Tag: Response

What is Eustress?

Published on by Andrew Marshall3 Comments

Introduction

Eustress means beneficial stress – either psychological, physical (e.g. exercise), or biochemical/radiological (hormesis).

The term was coined by endocrinologist Hans Selye, consisting of the Greek prefix eu- meaning “good”, and stress, literally meaning “good stress”.

It is the positive cognitive response to stress that is healthy, or gives one a feeling of fulfillment or other positive feelings. Selye created the term as a subgroup of stress to differentiate the wide variety of stressors and manifestations of stress.

Eustress is not defined by the stress or type, but rather how one perceives that stressors (e.g. a negative threat versus a positive challenge). Eustress refers to a positive response one has to a stressor, which can depend on one’s current feelings of control, desirability, location, and timing of the stressor. Potential indicators of eustress may include responding to a stressor with a sense of meaning, hope, or vigour. Eustress has also been positively correlated with life satisfaction and well-being.

Refer to Distress.

Definition

Eustress occurs when the gap between what one has and what one wants is slightly pushed, but not overwhelmed. The goal is not too far out of reach but is still slightly more than one can handle. This fosters challenge and motivation since the goal is in sight. The function of challenge is to motivate a person toward improvement and a goal. Challenge is an opportunity-related emotion that allows people to achieve unmet goals. Eustress is indicated by hope and active engagement. Eustress has a significantly positive correlation with life satisfaction and hope. It is typically assumed that experiencing chronic stress, either in the form of distress or eustress, is negative. However, eustress can instead fuel physiological thriving by positively influencing the underlying biological processes implicated in physical recovery and immunity.

Measurement

Occupational eustress may be measured on subjective levels such as of quality of life or work life, job pressure, psychological coping resources, complaints, overall stress level, and mental health. Other subjective methodological practices have included interviews with focus groups asking about stressors and stress level. In one study participants were asked to remember a past stressful event and then answer questionnaires on coping skills, job well-being, and appraisal of the situation (viewing the stressful event as a challenge or a threat). Common subjective methodologies were incorporated in a holistic stress model created in 2007 to acknowledge the importance of eustress, particularly in the workplace. This model uses hope, positive affect, meaningfulness, and manageability as a measure of eustress, and negative psychological states, negative affect, anxiety, and anger as a measure of distress. Objective measures have also been used and include blood pressure rate, muscle tension, and absenteeism rates. Further physiological research has looked for neuroendocrine changes as a result of eustress and distress. Research has shown that catecholamines change rapidly to pleasurable stimuli. Studies have demonstrated that eustress and distress produce different responses in the neuroendocrine system, particularly dependent on the amount of personal control one feels over a stressor.

Compared with Distress

Distress is the most commonly referred to type of stress, having negative implications, whereas eustress is usually related to desirable events in a person’s life. Selye first differentiated the two in an article he wrote in 1975. In this article Selye argued that persistent stress that is not resolved through coping or adaptation should be known as distress, and may lead to anxiety, withdrawal, and depressive behaviour. In contrast, if stress enhances one’s functioning it may be considered eustress. Both can be equally taxing on the body, and are cumulative in nature, depending on a person’s way of adapting to the stressor that caused it. The body itself cannot physically discern between distress or eustress. Differentiation between the two is dependent on one’s perception of the stress, but it is believed that the same stressor may cause both eustress and distress. One context that this may occur in is societal trauma (e.g. the black death, World War II) which may cause great distress, but also eustress in the form of hardiness, coping, and fostering a sense of community. The Yerkes–Dodson model demonstrates the optimum balance of stress with a bell curve (shown in the image in the top right).[17] This model is supported by research demonstrating emotional-coping and behavioural-coping strategies are related to changes in perceived stress level on the Yerkes-Dodson Curve. However, the Yerkes-Dodson Curve has become increasingly questioned. A review of the psychological literature pertaining work performance, found that less than 5% of papers supported the inverted U-shaped curve whereas nearly 50% found a “negative linear” relationship (any level of stress inhibits performance).

Occupational

Much of the research on eustress has focused on its presence in the workplace. In the workplace, stress can often be interpreted as a challenge, which generally denotes positive eustress, or as a hindrance, which refers to distress that interferes with one’s ability to accomplish a job or task.

Research has focused on increasing eustress in the workplace, in an effort to promote positive reactions to an inevitably stressful environment. Companies are interested in learning more about eustress and its positive effects to increase productivity. Eustress creates a better environment for employees, which makes them perform better and cost less. Occupational stress costs the United States somewhere in between 200 and 300 billion dollars per year. If this were eustress instead of distress, these companies would retain this money and the US economy could improve as well. Stress has also been linked to the six leading causes of death: “disease, accidents, cancer, liver disease, lung ailments, suicide.” If workers get sick and/or die, there is obviously a cost to the company in sick time and training new employees. It is better to have productive, happy employees. Eustress is necessary for achievement. Eustress is related to well-being and positive attitudes and thus increases work performance.

