Psych Exam 1 review PDF

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Psych Exam 1 Test Review, Professor Shaw...

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M&J PSYCH Exam #1

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Ch. 1 Stress Adaptation An individual’s reaction to change that requires adjustment or a response; can be physical, mental, or emotional. Roy’s Adaptation Model (1976) Roy defined adaptive response as behavior that maintains the integrity of the individual. Adaptation: viewed as positive and is correlated with a healthy response. Adaptation: restoration of homeostasis of the internal system. Response directed to stabilizing biological processes and psychological preservation of self-identity and self-esteem. o When behavior disrupts the integrity of the individual, it is perceived as maladaptive. o Maladaptive response: perceived as negative or unhealthy Selye’s General Adaptation Syndrome Hans Selye defined stress as “state manifested by a specific syndrome that consists of all the nonspecifically induced changes within a biologic system.” “Fight-or-flight” syndrome o Alarm reaction stage: physiological responses of “fight or flight” is initiated. o Stage of resistance: individual uses physiological responses from first stage as defense in an attempt to adapt to stressors. If adaptation occurs, the third stage is prevented or delayed. Physiological symptoms may disappear. o Stage of exhaustion: occurs when there is a prolonged exposure to stressors and the body has become adjusted. The adaptive energy is depleted, the individual can no longer use the resources for adaptation described in the first two stages. Diseases of Adaptation: Headaches, mental disorders, coronary artery disease, ulcers, colitis. o Without intervention for reversal, exhaustion, and in some cases even death ensues Stress as a Biological Response  The Fight-or-Flight Syndrome: Initial stress response:

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Sustained stress response:

Stress as an Environmental Event Defines stress as a “thing” or “event” that triggers adaptive physiological and psychological responses in an individual. The event is one that: o Creates change in the life pattern of the individual o Requires significant adjustment in lifestyle o Taxes available personal resources Stress is measured by the Miller and Rahe Recent Life Changes Questionnaire. o RLCQ: A high score on the Recent Life Changes Questionnaire (RLCQ) places the individual at greater susceptibility to physical or psychological illness. o A weakness in the Miller and Rahe tool is that it does not consider: individual’s perception of the event & their coping strategies or support systems at the time of the life change. It is not certain whether stress overload merely predisposes a person to illness or precipitates it, but there does appear to be a clear causal link. Stress as a Transaction Between the Individual and the Environment Precipitating event: stimulus arising from internal or external environment, perceived by the individual in a specific manner Individual’s perception of the event include: o Stress appraisals include harm/loss, threat, and challenge. o Harm/loss appraisals refer to damage or loss already experienced by the individual. o Appraisals of a threatening nature are perceived as anticipated harms or losses.

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M&J PSYCH Exam #1 When an event is appraised as challenging, the individual focuses on potential for gain or growth, rather than on risks associated with the event. Primary appraisal: judgment about the situation in one of the following ways o Irrelevant: event is judged unimportant when the outcome holds no significance for the individual. o Benign-positive: outcome is perceived as producing pleasure for the individual. o Stress appraisal: includes harm/loss, threat, and/or challenge, refer to damage or loss already experienced by the individual. Appraisals of a threatening nature are perceived as anticipated harms or losses. Secondary appraisal: assessment of skills, resources, and knowledge a person has to deal with the situation o

