COUN 235 Psychology of Human Adjustment Odlm Notes 2revised From Mer

KENYA METHODIST UNIVERSITY
FACULTY OF ARTS AND SCIENCES

DEPARTMENT OF EDUCATION AND COUNSELING
B. A. IN COUNSELING
ODLM MATERIALS FOR

COUN 235: PSYCHOLOGY OF HUMAN
ADJUSTMENT
PREPARED BY
DOREEN KATIBA
NOVEMBER, 2010
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COUN 235 PSYCHOLOGY OF HUMAN ADJUSTMENT
CREDITS (3)
Course Purpose
The purpose of this course is to provide you with skills required in assisting clients
to adjust appropriately to their changing environments. It will also help you to
understand yourself and adjust appropriately to changing circumstances and
situations in order to provide effective counselling.
Course Objectives
By the end of this course, you should be able to:

1. Explain psychology of human adjustment.
2. Identify and describe various factors that may necessitate human adjustment.
3. Evaluate client adjustment to change.
4. Describe strategies and techniques for adjusting.
5. Demonstrate ability to cope and adjust to various situations.
Course Content
Broad areas that will be covered in this course will include:-
1. Introduction to psychology of human adjustment
2. Theories related to psychology of human adjustment
3. Adjustment and the role of the student
4. Physical factors influencing human adjustment
5. Social factors influencing human adjustment
6. Psychological factors influencing human adjustment
7. Emerging issues and research in psychology of human adjustments.
Teaching Methods
The course will be implemented using interactive and participatory teaching,
learning and studying methods, which will include independent reading of the
materials, carrying out the activities in the materials, working on the assignment,
consulting and preparing for the final examination.
Assessment and Evaluation
You will be expected to take responsibility for the learning process and the instructor
will provide necessary support and facilitation in order to achieve the course
objectives. You will be assessed by two (2) assignments, each out of twenty (20)
marks, and a final examination which will be marked out of sixty percent (60%).
Both the assignments and the final examination will contribute to the final grade.
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COURSE OUTLINE FOR THE SEMESTER
Week 1: Introduction to the psychology of human adjustment
Week 2: Theories related to psychology of human adjustment
Week 3: Adjustment and the role of the student
Week 4: Organic factors influencing human adjustment
Week 5 & 6: Lifestyle and health
Week 7 & 8: Physical factors influencing human adjustment
Week 9: Social factors influencing human adjustment
Week 10: Psychological factors influencing human adjustment
Week 11: Mental illness and human adjustment
Week 12: Emerging issues and research in psychology of human
adjustment
Week 13: Revision Week
Week 14 and 15: Course examination
LEARNING RESOURCES
Course Texts
1. Mutie E. And Ndambuki, P(2002)Guidance and counselling for schools and
colleges Nairobi: Oxford
2. Cohen R.J (1994) Psychology and adjustment: Values, Culture and Change.
Boston: Allyn: Bacon
3. Snyder, C. R.(1999) Coping : The Psychology of What Works. Cary, NC, USA:
Oxford University Press, 1999. p 93.
4. Glantz, Meyer D. (Editor); Johnson, Jeannette L. (1999) Resilience and
Development: Positive Life Adaptations. USA: Kluwer Academic Publishers, 1999.
p 117.
http://site.ebrary.com/lib/kmethke/Doc?id=10047420&ppg=117
Further Reading
1. Wango, G (2007) Counselling in schools. Nairobi: Phoenix publishers
2. Hill, M, (2005) Healing the wounds of trauma. Nairobi: Pauline Publications
http://EzineArticles.com/?expert=Mike_Strawbridge
SYMBOLS:
The meaning of the available symbols:
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Course and Lecture Objectives:
Activity
! Key note
Summary
Self Assessment Question (SAQ)
Further reading
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Contents
1. INTRODUCTION TO PSYCHOLOGY OF HUMAN ADJUSTMENT.................................9
1.1 Introduction........................................................................................................9
1.2 Behavioral science and adjustment...................................................................9
1.3 Adjustment and values....................................................................................10
1.4 Adjustment and culture....................................................................................12
1.5 Adjustment and change...................................................................................12
2. THEORIES RELATED TO PSYCHOLOGY OF ADJUSTMENT.....................................18
2.1 Introduction......................................................................................................18
2.2 Views of Life Transitions...................................................................................19
2.2.1 Metaphors from Classical Literature.............................................................19
2.2.2 Social Interaction Model................................................................................19
2.2.3 Predictable Overlapping Stages....................................................................20
2.3 Coping Attitudes and Skills..............................................................................21
3. ADJUSTMENT AND THE ROLE OF THE STUDENT.................................................24
3.1 Introduction......................................................................................................24
3.2 Study behaviour...............................................................................................25
3. How to study......................................................................................................26
3.3 Study behavior in class....................................................................................28
4. PHYSICAL FACTORS INFLUENCING ADJUSTMENT................................................30
4.1 Introduction......................................................................................................30
4.2 Adjustment and Health....................................................................................30
4.3 Emotions and adjustment................................................................................32
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4.4 Optimism and adjustment................................................................................34
4.5 Positive thinking...............................................................................................37
4.6 Hope, Coping and Adjustment.........................................................................37
4.7 Personality and Adjustment.............................................................................38
4.8 Benefit-Finding.................................................................................................39
5. LIFESTYLE AND HEALTH......................................................................................41
5.1 Introduction......................................................................................................41
5.2 Eating Habits....................................................................................................41
5.3 Drug Use..........................................................................................................43
5.4 Escaping reality................................................................................................46
5.5 Levels of dependency......................................................................................47
5.6 Case study: 911 terrorist attacks and drug use...............................................48
5.7 Other Risk Factors for Drug Use.......................................................................50
6. ADJUSTMENT AND DEVELOPMENT.....................................................................53
6.1 Introduction......................................................................................................53
6.2 Overview of Lifespan Development.................................................................53
6.3 Retirement.......................................................................................................56
6.4 Losing a Loved One..........................................................................................57
6.5 Remarriage......................................................................................................58
6.6 Changes in Living Arrangements.....................................................................59
7. SOCIAL FACTORS INFLUENCING ADJUSTMENT....................................................63
7.1 Introduction......................................................................................................63
7.2 Adjustment and Interpersonal Relations..........................................................63
7.3 Need for consistency........................................................................................64
7.4 Groups and adjustment....................................................................................65
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7.5 Conflict and adjustment...................................................................................65
7.6 Friendship and living........................................................................................65
7.7 Somatoform and Facticious Disorders..............................................................66
7.8 Suicidal Behavior.............................................................................................67
8. PSYCHOLOGICAL FACTORS INFLUENCING ADJUSTMENT.....................................77
8.1 Introduction......................................................................................................77
8.2 Stress and Adjustment.....................................................................................77
8.3 Stress and Perception......................................................................................78
8.4 The Decision to Cope.......................................................................................78
8.5 The Positive Side of Stress...............................................................................79
8.6 Acute Stress Disorder.......................................................................................79
8.7 Posttraumatic Stress Disorder..........................................................................81
9. MENTAL HEALTH AND ADJUSTMENT...................................................................85
9.1 Introduction......................................................................................................85
9.2 Abnormal Behavior and Adjustment................................................................85
9.3 Anxiety Disorders.............................................................................................86
9.4 Panic Attacks and Panic Disorder.....................................................................89
10. EMERGING ISSUES AND RESEARCH IN PSYCHOLOGY OF HUMAN ADJUSTMENTS

.......................................................................................................................93
10.1 Introduction....................................................................................................93
10.2 Emerging Issues in psychology of human adjustment...................................93
10.3 Research in psychology of adjustment...........................................................94
10.4 Ethics in Social psychological research........................................................101
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Welcome to the study of Psychology of human adjustment. In this course
we shall study how humans adjust to change. The topics are arranged in
12 weeks and each week has one or more lectures depending on the
topic’s depth.
There are 12 lectures and each lecture has its own objectives. At the end
of every lecture, you will find a series of SAQs that are meant to help
you to evaluate your understanding of the concepts presented. I expect
you to attempt all the questions and activities once you have finished
studying the relevant work. A summary of each lecture is also provided
at the end.
Kindly, make sure that:
 You complete each lecture at a time before proceeding to the next on
 Refer to the suggested additional resources provided in the bibliography
at the end of the module to get further information
 Make notes so as to simplify your study
 Complete all activities and questions as you progress
 Spend at least four hours to complete each Lecture / topic for you to
understand and apply the knowledge and skills acquired.
Once again welcome and let us begin. Good luck!!!!
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GLOSSARY
ABNORMAL BEHAVIOR is defined as over action or thinking that is

statistically rare in the population, counter to the prevailing cultural
and /or sub-cultural norms, and usually harmful to the well-being of
oneself or others.
ACUTE STRESS DISORDER is a brief period of intrusive recollections
occurring within 4 weeks of witnessing or experiencing an
overwhelming traumatic event.
ADDICTION refers to compulsive use and overwhelming involvement
with a drug, including spending an increasing amount of time
obtaining the drug, using the drug, or recovering from its effects.
ADJUSTMENT is change or adaptation made in response to a new
situation.
ANXIETY is a distressing, unpleasant emotional state of nervousness
and uneasiness whose causes are not clear.
ATTRIBUTION is to regard, or mentally assign, for example, we
attribute characteristics to causation.
BIOPSYCHOSOCIAL PERSPECTIVE is a perspective that places
emphasis on the need for individuals themselves to prevent
problems by engaging in wellness-promoting behaviours.
CULTURE is defined as the socially transmitted behaviour pattern,
beliefs and product of human work of a particular population,
community or group of people.
FACTITIOUS DISORDERS are disorders that involve the conscious and
volitional feigning of symptoms without any external incentive
LIFESTYLE is defined as an individual’s or group relatively
consistent day to day patterns of living.
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MALINGERING is intentional feigning of physical or mental
symptoms motivated by an external incentive
PANIC ATTACK is the sudden onset of a discrete, brief period of
intense discomfort, anxiety, or fear accompanied by somatic or
cognitive symptoms.
PANIC DISORDER is occurrence of repeated panic attacks typically
accompanied by fears about future attacks or changes in behaviour
to avoid situations that might predispose to attacks.
POSTTRAUMATIC STRESS DISORDER (PTSD) is recurring, intrusive
recollections of an overwhelming traumatic event.
PHYSICAL DEPENDENCE is manifested by a withdrawal (abstinence)
syndrome, in which outward physical effects occur when the drug is
stopped or when its effect is counteracted by a specific antagonist.
PSYCHOLOGY is the study of mental processes and behaviour.
PSYCHOLOGY OF ADJUSTMENT involves the changes in thoughts,
feelings and behaviour that contribute to effective adaptation.
PSYCHOLOGICAL DEPENDENCE is addiction that includes feelings of
satisfaction and a desire to repeat the drug experience or to avoid
the discomfort of not having it.
PSYCHO-NEUROIMMUNOLOGY refers to the study of how the nervous
system interacts with the endocrine and immune systems.
ROLES are defined as expected behaviour for example; there is
expected behaviour or characteristics of policeman, teacher or wife.
ROLE CONFLICT can be defined as a state in which the demands and
expected behaviour in the context of a particular situation is at
odds with each other.
SOCIAL PERCEPTION is defined as the process or act of becoming
aware of other people in relation to oneself.
SOMATIZATION is the expression of mental phenomena as physical
(somatic) symptoms.
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SOMATOFORM DISORDERS are characterized by physical symptoms
that are not fully explained by another disorder, physical or mental.
STRESS is defined as mental and /or physical strain resulting from
adjective demands or challenges.
SUICIDE is an act that results in death. Attempted suicide is an act
intended to be self-lethal, but one that does not result in death.
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1. INTRODUCTION TO PSYCHOLOGY OF HUMAN ADJUSTMENT
Week 1: Topic objectives

By the end of this topic, you are expected to be able to:
1. Define terms used in psychology of adjustment
2. Explain psychology of adjustment in relation to values, culture and change
3. Explain the relation of psychology of adjustment to counselling
4. Evaluate change in relation to changing times, roles and perspectives
1.1 Introduction
Welcome to the introductory chapter of this course. In this chapter, we shall

be basically looking at what psychology of human adjustment is all about.
The topics include bahavioral science and adjustment, which covers
adjustment and values, adjustment and culture, and adjustment and change.
As far as change is concerned, we shall focus on changing times, roles and
perspectives. We shall also discuss an article entitled ‘Dealing with life
changes’, by Mike Strawbridge.
Psychology is the study of mental processes and behavior. It is both a
profession and a science. Psychologists study how we sense, how we
perceive how we think, how we learn, how we remember and how we forget.
They also study motivation, emotion, personality and psychotherapy.
Adjustment is change or adaptation made in response to a new situation. An
individual here has to make some personal changes in order to cope or
incorporate the change that is occurring in his / her environment. Psychology
of adjustment involves the changes in thoughts, feelings and behavior that
contribute to effective adaptation.
1.2 Behavioral science and adjustment
Science entails the observation, description, identification, experimental

investigation and theoretical explanation of natural phenomena. Behavioral
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science on the other hand, refers to the observation, description,
identification experimental investigation and theoretical explanation of
behavioral related phenomena applies to both observed behavior such as
thinking and feeling. Behavioral science attempts to examine facts from
unexamined beliefs.
1.3 Adjustment and values
Values play a major role in adjustment, effective behavior and a healthy

personality. Values in this context mean that which we strongly believe in or
prize. Our values system involves how we prioritize issues in respect to our
values. This can contribute greatly to an individual’s increase or decrease in
life stress.
An individual who attempts to answer the question “who am I” may be in
search of his/her value system. Living a life style that is contrary to ones
value system is stressful to an individual can cause a perfect congruence
between values and lifestyle which can be equated to living a lie e.g. people
living in religious cults, who have a psychological comfort are not genuine.
What an individual talks about; whom an individual associates with; what
he/she dreams about; desires or fears one has; are all reflections of his/her
value system.
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Activity
Take a moment to explore your personal values

by ranking the following items in the order of
their importance to you. First rank them 1 to
10 on how you think they really are now, and
then secondly rank them on how you wish
them to be in future.
Being secure
Being at peace
Being excited
Being free
Being accomplished
Being sexy
Being liked
Being respected
Being wise
Being ambitious
How different are your real values from your
ideal values?
Source: Cohn RJ (1994) Psychology and
adjustment.
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1.4 Adjustment and culture
In this context, culture is defined as the socially transmitted behavior

pattern, beliefs and product of human work of a particular population,
community or group of people, thus culture plays a major role in an
individual’s identity. It influences life choices and dictates what happens at
each milestone from birth to death. Culture therefore is a major influence on
adjustment. For example amount of hours one reacts to and copes with for
example, death of a loved one, birth of new baby, or marriage may vary from
one culture to another.
How do you normally deal with

difficult emotions? What
role does your culture play
in this?
our African setting?
1.5 Adjustment and change
Both expected and unexpected change is part and parcel of life. Adjustment
to change is therefore a lifelong process. People may be said to be adjusted
after a process of adjusting, though this is not a permanent state of affairs,
one individual who is well adjusted may be maladjusted in a different
situation or time. Adjustment depends on among others, the demands and
challenges made on an individual.
Adjustive demands can be defined as factors originating primarily in the
environment that prompt us to respond constructively to change. For
example a cold and wet season that make us cloth in warm protective
outfits.
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Adjustive challenges on the other hand, are internal factors originating from
within self, that can hinder one from responding constructively to change,
examples are doubts relactance and fear, and also the ability to mobilize the
energy required to respond constructively. Whenever an individual meets
adjustive challenges he/she encounteres personal growth. An individual who
meets adjustive demands does so to stay afloat, and if there is any personal
growth, then it is by chance.
1.5.1 Changing times

