医学心理学课件

第一章绪论

Introduction

医学心理学概述

AboutMedicalPsychology医学心理学的研究方法

ResearchMethodsAboutMedicalPchologyMedicalPsychology的概念和研究范围

MedicalPsychology是医学和心理学相结合的交叉学科，它研究心理学变量与健康或疾病变量之间的关系，研究解决医学领域中有关健康和疾病的心理行为问题。KeyWordsMedicalpsychology

Medicalpsychologyisabranchofappliedpsychologydevotedtopsychologicalproblemsarisinginthepracticeofmedicine,includingpsychologicalaspectsofpain,terminalillness,bereavement,disability,andreactionstomedicaladvice.研究心理行为的生物学和社会学基础及在健康和疾病中的意义心理的实质研究心身相互作用的规律和机制研究心理行为因素在疾病发生、发展、诊断、治疗和康复及健康维护过程中的作用和规律性格与疾病研究各种疾病过程中的心理行为变化及干预方法研究如何将心理行为的科学知识和技术应用于医学其他领域心理的实质心理是脑的机能，即任何心理活动都产生于脑，所有心理活动都是脑的高级机能的表现（如前额叶损伤与异常社会行为有关等）心理是客观现实的主观能动的反映，即所有心理活动的内容都来源于外界，是客观事物在脑中的主观反映。

（狼孩、代沟、性格与成长环境等）A型性格与冠心病

"A型行为模式"表现为:个性强,过分的抱负,强烈的竞争意识,固执,好争辩,说话带有挑衅性,急噪,紧张,好冲动,大声说话,做事快,走路快,说话快,总是匆匆忙忙,富含敌意,具有攻击性等.抑郁型性格与健康抑郁是常见的心理感冒,许多人都不同程度的感受过情绪低落给人带来的精神上的痛苦.表现出:对自己不满,对生活不满,悲观绝望,失眠或嗜睡,食欲下降,不愿活动和参加社交活动,思维迟钝,反应缓慢,注意力不能集中,厌世并有自杀念头.癌症敏感型性格调查发现:克己、压抑、焦虑、易怒、抑郁、无助、敌视、完美主义、过分为别人着想等性格与癌症有关.外界社会生活压力作用于有上述性格的人,产生抑郁、愤怒和悲观的情绪,影响内分泌的正常功能,造成肾上腺激素和肾上腺皮质激素分泌增加,使免疫功能下降,产生肿瘤.

AboutMedicalPchologyMedicalPsychology的分支和相关学科ClinicalPsychology（临床心理学）Neuropsychology（神经心理学）PhysiologicalPsychology&PsychologicalPhysiology

（生理心理学与心理生理学）AbnormalPsychology（变态心理学）HealthPsychology（健康心理学）PsychosomaticMedicine（心身医学）BehavioralMedicine（行为医学）

AboutMedicalPchologyMedicalModel（医学模式）与MedicalModel的转变

MedicalModel是从总体上认识健康和疾病及其相互转化的哲学观点BiologicalMedicalModel（生物医学模式）Bio-psycho-socialMedicalModel（生物-心理-社会医学模式）HolisticMedicalModel（整体医学模式）神灵主义的医学模式自然哲学的医学模式BiologicalMedicalModel身心二元论Bio-psycho-socialMedicalModel

身心统一论HolisticMedicalModel

健康是整体素质健康，即身体素质、心理素质和素质三者完整结合：疾病是整体素质不好，主要是不良的行为习惯和行为方式导致。KeyWordsMedicalmodelMedicalmodelmeanstheconcepts,assumptionsandrulesthatdoctorsandresearchersintheirpursuitofknowledgeandthesolutionofproblems,thebriefdefinitionistheopinionofhealthanddisease.Bio-Psych-SocialmedicalmodelBiologicalfactors,psychologicalfactorsandsocialfactorscanalleffecthealthanddisease,andalsoeffectthetreatment.KeyWordsTheholisticmedicalmodelHealthconsistsofphysicalhealth,psychologicalhealthandhavingagoodsocialfunction.Holisticmedicalmodelthinksthatthebehaviorismoreimportantfactoreffectinghealthanddisease.ResearchMethods描述心理行为状况检验变量间的关系预测对象将来的发展ResearchMethodsCross-sectionstudie&Longitudinalstudy

