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Stress, Health and Coping
What is Stress?
 Stress is any circumstance that threatens or is perceived to
threaten one’s well-being and tax one’s coping abilities.
 Stress can interfere with neurogenesis, the formation of
new neurons in the brain.
The Biopsychosocial Model
 The Biopsychosocial Health model holds that physical
illness is caused by a complex interaction of biological,
psychological and sociocultural factors.
Health Psychologists
 Health Psychologists are concerned with how
psychosocial conflicts relate to the promotion and
maintenance of health and determine the causation,
prevention, and treatment of illness.
Four Types of Stress
 Frustration is experienced when you want something you
cannot have.
 Conflict is experienced when two or more choices are
available.
Approach-Approach conflict is when two attractive
goals are presented.
Avoidance-Avoidance conflict is when two unattractive
goals are presented.
Approach-Avoidance conflict is when a single goal has
both attractive and unattractive aspects.
Four Types of Stress
 Change is experienced when there are alterations in one’s
living circumstances that require readjustment.
 Pressure is experienced when there are expectations or
demands that a person respond or behave in a certain way.
Social Readjustment Rating Scale
 Major Life Events
 Research by Psychiatrists Dr. Thomas Holmes and Dr. Richard
Rahe revealed a list of common causes of stress that most
people would find stressful. They called this scale the Holmes
and Rahe Social Readjustment Scale. The scale is a list of 45
stressors each given a number of points, with the most stressful
at the top of the list (death of a spouse) and the least stressful at
the bottom of the scale (a minor violation of the law). The
research indicates that if your total score is more than 150 points
the chances are that it could have an impact on your health. A
score of over three hundred points in one year indicates that you
have a high risk of developing a stress related health problem.
Social Readjustment Rating Scale
 One of the weaknesses of the Holmes and Rahe Social
Readjustment scale is that it doesn’t take into account the
individual’s personality, their perception of how difficult
the stressor is, nor does it take into account how long the
stressor continues for; the scale just gives a single number
for each stressor. However, it s known that the longer a
stressor continues, then the more likely it is to cause stress
and that the individuals perception of an event is the key to
whether they will find a situation stressful or not.
Social Readjustment Rating Scale
Richard Lazarus and Daily
Hassels of Stress
 The majority of causes of stress that we face on a day-to-
day basis are not as extreme as life events. The day-to-day
causes of stress are called daily hassles. They are those
daily, minor irritations such as misplacing our car keys,
traffic jams, minor arguments with family, friends, or coworkers. Research by Richard Lazarus (1984), at the
University of California, indicated that it was the daily
hassles rather than the major life events that affected us the
most. Life events do not occur every day, but daily hassles
do; it’s the constant, daily frustration caused by these
hassles that cause us the most stress, because they occur so
regularly and therefore can undermine our health.
Richard Lazarus and Daily
Hassels of Stress
 “Stress resides neither in the situation nor in the person; it
depends on a transaction between the two.” –Dr. Richard
Lazarus
 We tend to think that stress is solely caused by external events, situations and people, yet this is not
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strictly correct. Research has found that the Transactional Model of Stress is more accurate. This
model says that stress is caused by a transaction, there is an interaction between the stressor, our view
of the stressor and our perceived ability to cope with it. It’s our own internal beliefs, attitudes,
interpretations, perceptions and other factors, in combination with the external events that tend to
create stress. Internal factors which influence how we perceive stress include·
Beliefs
·
Expectations
·
Locus of control
·
Low assertion
·
Low self esteem
·
People pleasing
·
Perception
·
Perfectionism
·
Personality
Barbara Fredrickson’s Positivity Ratio
 Barbara has done pioneering work that demonstrates how developing positive
emotions can improve our lives. Twenty years of research into emotions culminated
in her best selling book Positivity.
 People who have positive emotions in a ratio of 3:1 in relation to negative emotions
are more likely to flourish.
 Barbara believes in humanity’s ability to shape a successful future, but she is a
scientist, rather than a self-help guru. Her work is based on rigorous interviewing and
testing.
 So would you like to know your own Positivity Ratio? Here is a link to the Positivity
Self Test.
 One key point: this invites you to focus on your emotions today. Barbara and others
recommend that you try it over a period of a month to get a realistic reading.
 http://www.positivityratio.com/single.php
Barbara Fredrickson’s Broaden-and
Build Theory of Positive Emotions
Potentially Stressful
Objective Events
Subjective Cognitive
Appraisal
Emotional Response
Physiological
Response
Behavioral Response
Hans Selye’s General Adaptation Syndrome
(G.A.S.)