Change occurs in different ways for example times, roles and perspectives
changing times are seen more in daily news. Something can happen or an
event can occur and ultimately impact an individual’s life for example reports
on ongoing or beginning wars, insecurity droughts, famine amended laws
etc.
Think of a news item that

could impact on your
adjustment.
Comparing contemporary life with what was before there is a big difference
that directly co-relates with the difference in times, technology music and
style has changed continuously with time interestingly with more
technological advancement, people seem to work more and more and have
less leisure time. The availability of safe and fast travel has increased and
not reduced the amount of time business men spend away from home. There
have been great advancement in relation to treatment and medicine, yet
only a few can afford.
Food for thought: is modern
life easier or more difficult
than it was for our
ancestors? 17
1.5.2 Changing roles
Roles may be defined as expected behavior for example; there is expected
behavior or characteristics of policeman, teacher or wife. An individual could
be a neighbor, student, consultant or therapist and is therefore expected to
interact appropriately with various categories of the people he/she is
interacting with.
List down your own many different

roles
Roles change with time and situations, for example there is a time when a
counseling student becomes a therapist. These role changes may bring
about adjustment demands which must be dealt with. Some roles become
more complex with time, others end with accomplishment of certain
obligations. Individuals may be faced with role conflicts.
A role conflict can be defined as state in which the demands and expected
behavior in the context of particular situations are at odds with each other.
The role of business man or woman may conflict with the role of parenting if
the business demands traveling widely and spending more time away from
What does it mean for you to be a student?
family.
What are the adjustive demands and challenges
associated with your ideas a students?
Which other of your roles conflict with your roles
as student?
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1.5.3 Changing Perspectives
Behavior or actions can be seen from many adjustment perspectives. A
person’s view that may change with times may change drastically if he/she
becomes disabled. Likewise, one view of life may change once one gets a
child and becomes a parent.
Factors influencing perception include:

 The relationship between the individual and what is being viewed.
 The relationship between the particular elements and of what is
being looked at
 The relationship between the particular elements and the whole of
whatever is being looked at.
Take a close look at the following article from ezinearticles

Dealing With Life's Changes by Mike Strawbridge
Sometimes you just want to change. Other times, change seems to be forced
up you. In either event, change can be a very stressful time in your life.
When dealing with a change that has been forced upon you, you can make
two choices: you can decide to be a victim of circumstance, or you can
decide to take control of your life and make the best of the situation. The
remainder of this article is for those who decide to choose the latter.
When a change is forced upon you, you can choose to make the best of the
new circumstances that you are faced with. Note that this is a conscious
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choice. Take time to learn any lessons that you need to from the events that
lead to the forced change, but beyond that, let go of the past and focus on
the future you wish to create.
Take time to access your goals and dreams. Be sure to write them down. I
don't understand the mechanism behind writing them down, but there seems
to be some magic in committing your goals and dreams to paper. Maybe it is
the demonstration of faith required to actually write them that tells the
universe that you actually believe what you are saying.
By deciding what is really important in your life, you will know where to focus
your energy. Do you need to learn new skills to deal with your new situation?
Do you need to collect additional resources? Take time to carefully inventory
what you have and compare it with what you need to take your life in the
direction you want to go.
Often, this assessment is difficult for those who have little experience with
dealing with change or setting goals. If you feel you need help, I suggest
finding a life coach or a mentor to help you through the process.
My own experience in dealing with a forced change in employment when the
corporation I worked for decided to close the plant where I worked has
taught me a lot in how to deal with changes. I have chosen to help others
deal with changes by applying what I have learned through my own
situation. I suggest that you seek out a coach or mentor that has some
experience with the kinds of change you are dealing with. However, the
principles of dealing with change are universal, so any competent coach or
mentor can be of assistance.
Once you have a clear picture of what you want to accomplish and what it
will take to get there, you have to take the most important step in the
process - get started. This is where most people fail. They fail to start. It is all
too easy to fall back into victim mode at this point. Don't let that happen to
you. Choose each day to move forward toward your goals and creating your
new life the way you want it to be.
Even if you can't make a big step toward your goal, just make a step. For
example, if you decide you need more training, then look for classes that you
can attend or read a book on the subject. If there are other resources that
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you need, start looking for places that these resources are available. Make a
wish list.
Keep a journal of your progress and direction. Begin each day by rewriting
your main goals. This will keep your focus. Use your journal to not only chart
your progress but to inspire you as well.
Try asking questions to yourself. If you are stuck at some point, just write the
question and then wait for an answer. Write whatever comes to mind. You will
often be surprised at the insight that will come to you using this process.
If you are unsure of a goal, just give it a trial. If it does not feel right to you
after 30 days or so then drop it and move on to another goal. The great thing
about life is that you can begin again at any point.
Embrace the changes in your life. Even the ones that seem forced upon you.
Make the choice to live life to the fullest extent no matter what your current
circumstances. There is an abundance of resources waiting at your disposal -
all you have to do is choose to act.
In this lecture, we have covered introduction to the psychology of human
adjustment. We have also looked at human adjustment in relation to values,
culture, roles and perspectives.
SELF ASSESSMENT QUESTIONS (Lecture 1.)
1. Explain psychology of human adjustment.

2. Relate human adjustment to values and culture.
3. Changing times, roles and perspectives force us to
adjust. Discuss.
4. What do you learn from Mike Strabridge article about
change? 21
2. THEORIES RELATED TO PSYCHOLOGY OF ADJUSTMENT

By the end of this week and topic, you are expected to be able to:
1. Explain theories related to psychology of adjustment
2. Evaluate various approaches to psychology of adjustment
3. Demonstrate understanding of how these theories can be applied in adjustment
counseling
2.1 Introduction
Though it may be true that you have heard about psychology of human
adjustment for the first time in the course of this program, it is not
necessarily true that it is a new concept. It has been in existence since time
immemorial, and in fact, it is as old as mankind. This means that man has
had to adjust and cope with change throughout. It is therefore important to
understand how other scholars who were ahead explained human
adjustment.
This section is going to focus on theories related to psychology of
adjustment. Particularly the work of Brammer Lawrence (1992) from the ERIC
Digest is going to be highlighted. He identified three main ways of viewing
transitions, which include metaphors, social interaction model and
predictable overlapping stages. He also suggested possible coping attitudes
and skills that could help individuals to deal with transitions.
A transition is a short-term life change characterized by a sharp discontinuity
with the past. Thus, transitions have identifiable beginnings and usually
definite endings. Examples are job changes, disabling accidents, marriage,
birth, divorce, victimization, death, moving and travelling. These transitions
can be positive experiences, such as a vacation, or painful and tragic such as
losing a relationship. Such changes usually are experienced as losses; hence,
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transitions thrust the person into mourning. A transition can be voluntary or
involuntary, and it can be on-time (as in retirement), or off-time (as in the
fatal illness of a child).
2.2 Views of Life Transitions
Different scholars view transitions from a variety of angles. For the purpose
of this course, we shall focus on three specific views of life transitions,
namely, metaphors from classical literature, social interaction model, and
predictable overlapping stages.
2.2.1 Metaphors from Classical Literature
Bridges (1980) uses metaphors, mainly from classical literature, to describe

transitions over a lifetime. The journey, for example, is a common image.
Homer, the classical Greek poet, describes in vivid images Ulysses' decade of
travel changes. A counseling implication of this type of image is to
encourage clients to see their individual and serial transitions in terms of
personally meaningful metaphors, and as significant learning events on their
lifelines.
2.2.2 Social Interaction Model
A second way of characterizing a life transition is Schlossberg's (1984) social

interaction model. She characterizes a transition in terms of its type, context,
and impact. She states that a transition must be examined in regard to:
 The way a person appraises the transition event;
 The nature of the transition itself;
 The coping resources present at the time of the transition;
 The personal characteristics of the person and the environment
These interacting variables then are studied to ascertain the balance of

current and possible assets and liabilities. They also are linked to
developmental characteristics of the person, such as identity, age and
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maturity. A counseling implication of this model is that the counselor must do
a thorough assessment of these variables to determine where the person is
now in relation to the transition, the balance of coping assets and liabilities,
and what resources can be marshaled to help that person cope satisfactorily.
2.2.3 Predictable Overlapping Stages
A third model construes the transition as a process consisting of fairly

predictable stages that overlap one another and that often recycle through
earlier stages (Brammer, 1991). These stages are adaptations of the
literature on death as described by Kubler-Ross (1969) and Parkes (1972).
Hopson (1981) has adapted this model of the grieving process to transitions
in general.
The stages begin with the entry experience of confusion and emotional
discomfort, along with shock if the loss is unexpected and severe. Following
this initial reaction is a brief period of sadness or despair, often alternating
with relief and positive feelings. In a divorce, for example, the person
experiences alternating feelings of sadness over the dissolution of the
relationship, but also some relief that conflict and ambiguity are lessened.
Unless the loss is severe, a period of stabilized moods is experienced.

Defense mechanisms such as rationalization, denial and fantasy, for
example, are mobilized. Previously learned coping skills and resources such
as one's support network are tapped. But this stabilization is usually short-
lived as awareness of fears for the future and anger at the transition
emerges. Self-esteem usually plummets and feelings of sadness, dread, or
depression take over.
The length of this feeling of depression depends on the person's perception

of the severity of the loss, availability of coping resources, and cultural
attitudes about the appropriate length of grieving. The person is encouraged
to perceive this time as a healing period and relief from pressures of work
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and responsibility. Self-nurturing and frequent interaction with the support
networks are important, but each person must discover his or her own
method of getting through this painful period.
One goal is to let go of the past person, thing, job or value and take hold of a
new object or relationship. These attitudes and resources, combined with the
passage of time, enable the person to regain self-confidence and self-
esteem. The person begins to look to the future with optimism and hope. If
this process of healing and taking hold is successful, this stage emerges in a
renewal phase characterized by setting new goals, making plans, and
initiating actions. Thus, growth is enhanced through continual renewal
efforts.
One counseling implication of this model is the importance of determining

where people are in this process model after the transition has begun. In the
first stage, much support is needed to help people get through their initial
shock and the disruption of their lives. People need to understand the
confusing feelings of despair and hope following initial reactions to the
transition event. When the subsequent short stabilization period is
experienced, methods of sustaining hope and self-esteem, as well as
inoculation from depression, are needed. Since change frequently is injurious
to physical health also, people need to be cautioned to maintain optimal
health. Counselors need to be alert for indications that the person is letting
go of the past and is taking hold of the new, so that reinforcement of these
efforts at healing and renewal can be given. Thus, the renewal process and
the trend toward growth and recovery can be accelerated and maintained.
This process often does not proceed in nicely calibrated phases, and people
often recycle through the process. The sequences of these phases are not
always predictable. For example, some people might spend years grieving
the losses from their life transitions. A key criticism of this process model is
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that it is often oversimplified and the orderly progression of the stages for all
people in transition is taken for granted.
2.3 Coping Attitudes and Skills
Coping is viewed in the psychological literature as a form of self-initiated

problem solving. Thus, it is clearly distinguished from adjustment and
psychological defense, which are fairly automatic responses to change and
threat. Similarly, transformational forms of personal change often come
about through intense life experiences over which people have little control.
Skillful "copers" are effective in appraising the possible threats and dangers
in the change event, and can choose among alternative courses of
appropriate action (Lazarus & Folkman, 1984).
Attitudes contribute to a satisfactory coping response. A key attitude is to

view change as a normal part of living, as opposed to a view that the
transition is some kind of terrible curse, unlucky event, or unnecessarily
difficult problem to solve. The effectiveness of viewing the transition as a
challenging event, even welcoming it as an opportunity for creative growth,
has much support in research (Kobassa, 1979). A man, for example, who
sees his company about to reorganize and consolidate decides that he will
use this transition event to move towards the career he always wanted--a
business of his own. Thus, he viewed this move as a challenging opportunity.
People who perceive themselves as being in control of their lives, and to a

large extent over the events in their lives, are among what Kobassa (1979)
calls "hardy copers." A related attitude in the hardy copers' repertoire is
commitment--knowing their values and goals, as well as having the intention
of pursuing them diligently. In other words, they know who they are and what
they want. The transition is perceived as just another hurdle to jump along
life's raceway. They are willing to take responsibility for their actions and do
not blame others for the transitions that inevitably come into their lives.
26
When becoming ill, for example, they are willing to look for flaws in their own
lifestyles as well as to look for external physical causes.
The length of time required for satisfactory resolution of a transition depends

on a number of mediating factors. Some key ones are:
 The meaning that the transition has for the person;
 The extent to which the person is aware of and expresses feelings
about the transition;
 Previous experiences with transitions and learning from them;
 The availability of support systems;
 Counseling;
 Personal coping skills.
Coping skills can be classified in various ways, but a simple list that
incorporates several subcategories follows:
 Building and utilizing support networks;
 Cognitive restructuring, or reframing;
 Solving problems in the rational, intuitive, discovery, and systems
modes;
 Managing stress responses and stress-inducing events.
All of these skill clusters are teachable (Brammer & Abrego, 1981). The key
goal for counselors who are helping people cope with threatening personal
change is to teach them the skills they can use to conceptualize the nature
of their transitions (e.g., as a fairly predictable and understandable process)
and the skills to cope with various stages in the process. The principal goal
would be self-management of their transitions since they are such a common
part of human existence. A second goal would be to help people inoculate
themselves against the unwanted consequences of their transitions, such as
depression, hopelessness, chronic grief, and self pity, or awareness of being
in crisis and out of control.
What is the relevance of the theories that you
have learned to changes and transitions
in your life? 27
In this lecture, we have focused on theoretical explanations for human adjustment.
We have studied what these theoretical models are and how they relate and
apply to human adjustment.