Techniques such as Stress Management Interventions (SMI) have been employed to increase occupational eustress. SMI’s often incorporate exercise, meditation, and relaxation techniques to decrease distress and increase positive perceptions of stress in the workplace. Rather than decrease stress in the workplace, SMI techniques attempt to increase eustress with positive reactions to stressful stimuli.

Self-Efficacy

Eustress is primarily based on perceptions. It is how you perceive your given situation and how you perceive your given task. It is not what is actually happening, but a person’s perception of what is happening. Eustress is thus related to self-efficacy. Self-efficacy is one’s judgement of how they can carry out a required task, action or role. Some contributing factors are a person’s beliefs about the effectiveness about their options for courses of action and their ability to perform those actions. If a person has low self-efficacy, they will see the demand as more distressful than eustressful because the perceived level of what the person has is lower. When a person has high self-efficacy, they can set goals higher and be motivated to achieve them. The goal then is to increase self-efficacy and skill in order to enable people to increase eustress.

Flow

When an individual appraises a situation as stressful, they add the label for distress or eustress to the issue at hand. If a situation induces eustress, the person may feel motivated and can experience flow. Positive psychologist, Mihaly Csikszentmihalyi, created this concept which is described as the moments when one is completely absorbed into an enjoyable activity with no awareness of surroundings. Flow is an extremely productive state in which an individual experiences their prime performance. The core elements are absorption, enjoyment and intrinsic motivation.

Flow is the “ultimate eustress experience – the epitome of eustress”. Hargrove, Nelson and Cooper described eustress as being focused on a challenge, fully present and exhilarated, which almost exactly mirrors the definition of flow. Flow is considered a peak experience or “the single most joyous, happiest, most blissful moment of your life.”

Factors

There are several factors that may increase or decrease one’s chances of experiencing eustress and, through eustress, experiencing flow:

  • Stress is also influenced by hereditary predispositions and expectations of society. Thus, a person could already be at a certain advantage or disadvantage toward experiencing eustress.
  • If a person enjoys experiencing new things and believes they have importance in the world, they are more likely to experience flow.
  • Flow is negatively related to self-directedness, or an extreme sense of autonomy.
  • Persistence is positively related to flow and closely related to intrinsic motivation.
  • People with an internal locus of control, have an increased chance of flow because they believe they can increase their skill level to match the challenge.
  • Perfectionism, however, is negatively related to flow. A person downplays their skill levels therefore making the gap too big, and they perceive the challenge to be too large to experience flow. On the opposite end of perfectionism, however, there are increased chances of flow.
  • Active procrastination is positively related to flow. By actively delaying work, the person increases the challenge. Then once the challenge is matched with the person’s high skill levels, the person can experience flow. Those who passively procrastinate or do not procrastinate do not have these same experiences. It is only with the purposeful procrastination that a person is able to increase the challenge.
  • Mindset is a significant factor in determining distress versus eustress. Optimistic people and those with high self-esteem contribute to eustress experiences. The positive mindset increases the chances of eustress and a positive response to stressors. Currently, the predominant mindset toward stress is that stress is debilitating. However, mindsets toward stress can be changed.

This page is based on the copyrighted Wikipedia article <https://en.wikipedia.org/wiki/Eustress >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Acute Stress Disorder?

Published on by Andrew Marshall2 Comments

Introduction

Acute stress disorder (ASD, also known as acute stress reaction, psychological shock, mental shock, or simply shock) is a psychological response to a terrifying, traumatic or surprising experience.

It may bring about delayed stress reactions (better known as post-traumatic stress disorder, PTSD) if not correctly addressed.

Refer to Combat Stress Reaction.

Plutchik Wheel
Plutchik Dyads

Brief History

The term “acute stress disorder” was first used to describe the symptoms of soldiers during World War I and II, and it was therefore also termed “combat stress reaction” (CSR). Approximately 20% of US troops displayed symptoms of CSR during WWII. It was assumed to be a temporary response of healthy individuals to witnessing or experiencing traumatic events. Symptoms include depression, anxiety, withdrawal, confusion, paranoia, and sympathetic hyperactivity.

