Polytechnic University of the Philippines

Colleges of Social Sciences and Development

Department of Psychology

Stress, coping and Maladaptive Behavior

Bajao, Lovelle
De Guzman, Aundrea Pauline
Moral, Chatlette
Padaca, Analiza
Parba, Reychelle Jules

STRESS,
COPING,
and,
MALADAPTIVE BEHAVIOR

STRESS

feeling of being overloaded, wound up tight, tense and worried

a feeling of strain and pressure
It involves the "set of emotional, physical, and cognitive (i.e., thought) reactions to a
change."
A medical term for a wide range of strong external stimuli, both physiological and
psychological, which can cause a physiological response called the general adaptation
syndrome (GAS). (Hans Selye, 1936)

SIGNS OF STRESS
Our bodies respond by activating the nervous system and releasing hormones such as
adrenalin and cortisol.
The hormones increase our heart rate, breathing, blood pressure, metabolism and muscle
tension. Our pupils dilate and our perspiration rate increases.
Fight or Flight Response
-Our quick and effective reaction to get through the stressful situation.
Headaches, other aches and pains
Sleep disturbance, insomnia
Upset stomach, indigestion, diarrhea
Anxiety
Anger, irritability
Depression
Fatigue
Feeling overwhelmed and out of control
Feeling moody, tearful
Difficulty concentrating
Low self-esteem, lack of confidence
High blood pressure
Weakened immune system
Heart disease

HANS SELYE
-Father of Stress Research
- concluded that human beings and animals share a specific and consistent pattern of
physiological responses to illness or injury
-3 Stages of General Adaptation Syndrome

Alarm reaction

-where the body detects the external stimulus

- A stage of physiological (bodily) excitation and preparation for fighting the illness or injury
- Heart rate, blood pressure and breathing quicken in order to supply the muscles and the
brain with more oxygen
Adaptation
-where the body engages defensive countermeasures against the stressor
- The effects of the alarm phase lessen
-moderate pace
Exhaustion
-where the body begins to run out of defenses
- wear and tear
TYPES OF STRESS
Eustress
-positive stress
-resulting from positive events
Motivates, focuses energy.
Is short-term.
Is perceived as within our coping abilities.
Feels exciting.
Improves performance.
DISTRESS
-negative stress
Causes anxiety or concern.
Can be short- or long-term.
Is perceived as outside of our coping abilities.
Feels unpleasant.
Decreases performance.
Can lead to mental and physical problems.

Acute Stress
- Caused by the daily demands and pressures encountered by each one of us.
-Brief and specific to the demands and pressures of a particular situation, such as
a deadline, a performance or facing up to a difficult challenge or traumatic events.
-Occurs only at a very short period of time.

Symptoms:
Emotional distress, such as anger, anxiety, irritability, and acute periods of depression

Physical problems, such as headache, pain, stomach upset, dizziness, heart palpitations,
shortness of breath, hypertension and bowel disorders
Episodic Acute Stress
- Acute stress that is suffered too frequently.
- Not like chronic stress, though, because this type of stress ceases from time to time yet
not as frequently as acute stress does.
-Repetitive stress episodes may be due to a series of very real stressful challenges, for
example, losing a job, then developing health problems, followed by difficulties for a child in the
school setting.
-Some people tend to worry endlessly about bad things that could happen, are frequently
in a rush and impatient with too many demands on their time, which can contribute to episodic
acute stress.
Symptoms:
Longer periods of intermitted depression, anxiety disorders and emotional distress
Ceaseless worrying
Persistent physical symptoms similar to those found in acute stress
Coronary heart diseases, or other heart problems

Chronic Stress
- Tears the life of a person apart his mind, body or spirit.
- Brought about by long-term exposure to stressors, such as unhappy marriage, traumatic
experiences, unwanted career or job, stress of poverty, chronic illnesses, relationship conflicts,
political problems, and dysfunctional families.
- Can even lead a person to resort to violence, suicide and self-harm.
- Serious illnesses like stroke, heart attack, cancer, and psychological problems such as
clinical depression and post-traumatic disorder can originate from chronic stress.
-This involves ongoing demands, pressures and worries that seem to be unending.

Physical Signs and Symptoms:

dry mouth
difficulty in breathing
pounding heart
stomach ache
headache
diaphoresis
frequent urination
tightening of muscles
Mental Signs and Symptoms:
sudden irritability

tension
problems with concentration
difficulty in sleeping
narrowed perception
frequent feelings of fatigue
STRESS COPING

Identify warning signs

- These vary from person to person, but might include things like tensing your jaw,
grinding your teeth, getting headaches, or feeling irritable and short tempered.
Identify triggers
- If you know what the likely triggers are, you can aim to anticipate them and practice
calming yourself down beforehand, or even find ways of removing the trigger. Triggers might
include late nights, deadlines, seeing particular people, hunger or over-tired children.
Establish routines
- Routines can include:
Regular times for exercise and relaxation
Regular meal times, waking and bedtimes
Planning ahead to do particular jobs on set days of the week.
Spend time with people who care
-Spend time with friends and family, especially those you find uplifting rather than
people who place demands on you.
-Share your thoughts and feelings with others when opportunities arise. Dont bottle up
your feelings.
Look after your health
-Make sure you are eating healthy food and getting regular exercise.
-Take time to do activities you find calming or uplifting, such as listening to music,
walking or dancing.
- Avoid using alcohol, tobacco or other drugs to cope.
Notice your self-talk
-Notice when you are using unhelpful self-talk, and instead try saying soothing, calming
things to yourself to reduce your levels of stress. Try more helpful self-talk like Im coping well
given whats on my plate, or Calm down, or Breathe easy.
-Keeping things in perspective is also important. When we are stressed, its easy to see
things as worse than they really are. Try self-talk such as This is not the end of the world or In
the overall scheme of things, this doesnt matter so much.
Practice Relaxation
-Learn a formal technique such as progressive muscle relaxation, meditation or yoga.
-Make time to absorb yourself in a relaxing activity such as gardening or listening to
music.