1. Differentiate between change and transition.
2. How does Brammer (1992) view transitions?
3. Evaluate the social interaction model.
4. Counselors must teach coping skills. Discuss
28
3. ADJUSTMENT AND THE ROLE OF THE STUDENT

By the end of this week and topic, the student is expected to be able to:
1. Relate adjustment to your role as a student
2. Identify other roles that you have to adjust to
3. Apply psychology of adjustment to your life
3.1 Introduction
As a student, there are responsibilities and activities that you are required to
carry out. It is important that we look at adjustment in relation to studying at
the initial stage of this course since such knowledge can be applied later.
Since student responsibilities and activities are many, this course will only
focus on a few relevant ones, which are; critical thinking, generative
thinking, goal setting, and study behavior. You need to adjust to the role of
being a student by working on these areas and more. And that is all that this
topic is about. Do not just read it for the knowledge, but also try to apply the
concepts in your student life. You never know, it could be all you needed to
boost your academic life!
(a) Critical thinking.
Critical thinking means evaluative thinking. Judgment capabilities are
actively involved in the thinking as merits and elements are weighed.
Information is not just passively received and acted upon but actively and
carefully processed.
Thus, students are expected to critically analyze the reports coming to them
through media and from their instructors.
(b) Generative thinking
As a student, it is not only important, but also crucial for you to know:-
(i) What you are aiming at
(ii) Why are you aiming at it.
(iii) What you need to do.
29
As a student, you need to share your thoughts, not only with fellow students
but also your lecturers.
Generative thinking refers to the good-oriented ideas (Ohen (1994). It can be
manifested in many ways such as:-
1. Thinking of more valued new ways of using something familiar.
2. Spontaneously creating humour.
3. Anticipating issues that will be discussed.
4. Seeing how something that seems to be wrong may actually be right
etc.
(c) Goal setting

As a student it is important to have personal; goals and especially with
respect to the various courses being undertaken. Some causes are
compulsory, almost like a rite of passage; however, students could take time
to try to learn something for the purpose of knowing.
Students may also have mini goals for each day or week to do in a week;
such goals will depend on other factors, such as abilities, external demands
available resource and time management.
3.2 Study behaviour
Studying is a very individual matter because it may not be the same for
another. Some students like to study in quiet place, while others prefer
outdoor, some prefer to do it during the day, others at night, some make
brief notes, while others underline words in the text book.
How do you personally study

effectively?
30
1. When to study: time management
Sometimes it feels like there just aren’t enough hours in a day to accomplish
tasks. Especially at the university, students may feel a need to manage time
more effectively. It is helpful for students to take their role as an occupation.
People who work hand to regular schedule students need to adjust to a
“students like” schedule so as to succeed. Effective time management
directly co-relates to final grades.
2. Where to study
The life of a student requires some sacrifices that students need to
understand and expect and be comfortable with this fact. Students need to
study, learn and think. More often, these activities require solidarity rather
than group involvement. Studies have shown that a quiet place with few
distractions is the best environment for study.
A study table/desk is suitable since it is associated with learning. This is
unlike studying in a bed which is used basically for sleeping. The kitchen
table is associated with food, and thus the possibility of feeling unexplainable
hunger while studying. Where study room is not available, the library is the
best option.
Where do you study?
3. How to study
31
Students receive instructions in all skills they are expected to master. These
should include writing, studying and thinking skills. However, no student will
admit the need for help in study skills.
One method that has been studied most is the SQ3R method, which
originates from Francis P. Robinson. (1941).
SQ3R is a study method an acronym for survey, question, read, recite and
review. This method fosters an active involvement of the mind with the
materials being studied. This is unlike reading a novel.
To survey – is to examine/determine boundaries of. Similarly is SQ3R
surveying which involves having a glance at the content of the material to be
read, what type of material is it? How deep or wide is it? Other questions will
merge from the content outline.
Next, it is important to scan through the material, page by page. While
scanning headings and illustrations may also cause questions.
Question - questions may be created regarding each topic heading.
Questions may also arise after looking at the pictures without reading the
captions.
Read, recite and review - in the process of scanning through the book, try
not to read the captions, but instead write your own captions against each
picture, when you go back to read the book check if your guesses were
correct, By this time you have an idea of what to expect. It is now time to
read and recite and later, review the materials.
In the process of reading, try to answer any questions raised earlier. It helps
to close the book and recite out aloud these answers in your own words.
It may also be helpful to underline or highlight key points so as to stimulate
thinking on the subject.
Reviewing involves going back to the beginning of the chapter and work back
to the end. Check of answers to all the questioned are known. In case there
are some that are known, try the SQ3R process again, or better still, try the
supplemented SQ3R which are amounts to more RS.
Supplemented SQ3R
32
This is basically the SQ3R study system supplemented with 3 additional RS,
which are rewrite, remember and record.
(a) Rewrite - this is done in your own words of notes that are important to
you, during reading. Think of your own examples to illustrate the major
points and incorporate these in the writing. The rewriting must be in
summary form and understandable, especially to you, the rewriter.
(b) Remember - this refers to your personal memory techniques, for
example rehearsing, and using memories.
If you were given a shopping list of

seven items how would you go about
remembering the items on the list so as
not to carry the list with you to the shop,
and still buy the items on the list?
(c) Record - this could be done through tape recording, rewrite plans that can
be played back and forth. It is beneficial for you to hear yourself talk about
what you are trying to learn, it adds use of auditory senses to sight.
3.3 Study behavior in class
1. Listening
Listening in class is more like having engrossing telephone conservation,
hanging visualizing what is being described, it is actually, activate listening
which entails one’s undivided attention to whatever one is attending to. It
includes anticipation or visualization. In anticipation the listener thinks about
not only what is being said, but also what may also involve empathy, which
is immersion in what is being said to a degree that the listener actually
shares some of the speaker’s feelings as the speaker is speaking.
33
Some presentations and lecturers may be boring others, interesting. It is
important to know that class is not for entertainment, but for listening,
learning and actively processing what is heard.
2. Note taking
This involves noting important points, main ideas and insights, personal
original thoughts or questions about what is being said. Notes may be words,
drawings, or pictures. It is important that they are clear and legible. It may
be important to rewrite the notes after every class as the major points are
reviewed. Drawings may be about the lesson, or about prior knowledge, in
which case they serve as mnemonic devices.
3. Question asking
This is both by the teachers and the students to stimulate thought on the
materials being covered, for the student, the questions may be public
questions are noised in class for everyone to hear, while private may only be
raised to close or few chosen people e.g. instructor or discussion group
members.
4. Personal growth
This is change in the self for better, it is inseparable with this course,
psychology of adjustment is although provoking course that retouches on the
life of the student. It may provoke mixed feelings that will include anxiety,
inadequacy, social urgency, or uncertainty.
This is an opportunity for growth probably often such feelings are showed or
acted upon, thus, besides achieving grades, this course gives the student a
chance to achieve personal growth.
In SELF
this lecture, we have looked
ASSESSMENT at adjustment
QUESTIONS in relation
(Lecture 3) to the role of a student.
1. Relate
We have student lifeand
also discussed toexamined
the psychology of how
when, where and human
to study.
adjustment.
2. Differentiate between critical thinking and generative
thinking.
34
3. As a student, what factors influence your adjustment?
4. Describe when, where and how to study.
4. PHYSICAL FACTORS INFLUENCING ADJUSTMENT

1. Explain how adjustment influences health
2. Describe factors that influence resistance to stress
3. Rationalize the possibility of choosing wellness
4.1 Introduction
As you congratulate yourself for having successfully gone over the first three
topics of this module, I hope that you got correct answers for the SAQ. Even
if there is a question whose answer is still unclear, do not hesitate to get in
touch with me, or other instructors in the department. When you think about
physical factors influencing adjustment, what comes to your mind? Physical
resources and geographical features? It’s true, that these may be in play,
however, for the purpose of this module, let’s focus on the individual. The
health of an individual is the main physical factor that influences adjustment
that we shall study in detail.
4.2 Adjustment and Health
Physical state of health affects the mental state. Illness, disease, aches,
pains or discomfort affects moods, thoughts and competency. For example a
loss or impairment of hearing can totally change the lifestyle of an adult,
he/she will not find meaning any more in music, theater, or any other media
that uses sound, he/she may no longer walk, cycle or drive as before, more
still people around him/her will change behavior towards him/her.
Therefore, there is need for psychological adjustment so as to take care of
factors such as increased isolation, negative personal, psychological and
social consequences, in severe cases counseling may be involved.
The link between emotional and physical health.
35
Research has shown that the relationship between mind and body is
reciprocal. They both affect each other, and are probably linked by
communication between the nervous system and the immune system.
Psycho-neuroimmunology – refers to the study of how the nervous system
interacts with the endocrine and immune systems. It is aimed at finding out
how mental experience (e.g. positive or negative thinking) can strengthen or
weaken the immune system. However different people exhibit different
degrees of stress. These differences are presumed to be a function of the
strengths of ones genetic make-up. Other factors influencing resistance to
stress include:-
1. Individual hardiness which is characterized by commitment, challenge
and control. Appropriately, these people respond to stress in a more positive
way.
2. Positive thinking and optimum. Positive thinking is a process of
interpreting information in its best possible light, anticipating and mentally
working towards the best possible outcome, and focusing on whatever is
best or most hopeful. Optimum on the other hand is a general tendering to
visualize the future as favorable, unlike pessimism. This is a general
tendency to see the future as unfavorable.
3. Personality- Specific behaviour patterns are believed to place people
at high risk for heart attacks; some behaviour patterns include characters
such as impatience, competitiveness and feelings of time pressure. This type
A behaviour pattern, increases. Type B, on the other hand is characterized by
a more mellow and laid back behavioral patterns. Friedman and Roseman
(1974). Research has revealed that people classified as type A personality
are more physically reactive to stress than people classified as type B, their
sympathetic changes in normal secretions, blood pressure, and pulse rate
tend to be higher than those of type B.
4. Social support – this is another factor that affects tolerance. It may
be defined as understanding acceptance, empathy, advice, guidance and or
advice expression of case concern, agreement, trust and love from friends,
36
family, community care givers or others in one’s social environment. Social
support may be from family or friends, church or even a stranger. It affects
the activities of the heart. Research has shown a direct relationship between
loneliness and body immunity. (Glaser et al 1985). The sick role, much as
social support increases tolerance and coping with stress, may on the other
hand yield negative effects. For example, when a farming member is sick,
the others get overly concerned. For instance, fever can lead to skipping
school and getting mother’s and or care givers attention.
4.3 Emotions and adjustment
Emotions are comprised of experiential (affect and appraisal), physiological,