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Predisposing factors: Genetic influences: circumstances of an individual’s life that are acquired through heredity. o Ex: family history of physical and psychological conditions (strengths & weaknesses), temperament (behavioral characteristics present at birth that evolve with development) Past experiences: events that result in learned patterns that influence an individual’s adaptation response. o Previous exposure to the stressor or other stressors; coping responses, adaptation level to previous stressors. Existing conditions: adds vulnerabilities that influence the adequacy of the individual’s physical, psychological, & social resources for dealing with adaptive demands. o Ex: current health status, motivation, developmental maturity, severity & duration of the stressor, financial & educational resources, age, existing coping strategies, & a support system of caring others. Stress Management: Coping strategies are considered maladaptive when the conflict goes unresolved or intensifies. Coping strategies: Awareness, Relaxation, Meditation, Interpersonal communications, Problem-solving, Pets, Music CH. 2 Mental Health/Mental Illness Historical and Theoretical Concepts  The concepts of mental health and mental illness are culturally defined! (on test) Historical Overview Early beliefs thought of mental illness as evil spirits, supernatural and/or magical powers that had entered the body. Some people correlated it with witchcraft, and mentally ill individuals were burned at the stake. The mentally ill were beaten, starved, and otherwise tortured to “purge” the body of these “evil spirits.” Hippocrates associated mental illness with irregularity in the interaction among the four humors: blood, black bile, yellow bile, and phlegm. The first hospital in America to admit mentally ill clients was established in Philadelphia in the mid-18 th century. Benjamin Rush, (father of American psychiatry), a physician at the hospital who initiated the first humane tx for mentally ill individuals in the United States. In the 19th century, Dorothea Dix was successful in the establishment of state hospitals for the mentally ill. Her goal was to ensure humane tx for these patients, but the population grew faster than the system of hospitals, and the institutions became overcrowded and understaffed. Linda Richards, considered the 1st American psychiatric RN, graduated from New England Hospital for Women and Children in Boston. She helped establish the first school of psychiatric nursing in McLean Asylum in Waverly, Massachusetts, in 1882. Psychiatric nursing was not included in the curricula of schools of nursing until 1955. Deinstitutionalization movement (closing of state mental hospitals and discharging of individuals with mental illness) began in 1960’s. Mental Health (on test) The successful adaptation to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors that are age-appropriate and congruent with local and cultural norms. Mental Illness (on test) Maladaptive response to stressors from the internal or external environment, evidenced by thoughts, feelings, and behaviors incongruent w/ local and cultural norms, interferes with social, occupational, or physical functioning.

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Horwitz describes cultural influences that affect how individuals view mental illness, including: Incomprehensibility: inability of the general population to understand the motivation behind the behavior Cultural relativity: the “normality” of behavior is determined by the culture Psychological Adaptation to Stress Anxiety and grief; two major factors, primary psychological response patterns to stress. A variety of thoughts, feelings, and behaviors are associated with each of these response patterns. Adaptation: determined by extent to which the thoughts, feelings, and behaviors interfere with functioning. Anxiety: diffuse apprehension that is vague in nature, associated with feelings of uncertainty and helplessness. Extremely common in our society. Mild anxiety is adaptive and can provide motivation for survival. Peplau’s four levels of anxiety: Mild: seldom a problem; individuals employ various coping mechanisms to deal with stress. o Ex: eating, drinking, sleeping, physical exercise, smoking, crying, laughing, and talking to someone about it Moderate: perceptual field diminishes, reduced alertness (ex: may not hear someone talking to them) o Physical characteristics: Increased: restlessness, HR, RR, perspiration, & speech rate o Emotional/Behavior characteristics: feeling discontent leads to a degree of impairment in interpersonal relationships as individual begins to focus on self and the need to relieve personal discomfort. Severe: perceptual field is so diminished that concentration centers on one detail only or on many details. Extremely limited attention span, unable to concentrate/problem-solve o Physical Characteristics: HA, Dizziness,Nausea, Trembling, Insomnia, Tachycardia, Hyperventilation, Urinary frequency & Diarrhea o Emotional/Behavioral: Feelings of dread, loathing, horror, Total focus on self, intense desire to relieve anxiety. Panic: the most intense state (you see everything but yet nothing) Unable to focus on even one detail. Misperceptions of environment are common (a perceived detail may be elaborated and out of proportion). Unable to learn/concentrate/comprehend. o Physical Characteristics: Dilated pupils, Labored breathing, Severe trembling, Sleeplessness Palpitations, Diaphoresis and pallor. Muscular incoordination Immobility or purposeless hyperactivity, Incoherence or inability to verbalize. o Emotional/Behavioral: Sense of impending doom, Terror,Bizarre behavior, shouting, screaming, running wildly, clinging to anyone/anything from which a sense of safety and security is derived. Hallucinations; delusions; Extreme withdrawal into self Mild to moderate level, the ego calls on defense mechanisms for protection, such as: o Compensation: covering up a real or perceived weakness by emphasizing a trait one considers more desirable. o Denial: refusal to acknowledge existence of a real situation or the feelings associated with it. o Displacement: transferring of feelings from one target to another that is considered less threatening or neutral. o Identification: attempt to increase self-worth by getting certain attributes & characteristics of an individual one admires. o Intellectualization: attempt to avoid expressing actual emotions associated with a stressful situation by using the intellectual processes of logic, reasoning, and analysis. o Introjection: internalization of the beliefs and values of another individual such that they symbolically become a part of the self to the extent that the feeling of separateness or distinctness is lost. o Isolation: separation of thought or memory from the feeling, tone, or emotions associated with it (AKA emotional

