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Coping:

process by which people try to manage the perceived discrepancy between the demands and the resources they appraise in a stressful situation

Approaches could include:

1. mastery

2. alter perception of discrepancy


3. tolerate the harm or threat


4. escape/avoid situation

Coping with Stress x3 methods

1. Emotion - Focused Coping

Controlling the emotional response to the stressful situation


-Behavioural approaches-alcohol


-Cognitive approaches-reframe




2. Problem - Focused Coping


Reducing the demands of a stressful situation or expanding the resources to deal with it




3. Relationship - Focused Coping


Emotion and or problem focused coping aimed at social relationships during stress


dyadic coping=working together

Research to identify what coping methods can be measured accurately and relate to health outcomes: x4


slide 6, ... need to come back? read textbook

1. Engaging Positive Emotions

-listen to music


2. Finding benefits or meaning


-mother dies from cancer, advocating or donating to research facilities


3. Engaging in Emotional Approach


-emotional expression i.e. venting


4. Accommodating to a stressor


-carry on with life, i.e. tendonitis

Coping is stressor dependent! Why? x4


What are reasons why ppl cope differently

1. People tend to be consistent in their coping approach -same problem : same response




2. People seldom use just 1 method to cope with stressors, variance




3. Methods may be different for acute vs chronic stressors




4. twin studies suggest genetics may influence coping strategy

Do coping strategies change across the lifespan?

Not a lot of longitudinal research

-Based on what we know about child development we assume they move towards cognitive approaches as these facilities develop

Gender and Socio-cultural Differences in Coping

If you control for occupation and education few genderdifferences in coping are found between men and woman




Societal gender roles may affect the coping patterns of men and woman

Reducing the Potential for Stress x6 ways

Enhancing Social Support


Managing Interpersonal Problems


Improving Ones Personal Control


Organizing Ones World Better


Exercising: Links to Stress and Health


Preparing for Stressful Events

Enhancing Social Support


-Social Factors affecting social support x3

Support - decreases negative thoughts (dwelling)



1. Sex -men have greater social circles but women utilize them more effectively


2. Age - elderly are isolated


3. Education, income, social prestige , lower these are, the lower their social network

Managing Interpersonal Problems




Can be reduced by effective interpersonal behaviour: x3

↑Assertiveness

↓Aggressiveness


↓Unassertiveness




assertive people assess stressors as challenges unassertive people assess stressors as threats

Improving Ones Personal Control


how??

Recall the concept of self efficacy - belief that you can control your situation



People with low levels of personal control and/or selfefficacy - tend to end up feeling helpless in the face ofadversity




Decreasing pessimism and increasing self efficacy isassociated with improved coping and better health outcomes




how?showing a child love, care, setting them up to succeed,,... but there's no strategies in relation to oneself.

Organizing Ones World Better x3ways

Stress often results from time pressure - feeling late, not enough hours in the day or small organizational glitches



Time management


1. setting goals that are attainable


2. making daily to do lists


3. setting a schedule for the day

Exercising: Links to Stress and Health


Does exercise reduce the potential for stress and its effects onhealth? Why or why not x2

People who exercise routinely report having less stress andbetter health - difficult to interpret




1. Placebo - people who exercise expect to feel better basedon popular report




2. correlation doesn't equal causation, i.e. simply running can bring your mind out of a stressful situation rather than the literal exercise

Preparing for Stressful Events


Irving Janis (1958)

need to prepare people for stressful events Surgery as an example:

1. Behavioural control - reduce discomfort via strength training , meditating


2. Cognitive control - focus on benefits rather than draw back of procedure


3. Informational control* - provide information on the procedure

Reducing Stress Reactions:


Stress Management-definition


x5 +x6 subtypes

program of behavioral or cognitive strategies designed to reduce psych or phys reactions to stress