and behavioral (or action readiness) components and are expressed via
separate systems that are weakly, but positively, correlated: verbal report of
feelings, overt behavior, and expressive physiology. Levenson's defines
emotions as short-lived psychological-physiological phenomena that
represent efficient modes of adaptation to changing environmental demands.
Psychologically, emotions alter attention, shift certain behaviors upward in
response hierarchies, and activate relevant associative networks in memory.
Physiologically, emotions rapidly organize the responses of different
biological systems including facial expression, muscular tonus, voice,
autonomic nervous system activity, and endocrine activity to produce a
bodily milieu that is optimal for effective response.
Emotions serve to establish our position vis-avis our environment, pulling us
toward certain people, objects, actions, and ideas, and pushing us away from
others. Emotions also function as a repository for innate and learned
influences, possessing certain invariant features along with others that show
considerable variation across individuals, groups, and cultures. Our focus
here is on the potential utility of emotional processing and expression when
one confronts taxing circumstances.
4.3.1 Emotional Competence.
37
Emotional competence refers to the ability to use one's own emotional
responses, as well as those of other people, as cues for action and effective
interpersonal coping. In Saarni's view, emotionally competent individuals are
aware of and sensitive to their feelings, tolerant of negative emotional
experience, and able to express emotion strategically and flexibly (in
genuine or modified form depending on one's goals and the emotional
context).
According to Saarni (21), the following 11 specific skills comprise emotional
competence:
(a) awareness of one's emotional state, including the possibility that
one is experiencing multiple emotions and, at more mature levels,
awareness that one might not be consciously aware of all feelings;
(b) ability to discern others' emotions based on situational and
expressive cues that have some degree of cultural consensus;
(c) ability to use the vocabulary of emotion;
(d) capacity for empathic involvement in others' emotional experience;
(e) ability to realize that inner emotional state need not correspond to
outer expression, both in oneself and others;
(f) awareness of cultural display rules;
(g) ability to take into account unique personal information about
individuals and apply it when inferring their emotional states;
(h) understanding that one's emotionally expressive behavior may
affect another and taking this into account in self-presentation;
(i) capacity for coping adaptively with aversive or distressing emotions
by using self-regulatory strategies;
(j) awareness that the structure and nature of relationships is in part
defined by the degree of emotional immediacy or genuineness of
expressive display and by the degree of reciprocity or symmetry within
the relationship;
(k) capacity for emotional self-efficacy (viewing oneself as feeling the
way one wants to feel overall).
38
4.3.2 Emotional Intelligence.
Emotional intelligence is another construct that emphasizes the adaptive
value of emotional experience and expression. Emotional intelligence is
defined as a subset of social intelligence and is comprised of four
psychological processes:
(a) the ability to perceive, appraise, and express emotion accurately;
(b) the ability to access and/or generate feelings when they facilitate
thought;
(c) the ability to understand and use emotional knowledge effectively; and
(d) the ability to regulate emotions adaptively and reflectively in ways that
promote emotional and intellectual growth.
Thus, emotionally intelligent individuals presumably are geared toward
success in a number of ways. For example, they may thrive in interpersonally
oriented careers such as social work, teaching, and human relations, and
may develop satisfying intimate relationships.
4.3.3 Emotional Creativity.
Emotional creativity, involves the creation of emotional responses that are
novel with respect to the individual or the individual's group, effective in
enhancing the individual's well-being, and authentic, reflecting something of
the individual's unique self. According to Averill and Thomas-Knowles,
emotionally creative individuals display facility in integrating and expressing
emotions symbolically, form complex appraisals of situations, and deeply
explore emotional meanings. Such creativity supposedly renders individuals
more able to understand their own emotions and to communicate effectively
with others. Averill and Nunley described steps to facilitate the development
of emotional creativity. These include making a commitment to become
emotionally creative, gathering knowledge regarding the nature of emotions
(e.g., dispelling "myths of emotion," such as the notion that we are
"overcome" by emotion or that emotions are impossible to control),
increasing self-awareness, setting goals regarding an emotional life, and
practicing new emotional responses.
39
4.4 Optimism and adjustment
Optimists are people who expect good things to happen to them; pessimists
are people who expect bad things to come their way. These concepts have a
distinguished history in folk wisdom. It's long been believed that this
fundamental difference among people is important in many, if not all, facets
of life. Although folk wisdom sometimes turns out to be less than accurate,
this particular piece of folk wisdom is receiving a considerable degree of
support in contemporary research. As we describe later on, optimists and
pessimists differ in several ways that have a big impact on their lives. They
differ in how they approach problems and challenges in life, and they differ in
the manner, and the success, with which they cope with adversity.
4.4.1 Possible Origins of Optimism and Pessimism
Regardless of whether you think of optimism in terms of analyses of causal
processes or in terms of confidence and doubt per se, there are several ways
to think about how optimism comes to exist as a quality of personality. For
example, many aspects of personality are genetically influenced. Is optimism
one of them? The answer seems to be yes. The results of twin studies
suggest that optimism, whether assessed in terms of generalized
expectancies or in terms of explanatory style, is subject to genetic influence.
As is always true in considering heritability, there remains a question about
whether optimism is itself heritable, or whether it displays heritability
because it's closely related to some other aspect of biologically based
temperament. Optimism relates both to neuroticism and to extraversion, and
both of these qualities are known to be genetically influenced. Although it
appears that optimism and pessimism are distinguishable from these
temperaments, it may be that the observed heritability of optimism is a
product of these associations.
Another potential influence on having an optimistic versus pessimistic
outlook on life is early childhood experience. Many theories maintain that
40
early childhood is an important time in the formation of personality. For
example, Erikson's well-known theory of personality development (10) holds
that infants who experience the social world as predictable develop a sense
of "basic trust," whereas those who experience the world as unpredictable
develop a sense of "basic mistrust." These qualities aren't all that different
from the general sense of optimism and pessimism.
4.4.2 Optimism, Pessimism, and Coping
Optimists experience less distress than pessimists when dealing with
difficulties in their lives. Is this just because optimists are more cheerful than
pessimists? Apparently not, because the differences often remain, even
when statistical controls are incorporated for previous levels of distress.
There must be other explanations. Do optimists do anything in particular to
cope or adjust that helps them adapt better than pessimists? Many
researchers are now investigating this possibility as a potential mechanism
through which optimism confers psychological benefits.
In this section we consider the strategies that optimists and pessimists tend
to use and the broader meaning of these strategies. People who are
confident about the future exert continuing effort, even when dealing with
serious adversity. People who are doubtful about the future are more likely to
try to push the adversity away as though they can somehow escape its
existence by wishful thinking, more likely to do things that provide temporary
distractions but don't help solve the problem, and sometimes even give up
trying. Both the effort and the removal of effort can be expressed in a variety
of ways. Differences in coping methods used by optimists and pessimists
have been found in a number of studies. One researcher asked
undergraduates to recall the most stressful event that had happened to them
during the previous month and complete a checklist of coping responses with
respect to that event. Optimism related positively to problem-focused
coping, especially when the stressful situation was perceived to be
controllable. Optimism also related to the use of positive refraining and
(when the situation was perceived to be uncontrollable) with the tendency to
41
accept the reality of the situation. In contrast, optimism related negatively to
the use of denial and the attempt to distance oneself from the problem.
These findings provided the first indication that optimists not only use
problem-centered coping, but also use a variety of emotion-focused coping
techniques, including striving to accept the reality of difficult situations and
putting the situations in the best possible light. These findings hint that
optimists may enjoy a coping advantage over pessimists, even in situations
that cannot be changed.
Other research has studied differences in dispositional coping styles among
optimists and pessimists. As with situational coping, optimists reported a
dispositional tendency to rely on active, problem-focused coping, and they
reported being more planful when confronting stressful events. Pessimism
was associated with the tendency to disengage from the goals with which
the stressor is interfering. While optimists reported a tendency to accept the
reality of stressful events, they also reported trying to see the best in bad
situations and to learn something from them. (They seem to try to find
benefits in adversity.) In contrast, pessimists reported tendencies toward
overt denial and substance abuse, strategies that lessen their awareness of
the problem. Thus, in general terms optimists appear to be active copers and
pessimists appear to be avoidant copers.
4.5 Positive thinking
It is commonly held that positive thinking is good and negative thinking is

bad. The advice given to the student taking an exam, the athlete competing
at the Olympics, and the patient facing a life-altering diagnosis is to "think
positive." Are there really benefits to such positive thinking? The answer is
an emphatic yes. A growing literature supports the idea that expectations for
the future have an important impact on how people respond in times of
adversity or difficulty. The expectations influence the manner in which people
confront these difficulties, and they influence the success, both emotional
and behavioral, with which people deal with the difficulties. We have yet to
42
see clear evidence of a case in which holding positive expectations for one's
future is detrimental. There are many questions that are yet unanswered: for
example, about the precise mechanism by which optimism influences
subjective well-being, and about potential pathways by which optimism may
influence physical well-being.
4.6 Hope, Coping and Adjustment
Hope here is defined as a thinking process in which people have a sense of

agency and pathways for goals. Together, goals, pathways, and agency form
the motivational concept of hope. This definition clearly is cognitive in nature
and, as such, stands in contrast to other more emotion-based models of
hope. In more specific terms, we have defined hope as "a reciprocally
derived sense of successful (a) agency (goal-directed determination) and (b)
pathways (planning of ways to meet goals)". Although the agency and
pathways of hope are additive, reciprocal, and positively related, they are not
synonymous. To sustain movement toward life goals, both the sense of
agency and pathways must be operative. Thus, although agency and
pathways are necessary to define hope, neither alone is sufficient. Also, hope
does not entail just one iteration of thinking, in which a person first assesses
agency and then the available pathways thoughts, thereafter initiating goal-
directed behaviors; nor is it the case that one pathways thought unleashes
the agency thinking that leads to goal-directed behavior. Instead, at all
stages of goal-directed behavior, the iterations of agency/pathways and
pathways/agency thought continue and build on one another.
Hope is related to psychological adjustment in several ways. One way in
which psychological adjustment is affected by hope is through the belief in
one's self. Snyder, Hoza, et al. found that high-hope is related to perceived
competency in several life areas in children. In this study, hope was
positively correlated with perceptions of scholastic competence social
acceptance, athletic ability, and physical appearance. Therefore, hopeful
43
thinking in children is related to the belief that one has the necessary
competence to accomplish a specified goal.
In addition to perceived competence, psychological adjustment is related to
hope. For example, research has shown that level of hope, as measured by
the State Hope Scale, is positively related to state measures of positive
affect and negatively related to state measures of negative affect.
Another component of psychological adjustment is the presence of positive
feelings toward oneself. Evidence indicates that high-hope individuals feel
good about themselves on a fairly regular basis. For example, hopeful
thinking in children is associated with an increased feeling of self-worth.
4.7 Personality and Adjustment
Why do coping behaviors show these trait-like properties of stability and

consistency? At one level, these data may indicate that many of the
strategies assessed in popular coping inventories (e.g., venting, denial)
represent interesting trait dimensions. Coping strategies reflect broader and
more basic dispositional tendencies within the individual. In this regard, there
is no reason to believe that coping responses differ fundamentally from other
types of responses. In fact, as it typically is defined, "coping" simply reflects
how individuals respond to a particular class of events (i.e., stressors).
Because people show consistency in their responses across different events,
they should respond to stress in ways that relate systematically to the ways
in which they respond to other experiences. For instance, extraverts are
highly motivated to interact with others and actually spend more time
socializing than do introverts. Consequently, one would predict that
extraverts are more likely than introverts to turn to others for support during
times of stress. Similarly, conscientious individuals generally act in a
cautious, meticulous, and highly organized manner; accordingly, one would
expect that these individuals develop careful and precise plans (i.e., engage
in problem-focused coping) to help them adapt to stressful life events. Note,
moreover, that general traits likely have important implications for the types
44
of adaptational resources that are available to an individual. For instance,
people who generally are friendly and agreeable likely will have more
extensive social networks available to them during times of stress; this, in
turn, makes social support seeking a much more viable coping strategy.
4.8 Benefit-Finding: the case of patients with life threatening illness
Most of the evidence linking benefit-finding to positive adaptation and
wellbeing comes from cross-sectional studies. Benefit-finding relates to less
negative affect in cancer patients; less depression and greater
meaningfulness in life in stroke victims; less psychological distress in infertile
women and victims of taste and smell loss; superior psychological
adjustment in women with breast cancer; and less mood disturbance and
intrusive thoughts in mothers of acutely ill newborns. Because it is difficult to
disentangle temporal precedence in these cross-sectional studies, their
findings also can mean that those who are better adjusted to these problems
find it easier to construe positive aspects of their experience. Or, perhaps
positive adjustment and the ability to find benefits are both influenced by
differences in the severity of the problem.
Thus, research on the adaptational correlates of benefit-finding among
individuals facing serious medical problems has documented its unique
ability to predict emotional well-being. This, along with initial evidence that
benefit-finding also may confer long-term health benefits, is a good reason to
investigate why this positive appraisal of threatening events is related to
positive adaptational outcomes.
Choosing health
Rather than having to cope or adjust to illnesses it is possible in today’s
world to choose health.
Do you think it is reality possible to

choose wellness?
45
In this lecture, we have looked at adjustment and health. We have discussed and
examined factors influencing resistance to stress and analysed in detail the
role of emotions and personality traits in human adjustment.