 In 1936, Hans Selye created the stress model "General
Adaptation Syndrome", which thoroughly explains the
stress response and how aging and disease are caused by
chronic exposure to stress.
 “Every stress leaves an indelible scar, and the organism
pays for its survival after a stressful situation by becoming
a little older.”- Hans Selye (1907-1982)
Hans Selye’s General Adaptation Syndrome
(G.A.S.)
 Alarm Stage- in this phase, the initial reaction of the body
to stress is that it labels the stressor as a threat or danger to
balance, that is why it immediately activates its fight or
flight response system, and releases the “stress” hormones
such as adrenaline, noradrenaline and cortisol. These
hormones enable you to perform activities that you don’t
usually do.
Hans Selye’s General Adaptation
Syndrome (G.A.S.)
 Resistance Stage- After the body has responded to the stressor,
it is more likely that the stress level has been eradicated, or
simply reduced. What happens next to the fight or flight
response is that you body’s defenses become weaker, as it needs
to allocate energy to the repair of damaged muscle tissues and
lower the production of the stress hormones.
 Although the body has shifted to this second phase of stress
response, it remains on-guard, particularly when the stressors
persist and the body is required to fight them continuously,
although not as stronger as it could during the initial response.
Hans Selye’s General Adaptation Syndrome
(G.A.S.)
 Exhaustion Stage- During this phase, the stress has been
persistent for a longer period. The body starts to lose its
ability to combat the stressors and reduce their harmful
impact because the adaptive energy is all drained out. The
exhaustion stage can be referred to as the gate towards
burnout or stress overload, which can lead to health
problems if not resolved immediately.
 All in all, the General Adaptation Syndrome model by
Hans Selye presents a clear biological explanation of how
the body responds and adapts to stress.
Brain-Body Pathway in Response to Stress
Brain-Body Pathway in Response to
Stress
STRESS
Pituitary Gland
Hypothalamus
ACTH (Adrenocorticotropic Hormone) and ANS (Autonomic Nervous System)
Adrenal Cortex
Adrenal Medulla
Secretion of
Corticosteroids
Catecholamine's
Brain-Body Pathway in Response to Stress
 The major
communication center
for brain-body
interaction, the
hypothalamus works with
the pituitary gland to
regulate your body’s
hormones. When you have
a “stress response,” these
two structures throw the
adrenal glands into high
gear for “fight or flight.”
Brain-Body Pathway in Response to Stress
 When the brain perceives a
stress stimulus, it immediately
releases adrenaline from the
adrenal glands, and
corticotrophin-releasing
hormone (CRH) from nerve cells
in the hypothalamus. CRH
travels to the pituitary gland,
where it triggers the release of
adrenocorticotrophic hormone
(ACTH), which then stimulates
the production of cortisol in the
adrenal glands. Cortisol sustains
energy, but it also curbs the
surge of adrenaline and turns off
CRH.
Coping and Stress
 Coping is efforts to master, reduce, or tolerate the
demands of stress.
 Defensive Coping is using aggressive or addictive
behaviors to deal with stress. In defensive coping, defense
mechanisms are used to protect a person from unpleasant
emotions, such as anxiety and guilt.
 Constructive Coping are healthy efforts that people make
to deal with stressful events.
Ways to deal with Stress using Constructive
Coping
 Confront problems directly.
 Have a realistic understanding of resources available to
cope with stress.
 Recognize disruptive emotional reactions to stress.
 Make efforts to ensure that your body is not especially
vulnerable to the damaging effects of stress.
Three Factors which contribute to Illness from
Stress
 Personality – Type A or Type B
 Depression
 Immune Responses
Health Problems linked to Stress
 Stroke, hypertension, diabetes, heart disease, cancer,
chronic back pain, common cold, epileptic seizures,
rheumatoid arthritis, ulcers, infections, PMS, asthma,
appendicitis and AIDS.