（横断研究与纵向研究）Prospectivestudy&Retrospectivestudy

（前瞻性研究与回顾性研究）ResearchMethodsObservationmethod（观察法）Casestudy（个案法）Correlationalresearch（相关研究）Testmethod（测验法）Surveymethod（调查法）Experimentalmethod（实验法）KeyWordsObservationalmethod

Aresearchmethodologymostoftenusedincertainareasofsocialpsychology,developmentalpsychology,andethologyinwhichtheinvestigatorrecordsbehaviorasfaraspossiblewithoutinfluencingit.Anobservationalfieldstudyisconductedinanaturallyoccurringsituation,andanobservationallaboratorystudyiscarriedoutinanartificiallaboratoryenvironment.KeyWordsSurveyresearch

Researchmethodsforinvestigatingthedistributionofattitudes,opinions,mentaldisorders,andothercharacteristicsofindividualsinspecificsectionsofapopulation,orinawholepopulation,oftenbrokendownintodemographicgroupsdefinedbygeographicallocation,ethnicidentity,age,sex,socialclass,maritalstatus,education,andsimilarcriteria.Surveysdesignedtocomparedifferentculturesorsubculturesarecalledcross-culturalsurvey.KeyWordsCasestudy

Aresearchmethodinvolvingadetailedinvestigationofasingleindividualorasingleorganizedgroup,usedextensivelyinclinicalpsychologyandalso,thoughlessoften,inotherbranchesofthediscipline.Incasestudiesoforganizedgroups,participantobservationisoftenused.KeyWords

Correlationstudy

Anon-experimentaltypeofresearchdesign,withoutmanipulationofanindependentvariables,inwhichpatternsofcorrelationsbetweentwoormorevariablesareanalyzed.ExperimentaldesignThegeneralplanofanexperiment,includingthemethodofassigningresearchparticipantsorsubjectstotreatmentconditions,controllingextraneousvariables,manipulatingtheindependentvariable,andmeasuringthedependentvariable.SummaryMedicalpsychologyrevolvesaroundtheideathatboththebodyandmindareone,indivisiblestructure.Continuingwiththislineofthought,alldiseaseswhetherofthemindorofthephysicalbodymustbetreatedasiftheyhavebothbeenaffected.TheintentofMedicalPsychologyistoapplyknowledgefromallbranchesofpsychologyandmedicineintheprevention,assessment,andtreatmentofallformsofphysicaldiseases.Medicalpsychologyassertsitsmainfunctioninthedeterminationofpersonalitystylesofcopingandtheexaminationofattitudesofanindividualinresponsetosubjectiveandobjectivestressors.Medicalpsychologistsalsohelpinthedeterminationofgenetic,biochemical,andphysiologicfactorsinillnessesandreactiontoillnesses.Thesearejoinedwithpsychosocialfactorsdeemedcontributorytodiseasesprocesses.Specificbehavioralmethodsarethenusedtohelpthepersonmatchcopingandmanagementskillstotheperson’sability,character,andpersonalitystyle.SummaryThebiopsychosocialmodelwasdevelopedbyDr.GeorgeEngelwhowasaProfessorofPsychiatryandMedicine.Thebiopsychosocialmodeltakesintoaccountthepsychological,interpersonalandsocietalinfluencesinthediagnosisandtreatmentofpatients.

Thecomponentsofthebiopsychosocialmodeladdtothepurelybiomedicalmodelofclinicalcarewhichfocusesonpathologyandthemechanismsofdiseaseandtherapeutics.

