Stress 10

-How can these meanings lead to more stress?

*Stress - When there is incongruence between your situational & global meanings

Ellis' Rational Emotive Therapy (REBT) - Techniques used to dispute maladaptive beliefs

. COGNITIVE RESTRUCTURING - Reframing views, beliefs, thoughts - Several techniques toward A. Ellis' Rational Emotive Therapy (REBT) - ABCD Model A = Antecedent (event) B = Beliefs about the event C = Emotional consequences of beliefs D = Disputing maladaptive beliefs 1. Disputing techniques - -Challenging & debating -have client research & bring in evidence -Biblio therapy -Role playing

The Penn Optimism Program - What was it? What did it accomplish?

2. The Penn Optimism Program (Seligman et al. 1995). a. Trained at risk children optimistic attributions. - Children at risk of depression - showed fewer depressive symptoms after the program. And after 2 years continued with fewer depressive symptoms - Also found effective At reducing depressive symptoms in Latino & Chinese American children

Religious coping: Studies on its effectiveness & proposed reasons for effectiveness

2. Turning to Religion - religious coping - Did not distinctively load on any one of the 4 factors. 1. Studies have found: It yields Positive health & well-being outcomes - Park Study - amongst bereaved college students - Association between religious coping & well-being was mediated by positive re-appraisal coping (meaning-making coping) - Some also propose it is mediated by Social support & emotion-focused coping 2. Maladaptive Religious Coping - Reflects "religious struggle" e.g., "Questioned god's love for me" - Pargament et al. study - medically ill patients - - This type of religious coping - lead to higher mortality rates. 3. Absolute Best Coping: - Many agree - have several strategies available & be flexible in applying them.

Acceptance Commitment Therapy (ACT) - Know the core principles

ACCEPTANCE COMMITMENT THERAPY (ACT) A. ACT Steve Hayes - Accept your reactions & be present with yourself. - Choose a valued direction - Take action now toward those values B. Core Principles of ACT 1. Acceptance - Accept thoughts/feelings - good or bad 2. Cognitive Defusion - Realize thoughts/feelings are just that -nothing more 3. Being Present - Not try to avoid feelings/thoughts - be present with them in the moment 4. Self as Context - Be an observer of thoughts/feelings 5. Valuing - - Establish your true values & not goals - Similar to "living authentically" 6. Committed Action - - Move forward toward things you truly value.

-How can you cope with the stress caused by incongruence?

Coping with Incongruence & Stress - seek to make them congruent 1. Adjust Situational Meaning - How person interprets stressor e.g., Maybe without all the chaos/dissension family can get closer & happier. 2. Adjust Global Meaning - e.g., "Families do not always stay together; two-parent families are a thing of the past." - Successful Coping: Change global or situational meaning or both- reduces incongruence & reduces stress - Unsuccessful Coping: Fail to resolve the incongruence - can lead to rumination & brooding - try to make sense when cannot 3. Example - John Walsh & America's Most Wanted - lost his son to a sexual predator, & went on to spearhead this program which caught several criminals & predators. - Changed - both situational & global meanings

-Situational meanings vs. Global beliefs & meanings

B. Situational Experience & Situational Meaning - A stressful situation that significantly challenges us & our interpretation of the situation What it means to us ->important e.g., Divorce - parents are splitting, everything is changing C. Global Beliefs & Meanings - Overall beliefs about the world, coherence, predictability, families, etc. e.g., Families- always there for you - stay together-"safe place"

The effectiveness of Avoidance Coping - What are the benefits? Shortcomings?

C. Avoidance e.g., Avoid dealing with a stressor either physically or mentally. 1. Effectiveness of Avoidance Coping - For minor or transient stressors - maybe adaptive -prevents from undue physiological arousal. - For longer term more serious stressors - less adaptive - Only delays consequences - Prevents the process of positive growth from the experience

Thought-stopping

C. Thought-Stopping - Literally stop/interrupt recurrent thoughts 1. First Teach to recognize thoughts 2. Then, derive counter thoughts-alternative. Stop self when automatic thoughts come.

Beck's Cognitive Errors - Be able to recognize the different errors (Text & class)

D. Beck's Cognitive Errors - As spoken of before These automatic negative thoughts tend to follow particular dysfunctional patterns that produce systematic errors of thinking, in other words, cognitive processing styles that are distorted, biased, or illogical. As discussed in Chapter 7, such errors include (1) arbitrary inference through drawing conclusions without supportive evidence, (2) selective abstraction through focusing on a detail that ignores the more important big picture, (3) overgeneralization through drawing sweeping conclusions based on limited information, (4) dichotomous thinking through thinking in black or white terms rather than shades of gray, (5) magnification and minimization through exaggerating small events or trivializing big events, and (6) personalization through taking responsibility for events that are not under one's control. Using Beck's approach to cognitive restructuring we can ask basic

Dialectical Behavior Therapy (DBT) - How does it work? How similar/different from ACT?