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isolation). Projection: attribution of feelings or impulses unacceptable to one’s self to another person. The individual “passes the blame” for these undesirable feelings or impulses to another, thereby providing relief from the anxiety associated with them. Rationalization: attempt to make excuses or create logical reasons to justify unacceptable feelings or behaviors. REACTION FORMATION: prevention of unacceptable or undesirable thoughts or behaviors from being expressed by exaggerating opposite thoughts or behaviors. EX: The young soldier who has an extreme fear of participating in military combat volunteers for dangerous frontline duty. REGRESSION: going back to an earlier developmental level and the comfort measures associated with that level. REPRESSION: involuntary blocking of unpleasant feelings/ experiences from one’s awareness. EX: A woman cannot remember being sexually assaulted when she was 15 years old. Sublimation: rechanneling of drives/ impulses that are personally or socially unacceptable (e.g., aggressiveness, anger, sexual drives) into activities that are more tolerable and constructive. SUPPRESSION: is the voluntary blocking of unpleasant feelings and experiences from one’s awareness. Undoing: the act of symbolically negating or canceling out a previous action or experience that one finds intolerable.

Moderate to Severe levels of anxiety that remains unresolved over an extended period of time can cause physiological disorders, such as migraine headaches, irritable bowel syndrome, and cardiac arrhythmias. o May affect the course of a disease, including, but not limited to, cardiovascular, gastrointestinal, neoplastic, neurological, and pulmonary conditions. Extended periods of repressed severe anxiety can result in psychoneurotic patterns of behaving; for example, anxiety disorders, somatoform disorders, and dissociative disorders. o Severe anxiety: Neuroses are psychiatric disturbances, characterized by excessive anxiety that is expressed directly or altered through defense mechanisms. It appears as a symptom, such as: obsession, compulsion, phobia, or sexual dysfunction  Anxiety Disorders: characteristic features symptoms of anxiety and avoidance behavior (e.g: phobias, panic disorder, generalized anxiety disorder, and separation anxiety disorder).  Somatoform Disorders: characteristic features physical symptoms for with no demonstrable organic pathology. Psychological factors play a significant role in the onset, severity, exacerbation, or maintenance of the symptoms (e.g., somatic symptom disorder, illness anxiety disorder, conversion disorder, and factitious disorder).  Dissociative Disorders: characteristic features disruption in the usually integrated functions of consciousness, memory, identity, or perception of the environment (ex: dissociative amnesia, dissociative identity disorder, and depersonalization-derealization disorder). Extended periods of functioning at the panic level of anxiety may result in psychotic behavior.  Examples of psychoses include schizophrenic, schizoaffective, and delusional disorders.

