Quality Stress Management Course

The Well Being Way Stress Management Program

What you'll learn in the book is as follows: The Secret Formula I use every day to gain maximum happiness. Over 101 Ways To Reduce Stress. How To Use Your Body to Maximise Your Happiness. The one thing I did in 2010 which made a huge difference to my life which I didn't use for the 2 previous years. How To Deal With Challenging Emotions. The key to building a Joyful Life that if you implement will make huge changes. How To Turn Stressful Situations Around When Things Arent Going Your Way. Revealed. The best Spiritual Advice I've Ever Received. Affirmations. How To Make Affirmations Work For You. The Cornerstone of Maintaining Joy In Your Life. The One Technique To Cope With Huge Workloads in An American Fortune 500 Company. The 2 things that you need to start doing to overcome modern day stress in your life. More here...

The Well Being Way Stress Management Program Summary


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Stress Management And Psychiatric Interventions

Stress management techniques such as relaxation training, cognitive restructuring, and coping skills training may reduce negative mood states in HIV-positive persons by lowering physical tension and increasing self-efficacy (Antoni, 2003a). These affective changes are thought to be accompanied by an improved ability to regulate peripheral catecholamines and cortisol via decreases in ANS activation and improved regulation of the HPA axis, respectively. Neuroendocrine regulation may be associated with a partial normalization of immune system functions, providing more efficient surveillance of pathogens such as latent viruses that may increase HIV replication and enhance vulnerability to opportunistic infections or neoplasias. This normalization of stress-associated immune system decrements may ultimately forestall increases in viral load and the manifestation of clinical symptoms over extended periods. A relatively small number of controlled trials have examined the effects of...

Stress Management

Muscles tighten as stress starts, often causing intense headaches, backaches, and gastrointestinal problems. Stress also can cause testosterone levels to decrease and blood vessels in the penis to constrict, often resulting in erection problems. The rush of hormones caused by a stressful situation can bring on an asthma attack in a person with a history of asthma. Stress also draws the blood supply away from the abdominal area and encourages overproduction of acids in the digestive system, often leading to indigestion and other gastrointestinal problems. Other problems related to stress include insomnia and irritability. Talk about your stress. For example, talk to a friend, family member, teacher, or boss about what is bothering you. If that does not help to resolve the problem, consider seeking help from a professional therapist or counselor. Ask your doctor for a referral, or contact the employee assistance program at work. Know your limits. If a stressful situation gets beyond...

The Benefits of Exercise

Along with a healthy diet, exercise is the cornerstone of good health. Physical activity produces a multitude of benefits for your overall health and well-being. Being active helps prevent heart disease and stroke by lowering cholesterol levels and making the heart pump more efficiently. It reduces the risk of dying prematurely, especially of heart disease. Physical activity helps control your weight and prevent obesity, which is a risk factor for high blood pressure and diabetes. Regular exercise also can improve your mood, reduce stress, and relieve depression, not to mention build muscular strength and tone, increase your flexibility,

Primary Nursing Diagnosis

Because of the negative effect of physical and emotional stress on the patient with adrenal insufficiency, promote strategies that reduce stress. Teach the patient to rest between activities to conserve energy and to wear warm clothing to increase comfort and limit heat loss. To limit the risk of infection, encourage the patient to use good hand-washing techniques and to limit exposure to people with infections. To prevent complications, teach the patient to avoid using lotions that contain alcohol to prevent skin dryness and breakdown and to eat a nutritious diet that has adequate proteins, fats, and carbohydrates to maintain sodium and potassium balance.

The Hazards of Tobacco

When you quit smoking, you remove an important source of pleasure and a way to reduce stress from your daily routine. You need to replace the nicotine with something else that gives you pleasure and deal with your stress in more positive ways (see page 118). Maintaining your focus on negative reasons for quitting, such as worrying about your health, will not help you succeed. Forget the no pain, no gain attitude. Instead, embrace your new, more healthy lifestyle positively, without guilt for your past smoking habit. Praise yourself liberally by telling yourself how much better your life is going to be from now on. And remember the following positive things about quitting each time you feel the urge to take a puff

Pharmacological Interventions And Treatment Implications

Methadone, a long-acting opioid medication with effects that last for days, causes dependence, but because of its sustained stimulation of the mu receptors, it alleviates craving and compulsive drug use. In addition, methadone therapy tends to normalize many aspects of the hormonal disruptions found in addicted individuals (Kling et al., 2000 Kreek, 2000 Schluger, Borg, Ho, & Kreek, 2001). For example, it moderates the exaggerated cortisol stress response (discussed earlier) that increases the danger of relapse in stressful situations.

Common Features Of Cognitive Vulnerability Models A Framework Encapsulating Relationships

May shield them from disorders, or reduce the likelihood they will develop psychological problems. Such factors can be either transitory, providential factors (e.g., fortuitous, but temporary, social support during stress), or quite stable (e.g., lifelong relationships). Sometimes they can be unidentified by researchers or even unknown. In contrast, exacerbatingfac-tors are additional stresses or factors that worsen an emotional disorder after it has already been acquired. Examples include stressful life events (e.g., further medical illnesses, psychological problems, or negative affect expressed by others) that impinge on individuals subsequent to the onset of their emotional disorders.

