eClass 2: Coping and Risk Factors in Stress Responses

Lion-Frieze-from-the-Palace-of-Darius-I-mid Coping is positive response outcome expectancies. This means that the individual expects that he or she will be able to handle the situation with a positive result. In these situations, there is a low level of subjective health complaints and low levels of psychophysiological, psycho endocrine, and psycho immune arousal[i].

Coping can be divided into two general categories:

  • Problem-focused coping: those strategies aimed at doing something to solve the problem.
  • Emotion-focused coping: its goal is emotion-regulation.
Helplessness and Hopelessness

When it is impossible for the individual to establish coping, other expectancies may develop. When the individual learns that there are no relationships between anything the individual can do and the outcome, we refer to this as helplessness. Overmier & Seligman found that dogs with previous experience with inescapable shocks did not learn avoidance tasks[ii]. They found that this state of “helplessness” generalized to situations where control is possible. Helplessness occurs when the perceived probability of avoiding the aversive stimulus with a response is the same as for no response. In other words, the response is without any perceived consequence for the occurrence of the aversive event. The organism has no control. This expectancy has been accepted as a model for anxiety and depression[iii].

Hopelessness is even worse. This term is used for an acquired expectancy that most or all responses lead to negative results. Hopelessness is more directly opposite of coping than helplessness, since it is negative response outcome expectancy. There is control, responses have effects, but they are all negative. The negative outcome is his or her fault since the individual has control. This introduces the element of guilt, which may make hopelessness an even better model for depression than helplessness.

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Expert Advice: How To Tell Good vs. Bad Anxiety

Dr. Daniel Pine, a psychiatrist, directs the research program on mood and anxiety disorders of children and adolescents at the National Institute of Mental Health in Bethesda, MD

Q. What is the difference between an anxiety disorder and anxiety that is an appropriate response to an uncomfortable or threatening situation?

A. The easiest way to differentiate between these two responses is to talk about the concept of impairment. The idea behind impairment is that the person’s anxiety interferes with his or her ability to do something. The feelings of anxiousness prevent that person from doing something that other people in the same situation could do, leading to avoidance. In other words, the anxiety prevents the individuals from going places or doing things that they would like to do.

For example, everybody has some degree of anxiety in social situations. But we think of it as a disorder when the anxiety is so extreme that the person would refuse to do presentations at work or would refuse to go to parties or would not talk in public places where one is obligated to talk — for example, ordering a meal in a restaurant or requesting a book from a librarian. This is the easiest way to distinguish between normal and abnormal anxiety.

Generalized Anxiety Disorder – Expert Q & A – Evaluating Anxiety From an Early Age – NY Times Health

Business of Stress: Self-efficacy Predicts Success

StradaCampoImperatore In the demands-control model of occupational stress a situation is created whereby high demands are placed on the individual with little opportunity to exercise control over the work environment or the task design. This is the most common type of workplace stressor and it has been shown to have an impact on cardiovascular health. But is the problem simply a matter of demands/control stress diathesis? Why isn’t everyone succumbing to heart disease? Indeed, many individuals seem to thrive even in work environments where personal control is minimal and job demands are chronically high. How?

At least a partial explanation can be found in self-efficacy. Self-efficacy is the perception that personal resources are adequate to meet life’s demands. Even in situations of low control/high demands, adequate self-efficacy can act as an important protective factor.

When personal resources are perceived as lower than perceived job demands, low self-efficacy results. Task demands are felt to exceed coping abilities, which often creates emotional and physiological overload. Prolonged exposure to occupational stress with low self-efficacy increases vulnerability to burnout, which is characterized by physical and emotional exhaustion, interpersonal difficulties, apathy toward personal accomplishment, and occupational disengagement through cynicism about the importance or worth of one’s work contribution.