Amedicalmanhadtopayattentiontothebiopsychosocialaspectsinconjunctionwiththebiomedicalprinciplesindeliveringclinicalcare,providingeducation,communityserviceandconductingresearch.精神分析理论

TheTheoryofPsychoanalysis行为主义理论

TheTheoryofPsychologicalbehaviorism人本主义理论

TheTheoryofHumanisticPsychology认知理论

TheTheoryofPsychologicalCognitionTheTheoryofPsychoanalysis潜意识理论(Unconsciousnesstheory）人格结构理论（Structuresofpersonality）性欲发展阶段理论（Psychosexualstages）心理防御机制理论（Defensemechanisms）释梦理论（Dreaminterpretation）决定论的观点严格的决定论者：所有的行为都有原因，行动以及思想和感觉都不会偶然发生精神分析的作用及方法：在隐藏的驱力和冲突中寻找思想、感觉和行动的来源，以及考察个体早期经验与基本的人类本质交互作用以产生成人个性的方式MentalStructureofPsychoanalysis意识（Conscious）

包括存在于可以立即觉察到的水平的东西意识潜意识（Unconscious）

包括我们没有觉察到的心理活动的所有方面前意识（Preconscious）

许多思想和主意在我们对它们集中注意时或企图将它们带入意识水平时就会得到，但其并不总是处于意识水平KeyWordsUnconscious

Apartofthepersonalityofwhichapersonisunaware.Theunconsciouscontainsinstinctualdrives:infantilewishes,desires,demands,andneedsthatarehiddenfromconsciousawarenessbecauseoftheconflictsandpaintheywouldcauseusiftheywerepartofoureverydaylife.Preconscious

Thememoriesorfeelingsthatarenotpartofone'simmediateawarenessbutthatcanberecalledthroughconsciouseffort.PersonalityStructure本我（Id

）“Pleasureprinciple”自我（Ego）“Realityprinciple”超我（Superego）“Principleofideal”KeyWordsId

Theraw,unorganized,inheritedpartofpersonalitywhosepurposeistoreducetensioncreatedbybiologicaldrivesandirrationalimpulses.Presentfromthetimeofbirth,thesolepurposeoftheidistoreducetensioncreatedbyprimitivedrivesrelatedtohunger,sex,aggressionandirrationalimpulses.Theidoperatesaccordingtothepleasureprinciple,inwhichthegoalistheimmediatereductionoftensionandthemaximizationofsatisfaction.KeyWordsEgoThepartofpersonalitythatprovidesabufferbetweentheidandtheoutsideworld.Incontrasttothepleasure-seekingnatureoftheid,theegooperatesaccordingtotherealityprinciple,inwhichinstinctualenergyisrestrainedinordertomaintainthesafetyoftheindividualandhelpintegratethepersonintosociety.KeyWordsSuperego

Thepartofpersonalitythatrepresentsthemoralityofsocietyaspresentedbyparents,teachers,andothers.Thesuperegoactuallyhastwocomponents,theconscienceandtheego-ideal.Theconsciencepreventsusfromdoingmorallybadthings,whiletheego-idealmotivatesustodowhatismorallyproper.Psychosexualstages&oedipuscomplex口腔期（oralstage）肛门期（analstage）性器期（phallicphase）潜伏期（Latencystage）生殖器性期（Genitalstage）Oralphase(0-2yearsold)Freud’sfirststageofpersonalitydevelopment,frombirthtoaboutage2,duringwhichinfantsobtaingratificationprimarilythroughthemouth口腔是第一个给予婴儿快感的身体器官，通过口腔获得维持生命的营养，还通过吸吮和啃咬获得快感固着：部分利必多能量分配给了对前一个心理性阶段的注意，没有转到后一个发展阶段过食、酗酒、强迫性吸烟、咬铅笔/手指、冷嘲热讽Analphase(2-3yearsold)Freud’ssecondstageofpersonalitydevelopment,fromabout2toaboutage3,duringwhichchildrenlearntocontroltheimmediategratificationtheyobtainthroughdefecationandtobecomeresponsibletothedemandsofsociety肛门是这一时期的性快感带，对大便的保留和排泄引起快感的推迟及满足，通过攻击行为和排泄功能获得满足肛门性格：吝啬、固执、对整洁和秩序过分注意Phallicphase(3-5yearsold)Freud’sthirdstageofpersonalitydevelopment,fromaboutage3toaboutage5,duringwhichchildrenobtaingratificationprimarilyfromthegenitals生殖器区是这一时期主要的性感带俄底普斯情结（oedipuscomplex）