1. How does health relate to human adjustment?
2. Adjustment involves controlling our emotions. Discuss.
3. Differentiate between emotional competence and
intelligence.
4. Link optimism to human adjustment.
5. Personality traits influence our adjustment. Discuss
46
5. LIFESTYLE AND HEALTH
Week 5 & 6: Topic objectives

1. Explain healthy living in relation to adjustment
2. Describe major health related concerns
3. Evaluate the role of drug use in relation to healthy living
4. Identify areas of improvement in your personal life
5.1 Introduction
In this chapter, we shall look at lifestyle and health. You may wonder what
one’s lifestyle has to do with one’s ability to adjust. The truth is that as we
shall see, these two variables are directly interrelated. How you choose your
life directly affects coping with lefe changes.
Lifestyle may be defined as an individual’s or group relatively consistent day
to day patterns living. These patterns include how one dresses, shops, works,
and spends money. It may also include whom one associates with the kinds
of food eaten, the kind of car one drives or even the number of hours one
sleeps. All these are founded on
(i) values
(ii) motivation
(iii) physical activity
(iv) interpersonal relationships
5.2 Eating Habits
Research has shown that health related concerns in areas such as nutrition,
dieting exercise and sleep are common, (Harris & Cuten 1979).
As far as nutrition is concerned one may choose a diet that can prevent
certain diseases, for example. Food that is low in animal fat and high in fruit
and vegetables reduce cancer risks. Such food also reduces the chances of
47
obesity, which is a condition that exists when body fat exceeds 20% of total
weight in women.
Dieting may be helpful if the individuals involved can follow the regime. It
will work as long the dieter remains committed and if the direction is not
harsh to the dieter. It helps to eat slowly, at regular times and at regular
intervals with a realistic weight loss goal.
Exercise is extremely important for healthy living. Research has shown that
people who are involved in exercise or sport live on an average of ten
months longer than their counterparts (Paffenbarger et al 1993) in the same
study, subjects who stopped smoking and stated exercising added 3 more
years to their lives. Exercises move gradually to regular and enjoyable levels.
Sufficient sleep is equally important for good health, since it is through
sleeps that the body is restored, research has revealed that sleep deprivation
may lead to symptoms such as suitability, distractibility and concentration
problems. Long term sleep deprivation leads to more severe symptoms
including hallucinations. Barriers to a good night’s sleep may include worry
anxiety, physical pain, noise, stimulants and light, (Webb and Campbell,
1983).
Finally, drug use and abuse play an important role in healthy living. Drugs
are capable in different strengths and concentrations of affecting human
health & behavior, besides leading to accidents that could be fatal, drugs
also lead to addition and serious withdrawal effects.
What specific aspects of your own

lifestyle would you like to
improve?
Values, choices and the bio psychosocial perspective.
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A biopsychosocial perspective places emphasis on the need for individuals
themselves to prevent problems by engaging in wellness-promoting
behaviors. It also emphasizes illness from not only a biological perspective,
but also a psychosocial one. How much one values ones life /health
determines the choices made. Apparently this valuing is determined by other
factors, such as one’s self-esteem, and even one’s gender.
To the extent that one’s lifestyle does contribute to one’s health, one can
choose health.
5.3 Drug Use
Some people who use drugs do so in large enough amounts often enough
and long enough to become dependent.
5.3.1 Definitions
A single definition for drug dependence is elusive. Concepts that aid in

defining drug dependence are tolerance and psychological and physical
dependence.
Tolerance describes the need to progressively increase the drug dose to
produce the effect originally achieved with smaller doses.
Psychological dependence includes feelings of satisfaction and a desire to
repeat the drug experience or to avoid the discontent of not having it. This
anticipation of effect is a powerful factor in the chronic use of psychoactive
drugs and, with some drugs, may be the only obvious reason for intense
craving and compulsive use. Craving and compulsion to use a drug lead to
using it in larger amounts, more frequently, or over a longer period than was
intended when use began. Psychological dependence involves giving up
social, occupational, or recreational activities because of drug use, as well as
persistent use despite knowing that the drug is likely to cause a physical or
mental problem. Drugs that cause psychological dependence often have ≥ 1
of the following effects:
 Reduced anxiety and tension
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 Elation, euphoria, or other pleasurable mood changes
 Feelings of increased mental and physical ability
 Altered sensory perception
 Changes in behavior
Drugs that cause chiefly psychological dependence include marijuana,

amphetamine, methylenedioxymethamphetamine (MDMA), and
hallucinogens, such as lysergic acid diethylamide (LSD), mescaline, and
psilocybin.
Physical dependence is manifested by a withdrawal (abstinence)
syndrome, in which outward physical effects occur when the drug is stopped
or when its effect is counteracted by a specific antagonist. Drugs that cause
strong physical dependence include heroin, alcohol, benzodiazepines, and
cocaine. Abstinence syndromes are drug- or drug class–specific and may
vary considerably based on the amount and frequency of use and on patient
characteristics, which may affect how patients experience withdrawal.
Addiction, a concept without a consistent, universally accepted definition, is
used here to refer to compulsive use and overwhelming involvement with a
drug, including spending an increasing amount of time obtaining the drug,
using the drug, or recovering from its effects. It may occur without physical
dependence. Addiction implies the risk of harm and the need to stop drug
use, regardless of whether the addict understands and agrees.
Drug abuse is definable only in terms of societal disapproval. Drug abuse
may involve the following:
 Experimental and recreational use of drugs, which is usually illegal
 Unsanctioned or illegal use of psychoactive drugs to relieve problems
or symptoms
 Use of drugs because of dependence or the need to prevent
withdrawal
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Illicit drug use, although usually considered abuse simply because it is illegal,
does not always involve dependence. Use of legal substances, such as
alcohol and prescription drugs, may involve dependence and abuse. Abuse of
prescription and illegal drugs cuts across all socio-economic groups.
Recreational drug use has increasingly become a part of Western culture,
although in general, it is not sanctioned by society. Some users apparently
are unharmed; they tend to use drugs episodically in relatively small doses,
precluding clinical toxicity and development of tolerance and physical
dependence. Many recreational drugs (eg, crude opium, alcohol, marijuana,
caffeine, hallucinogenic mushrooms, coca leaf) are “natural” (ie, close to
plant origin); they contain a mixture of relatively low concentrations of
psychoactive compounds and are not isolated psychoactive compounds.
Recreational drugs are most often taken orally or inhaled. Taking these drugs
by injection makes it harder to predict and control desired and unwanted
effects.
Intoxication refers to development of a reversible substance-specific
syndrome of mental and behavioral changes that may involve altered
perception, euphoria, cognitive impairment, impaired judgment, impaired
physical and social functioning, mood lability, belligerence, or a combination.
Taken to the extreme, intoxication can lead to overdose, significant
morbidity, and risk of death.
Narcotics and scheduled drugs: Narcotics are drugs that produce
insensibility or stupor (narcosis), but the term is typically restricted to drugs
that bind to opiate receptors: opium, opium derivatives, and their semi-
synthetic and synthetic analogues. However, the US government classifies
cocaine as a narcotic, even though it does not bind at opiate receptors or
have morphine -like effects. Many narcotics (specifically, opioids) are used
therapeutically to induce anaesthesia and to relieve pain, cough, and
diarrhoea. The morphine -like effects of opioids are welcomed in most clinical
situations but contribute to the attractiveness of narcotics for abuse.
51
What is the link between substance abuse
and adjustment?
52
5.4 Escaping reality
People often try to dull the pain of this 20th century “disease” by using
alcohol and drugs (either illegal drugs or prescription medications). But the
supposed cure is itself an epidemic. Organizational development consultant
Karl Albrecht aptly summarizes today’s state of mind in these words:
“The use of mood-altering chemicals in America, and to some extent in
other developed countries, has run completely wild. Cultures we are
pleased to label ‘primitive’ all without exception reserve the use of
tobacco, drugs and intoxicants for special occasions such as
celebration and rituals. Only in the so-called advanced cultures do we
use these chemically induced altered states of awareness as routine
means for escaping reality.”
A person may have emotional issues and choose to mask, numb, or escape
them through the use of drugs or alcohol or, as a result of drug or alcohol
use, a person may begin to suffer from emotional issues. It doesn’t much
matter. It becomes a negative cycle of behavior. The emotional issues may
trigger the substance abuse and/or the substance abuse may trigger the
emotional issues. Those issues cannot be ignored and must be addressed.
Drugs and alcohol change a person’s chemistry and subsequent behavior.

They contribute to loss of inhibitions and impairment of judgment. While they
may serve to be a ‘quick fix’ to mask, numb or escape the realities of life,
when the literal smoke clears, the emotional issues remain and may even
potentially be exacerbated. Although genetics may be a contributing factor
to drug and alcohol dependence, an individual (especially an adolescent)
suffering from an emotional problem who turns to drugs and alcohol to
cope will have a greater risk, and face the danger, of becoming chemically
dependent.
53
Substance misuse is widespread in society. Anecdotal evidence suggests that
many people involved in drug and alcohol services have been the victims of
sexual abuse, in fact research "found that males were more likely than
females to experience denial and to control their emotional response
through the use of drug abuse" (Kaufman, et al. 1980).
To some people, drugs were the ultimate form and vehicle for escapism, to
change their head space so they didn’t have to deal with the thoughts and
feelings of the past. Inevitably, it led to unproductive, unfulfilled human
beings heading nowhere other than prison, or a section at the local
psychiatric ward (if lucky enough for them to take you).
For many others, drugs seemed to be the ultimate way to escape from past
negative experiences. With the help of a good therapist, they may realize
what they are doing and made the connection between their drug use and
being victims of sexual abuse, for example. They may beat themselves up
for taking drugs and not understand why they couldn’t stop relapsing. After
detox they may see that they take drugs to forget about their past, a method
that wasn’t healthy or adaptive to cope with the past.
Drug addiction can be a life sentence just like being a victim of sexual abuse.
It means we’re handing our control over to another perpetrator, only this
time it’s called drugs. We are certainly not in the habit of doing that anymore
because “where did that plan get us last time….”. We need to clear ourselves
of everything that is torturing us in order to move on.
5.5 Levels of dependency
A substance abuser does not just start off as an addict. It is a gradual

process that can be explained in three stages or levels of dependency.
1. The experimental stage
The first stage is experimental this is when one is first starting off and
doesn’t know anything about drugs. It may normally occur at a young age,
54
probably 13 and above. These young people hear about drugs and older
peers experiences and it sounds exciting maybe just what they are looking
for, a chance to change the way they feel. So they start off with the basics
smoking a bit of cigarettes, marijuana, and maybe trying a trip (lsd), gas,
glue etc. Soon they start trying the different drugs find out what sort they
like, uppers or downers. Nothing is problematic at this stage it is just fun,
funded by pocket money or given to us by an older friend or sibling. No
major problems really?
2. The recreational stage
The next stage is a little more serious. This is when they are a little bit more
experienced trying other substances like coke, ecstasy, speed and the like.
This is known as the recreational stage. It is not too problematic at this stage
just using drugs at weekends maybe to enhance our nights out. A good way
to describe this is going out clubbing at weekends, still holding down a job,
maybe a bit of social supplying to friends but nothing life wrecking. Still fun
at this stage?
3. The dependency stage
The next stage is dependency. This is when they cannot function or go out
without having drugs in the system and are possibly physically addicted.
Now they are masters of drug abuse. It is not fun anymore because they will
definitely be committing serious crime at this stage or selling their bodies to
fund the habit, whatever the drug of choice. An example of this is forming a
dependency on a physically or psychologically addictive substance like
heroin or any of the so called party drugs. But when the party is truly over a
serious intervention from a professional is required to help them learn to
control the problem and understand how to unravel the addiction.
According to survivors and drug users, psychological damage from childhood

or adult abuse issues, increase the likely hood to form a habit on substances
to cope with past traumatic experiences. For those laden with issues, drugs
55
seem to be the perfect coping mechanism to get by, though they are
certainly not the long term answer.
5.6 Case study: 911 terrorist attacks and drug use
A survey of New York City residents in the wake of the September 11, 2001,
terrorist attacks found high levels of both depression and posttraumatic
stress disorder (PTSD) among respondents and documented an increase in
substance abuse. The survey, conducted by NIDA-funded researchers Dr.
David Vlahov and his colleagues at the New York Academy of Medicine 5 to 8
weeks after the terrorist attacks, quantifies the relationships among stress,
depression, and substance abuse. Stress has long been recognized as one of
the most powerful triggers for drug craving and relapse to drug abuse.
Research has shown that survivors of disasters are prone to stress-related
problems such as PTSD and depression. People who experience major
trauma and those with PTSD or depression may self-medicate with drugs or
alcohol to relax, cope with stress, or relieve symptoms. "This study is one of
the first to capture data on the effects of traumatic events on substance
abuse patterns," says Dr. Jacques Normand of NIDA's Center on AIDS and
Other Medical Consequences of Drug Abuse. "The increase in substance
abuse found here was of significant magnitude. This study reminds
counselors and treatment providers to be alert to increased use of alcohol,
tobacco, and marijuana in the wake of such events."
Survey respondents reported post-attack rates of depression and PTSD that

were approximately twice the baseline levels previously documented in a
1999 benchmark national study. Some 9.7 % had symptoms of depression,
and 7.5 % qualified for a diagnosis of PTSD compared to baseline levels of
4.9 % for depression and 3.6 % for PTSD.
In looking at rates of new substance use among respondents, the

researchers found that, of respondents who did not use these substances
56
during the week before September 11, 3.3 % started smoking cigarettes
after September 11; 19.3 %started drinking alcohol; and 2.5 % began using
marijuana. Overall, the percentages of respondents who smoked, consumed
alcohol, and used marijuana increased 9.7 5, 24.6 percent, and 3.2 5,
respectively, after the attacks.
Almost 29 % of respondents reported that they were smoking more

cigarettes and/or marijuana and/or drinking more alcohol. Among those who
were already using these substances before September 11, 41.2 % smoked
more cigarettes and 41.7 % drank more alcohol after the attacks. Among
smokers, 8.2 % smoked at least one additional pack of cigarettes a week;
20.8 % of drinkers had at least one additional drink a day.
"The survey results are significant for the sheer numbers of people revealed
to be affected by the disaster, the scope of the problem on a citywide scale,
and challenges to the delivery of services," says Dr. Vlahov. He estimates
that of the approximately 911,000 people in the area of New York under
study, 67,000 had PTSD and approximately 87,000 had depression at the
time of the study. Likewise, he estimates that 265,000 people increased their
use of any of the substances in question:
 89,000 smoked more cigarettes,
 226,000 consumed more alcohol, and
 29,000 used more marijuana.
"This survey demonstrated that whole populations are affected by such

