What is the term used to describe the physical and psychological responses to events that are threatening or challenging?

1 Introduction

Psychological responses to the experience of traumatic events have long been recognized, although the meaning attached to and the terms used to describe such reactions have varied over the years, and continue to do so, influenced by the prevailing beliefs and interests of the time and depending on the culture studied. ‘Post-traumatic stress disorder’ (PTSD) is the term now given, at least in Western psychiatry, to a constellation of symptoms which may follow exposure to a traumatic event, and which cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. The word ‘trauma’ is derived from ancient Greek surgical terminology, meaning an injury stemming from penetration of the body defense (intactness) such as skin. Exposure to major trauma does not cause psychiatric disorder in all those who experience it, possibly due, at least in part, to differences in vulnerability and resilience. The concept of PTSD has been extended from adults to include children, although it is still uncertain to what extent the developmental status of the child influences the symptoms (Scheeringa et al. 1995). The child's perception of its family's reaction to a disaster may also be relevant.

Unfortunately, the recent burgeoning of interest in PTSD has perhaps given some the idea that PTSD is the only response after trauma. This is not the case (see Udwin 1993 for a discussion regarding children). It should be emphasized at the outset that PTSD is only one of a number of possible psychological sequelae of traumatic experiences, and the concept is not without its critics.

2.4.2 Psychological responses

Many studies of job stress include psychological responses, and they have been summarized in a number of review articles (Holt 1982, Cooper and Payne 1988, Kahn and Byosiere 1992, Lundberg 1999). As these reviews indicate, most of the psychological responses to job stress in this research are self-reported and unlinked to clinical validation or physiological measures. An exception is the work of colleagues at Stockholm University, both at the Karolinska Institute and the Department of Psychology (Stockholm University 1999).

By far the most frequently cited response to job stress is dissatisfaction with the job. More intense affective responses include anger, frustration, irritation, and hostility toward supervisors and the organization as a whole. Other negative responses correlated with job stress are more passive; among them are boredom, burnout, fatigue, feelings of helplessness and hopelessness, and depressed mood. Many of these words are virtual synonyms, a fact that reflects the tendency of researchers to design and label their own measures rather than replicate previous work. Replication in diverse organizations would be very useful, however, as would the combination of physiological and behavioral criteria with psychological responses.

2.3 Coping with Prejudice and Discrimination

Coping strategies used by stigmatized individuals can be divided into psychological and behavioral responses. In many cases, coping strategies protect people from the negative effects of prejudice and discrimination and have potential costs. Disengagement or disidentification is a possible psychological response to discrimination that can allow one to not attend to potentially demeaning feedback from others (Crocker et al. 1998). However, this can result in disidentification with domains that might be useful for promoting one's academic success. One type of behavioral response is preventative. Stigmatized individuals may choose to avoid situations where they feel that they may encounter prejudice (Swim et al. 1998) or to engage in behaviors that might compensate for the negative expectations that others might have of them (Miller and Myers 1998). Although these prevention strategies may protect the individual from future encounters with prejudice, they too have their costs. Avoidance can cause people to miss opportunities, prevent disconfirmation of beliefs, and prevent the development of meaningful relationships. People can overcompensate for prejudice, which may appear out of place or fake, or they may undercompensate particularly if they are in situations where they do not feel threatened. Other behavioral responses occur after an event and these responses can be both nonassertive and assertive (Swim et al. 1998). People may choose to politely confront a person, for instance, by asking the perpetrator to explain themselves, by attempting to educate the perpetrator, or by engaging in collective action against the perpetrator. While these responses may result in change and may leave the target feeling more empowered, there are potential costs, such as retaliation on the part of the perpetrator especially with the more assertive responses.

3.3 Psycho→Somatic Causation

This is the counterpart of the preceding. It states that psychological responses to external events cause the somatic changes. Most commonly, stress or strong emotions are invoked as intervening mechanisms. Weiner (1977) noted that it may be the behavioral concomitants of the psychological processes which act on the body: ‘lifestyle factors’ such as smoking or substance abuse. Except for ‘specificity’ theories already described, the ‘choice’ of the resultant disease is usually left to other, biological factors. Again, secondary feedback is often added, bodily changes acting back on the mind.

3.3 Self-management Training

A logical next step, given the evidence for the impact of the psychological response (coping behavior) of patients to their asthma, pertains to teaching asthma patients to optimize their handling, or self-management, of the disorder. Creer (1979) represents the first psychologist who studied the effects of this type of intervention in children and adults. In self-management training, patients with asthma are taught skills to perceive the first signs of periods of shortness of breath, take appropriate action to prevent or control episodes of shortness of breath, and manage bouts of asthma if they occur. Reviews of the effects of self-management training report reductions in symptom frequency and severity, use of medical resources, and fewer disruptions of daily life (e.g., absenteeism from school or work, levels of anxiety) (Clark and Gong 2000).

Current research on asthma by psychologists focuses on refining self-management training, symptom perception, and the effects of emotional expression on pulmonary function (Smyth et al. 1999).