The American Psychological Association (APA) officially included the term ASD in the DSM-IV in 1994. Before that, symptomatic individuals within the first month of trauma were diagnosed with adjustment disorder. According to the DSM-IV, acute stress reaction refers to the symptoms experienced immediately to 48 hours after exposure to a traumatic event. In contrast, acute stress disorder is defined by symptoms experienced 48 hours to one month following the event. Symptoms experienced for longer than one month are consistent with a diagnosis of PTSD.

Initially, being able to describe different ASRs was one of the goals of introducing ASD. Some criticisms surrounding ASD’s focal point include issues with ASD recognising other distressing emotional reactions, like depression and shame. Emotional reactions similar to these may then be diagnosed as adjustment disorder under the current system of trying to diagnose ASD.

Since its addition to the DSM-IV, questions about the efficacy and purpose of the ASD diagnosis have been raised. The diagnosis of ASD was criticised as an unnecessary addition to the progress of diagnosing PTSD, as some considered it more akin to a sign of PTSD than an independent issue requiring diagnosis. Also, the terms ASD and ASR have been criticised for not fully covering the range of stress reactions.

Types of ASD

Sympathetic (also known as “Fight or Flight” Response)

Sympathetic acute stress disorder is caused by the release of excessive adrenaline and norepinephrine into the nervous system. These hormones may speed up a person’s pulse and respiratory rate, dilate pupils, or temporarily mask pain. This type of ASD developed as an evolutionary advantage to help humans survive dangerous situations. The “fight or flight” response may allow for temporarily-enhanced physical output, even in the face of severe injury. However, other physical illnesses become more difficult to diagnose, as ASD masks the pain and other vital signs that would otherwise be symptomatic.

Parasympathetic

Parasympathetic acute stress disorder is characterised by feeling faint and nauseous. This response is fairly often triggered by the sight of blood. In this stress response, the body releases acetylcholine. In many ways, this reaction is the opposite of the sympathetic response, in that it slows the heart rate and can cause the patient to either regurgitate or temporarily lose consciousness. The evolutionary value of this is unclear, although it may have allowed for prey to appear dead to avoid being eaten.

Signs and Symptoms

The DSM-IV specifies that acute stress disorder must be accompanied by the presence of dissociative symptoms, which largely differentiates it from PTSD.

Dissociative symptoms include a sense of numbing or detachment from emotional reactions, a sense of physical detachment – such as seeing oneself from another perspective – decreased awareness of one’s surroundings, the perception that one’s environment is unreal or dreamlike, and the inability to recall critical aspects of the traumatic event (dissociative amnesia).

In addition to these characteristics, ASD can be present in the following four distinct symptom clusters;

  • Intrusion symptom cluster:
    • Recurring and distressing dreams, flashbacks, and/or memories related to the traumatic event.
    • Intense/prolonged psychological distress or somatic reactions to internal or external traumatic cues.
  • Negative mood cluster:
    • A persistent inability to experience positive emotions such as happiness, loving feelings, or satisfaction.
  • Avoidance symptom cluster:
    • The avoidance of distressing memories, thoughts, feelings (or external reminders of them) that are closely associated with the traumatic event.
  • Arousal symptom cluster:
    • Sleep disturbances, hyper-vigilance, difficulties with concentration, easily startled, and irritability/anger/aggression.

Potential Developments

There are a number of issues that can arise from acute stress. Depression, anxiety, mood disorders, and substance abuse problems can develop from acute stress. Untreated ASD can also lead to the development of PTSD.

Causes

There are several theoretical perspectives on trauma response, including cognitive, biological, and psycho-biological. While PTSD-specific, these theories are still useful in understanding acute stress disorder, as the two disorders share many symptoms. A recent study found that even a single stressful event may have long-term consequences on cognitive function. This result calls the traditional distinction between the effects of acute and chronic stress into question.

Pathophysiology

Stress is characterised by specific physiological responses to adverse or noxious stimuli.

Hans Selye was the first to coin the term “general adaptation syndrome” to suggest that stress-induced physiological responses proceed through the stages of alarm, resistance, and exhaustion.

The sympathetic branch of the autonomic nervous system gives rise to a specific set of physiological responses to physical or psychological stress. The body’s response to stress is also termed a “fight or flight” response, and it is characterised by an increase in blood flow to the skeletal muscles, heart, and brain, a rise in heart rate and blood pressure, dilation of pupils, and an increase in the amount of glucose released by the liver.

The onset of an acute stress response is associated with specific physiological actions in the sympathetic nervous system, both directly and indirectly through the release of adrenaline and, to a lesser extent, noradrenaline from the medulla of the adrenal glands. These catecholamine hormones facilitate immediate physical reactions by triggering increases in heart rate and breathing, constricting blood vessels. An abundance of catecholamines at neuroreceptor sites facilitates reliance on spontaneous or intuitive behaviours often related to combat or escape.

