Risk and Resilience in Coping With Chronic Life Stress

Abstract

Despite being charged with addressing patients' stress-related ailments, practitioners commonly struggle to manage their own work and family challenges.Abstract: This review discusses evidence-based perspectives on risk and resilience in coping with chronic life stress. Future directions for inquiry and practice also are addressed.

Inflamed by the Flames? The Impact of Terrorism and War on Immunity

“…This study examined the impact of exposure to rocket and terrorist attacks on citizens’ physiological well-being by analyzing biological markers of immunity and inflammation in a sample of Israelis from Southern Israel in close proximity to the Gaza border. Understanding the health consequences of psychological stress has significant implications for the management, treatment, and progression of disease in individuals (McEwen, 1998; Terre, 2011; Wilkinson & Goodyer, 2011; Yehuda et al, 2009). Traumatic stressors including combat, terrorist attacks, rape, and disaster, and the resultant symptoms of posttraumatic stress disorder (PTSD) often associated with trauma, have been linked to negative health consequences, including heart disease and cancer (Boscarino, 2008; Coussens & Werb, 2002; O'Toole & Catts, 2008; Sareen, Cox, Clara, & Asmundson, 2005).…”

Clinical Implications of Impaired Sleep

“…In this regard, lifestyle modification is an especially attractive first-line treatment given its broad-spectrum, beneficial effects on impaired sleep and its comorbidities (eg, obesity, cardiometabolic, and psychological problems). 68,118,277-284 As a further advantage, lifestyle approaches (eg, incorporating more activity into daily routines and successively approximating a Mediterranean-style diet) are associated with few risks. For these reasons, lifestyle interventions are well suited for pediatric and adult patients, in contrast to some pharmacotherapeutics.…”

“…Providers may perceive a lack of time, expertise, and resources to provide behavioral treatments. 41,68,131,249,271,275 Even if nonpharmacological options are offered, some patients may request medications for more rapid symptom relief compared with the somewhat slower-to-emerge benefits produced by sustained behavior modification. For such patients, accepting and adhering to lifestyle recommendations may be especially challenging, particularly if insurance reimbursements privilege less costly prescriptions over nonpharmacological care that typically demands more dedicated resources (eg, provider and/or staff time and expense).…”

“…• On average, women report less sleep than men. 8,43,[51][52][53][63][64][65][66][67][68][69][70] • • In recent years, inadequate sleep has increased in pediatric and adult populations, with significant adverse effects. 34,55,[74][75][76][77][78][79][80][81][82][83][84][85][86][87] • • Although suboptimal sleep has been correlated with socioeconomic disparities and ethnic minority status, interpretation of these findings remains controversial.…”

“…4,10,28,35,36,56,62,72,[88][89][90][91][92][93][94][95] • • Sleep affects and is affected by social relationships. 9,68, men. 8,43,[51][52][53][63][64][65] Explanations for this gender discrepancy often emphasize women's lived experiences in which the ascendancy of interpersonal priorities exacts a cumulative toll on health and well-being.…”