disasters," says Dr. Vlahov. "The increases in use of cigarettes, alcohol, and
marijuana across the population are large, making this a broad public health
issue."
5.7 Other Risk Factors for Drug Use
Risk factors for drug use include such characteristics as poor neighborhood
environments, family dysfunction, school dropout, drug use by friends, traits
57
such as high anger or sensation seeking, and many other social and
psychological characteristics. A thorough review of risk and protective factors
is provided by Hawkins, Catalano, and Miller (1992). Risk factors can differ
depending on the problem, but usually a risk factor for drug use operates
through increasing the probability of incorporation of deviant norms,
generally by increasing the chances of involvement with deviant peers
(Oetting & Beauvais, 1986, 1987a, 1987b). The total number of different risk
factors may be important. There is research evidence of a linear relationship,
with increasing risk of drug use for each additional risk factor (Maddahian,
Newcomb, & Bentler, 1986).
5.7.1 Protective Factors Against Drug Use
These include characteristics such as strong family sanctions against drugs,
religious identification, school success, etc. Some risk and protective factors
are defined as opposite poles of the same dimension, but this is not
essential; being in the lowest quartile for trait anger, for example, might not
protect against drug use, but being in the upper quartile is a risk factor. A
protective factor against drug abuse usually operates by increasing the
chances of incorporation of pro-social norms, reducing the chances of
involvement with deviant peers, and reducing the probability of drug
involvement. There is evidence that the balance of risk and protective factors
is important; that if more risk factors are present, more protective factors are
needed to compensate (Werner, 1989).
5.7.2 Resilience and Drug Use
Resilience, is defined here as the ability to tolerate, to adapt to, adjust to, or
to overcome life crises. Resilience reduces the chances of drug use because,
under some circumstances, the inability to deal with a crisis can place a
person at greater risk for drug involvement. Resilience consists of those
personal and social resources for dealing with the problems and crises that
are bound to appear in life, and it becomes important only when those
problems appear. Protective factors save you from disaster; resilience lets
you bounce back. For example, an adolescent crisis, such as the breakup of a
58
relationship, can lead to negative feelings, among them a sense of rejection
and possibly self-derogation. Kaplan (1986) has shown that self-derogation
can increase the chances that a child will bond with deviant peers and
therefore get involved with drugs. The resilient youth, however, when
meeting the same crisis, may have the personal and social resources that
help deal with the crisis, reducing the probability of negative emotional and
behavioral consequences. A protective factor may or may not produce
resilience. A high level of parental monitoring is usually a protective factor
for drug use. But in the extreme, while families that severely restrict peer
contacts can prevent drug use because children from those families have no
contact with peers who might use drugs, those overprotected and restricted
youth may not develop resilience. They may lack confidence in peer
relationships and may not develop the social skills that could help them deal
with crises and problems that occur later in life. When the youth leaves the
protective family circle, the youth may lack resilience.
Resilience is often defined as a personal characteristic, but there are also
resilience factors that exist outside of the person. These are external
resources that help a person deal with crises. Some are both protective and
resilience factors. A closely linked extended family can make family/child
bonding stronger and therefore be a protective factor. The extended family
can also provide emotional support and advice in a crisis, particularly if that
crisis involves illness or other problems in the primary family, and therefore
it can also become a resilience factor. There are resilience factors that are
outside of the person, but do not serve as protective factors. They help the
person deal with crises. Examples would include legal services, rape
counseling services and the availability of treatment for sexually transmitted
diseases. Personal resilience can include the attitudes and skills needed to
identify and make use of these external resources.
59
In these lectures, we have covered healthy living and how it relates to human
adjustment. We have also looked at drug use and abuse and how it
influences human adjustment.
SELF ASSESSMENT QUESTIONS (Lecture 5)

1. Explain the relation between lifestyle and adjustment.
2. Differentiate between physical and psychological
dependence.
3. All drug abusers have deeper underlying issues from
their past. Discuss.
4. Recreational drug use enhances adjustment. Discuss.
5. What do you learn from the case study of 911 terrorist
attack and drug use?
6. How can resilience among the youths be increased?
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6. ADJUSTMENT AND DEVELOPMENT
Week 7 & 8: Topic objectives

1. Relate adjustment to physical development
2. Explain various adjustment needs for different stages of development
3. Demonstrate understanding of personal adjustment challenges
6.1 Introduction
At what developmental stage are you? Think about it, can you say that you
have successfully adjusted to this stage? Better still, think back about your
earlier stages, is there any that you had difficulty adjusting to the changes it
brought? If you have had the opportunity of raising a child or watching one
grow, you may have appreciated the fact that parents and caregivers too
need to adjust to changes in a growing child.
The process of adjustment to development begins before birth. The fetus
adjusts continuously to environmental conditions within the mother’s womb.
These conditions are determined by the mother’s behavioral, including her
nutrition, relaxation dealing with stress etc. the process of adjustment
continuous throughout one’s lifespan.
6.2 Overview of Lifespan Development
6.2.1 Infancy
A child between birth and two years of age has to continuously to adjust to
development of motor skills, such as sitting, standing, crawling or challenged
with self perceptions of the external world. Emotionally, the child has
challenges relating to attachment to care givers, who must also adjust to the
child’s development.
Caregivers must provide proper nutrition and protection. They must also
institute effective discipline measures, impart values, build child’s self
61
esteem and provide guidance for the child to meet daily challenges. They
must also provide an environment that stimulates curiosity, exploration,
discovery and learning.
6.2.2 The pre-school years.
During the age between 2 to six years children continue to develop
physically.
There is need, both on the part of the child and the caregivers to adjust
accordingly to the development of gross motor skills (activities involving
large muscle movements such as running, throwing and climbing) smaller
muscle movements such as trying a show race/ one net want to show the
caregivers that they can do most of what adults can do. They need to be
complimented and encouraged for their achievements. Also they need to be
protected from injury and limit setting is crucial. Socially these children can
survive pointing, with the knowledge that their caregivers are there for them.
6.2.3 The Middle Childhood Years
Children between 7 and 12 years continue to develop adult-like capabilities.
Some can even do adult - like work. Social skills also progress as many of
these are already charged with the responsibility of baby- sitting their
siblings. Cognitive challenges include learning to read and write.
They are serious – minded, pre-occupied with solitary play and interested in
school- related task.
Caregivers need to adjust to the pace of the progress being made by the
child and to refrain from comparing or pressuring the child to be adults.
Other adjustment here involve moral training especially T.V. Gradually they
realize advertisements and cartoons are not really true.
Challenges to health may be from poor nutrition, allergic reactions or bicycle
accidents.
All in all caregivers need to keep open lines of communication with children
on topics such as values sex education and use of drugs.
6.2.4 Adolescence
62
This age begins with puberty and ends at around ages 18 or 19, it is a kind of
crossroad between childhood and adulthood, puberty here refers to a time
when hormonal and physiological changes are acting to transform a child
into a person capable of reproduction.
Both primary and secondary sexual characteristics develop, pausing a
challenge to the growing youth, who have to adjust to these changes. They
need to be understood by the adults as they try to understand their own
dramatically changing bodies.
Cognitively, adolescents are more capable of speculation, hypothesizing and
fantasizing. Now in secondary schools they are expected and are capable of
undertaking more complex mental challenges and to choose their subjects of
interest. They may move to educational levels higher than their parents and
thus some may be forced to study away from home. All these require
adjustment.
Socially, adolescents are struggling to establish their identity, a fact that is
often too difficult for their parents to adjust to. There is the issue of
conformity to parental rules verses conformity and preference to hang out
with peers. Whether or not the adolescents will turn to parents or peers for
guidance depends on the past parent-child relationship.
Adolescents are daring and willing to take risks to experiment with their likes.
This includes indulging in drug abuse exposure to violence and even suicidal
behavior.
Teenage parents (young adolescents nursing their unplanned children) have
to adjust to becoming parents sooner than their parents need to adjust to
becoming grandparents and also letting children grow out of the nest.
6.2.5 Adulthood
The bridge from adolescents to adulthood is crossed when an individual
becomes comfortable with a particular identity and cosmists to this identity
in behaviour, thought and feeling, besides change from an adolescent to an
adult.
63
As people grow older, they slow down, meaning a decrease in heart rate,
respiration and muscle mass. To this they may engage in regular exercises.
Another adjustive challenge is confronting eminent death, retirement and
relocation.
According to Wetle (2008) As people grow older, they face many changes.
With aging, the ability to carry out the tasks of everyday life (functional
ability) declines to some degree in every person, and older people, on
average, tend to have more disease and disability than do younger people.
But the changes of aging are more than just changes in health. As people
age, they are often faced with events that can dramatically alter their lives,
such as retiring from the workforce, losing a loved one, or changing their
living arrangements.
Whether the changes that accompany aging are viewed as a blessing or a
curse may hinge on people's ability to cope with or adapt to change.
Successful coping skills are often linked with how well older people stay
connected with family and friends, with their community, and with their own
values and sense of purpose. In general, older people are well able to cope
with the many changes that occur in later life. These transitions can be
substantially eased with planning and preparation as well as with assistance
tailored to individual needs.
6.3 Retirement
For people who have been in the workforce, the day they leave work
permanently, they lose one of the most obvious ways in which they measure
their place in society. In addition, they are faced with the decision of what to
do with the rest of their life. People who retire often go from a routine that
fills much of their day to one in which they have much more free time.
Whether retirement is viewed as a positive or negative event often depends

on the reasons for retiring. Some people choose to retire, having looked
forward to quitting unpleasant work or to pursuing more fulfilling interests.
64
Others find themselves forced to retire because of employment
circumstances, family issues, or ill health.
About one third of retirees have difficulty coping with the consequences of
retirement. People who retire unexpectedly because of illness or job loss or
those who tended to work long hours and bring work home with them may
be most likely to experience difficulty. Spouses may have to adjust to seeing
more of one another. Some retirees have difficulty coping with reduced
income. Others resent their diminished role in society, believing that they are
unimportant and powerless, with little left to contribute. Still others relish the
time they now have to pursue their interests, to volunteer, and to enjoy
friends and loved ones.
The transition from work to retirement can be eased through planning.

Beginning to plan for retirement several years before retirement is
anticipated is very helpful. Many employers offer retirement planning
services, as do some community agencies. Retirement planning focuses on
finding ways to meet financial needs and obligations and on identifying ways
to fill available time through part-time employment, volunteer positions,
leisure activities, or adoption of a pet. Counseling may help retirees and their
families who experience difficulties despite planning or due to lack of
planning.
6.4 Losing a Loved One
The death of a loved one can weigh heavily on the heart and mind of an
older person. When a spouse or partner or a close family member or friend
dies, a strong sense of loss is accompanied by an awareness of one's own
mortality. In addition to a loss of companionship, older people may
experience less interaction with family and friends and a decline in social
standing.
65
The death of a spouse or partner is perhaps the most striking loss older
people confront. In some cases, the surviving spouse or partner dies soon
afterward, although death is more likely to occur when the survivor is the
husband rather than the wife. Parents experiencing the death of a child, even
in old age, also face a particularly difficult loss.
Dealing with multiple deaths is another difficult issue. Older people may be
confronted with the death of several loved ones or friends within a brief
period of time. Many deaths occurring close together can be particularly
difficult to cope with, causing older people to feel especially lonely and
isolated. Each death may revive feelings of sadness and grief related to
earlier losses.
When people are grieving over the loss of a loved one or friend, sadness is
usually apparent. Sadness, a natural response to death, is not the same as
depression and therefore does not necessarily indicate a need for treatment.
People experience grief and sadness differently, and they may express grief
in different ways. Some people are very vocal about their feelings and others
may be more private. Some people need more time alone, while others seek
out the company of others to help them. Some older people who are grieving
find it helpful to join a support group or to discuss their feelings with a clergy
member or counselor.
Feelings of intense sadness over an extended period of time or signs of

declining health may indicate depression. If grief is prolonged or
overwhelming, or if people become unable or unwilling to carry out even
essential daily activities or speak of suicide, then evaluation and treatment
by a doctor are necessary. If the doctor diagnoses depression, people may be
referred to a mental health practitioner. At times, antidepressant drugs may
be helpful. Some older people prefer to be counseled by a clergy member,
which they may view as less stigmatizing than being counseled by a mental
66
health practitioner. However, many clergy members do not have extensive
training in mental health counseling.
Have you ever lost a loved one? How

did you adjust to the loss?
6.5 Remarriage
Some older people choose to remarry or live with a new partner after a
divorce or the death of a spouse because they desire companionship or
intimacy. However, when older people marry, they may have to consider
situations that do not usually arise when people marry at younger ages. For
example, adult children may oppose a marriage, feeling their parent may be
taken advantage of, for example, to care for an ill partner or provide
economic support. Other adult children may be concerned about who will
inherit their parent's money or personal property.
Some older people may choose not to remarry because marriage restricts
their access to benefits, such as survivor's benefits, including medical
benefits, from a spouse's pension or social security. Others may be
concerned about taking on the role of caregiver.
Older people should ensure that they understand how remarriage will affect
their benefits and finances. They may need to consult an attorney before the
marriage. Open discussion of the changes in family and lifestyle may
minimize conflicts after the marriage.
6.6 Changes in Living Arrangements
67
Living alone is a common situation for many older people and can present
many challenges.
 People who live alone are more likely to be poor, and poverty is
increasingly more likely the longer they live alone.
 Many older people who live alone describe feelings of loneliness and
isolation.
 Because eating for most people is a social activity, some older people
who live alone do not prepare full, balanced meals, thus under-nutrition
becomes a concern.
 Among people with health problems or difficulty seeing or hearing, it is
all too easy for new or worsening symptoms of disease to go unnoticed.
 Many older people who live alone have problems following directions
for prescribed treatments.
Despite these challenges and problems, older people who live alone express
a keen desire to maintain their independence. Many fear being overly
dependent on others and wish to continue to live alone despite the
challenges they face. Engaging in regular physical and mental activities and
staying connected with others help older people who are living alone
maintain their independence.
People returning home from a hospital stay, particularly after surgery, may
benefit from having a discussion with a social worker or health care
practitioner about any extra service that will be needed. Such services,
which may include home health aides or visiting nurses, can help ensure that
people resume living independently.
Alternative living arrangements may be an option when living alone is

not. In some instances, someone may be willing to move into the dwelling of
an increasingly dependent older person. That someone is most often an adult
child, but it may be another family member or even a friend. The person
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moving in may provide companionship only or may undertake some care-
giving responsibilities. This type of living arrangement may extend the time
older people are able to remain in their own home and may be quite
satisfying to all involved. However, expectations of each person regarding
the arrangement should be clearly expressed and agreed on.
Relocation, or moving to another residence, sometimes becomes an