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Grief: Subjective state of emotional, physical, and social responses to the loss of a valued entity; the loss may be real or perceived Elisabeth Kübler-Ross (5 Stages of Grief): Denial, Anger, Bargaining, Depression, Acceptance Anticipatory grief: experiencing of the grief process before the actual loss occurs Resolution: length of the grief process is individual. May last from weeks-years, influenced by many factors Resolution is hindered or delayed by: The experience of guilt for having had a “love-hate” relationship with the lost entity

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Having experienced a number of recent losses and being unable to complete one process before another one begins Resolution is facilitated by Anticipatory grieving: being able to experience feelings associated with grief before the actual loss occurs. Resolution is thought to occur when an individual can look back on the relationship with the lost entity and accept both the pleasures and the disappointments of the association. Maladaptive Grief Response (on test) Prolonged Response: characterized by intense preoccupation w/ memories of the lost entity for years after the loss has occurred. Behaviors associated w/ the stages of denial/anger are manifested, and disorganization of functioning and intense emotional pain related to the lost entity is evident. Delayed/Inhibited Response: individual becomes fixed in the denial stage. The emotional pain associated w/ the loss is not experienced, but anxiety disorders (ex: phobias, somatic symptom disorders) or sleeping/eating disorders (ex: insomnia, anorexia) may show. Individual may remain in denial for years, until grief response is triggered by a reminder of the loss or by another unrelated loss. Distorted Response: individual experiences a distorted response fixed in the anger stage. All the normal behaviors associated with grieving, such as helplessness, hopelessness, sadness, anger, and guilt, are exaggerated out of proportion to the situation. The individual turns the anger inward on the self, is consumed with overwhelming despair, and is unable to function in normal ADLs. Pathological depression is a distorted grief response. CH. 3 Theoretical Models of Personality Development Personality traits are defined by the DSM-V as “enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contexts.” Stages identified by age; however, personality is influenced by temperament (inborn personality characteristics) and the environment. Stages overlap, and individuals may work on tasks from more than one stage at a time. Individuals may become fixed in a certain stage and remain developmentally delayed. personality disorders occurs when personality traits become inflexible and maladaptive, causing either significant functional impairment or subjective distress. Freud: Psychoanalytic Theory Freud believed that character is formed by age 5. He organized the structure of the personality into three major components (on test)  Id: The locus of instinctual drives, the “pleasure principle.” Present at birth, it gives the infant instinctual drives that seek to satisfy needs and achieve immediate gratification. Id-driven behaviors are impulsive and may be irrational.  Ego: AKA rational self or the “reality principle,” develops between 4 and 6 months. Primary function of the ego is mediator; that is, to maintain harmony among the external world, the id, and the superego. (balances)  Superego: AKA “perfection principle”. Develops between ages 3 and 6, internalizes the values and morals set forth by primary caregivers. Derived out of a system of rewards and punishments, the superego is composed of two major components: the ego-ideal and the conscience. Topography of the mind  The conscious: memories that remain within an individual’s awareness. Ex: phone numbers, birthdays, special holidays & what u had for lunch.

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The preconscious: forgotten memories or that are not in the present awareness but can be recalled into consciousness. Helps suppress unpleasant memories or nonessential ones. The unconscious: memories that one is unable to bring to conscious awareness. (The largest of the 3 levels), memories have been repressed if they are unpleasant or unnecessary. Can be retrieved only through therapy, hypnosis, and w/ certain substances that alter awareness, have the capacity to restructure repressed memories.

Dynamics of the personality Psychic energy: force required for mental functioning. Originating in the id, instinctually fulfills basic physiological needs. Freud called this energy the libido (the drive to fulfill basic physiological needs, ex: hunger, thirst, and sex). Cathexis: process by which the id invests energy into an object to achieve gratification. Ex: the individual who instinctively turns to alcohol to relieve stress. Anticathexis: use of psychic energy by the ego and the superego to control id impulses. Ex: the ego would attempt to control the use of alcohol with rational thinking, such as, “I already have ulcers from drinking too much. I will call my AA counselor for support. I will not drink.” Development of the personality (on test)  Oral stage (birth–18 months): directed by id, goal is immediate gratification of needs. The focus is the mouth (sucking, chewing, & biting). Development Task: Relief from anxiety through oral gratification of needs  Anal stage (18 months–3 years): Development task is to gain independence & control, w/ focus on excretory function. He believed that depending how toilette training was handled, it would have effects on the...