Three Factors Moderating the Impact of Stress
 Social Support
 Optimism
 Conscientiousness
Health-Impairing Behavior which affects
Stress
 Smoking
 Poor Nutritional habits
 Lack of Exercise
 Drinking Alcohol
 Drug Use
Albert Ellis (1913-2007)
 Albert Ellis, Ph.D., was born in
Pittsburgh on September 27, 1913,
and raised in New York City. He
holds M.A. and Ph.D. degrees in
clinical psychology from Columbia
University, and has held many
important psychological positions,
including chief psychologist of the
State of New Jersey and adjunct
professorships at Rutgers and other
universities.
 He is the founder of Rational
Emotive Behavior Therapy
(REBT), the first of the now
popular Cognitive Behavioral
Therapies (CBT).
Albert Ellis (1913-2007)
 Albert Ellis, Ph.D., was born in Pittsburgh on September
27, 1913, and raised in New York City. He holds M.A. and
Ph.D. degrees in clinical psychology from Columbia
University, and has held many important psychological
positions, including chief psychologist of the State of New
Jersey and adjunct professorships at Rutgers and other
universities.
 He is the founder of Rational Emotive Behavior Therapy
(REBT), the first of the now popular Cognitive Behavioral
Therapies (CBT).
Albert Ellis (1913-2007)
 The Albert Ellis Institute (AEI), a world-renowned psychotherapy
training institute established in 1959, committed to promoting
emotional well-being through the research and application of
effective, short-term therapy with long-term results.
 AEI’s therapeutic approach is based on rational emotive behavior
therapy (REBT), the pioneering form of cognitive behavior therapy.
REBT is an action-oriented psychotherapy that teaches individuals to
identify, challenge, and replace their self-defeating thoughts and
beliefs with healthier thoughts that promote emotional well-being and
goal achievement. REBT was developed in 1955 by Dr. Albert Ellis.
Dr. Ellis has been considered the second most influential
psychotherapist in history. Prior to this death in 2007, Psychology
Today described him as the “greatest living psychologist.”
Rational Emotive Behavior Therapy
 Ellis suggested that people mistakenly blame external
events for unhappiness. He argued, however, that it is our
interpretation of these events that truly lies at the heart of
our psychological distress. To explain this process, Ellis
developed what he referred to as the ABC Model:
 A – Activating Event: Something happens in the
environment around you.

B – Beliefs: You hold a belief about the event or situation.

C – Consequence: You have an emotional response to your
belief.
Rational Emotive Behavior Therapy
Activating Event
Beliefs- Irrational
and Rational
Appraisal
ConsequencesEmotional Turmoil
or Emotional Calm
The Basic Steps in Rational Emotive Behavior Therapy
1. Identifying the underlying irrational thought
patterns and beliefs.
 The very first step in the process is to identify the irrational thoughts, feelings, and
beliefs that lead to psychological distress. In many cases, these irrational beliefs are
reflected as absolutes, as in "I must," "I should," or "I cannot." According to Ellis, some of
the most common irrational beliefs include:
 Feeling excessively upset over other people's mistakes or misconduct.

Believing that you must be 100 percent competent and successful in everything to be
valued and worthwhile.

Believing that you will be happier if you avoid life's difficulties or challenges.

Feeling that you have no control over your own happiness; that your contentment and joy
are dependent upon external forces.
 By holding such unyielding beliefs, it becomes almost impossible to respond to
situations in a psychologically healthy way. Possessing such rigid expectations of
ourselves and others only leads to disappointment, recrimination, regret, and anxiety.
The Basic Steps in Rational Emotive Behavior
Therapy
2. Challenging the irrational beliefs.
 Once these underlying feelings have been identified, the
next step is to challenge these mistaken beliefs. In order to
do this, the therapist must dispute these beliefs using very
direct and even confrontational methods. Ellis suggested
that rather than simply being warm and supportive, the
therapist needs to be blunt, honest, and logical in order to
push people toward changing their thoughts and
behaviors.
The Basic Steps in Rational Emotive Behavior
Therapy
3. Gaining Insight and Recognizing Irrational Thought
Patterns
 As you might imagine, REBT can be a daunting process for the client.
Facing irrational thought patterns can be difficult, especially because
accepting these beliefs as unhealthy is far from easy. Once the client has
identified the problematic beliefs, the process of actually changing these
thoughts can be even more difficult.
 While it is perfectly normal to feel upset when you make a mistake, the
goal of REBT is to help people respond rationally to such situations. When
faced with this type of situation in the future, the emotionally healthy
response would be to realize that while it would be wonderful to be perfect
and never make mistakes, it is not realistic to expect success in every
endeavor. You made a mistake. But that's okay because everyone makes
mistakes. All you can do is learn from the situation and move on.