attractive option or even a necessity for older people after retirement or the
death of a spouse or relative. Older people may move when declining health
uncovers a need for supervision or help with personal care. Alternatively, a
decision to relocate may come about simply because older people are
looking for better weather, more companionship, a greater sense of safety
and security, or closer proximity to a family member. In other instances,
older people relocate to reduce costs or to establish a simpler lifestyle.
Usually the move is from a larger to a smaller dwelling. For example, older
people might move from a family home to retirement housing and eventually
to an assisted living community or nursing home.
People who respond poorly to relocation are more likely to have been living
alone, socially isolated, impoverished, and depressed. Men respond more
poorly than women do. Relocation can be very stressful. Much of the stress
seems to arise when people feel they lack control over the move and do not
know what to expect in the new environment. For older people who have
memory loss, moving away from familiar surroundings may intensify
confusion and dependence on others leading to frustration.
Sometimes relocation involves moving into someone else's home. Older

people may move into the home of an adult child. Less often, people move
into the home of a sibling, another relative, or a friend. Even when older
people have been independent or nearly so, choosing to live with another
person can produce mixed results. Problems may develop if older people
believe they are or might become a burden to others in the household. In
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some instances, not everyone in the household is pleased to have the older
person move in. This situation may arise when adult children ask their
parents to live with them out of a sense of guilt or obligation. An older person
moving into the home of a relative may be vulnerable to mistreatment or
other problems if others in the household feel angry and frustrated with the
arrangement.
On the other hand, relocation may involve a very positive arrangement in

which people provide services to one another as well as companionship and
financial relief. Such relocations are most likely to go well when the older
person is well prepared and when discussion regarding expectations and
concerns is open and ongoing.
Many moves happen suddenly, but even a little preparation can help
decrease the stress of relocating. Before a decision is made for an older
person to move into someone else's home, it is important that every person
already living in that home have an opportunity to participate in a discussion
about what to expect and how to handle problems. This type of discussion
can help everyone involved to anticipate and possibly prevent conflicts.
People who are moving should be acquainted with the new setting well in
advance, if possible. The opportunity to tour future surroundings and meet
potential neighbours can be very helpful.
Once a move has occurred, several actions help make the move successful.
Older people should maintain or increase their level of physical activity to
support good health. Getting involved in social activities in the new
environment helps alleviate the stress of the move. Friends and family can
help by being supportive and encouraging involvement in activities.
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To you, who copes better with
relocation? The young or the older?
Females or males?
In these lectures, we have looked at an overview of lifespan development. We have
also discussed several challenges to human adjustment; such as loss of a
loved one, remarriage, and relocation.

1. How does human adjustment relate to growth and
development?
2. When does adjustment begin and end?
3. Care givers need to adjust to infancy and middle childhood
years. Explain.
4. What are some of the developmental changes that
adolescents must adjust to?
4. What are some of the developmental challenges to human
adjustment for adults?
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7. SOCIAL FACTORS INFLUENCING ADJUSTMENT

1. Relate adjustment to interpersonal relations
2. Explain major theories behind relations
3. Demonstrate understanding of adjustment and groups
4. Relate friendship, and conflict to adjustment
7.1 Introduction
As an individual, you may have a way of adjusting that has worked

throughout your life. You may have as an adult, made personal decisions
about what you want in life, what makes you happy, what stresses you, and
what to do under certain circumstances. Whereas this may seem to work
perfectly, there may be times when you are not in isolation. As we try to
adjust in life, there are other people with us and around us, thus our relations
with others matter to some degree, in our adjustment.
This chapter is about social factors that influence adjustment. We shall
therefore discuss adjustment and interpersonal relations, which includes
social perception, attribution, need for consistency, groups, conflicts and
friendship. We shall also look at disorders that normally arise from poor
coping skills such as somatoform and factitious disorders, malingering and
suicide.
7.2 Adjustment and Interpersonal Relations
We defined adjustment as change or adaptation made in response to a new

situation or a new perception of a situation. We know that interpersonal
relations have to do with how people relate to each other. The question is,
are there even changes in our interpersonal relations that require us to
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adjust to? This question can only be answered after looking at some general
principles of interpersonal relations.
(i) Social perception- is defined as the process or act of becoming aware of
other people in relation to oneself. Social perception enables people to
compare themselves to others and to anticipate other people’s behavior or
motives. Humans are dynamic people change behaviors making it necessary
for the need to revise or update social perception for the sole purpose of
adjustment.
(ii) Attribution- on the other hand means to regard, or mentally assign and
in thus care, characteristics, we attribute characteristics to causation.
There are factors that influence the process by which people make
attributions about the behavior of others as well as themselves. These
factors may include past experiences, social comparison and the need for
consistency.
As far as past experiences are concerned every experience is a learning
experience. The outcome determines whether or not the behavior will be
repeated. Thus humans make behavior adjustments with every new
experience.
Social comparison helps people to define and identify themselves for
example; people may conclude that they are tall, rich, poor, cute, or
outgoing etc. after comparing themselves to others. These, too are subject to
change with time, age and location. Thus, there need to adjust to such
change.
7.3 Need for consistency
In all attribution there is need for consistency. Amidst all conclusions that
come from attributions there are exceptions to the rule due to this need for
consistency, people tend to ignore or give a deaf / blind ear or eye these
exceptions. They prefer to focus on the rule rather than the exception.
Cognitive dissonance results when the exception bears the same weight as
the rule. It can be described as an unpleasant mental state owing to the
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simultaneous existence of two or more thoughts that have contradictors
implications for behavior. For example, smokers who continue the habit
regardless of anti-smoking advisories and research findings which show that
smoking or finding, people may need to make adjustment, in their behavior.
In case of congruities dissonance, they may not be able to know whether
they need to change or not.
7.4 Groups and adjustment
Interpersonal; relations occurs not only on one to one basis but also at the
group level much as people have a need to be alone, thus also to belong.
Identity refers to a sense of close affiliation with other people on the basis of
a common variable such as interests, abilities and demographic
characteristics.
A part from seeing themselves as individuals, people sometimes see
themselves as members of some groups. This has many benefits, including
the opportunity to mingle with people who are experiencing many of the
same trials, tribulations and joys. Membership to a group says something
about ones identity. Besides, membership leads to conformity.
Conformity is similarity in behaviour and thinking, between two or more
people. Sometimes people have to change behavior so as to fit into groups.
This has an influence on adjustment. On one hand, individuals make personal
adjustment so as to belong to a certain group. On the other hand, an
individual who is facing challenges may cope better due to support from the
group.
7.5 Conflict and adjustment
This is another aspect of interpersonal relations. Conflict could be

intrapersonal or interpersonal. Intrapersonal conflicts exist in the mind of an
individual and involves simultaneous existence of two mutually exclusive
wishes, impulses, on the other hand refer to a state in which two or more
people disagree, are opposed to one another or engage in mortally
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aggressive behavior. The process of adjustment or lack of it may lead to
conflict which is either avoided or confronted. On the other hand, conflict
may necessitate adjustment.
7.6 Friendship and living
Humans have the need for affiliation. This means that they are motivated to
interact with other people, to please or comfort them or to be pleased and
comforted by them. In the absence of friends people suffer from coldness.
Factors that influence friendship and liking include proximity, attractiveness,
personality, equality, reciprocity and similarity. Thus a change in these
factors leads to a direct change in the solid relations. Individuals may need
to make adjustments in these factors so as to increase or decrease their
friendship levels. Also, they may need to adjust to changes in relationships.
Love and friendship can be likened to a living thing which needs nourishment
so as to grow. Adjustment is required at every stage of this growth.
Is there a time you have had to adjust

to an adjustment made by
someone close to you?
7.7 Somatoform and Facticious Disorders
Somatization is the expression of mental phenomena as physical (somatic)

symptoms. Typically, the symptoms cannot be explained by a physical
disorder. Disorders characterized by somatization extend in a continuum
from those in which symptoms develop unconsciously and nonvolitionally to
those in which symptoms develop consciously and volitionally. This
continuum includes somatoform disorders, factitious disorders, and
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malingering. Somatization typically leads to seeking medical evaluation and
treatment.
(a) Somatoform disorders are characterized by physical symptoms that

are not fully explained by another disorder, physical or mental. Symptoms of
somatoform disorders are not volitional. Somatoform disorders are
distressing and often impair social, occupational, academic, or other aspects
of functioning. These disorders include body dysmorphic disorder, conversion
disorder, hypochondriasis, pain disorder, somatization disorder,
undifferentiated somatoform disorder, and somatoform disorder not
otherwise specified. Body dysmorphic disorder differs somewhat from other
somatoform disorders in that it is characterized by preoccupation with
perceived defects in physical appearance.
(b) Factitious disorders involve the conscious and volitional feigning of

symptoms without any external incentive (e.g. time off from work) and are
thus distinguished from malingering. Patients gain gratification from
assuming the sick role through the simulation, exaggeration, or aggravation
of symptoms and signs. Symptoms and signs may be mental, physical, or
both. The most severe and chronic form is Munchausen syndrome.
(c) Malingering is intentional feigning of physical or mental symptoms

motivated by an external incentive (eg, feigning illness to avoid work or
military duty, to evade criminal prosecution, or to obtain financial
compensation or drugs for abuse). Malingering is suspected in the following
cases:
 Patients report symptoms, yet little is detected through unannounced

observation, physical examination, or laboratory testing.
 The claimed disability and objective findings are markedly discrepant.
 Patients do not cooperate with efforts to diagnose or treat potential
causes of symptoms.
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Katharine A. Phillips, MD
(2008)
7.8 Suicidal Behavior
Many times, individuals resort to suicidal behavior when they cannot, for
some reason adjust to change. Probably, better adjustment would reduce the
rate of suicide in our world today.
Suicidal behavior includes 3 types of self-destructive acts: completed suicide,

attempted suicide, and suicide gestures. Thoughts and plans about suicide
are referred to as suicide ideation.
Completed suicide is a suicidal act that results in death. Attempted suicide is

an act intended to be self-lethal, but one that does not result in death.
Frequently, suicide attempts involve at least some ambivalence about
wishing to die and may be a cry for help. Suicide gestures are attempts that
involve an action with a very low lethal potential (eg, inflicting superficial
scratches on the wrist, overdosing on vitamins). Suicide gestures and suicide
ideation may reflect pleas for help from people who still wish to live.
However, they should not be dismissed lightly
7.8.1 Epidemiology of suicide
Statistics on suicidal behavior are based mainly on death certificates and

inquest reports and underestimate the true incidence. Suicide ranks 11th
among causes of death in the US, with 32,439 completed suicides in 2004. It
is the 3rd leading cause of death among people 10 to 24 years of age. Men
aged over 75 years have the highest rate of death by suicide. In all age
groups, male deaths by suicide outnumber female deaths by 4:1.
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Each year, an estimated 700,000 people attempt suicide. About 25 attempts
are made for every death that occurs by suicide. However, 3.5 to 12.5% of
people who make an attempt eventually die by suicide because many people
make repeated attempts. About 20 to 30% of people who attempt suicide try
again within 1 yr. Women attempt suicide twice as often as men, but men
complete suicide 4 times more often than women.
People in a secure relationship have a significantly lower suicide rate than

single people. Attempted and completed suicide rates are higher among
those who live alone. Suicide is less common among practicing members of
most religious groups (particularly Roman Catholics).
Group suicides, whether of many people or only 2 (such as lovers or

spouses), represent an extreme form of personal identification with others.
A suicide note is left by about 1 in 6 people who complete suicide. The

content may indicate the mental disorder that led to the suicidal act.
7.8.2 Possible causes of suicide
Suicidal behaviors usually result from the interaction of several factors. The
primary remediable risk factor in suicide is depression. Suicide and suicide
attempts appear to be more common among patients with anxiety disorders,
and severe anxiety is associated with major depression or bipolar disorders.
Other factors include the following:
 Social factors
 Personality abnormalities
 Traumatic childhood experiences
 Serious physical disorders
 Alcohol and drugs of abuse
 Serious psychiatric disorders
Certain social factors (eg, disappointment, loss) and personality
abnormalities (eg, impulsivity, aggression) appear associated with suicide.
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Traumatic childhood experiences, particularly the distresses of a broken
home, parental deprivation, and abuse, are significantly more common
among people who commit suicidal acts. Suicide is sometimes the final act in
a course of self-destructive behavior, such as alcoholism, reckless driving,
and violent antisocial acts. Often, one factor (commonly disruption of an
important relationship) is the last straw. Serious physical disorders,
especially those that are chronic and painful, play an important role in about
20% of suicides among the elderly.
Alcohol and drugs of abuse may increase disinhibition and impulsivity, as
well as worsen mood, a potentially lethal combination. About 30% of people
who attempt suicide have consumed alcohol before the attempt, and about
half of them were intoxicated at the time. Alcoholics are suicide-prone even
when sober.
Some patients with schizophrenia commit suicide, sometimes because of

depression, to which these patients are prone. The suicide method may be
bizarre and violent. Attempted suicide is uncommon, although it may be the
first sign of psychiatric disturbance, occurring early in schizophrenia.
People with personality disorders are prone to attempted suicide—especially

emotionally immature people with a borderline or an antisocial personality
disorder because they tolerate frustration poorly and react to stress
impetuously with violence and aggression.
Aggression toward others is sometimes evident in suicidal behavior. Rarely,

former lovers or estranged spouses are involved in murder-suicides; one
person murders the other, then commits suicide.
Food for thought: one day you will be

expected to assist a client to
adjust the loss of a loved one
through suicide. Are you set?
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7.8.3 Methods of Suicide
Choice of methods is determined by many things, including cultural factors

and availability as well as the seriousness of intent. Some methods (eg,
jumping from heights) make survival virtually impossible, whereas others
(eg, drug ingestion) may allow rescue. However, using a method that proves
not to be fatal does not necessarily imply that the intent was less serious.
A bizarre method suggests an underlying psychosis. Drug ingestion is the

most common method used in suicide attempts. Violent methods, such as
shooting and hanging, are uncommon among attempted suicides. Some
methods, such as driving over cliffs, can endanger others. Suicide by police
is a bizarre form of suicide; people commit an act (eg, brandishing a weapon)
that forces law enforcement agents to kill them.
For completed suicides, firearms are most commonly used by both men
(74%) and women (31%), followed by hanging in men and drug ingestion in
women.
7.8.4 Management of Suicidal Acts
A health care practitioner who foresees the likelihood of suicide in a patient

