LINKAGES Stress and Psychological Disorders

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Chapter 10 Health, Stress, and Coping
as discussed in the chapter on learning, escape and avoidance tactics deprive people of
the opportunity to learn more adaptive ways of coping with stressful environments,
including college (Cooper et al., 1992). Aggression is another common behavioral
response to stressors. All too often, this response is directed at members of one’s own
family (Polusny & Follette, 1995). So areas devastated by hurricanes and other natural
disasters are likely to see not only suicides, but dramatic increases in reports of domestic violence (Curtis, Miller, & Berry, 2000; Rotton, 1990).
LINKAGES
When do stress responses
become mental disorders?
(a link to Psychological
Disorders)
burnout A pattern of physical and
psychological dysfunctions in response
to continuous stressors.
posttraumatic stress disorder (PTSD)
A pattern of adverse reactions following a traumatic event, commonly
involving reexperiencing the event
through nightmares or vivid memories.
LINKAGES
hysical and psychological stress responses
sometimes appear together in patterns
Stress and Psychological
known as burnout and posttraumatic
stress disorder. Burnout is an increasingly
Disorders
intense pattern of physical and psychological
dysfunction in response to a continuous flow
of stressors or to chronic stress (Maslach, 2003). As burnout nears, previously reliable
workers or once-attentive spouses become indifferent, disengaged, impulsive, or accident
prone. They miss work frequently; oversleep; perform their jobs poorly; abuse alcohol
or other drugs; and become irritable, suspicious, withdrawn, and depressed (Taylor,
2002). Burnout is particularly common among those who do “people work,” such as
teachers and nurses, and those who perceive themselves as being treated unjustly by
employers (Elovainio, Kivimäki, & Vahtera, 2002; Schultz & Schultz, 2002).
A different pattern of severe stress reactions is illustrated by the case of Mary, a thirtythree-year-old nurse who was raped at knifepoint by an intruder in her apartment. In
the weeks following this trauma, she was fearful about being alone and was preoccupied
with thoughts about the attack and about the risk of it happening again. She installed
additional locks on her doors and windows but experienced difficulty concentrating and
could not immediately return to work. The thought of sex repelled her.
Mary suffered from posttraumatic stress disorder (PTSD), a pattern of severe
negative reactions following a traumatic event. Among the characteristic reactions are
anxiety, irritability, jumpiness, inability to concentrate or work productively, sexual dysfunction, and difficulty in getting along with others. PTSD sufferers also experience
sleep disturbances, intense startle responses to noise or other sudden stimuli, and longterm suppression of their immune systems (e.g., Goenjian et al., 2001; Guthrie &
Bryant, 2005; Johnson et al., 2002; Kawamura, Kim, & Asukai, 2001). High-tech scanning techniques reveal that PTSD symptoms are accompanied by noticeable changes in
brain functioning, and even in brain structure (Kitayama et al., 2005). The most common feature of posttraumatic stress disorder is reexperiencing the trauma through
nightmares or vivid memories. In rare cases, flashbacks occur in which the person
behaves for minutes, hours, or days as if the trauma were occurring again.
Posttraumatic stress disorder is usually associated with events such as war, rape, terrorism, assault, or abuse in childhood (e.g., Galea, Ahern, et al., 2002; Galea, Resnick,
et al, 2002; Goldberg & Garno, 2005; Shalev & Freedman, 2005; Shalev et al., 2006), but
researchers now believe that some PTSD symptoms can be triggered by any major
stressor, from car accidents to being stalked (Ironson et al., 1997; Kamphuis &
Emmelkamp, 2001). PTSD may appear immediately following a trauma, or it may not
occur until weeks, months, or even years later (Gilboa-Schechtman & Foa, 2001; Heim
et al., 2000; Port, Engdahl, & Frazier, 2001). Many people affected by PTSD require professional help, although some seem to recover without it (Bradley et al., 2005; Perkonigg
et al., 2005). For most, improvement takes time; for nearly all, the support of family
and friends is vital to recovery (Foa et al., 1999; Foa et al., 2005; LaGreca et al., 1996).
For some people, though, PTSD never appears, even after severe trauma (Breslau et al.,
2005). Researchers are working to discover what protective factors are operating in these
individuals and whether those factors can be strengthened through PTSD treatment
programs (Yehuda et al., 2005).
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