difficulties

• Four causes of stress

  -Frustration

  -Conflict

  -Change

  -Pressure
• Types of conflict


  -The approach-approach

  -The avoidance-avoidance

  -The approach-avoidance
• The approach-approach conflict


  Choose between two positive competing alternatives
• The avoidance-avoidance conflict


  Choose between two really unattractive possibilities
• The approach-avoidance conflict


  NOT about a choice between two different behaviours.

  
  

  A choice about a goal or behaviour that has positive AND negative aspects to it.
• Social Readjustment Rating Scale: First 10 items

  1) Marriage

  2) Troubles with the boss

  3) Detention in jail or other institution

  4) Death of spouse

  5) Major change in sleeping habits

  6) Death of a close family member

  7) Major change in eating habits

  8) Foreclosure on a mortgage or loan

  9) Revision of personal habits

  10) Death of a close friend
• Emotional responses from stress

  Annoyance

  Anger

  Rage

  Apprehension

  Anxiety

  Fear

  Dejection

  Sadness

  Grief
• Paradoxical problem of strong emotional responses from stress

  Can interfere

  
  

  -Attention

  -Memory

  -Judgment

  -Decision-making
• Physiological response to stress

  -Fight or flight

  -Autonomic Nervous System

  -Tachycardia

  -Hypertension

  -Increased respirations

  -Reduced digestion
• General Adaptation Syndrome's 3 stages

  -Alarm response

  -Resistance stage

  -Exhaustion stage
• Alarm response (first stage)

  -Initial physiological reaction.

  -Cortisol and adrenaline release
• What is "choking under pressure"

  -Performance impairment

  -Elevated self-awareness

  -Elevated self-consciousness

  -Interferes with attention on the task
• Constructive coping involves what factors

  -Task orientated

  -Realistic appraisal

  -Inhibit emotions

  -Eat healthy

  -Sufficient sleep
• PTSD


  -Severe psychological effect

  -Nightmares

  -Flashbacks

  -Reliving the traumatic event

  -Loss of interest in important activities

  -Hypervigilance

  -Difficulty concentrating
• Military stats on PTSD

  -Iraq: 15.6% to 17.1%

  -Afghanistan: 11.2% of those

  -300,000 former military PTSD post war
• Consequences of prolonged stress

  -Sleep disturbances

  -Sexual difficulties

  -Poor academic/work performance

  -Alcohol and drug abuse
• Benefits if strong social support and optimism

  -Stronger immune system

  -More likely to seek support

  -Constructive coping

  -Positive appraisals
• Prevalence of mental disorders (older adults, general population, nursing homes)

  -Older adults: 15-25%

  -General population: 20%

  -Nursing homes: 70-90% (6-7% of population)
• Key risk factors for depression include:

  -Disability

  -Newly diagnosed medical illness

  -Poor health status

  -Poor self-perceived health

  -Prior depression -Bereavement
• Protective factors for depression in elderly include

  -Greater perceived social support

  -Regular physical exercise

  -Higher socioeconomic status
• % of misdiagnosed dementia actually being depression

  20%
• Key risk factors for anxiety include

  -Poor self-rated general health status

  -Physical or sexual abuse in childhood

  -Current smoker.
• Protective factors of anxiety include

  -Greater perceived social support

  -Regular physical exercise

  -Higher level of education.
• Evidence-based psychotherapeutic interventions for anxiety in older adults

  -Cognitive behavioural therapy

  -Relaxation training

  -Supportive therapy
• What type of therapy is used for crisis

  Supportive therapy
• Psychotherapies for older adults with depression:

  -Cognitive behavioural therapy

  -Interpersonal psychotherapy

  -Problem-solving therapy

  -Brief psychodynamic psychotherapy
• Stats: Bipolar and Schizophrenia in elderly females


  -Females 2-3x more than males
• Stats: Schizophrenia early onset compared to older onset

  -75% early and mid life onset

  -25% later life onset
• What percentage of all dementias are attributed to Alzheimer's disease?

  50-70%
• Dementia definition


  An acquired syndrome of intellectual impairment produced by brain dysfunction.
• Dementia is characterized by changes in

  -Thinking

  -Personality

  -Behaviour
• Common age of onset dementia

  65
• Prevalence of developing dementia

  6-7%
• World wide stats on dementia

  27-36 million

  2/3 in Developing world
• Psychosocial interventions for people with dementia

  -Activity based therapy

  -Supportive therapy

  -Environmental approaches
• WHO Age friendly city's, Eight dimensions of the living environment are targeted:

  -The built environment

  -Transport

  -Civic participation

  -Communication

  -Community support

  -Social inclusion

  -Social participation

  -Housing

  -Health services

  -Employment

  -Respect
• Stats on Non verbal communication according to Burgoon


  60-66%
• Paul Ekman's six basic emotions

  Happiness.

  Surprise.

  Sadness.

  Fear.

  Disgust.

  And anger.
• Baby's demonstrate fear and disgust what age

  Immediately
• Baby's demonstrate smile at what age

  6-8 weeks