Stress Theory Historical Perspective and Stress Adaptation Theory 1
Mar 28, 2015
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Stress TheoryHistorical Perspective andStress Adaptation Theory
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What stress is and what it isn’t
•Stress is one’s reaction to any change that requires a restructuring of one’s orientation to any given situation.
•It is not always a detrimental reaction.
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Stressor
•Any stimulus that causes tension.
•May contribute to certain illnesses.
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Sister Callista Roy(1976)
•Distinguished between adaptive and maladaptive responses:
•Adaptive—responses that preserve one’s physical and/or mental integrity
•Maladaptive—responses that interrupt the individual’s physical and/or mental integrity.
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Methods of Conceptualizing Stress•As a biological response (Selye)
•As an environmental event
•As a transaction (Lazarus and Folkman)
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Hans Selye (1976)
•Described the “General Adaptation Syndrome.”
•The physical reaction to stress prompting the “fight or flight” syndrome.
•The reaction occurs in 3 defined stages.
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1. Alarm Reaction Phase
•“Fight or flight” responses are stimulated.•Sympathetic nerves release acetylcholine•Adrenal medulla releases epinephrine and
norepinephrine.•Trigger immediate increase in heart rate
and breathing, blood vessels constrict and muscles tighten.
•Initiates spontaneous behaviors associated with combat or escape.
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2. Stage of Resistance
•The triggered physiological responses of Stage 1 are used to defend the individual in an attempt to adjust to the stressor (adaptation).
•If adaptation is successful, this is the end of the biological response and Stage 3 does not occur.
•Eventually the physiological responses decline.
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3. Stage of Exhaustion
•Occurs if adaptation is not successful.•The person/body fatigues under the
internal stress of the physiological responses of the sympathetic nervous system.
•Reserves are depleted.•Stage is associated with disease and even
death.
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Stress as an Environmental Event•The Recent Life Changes Questionnaire
(RLCQ).•Attempts to quantify an individual’s
current life stress.
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Stress: The Interaction Between the Individual and the Environment
PrecipitatingEvent
Predisposing Factors:• Genetics• Past
Experiences• Existing
Conditions
Individual’s Perception of the Event:• Irrelevant• Benign• Stress due
to Harm or Loss
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Stress Management
Adaptation
Awareness
Relaxation
Meditation
Communication
Problem Solving
Pets
Music
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Roots of Modern Mental Health Care
Benjamin Rush•“Father of American Psychiatry”•Signator of the Declaration of
Independence•Founded a movement for more humane
treatment of the mentally ill•Believed in the need for restraint to help
the patient “regain his senses.”
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Roots of Modern Mental Health Care
Dorthea Dix•Advocated for more human treatment of
the mentally ill (1840s)•Instrumental in founding the first public
mental health hospitals
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Roots of Modern Mental Health Care
Linda Richards•First American trained professional nurse•“First American Psychiatric Nurse”•Helped establish the first school of
psychiatric nursing
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Multiple Definitions of Mental Health
•Successful adaptation to stressors…•from internal and external
environments…•with thoughts feelings and behaviors that
are…•age appropriate and •congruent with local and cultural norms
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Cultural Relativity
•Culture and society determine normal and abnormal behavior.
•The more removed a culture is from the mainstream culture of a society, the more likely any aberrant behavior will be met negatively.
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Maslow’s Hierarchy of Needs
•A “humanistic” psychologist•Theory focuses on potentials of the
individual•Humans are constantly striving for higher
levels of capabilities•Always seeking higher levels of
consciousness, creativity and wisdom•The obstacles of society prevent reaching
the next higher level
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Maslow’s Hierarchy of Needs
Self-Actualization
Esteem & Self-Esteem
Love & Belonging
Safety & Security
Physiologic
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Primary Response Patterns to Stress
Stress
Anxiety Grief
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Anxiety
•“A diffuse apprehension that is vague in nature and is associated with feelings of uncertainty and helplessness.”
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Levels of Anxiety (Peplau, 1963)
Mild Anxiety•Everyday occurrence•Can be beneficial, motivating•Increased awareness and alertness
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Levels of Anxiety
Moderate Anxiety•Perceptual field reduces•Reduced alertness, awareness•Increased restlessness, muscular tension
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Levels of Anxiety
Severe Anxiety•Perceptual field greatly diminished•Very limited attention span•Unable to concentrate•Feelings of dread
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Levels of Anxiety
Panic•Unable to focus at all•Unable to comprehend•Impending doom•Bizarre behavior
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Behavioral Responses to Anxiety
Responses to Mild Anxiety
•Mild anxiety is…uncomfortable!•The coping mechanism is selected to
satisfy the need for comfort .
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Behavioral Responses to AnxietyResponses to Mild to Moderate Anxiety
•One’s ego is challenged to defend itself as anxiety increases.
•Ego defense mechanism are protective.•May be adaptive or maladaptive.
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Behavioral Responses to Anxiety
Responses to Moderate to Severe Anxiety
•Individual is likely to manifest symptoms of disease of any physiological system
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Behavioral Responses to Anxiety
Responses to Severe Anxiety•Ego defense mechanisms are carried to
extreme.•The person knows his behavior is harmful
to his well-being.•He does not know there is a psychological
origin to the behavior.•He feels helpless to change.
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Behavioral Responses to Anxiety
Response to Panic Anxiety
•Person may lose contact with reality•There is a mental retreat to a less
threatening world.
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Grief
Grief is a Response to a Loss.
•The loss may be obvious.•The loss may be apparent to only the
individual.•The loss may be one that the individual
merely fears in the future (anticipatory).
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Elizabeth Kubler-Ross’ Theory
Acceptance
Depression
Bargaining
Anger
Denial
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Maladaptive Grief Responses
Prolonged• Lasts for many
years
Delayed• Fixed in denial
stage
Distorted• Fixed in anger
stage