Occurringduringthephallicstage,feelingsofrivalrywiththeparentofthesamesexandloveoftheparentoftheoppositesex,ultimatelyresolvedthroughidentificationwiththeparentofthesame阉割焦虑（castrationanxiety）/阴茎妒忌（penisenvy）认同（identity）同性恋DefenseMechanism三种焦虑：现实焦虑（环境）、神经焦虑（本能）、道德焦虑（道德）心理防御机制（mentaldefensemechanism）是指个体处在挫折与冲突的情景时，在其内部心理活动中具有对抗焦虑的一种适应性倾向，是一种潜意识的心理保护机制KeyWordsDefensemechanism

Unconsciousstrategiespeopleusetoreduceanxietybyconcealingitssourcefromthemselvesandothers.心理防御机制与心理健康的关系常见心理防御机制的表现

压抑（Repression）Theprimarydefensemechanism,inwhichunacceptableorunpleasantidimpulsesarepushedbackintotheunconscious.Forexample,acollegestudentwhofeelshatredforhermothermightrepressthesepersonallyandsociallyunacceptablefeelings倒退/退行（Regression）Peoplebehaveasiftheywereatanearlierstageofdevelopment.Forexample,astudentwhoisoverwhelmedbyexamsmightactinachildish,immaturemannertoescapehisresponsibilities转移（Displacement）Theexpressionofanunwantedfeelingorthoughtisredirectedfromamorethreatening,powerfulpersontoaweakone.Aclassiccaseisyellingatone’ssecretaryafterbeingcriticizedbytheboss合理化（Rationalization）Adistortionofrealityinwhichapersonjustifieswhathappens.Forexample,apersonwhoispassedoverforanawardsaysshedidn’treallywantitinthefirstplace否认（Denial）Refusaltoacceptoracknowledgeananxiety-producingpieceofinformation.Forexample,astudentrefusestobelievethathehasflunkedacourse投射（Projection）Attributingunwantedimpulsesandfeelingstosomeoneelse.Forexample,amanwhoisangerathisfatheractslovinglytohisfatherbutcomplainsthathisfatherisangrywithhim升华（Sublimation）Diversionofunwantedimpulsesintosociallyapprovedthoughts,feelingsorbehaviors.Forexample,apersonwithstrongfeelingsofaggressionbecomesasoldierDreamInterpretation梦是有意义的心理现象，是个体愿望迂回的满足，是潜意识冲突和愿望的隐晦的表达。显梦（manifestdream）

Theovertstoryline,characters,andsettingofadream---theobvious,clearlydiscernibleeventsofthedream隐梦（latentdream）Thedeepermeaningofadream,usuallyinvolvingsymbolism,hiddencontent,andrepressedorobscuredideasandwishes述评TheTheoryofPsychologicalBehaviorism经典条件反射

Classicalconditioning操作条件反射

Operantconditioning社会学习/观察模仿

Sociallearning/ObservationallearningClassicalConditioning巴甫洛夫Pavlov'sexperiment无条件刺激(Unconditionedstimulus/US)无条件反射(Unconditionedreflex/UR)条件刺激(Conditionedstimulus/CS)条件反射(Conditionedreflex/CR)CharacteristicsofClassicalConditioning强化（Reinforcement）泛化（Generalization）分化（Discrimination）消退（Extinction）KeyWordsReinforcementTheprocessbywhichastimulusincreasestheprobabilitythataprecedingbehaviorwillberepeated.StimulusgeneralizationThetransferofalearnedresponsetodifferentbutsimilarstimuli.StimulusdiscriminationLearningtorespondtoonlyonestimulusandtoinhibittheresponsetoallotherstimuli.ExtinctionAdecreaseinthestrengthorfrequency,orstopping,ofalearnedresponsebecauseoffailuretocontinueparingtheUSandCSorwithholdingofreinforcement.Operantconditioning斯金纳Skinner'sexperiment奖赏（Reward）CharacteristicsofOperantConditioning正强化（Positivereinforcement）负强化（Negativereinforcement）消退（Extinction）

惩罚（Punishment）KeyWordsPositivereinforcementPresentationofarewardingorpleasantstimulusafteraparticularresponsetoincreasethelikelihoodthattheresponsewillrecur.NegativereinforcementRemovalofanaversivestimulusafteraparticularresponsetoincreasethelikelihoodthattheresponsewillrecur.PunishmentAstimulusthatfollowsabehavioranddecreasesthelikelihoodthatthebehaviorwillberepeated.UnderstandingPsychology心理的神经生理机制认知过程(TheCognitionProcess)动机与情绪(Motivation&Emotion)人格(Personality)心理的神经生理基础心理是脑的功能大脑皮层(Cerebralcortex)的分区及功能Brodmann,1909