-Plan things to do each day that you look forward to and which give you a sense of
pleasure, like reading a book.
CATEGORIES OF STRESSORS
" Stressors that involve the more important aspects of a person's life- such as illness, or
negative social changes - tend to be highly stressful for most people."
(Aldwin, 2007 ; Newsom et. al 2008)
CATASTROPHIC EVENTS
- a sudden, unexpected, potentially life-threatening experiences or traumas
- unforeseen, unpredictable and as such, is completely out of control of the individual.
RESILIENCE
Healthy psychological and physical functioning after a potentially traumatic event.
In fact, resilience is the most common reaction following loss or trauma.
(Bonnano et.al, 2011; Quale and Shanke, 2010)
ACUTE STRESSORS
- sudden and intense stress
- short-term stressful situations that will soon be resolved.
CHRONIC STRESSORS
- long-term stressful situations that have no resolution in sight
MAJOR LIFE EVENTS
- Life changes or events that can be either positive or negative one.
DAILY HASSLES
- includes daily annoyance and minor hassles
CONFLICT WITH OTHERS
it includes conflict with other people
Three major psychological types of conflict that can
cause stress:
The approach-avoidance conflict - occurs when a person is choosing between two
equally attractive options.
The avoidance-avoidance conflict - were a person has to choose between two equally
unattractive option
The approach-avoidance conflict - occurs when a person is forced to choose whether or
not to partake in something that has both attractive and unattractive traits
STRESS DISORDERS
Acute Stress Disorder (ASD)
A disorder resulting from exposure to a major stressor, with symptoms of anxiety
recurring nightmares, sleep disturbances, problems in concentration and moments jn

which people seem to relive the event in dreams and flashbacks for as long as one
month following the event.

Diagnostic Criteria
Exposure to actual or threatened death, serious injury , or sexual violation in one (or
more) of the following ways:
- Directly experiencing thee traumatic event(s).
- Witnessing, in person, the event(s) as it occurred to others.
- Learning that the event(s) occurred to a close family member or friend
Note: In case of actual or threatened death of a family member or friend, the event(s)
must have been violent or accidental.
- Experiencing repeated or extreme exposure to aversive details of the traumatic event(s)
(e.g., first responders collecting human remains, police officers repeatedly exposed to details of
child abuse).
Note: This does not apply to exposure through electronic media, television, movies, or
pictures, unless this exposure is work related.
Presence of nine (or more) of the following symptoms from any of the five categories of
intrusion, negative mood, dissociation, avoidance, and arousal, beginning or worsening
after the traumatic event(s) occurred:
Intrusion Symptoms
Recurrent, involuntary, and intrusive distressing memories of the traumatic
event(s). Note: In children, repetitive play may occur in which themes or aspects
of the traumatic event(s) are expressed.
Recurrent distressing dreams in which the content and/or affecting the dream are
related to event(s). Note: In children, there may be frightening dreams without
recognizable content.
Dissociative reactions(e.g., flashback) in which the individual feels or acts as if
the traumatic event(s) recurring.(Such reactions may occur on a continuum, with
the most extreme expression being a complete loss of awareness of present
surroundings.) Note: In children, trauma-specific re-enactment may occur in play.
Intense or prolonged psychological distress or marked physiological reactions in
response to internal or external cues that symbolize or resemble an aspect of the
traumatic event(s).
Negative Move
Persistent inability to experience positive emotions (e.g., inability to experience
happiness, satisfaction, or loving feelings.)
Dissociative Symptoms
An altered sense of the reality of one's surroundings or oneself (e.g., seeing
oneself from anothers perspective, being in a daze, time slowing).

Inability to remember an important aspect of the traumatic event(s) ( typically due

to dissociative amnesia and not to other factors such as head injury, alcohol, or
drugs).
Avoidance Symptoms
Efforts to avoid distressing memories, thoughts, or feelings about or closely
associated with the traumatic event(s).
Efforts to avoid external reminders (people, place, conversations, activities,
objects, situations) that aroused distressing memories, thoughts, or feelings about
or closely associated with the traumatic event(s).
Arousal Symptoms
Sleep disturbance (e.g., difficulty falling or staying asleep, restless sleep).
Irritable behaviour and angry outbursts (with little or not provocation), typically
expressed as verbal or physical aggression towards people or objects.
Hyper-vigilance.
Problems with concentration.
Exaggerated startled responses.
Duration off the disturbance ( symptoms in Criterion B ) is 3 to 1 month after trauma
exposure.
Note: Symptoms typically begin immediately after the trauma, but persistence for at least
3 days and up to a month is needed to meet disorder criteria.
The disturbance causes clinically significant distress or impairment in social ,
occupational, or other areas of functioning
The disturbance is not attributable to the physiological effects of a substance (e.g.,
medication or alcohol) or another medical condition (e.g., mild traumatic brain injury)
and is not better explained by brief psychotic disorder.
Post-traumatic Stress Disorder (PTSD)
When the symptoms associated with ASD last for more than one month , the disorder is
then called Post-traumatic Stress Disorder.
Diagnostic Criterion
Note: The following criteria apply to adults, adolescents, and children older than 6 years.
For children 6 years and younger, see corresponding criteria below.
Exposure to actual or threatened death, serious injury, or sexual violence in one (or more)
of the following ways:
Directly experiencing the traumatic event(s).
Witnessing, in person, the event(s) as it occurred to others.
Learning that the traumatic event(s) occurred to a close family member or close
friend. In case of actual or threatened death of a family member or friend, the
event(s) must have been violent or accidental.

