Chapter 1
Body’s response to stress – The body in the aroused condition for extended periods promotes
susceptibility to diseases of adaptation. (It becomes sick)
Anxiety - A diffuse apprehension that is vague in nature and is associated with feelings of uncertainty
and helplessness.
1. Mild Anxiety - This level of anxiety is seldom a problem for the individual. Helps you in test
taking ability.
2. Moderate Anxiety - The individual’s attention span and ability to concentrate decrease,
although he or she may still attend to needs with direction.
3. Severe Anxiety - Attention span is extremely limited, and the individual has much difficulty
completing even the simplest task.
4. Panic Anxiety - In this most intense state of anxiety, the individual is unable to focus on even
one detail within the environment.
Body’s Stress Response
Selye’s general adaptation syndrome has three distinct stages:
1) Alarm reaction stage: Fight-or-flight syndrome responses are initiated
2) Stage of resistance: Using the physiological responses of the first stage, the person attempts to
adapt to the stressor. If adaptation occurs, the third stage is prevented or delayed. Physiological
symptoms may disappear.
3) Stage of exhaustion: The adaptive energy is depleted, and diseases of adaptation may ensue.
§ Biological responses associated with fight-or-flight can include immediate responses (release
of norepinephrine and epinephrine, increased respiration rate, increased heart rate, etc.) and
sustained responses (increased gluconeogenesis, increased basal metabolic rate, decrease in
secretion of sex hormones, etc.).
Defense Mechanisms – We use these to protect our ego & self-esteem.
1. Reaction Formation - Preventing unacceptable or undesirable thoughts or behaviors from being
expressed by exaggerating opposite thoughts or types of behaviors. (Example) Jane hates
nursing. She attended nursing school to please her parents. During career day, she speaks to
prospective students about the excellence of nursing as a career.
2. Displacement - The transfer of feelings from one target to another that is considered less
threatening or that is neutral. (Example) A client is angry at his doctor, does not express it, but
becomes verbally abusive with the nurse.
3. Rationalization - Attempting to make excuses or formulate logical reasons to justify
unacceptable feelings or behaviors. (Example) John tells the rehab nurse, “I drink because it’s
the only way I can deal with my bad marriage and my worse job.”
4. Denial - Refusing to acknowledge the existence of a real situation or the feelings associated with
it. (Example) A woman drinks alcohol every day and cannot stop, failing to acknowledge that she
has a problem.
,Grief - Grief is a subjective state of emotional, physical, and social responses to the loss of a valued
entity. A loss is anything that is perceived as such by the individual. They may be real or they may be
perceived by the individual alone and unable to be shared or identified by others. (e.g., loss of the
feeling of femininity following a mastectomy).
Maladaptive Grief Responses - occur when an individual is not able to progress satisfactorily through
the stages of grieving to achieve resolution. When the mourning process is prolonged, delayed or
inhibited, or becomes distorted and exaggerated out of proportion to the situation.
Prolonged - characterized by an intense preoccupation with memories of the lost entity for
many years after the loss has occurred.
Neurosis - psychiatric disturbances characterized by excessive anxiety that is expressed directly or
altered through defense mechanisms. It appears as a symptom, such as an obsession, a compulsion, a
phobia, or a sexual dysfunction. In touch with reality.
● They are aware that they are experiencing distress.
● They are aware that their behaviors are maladaptive.
● They feel helpless to change their situation.
● They experience no loss of contact with reality.
Psychosis - a severe mental disorder characterized by gross impairment in reality testing, typically
manifested by delusions, hallucinations, disorganized speech, or disorganized or catatonic behavior.
Not in touch with reality. Examples of psychotic responses to anxiety include the schizophrenic,
schizoaffective, and delusional disorders.
● They exhibit minimal distress (emotional tone is flat, bland, or inappropriate).
● They are unaware that their behavior is maladaptive.
● They are unaware of any psychological problems.
● They are exhibiting a flight from reality into a less stressful world or into one in which they are
attempting to adapt.
Grief vs. Depression
The individual who experiences a distorted response is fixed in the anger stage of grieving. In the
distorted response, 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 activities of daily living. Pathological depression is a distorted grief response.
Interventions appropriate for a grief-stricken person
I couldn’t find anything in the book with this wording, so I emailed her, and she told that if given a
scenario, with 4 options to choose from, that she was confident I would find the correct answer using
critical thinking.
Mental Health - 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 – maladaptive responses to stressors from the internal or external environment,
evidenced by thoughts, feelings, and behaviors that are incongruent with the local and cultural norms,
and interfere with the individual’s social, occupational, and/or physical functioning. A universal concept
of mental illness is difficult to define because of the cultural factors that influence such a concept.
However, certain elements are associated with individuals’ perceptions of mental illness, regardless of
cultural origin. Horwitz(2002) identifies two of these elements as incomprehensibility and cultural
relativity. Incomprehensibility relates to the inability of the general population to understand the
motivation behind the behavior. The element of cultural relativity considers that these rules,
conventions, and understandings are conceived within an individual’s own particular culture.
Maslow’s Hierarchy of Needs - Maslow (1970) emphasized an individual’s motivation in the continuous
quest for self-actualization. He identified a “hierarchy of needs,” the lower needs requiring fulfillment
before those at higher levels can be achieved, with self-actualization being fulfillment of one’s highest
potential.
Chapter 2