Discharge And Home Healthcare Guidelines

ADHERENCE TO THE REHABILITATION PROGRAM. Ensure that the patient understands that the condition is chronic and not curable. Stress the importance of adhering to a balanced exercise program, using measures to prevent trauma and reduce stress. Include the patient's family in the plans.

Design in a Best Case Scenario

Studies, participants are asked to recall information about their cognitive vulnerabilities (or past stresses) before their first episodes. The main problem with these designs is that the recall of participants can be influenced by forgetting, cognitive biases, or even the presence of a current disorder (or early beginnings of disorder Alloy et al., 1999). For example, if depressed individuals are asked to recall past life experiences, they might exhibit biased recall of stressful events or past dysfunctional attitudes as a consequence of their current depressive moods. In follow-back studies, which are more unbiased in these respects, objective records of participants are located that existed before the onset of disorder (e.g., medical records, personal diaries) and are then compared for group differences. This being said, for present purposes, an especially relevant form of follow-back studies applies content analysis techniques (Peterson, Seligman, Yurko, Martin, & Friedman, 1998)...

Biological Correlates Of Acute Posttrauma Predictors Of Chronic Symptom Development

Basic science research on memory consolidation and fear conditioning during states of heightened arousal (i.e., adrenergic activation) is consistent with the idea that peri-traumatic panic, or even intense distress during and immediately after a traumatic event, might contribute to the production of intrusive recollections. However, clarifying the precise nature and biological correlates of symptoms that appear in the immediate aftermath of a trauma, and or that predict the continued presence of long-term symptoms, will no doubt assist in developing models for potential prophylactic interventions and early treatments. For example, to the extent that panic reactions are associated with increased catecholamine responses at the time of trauma, early and aggressive intervention with adrenergic blocking agents 26 , or cognitive-behavioral stress management techniques emphasizing relaxation, may be the most appropriate interventions for persons who panic in the hours immediately following...

Emotional Health and Wellbeing

As a boy, you were probably taught not to cry, but to act tough and be a man. Although attitudes are changing in our society, many males are still brought up not to express their emotions, learning that any display of feeling (other than anger) is a sign of weakness. While living up to the traditional, aggressive masculine identity may give a man certain advantages in a competitive society, it also can explain why the rates of substance abuse, domestic violence, homicide, suicide, sexual abuse, automobile accidents, and stress-related chronic illness are higher in men than in women. If a man has not learned to properly deal with and express his emotions, then stressful situations may lead to inappropriate responses such as anger or violence. Of course, not all emotional problems can be classified as a disorder. We all feel stress to varying degrees in a variety of situations. In terms of major stresses, men are just as likely as women to undergo an emotional upheaval during a time of...

Rumination As A Mediator And Moderator Of Cognitive Vulnerability To Depression

Expanding on the response styles theory, Robinson and Alloy (2003) hypothesized that individuals who have negative inferential styles and, additionally, who tend to ruminate about these negative cognitions in response to the occurrence of stressful life events (stress-reactive rumination), may be more likely to develop episodes of depression in the first place. The idea is that negative cognitive styles provide the negative content, but this negative content may be more likely to lead to depression when it is on one's mind than when it is not. Accordingly, Robinson and Alloy proposed that stress-reactive rumination would exacerbate the association between negative cognitive styles and the onset of a depressive episode. Consistent with this hypothesis, using CVD project data, they found that stress-reactive rumination when assessed at Time 1 interacted with cognitive risk to predict prospective onsets of MD and HD episodes (see Fig. 2.1). Among the cognitively LR participants, there...

Cognitive Vulnerabilitystress Interaction And Prospective Development Of Depression

Studies have provided more consistent support for the hypothesis that negative parental inferential feedback may contribute to the development of a negative cognitive style in their children. For example, according to both participants' and their parents' reports and controlling for respondents' levels of depressive symptoms, both mothers and fathers of HR participants in the CVD project provided more stable, global attributional feedback than did mothers and fathers of LR participants (Alloy et al., 2001). Similarly, controlling for respondents' levels of depressive symptoms, mothers of HR participants also provided more negative consequence feedback for negative events in their child's life than did mothers of LR participants, according to both respondents' reports, as did fathers of HR participants according to the participants' reports. In addition, negative attributional and consequence feedback from mothers interacted with a history of high levels of childhood stressful life...

Definitions of Vulnerability

There are few explicit definitions of vulnerability available in the literature (Ingram et al., 1998 Ingram & Price, 2001). However, theory and research on vulnerability suggest a number of features essential to the construct of vulnerability and can therefore be used to arrive at a suitable definition of vulnerability. The most fundamental of these features is that vulnerability is conceptualized as a trait rather than as the kind of state that characterizes the appearance of depression. That is, even as episodes of depression emerge and then disappear, vulnerability remains constant. It is important to note in this regard that even though vulnerability is seen as a trait, this does not mean it is necessarily permanent or unalterable. Although psychological vulnerability may be resistant to change, corrective experiences can occur that attenuate vulnerability (e.g., therapy). Vulnerability is also viewed as endogenous to the person (in contrast to risk that is a function of external...

Diagnosis of insomnia

In a recent study of a large group of people, representative of seven European countries, about 11 complained of nonrestorative sleep 40 . The complaints concerning nonrestorative sleep are indicative of hyperarousal not allowing relaxation during sleep. Nonrestorative sleep was associated with the presence of anxiety, and stressful life. Furthermore, the prevalence was higher in the United Kingdom (16.1 ), and Germany (15.5 ), than in Spain (2.4 ). By these findings one may conclude that the more society is following the modern western pattern of life, the harder the stress management becomes, and consequently sleep disturbances become more common.