- Medication


- Behavioural and Cognitive Methods
Sub-types:
Relaxation


Systematic Desensitization


Biofeedback


ModellingApproaches Focusing on Cognitive Processes


Multidimensional Approaches


- Massage


- Meditation


- Hypnosis

Medication x4

Generally pharmacological treatment requires a diagnosis - Peoplehaving problems coping with high levels of stress likely diagnosed anxious


1. SSRI - selective serotonin re-uptake inhibitors-depression


2. Benzodiazepines-anxiety


3. Other antidepressants - Tricyclics or MAOI’s


4. Beta - blockers-anxiety

Behavioural and Cognitive Methods: Relaxation




how

Progressive Muscle Relaxation:-muscle tension is reduced if people focus on sensations asthey tense and relax individual groups of muscles




Muscle groups are done in sequence- For each muscle group - tense (10 sec) then relax (15 sec)- While paying attention to how the muscles feel- Repeat 2-3 times

Behavioural and Cognitive Methods:




Systematic Desensitization


useful for what?
important feature?

fear and anxiety




Based on assumption that fears are learned through classicalconditioning Fears can be “unlearned” by counterconditioning


-Pair feared situation with a pleasant or neutral event to elicit a calm response




Start with a stimulus hierarchy - the fear eliciting stimulus from lowest to highest




Can be imagined or symbolic (actual photos, videos, etc) Engage in relaxation techniques while presented with stimuli from the stimulus hierarchy starting at the bottom




Once person can handle that level of exposure calmly - move up to the next step in the hierarchy

Behavioural and Cognitive Methods: Biofeedback

Using monitoring equipment (heart rate or muscle tension) to report immediately back to the patient their physiological state




Using Operant conditioning gain voluntary control ofphysiological state.


-if blood pressure feedback from device shows reduction from a behavior, it reinforces the operation to the person to pattern it.

Children may be better suited to biofeedback than adultsa cquire biofeedback control faster than adults x3

1. More enthusiastic than adults


2. less skeptical in their ability to succeed


3. more likely to practice from being instructed vs. adult comply

Behavioural and Cognitive Methods: Modelling

People and especially children learn by observing


Modelling or observational learning can be used to teach a calm response to a feared situation

Behavioural and Cognitive Methods: Cognitive Processes

Approaches? x3

Cognitive Restructuring can be used to replace stress eliciting thoughts with constructive ones that reduce feelings of stress




Aim of cognitive therapy replace maladaptive anxiety elicitingthoughts and replace them with adaptive ones




Some approaches for this:


1. Hypothesis testing-challenge belief as a hypothesis .i.e. i'm ugly, think about times when people have said otherwise.


2. Problem solving training-teach someone how to identify, discover or event effective ways to solve a problem. Logic.


3. Stress Inoculation Training





Common erroneous thought patterns that elicit stress x2ppl x2concepts

Albert Ellis Rational Emotive Behaviour Therapy


1. can't stand itis


2. musterbating-people must like me




Aaron Beck Cognitive Therapy


1. Arbitrary inference-directing someone's negative attitude attributing it to yourself. Are you mad at me?


2. Magnification-exaggeration. i.e. split ends on hair.

3. Stress Inoculation Training x3
**********study

- Learn about the nature of stress and how people react to it



Acquire behavioural and cognitive skills to cope (social support, relaxation techniques)






Practice coping skills with actual or imagined stressors

Behavioural and Cognitive Methods: MultidimensionalApproaches




expected pregnant mother example

Most effective stress interventions usually employ multiple techniques They should also be tailored to the individual



stress management + group based social support + problem solving + education reduce risk of premature birth.

Massage




may reduce:x5

Not a lot of empirical study




anxiety


depression


hypertension


pain


asthma

Meditation x2

TM- focus
Increase the ability in the presence of a stressor to engage in a relaxation response



A means of improving physical and mental health and reducing stress




Promotes mindfulness: insight regarding ones experience unaltered by ones cognitive or emotional distortions




People who score high on measures of mindfulnessexperience less stress and better emotional adjustment