 REBT can be effective in the treatment of a range of psychological disorders
including anxiety disorders and phobias as well as specific behaviors such as severe
shyness and excessive approval seeking.
Ways to Reduce Stress
 Humor or Laughing
 Release pent up emotions- Catharsis
 Forgive others
 Learn to relax
 Yoga
What Is Catharsis?
 A catharsis is an emotional release. According to
psychoanalytic theory, this emotional release is linked
to a need to release unconscious conflicts. For
example, experiencing stress over a work-related
situation may cause feelings of frustration and tension.
Rather than vent these feelings inappropriately, the
individual may instead release these feelings in
another way, such as through physical activity or
another stress relieving activity.
Psychological Disorders
Psychological Disorders
 Psychological Disorders are diagnosed by
psychologists by first determining if a behavior is
deviant, maladaptive and causes personal distress.
This is done through a diagnosis, (determining the
illness), etiology, (cause of illness) and prognosis
(probable cause of illness in the future). This is done
using the Axis System within the DSM-IV. This is a
reference book of about 300 disorders that
psychologists can use to determine what illness a
patient has, if any.
DSM-IV , TR
 Psychiatric Diagnoses are categorized by the Diagnostic and Statistical Manual of Mental
Disorders, 4th. Edition. Better known as the DSM-IV, the manual is published by the
American Psychiatric Association and covers all mental health disorders for both
children and adults. It also lists known causes of these disorders, statistics in terms of
gender, age at onset, and prognosis as well as some research concerning the optimal
treatment approaches.
 Mental Health Professionals use this manual when working with patients in order to
better understand their illness and potential treatment and to help 3rd party payers (e.g.,
insurance) understand the needs of the patient. The book is typically considered the
‘bible’ for any professional who makes psychiatric diagnoses in the United States and
many other countries. Much of the diagnostic information on these pages is gathered
from the DSM IV.
 The DSM IV is published by the American Psychiatric Association. Much of the
information from the Psychiatric Disorders pages is summarized from the pages of this
text. Should any questions arise concerning incongruencies or inaccurate information,
you should always default to the DSM as the ultimate guide to mental disorders.
DSM-IV , TR
 The DSM-IV, TR uses a multiaxial or multidimensional approach
to diagnosing because rarely do other factors in a person's life not
impact their mental health. It assesses five dimensions as
described below:
Axis I: Clinical Syndromes
 This is what we typically think of as the diagnosis (e.g.,
depression, schizophrenia, social phobia)
Axis II: Developmental Disorders and Personality Disorders
 Developmental disorders include autism and mental retardation,
disorders which are typically first evident in childhood
 Personality disorders are clinical syndromes which have a more
long lasting symptoms and encompass the individual's way of
interacting with the world. They include Paranoid, Antisocial,
and Borderline Personality Disorders.
DSM-IV , TR
Axis III: Physical Conditions which play a role in the
development, continuance, or exacerbation of Axis I
and II Disorders
 Physical conditions such as brain injury or HIV/AIDS
that can result in symptoms of mental illness are
included here.
Axis IV: Severity of Psychosocial Stressors
 Events in a persons life, such as death of a loved one,
starting a new job, college, unemployment, and even
marriage can impact the disorders listed in Axis I and
II. These events are both listed and rated for this axis.
Axis V: Highest Level of Functioning
 On the final axis, the clinician rates the person's level of
functioning both at the present time and the highest level
within the previous year. This helps the clinician
understand how the above four axes are affecting the
person and what type of changes could be expected.
Anxiety Disorders
 Anxiety is a familiar emotion to all of us- the feeling
of tension, apprehension, and worry that often hits
during personal crisis and everyday conflicts.
 In Anxiety Disorders, the anxiety is maladaptive
(inhibit a person’s ability to adjust to particular
situations.) disrupting activities, moods, and thought
processes. Three features distinguish normal anxiety
from pathological anxiety. Pathological anxiety is ;
irrational, uncontrollable, and disruptive.
Anxiety Disorders
 Generalized Anxiety Disorder (GAD)
 Global, persistent, chronic and ongoing anxiety is the
main feature of GAD. Normal anxiety quickly
dissipates when a threatening situation is resolved. In
GAD, when one source of worry is removed, another
quickly take it’s place. The anxiety can be attached to
any object or person or none at all. GAD is often
referred as “free-floating anxiety”.
