Stress & Sleep-Wake Disorders

Stress and Stress-Related Disorders

I. What is Stress?

A. Stress: the pattern of responses an organism experiences when stimuli disrupt its equilibrium or coping abilities.

B. Stressor: an internal or external event or stimulus that induces stress.

C. Acute Stress: a temporary state of arousal with typically clear onset and offset patterns.

D. Chronic Stress: a continuous state of arousal in which an individual perceives demands as greater than the inner and outer resources available for dealing with them.

A. Alarm: a brief period of high arousal of the sympatheticnervous system, which readies the body for vigorous activity.

B. Resistance: if the stressor goes on for longer than a fewminutes, the body enters a phase of prolonged but moderatearousal.

C. Exhaustion: intense and long-lasting stress causes adepletion of proteins in the immune system that can lead toillness, fatigue, weakness, and possibly death.

II. The General Adaptation Syndrome

Procrastination and Stress… Time of Semester

Early Late

Procrastinators

Nonprocrastinators

1 8

3 5

College students that procrastinate,report significantly more symptomsof physical illness by the end of a semester than do those who donot procrastinate.

III. Coping with Stress

A. Coping: Adaptive thinking or behavior aimed at reducing or relieving stress that arises from harmful, threatening, or challenging conditions.

B. Cognitive-Appraisal Model: a model of coping, proposed by Lazarus and Folkman, which holds that, on the basis of continuous appraisal of their relationship with the environment, people choose appropriate coping strategies to deal with stressful situations that tax their normal resources.

C. Resources Relativeto Magnitude of ThreatModel of Stress and Activity: an unhealthylevel of stress occurswhen the stressfulsituation is one that aperson regards asthreatening andpossibly exceedinghis or her resources.

D. Problem-Focused Coping: people attend carefully to the stressful event and try to take effective action. 

E. Emotion-Focused Coping: people try to weaken their emotional reaction to a stressful event through relaxation, exercise, and / or distraction.

F. Allostatic Overload: excessive stress resulting in psychological and / or physiological damage.

G. Occupational Burnout: emotional exhaustion and a sense that one can no longer accomplish anything related to one’s job.

IV. The Relationship Between Personality Characteristics and Stress

A. Self-Efficacy Expectancies: beliefs in one’s ability to cope with challenges and to accomplish particular tasks.

B. Psychological Hardiness: a cluster of stress-buffering traits characterized by commitment, challenge, and control.

C. Internal Locus of Control: an individual’s belief that the outcomes in one’s life are primarily determined by one’s own actions and choices.

D. Optimism: seeing the proverbial glass as half full rather than half empty is linked to better physical health and emotional well-being.

E. Sociability1) Social Support

2) Ethnic Identity

F. Type “A” Personality: describes a highly competitive, impatient, hurried person who typically has an angry and hostile temperament.  

G. Type “B” Personality: designates those who are easygoing, less hurried, and less hostile.

H. What can you do to reduce stress?

1) Self-Awareness 5) Diet2) Time Management 6) Relaxation Activities3) A Support System 7) Sleep4) Regular Exercise 8) Attitude

V. Adjustment Disorder: a cognitive, emotional, and / or behavioral reaction to one or more changes or stressors in a person’s life that is more extreme than would be normally expected under the circumstances.

A.Type 5: adjustment disorder with mixed disturbance ofemotions and conduct; a mix of depression and anxiety as wellas behavioral problems.

B. Common Risk Factors 1) Being diagnosed with a serious illness

2) Preexisting psychological disorders

3) Poor adaptation to societal changes

4) Divorce or relationship breakup5) Job loss

6) Having a baby7) Financial problems8) Retirement9) Death of a loved

one10) Going away to

college

C. Demographics…

D. Prevalence…

E. Complications…

1) Psychotic Break: a symptom or feature of mental illnesstypically characterized by radical changes in personality,impaired functioning, and a distorted or nonexistent senseof objective reality.

F. Treatment for Adjustment Disorder…

VI. Personality Predictors of Severe andChronic Cases of Adjustment Disorder

A.The Identity Adaptation Model of Personality: a model ofidentity development based on the processes of assimilationand accommodation.

B. Identity Style: characteristic ways of confronting,interpreting, and responding to experience.

1) Assimilative Identity Style: when one is very resistant tochange and exerts great effort to fit any unavoidable newexperiences into an existing self-concept.

2) Accommodative Identity Style: when one is very open tochange and regularly adjusts one’s self-concept to fit newexperiences.

