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    468 U N I T 4: Nursing Care of Clients With Alterations in Psychosocial Adaptation

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    Mercy Jacob
    This document summarizes a model of the dynamics of depression using a transactional model of stress and adaptation. It shows that depression can result from a precipitating event like a loss combined with predisposing genetic, past experience, and existing condition factors. This leads to a primary cognitive appraisal of a threat to self-esteem. Due to weak ego strength, coping mechanisms are not used effectively and maladaptive defense mechanisms like denial and repression are used instead of adaptive grief. This can result in clinical depression.

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    468 U N I T 4: Nursing Care of Clients With Alterations in Psychosocial Adaptation

    Uploaded by

    Mercy Jacob
    188 views1 page
    This document summarizes a model of the dynamics of depression using a transactional model of stress and adaptation. It shows that depression can result from a precipitating event like a loss combined with predisposing genetic, past experience, and existing condition factors. This leads to a primary cognitive appraisal of a threat to self-esteem. Due to weak ego strength, coping mechanisms are not used effectively and maladaptive defense mechanisms like denial and repression are used instead of adaptive grief. This can result in clinical depression.

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    conceptual framework of research

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    conceptual framework

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    This document summarizes a model of the dynamics of depression using a transactional model of stress and adaptation. It shows that depression can result from a precipitating event like a loss combined with predisposing genetic, past experience, and existing condition factors. This leads to a primary cognitive appraisal of a threat to self-esteem. Due to weak ego strength, coping mechanisms are not used effectively and maladaptive defense mechanisms like denial and repression are used instead of adaptive grief. This can result in clinical depression.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    188 views1 page

    468 U N I T 4: Nursing Care of Clients With Alterations in Psychosocial Adaptation

    Uploaded by

    Mercy Jacob
    This document summarizes a model of the dynamics of depression using a transactional model of stress and adaptation. It shows that depression can result from a precipitating event like a loss combined with predisposing genetic, past experience, and existing condition factors. This leads to a primary cognitive appraisal of a threat to self-esteem. Due to weak ego strength, coping mechanisms are not used effectively and maladaptive defense mechanisms like denial and repression are used instead of adaptive grief. This can result in clinical depression.

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    4092_Ch25_458-497 24/07/14 5:28 PM Page 468

    468 UNIT 4 ■ Nursing Care of Clients With Alterations in Psychosocial Adaptation

    Precipitating Event
    (A Loss--Real or Perceived)

    Predisposing Factors
    Genetic Influences: Family history of depression
    Possible biochemical alterations

    Past Experiences:
    Anger turned inward on the ego
    Learned helplessness--numerous failures
    Object loss in infancy
    Defect in cognitive development

    Existing Conditions: Inadequate coping skills


    Lack of adequate support system
    Possible neuroendocrine disturbances
    Medication side effects
    Other physiological conditions

    Cognitive appraisal

    * Primary *

    (Threat to, or loss of, self-esteem)

    * Secondary *

    Because of weak ego strength, patient is unable to use coping mechanisms effectively.
    Defense mechanisms utilized: denial, regression, repression, suppression, displacement, isolation

    Quality of response

    Adaptive Maladaptive

    Delayed/ Exaggerated/
    Uncomplicated
    Inhibited Distorted
    Bereavement
    Grief Grief

    Denial of
    Loss
    Clinical
    Depression

    FIGURE 25–2 The dynamics of depression using the Transactional Model of Stress/Adaptation.

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