Experiencing repeated or extreme exposure to aversive details of the traumatic

event(s) (e.g., first responders collecting human remains; police officer repeatedly
exposed to details of child abuse).
Note: Criterion A4 does not apply to exposure through electronic media, television,
movies, or pictures, unless this exposure is work related
Persistent avoidance of stimuli associated with the traumatic event(s), beginning after the
traumatic event(s), as evidenced by one or both of the following:
Recurrent, involuntary, and intrusive distressing memories of the traumatic
event(s).
Note: In children older than 6 years, repetitive play may occur in which themes or
aspects of the traumatic event(s) are expressed.
Recurrent distressing dreams in which the content and/or affect of the dream are
related to the traumatic event(s)
Dissociative reactions (e.g., flashback) in which the individual feels or acts as if
the traumatic event(s) were recurring. (Such reactions may occur on a continuum,
with the most extreme expression being a complete loss of awareness of present
surroundings).
Note: In children, trauma specific re-enactment may occur in play.
Intense or prolonged psychological distress t exposure to internal or external cues
that symbolize or resemble an aspect of the traumatic event(s).
Marked physiological reactions to internal or external cues that symbolize or
resemble an aspect of the traumatic event(s).
Negative alterations in cognition and mood associated with the traumatic event(s)
beginning or worsening after the traumatic event(s) occurred, as evidence by two(or
more) of the following:
Avoidance of or efforts to avoid distressing memories, thoughts or feelings about
or closely associated with the traumatic event(s).
Avoidance or efforts to avoid external remainders( people, places , conversations,
activities, objects, situations) that arouse distressing memories, thoughts, or
feelings about or closely associated with the traumatic event(s)
Marked alterations in arousal and reactivity associated with the traumatic event(s),
beginning or worsening after the traumatic event(s) occurred, as evidence by two (or
more) of the following:
Inability to remember an important aspect of the traumatic event(s) ( typically due
to dissociative amnesia and not to other factors such as head injury, alcohol, or
drugs).
Persistent and exaggerated negative beliefs or expectation about oneself, others,
or the world (e.g., I am bad, No one can be trusted, The world is completely
dangerous, My whole nervous system is permanently ruined)

Persistent, distorted cognitions about the cause or consequences of the traumatic

event(s) that lead the individual to blame himself/herself or others.
Persistent negative emotional state (e.g., fear, horror, anger, guilt, or shame).
Markedly diminished interest or participation in significant activities.
Feelings of detachment or estrangement from others.
Persistent inability take experience positive emotions (e.g., in ability to
experience happiness, satisfaction, or loving feelings)
Duration of the disturbance (Criteria B, C, D, and E) is more than 1 month.
Irritable behaviour and angry outbursts( with little or no provocation) typically
expressed as verbal or physical aggression toward people or objects.
Reckless or self destructive behaviour.
Hyper vigilance.
Exaggerated startle response
Problem with concentration
Sleep disturbance (e.g., difficulty falling or staying asleep or restless sleep).
The disturbance causes clinically significant distress or impairment in social,
occupational, or other important areas of functioning.
The disturbance is not attributable to the physiological effects of a substance (e.g.,
medication, alcohol) or another medical condition

Stress and the Sympathetic Nervous System

The Sympathetic Nervous System

Is one of the two main divisions of the autonomic nervous system, the other being
the parasympathetic nervous system. The autonomic nervous system functions to regulate
the body's unconscious actions.
Like other parts of the nervous system, the sympathetic nervous system operates through
a series of interconnected neurons.
The sympathetic nervous system's primary process is to stimulate the body's fight-orflight response.
So what does sympathetic nervous system do when stress occur?
Adrenaline glands pumps hormone epinephrine (also known as adrenaline) and cortisol
into the bloodstream. As epinephrine circulates through the body, it brings on a number of
physiological changes.
The heart beats faster than normal, pushing blood to the muscles, heart, and other vital
organs.
Pulse rate and blood pressure go up.