Normally, when a person is in a serene, non-stimulated state, the firing of neurons in the locus ceruleus is minimal. A novel stimulus, once perceived, is relayed from the sensory cortex of the brain through the thalamus to the brain stem. That route of signalling increases the rate of noradrenergic activity in the locus ceruleus, and the person becomes more alert and attentive to their environment.

If a stimulus is perceived as a threat, a more intense and prolonged discharge of the locus ceruleus activates the sympathetic division of the autonomic nervous system. The activation of the sympathetic nervous system leads to the release of norepinephrine from nerve endings acting on the heart, blood vessels, respiratory centres, and other sites. The ensuing physiological changes constitute a major part of the acute stress response. The other major player in the acute stress response is the hypothalamic-pituitary-adrenal axis. Stress activates this axis and produces neuro-biological changes. These chemical changes increase the chances of survival by bringing the physiological system back to homeostasis.

The autonomic nervous system controls all automatic functions in the body and contains two subsections within it that aid the response to an acute stress reaction. These two subunits are the sympathetic nervous system and the parasympathetic nervous system. The sympathetic response is colloquially known as the “fight or flight” response, indicated by accelerated pulse and respiration rates, pupil dilation, and a general feeling of anxiety and hyper-awareness. This is caused by the release of epinephrine and norepinephrine from the adrenal glands. The epinephrine and norepinephrine strike the beta receptors of the heart, which feeds the heart’s sympathetic nerve fibres to increase the strength of heart muscle contraction; as a result, more blood gets circulated, increasing the heart rate and respiratory rate. The sympathetic nervous system also stimulates the skeletal system and muscular system to pump more blood to those areas to handle the acute stress. Simultaneously, the sympathetic nervous system inhibits the digestive system and the urinary system to optimise blood flow to the heart, lungs, and skeletal muscles. This plays a role in the alarm reaction stage. The parasympathetic response is colloquially known as the “rest and digest” response, indicated by reduced heart and respiration rates, and, more obviously, by a temporary loss of consciousness if the system is fired at a rapid rate. The parasympathetic nervous system stimulates the digestive system and urinary system to send more blood to those systems to increase the process of digestion. To do this, it must inhibit the cardiovascular system and respiratory system to optimise blood flow to the digestive tract, causing low heart and respiratory rates. The parasympathetic nervous system plays no role in acute stress response.

Studies have shown that patients with acute stress disorder have overactive right amygdalae and prefrontal cortices; both structures are involved in the fear-processing pathway.

Diagnosis

According to the DSM-V, symptom presentation must last for three consecutive days to be classified as acute stress disorder. If symptoms persist past one month, the diagnosis of PTSD is explored. There must be a clear temporal connection between the impact of an exceptional stressor and the onset of symptoms; onset is usually within a few minutes or days but may occur up to one month after the stressor. Also, the symptoms show a mixed and rapidly changing picture; although “daze” depression, anxiety, anger, despair, hyper-activity, and withdrawal may all be seen, no one symptom dominates for long. The symptoms usually resolve rapidly where removal from the stressful environment is possible. In cases where the stress continues, the symptoms usually begin to diminish after 24-48 hours and are usually minimal after about three days.

Evaluation of patients is done through close examination of emotional response. Using self-report from patients is a large part of diagnosing ASD, as acute stress is the result of reactions to stressful situations.

The DSM-V specifies that there is a higher prevalence rate of ASD among females compared to males due to higher risk of experiencing traumatic events and neurobiological gender differences in stress response.

Treatment

This disorder may resolve itself with time or may develop into a more severe disorder, such as PTSD. However, results of Creamer, O’Donnell, and Pattison’s (2004) study of 363 patients suggests that a diagnosis of acute stress disorder had only limited predictive validity for PTSD. Creamer et al. found that re-experiences of the traumatic event and arousal were better predictors of PTSD. Early pharmacotherapy may prevent the development of post-traumatic symptoms. Additionally, early trauma-focused cognitive behavioural therapy (TF-CBT) for those with a diagnosis of ASD can protect an individual from developing chronic PTSD.

Studies have been conducted to assess the efficacy of counselling and psychotherapy for people with acute stress disorder. Cognitive behavioural therapy, which includes exposure and cognitive restructuring, was found to be effective in preventing PTSD in patients diagnosed with acute stress disorder with clinically significant results at six-month follow-up appointments. A combination of relaxation, cognitive restructuring, imaginal exposure, and in-vivo exposure was superior to supportive counselling. Mindfulness-based stress reduction programmes also appear to be effective for stress management.