Anxiety Disorders
 Panic Disorder
 In panic disorder, the anxiety is sudden, intense and
short-lived. A Panic Attack is a sudden episode of
extreme anxiety that rapidly escalates in intensity. The
most common symptoms of a panic attack are a
pounding heart, rapid breathing, breathlessness, and a
choking situation. When panic attacks occur
frequently and unexpectedly, the person is said to
suffer from panic disorder.
Anxiety Disorders
 Phobias
 A phobia is a strong irrational fear of something, usually a specific
object or situation. Having a phobia does not mean a person has a
psychological disorder.
 People with a Specific Phobia have an irrational fear of a specific
object or situation that interferes with the ability to function in
everyday life.
 People with Social Phobia or Social Anxiety Disorder have an
extreme or irrational fear of being embarrassed, judged or scrutinized
in social situations. Social Phobia is far more debilitating than everyday
shyness. People with social phobia are intensively fearful of being
watched and judged by others. Even in everyday activities, such as
eating with friends in a restaurant, can cause unbearable anxiety.
 Phobias can partly be explained by; classical conditioning, operant
conditioning, and observational learning.
Anxiety Disorders
 Agoraphobia
 This is a type of phobia that deserves special attention.
Agoraphobia is an extreme and irrational fear of
experiencing a panic attack in a public situation and being
unable to escape or get help. Agoraphobia means “fear of
the marketplace”. Although agoraphobia and panic
disorder are characterized by panic attacks, not everyone
with panic disorder develops agoraphobia. Many people
with agoraphobia will become prisoners in their own
homes, unable to go out the door.
Anxiety Disorders
 Posttraumatic Stress Disorder (PTSD)
 PTSD is a long-lasting anxiety disorder that develops in
response to an extreme physical or psychological trauma.
Extreme traumas are events that produce intense feelings
of horror and helplessness, such as a serious physical injury
or threat of injury to yourself or to loved ones.
 PTSD was originally associated with direct experiences of
military combat. However, it now know n that PTSD can
develop in survivors of other sorts of extreme traumas,
such as natural disasters, physical or sexual assault,
random shooting sprees, or terrorist attacks.
Anxiety Disorders
 Obsessive- Compulsive Disorder (OCD)
 OCD is characterized by symptoms of anxiety which are triggered by intrusive, repetitive
thoughts and urges to perform certain actions. A deficiency in the neurotransmitter
serotonin seems to be associated with OCD.
 Obsessions are repeated, intrusive, uncontrollable thoughts or mental images that cause
a person great worry and distress. One common obsession is an irrational fear of dirt,
germs, and other forms of contamination. Another common theme is the
pathological doubt about having accomplished a simple task, such as shutting off
appliances or locking a door.
 Compulsions are repetitive behaviors that a person feels driven to perform, Typically,
compulsions are ritual behaviors that must be carried out in a certain process or
sequence. Compulsions may be overt physical behaviors, such as repeated hand washing,
checking doors and windows. Other compulsions may be covert mental behaviors, such
as counting or reciting certain phrases to yourself.
 If a person tries to resist performing the ritual, unbearable tension, anxiety and distress.
 Many people with OCD have the irrational belief that failure to perform the ritual action
will lead to catastrophic or disastrous outcome.
Mood Disorders
 Mood Disorders are a category of mental disorders in
which significant and persistent disruptions in mood or
emotions cause impaired cognitive, behavioral, and
physical functioning; also called affective (affect is
another word for “emotion or mood”) disorders. The
DSM-IV-TR defines a mood disorder as a serious,
persistent disturbance in a person’s emotions that cause
psychological discomfort which impairs the ability to
function or both.
Mood Disorders
 Major Depression
 Major Depression is characterized by extreme and
persistent feelings of despondency, worthlessness, and
hopelessness causing impaired emotional, cognitive,
behavioral, and physical functioning. It is often triggered
by traumatic and stressed events.
 In Major Depression, there is a loss of pleasure in almost
all activities, feelings of emptiness, excessive guilt,
preoccupation with death or suicidal thoughts, difficulty
sleeping, dimished ability to think, concentrate or make
decisions, and diminished appetite and significant weight
loss.