 Blood vessels in the arms and legs to dilate

The person breathe more rapidly.
Small airways in the lungs open wide. This way, the lungs can take in as much oxygen as
possible with each breath.
Extra oxygen is sent to the brain, increasing alertness.
Sight, hearing, and other senses become sharper.
Once the crisis is over, the body usually returns to the pre-emergency, unstressed state.
STRESS AND THE IMMUNE SYSTEM
IMMUNE SYSTEM
the bodily system that protects the body from foreign substances, cells, and tissues
a host defense system comprising many biological structures and processes within an
organism that protects against disease
a diffuse, complex network of interacting cells, cell products, and cell-forming tissues
that protects the body from pathogens

Psychoneuroimmunology (PNI), also referred to as

psychoendoneuroimmunology (PENI) or psychoneuroendocrinoimmunology (PNEI), is
the study of the interaction between psychological processes and the nervous and immune
systems of the human body .
Effects of Stress
Good Stress
provides a temporary extra boost of energy or
alertness, which increases performance
causes release of adrenaline which speeds up the heart rate and metabolism
increased reaction and reflexes
acts as a painkiller for better endurance
helps fight tiredness or fatigue
Bad Stress
results in high levels of cortisol and corticosteroids circulating the blood
exposure to such hormones for a long time can cause mental and physical damage
causes sleep problems
risk high blood pressure, heart disease and digestive problems
causes exhaustion and low energy level
overreaction and emotional strain
Mind-Body Therapies
Relaxation exercises
Positive thinking
Behavior modification techniques
Social support

PSYCHOLOGICAL EFFECTS OF LONG TERM STRESS

Stress to Physical Illness
CARDIOVASCULAR DISEASES
HYPERTENSION
-Many clinicians and investigators think that hypertension begins when a person has a
biological tendency toward high cardiovascular reactivity to stress (Tuomisto, 1997; Turner,
1994).
- Having a persisting systolic blood pressure of 140 or more and a diastolic blood pressure of 90
or higher.
Systolic-The blood pressure when the heart is contracting
Diastolic- Referring to the time when the heart is in a period of relaxation and dilatation
(expansion).
-Blood pressure should be below 120/80 ( By convention, the first number given is the systolic
pressure when the heart contracts, the second is the diastolic or between-beat pressure.
-increases the risk of CHD and stroke
Coronary Heart Disease/ CHD
-occurs when the blood vessels that supply the heart muscles are narrowed or closed by the
gradual buildup of a hard, fatty substance called plaque, blocking the flow of oxygen and
nutrients to the heart. This can lead to pain, called angina pectoris, which radiates across the
chest arm.
RISK AND CAUSAL FACTORS IN CARDIOVASCULAR DISEASE
Chronic and Acute Stress
-increases the risk of having a heart attack
- everyday forms of stress can also elevate risk for CHD and death (Matthews and Gump, 2002;
Smith and Ruiz, 2002)
-mental stress is known to raise systolic blood pressure and also to cause an elevation in
epinephrine.
-reduce the oxygen supply to the heart muscle ( Yeung et.al., 1991)

Personality
~TYPE A BEHAVIOR PATTERN- characterized by exercise, competitive drive, extreme
commitment to work, impatience or time urgency and hostility.
~TYPE B BEHAVIOR PATTERN- tend to be more relaxed, more laid back and less time
pressured people
~TYPE D PERSONALITY " Distress,"
-have a tendency to experience negative emotions and also to feel insecure and anxious

TEST: ARE YOU A TYPE D

Read each statement and circle the appropriate number to indicate your answer. There are no
right or wrong answers: Your own impression is the only that matters.

ADD YOUR ANSWERS

-Negative Affectivity:
Add scores for questions 2,4,5,7,9,12 and 13
-Social Inhibition:
Add scores for questions 1,3,6,8,10,11 and 14
SCORE THE RESULTS
You qualify as a Type D personality if your negative affectivity is 10 or higher and your Social
Inhibition is 10 or higher
-People with the higher scores on the negative affectivity component of Type D personality are
also at increased risk of having more problems after cardiac surgery.

 Depression
-People with heart disease are approximately three times more likely that healthy people to be
depressed ( Chesney, 1996: Shapiro, 1996)
-when medical history and other variables were taken into account, those who had experienced
major depression were found to be four times more likely to have had a heart attack.

Anxiety
Social Isolation and lack of Social Support
The Importance of Emotion Regulation

Stress Case Studies

The high-flyer
Louise Palmer, 36, is co-founder of 7days, a management consultancy business. She
earns 200,000 a year and lives with her husband Adrian, 42, who works part-time, and their
seven-month-old son Archie, in Buckinghamshire.
There are several factors that make her feel stressed: being the family's principal
breadwinner; making sure her employees are paid; the constant pressure to win new business;
and worrying about whether she spends enough time with her son.
But she thrives on the pressure of her job and, because she feels largely in control of her
life, says that her stress levels are manageable.
'Of course, I feel stressed because running your own business is a 24/7 commitment. It is
very difficult to walk away and switch off or to wind down. However, when I think about my
mother, who had to worry about whether she had enough money to put food on the table, I think
she would have encountered far greater levels of stress than me. Having had a childhood without
much money, I think that would be the biggest source of stress anyone could have.
'I know that, if the worst comes to the worst, we could sell the house, downsize and have
an easier life.'
The tank driver
John Nelson, 50, drives a petrol tanker. He earns 29,000 a year and lives with his wife in
Cumbernauld, outside Glasgow. He has two adult children who have left home.

