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Novaco+P102++2010+lecture+3+notes - Clinical Distress The...

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Abnormal Behavior Raymond W. Novaco University of California, Irvine Stress, Anxiety, PTSD, and Dissociative Disorders P102, Fall 2010 Clinical Distress The Scream” Edvard Munch, 1893 De-Institutionalization and Community Mental Health checkbld the demise of asylums recognition of detriments of institutionalization advent of new psychotropic medications costs of institutional care prevention zeitgeist checkbld the Community Mental Health Center movement recognition of environmental forces in affecting disorder large scale efforts to supplant state hospitals began during Kennedy administration in 1960s major implementation during Johnson years with the construction of CMHC around the country mental health professionals providing clinical, consultative, preventive, and research evaluative services emphasis on access, affordability, normalization A Promise as Yet Unfulfilled: Lack of community support Psychiatric homeless population Active community resistance Lack of public housing Limits of psychotropic drugs Deinstitutionalization and Community-Based Care Prevention of Disorder Primary -- prevention of incidence of disorder • reducing/blocking exposure to pathogen/stressor • increasing coping resources Secondary -- reducing duration of disorder • early detection • provision of remedial care Tertiary -- reduction of residual defect of disorder • provides supplementary care to facilitate readjustment • continued monitoring and maintenance of treatment Alternatively: Prevention, Treatment, Rehabilitation Steps to Preventive Interventions
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Human Stress Stress ” is an engineering metaphor barb4right what happens before something collapses In Psychology: “stress” is a hypothetical construct checkbld a condition of the organism or system that signifies a state of imbalance between demands and resources checkbld it is defined in terms of the associations between: • environmental demands -- stressors and • adverse health and behavioral consequences -- stress reactions resulting from exposure to those demands checkbld the connection between “stressors” and “stress reactions” is characterized by sequences of reciprocal relationships between environmental elements/conditions and person attributes/behavior Human Stress - background Very Abbreviated Early History: Cannon (1914-35): changes in bodily states associated with pain, fear, hunger, and rage “emotional stress” Selye (1935-78): the father of stress research “stress” as condition of organism; non-specific response to any demand in 1950 introduced “stressor” concept for evocative agents also, “general adaptation syndrome” and triparte stress response • adrenocortical enlargement • shrinkage of lymphatic structures • gastrointestinal disturbances Dohrenwend (1961): concept of psychological stress emerges person’s effort to reduce internal and external constraints Lazarus (1966) landmark bk: threat, appraisal, and coping Major Glands of the Endocrine System
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