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PEARLIN - STRESS PROCESS STRESSORS MEDIATORS OUTCOME DIFFERENCES WITH SRRS STRESS PROCESS • 1. MUST LOOK AT CONTEXT AND MEANING DIMENSIONS OF STRESSFUL LIFE EVENTS • • • • DESIRED VS. NOT DESIRED UNEXPECTED VS. EXPECTED PREEXISTING CONTEXT OF EVENT POST-EVENT CONTEXT STRESS PROCESS (CONT.) • 2. EVENTS NOT ISOLATED BUT INTERCONNECTED • STRESS PROLIFERATION - PRIMARY AND SECONDARY STRESSORS • 3. EMPHASIZES SOCIAL ROLES OVERLOAD, CONFLICT, CAPTIVITY NEW CATEGORIES OF STRESSORS (WHEATON) • • • • 1. CHRONIC STRESSORS 2. LIFETIME TRAUMAS 3. DAILY HASSLES 4. DISASTERS MEDIATORS • WHY SOME PEOPLE WITH FEW STRESSORS HAVE HIGH DISTRESS (VULNERABILITY) • WHY SOME PEOPLE WITH MANY STRESSORS HAVE LOW DISTRESS (RESILIENCE) MEDIATORS (TURNER) • SOCIAL RESOURCES • 1. SUPPORT - SENSE OF BEING CARED FOR, BELONGING, WANTED • ONE INTIMATE • STRONG FAMILY TIES, RELIGION • 2. MATERIAL SUPPORT SOCIAL COMPARISON • STRESSFULNESS DEPENDS ON REFERENCE GROUP • INCOME • QUADRIPLEGICS • DOWNWARD COMPARISONS BETTER THAN UPWARD COMPARISONS CONTROL • ACTIVE COPING BETTER THAN PASSIVE COPING (MASTERY VS. FATALISM) OUTCOMES • STANDARDIZED SCALES OF DISTRESS LIKE CES-D • GENERAL NOT DIAGNOSTIC • CONTINUOUS – FROM MILD TO SEVERE TREATMENT • ONLY THEORY WITH NO DIRECT TREATMENT ASPECT • CHANGE ENVIRONMENT • MUCH DISTRESS TRANSIENT (9-11) • IMPORTANCE OF INFORMAL SUPPORT STRENGTHS OF SOCIAL • BETTER AT EXPLAINING DISTRESS THAN PARTICULAR MENTAL ILLNESSES • BETTER AT LOOKING AT GROUP, RATHER THAN AT INDIVIDUAL, DIFFERENCES • EMPHASIS ON EXTERNAL AND CURRENT CAUSES OF DISTRESS CRITICISMS OF SOCIAL • IGNORES HOW MENTAL SYMPTOMS ARE DEEPLY ROOTED IN INDIVIDUALS NOT SITUATIONS • NOT SO GOOD FOR EXPLAINING MOST SERIOUS TYPES OF MENTAL ILLNESS • UNSPECIFIC TREATMENT COMPONENT STRENGTHS OF PSYCHODYNAMIC • DEVELOPMENTAL ASPECT • PEOPLE ARE OFTEN IRRATIONAL • IMPACT ON CHILD REARING AND SEXUALITY WEAKNESSES OF PD • UNSCIENTIFIC - UNOBSERVABLE AND UNFALSIFIABLE • OVEREMPHASIZES EARLY CHILDHOOD, UNDEREMPHASIZES ADAPTABILITY • RESISTANCE TO MEDICATIONS • HISTORICALLY AND CULTURALLY SPECIFIC WEAKNESSES OF PA THERAPY • IMPRACTICAL – LONG AND EXPENSIVE • CULTURALLY-SPECIFIC • DOESN’T WORK WITH MOST SERIOUSLY ILL STRENGTHS OF BIOLOGY • BEST FOR PSYCHOTIC DISORDERS • MORE KNOWLEDGE ABOUT BRAIN • ADVANCES IN DRUG TREATMENTS FOR MANY CONDITIONS 1. OVERSTATEMENTS • MOST CONVINCING FOR PSYCHOSES • LESS EVIDENCE FOR OTHERS • ARE BRAIN STATES CAUSES OR EFFECTS OF M.I.? • CAUSES CAN BE SOCIAL OR PSYCH AS WELL AS BIOLOGICAL 2. GENES NOT DESTINY • ONLY A MINORITY OF PEOPLE WITH GENETIC SUSCEPTIBILITY DEVELOP DISORDER • OFTEN NEED ENVIRONMENTAL PRECIPITANT • ENVIRONMENT CAN SUPPRESS MORMONS AND ALCOHOLISM 3. WHAT DOES A GENE DO? • DIFFERENCE OF GENOTYPE AND PHENOTYPE (APPEARANCE) • E.G. ANOREXIA • CULTURE CAN SHAPE PHENOTYPE • GENES MAY HAVE GENERAL, NOT SPECIFIC, EFFECTS 4. MOST M.I. NOT GENETIC • MOST PEOPLE WHO GET A DISORDER DO NOT HAVE GENETIC PROPENSITY TO THE DISORDER SCHIZ. IN DENMARK • THOSE WITH 1ST DEGREE RELATIVES HAVE 10x RATE OF SCHIZ • BUT 90% OF PEOPLE WHO DO GET SCHIZ HAVE NO SCHIZ RELATIVES • FAR MORE PEOPLE HAVE NO FAMILY HISTORY OF SCHIZ SO DESPITE LOWER % PRODUCE MORE CASES CONCLUSION • GENES AND BRAINS ARE IMPORTANT • BUT, FAR FROM THE ENTIRE STORY