He says life has become increasingly difficult for manual workers over the years because
all of the fun has gone out of work.
'It is all about getting a pound of flesh from human beings. Businesses are all about profit
and people feel much more stressed because of that. Years ago, most big organisations would
have a social club, a football team, a pipe band. But that has all stopped. It is just work, work,
work and no play.'
A 'blame culture' and the increasing use of short-term contracts have, says John, created a
climate of fear and insecurity. 'You can work all year doing an excellent job and no one will say
anything, then you do one thing wrong and you'll be crucified. '
John says long shift patterns, boredom, working in isolation and the plethora of health
and safety regulations that have to be adhered to also create immense pressure. 'I have learnt to
switch on when I start work and switch off the minute I leave. But some of the other boys can't.'
The Angry Physician
Dr. M was a 44 year old physician. The middle son of parents, who emigrated from Italy,
ha was ambitious and determined to make a successful life for himself and his family. He worked
long hours to help patients with cancer and he was caring and compassionate. His patients loved
him. But his job was also very stressful. Added to the many demands of maintaining a busy
medical practice was the great sadness that he felt when (inevitably) many of his terminally ill
patients died.
At home Dr. M was a loyal husband and devoted father to his three children. But he was
not an easy person to live with. He found it hard to relax, and he has a very volatile disposition.
He was frequently angry and would shout at everyone whenever he had a bad day. Often his
moods were caused by his feelings that he was not fully appreciated by the other doctors with
whom he worked. Although his wife realized the he just needed to vent his moods took a toll
to his family. His children distanced themselves from him much of the time, and his wife
becomes less and less happy with the marriage.
One day at work Dr. M started to feel unwell. He began to sweat and experienced heavy
pressure on his chest. It was difficult for him to breath. Dr. M recognized the severity of his
symptoms and called out for medical help. He had a sudden and severe heart attack and survived
only because he was working in a hospital at the time of the attack. If he had not received prompt
medical attention, he almost certainly would have died.
After his heart attack Dr. M became very depressed. It was almost as though he could not
accept that he, a physician, had a severe medical problem. Although he lived in free of having
another heart attack, his efforts to lose weight (which his doctor had told him to do) were
sabotage by his unwillingness to follow any diet. He would try and give up, coming back from
the Italian bakery full of pastries. Making the problem worse was the fact that because he was a
doctor, his own doctors were somewhat reticent about telling him what he had to do to manage

his illness. He went back to work, and his family walked on eggshells, afraid to do or say
anything that night stress him. His wife encouraged him to do what the doctors
recommendation. However, Dr. Ms attitude was that if he was going to die anyway, he might as
well enjoy himself until he did.

Find your stress level right now by completing this test.

Top of Form
DO YOU FREQUENTLY:
Neglect your diet?
Try to do everything yourself?
Blow up easily?
Seek unrealistic goals?
Fail to see the humour in situations others find funny?
Act rude?
Make a 'big deal' of everything?
Look to other people to make things happen?

YES

NO

Have difficulty making decisions

Complain you are disorganized?
Avoid people whose ideas are different from your own?
Keep everything inside?
Neglect exercise?
Have few supportive relationships?
Use sleeping pills and tranquilizers without a doctor's approval?
Get too little rest?
Get angry when you are kept waiting?
Ignore stress symptoms?
Put things off until later?
Think there is only one right way to do something?
Fail to build relaxation time into your day?
Gossip?
Race through the day?
Spend a lot of time complaining about the past?
Fail to get a break from noise and crowds?

What Your YES Score Means:

0-5: There are few hassles in your life. Make sure though, that you are not trying so hard to avoid
problems.
6-10: Youve got your life in fairly good control. Work on the choices and habits that could still
be causing you some unnecessary stress in your life.
11-15: Youre approaching the danger zone. You may well be suffering stress-related symptoms
and your relationships could be strained. Think carefully about choices youve made and take
relaxation breaks every day.
16-25: Emergency! You must stop now, re-think how you are living, change your attitudes and
pay careful attention to diet, exercise and relaxation.
While we all get stressed, how much is too muchand how can you tell if your stress level is
OK or over-the-top? (Without yanking any hairs, of course.) Dr. Elefteriades helped us create the
following quiz to gauge your stress level. Check the letter that most suits you.
1. Youve heard 8 hours of sleep is optimal, but how much do you really get?
A. Eight! I sleep like a baby and nothing can keep me from my shut-eye.
B. Sometimes 8 hours, sometimes 6. It depends on how much I can get done before hitting the
sack.
C. Sixif Im lucky. Sometimes I have a hard time falling asleep, or I wake in the middle of the

night.
2. When it comes to food, you:
A. Make a point to eat three well-rounded meals a day, complete with protein, whole grains and
veggieshealthy eating is important and worth the time.
B. Eat breakfast and usually grab lunch and/or dinner at work. Its hard to find time to prepare
healthy meals (and tough to resist Chinese takeout or cupcakes in the break room).
C. Sometimes go a little overboarddont leave me alone with a box of cookies. Or, sometimes
I just forget to eat.
3. On most days when you first wake up you feel:
A. Excited about the day. Todays presentation? Bring it!
B. Ready for almost anything once a cup of coffee is down the hatch.
C. Like the last thing I want to do is get out of bed.
4. For you, headaches are:
A. Something friends discuss but fortunately happen only once in a while for me.
B. Infrequent. They can happen but usually go away, and seem to coincide with colds or
allergies.
C. Pretty common.
5. Sex is something you:
A. Want as often as possible, depending on my schedule, partner, and circumstance.
B. Enjoy, but I could take it or leave it. Sometimes I'm just not feeling up to it.
C. Remember liking. Now it seems as if my libido is on hiatus.
6. Your muscles feel:
A. Good! StrongIve been working on them in the gym, outside running, at yoga class
B. OK. Sometimes I get sore from working out, or my back feels stiff from sitting too long.
C. Achyespecially around my neck, shoulders, and jaw.
7. When it comes to your body shape you:
A. Are pretty fit and trim. I have some room for improvement, but who doesnt? I feel and look
healthy.
B. Know Id be healthier if I shed some pounds, but I'm not dangerously overweight. I tend to
carry weight around my belly.
C. Seem to carry a lot of fat around my middle, which I just cant seem to lose.
You picked:
Mostly As: Congratulations! You seem to have found the magic balance in life, where youre