Treatment of insomnia

Insomnia may be distinguished in two different states. The first is a state of transient insomnia due to an acute event, while the second is the state of chronic insomnia. What is required in the first case is a treatment lasting for a few days only, i.e., for the period of the underlying event that caused insomnia. Such a case requires a medicine able to induce sleep immediately, while its effect quickly diminishes, so that the individual does not experience after effects when awakened. In the case of chronic insomnia, i.e. , when a person cannot relax in order to fall asleep, the therapeutic effort should be aimed at the reduction of chronic stress. The objective is to reduce the level of arousal when going to bed. Thus, the treatment may be more on a psychological basis, employing psychotherapeutic techniques, so that the patient can control the levels of his or her stress. In fact, all psychotherapeutic techniques, ranging from those of a psychoanalytical nature to those of...

Youth Smoking Cessation

Reviews of quit-smoking programs for adolescents painted a bleak picture (Burton, 1994 Digiusto, 1994 Sussman, et al., 1999). Retention and recruitment of students were problematic, and end-of-group quit rates were modest. Many studies failed to use appropriate control groups, objective measures of smoking status, and long-term follow-up of graduates (Sussman et al., 1999). Teenage focus groups have provided insight into the nature of smoking cessation programs that appeal to youth (Balch, 1998). Some suggestions were to (1) highlight the seriousness of quitting smoking before becoming an adult (2) include mood control and stress management (3) help teen smokers deal with

Adjustment Disorder with Depressive Features

Leserman and colleagues (2002) documented the impact of psychosocial factors such as stressful life events, depressive symptoms, and lack of social support on HIV illness progression, but these studies have not been limited to the diagnosis of adjustment disorder. Therefore, while providing valuable inferential information on the role of adjustment disorder, they are limited to subjects with more profound depressive illness as well as chronic time spans extending beyond the 3-month diagnostic limit (Evans et al., 1997 Leserman et al., 1999, 2000, 2002).

Early Postimpact Stress Reactions

In addition to properly addressing the aforementioned presenting complaints, 102 subjects were fully investigated through a checklist of sociodemographic variables and a semi-structured psychiatric interview focusing on the detection of acute stress reaction (ASR) and PTSD. This interview was devised according to the ICD-10 Research Diagnostic Criteria and consisted of 35 items pertaining to the ASR diagnosis and 10 items pertaining to the PTSD diagnosis. Items were ascertained dichotomously as either present or absent. More specifically, the 35 items assessing ASR were grouped into the eight symptom clusters described in the ICD-10 (i.e., autonomic arousal symptoms, symptoms involving chest and abdomen, symptoms involving mental state, general physical symptoms, symptoms of tension, dissociative symptoms, other ''psychic'' symptoms, and other nonspecific symptoms of stress response), while the 10 items referring to PTSD assessed the presence of symptoms of persistent ''reliving'' of...

Behavioral High Risk Research

Data reported from this project thus far have suggested a number of cognitive factors that may be linked to vulnerability. Most critically, those identified as being at high cognitive risk are more likely to experience depression at some point in the future (Abramson et al., 1999). Results have also suggested that, compared to the low risk group, high risk subjects process negative self-referent information more fully than positive self-referent information (Alloy, Abramson, Murray, Whitehouse, & Hogan, 1997). Regarding the origins of vulnerability, Alloy et al. (2001) also reported that the mothers of cognitively high risk individuals exhibit more negative cognition than do the mothers of low risk individuals, the fathers of high risk students are less emotionally accepting, and both the mothers and fathers of high risk students are more likely to make more stable and global attributions for the stressful events that their children experience. Gibb et al. (2001) also found more...

Health And Daily Living Form

Purpose To focus on the social resources people use to prevent and adapt to stressful life circumstances Stressful Life Circumstances The nature of individual coping responses to stressful life events was explored in a representative adult community sample. Two approaches to the classification of coping strategies were operationalized. Using these measures, small but significant gender and contextual differences in coping were identified. Mood and symptom levels were related to coping responses and to quantitative and qualitative measures of social resources. Measures of coping and social resources attenuated the relationship between undesirable life events and personal functioning.

Summary of Research on Cognitive Vulnerability to Depression

The extant data clearly suggest that negative self-related cognitions, whether conceptualized from a cognitive schema standpoint or an attri-butional standpoint, serve as cognitive vulnerability factors within the context of a diathesis-stress relation. Priming data show that these cognitive factors exist in vulnerable individuals, and they can be activated by the effects of stresslike experiences, such as the occurrence of negative mood. Moreover, some of these data, along with data on attributional styles, show that dysfunctional cognitive factors are associated with the onset of depression in response to stressful events. High risk research has also shown that the match between the type of event and the particular

Pharmacologic Highlights

The nurse's role is one of monitoring and support. Support the patient who is experiencing symptoms from any rhythm disturbance. Maintain the patient's airway, breathing, and circulation. To maximize oxygen available to the myocardium, encourage the patient to rest in bed until the symptoms are treated and subside. Remain with the patient to ensure rest and to allay anxiety. Discuss any potential precipitating factors with the patient. For some patients, strategies to reduce stress or lifestyle changes help limit the incidence of dysrhythmias. Teach the patient to reduce the amount of caffeine intake in the diet. If appropriate, encourage the patient to become involved in an exercise program or a smoking cessation group. Provide emotional support and