Mood Disorders
 Dysthymic Disorder
 In contrast to major depression, which significantly
impairs a person’s ability to function, some people
experience a less severe form of depression called
dysthymic disorder.
 Dysthymic Disorder is chronic, low-grade
depression. It is characterized by many symptoms of
depression, but the symptoms are less intense.
Although the person functions adequately, they have a
chronic case of “the blues” that can continue for years.
Mood Disorders
 Seasonal Affective Disorder (SAD)
 SAD is repeated episodes of depression in the
changing seasons of the onset of autumn to winter. In
the most common form of SAD, episodes of depression
recur in the fall and winter months when there is the
least amount of sunlight.
Mood Disorders
 Bipolar Disorder
 Bipolar Disorder involves periods of depression
alternating with periods of extreme euphoria and
excitement (Mania). A person with Bipolar Disorder
experience extreme mood swings
 During manic episodes, the person’s thoughts often
rapidly shift from topic to topic. This is often referred to as
a “flight of ideas”. For most people with Bipolar
Disorders, a manic episode immediately precedes or
follows a bout with major depression. However, according
to the DSM-IV-TR , a small percentage of people
experience only manic episodes.
Mood Disorders
 Cyclothymic Disorder
 Cyclothymic Disorder is characterized by moderate
but frequent mood swings, which last two years or
more that are not severe enough to qualify as bipolar
disorder.
Personality Disorders
 Personality Disorders are inflexible, maladaptive
patterns of thoughts, emotions, behaviors, and
interpersonal functioning that are stable over time and
across situations, and deviate from the expectations of the
individuals culture. Personality traits are consistent over
time and across situations, but they are not etched in
stone. A psychologically well-adjusted person possesses a
fair degree of flexibility and adaptiveness. Based on our
experiences with others, we are able to modify are
behaviors and how we display our personality traits. In
contrast, someone with personality disorder has
personality traits that are inflexible and maladaptive
across a broad range of situations.
Personality Disorders
 Paranoid Personality Disorder is characterized by
pervasive distrust and suspiciousness of the motives of
other without sufficient basis. About 3% of the general
population display this disorder, which occurs more
frequently in men.
 These individuals are constantly on guard because
they think that other people are out to exploit, harm,
or dupe them.
Personality Disorders
 Antisocial Personality Disorder is characterized by a
pervasive pattern of disregarding and violating the rights of
others. These people are often referred to as “psychopaths
or sociopaths”.
 These people have the ability to lie, steal, cheat, and otherwise
manipulate and harm other people. Evidence of this personality
trait can be seen in childhood or early adolescence. In many
cases, the child has repeated run-ins with the law or school
authorities. Behaviors that draw the attention of authorities can
include; cruelty to animals, attacking or harming adults or other
children, theft, setting fires, and destroying property. This
pattern of behavior is typically diagnosed as conduct disorder.
Personality Disorders
 Borderline Personality Disorder is characterized by instability
of interpersonal relationships, self-image, and emotions, and
marked impulsivity. This is the most commonly diagnosed
personality disorder, of 10 million Americans diagnosed with
personality disorder, about 75% are women. The person has
extreme mood swings and angry outbursts are common. They
often have feelings of emptiness and are afraid of abandonment.
There sense of self is just as unstable and just as chaotic as their
external world, partly because their identity is so fragile.
 Some researchers believe that a disruption in attachment
relationships in early childhood is an important cause.
Personality Disorders
 Schizoid Personality Disorder
 Schizoid personalities are introverted, withdrawn,
solitary, emotionally cold, and distant. They are often
absorbed with their own thoughts and feelings and are
fearful of closeness and intimacy with others. For
example, a person suffering from schizoid personality
is more of a daydreamer than a practical action taker.
Personality Disorders
 Schizotypal Personality Disorder
 A pattern of peculiarities best describes those with
schizotypal personality disorder. People may have odd or
eccentric manners of speaking or dressing. Strange,
outlandish or paranoid beliefs and thoughts are common.
People with schizotypal personality disorder have
difficulties forming relationships and experience extreme
anxiety in social situations. They may react inappropriately
or not react at all during a conversation or they may talk to
themselves. They also display signs of “magical thinking”
by saying they can see into the future or read other people’s
minds.