The pharmacological approach has made some progress in lessening the effects of ASD. To relax patients and allow for better sleep, Prazosin can be given to patients, which regulates their sympathetic response. Hydrocortisone has shown some success as an early preventative measure following a traumatic event, typically in the treatment of PTSD.

In a wilderness context where counselling, psychotherapy, and cognitive behavioural therapy is unlikely to be available, the treatment for acute stress reaction is very similar to the treatment of cardiogenic shock, vascular shock, and hypovolemic shock; that is, allowing the patient to lie down, providing reassurance, and removing the stimulus that prompted the reaction. In traditional shock cases, this generally means relieving injury pain or stopping blood loss. In an acute stress reaction, this may mean pulling a rescuer away from the emergency to calm down or blocking the sight of an injured friend from a patient.

This page is based on the copyrighted Wikipedia article <https://en.wikipedia.org/wiki/Acute_stress_disorder >; it is used under the Creative Commons Attribution-ShareAlike 3.0 Unported License (CC-BY-SA). You may redistribute it, verbatim or modified, providing that you comply with the terms of the CC-BY-SA.

What is Functional Analysis (Psychology)?

Published on by Andrew MarshallLeave a comment

Introduction

Functional analysis in behavioural psychology is the application of the laws of operant and respondent conditioning to establish the relationships between stimuli and responses.

To establish the function of operant behaviour, one typically examines the “four-term contingency”: first by identifying the motivating operations (EO or AO), then identifying the antecedent or trigger of the behaviour, identifying the behaviour itself as it has been operationalised, and identifying the consequence of the behaviour which continues to maintain it.

Functional assessment in behaviour analysis employs principles derived from the natural science of behaviour analysis to determine the “reason”, purpose, or motivation for a behaviour. The most robust form of functional assessment is functional analysis, which involves the direct manipulation, using some experimental design (e.g. a multielement design or a reversal design) of various antecedent and consequent events and measurement of their effects on the behaviour of interest; this is the only method of functional assessment that allows for demonstration of clear cause of behaviour.

Applications in Clinical Psychology

Functional analysis and consequence analysis are commonly used in certain types of psychotherapy to better understand, and in some cases change, behaviour. It is particularly common in behavioural therapies such as behavioural activation, although it is also part of Aaron Beck’s cognitive therapy. In addition, functional analysis modified into a behaviour chain analysis is often used in dialectical behaviour therapy.

There are several advantages to using functional analysis over traditional assessment methods. Firstly, behavioural observation is more reliable than traditional self-report methods. This is because observing the individual from an objective stand point in their regular environment allows the observer to observe both the antecedent and the consequence of the problem behaviour. Secondly, functional analysis is advantageous as it allows for the development of behavioural interventions, either antecedent control or consequence control, specifically designed to reduce a problem behaviour. Thirdly, functional analysis is advantageous for interventions for young children or developmentally delayed children with problem behaviours, who may not be able to answer self-report questions about the reasons for their actions.

Despite these benefits, functional analysis also has some disadvantages. The first that no standard methods for determining function have been determined and meta-analysis shows that different methodologies appear to bias results toward particular functions as well as not effective in improving outcomes. Second, Gresham and colleagues (2004) in a meta-analytic review of JABA articles found that functional assessment did not produce greater effect sizes compared to simple contingency management programmes. However, Gresham et al. combined the three types of functional assessment, of which descriptive assessment and indirect assessment have been reliably found to produce results with limited validity Third, although functional assessment has been conducted with a variety host of populations much of the current functional assessment research has been limited to children with developmental disabilities.

Professional Organisations

The Association for Behavioural and Cognitive Therapies (ABCT) also has an interest group in behaviour analysis, which focuses on the use of behaviour analysis in the school setting including functional analysis.

Doctoral level behaviour analysts who are psychologists belong to the American Psychological Association’s division 25 – Behaviour analysis. APA offers a diplomate in behavioural psychology and school psychology both of which focus on the use of functional analysis in the school setting.

The World Association for Behaviour Analysis offers a certification for clinical behaviour therapy and behavioural consultation, which covers functional analysis.

The UK Society for Behaviour Analysis also provides a forum for behaviour analysts for accreditation, professional development, continuing education and networking, and serves as an advocate body in public debate on issues relating to behaviour analysis. The UK-SBA promotes the ethical and effective application of the principles of behaviour and learning to a wide range of areas including education, rehabilitation and health care, business and the community and is committed to maintaining the availability of high-quality evidence-based professional behaviour analysis practice in the UK. The society also promotes and supports the academic field of behaviour analysis with in the UK both in terms of university-based training and research, and theoretical develop.