感觉区(Sensoryarea)

运动区(Motorarea)

言语区(Speecharea)

联合区(Associationarea)大脑两半球的一侧优势(CerebralLateralization)

速视法双耳分听试验一侧脑麻痹法对割裂脑病人的临床观察和有控制的测验

根据上述不同方法的研究,一般认为:大多数右利手者大脑左侧半球的优势在语音、顺序、时间、节奏以及命题的逻辑分析等方面；右半球的优势在非语言的、整体的形状和空间的知觉方面；此外左、右两半球在情绪反应方面似乎也有差别。右半球的反应较强烈或较不乐观。

人的面部表情也是左右不对称的,有人做过试验:将演员表演喜、怒、哀、惧各种表情的照片，从脸的正中线切成两半，再把反着面洗印的两半照片拼接成一个左右两侧都是原来的左边脸或右边脸的脸部照片。将这两种拼接的照片混在一起，请被试者从中挑选出他们认为表情更丰富的照片。结果挑选出的用左边脸拼成的照片要多得多。这结果也同解剖的知识相吻合。左边脸，特别是其下部,接受来自右脑投射来的神经纤维。看来,右侧脑在脸部表情中起更多的作用。

TheCognitionProcess感觉与知觉(Sensation&Perception)学习(Learning)记忆(Memory)思维(Thinking)Sensation的概念与作用感觉剥夺SensoryDeprivation

感受性(Sensitivity)及其变化规律感觉阈限(SensoryThreshold)

感觉适应(SensoryAdaptation)

感觉对比感觉的相互作用感觉代偿KeyWordsSensationTheprocessinwhichthesenseorgans’receptorcellsarestimulatedandreplyinitialinformationtohigherbraincentersforfurtherprocessingPerception的概念Perception的一般特性知觉的选择性PerceptualSelectiveness

知觉定势PerceptualSet

知觉的整体性PerceptualOrganization

知觉的理解性PerceptualInterpretation

知觉的恒常性

(PerceptualConstancy)KeyWordsPerceptionTheprocessbywhichanorganismselectsandinterpretssensoryinputsothatitacquiresmeaning.AbsolutethresholdTheminimumamountofphysicalenergyneededforanobservertoperceiveastimulusiscalledanabsolutethreshold.Differentthreshold(JND)Thelowestlevelofstimulationrequiredtosensethatachangeinstimulationhasoccurred.SensoryadaptationThetendencyofsensorysystemstorespondlesstostimulithatcontinuewithoutchange.PerceptualconstancyTheorganizationofchangingsensationsintoperceptsthatarerelativelystableinsize,shape,andcolor.Learning的概念行为或行为潜能的改变行为变化是相对持久的由练习或经验引起的Learning的理论

Classicalcondition

OperantconditionObservationallearningCognitiveLearning

KeyWordsLearningRelativepermanentchangeinanorganismthatoccursasaresultofexperiencesintheenvironmentClassicalconditiondingConditioningprocessinwhichanoriginallyneutralstimulus,byrepeatedpairingwithastimulusthatnormallyelicitsaresponse,comestoelicitasimilarorevenidenticalresponse;alsoknowasPavlovianconditioningOperantconditioningConditioninginwhichanincreaseordecreaseintheprobabilitythatabehaviorwillrecurisaffectedbythedeliveryofreinforcementofpunishmentasaconsequenceofthebehavior;alsoknownasinstrumentalconditioning.ObservationallearningOrganismslearnnewresponsesbyobservingthebehaviorofamodelandthenimitatingit.格式塔的学习理论——顿悟学习Insight

知觉重组内隐学习(Latentlearning)Memory概述Memory的过程识记(Memorization)

保持(Retention)

再认(Recognition)

