A. Mind, Body and Stress
1. What is stress: stimulus, response, or combination?
2. Hassles, stresses and traumas
3. The ABCS of stress responses
   a. Affective (emotional)
   b. Behavioral
   c. Cognitive
   d. Somatic (physiological)
4. Stress and mind-body relationships
   a. Mental health
   b. Physical health

B. Stress, Trauma and Dissociation
1. Adjustment disorders
   a. Normal adjustment vs. excessive distress and/or impairment
   b. Adjustment disorders in DSM
      (1) Identifiable stressor preceding problem
      (2) Resolution after termination of stressor
2. Stress disorders
   a. Ordinary and extraordinary stress
   b. Stress disorders in DSM
      (1) Acute stress disorder
      (2) Posttraumatic stress disorder (PTSD)
3. Dissociative disorders
   a. The concept of dissociation
   b. Dissociative disorders in DSM
      (1) Depersonalization disorders
      (2) Dissociative amnesia and dissociative fugue
      (3) Dissociative identity disorder (DID)
      (4) [Trance disorder]
   c. The multiple personality disorder controversy (see Lilienfeld Ch. 8)

C. Somatic and Health-related Disorders in DSM
1. Psychosocial influences on biology
   a. Can the mind influence the body?
      (1) Hypnosis
      (2) The placebo effect
      (3) Voodoo
   b. The physiological effects of stress
2. Links to psychological theory and practice
   a. Mind-body dualism
   b. Psychosomatic medicine
   c. Behavioral medicine and behavioral health
   d. Health psychology
3. Somatic symptoms secondary to other mental disorders
4. A puzzle: physical symptoms without confirmed organic basis
   a. Malingering
   b. Factitious disorders
   c. Somatoform disorders
      (1) Hypochondriasis
      (2) Somatization disorder and pain disorder
      (3) Conversion disorder
      (4) Body dysmorphic disorder
   d. The mystery syndromes: CFS and PMS
5. The grey area: sexual problems, physical or psychological?
   a. Normal and abnormal sexual functioning
      (1) Dysfunction
      (2) Deviance
      (3) Sexual orientation
   b. Sexual dysfunctions
      (1) Desire disorders
      (2) Arousal disorders
      (3) Orgasmic disorders
      (4) Sexual pain disorders
6. Psychological factors affecting real medical conditions
   a. Earlier views: psychosomatic illnesses
   b. Current views
      (1) Psychological factors can influence the development and course of a medical condition
      (2) Psychological factors can interfere with the treatment of a medical condition
      (3) Psychological factors can create additional health risks
      (4) Stress-related physiological responses can precipitate or aggravate a medical condition
   c. Representative areas of current focus
      (1) AIDS
      (2) Cardiovascular diseases
      (3) Cancer
      (4) Headaches and lower back pain

D. Etiology of Stress-and-Health Related Disorders
1. The role of the person in stress and trauma
   a. Threshold models
   b. Diathesis-stress model
   c. Preexisting illness models
2. The biomedical perspective
   a. Genetic influences
   b. Neurobiological factors
      (1) Stress and disease
      (2) Biological aspects of arousal and trauma
      (3) Reproductive biology and sexual dysfunction
      (4) Undiagnosed illness in somatoform disorders
3. The cognitive-behavioral perspective
   a. Maladaptive learning and behavior
      (1) Reinforcement (secondary gain)
         (a) Positive (e.g. attention)
         (b) Negative (e.g. escape from responsibility)
      (2) Foa’s two-factor theory of PTSD
      (3) Unhealthy habits
      (4) Conditioned anxiety and sexual dysfunction
   b. Coping styles: Type A and heart disease
   c. Faulty cognitions
      (1) Self-efficacy and changing health behaviors
      (2) Attention and interpretation
      (3) Self-blame and fearful expectancies
      (4) Distinguishing cognition as cause from cognition as symptom/effect
4. The intrapsychic perspective
   a. The unconscious and primary gain – conversion and repression/dissociation
   b. Defenses and their breakdown in PTSD
   c. Negative affectivity and emotional distress
5. The socio-cultural perspective
   a. Life stress and social support
   b. Trauma, dissociation and dissociative disorders and PTSD
   c. Social reinforcement and the “sick” role
   d. Relationship issues in sexual dysfunction
   e. Attitudes and beliefs about sexuality
   f. Cultural variations in expressing emotions as illness
   g. Iatrogenesis, DID and PTSD

Copyright ©1998 Beverly J. Volicer and Steven F. Tello, UMass Lowell.  You may freely edit these pages for use in a non-profit, educational setting.  Please include this copyright notice on all pages.