Interpersonal Model

• Harry Stack Sullivan

• Development occurs in stages with changing
relationships
• Infancy-crying
• Childhood-learning to delay gratification of
needs
• Juvenile-cooperation,
competition
• Preadolescence-collaboration “ chum relationship”
• Early Adolescence –relationship with opposite sex
• Later adolescence –form a lasting sexual relationship
• Goal- is to develop mature and satisfactory rel that are relatively free
fromanxiety.
HILDEGARD
PEPLAU

 Mother of Psychiatric nursing

GOAL: reduce symptoms, improve social

functioning and assist the person in developing
more skills
Nursing is a
process Health is the
between goal of nursing.
persons.
Communication Anxiety
is an essential impedes the
component of development of
nursing. relationships.
Cognitive Stage of
Development

• Jean Piaget
• Explained how intelligence and cognitive
functioning develop in children
 Child develops sense
of self as separate
Sensorimotor (birth to from the environment
2 years) and the concept of
object and
permanence
• Child slowly develops concepts that people, and objects have
permanence, even though they are no longer visible
 Child develops the ability
to express self with
Preoperational (2-6yrs language, understand
old) the meaning of symbolic
gestures and begins to
classify objects
• Child focuses on one aspect at a time (centration) and thought often
seems illogical because child reason from one specific to another
 Child begins to apply logic
to thinking, understand
spatiality and reversibility
Concrete operation ( 6-12
and is increasingly social
yrs old)
and able to apply
rules:however, thinking is
still concrete
• Child’s thinking is restricted to immediate and physical. School-aged
children can reason about what is but cannot hypothesize about
what may be and thus cannot think about future problems
 Child learns to think
and reason in abstract
Formal operation (12- terms, further develops
15 years and above) logical thinking,
achieves cognitive
maturity
• Adolescent may confuse ideal with practical but when problem, can
suggest a number of solutions. Ability to consider moral and political
issues from variety of perspective is present.
CBT

AARON BECK (CT)

ALBERT ELLIS(RET)

 A-----------B----------C
(event) (belief) (emotional response)
Irrational beliefs

One should feel loved One must totally be

and approved by competent to be
everybody. considered worthwhile.
Individuals have Rejection or unfair
little ability to treatment can
control their cause catastrophic
feelings. consequences.
One is disliked when a
disagreement exist.

One should never make mistake.

Being passive in life is easier

than confronting difficulties
Problem solving and reality
testing is aimed at correcting
faulty cognition.

Develop a more realistic

appraisal of self and the world
Hans Selye- General
Adaptation Syndrome

Stage 1- Alarm Reaction

-increase level of alertness
-increase level of anxiety
-task-oriented
o Stage II-Stage of Resistance
-use of coping and defense mechanism
-psychosomatic symptoms develop
• StageIII- Stage of exhaustion
-disorganization of thinking
-disorganization of personality
-stupor/violence
Lazaru’s
Interaction Model

• Psychological stress is a relationship

between the person and the
environment that is appraised by the
person as taxing and endangering his
well-being.
• Anxiety is the response to threat.
Stress
Stress is a feeling of emotional or physical tension. It can come from
any event or thought that makes you feel frustrated, angry, or nervous
  Low energy
 Headaches
 Upset stomach, including diarrhea, constipation,
and nausea
Physical  Aches, pains, and tense muscles

Responses  Chest pain and rapid heartbeat

 Insomnia
 Frequent colds and infections
 Loss of sexual desire and/or ability
 Nervousness and shaking, ringing in the ear, cold or sweaty hands and feet
 Dry mouth and difficulty swallowing
 Clenched jaw and grinding teeth
 Psychological Responses

 Changes in appetite -- either not eating or eating too much

 Procrastinating and avoiding responsibilities
 Increased use of alcohol, drugs, or cigarettes
 Exhibiting more nervous behaviors, such as nail biting, fidgeting,
and pacing
  Mental health problems, such
as depression, anxiety, and personality disorders
 Cardiovascular disease, including heart
Long Term Effects disease, high blood pressure,
abnormal heart rhythms, heart attacks, and stroke
of Stress  Obesity and other eating disorders
 Menstrual problems
 Sexual dysfunction, such as impotence and premature
ejaculation in men and loss of sexual desire in both men
and women
 Skin and hair problems, such as acne, psoriasis,
and eczema, and permanent hair loss
 Gastrointestinal problems, such
as GERD, gastritis, ulcerative colitis, and irritable colon
Psychoneuroimmunological Mode

is the study of the interactions among behavioral, neural and endocrine, and immune
processes

The brain communicates with the immune system through autonomic nervous system and
neuroendocrine activity.

Conversely, an activated immune system generates chemical signals (cytokines) that are
perceived by the nervous system. Thus, bidirectional pathways connect the brain and the
immune system and provide the foundation for behavioral influences on immune functions.
• Pavlovian conditioning can suppress or enhance immune responses and stressful life
experiences and emotional states (e.g., depression) are generally immunosuppressive.
These effects are biologically meaningful in that they appear to be implicated in altering
the development and/or progression of immunologically mediated disease processes.
• Thank you!!!