再现(Repruduction)KeyWordsMemoryTheabilitytorecallpastevents,images,ideas,orskills;thestoragesystemthatallowsforretentionandretrievalofpreviouslylearnedinformation.感觉记忆(Sensorymemory)短时记忆(STM,Short-termmemory)长时记忆(LTM,Long-termmemory)Sensorymemory无限量存贮存贮时间短0.25-2s’“一瞥之见”感觉后像，即按刺激的物理特征原样直接加以编码和储存的模式识别(patternrecognition)即从sensorymemory向short-termmemory传递信息并赋予它意义的过程。确定选择哪些信息传输到短时记忆，而让哪些信息从感觉记忆中衰退，是注意(attention)的作用。Short-termmemory

编码形式：听觉代码R.Conrad,1964

视觉代码语义代码存贮容量:7±2组块(chunk)

存贮持久性L.R.Perterson,1959

影片：《记忆碎片》

康拉德(R.Conrad,1964)的经典性研究：选用B、C、P、T、V、F、M、N、S、X等10个字母为材料,从中随机取出6个组成字母序列,用视觉方式一个个地呈现给被试,要求他们记住。然后让被试严格地按字母呈现的顺序进行回忆,并对回忆中出现的差错进行分析。结果表明,回忆时出现的错误主要表现为声音混淆。即发音近似的字母混淆程度较高,如将B误为P,将V误为B,而发音不相似的字母之间则较少发生混淆。在彼德森等人(L.R.Peterson&M.J.PeterSOIl,1959)的实验：被试的任务是记住3个辅音字母组成的无意义音节,18秒钟后再进行回忆。在正常情况下,被试正确完成这个任务是轻而易举的事。然而,在剌激呈现以后,立即呈现一个三位数的数字,要求被试以这个数字为起点,进行连续减3的倒数数,持续到18秒为止。这时再让被试回忆字母,回忆成绩不足20%,即回忆的平均数还达不到一个字母。是倒数数的任务阻止了被试对识记材料的复述。Long-termmemory

编码形式：

语义代码视觉代码（遗觉像实验/照片式记忆）遗忘(Forgetting)

干扰理论衰退理论动机性遗忘理论提取失败理论“提笔忘字”“舌尖现象”有关虚假记忆Thinking概述概括性间接性对经验的改组Thinking的过程问题解决(Problemsolving)

影响问题解决的因素KeyWordsThinkingThehighermentalprocesswhichisthemanipulationofmentalrespresentationsofinformationProblemsolvingTheprocessoftransformingonesituationintoanotherthatmeetsagoalMotivation&EmotionMotivationEmotionMotivation的涵义与功能动机与需要

Motivation&Need动机理论

MotivationTheory动机冲突与挫折

MotivationConflict&FrustrationKeyWordsMotivationAnyinternalcondition,althoughusuallyaninternalone,thatinitiates,activates,ormaintailnsanorganism’sgoal-directedbehavior.本能理论(Instincttheory)驱力理论(Drivetheory)唤醒理论(Arousaltheory)诱因理论(Incentivetheory)认知理论(Cognitivetheory)

期待价值理论(Expectancy-valuetheory)

自我效能论(Self-efficacytheory)Motivationconflict双趋冲突(Approach-approachconflict)双避冲突(Avoidance-avoidanceconflict)趋避冲突(Approach-avoidanceconflict)多重趋避冲突

(Multipleapproach-avoidanceconflict)Frustration的涵义挫折情境挫折认知挫折行为Frustration反应情绪性反应攻击/冷漠/退化/固执等理智性反应个性变化（如：文革迫害）Emotion概述情绪、情感与感情主观体验(Subjectiveexperience)

外部表现/表情(Emotionalexpression)

生理唤醒(Physicalarousal)KeyWordsEmotionAnevaluativeresponse(apositiveornegativefeelingstate)thattypicallyincludessubjectiveexperience,physiologicalarousal,andemotionalexpressionEmotion的分类

基本情绪(Basicemotion)

快乐(Happiness)

悲哀(Sadness)

愤怒(Anger)

恐惧(Fear)

情绪状态的分类心境(Mood)

激情(Affectiveimpluse)