Individuals with adequate self-efficacy believe that their available personal resources are sufficient and may even exceed what is required by their workloads. In day-to-day work activities, this belief in one’s adequate resources accompanies the process of assessing tasks and personal capabilities: in most instances, the perceived balance is in favor of having more than what it takes and the task is undertaken with vigor and confidence. Read more

Research News: PTSD, Attachment and Healing

Leutze_1851_WashCrossDelaware The number of suicides reported by the Army has risen to the highest level since record-keeping began three decades ago. Last year, there were 192 among active-duty soldiers and soldiers on inactive reserve status, twice as many as in 2003, when the war began. (Five more suspected suicides are still being investigated.) This year’s figure is likely to be even higher: from January to mid-July, 129 suicides were confirmed or suspected, more than the number of American soldiers who died in combat during the same period. The New York Times

What Is PTSD?

Posttraumatic stress disorder (PTSD) can occur after the trauma of experiencing or witnessing  threatened or actual death or serious injury, or other serious threat to the physical integrity of self or others, such as assault. This type of trauma is usually accompanied by intense fear, helplessness, or horror at the time of the event. Symptoms of reliving the trauma and avoiding any reminder of it often create significant distress and negatively affect the individual’s  interpersonal and occupational functioning. In the acute phase, PTSD symptoms can last up to three months after the event. When the symptoms persist longer, PTSD is said to be chronic. Often, symptoms do not begin immediately and they can be delayed for six months or more after the event. When inadequately treated, PTSD can have fatal consequences such as homicide and suicide.

Who Is Affected?

It is estimated[i] that 50%–90% of all people are exposed to at least one serious traumatic event during their lifetimes. However, only about 6%-8% develop PTSD and a third of those suffer a severe form of the condition.

What Are the Causes?

The mechanism by which some individuals are vulnerable to PTSD and not others has been variously hypothesized. The most prominent theories are:

  1. The biological model
    Information about external stimuli and their assessment is processed by the amygdala. Traumatic stressors produce an emotional reaction of fight, flight or freeze and significant increases in stress hormones. The hippocampus and medial prefrontal cortex mediate the final response of the individual in trying to cope with the traumatic event. This theory suggests that posttraumatic stress disorder occurs when there is a failure to regulate the activity of the amygdala, which results in hyper-reactivity to threat (what is often referred to as the amygdala hijack).
  2. The early childhood experiences model
    Most researchers have found that childhood trauma, chronic adversity, and family stressors increase the risk for PTSD in adulthood.
  3. The traumatic memory model 
    A theory that has gained prominence in recent years, it distinguishes between memories that are easily recalled and are associated with emotions related to the trauma and repressed memories that cannot be deliberately accessed and are associated with typical PTSD symptoms such as nightmares and flashbacks.
How Is It Treated?

Most treatments for PTSD consist of techniques that expose the individuals to imagined re-experiencing of the trauma under safe therapeutic conditions, an approach that dates back to the treatment of World War II veterans. This type of treatment includes extensive emotional processing and narrative reconstruction of traumatic events in psychotherapy session, and may also include daily home review of audiotaped sessions.

Other efficacious treatments are cognitive behavioral psychotherapy and eye movement desensitization and reprocessing (EMDR). These treatments also induce patients to consciously review (and thus reprocess) painful details of their traumatic experience in a therapeutically safe environment.

PTSD and Childhood Attachment

A recent study[ii] by Columbia and Cornell researchers suggests that childhood attachment problems may play a crucial role in the development of adult PTSD and that exposure treatment may not be the sole important treatment mechanism.

According to attachment theory, secure and insecure childhood attachment to the primary caregiver (most often the mother) has important consequences for adult functioning and psychopathology. The theory, developed by British psychologist, psychiatrist and psychoanalyst John Bolwby, suggested that the innate human drive to form attachments that elicit protective, caretaking behaviors from adults is a crucial aspect of healthy infant development. When the caregivers are available and responsive, the infant develops a secure attachment “base” that facilitates the child’s exploration of the world and relationships. When the caregivers are absent or uncaring, an insecure attachment style results, with consequences for adult self-esteem, perceived safety and interpersonal functioning.
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