Psychological Debriefing

Everly and Mitchell 45 pointed out several methodological problems in research carried out up to now on debriefing. Some studies pooled the results of interventions offered by practitioners with varied levels of skills and training, and possibly using different debriefing models. Other studies involved an improper application of debriefing, using it as a freestanding intervention rather than as one component of a complete critical incident stress management (CISM) program. Apparently, similar difficulties commonly arise whenever researchers attempt to study the efficacy of psychotherapy using randomized experimental designs. The only way to get an accurate picture of the effectiveness of these interventions may be to allow a broader research approach, including the use of non-randomized designs and survey research 45 . A National Institute of Mental Health (NIMH) workshop on mass violence concluded that early intervention in the form of ventilation of events and emotions evoked by a...

Additional Nursing Diagnoses Fear

Children cope with stressful events best when in the presence of their parents. Stressful events may cause the child to need extra reassurance and may cause a temporary regression in development as the child reverts to comfortable, familiar safe activities children, like adults, have a need to replay stressful events in order to understand and cope, and this is often accomplished through play activities.

The Cognitive Vulnerabilitystress Models Of Unipolar Depression

Given that people vary in their responses to stressful life events, the cognitive theories of unipolar depression have sought to explain why some individuals are vulnerable to depression when confronted with stressful events, whereas others do not become depressed at all or suffer only mild, short-lived dysphoria. From the cognitive perspective, the meaning or interpretation people give to their life experiences influences their vulnerability to depression. According to the hopelessness theory of depression (Abramson et al., 1989 Alloy, Abramson, Metalsky, & Hartlage, 1988), individuals who tend to attribute negative life events to stable (enduring) and global (general) causes infer that further negative consequences will follow from a current negative event, and infer that the occurrence of a negative event in their lives means that they are deficient or unworthy are hypothesized to be more likely to experience an onset of depression or a worsening of current depression when...

Life Events And Bipolar Spectrum Disorders

A growing body of evidence suggests that life events may have an impact on the onset and course of bipolar spectrum disorders (Johnson & Kizer, 2002 Johnson & Roberts, 1995). For the most part, these studies have found that bipolar individuals experienced increased stressful events prior to onset or subsequent episodes of their disorder. Moreover, most have found that the manic hypomanic, as well as the depressive, episodes of bipolar individuals were preceded by negative life events (Johnson & Roberts, 1995). However, several methodological limitations make interpretation of many of these studies difficult. First, many studies used retrospective rather than prospective designs. Retrospective designs have the problems that recall of events may decrease over time and become biased by the individuals' attempts to explain the cause of their disorder to themselves (Brown, 1974,1989). Second, many studies do not distinguish between the depressive and manic hypomanic episodes of bipolar...

Retrospective Studies

Several retrospective studies relied on review of medical charts to assess life events in patients with bipolar disorder. Based on retrospective chart review, Leff, Fischer, and Bertelson (1976) found that 35 of bipolar inpa-tients reported a stressful event rated as independent of their behavior in the month prior to onset of episode. Clancy, Crowe, Winokur, and Morrison (1973) also used retrospective chart review and found that 39 of unipolar, 27 of bipolar, and 11 of schizophrenic patients had a stressful event in the 3 months prior to onset of their disorder. No significant differences were found for types of precipitating stressful events for bipolar versus unipolar patients. Ambelas (1979, 1987) conducted two retrospective chart review studies. In the 1979 study, 28 of 67 hypomanic or manic inpatients versus 6 of 60 surgical control patients had experienced an independent stressful event during the 4 weeks prior to hospital admission. In almost all the cases reported, the...

Worksite Health Promotion

Health promotion at the worksite covers a wide variety of activities, including exercise and fitness, stress management, smoking cessation, and cholesterol reduction. Specific programs targeting women may include prenatal care, parenting, breast examinations, and mammograms.

Treating Direct Survivors Acute Psychological Responses

Systematic debriefing has been attempted in some settings but is far from being accepted by all. Help at this early phase is generally conceived as ''stress management'' and mainly consists of optimizing early recuperation, reducing secondary stressors and providing soothing human contact and support for natural helpers (e.g., families). There are no data showing any relationship between these interventions and subsequent rates of post-traumatic stress disorder (PTSD), and the general belief is that early stress management and the prevention of PTSD are two separate matters. Survivors are often provided with advice and contact phone numbers, often to the same therapist or group of therapists that saw them in the ER. Criteria for release from ERs consist of having attended to and reduced uncontrollable dissociative states, assuring continuity of care by informed family members and having

Proportion of Negative Events

Nation with positive cognitive styles. Thus, more work is needed to understand the conditions under which positive versus negative events and positive versus negative cognitive styles provide vulnerability to mania hypomania. Second, given that some of the studies reviewed here found that negative life events interact with negative cognitive styles and information processing to predict increases in both depressive and manic symptoms, what determines which type of episode a bipolar individual will experience at any particular time Reilly-Harrington et al. (1999) speculated that the particular kind of stressful event may be key, with manic hypomanic episodes more likely to follow stressors that disrupt the sleep-wake cycle (i.e., social rhythm disruptors Malkoff-Schwartz et al.,

