward others.
-there is the illusion of compliance making hidden resistance, resentment or hostility |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
projection |
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attributing feelings or impulses unacceptable to one's self to another person
-- when attracted to her boss jane says he is coming on to her |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
rationalization |
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attempting to make excuses or formulate logical reasons to justify unacceptable behavior or feelings
--ie I drink because its the only way to deal with losing my job. |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
reaction formation |
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preventing unacceptable or undesired thoughts or behaviors from being expressed by exaggerating the opposite thoughts or types of behaviors
-- ie jane hates nursing. attended school for nursing cause of parents. tells others about how much she love it. |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
regression |
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| responding to stress by retreating to an earlier level of development and the comfort measures associated with that level of functioning. |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
repression |
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INVOLUNTARY blocking unpleasant feelings and experiences form one's awareness
-- not remembering accident though they did not lose consciousness |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
self assertion |
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dealing with emotional stress by
-expressing feelings and thoughts directly in a way that is not coercive or manipulative |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
self-observation |
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dealing with emotional stress by
-reflecting on own thoughts, feelings, motivation and behavior
-and responding appropriately |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
splitting |
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dealing with emotional stress by
-compartmentalizing opposite affect states and failing to integrate the positive and negative qualities of the self or others into cohesive images.
-self and object images tend to alternate between polar opposites
???? |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
sublimation |
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Definition
re channeling of drives or impulses that are personally or socially unacceptable into activities that are constructive
-- mother of child killed by drunk driver channels emotion to mothers against drunk driving. |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
suppression |
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the VOLUNTARY blocking of unpleasant feelings and experiences from awareness
-- ill think about that tomorrow |
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adaptation responses
ego defense mechanisms for
mild to moderate stress
undoing |
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symbolically negating or canceling out an experience that one finds intolerable
-- after yelling at wife you buy her flowers |
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| end result of unresolved moderate to severe stress |
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Definition
physiological disorders
migraines
IBS
cardiac arrhythmias |
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| result of extended repressed severe anxiety |
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psychoneurotic behavior patterns
-anxiety disorders
physiological (somatoform) disorders |
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| extended panic anxiety results in |
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psychotic behavior
-schizopherenia
-schizoeffective
-delusional disorders |
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a subjective state of emotional, physical and social responses to the loss of valued entity
-loss may be real or perceived |
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Kubler-Ross
-Denial (of event, loss or severity)
-Anger (towards those not affected, family, self or God)
-Bargaining (in attempt to postpone or reverse loss)
-Depression (full impact of loss experienced)
-Acceptance (feeling of peace regarding loss, realization of the meaning of such loss) |
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experiencing grief process before actual loss
- many times ppl will still re experience when actual loss occurs, but preparation eases the grief process
- can cause disengagement from the dying individual. |
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length of grief process depends on the individual and is influenced by several factors
- when the individual can look back at relationship and accept both pleasures and disappointments of association |
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| what factors influence resolution |
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-guilt (love-hate relationship will lengthen)
-anticipatory grief (will shorten)
-other simultaneous losses (will lengthen) |
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| maladative grief responses |
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prolonged
delayed
distorted |
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clinical disorders and other disorders
-focus of clinical attention
-- ie: dysthymic disorder |
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personality disorders and mental retardation
--ie: dependent personality disorder |
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general medical conditions
--ie: hyperthyroidism |
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psychosocial and environmental problems
--ie: unemployed or homeless |
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measurement of an individual's psychological, social and occupational functioning
-global assessment functioning scale |
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