应激(Stress)Emotion与脑

Emotion的脑中枢机制

Emotion的外周神经机制

EmotionTheoryJames-Langetheroy

情绪是植物神经系统活动的产物，外界刺激—生理反应—情绪体验

Cannon-Bardtheory

情绪的中心不在外周神经系统，而在中枢神经系统的丘脑

Cognition&EmotionArnold的评定-兴奋说

情绪的产生是大脑皮层和皮下组织协同活动的结果，大脑皮层的兴奋是情绪产生最重要的条件。

Schachter’stwo-factortheoryofemotion

对特定情绪而言，生理唤醒与对生理变化的认知性唤醒两大因素必不可少。情绪状态是由认知过程、生理状态和环境因素在大脑皮层中整合的结果。动机-分化理论

PersonalityPersonality的涵义独特性/稳定性/整体性/功能性Personality的结构Personality的成因PersonalityTheoryKeyWordsPersonalityTheenduringpatternsofthoughts,feeling,andbehaviorthatareexpressedindifferentcircumstances.气质(Temperment)

高级神经活动类型说

Thomas-Chess的气质类型说活动水平/生理活动的节律性注意分散程度/接近或回避/适应性注意的广度和坚持性/反应的强度反应阈限/心情质量容易型困难型迟缓型性格(Character)C.G.Jung“心理倾向”

Spranger“社会文化形态”

Friedman&Rosenman“攻击性\好胜心等自我调控系统自我认知(Self-cognition)“点红实验”自我体验(Self-experience)

自我控制(Self-regulation)Personality的成因生物遗传因素社会文化因素家庭环境因素早期童年经验自然物理环境PsychologicalstressThedefinitionofstress

Canon

SelyeH，1907-1982generaladaptationsyndromealarmresistanceexhaustion

ThedevelopmentofdefinitionofstressStressor:应激是引起机体发生应激反应的刺激物。Response:应激是机体对有害刺激的反应。Interaction:应激是应激源和应激反应的中间变量。Psychologicalstress心理应激是个体在觉察需求与满足需求的能力不平衡时倾向与通过整体心理和生理反应表现出来的多因素作用的适应过程。过程：适应和不适应过程结果：适应的和不适应的应激源：生物、心理、社会等应激反应：心理、生理、行为认知评价：起重要作用PsychologicalstressTheprocessofstress生活事件认知评价应对方式社会支持个性特征心理反应行为反应生理反应心理疾病躯体疾病Physiologicalinteractionstressor应激源的概念：应激源是造成心理应激并可能导致躯体和心理损伤的刺激物。Thetypesofstressors按应激源的属性分类:

1.躯体性应激源physicalstressor2.心理性应激源psychologicalstressor3.社会性应激源socialstressor4.文化性应激源culturalstressorThetypesofstressors按事件的现象学分类1.工作问题2.恋爱、婚姻、家庭问题3.人际关系问题4.经济问题5.个人健康问题6.自我实现和自尊方面7.喜庆事件Thetypesofstressors按事件对个体的影响分

1.正性生活事件positiveliveevents2.负性生活事件negativeeventsThetypesofstressors按事件的主客观属性分

1.客观事件objectiveevents2.主观事件subjectiveeventsTheresearchofstressorHolmesandRahe(1976)5000subjectsSocialReadjustmentRatingScale,SRRS,LifeChangeUnite,LCU<150LCU:0%150-300LCU:50%>300:86%应激性生活事件的量化研究Theresearchofstressornegative,unpredictable,persistant,Un-control(模拟现实生活中的应激如：束缚、孤养、噪音、拥挤等)。

Psychologicalresponseofstress

1.Excessiveandcompulsivebehaviors,suchasnailbiting,overeating,pacing,pickingandtalking.2.Illogicalandnon-coherentthinking,asevidencedbymemoryloss,repetitivethoughts,reducedabilitytosolvedaytodayproblems.3.negativeemotion,suchasanger,anxiety,depression,guilt,orshame.Behaviorresponseofstress1.escapeoravoidance2.regressionordependence3.hostilityorattack4.helplessnessandself-pity5.drugaddictionphysiologicalresponseAccordingtoSelye’sandCannon:theresponseofstressisfightandflightresponsefight---confrontationflight---escapeFight-flightresponse(reflection)PhysiologicalresponseofstressTheendocrineResponse:Ourendocrinesystemsecreteshormonesdirectlyintoourbloodstreamviaaseriesofglands.Adrenalglands:

Adrenalmedulla(innercove)-----adrenaline-----increasetheactivitylevelofourheart,liver,andmuscles.