Hnc Qol Perspective Where Are We Going

Well-being remains to be clearly defined in patients with altered states of health. It is tentatively defined as a person's perception of life quality, a personal experience that is influenced by both the individual's past experiences and current expectations. This emphasizes the importance of imparting realistic expectations in cancer treatment planning to the patient before treatment is administered. One article illustrates the types of domains that are taken into consideration in attempting such definitions.25 This study is described in some detail to indicate the complex and sophisticated level to which QOL research has developed, and to illustrate the types of factors currently thought to be relevant and that are probably not typically taken into consideration by many HNC treatment managers. Well-being under a stressful life circumstance such as illness may be mediated by three factors (1) the extent to which people see themselves as being in control of their environment (2) the...

Basic Tenets Of Cognitive Models Of Emotional Disorder

The cognitive factors conceived to be important in emotional disorders can include both distal phenomena that were present before the disorder, and proximal phenomena that occur very close to, or even during, the episode of disorder and its symptoms (Abramson, Metalsky, & Alloy, 1989). Distal cognitive factors are normally relatively enduring cognitive predispositions to respond to stressful situations in maladaptive ways (e.g., dysfunctional attitudes or explanatory styles). They are higher in generality (or abstraction) as well as more distal to future episodes of disorders than proximal cognitions, which are more transitory or specific thoughts or mental processes that occur very close to, or even during, the episode of disorder. And, proximal cognitions (e.g., specific thoughts or images) are typically produced when individuals process the meaning of a stressful Today, most cognitive models presuppose that the outcomes resulting from cognitive vulnerabilities depend on...

Acupuncture and Traditional Chinese Medicine

There are five components of traditional Chinese medicine. In addition to acupuncture, they include traditional Chinese herbs, diet and nutrition, exercise, stress reduction and counseling, and massage. T'ai chi, which is discussed elsewhere in this book, is also a component of traditional Chinese medicine. This chapter discusses acupuncture as well as two types of herbal medicine Asian herbal medicine and Asian proprietary (or patent) medicine.

NOC Knowledge Disease Process

Teach parents and child about the administration and side effects of anti-inflammatories and immunosuppressant drugs (specify), not to decrease or skip the dose if side effects appear, and the need to adjust dosage during stressful situations. Teach clients about child's need to take naps and have 8 hours of sleep night avoid fatigue or stressful situations avoid medica-tions such as sulfonamides, tetracyclines, anticonvulsants, and others that cause an exacerbation.

Cognitive Behavioral and Nonpharmacological Treatments

Drug supplies and paraphernalia, breaking off relationships with dealers and drug-using comrades, limiting finances, changing one's telephone number and or geographic location, and structuring one's time during all waking hours. Instead of simply replacing cocaine's central role in one's existence, emphasizing lifestyle changes such as stress reduction, wellness, exercise, and leisure activities is important. This may be more difficult for persons of lower socioeconomic groups and or those with an earlier onset of addiction. These persons lack the knowledge, experience, and resources to make these changes. Such patients may need linkage to other social services and habilitation, in addition to the rehabilitation just discussed. The involvement of significant others in the treatment of cocaine use disorders can have a positive impact. For instance, Higgins, Budney, Bickel, and Badger (1994) recently showed that patients who had family involvement were 20 times more likely to complete...

The cardiac pacemaker

The lead wire design of the cardiac pacemaker is similar to the lead wire design in the motor prosthesis. The lead wire consists of multiple stands of wire, helically wound, in an encapsulating sheath.4345 The multistrand approach to the lead wire ensures that electrical impulses can still be delivered even if one of the strands breaks due to stress on the wire. Stress on the wire, however, is reduced by the helical coil structure. This structure acts like a spring, allowing for stretching and bending, reducing breakage. The encapsulating sheath acts to further reduce stress on the wire by allowing the wire to move freely in the body by preventing tissue adhesions. The sheath also provides insulation of the wire from the body, ensuring proper electrical conduction and preventing unwanted biological reactions. point. Finally, the material from which the electrode is constructed has to be biologically compatible. The design that was developed for the electrode was a platinum or platinum...

The Cognitive Diathesis in Diathesis Stress Models

The cognitive diathesis proposed by most cognitive models can be traced to the depression theory proposed by Beck (1963,1967). Beck was the first to argue that depression is the result of maladaptive cognitive structures in particular, that schemas about the self are causally linked to the disorder and are triggered by stressful life events. Although definitions vary somewhat, many investigators conceptualize self-schemas as organized

Disorders of the Large Intestine and Rectum

To control irritable bowel syndrome, avoid the foods that cause your symptoms. You also may find relief by eating smaller, more frequent meals and by eating less fat and more fruits, vegetables, and whole grains. Taking fiber supplements also may help. Stress management techniques (see page 118) will help you reduce or control stress. If self-help measures are ineffective, your doctor may prescribe anticholinergic or antispasmodic medication (such as atropine or dicyclomine) to help relieve spasms in the colon.

Stress Buffering Model

According to this model, social support may intervene in the pathway between the stressful event and the receiver individual (McMahon, Schram, & Davidson, 1993, p. 242). In other words, friends may intervene by encouraging the person who is experiencing the stress, and the more positive the response, the more effective should be the outcome (McMahon et al., 1993 Ulbrich & Bradsher, 1993).