3) Balanced Identity Style: the healthiest style, in whichidentity is flexible enough to change when warranted but notunstructured to the point that every new experience causesthe person to question fundamental assumptions aboutthe self.

VII. Traumatic Stress Disorders

A. Flashbulb Memories: these occur when you experience something so emotionally shocking that you remember the event, but as time goes by, you forget the details.

B. Acute Stress Disorder: a traumatic stress reaction in which the person shows a maladaptive pattern of behavior for a period of three days to one month following exposure to a traumatic event.

C. Posttraumatic Stress Disorder (PTSD): a prolonged period (months to years) of anxiety and depression following the experience of an extremely stressful event.

1) Treatment…

VIII. Positive Effects of Stress

A. Eustress: positive stress or stressful experiences that are sought after and experienced as enjoyable.

B. Posttraumatic Growth: positive psychological change in response to serious illnesses, accidents, natural disasters and other traumatic events.

Sleep-Wake Disorders

I. Stages of Sleep

A. Rapid-Eye Movement (REM): the sleeper’s eyes aremoving rapidly around under the closed eyelids.

B. Non-REM (NREM) Stages of Sleep

Stage 1: there is little eye movement, and a fair amount of brain activity.

Stage 2: a gradual transition to slow brain wave deep sleep.

Stages 3 and 4: stages of even deeper sleep.

You gradually move back through stages 3 and 2 and then have your first brief REM episode of the night. (REM replaces stage 1 and then the cycle of stages repeats).

A healthy adult has several 90-100 minute sleep cycles during the night.

The last sleep cycles of the night are usually comprised of alternations between stage 2 and REM.

II. Dreaming

A. Adults awakened during REM sleep report dreams 85-90% of the time.

B. Adults awakened during NREM sleep report dreams 50-60% of the time.

C. Children less than 5 years old rarely report any dreams.

D. Dreams appear to follow REM in length; 1 minute of REM produces a brief dream, longer periods are associated with more complex dream stories.

E. When people are deprived of only REM sleep (experimenters will monitor sleepers and then wake them up only during REM sleep), their brains will engage in more and more of it on subsequent nights. They will also become quite irritable, anxious and distracted.

III. Disorders

A. Insomnia: Difficulties falling asleep, remaining asleep, or achieving restorative sleep.

B. Insomnia Disorder: a sleep disorder characterized by chronic or persistent insomnia that is often a result of an underlying physical problem or a psychological disorder, such as depression, substance abuse, or physical illness.

C. Hypersomnolence Disorder: excessive sleep that is unrefreshing (a.k.a. hypersomnia).

1) Suprachiasmic Nucleus (SCN): a tiny structure in the brain that governs the circadian cycle of sleep and wakeful states. The SCN controls the sleep-wake cycle in part by regulating the secretion of the hormone melatonin by the pineal gland.

D. Narcolepsy: sudden attacks of irresistible sleep during the day.

E. Cataplexy: a sudden loss of voluntary muscle control triggered by strong emotional experiences such as joy, crying, anger, extreme fear, or intense laughter.

F. Sleep Paralysis: a temporary state following awakening in which people incapable of moving or talking.

G. Hypnagogic Hallucinations: hallucinations, often frightening, occurring just before the onset of sleep or shortly upon awakening (a.k.a. sleep hallucinations).

H. Obstructive Sleep Apnea: involves repeated episodes during sleep of snorting or gasping for breath, pauses of breath, or abnormally shallow breathing.

I. Parasomnias: sleep disorders involving abnormal behavior patterns associated with partial or incomplete arousals.

J. Sleep Terrors: involve waking up during non-REM sleep in an extreme panic.

K. Sleep Walking Disorder: a non-REM sleep disorder involving persistent and recurring episodes of sleepwalking in adulthood.

L. REM Sleep Behavior Disorder: repeated episodes of acting out one’s dreams during REM sleep either by thrashing about or talking.

M. Nightmare Disorder: a sleep disorder characterized by recurrent awakenings due to frightening nightmares.

N. Sexsomnia: a non-REM sleep disturbance that causes people to engage in sexual acts such as masturbation, fondling, intercourse, and possibly rape while they are asleep.

O. Restless Leg Syndrome: prolonged “crawly” sensations in the legs, accompanied by strong repetitive leg movements that can wake the sleeper.

IV. Treatments for Sleep-Wake Disorders

A. The Biological Approach

B. Cognitive-Behavioral Techniques

C. Stimulus Control