Adrenalcortex(outershell)----corticosteroids-----reduceinflammationPhysiologicalresponseofstressPhysiologicalresponseofstressTheImmuneResponseImmuno-suppressants:ourbodiesreleasenaturalsuppressantswhenunderstress.Thosesuppressantsdecreasetheefficiencyofourimmunesystem.Stresssystem(interactionofphysiology)下丘脑-垂体-肾上腺皮质系统蓝斑-交感-肾上腺髓质系统

导致糖皮质激素和盐皮质激素分泌增加和交感神经功能亢进。TheinteractionofpsychologyCognitiveappraisal:meanstheideasofthenature,intensity,persistencetimeanddangeraboutstressor.Therearetwotypesofcognitiveappraisal:FirstcognitiveappraisalandsecondCognitiveappraisalCognitiveappraisaleventFirstappraisaladaptationSecondappraisalProblemfocusEmotionfocusCopingWhatiscoping?Characteristicwayofonehandlewithstress.Typesofcoping:Copingcanbedividedintotwotypes.problemsolvingandemotionalcopingTypesofcopingProblemsolving:attemptstochangetheconditionsthatproducestress.eg.reducethetensionofnoise,studyhard,andtakerest.Emotionalcoping:alteringofoneselftoreducetress.eg:cry,doingexciseandrelax.ThestudyofcopingThestudyofcopingstylepositiveandnegativecopingThestudyofcopingandstresscopingstyleseffecttheresponseofstressThestudyofcopingtheoryDefensemechanismThedefinitionofDefensemechanismThekindofDefensemechanismdenial,regression,fantasy,displacement,rationalization,reactionformation,etc.Personalitytraitsandvulnerabilitytostress1.Anxiety:afearresponsetoaperceivedfuturethreat2.Depression:amooddisordercharacterizedbyexcessivesadness3.Learnedhelplessness:Occurswhenapersonhaslearnedtobehelplessinonesituationandtransfersthatappraisaltoanewsituationinwhichanadequateresponseispossible.Personalitytraitsandvulnerabilitytostress4.Hostility:astateofantagonismorenmity5.Self-absorbed:excessivelyengrossesinone’sselforone’saffairs.6.Vigilance:alertwatchfulnessPersonalityTypesandVulnerabilityTypeA:apersonalitytypecharacterizedbyimpatienceandworkaddiction;thoughtsusceptibletoprematureheartdisorders.TypeB:personalitytypecharacterizedbypatience,trust,goodnature,andaneasygoingstylethatisthoughttoprotectthemagainstprematureheartdisorders.TheurgentbehavioroftypeApersonalitybasedonasetofbeliefsandfears,manyofwhichareirrationalBeliefs:1.Myself-esteemisbasedonmymaterialaccomplishments.2.IamworthlessifIdonotachieveworldlysuccess.3.Therearenouniversalmoralprinciples.4.AllhumanandnaturalresourcesarelimitedTheurgentbehavioroftypeApersonalitybasedonasetofbeliefsandfears,manyofwhichareirrationalFears:1.Goodmaynotprevailoverevil;therefore,Icannotexpectjusticeinthisworld.2.Imaynotgetmyfairshareofworldlygood.3.Alackofsuccesswillcausemetobejudgedasworthless.HardypersonalityTherearesomepersonalitytraitsthatmakeiteasierforapersontohandlestressHardypersonalitystudyKobasa(1979)studiedtwogroupsofexecutiveswhohadallexperiencedstressfullifeeventswithinthepast3years.Thoseinonegrouphadbecomephysicallyillfollowingtheevents,whiletheotherhadnot.HardypersonalitystudyThehardyexcutivespossessedthreecharacteristicsthattheothersdidnot:1.Theyhadagreatfeelingofcontrol;2.Theyhadastrongsenseofcommitmenttospecificgoalsintheirlives;3.Theyviewedchangeasachallengeratherthanasathreat.ThegoodwaytocopywithstressThegoodwaytocopywithstressRethinkReduceRelaxReleaseRethinkthevalueofstressthingNormallywethinkordecidedthe