Diagnostic Evolution

Has been created in a litigious Western society that seeks to place blame and identify victims and perpetrators. Skeptics argue that PTSD is not found in non-Westernized cultures and contend that normal human reactions to a stressful event only become pathological when diagnoses are applied to them. At their worst, these opponents propose that diagnosing posttraumat-ic reactions has iatrogenic effects on those who are diagnosed.

Cognitive Appraisals

Individual differences in cognitive appraisals of stressors may moderate the association between stressful life events and health status in HIV-positive persons. Specifically, one research group has demonstrated that positive illusions and unrealistically optimistic appraisals may confer health-protective benefits (Taylor et al., 2000). Results from an investigation of bereaved HIV-positive men indicated that those who engaged in cognitive processing (deliberate, effortful, and long-lasting thinking) about the death of a close friend or partner were more likely to report a major shift in values, priorities, or perspectives (i.e., finding meaning) following the loss (Bower et al., 1998). For those who were classified as finding meaning, positive health effects appeared to follow. Finding meaning predicted slower CD4+ decline and greater longevity over a 2- to 3-year follow-up period (Bower et al., 1998). Decreased cortisol is one plausible mediator of the effects of finding meaning on...

Negative Mood

Negative mood states such as depression and anxiety have been associated with additional functional impairment, mortality, and an approximately 50 increase in medical costs for persons managing a variety ofchronic medical conditions (Katon, 2003). Because HIV-positive individuals are at increased risk for developing an affective or adjustment disorder across the disease spectrum (Bing et al., 2001), effectively managing negative mood may be an especially relevant task. In fact, elevated negative mood may result in decrements in immune status, HIV disease progression, and mortality (Leserman, 2003). However, the directionality of this relationship has been hotly debated. Because clinically significant reductions in HIV viral load have been observed to predict decreased distress (Kalichman et al., 2002), longitudinal investigations with repeated measurements of psychosocial and im-munologic data provide the most reliable findings on the temporal associations between negative mood and...


Stress management and psycho-neuroimmunology in HIV infection. CNS Spectrums 8 40-51. Antoni MH (2003b). Stress management effects on psychological, endocrinological and immune function in men with HIV empirical support for a psycho-neuroimmunological model. Stress 6 173-188. Antoni MH, and Schneiderman N (1998). HIV AIDS. In A Bellack and M Hersen (eds.), Comprehensive Clinical Psychology (pp. 237-275). New York Elsevier Science. Antoni M, August S, LaPerriere A, Baggett H.L, Klimas N, Ironson G, et al. (1990). Psychological and neuroendocrine measures related to functional immune changes in anticipation of HIV-1 serostatus notification. Psychosom Med 52 496-510. Antoni MH, Baggett L, Ironson G, August S, LaPerriere A, Klimas N, et al. (1991). Cognitive behavioral stress management intervention buffers distress responses and immunologic changes following notification of HIV-1 seropositivity. J Consult Clin Psy-chol 59 906-915. Antoni MH, Lutgendorf S, Ironson G,...


We are interested in how people respond when they confront difficult or stressful events in their lives. There are lots of ways to try to deal with stress. This questionnaire asks you to indicate what you generally do and feel, when you experience stressful events. Obviously, different events bring out somewhat different responses, but think about what you usually do when you are under a lot of stress. Then respond to each of the following items by blackening one number on your answer sheet for each, using the response choices listed just below. Please try to respond to each item separately in your mind from each other item. Choose your answers thoughtfully, and make your answers as true FOR YOU as you can. Please answer every item. There are no right or wrong answers, so choose the most accurate answer for YOU--not what you think most people would say or do. Indicate what YOU usually do when YOU experience a stressful event.

Brandon E Gibb

Research has suggested that depression often occurs following stressful life events (see Monroe & Hadjiyannakis, 2002, for a review). However, individuals can vary widely in their responses to such events. Some may develop severe or long-lasting depression, whereas others do not become depressed at all or may experience mild dysphoria. Several factors have been proposed to explain such individual differences in response to life events. For example, the severity of a given negative life event, the amount of social support an individual receives in the face of a traumatic life event, or individual differences in one's biological constitution or psychological characteristics may all modulate reactivity to stressful events. From a cognitive perspective, the meaning or interpretation individuals give to the life events they experience influences whether or not they become depressed and are vulnerable to recurrent, severe, or long-lasting episodes of depression. Two major cognitive theories...


Existing measures of coping styles can be used in an ACT-consistent fashion. There is a significant relationship between methods of coping and certain forms of symptomatology (Abramsom, Seligman, & Teasdale, 1978 Fondacaro & Moos, 1987), many of which are included in the diagnosis of PTSD. The Ways of Coping Questionnaire (WOC Folkman & Lazarus, 1988), a widely used research instrument for assessing coping strategies, and the Coping Inventory for Stressful Situations (CISS Endler & Parker, 1994) are both useful instruments that tap into emotion-focused or avoidant strategies. They assess a wide range of thoughts and behaviors that individuals use to deal with stressful life experiences. Three dominant means of coping with stressful situations have been identified task-oriented, emotion-oriented (Folkman & Lazarus, 1988), and avoidance-oriented (Endler & Parker, 1994). Task-oriented coping refers to the attainment of problem resolution through conscious efforts to solve or modify the...