1.2 Psychological Effects of Modeling

Peer models maximize similarity between the observer and model, and thus may especially motivate changes in children's psychological responses to activities they perceive as frightening or difficult. Weiss et al. (1998) examined the effect of peer mastery and coping models with children (ages 5–8) who were fearful of swimming. Peer coping and mastery models produced better performance, higher self-efficacy, and lower fear than did control participants. Peer coping models had a stronger effect on self-efficacy than peer mastery models (see Self-efficacy). Findings imply that using a peer model along with swim lessons is an effective means of instructing children who are fearful of the water.

Developmental differences in children's use of social comparison are an important consideration in peer modeling of motor and psychological skills. Butler (1989) contends that younger children (less than 8 years) primarily use peers for observational learning, while older children use peers for evaluating one's ability. It is conceivable that children in the Weiss et al. study primarily used peer models as sources of information for how to perform the skills. Older children who emphasize social comparison over observational learning may respond differently to peer models who demonstrate skills of which they are afraid or see as difficult.

1.3.9 Emotion

Emotion is a complex psychophysical process that arises spontaneously, rather than through conscious effort, and evokes either a positive or negative psychological response and physical expression. Research on emotion is conducted at varying levels of abstraction, using different computational methods, addressing different emotional phenomena, and basing their models on different theories of affect.

Since the early 1990s, emotional intelligence has been systematically studied [33]. Scientific articles have suggested that there exists an unrecognized but important human mental ability to reason about emotions and to use emotions to enhance thought. Emotional intelligence refers to an ability to recognize the meanings of emotion and their relationships and to reason and problem-solve based on them. Emotional intelligence involves in the capacity to perceive emotions, assimilate emotion-related feelings, understand the information of those emotions, and manage them.

In the book Emotion Machine, M. Minsky points out that emotion is a special way of thinking for human beings and proposes six dimensions of building future machines [34].

41 Goals of Security Lighting

1.

Objective illumination: will allow observation of the protected item.

Physical deterrence: uses a sufficient light level to cause psychological responses such as pain and temporary blindness. The light source can be continuous or event-responsive and 100,000 fc will cause temporary blindness for 2–3 min.

Glare projection: achieved by projecting light away from the protected property so that an approaching intruder cannot see onto the premises, but they are highly visible from the inside.

Psychological deterrence: results when lighting leaves potential intruders fearful that they will be detected, identified, and/or apprehended.

5.4 Elderly people detect depression signs and symptoms

The understanding of the signs and symptoms starts with an elderly person. Red flags include depression, sadness, or misery, mysterious or exacerbated pains and sorrows, lack of confidence in socializing, loss of weight or appetite, feelings of exhaustion or inability, determination or energy deficit, sleep issues (sleep challenges, sleep disorders, over-sleeping, or sleepiness in the morning), loss of self-worth (individual care), sluggish movement or voice, alcohol use or other prescription drugs, emphasis on mortality, depression, difficulty of memory, negligence for personal treatment (skipping appointments, medical recklessness/carelessness), lack of self-respect.

The Wandering Patient (Dementia- and Psychological-related)

Wandering patients are a security concern presented by certain types of dementia patients, most frequently those with Alzheimer’s disease. It is estimated that each week at least one resident of the nation’s nursing home facilities wanders away from a care facility and dies. The wandering patient situation is of course not limited to nursing homes. The mental health facility and even certain patients in the general medical/surgical category can be wandering patients. Intensive care staff have long recognized psychological responses of patients, which include delirium, catastrophic reaction, and euphoric response. The most common of these responses is delirium, which has been described on a range from slight clouding of consciousness to a full-blown psychotic reaction. In this respect, patients experience varying degrees of cognitive impairment.

A patient movement control system, utilizing an electronic tag, is a fairly common safeguard for suspected wandering patients. The patient wears a tag that contains a radio frequency circuit; this circuit communicates with a detection sensor usually installed at the exit door or elevator opening. Some systems do not use multiple-detection sensors at doors, but have a radio receiver installed at a central location instead. In these systems, the distance between the tag and central monitor is constantly measured with an alarm, which sounds when a predetermined distance is exceeded. Electronic systems can be installed as stand-alone systems at each door or as centralized computer-controlled systems. Computerized systems are capable of identifying the individual patient and can display the alarm information as either text or a graphic map. Individual tags can be deactivated in a number of ways to allow family or staff to take a patient out of the defined secured area.31

A rather extensive radio frequency tag system for managing long-term care patients is currently being used at the Sunnybrook Health Sciences Center, which is part of the University of Toronto (Canada). The Sunnybrook Health Sciences Center is a 1,300-bed facility, with 550 beds being occupied by long-term care patients. There are, thus, varying degrees of control depending on the unit and type of patients. In addition to the radio frequency system, the hospital has what they refer to as the “Blue Shirt Program.” In this program, the at-risk cognitively impaired patients wear a blue shirt with the Sunnybrook Health Sciences Center logo emblazoned in yellow across the back. All staff members—and even members of the immediate community—are educated on the Blue Shirt Program and are asked to report any observed wandering patients.32

An effective approach to managing the problem of wandering patients requires proper facility design and physical security safeguards, good control policies and procedures put into practice by staff, and ongoing staff training in the management of the wandering patient.