practically stress-free. You live a healthful, happy life and know how to prioritize and take care
of yourself.
Mostly Bs: You carry an average amount of stress, and it pops up in stealthy ways. For example,
belly fat has been linked to increased levels of cortisol, and therefore stress and heart disease.
(And of course, impulsive eating, like scarfing cupcakes, can be linked to belly fat.) For the most
part, you have healthful habits, but some, like not getting enough sleep, may actually contribute
to stress.
Mostly Cs: You're stressed out. Muscle pain, loss of libido, and frequent headaches can all
signify too much stress in your life. A lack of sleep may also signal anxiety, which can elevate
cortisol levels. Maintaining a healthy schedule, which includes nutritious meals and as much
sleep as you can manage, will help bring your stress level out of orbit.

Reference:

Australian Psychological Society . 2012.

[https://www.psychology.org.au/Assets/Files/StressTipSheet.pdf]
Abnormal Psychology, Pearson, 2015
Brodal, Per (2004). The Central Nervous System: Structure and Function (3 ed.). Oxford
University Press US. pp. 369396. ISBN 0-19-516560-8.
DSM-5
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Rosenbaun, L. April 24, 2013.[ http://www.prevention.com/mind-body/emotional-health/quizhow-stressed-are-you]

1) What are the signs of stress?

a) Depression
c) Diarrhea
b) Headaches, other aches and pain
d) All of the above
e)
f) Answer:D, such stress raises the level of adrenaline and corticosterone in the body,
which in turn increases the heart rate, respiration, blood pressure, and puts more, physical
stress on bodily organs. Long term stress can be contributing factor in heart disease, high
blood pressure,stroke and other illneses.
g)
2) Who is the Father of Stress Research?
a) Sigmund Freud
c) Hans Selye
b) B.F Skinner
d) Erik Erickson

3)

4)

5)

6)

e)
f) Answer:C, the first person to study stress scientifically was a physiologist named Hans
Selye, Dr. Selye spent many years studying the physical reactions of animals to injury and
disease. Based on his research , Selye concluded that human beings and animas share a
specificand consistent pattern of physiological response to illness or injury. These changes
represent our bodys attempt to cope with the demands imposed by the illness or injury
process.
g)
A kind of stress which is brief and specific to the demands and pressure of a particular
situation, such as a deadline, a performance or facing up to a difficult challenge or traumatic
events.
a) Eustress
c) Episodic acute stress
b) Acute stress
d) Chronic stress
e)
f) Answer:B, it is caused by the daily demands and pressure encountered by each on of us.it
occurs only at a short period of time.
g)
One of the stress coping technique in which you can plan things to do each day that you look
forward to and which give you a sense of pleasure, like reading a book.
a) Relaxation
c) Spending with people who care
b) Noticing Self talk
d) Looking after your health.
e)
f) Answer:A,because it can help your body and your nervous system to settle and readjust.
g)
Our quick and effective reaction to get through the stressful situation.
a) Adrenaline Rush
c) Panic attack
b) Fight or flight response
d) Chronic stress
e)
f) Answer:B,the bodys fight or flight response is initiated by the part f the brain known as
the hypothalamus. The hypothalamus stimulates the sympathetic division of the automatic
nervous system, which action acts on smooth muscle and internal organs to produce the
bodily changes. The hypothalamus also release corticotrophin release factor (CRF), which
triggers the pituitary gland to release adrenocorticotropic hormone (ACTH). In turn, ACTH
then stimulates the adrenal glands to release about 30 other hormones. These hormones act
on organs and muscle to prepare the body to fight or flee.
g)
Which of the first phase of general adaptation syndrome?
a) Adaptation
c) Alarm reaction
b) Exhaustion
d) Relaxation
e)
f) Answer: the body mobilizes to confront a threat by triggering sympathetic nervous
system activity.
g)