Resistance Form

One of the functions of a post-and-core is to improve resistance to laterally directed forces by distributing them over as large an area as possible. However, excessive internal preparation of the root weakens it, and the possibility of failure increases. The post design should distribute stresses as evenly as possible. The incidence of radicular fracture increases with the use of threaded posts, and threaded flexible posts do not appear to reduce stress concentrations during function.

Retention Form

Tooth Restoration Interface Pictures

When a retentive failure occurs, cement often adheres to both the tooth preparation and the fitting surface of the restoration. In these cases, cohesive failure occurs through the cement layer because the strength of the cement is less than the induced stresses. A computerized analysis of these stresses-', reveals that they are not uniform throughout the cement but are concentrated around the junction of the axial and occlusal surfaces. Changes in the geometry of the preparation (e.g., rounding the internal line angles) may reduce stress concentrations and thus increase the retention of the restoration.

What We Have Learned

There may be many reasons and possible interpretations for the low rate of PTSD among the victims in Kobe. One explanation is the low reporting of PTSD symptoms victims might have had some reservations in reporting such symptoms as dissociation to medical professionals due to the stigma attached to mental symptoms. A second explanation could be the low recognition of PTSD by medical professionals there was no particular motivation among medical professionals to ask about the existence of PTSD among victims. On the other hand, the PTSD concept became so popular soon after the earthquake that its widespread use contributed to reduce even the stigma attached to psychological problems in general. The media reported almost every day about PTSD. Almost all Japanese psychiatrists became familiar with the DSM-IV and its criteria for PTSD. A third explanation could be that Asians, including Japanese, tend to somatize rather than to develop psychological symptoms such as dissociation under a...

Patient Education

The greater part of patient education is done by nurses, although health educators and preventive medicine professionals are often employed to plan and teach patients about exercise regimens, dietary changes, and inherited traits of disease to help them reduce stress and cope with their illnesses.


The requirement for pertussis toxin for efficient induction of active disease in certain protocols is thought to relate to its ability to increase permeability of the blood-brain barrier. The authors have not had to use pertussis toxin with PLP or the immunodominant peptides of PLP to induce reliable EAE. However, others have reported that induction of EAE with PLP and PLP139-151 requires the use of pertussis toxin. In general, R-EAE is more easily induced in female than in male SJL mice. In addition, female mice are preferred due to the fact that male SJL mice are quite aggressive if male mice are used, they should be housed one mouse per cage to avoid fighting and reduce stress, which can negatively affect the induction of disease. It should be noted that increased stress and production of corticosteroids have been shown to inhibit EAE (Mason, 1991). The reader is encouraged to consult the relevant literature for details pertaining to disease induction in different mouse strains...


Psychotherapy is an excellent first-line therapy for patients suffering from mild anxiety symptoms or can be used in combination with medication for those in need of more immediate relief or those suffering from more severe symptoms. Psychotherapeutic treatments have been shown to be effective in alleviating the distress of patients suffering from anxiety disorders. A therapeutic modality should be chosen that takes into account a patient's physical and psychological symptomatology, social supports, stressors, prior therapy or medication experience, ability to cope, cultural or religious background, and goals (Zegans et al., 1994). Numerous studies have demonstrated the overall benefits of group therapy as an intervention that ameliorates symptoms ofdepression, anxiety, and distress, and enhances coping in patients suffering from chronic illnesses, including HIV (Mulder et al., 1994 Sherman et al., 2004). Cognitive-behavioral stress management has been shown to result in significant...


Stress management effects on psychological, endocrinological, and immune functioning in men with HIV infection empirical support fora psychoneuroimmunological model. Stress 6(3) 173-188. Antoni MH, Cruess DG, Cruess S, Lutgendorf S, Kumar M, Ironson G, Klimas N, Fletcher MA, and Schnei-derman N (2000). Cognitive-behavioral stress management intervention effects on anxiety, 24-hr urinary norepinephrine output, and T-cytotoxic suppressor cells over time among symptomatic HIV-infected gay men. J Consult Clin Psychol 68(1) 31-45. Cruess DG, Antoni MH, Schneiderman N, Ironson G, McCabe P, Fernandez JB, Cruess SE, Klimas N, and Kumar M (2000b). Cognitive-behavioral stress management increases free testosterone and decreases psychological distress in HIV-seropositive men. Health Psychol I9(I) I2-20. Lutgendorf SK, Antoni MH, Ironson G, Starr K, Costello N, Zuckerman M, Klimas N, Fletcher MA, and Schneiderman N (1998). Changes in cognitive coping skills and social support...

Of Communication

In stressful situations the function of communication is of utmost importance. Information increases the controllability of a threatening situation if the child understands what can be done about the situation, how negative consequences can be avoided or ameliorated by his her own actions. Information thus reduces uncertainty about a threatening situation if it increases the predictability of the situation.

Double Protection

To their children than parents of children with asthma and parents of healthy children. The findings obtained were equivalent for the mothers and the fathers. We believe that, in order to be able to count their child among the lucky ones who will survive the disease, parents create an image of vitality and zest for life. This positive attribution by parents of children with cancer may be a beneficial coping strategy as long as the emotional feelings of children are not underestimated. Caregivers should be aware of this coping strategy, especially if this coping strategy is out of balance or pathological. It can also be possible that children give their parents the impression they are doing fine to protect their parents from the more negative emotions resulting from the stressful situation.