DIALECTICAL BEHAVIOR THERAPY (DBT) "Dialectic" - Acceptance & change A. Mindfulness - core concept - Be in the moment, but not swept away be emotions - Observe emotions without acting impulsively on them B. Acceptance & Self-Soothing - Learn to validate own emotions - Learn to soothe themselves - E.g., use of music, relaxation training, imagery C. Commitment - Commit to more positive & less emotionally charged (& damaging) behaviors

James Pennebaker's work with expressive writing: Earlier findings & recent effectiveness studies

EXPRESSIVE WRITING A. James Pennebaker - wrote (and talked) expressively about stressors/trauma - 1. Findings: - Fewer health care visits- - Immune system increases B. Overall effectiveness studies: Modest effects 1. Smyth & Pennebaker (2008) - Reviewed multiple studies a. Concluded: (1) Writing about positive experiences is also helpful (2) Writing does not have to be for days - just one day- benefits (3) No one single process completely explains why there are benefits.

The Goodness of Fit Model: What does it say?

Goodness of Fit Hypothesis 1. Either strategy may be adaptive depending on the situation e.g., - problem focused is better when there is something you can do -Emotion focused is better when nothing can be done.

Humor as coping: Types of humor associated with positive & negative psychological well-being

HUMOR A. Normal Cousins - "Anatomy of an Illness" - Ankylosing spondylitis - autoimmune disorder (painful) - Watched humorous videos -> Relief of symptoms & regained some function B. Subsequent studies: No real strong support 1. Problems with studies - -Artificial lab conditions -No real way of determining true laughter -Methodological weaknesses. C. Coping Humor - Using humor to cope with stress - - Received more empirical support -Associated with several positive outcomes - Types of humor important: - Positive psychological well-being - (1) Affiliative humor- (2) Self-enhancing humor - Negative psychological well-being - (1) Self-defeating humor (2) Belabored humor (forced humor)

Problem-Focused Coping vs. Emotion-Focused Coping

I. BROAD-BASED COPING STRATEGIES (Folkman & Lazarus) A. Problem-Focused Coping 1. Deals with the problem - either mentally or physically B. Emotion-Focused Coping 1. Deals with the distress caused by the stressor - either mentally or physically

Active Cognitive vs. Active Behavioral Coping

II. THREE CATEGORIES OF COPING MODEL (Billings & Moos) A. Active Cognitive e.g., planning on how to deal with stressor -active mental strategy B. Active Behavioral e.g., - work toward an actual solution to a stressor - active physical strategy

Meaning-Making Coping - What is it?

MEANING-MAKING COPING - A fourth strategy (Park & Folkman) A. What is it? - Derive meaning from stressful situation for which active coping is not possible

The Cope measure of stress: What are the derived 4 general factors?

MEASUREMENT OF COPING A. Difficulties with Measurement - Subjective to retrospective reporting bias - Establishment of most important types of coping - To determine how to breakdown the different types B. The COPE Scale - 1. Subscales - 14 dimensions of coping. a. Factor analysis - derived 4 general factors (1) Problem-focused - Active coping, planning, restraint coping. (2) Emotion-focused - Denial, mental disengagement, drug & alcohol use. (3) Social Support - Seeking social support for instrumental & emotional reasons (4) Meaning-making - Positive interpretation & growth, acceptance

Pets as coping: What are the positive effects?

PETS A. Positive Effects: (1) Lower blood pressure (2) Lower heart rate (3) Better arousal response to acute stress (4) Can increase the oxytocin levels in both males & females B. Nonevaluative Social Support - unconditional social support "unconditional positive regard"

Stress Inoculation Training - Proposed reasons for its effectiveness

STRESS INOCULATION TRAINING (SIT) - AKA Cognitive Rehearsal A. Target: Reduces stress for an upcoming stressor or an extreme current stress. B. Phases of Treatment: 1. Conceptualization Phase - Work with patient to reconceptualize the upcoming stressor, or current stressor, view it more realistically & as a challenge rather than threat. - Break down global stressor - Into short & long-term coping goals. 2. Skills Acquisition & Rehearsal - Work toward training in skills necessary for the client in this situation - e.g., Relaxation training, assertiveness training, use of social support, self-soothing techniques - Client rehearses these new skills in clinic & in vivo 3. Application & Follow Through - Client applies what was learned in increasing levels of stress. - Client applies using - Imagery, behavioral rehearsal, role-playing, - progressive exposure. C. Usefulness of SIT - 1. Currently used with: - Medical pts' undergoing procedures - PTSD pt's - Performance anxiety - Professional groups - Stressful life transitions (e.g., unemployment, applying for jobs, going back to school, moving to a new setting, etc.) *Important: Increases predictability!! Decreases anxiety Increase self-efficacy

Pessimistic vs. optimistic explanatory styles - how do they differ on the 3 dimensions of causal attributions?

VII. LEARNED OPTIMISM (vs. Learned Helplessness) A. Seligman - "People can learn to be optimistic" - 1. Causal attributions - to what do we attribute outcomes/stressors? 2. 3 Dimensions: (1) Stable/unstable (2) Global/specific (3) Internal/external 3. Pessimistic explanatory style - e.g., "I got a bad grade because I'm not smart at anything" attributes it to stable, personal, global, short comings. 4. Optimistic explanatory style - e.g., "I got a bad grade this time because this material is just not my strong suit" Attributes it to a temporary, external, specific circumstance B. Training Techniques 1. Rational Emotive Behavioral Therapy (REBT - ABCD Model) Change thoughts involved with attributions