Personality Disorders
 Narcissistic Personality Disorder
 People with narcissistic personality have an
exaggerated sense of self-importance, are absorbed by
fantasies of unlimited success, and seek constant
attention. The narcissistic personality is oversensitive
to failure and often complains of multiple somatic
symptoms. Prone to extreme mood swings between
self-admiration and insecurity, these people tend to
exploit interpersonal relationships.
Personality Disorders
 Avoidant Personality Disorder
 Avoidant personalities are often hypersensitive to rejection
and are unwilling to become involved with others unless
they are sure of being liked. Excessive social discomfort,
timidity, fear of criticism, avoidance of social or work
activities that involve interpersonal contact are
characteristic of the avoidant personality. They are fearful
of saying something considered foolish by others; worry
they will blush or cry in front of others; and are very hurt
by any disapproval by others. People with avoidant
personality disorder may have no close relationships
outside of their family circle, although they would like to,
and are upset at their inability to relate well to others.
Personality Disorders
 Dependent Personality Disorder
 People with dependent personality disorder may exhibit a
pattern of dependent and submissive behavior, relying on
others to make decisions for them. They require excessive
reassurance and advice, and are easily hurt by criticism or
disapproval. They feel uncomfortable and helpless if they
are alone, and can be devastated when a close relationship
ends. They have a strong fear of rejection. Typically lacking
in self-confidence, the dependent personality rarely
initiates projects or does things independently. This
disorder usually begins by early adulthood and is
diagnosed more frequently in females than males.
Personality Disorders
 Obsessive-Compulsive Personality Disorder
 Obsessive-Compulsive personalities are conscientious and have
high levels of aspiration, but they also strive for perfection. Never
satisfied with their achievements, people with compulsive
personality disorder take on more and more responsibilities.
They are reliable, dependable, orderly, and methodical, but their
inflexibility often makes them incapable of adapting to changed
circumstances. People with compulsive personality are highly
cautious, weigh all aspects of a problem, and pay attention to
every detail, making it difficult for them to make decisions and
complete tasks. When their feelings are not under strict control,
events are unpredictable, or they must rely on others, compulsive
personalities often feel a sense of isolation and helplessness.
Somatoform Disorders
Somatoform Disorders are physical ailments that
cannot be fully explained by organic conditions and are
largely due to psychological factors.
 Somatization Disorder is marked by a history of diverse
physical complaints that appear to be psychological in
origin.
 Hypochondriasis is characterized by an excessive
preoccupation with one’s own health and worry about
developing a physical illness.
 Conversion Disorder is characterized by a significant loss
of physical function usually in a single organ system, with
no organic basis.
Eating Disorders
 Anorexia nervosa involves intense fear of gaining
weight, disturbed body image, refusal to maintain
normal weight, and used dangerous measures to lose
weight.
 Bulimia nervosa involves engaging in out-of-control
overeating followed by unhealthy compensatory
efforts.
Dissociative Disorders
 Dissociative Disorders are a category of psychological
disorders in which extreme and frequent disruptions of
awareness, memory, and personal identity impair and
function. Dissociative experience is one in which a
person’s awareness, memory, and personal identity become
separated or divided. While that may sound weird,
dissociative experiences are not inherently pathological.
Mild dissociative experiences are quite common and
completely normal. In Dissociative Disorders, the
dissociative experiences are more extreme and frequent
and severely disruptive in everyday functioning.
Dissociative Disorders
 Dissociative Fugue
 Dissociative Fugue is a closely related disorder to
dissociative amnesia. In dissociative fugue, the
person outwardly appears completely normal.
However, the person has extensive amnesia and is
confused about his identity. While in the fugue state,
they suddenly and inexplicably travels from their
home, wandering to other cities or even countries. In
some cases, people in a fugue state adopt a completely
new identity. It is thought to be associated with
traumatic events or stressful periods.
Dissociative Disorders
 Dissociative Identity Disorder (DID)
 Dissociative Identity Disorder (DID) among all dissociative
disorders is more fascinating- or controversial than any other,
formerly known as multiple personality disorder. It involves
extensive memory disruptions for personal information with the
presence of two or more distinct identities or “personalities”
within a single person. Typically, each personality has its own
name and is experienced as if it has its own history and selfimage. These alternate personalities are often called alters or
alter egos, each of which may have different ages and genders.
 In order to explain dissociative identity disorder, research has
shown that a very high percentage of DID patients report having
suffered extreme physical or sexual abuse in childhood- over
90% in most surveys.