Stress Response

Relatively stereotypical sets of interacting psychological and biological patterns that organisms exhibit in response to exposure to a stressor. When the body experiences certain stressful events, a stress response is induced if the person feels that he or she cannot cope with the adversity or stressor (Kaplan, Sallis, & Patterson, 1993). See Stressor.

Anxiety Disorders

Anxiety disorders are the most prevalent mental disorders in adults. About 30 million people in the United States have some type of anxiety disorder, and twice as many women as men are affected. Anxiety disorders appear to arise from a combination of stressful life experiences, psychological traits, and genetic inheritance, although certain disorders such as panic disorder (see page 352) appear to have a stronger genetic component than others. The most common anxiety disorders include generalized anxiety disorder, phobias, panic disorder, obsessive-compulsive disorder, and posttraumatic stress disorder.

Wellness Centers

Facilities organized and operated mainly by health professionals, such as health education specialists, preventive care specialists, nurses, therapists, nutritionists, medical doctors with an interest in prevention, and health administrators, to provide people with learning opportunities about health behavior, risk reduction, and issues related to the health of the population. Learning opportunities may involve health education workshops, weight maintenance and control clinics, exercise demonstrations, cooking demonstrations, nutrition classes, and stress management programs.

Prospective Studies

Stronger evidence for the role of stressful life events as proximal triggers of affective episodes in individuals with bipolar disorders comes from the more methodologically adequate prospective studies. Hall, Dunner, Zeller, and Fieve (1977) assessed 38 bipolar patients prospectively at monthly intervals for a total of 10 months. Although overall numbers of life events did not differ for patients who relapsed versus those who did not, hypomanic relapsers had greater numbers of employment-related events than did nonrelapsers. In another report from this study, Hall (1984) noted that a higher number of severe loss events, as well as work-related events, also were reported prior to manic relapse in this sample. Limitations of this study included the failure to control for medication or illness duration, as well as the lack of structured diagnostic interviews to determine relapse. Johnson and Miller (1997) examined negative life events as a predictor of time to recovery from an episode...


In the pharmaceutical industry of today, you can spend much of your time reading and sending e-mails, informing yourself via the intranet and internet, and going to meetings, seminars, symposia, and courses. As a result, many people feel stressed and frustrated, yet most of these activities are, in themselves, useful and necessary. We cannot blame the surrounding world, but must decide for ourselves how our time should be used. We all know this, but what can we do

Treatment Strategies

The negative impact of HIV-related fatigue on quality of life has been emphasized throughout this chapter. Addressing the consequences of fatigue is also crucial to improve the patient's quality of life. Treatment of fatigue should not merely involve the restoration or amelioration of energy, but also the preservation of energy to improve the patient's level of functioning. This may entail appropriate rest, pacing of energy-consuming activities, stress reduction, meditation or relaxation techniques, aerobic exercise (if it is not contraindicated), and participation in pleasurable activities. Counseling and communication can help patients re-prioritize their activities, adjust to their limitations, and restructure their goals and expectations

Predisposing Factors

Stressful life events in the context of poor social support can heighten suicide risk (Kalichman et al., 2000 Haller and Miles, 2003). Persons with HIV infection can have distorted perceptions of illness. Just as an asymptomatic HIV-positive individual can become suicidal upon learning of his or her HIV serostatus, changes in immune parameters can also trigger a suicidal crisis. Learning that one has an increased viral load or decreased CD4 cell count can precipitate a suicidal crisis, even with reassurance that a change in medical treatment can easily reverse the situation (Alfonso et al., 1994 Haas et al., 1997).


Establish physician-patient relationship Reassurance Education Lifestyle modifications Stress management Dietary changes Healthy habits, exercise Pharmacotherapy Psychological behavioral therapy Elimination of lactose is recommended, as up to 60 of the population in the United States has lactose intolerance and these symptoms can mimic IBS.31 Both caffeinated and decaffeinated coffee have been demonstrated to stimulate motor activity of the rectosigmoid colon in normal volunteers.32 Sorbitol, a sugar alcohol that is a common ingredient of sugar-free candies, medicines, and antacids, may produce bloating, diarrhea, and gas, mimicking IBS. Establishment of exercise and stress management routines is often also recommended. A method for determining whether life stresses, dietary components, and other psychosocial factors exacerbate IBS symptoms involves the use of a symptom diary for 2 to 6 weeks. This may be used to determine if dietary factors and stressful events are associated with...

Diathesis Stress

Most cognitive models of depression, and by extension cognitive vulnerability models of depression, are explicitly diathesis-stress models these models argue that depression is the result of the interaction between cognitive factors and environmental stressors. The diathesis-stress approach specifies that, under ordinary conditions, people who are vulnerable to the onset of depression are indistinguishable from nonvulnerable people (Segal & Ingram, 1994). According to this idea, only when confronted with certain stressors do cognitive differences between vulnerable and non-vulnerable people emerge, which then turn into depression for those who are vulnerable (Ingram & Luxton, in press Monroe & Hadjiyannakis, 2002 Monroe & Simons, 1991 Segal & Shaw, 1986). More specifically, most cognitive models propose that when stressful life events are encountered by vulnerable people, these events precipitate a pattern of negative, biased, self-referent information processing that initiates the...

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