7) Feeling of being overloaded, wound up tight, tense and worried, feeling of strain and
pleasure.
a) Paranoia
c) Hallucination
b) Anxiety
d) Stress
e)
f) Answer:D, In general terms, experiencing stress means experiencing our physical or
physiological well being. It is also a medical term for wide range strong external stimuli,
both physiological and psychological
g)
8) Researcher Hans Selye (1979) described such physiological changes as part of the _____ that
all organism show in response to stress.
a) General Adaptation Syndrome
c) Fight or flight response
b) Stress coping strategies
d) Environment
e)
f) Answer:A, according to hans seslye, the body reacts in three phase. In the first phase,
alarm, the body mobilizes to confront the threat, which temporarily expends resources and
lowers resistance. In the resistance phase , the body is actively confronting the threat and
resistance is high, if the threat continues, the body moves into exhaustion.
g)
9) A complex network of interacting cells and cell products that protects the body from
pathogens.
a. Sympathetic nervous system
c. Parasympathetic nervous system
b. Immune system
d. Endocrine system
e.
Answer: B, the immune system acts as a hosts shield from foreign substances.
10) The study of the interaction between psychological processes and the nervous and immune
systems of the human body.
a. Psychoneuroimmunology
c. Psychoneuroendocrinoimmunolo
b. Psychoendoneuroimmunology
gy
d. Psychoimmunology
e.
f. Answer: A, B and C are like terms. They are all composed of various branches of
science that is put into one, focusing on psychological processes and its connection to
the immunity.
11) Stress speeds up the heart rate and metabolism because of the release of this hormone.
a. Adrenaline
c. Cortisol
b. Aldosterone
d. Corticosteroids
e.
Answer: A, adrenaline is released by the adrenal gland when stressed.
12) The point in which stress becomes bad.
a. Eustress
c. Chronic stress
b. Acute stress
d. Episodic acute stress
e.
Answer: C, stress becomes bad when its experienced in a long time.
13) The study not included in psychoneuroimmunology.

a. Physiology
c. Infectious diseases
b. Pharmacology
d. Anatomy
e.
Answer: D, anatomy is the study of parts only, thus, not included.
14) An effective way of preventing stress.
a. Meditation
c. Seeing new people
b. Attending parties
d. Spending some time alone
e.
Answer: A and D, time off and relaxation exercises help the mind relax.
15) Stressful situations that have no resolution in sight.
a. Chronic stressors
c. Daily hassles
b. Acute stressors
d. Major life events
e.
Answer: A, chronic stressors last for a long term.
16) Considered good stress.
a. Acute stress
c. Episodic acute stress
b. Chronic stress
d. Eustress
e.
Answer: D, eustress is the term for good stress.
f.
17) After the car accident, Yoshiro suffered from nightmares and other sleeping problems, and
could not concentrate on his work. After about two weeks these symptoms disappeared and
he was able to work and sleep normally again. Yoshiro was suffering from _______.
a) Acute stress disorder
c) Mild stress reaction
b) Post-traumatic stress disorder
d) Shell shock
e) Answer: A, the symptoms only occurred for two weeks.
18) Anxiety , recurring night mares , sleep disturbances, and concentration problems that occur
for more than one month after a major stressor are symptoms of__________.
a) Acute stress disorder
c) Pre traumatic stress disorder
b) Post-traumatic stress disorder
d) General stress disorder
e) Answer: b, based on DSM-5 when the symptoms associated with ASD last for more than
one month it is called Post-traumatic stress disorder
19) Sleep disturbance is under what category?
a) Dissociative Symptoms
c) Arousal Symptoms
b) Avoidance symptoms
d) Intrusion symptoms.
e) Answer: C, arousal may manifest in a variety of ways, such as having problems sleeping,
being easily startled, feeling restless or irritable, or having a hard time concentrating.
Sometimes people with ASD become hyper vigilant
20) ________ symptoms are efforts people make to avoid the traumatic event.
a) Negative mood
c) Avoidance Symptoms
b) Dissociative Symptoms
d) Intrusion symptoms.
e) Answer: C, Avoidance is a common reaction to trauma. It is natural to want to avoid
thinking about or feeling emotions about a stressful event. But when avoidance is extreme, or
when its the main way you cope, it can interfere with your emotional recovery and healing.
21) A person may relive the traumatic event over and over through:
a) Crying
b) Flashbacks

c) Outburst
d) Distressed feeling
e) Answer: B, the symptoms can start from the persons own thoughts and feelings. Words,
objects, or situations that are reminders of the event can also trigger re-experiencing
symptoms.
22) ASD is diagnosed through blood test.
a) True
c) Maybe
b) False
d) I dont know
e) Answer: B, Its diagnosed by a mental health or medical professional based primarily
upon the symptoms that appear following a traumatic event.
23) What are the two stress related stress disorder
a) Anxiety disorder & obsessive compulsive disorder
b) Post-traumatic stress disorder & acute stress disorder
c) Acute Stress disorder & Anxiety disorder
d) Dissociative disorder & Major depressive disorder
e) Answer: B, *answer based on DSM-5; no further explanation.
24) Persistent inability to experience positive feeling is under what symptoms?
a) Intrusion symptoms.
c) Dissociative Symptoms
b) Avoidance symptoms
d) Negative mood
e) Answer: D, Negative mood is usually the result of irrational thinking about people or
events. This could mean focusing on the negative and not seeing the positive in your life and
work. You may see situations as problems rather than as challenges.
25) Sexual assault, plane crash, or natural disasters can be categorized as?
a) Daily hassles

c) Catastrophic events

b) Major life events

d) Acute stressors

e) Answer: C; catastrophic events is a sudden, unexpected, potentially life-threatening

experiences or traumas
26) Alvin is a lonely boy. He is always alone in everything he does. He isolate himself to others.
Until, one day, he was diagnosed by coronary heart disorder. What do you think is the risk
and causal factors of Alvin's CHD development?
a) Depression
b) Personality
c) Anxiety
d) Social Isolation and Lack of social support