Schizophrenia
 Schizophrenia according to the DSM-IV-TR is a disorder
characterized by impaired functioning by severely distorted
beliefs, perceptions, and thought processes.
 Schizophrenia can be described in terms of two broad
categories: positive and negative symptoms. Schizophrenia is
an extremely complex disorder also called psychosis, which is a
characterized by a loss of contact with reality. There are
enormous individual variability in the onset, symptoms,
duration, and recovery from schizophrenia. According to the
dopamine hypothesis, schizophrenia is related to excessive
activity of the neurotransmitter dopamine in the brain. There is
also strong evidence that shows there is genetic involvement .
Schizophrenia
Positive Symptoms of Schizophrenia
 Delusions are false beliefs that persists in spite of contradictory evidence.
Delusions of Reference occur when a person convinced that other people are
constantly talking about them and everything that is related to them in some
way. They believe the person on the radio is speaking to them. Delusions of
Grandeur are when a person believes they are extremely powerful, wealthy, or
important. They believe they are the president of the United States or Jesus.
Delusions of Persecution are when a person believes other people are
plotting against them to harm them or someone important to them. A person
may believe that “terrorist forces” are going to attack them in their own home.
 Hallucinations are false or distorted perceptions that seem vividly real. The
content of hallucinations is often tied to the person’s delusional beliefs.
Hallucinations include; visual, smell or taste, touch or tactile and the
most common type of hallucination which is auditory.
Schizophrenia
Negative Symptoms of Schizophrenia
 Negative Symptoms of Schizophrenia include; social
withdrawal, loss of motivation, very limited speech,
slowed movements, poor hygiene, poor problemsolving abilities and a distorted sense of time. Some
people may exhibit a flat affect, showing practically
no emotional response at all, even though they may
report feeling emotional.
Schizophrenia
Four Types of Schizophrenia
 Paranoid Schizophrenia is the most common type of
schizophrenia with symptoms of delusions and
hallucinations.
 Disorganized Schizophrenia is the most serious type
marked by extreme social withdrawal, hallucinations,
delusions and inapproiate behavior.
 Catatonic Schizophrenia is characterized by bizarre
postures or grimacing or echoing words spoken by another
person.
 Undifferentiated Schizophrenia is when the symptoms
do not conform to one type of schizophrenia.
Therapies
Psychoanalytic Therapy
 Psychoanalytic Therapy or Psychoanalysis is a form of therapy
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developed by Sigmund Freud.
Psychotherapy can be described as the use of psychological
techniques to increase understanding and treat emotional, behavioral
and interpersonal problems. All forms of psychotherapy share the
assumption that psychological factors play a significant role in
problematic emotions, behaviors and thoughts.
Psychoanalysis is a form of therapy based on dream interpretation,
transference and resistance.
Transference refers to a patient responding to the therapist as though
the therapist was a significant person in their life.
Resistance refers to patients unconscious attempts to block repressed
memories and conflicts.
Behavior Therapy
 Behavior therapy, also called Behavior
Modification is to modify a specific problem
behavior, not to change the entire personality.
Behavior therapy use techniques of learning and
conditioning to change behavior.
 Mary Cover Jones was the first behavior therapist
who developed was the first behavior therapist who
developed counterconditioning- the learning of a
new response that is incompatible with a previously
learned response.
Humanistic Therapy- “Client-Centered
Therapy”
 The humanistic perspective has exerted a strong
influence on psychotherapy. The most influential of
the humanistic psychotherapies is client-centered
therapy, also called person-centered therapy
developed by Carl Rogers.
 Carl Rogers believed to promote self-awareness,
psychological growth and self-directed change the
three qualities important of a therapist are;
genuineness, unconditional positive regard and
empathic understanding.
Cognitive Therapies
 Cognitive therapies is based on the assumption that
psychological problems are due to maladaptive patterns of
thinking, treatment techniques focus on recognizing and
altering these unhealthy thinking patterns.
 Albert Ellis developed rational-emotional therapy
(RET) which promotes psychologically healthier thought
process by disputing irrational beliefs and replacing them
with more rational interpretations of events. “ABC”
Model- (A) Activating Event (B) Beliefs and (C)
Consequences
Cognitive-Behavioral Therapy
 Cognitive-Behavioral Therapy (CBT) integrates
cognitive and behavioral techniques and based on the
assumption that thoughts, moods, and behaviors are
interrelated.