e) Answer: d; Alvin's feeling of loneliness, being alone and isolation maybe one of the
causal factors of having his CHD
27) Jimmy is a dependent boy and he is going to college next school year were he will leaving in
a dormitory which is far from their home. What category of stressor is given from the
situation?
a) Daily hassles

c) Catastrophic events

b) Major life events

d) chronic stressors

e)
Answer: b; major life events are Life changes or events that can be either positive or
negative one
28) Gigi want to go on a concert with her best friends that ends late but she was scolded by her
mother. Her mother asked, " Do you want to be grounded for 1 week or you will stay here?"
What kind of conflict Gigi faced?
a) Aproach-aproach conflict

c) Aproach-avoidance conflict

b) Avoidance-avoidance conflict

d) Conflict

e) Answer; a; it occurs when a person is choosing between two equally unattractive

options.
29) Tanya is a competitive, hostile and impatient individual. what pattern of personality she
possessed?
a) Type A behavior pattern

c) Type C behavior pattern

b) Type B behavior pattern

d) Type D behavior pattern

e) Answer: a; because type A behavior pattern is characterized by excessive competitive

drive, extreme commitment to work, impatience or time urgency and hostility.
30) Filipino's are well known of this characteristic because no matter what natural disasters we've
been faced, we still end up smiling and keep moving forward.
a) Adaptation

c) Acceptance

b) Coping up

d) Resilience

e)
f) Answer: d; resilience is the healthy psychological and physical functioning after a
potentially traumatic event.

31) Mr. Cruz is always bombarded by stress from his workplace and from his family. When he
had a chance to check his blood pressure, he was shocked because it's already 140/90. What
cardiovascular disease it will fall?
a) Heart attack

c) Coronary heart disease

b) Hypertension

d) Stroke

e) Answer: b; Hypertension is having a persisting systolic blood pressure of 140 or more

and a diatolic blood pressure of 90 or higher.
32) Tara is a dark skin toned girl and she always experienced discrimination wherever she goes.
What category of stressor is this?
a) Daily hassles

c) Acute stressors

b) Catastrophic events

d) Chronic stressors

e) Answer: d, chronic stressors is a long-term stressful situations that have no resolution in

sight like discrimination.
f)
33) This system is one of the two main subdivisions of nervous system which function is to
regulate the body's unconscious actions.
a) Somatic Nervous System
b) Autonomic Nervous System
c) Central Nervous System
d)
e) Answer: b.,The autonomic nervous system (ANS) is a division of the peripheral nervous
system that influences the function of internal.[1] The autonomic nervous system is a control
system that acts largely unconsciously and regulates bodily functions such as the heart rate,
digestion, respiratory rate, pupillary response, urination, and sexual arousal.
f)
34) This system in the nervous system primary process is to stimulate fight or flight response.
a) Central Nervous System
c) Parasympathetic Nervous System
b) Sympathetic Nervous system
d)
e) Answer: b., The sympathetic nervous system (SNS) is part of the autonomic nervous
system (ANS). It is involved in the stimulation of activities that prepare the body for action,
such as increasing the heart rate, increasing the release of sugar from the liver into the
blood, and other generally considered as fight-or-flight responses.
35) This system in the nervous system primary process is to stimulate feed or breed response.
a) Central Nervous System
c) Parasympathetic Nervous System
b) Sympathetic Nervous system
d)

e) Answer: c.,The parasympathetic nervous system is one of three divisions of the

autonomic nervous system. Sometimes called the rest and digest system, the
parasympathetic system conserves energy as it slows the heart rate, increases intestinal and
gland activity, and relaxes sphincter muscles in the gastrointestinal tract.
f)
36) Is a physiological reaction that occurs in response to a perceived harmful event, attack, or
threat to survival?
a) Feed or breed response
c) Fight or flight response
b) Immune response
d)
e)
Answer: c.,The fight-or-flight response, a sequence of internal processes that
prepares the aroused organism for struggle or escape. It is triggered when we interpret a
situation as threatening. The resulting response depends on how the organism
has learned to deal with threat, as well as on an innate fight-or-flight program built
into the brain.
37) What hormone is pumped in the body when body is stressed?
a. epinephrine
c. serotonin
b. oxytocin
d.
e.
Answer: a.,Epinephrine, also known as adrenalin or adrenaline, is primarily a
medication and hormone. An adrenaline gland pumps hormone epinephrine into the
bloodstream. As epinephrine circulates through the body, it brings on a number of
physiological changes.
38) Which of the following is not true when body is under stressed?
a. heart pounds faster
c. muscles loosen
b. blood pressure rises
d.
e.
Answer: c., Muscles tighten not loosen.
39) As the Sympathetic NS continues to trigger physical reactions, it causes a wear-and-tear on
the body.
a. True
c. Maybe
b. False

d.
e.
Answer: c , Because continuous activation of the nervous system does to other
bodily systems is a problem.
40) ______________ pumps hormone epinephrine and cortisol into the bloodstream.
a) Adrenaline gland
f. b) Thyroid Gland
g. c) Thymus Gland
h.
i. Answer: A, located at the top of each kidney, produce hormones that help the body
control blood sugar, burn protein and fat, react to stressors like a major illness or injury, and
regulate blood pressure. Two of the most important adrenalhormones are cortisol and
aldosterone.
j.
k.
l.
m.