is, required to inform an empowered agency to intervene. Failure to do so
can result in criminal and civil actions. Similarly, you as a counselor are
required to break confidentiality. Such patients should not be left alone until
they are in a secure environment. They should be transported to a secure
environment (often a psychiatric facility) by trained professionals (eg,
ambulance, police), never by family members or friends.
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Any suicidal act, regardless of whether it is a gesture or an attempt, must be
taken seriously. Involve all the helpful people and agencies available. Every
person with a serious self-injury should be evaluated and treated for the
physical injury. If an overdose of a potentially lethal drug is confirmed,
immediate steps are taken to prevent absorption and expedite excretion,
administer any available antidote, and provide supportive treatment.
Initial assessment can be done by any health care practitioner trained in the
assessment and management of suicidal behavior. However, all patients
require psychiatric assessment as soon as possible. A decision must be made
as to whether patients need to be admitted and whether involuntary
commitment or restraint is necessary. Patients with a psychotic disorder,
delirium, or epilepsy and some with severe depression and an unresolved
crisis should be admitted to a psychiatric unit.
After a suicide attempt, the patient may deny any problems because the
severe depression that led to the suicidal act may be followed by a short-
lived mood elevation. Nonetheless, the risk of later, completed suicide is high
unless the patient's problems are resolved.
Psychiatric assessment identifies some of the problems that contributed to

the attempt and helps the counselor or physician plan appropriate treatment.
It consists of the following:
1. Establishing rapport
2. Understanding the suicide attempt, its background, the events
preceding it, and the circumstances in which it occurred
3. Appreciating the current difficulties and problems
4. Thoroughly understanding personal and family relationships, which are
often pertinent to the suicide attempt
5. Fully assessing the patient's mental state, with particular emphasis on
recognizing depression, anxiety, agitation, panic attacks, severe
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insomnia, other mental disorders, and alcohol or drug abuse; many of
these require specific treatment in addition to crisis intervention
6. Interviewing close family members and friends
7. Contacting the family physician
7.8.5 Prevention of Suicide
Prevention requires identifying at-risk people and initiating appropriate

interventions although some attempted or completed suicides are a surprise
and shock, even to close relatives and associates, clear warnings may have
been given to family members, friends, or health care practitioners. Warnings
are often explicit, as when patients actually discuss plans or suddenly write
or change a will. However, warnings can be more subtle, as when patients
make comments about having nothing to live for or being better off if dead.
They may give indirect hints.
On average, primary care physicians encounter 6 or more potentially suicidal

people in their practice each year. About 77% of people who commit suicide
were seen by a physician within 1 year before killing themselves, and about
32% had been under the care of a mental health care practitioner during the
preceding year. Because severe and painful physical disorders, substance
abuse, and mental disorders (particularly depression) are often a factor in
suicide, recognizing these possible factors and initiating appropriate
treatment are important contributions a physician can make to suicide
prevention.
Each depressed patient should be questioned about thoughts of suicide. The

fear that such inquiry may implant the idea of self-destruction is baseless.
Inquiry helps the physician obtain a clearer picture of the depth of the
depression, encourages constructive discussion, and conveys the physician's
awareness of the patient's deep despair and hopelessness.
Even people threatening imminent suicide (eg, those who call and declare
that they are going to take a lethal dose of a drug or who threaten to jump
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from a high height) may have some desire to live. The physician or another
person to whom they appeal for help must support the desire to live.
Emergency psychiatric aid for suicidal people includes the following:
(a) Establishing a relationship and open communication with them
(b)Reminding them of their identity (ie, using their name repeatedly)
(c) Helping sort out the problem that has caused the crisis
(d)Offering constructive help with the problem
(e) Encouraging them to take positive action
(f) Reminding them that family and friends care for them and want to help
7.8.6 Treatment of depression and risk of suicide

People with depression have a significant risk of suicide and should be
carefully monitored for suicidality (suicidal behaviors and ideation). Risk of
suicide may be increased early in the treatment of depression, when
psychomotor retardation and indecisiveness have been ameliorated but the
depressed mood is only partially lifted. When antidepressants are started or
when doses are increased, a few patients experience agitation, anxiety, and
increasing depression, which may increase suicidality. Recent public health
warnings about the possible association between antidepressant use and
suicidality in children, adolescents, and young adults have led to a significant
reduction (> 20%) in antidepressant prescriptions to these populations.
However, youth suicide rates increased by 14% during this period. Thus, by
discouraging drug treatment of depression, these warnings may have
resulted in more, not fewer, deaths by suicide. Together, these findings
suggest that the best approach is to encourage treatment, but with
appropriate precautions (dispensing antidepressants in sub-lethal amounts,
giving a clear warning to patients and to family members and significant
others to be alert for worsening symptoms or suicidal ideation, and, if either
occurs, immediately calling the prescribing clinician or seek care elsewhere).
7.8.7 Risk Factors and Warning Signs for Suicide
Type Specific Factors
Demographic Male
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data Age > 65
Social situation Personally significant anniversaries

Unemployment or financial difficulties, particularly if causing a
drastic fall in economic status
Recent separation, divorce, or widowhood
Social isolation with real or imagined unsympathetic attitude of
relatives or friends
History of Previous suicide attempt
suicidality Making detailed suicide plans, taking steps to implement plan
(obtaining gun, pills), taking precautions against being
discovered
Family history of suicide or of affective disorder
Clinical features Depressive illness, especially at onset
Marked motor agitation, restlessness, and anxiety with severe
insomnia
Marked feelings of guilt, inadequacy, and hopelessness; self-
denigration; nihilistic delusion
Delusion or near-delusional conviction of a physical disorder (eg,
cancer, a heart disorder, sexually transmitted disease)
Command hallucinations
Impulsive, hostile personality
A chronic, painful, or disabling physical disorder, especially in
formerly healthy patients
Drug use Alcohol or drug abuse, especially of recent onset
Use of drugs that may contribute to suicidal behavior (eg,
abruptly stopping paroxetine and certain other antidepressants
can result in increased depression and anxiety, which in turn
increases risk of suicidal behavior)
7.8.8 Effects of Suicide

Any suicidal act has a marked emotional effect on all involved. The
counselor, physician, family members, and friends may feel guilt, shame,
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and remorse at not having prevented a suicide, as well as anger toward the
deceased or others. The counselor can provide valuable assistance to the
deceased's family members and friends in dealing with their feelings of guilt
and sorrow.
7.8.9 Assisted Suicide
Assisted suicide refers to the assistance given by physicians or other

practitioners to people who wish to end their life. Assistance may be
requests about drugs that can be saved up to provide a lethal dose, about
instructions for a painless way to commit suicide, or for administration of a
lethal dose of drug.
Assisted suicide is controversial and is illegal in most states in the US.

Nonetheless, patients with painful, debilitating, and untreatable conditions
may initiate a discussion about it with a physician. Assisted suicide may pose
difficult ethical issues for physicians.
According to you, how is suicide related to

coping with change?
In this lecture, we have studied how human adjustment relates to interpersonal
relations. We have also looked at somatoform disorders, and examined the
suicidal behaviour in relation to adjustment.
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1. How do interpersonal relations influence human
adjustment?
2. Relate somatoform disorders to human adjustment.
3. Suicidal people have adjustment problems. Discuss.
4. Alcoholics are suicide – prone. Explain.
5. Describe how a counsellor may intervene in a suicidal
act by a client.
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8. PSYCHOLOGICAL FACTORS INFLUENCING ADJUSTMENT

1. Explain psychological factors that influence adjustment
2. Relate adjustment to stress, depression, loneliness and anxiety
3. Evaluate the usefulness of stress
8.1 Introduction
As you may already know, there are many psychological disorders that can
result from failure to appropriately adjust to change and transitions. The
most generalised one being termed as stress. Others include a myriad of
anxiety disorders which you have probably already covered in other courses
such as abnormal psychology.
8.2 Stress and Adjustment
Stress maybe defined as mental and /or physical strain resulting from
adjective demands or challenges. There are four types of stress as explained
by Selye(1974), Eustress is a pleasurable type of stress brought about by
voluntary and purposeful demands whose results are beneficial .
Distress, on the other hand is a type of stress that is un-pleasurable and
caries harmful consequences, emotional upset or physical strain may be
involved. Hypostress is a condition involving too little stress, such as in
boredom, whereas hyperstress involves an exercise demand on ones
coping ability.
These are many types of stressors, some physical, others psychological and
all these need different adjustment strategies.
Physical stressors may include physical trauma, physical disorders,
malnutrition, insomnia, drugs, guns and other threats to life which people
may be exposed to.
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Psychological stressors, on the other hand may include change, conflict.
8.3 Stress and Perception
Adjustment to stress starts with perception. Perception maybe defined as the

process whereby sensory stimuli are organized and Interpreted into
meaningful cognitions. There is a difference between what is real and what is
perceived. This is due to a variety to factors such as individual differences,
education and experience, factors involved in perception may be
physiological, situational or psychological.
Physiological factors include the sensory organs their level of functioning and
the area of the nervous system processing the input. Besides, pre-existing
stimuli may affect perception for example the taste of orange juice after
brushing teeth with toothpaste.
Situational factors include the background against which something is
perceived, activity with the environment available light and general lifestyle.
A simple house may seem like a place for a homeless person, while a place
may seem like a prison for a pampered, unhappy princess.
Psychological factors may include level of psychopathology, education
needs, and motivation and past experiences. These factors bring into action
filters that sort out the information reaching the sensory organs. These
filters, may block allow or alter information, thus some people are more
disposed to laugh than cry when stressed.
8.4 The Decision to Cope
To cope or not cope with stress and how, is a decision that one makes. It
involves national thoughts that are likely to lead to constructive solutions.
Making no response at all to stress when adjustment is warranted is viewed
as maladaptive. The decision to cope is determined by a variety of factors
which may include the decision maker’s personality physiological state,
mental state and learning history.
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8.5 The Positive Side of Stress
Stress is part of life and we must learn to live with it. A bit of it is normal and
in some cases, people seek out a moderate amount of it to avoid boredom or
to maintain an optimal level of arousal. Stressful experiences such as
academic examinations, public speeches or emotional argument with loved
ones are all hearing experiences. Coping positively with them brings about a
sense of fulfilment and personal growth.
Different people cope with stress in different ways. In some cases, people
use personal coping methods such as prayer or mediation or exercise. In
other cases, assistance from others is required. This is where friends and
family provide social support which act as a buffer from oversize life events.
The action taken in the event of stress could be direct or indirect, adaptive or
maladaptive.
There are many different coping strategies which have both costs and
benefits. Depending on the situation, coping with stress may involve
acquiring certain, competencies; using certain techniques e.g. relaxation
exercises.
All in all an individual may need professional help if a radical change in
everyday behavior transforms that otherwise well-functioning individual into
a clear danger to self and others.
Stress disorders include acute stress disorder and posttraumatic stress
disorder.
8.6 Acute Stress Disorder
Acute stress disorder is a brief period of intrusive recollections occurring

within 4 weeks of witnessing or experiencing an overwhelming traumatic
event.
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In acute stress disorder, people have been through a traumatic event, have
recurring recollections of the trauma, avoid stimuli that remind them of the
trauma, and have increased arousal. Symptoms begin within 4 weeks of the
traumatic event and last a minimum of 2 days but, unlike posttraumatic
stress disorder, last no more than 4 weeks. People with this disorder
experience dissociative symptoms.
8.6.1 Diagnosis of Acute Stress Disorder
With exclusion of other causes, affirmative answers to the following
questions confirm the diagnosis:
1. Has the patient experienced or witnessed an overwhelming
traumatic event?
2. Did the patient respond to the event with intense fear,
helplessness, or horror?
3. Is the patient experiencing 3 or more dissociative symptoms:
 Feeling numb, detached from other people, or emotionally
unresponsive
 Being less aware of surroundings (eg, feeling in a daze)
 Feeling unreal or detached from self (depersonalization)
 Feeling that the external world is strange or unreal (derealization)
 Being unable to remember significant parts of the event (dissociative
amnesia)
4. Does the patient constantly relive the event?
5. Does the patient avoid people, places, objects, or thoughts
associated with the event?
6. Does the patient have symptoms of increasing anxiety, such as
the following:
 Difficulty sleeping
 Irritability
 Lack of concentration
 Restlessness
 Increased startle response
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 Hyper-vigilance
7. Have symptoms caused substantial distress or interfered with
functioning?
8. Did symptoms start within 4 weeks of the event?
9. Have symptoms lasted ≥ 2 days and ≤ 4 week?
8.6.2 Treatment
Nondrug measures
Many people recover once they are removed from the traumatic
situation, shown understanding and empathy, and given an
opportunity to describe the event and their reaction to it. To prevent or
minimize this disorder, some experts recommend systematic
debriefing to assist people who were involved in or witnessed a
traumatic event as they process what has happened and reflect on its
effect. In one approach to debriefing, the event is referred to as the
critical incident and the debriefing is referred to as critical incident
stress debriefing (CISD). Other experts have expressed concern and
some studies show that CISD may not be as helpful as supportive,
empathic interviewing, may be quite distressful for some patients, and
may even impede natural recovery.
Drugs to assist sleep may help, but other drugs are generally not
indicated.
8.7 Posttraumatic Stress Disorder
Posttraumatic stress disorder is recurring, intrusive recollections of an

overwhelming traumatic event. The pathophysiology of the disorder is
incompletely understood. Symptoms also include avoidance of stimuli
associated with the traumatic event, nightmares, and flashbacks. Diagnosis
is based on history. Treatment consists of exposure therapy and drug
therapy.
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When terrible things happen, many people are lastingly affected; in some,
the effects are so persistent and severe that they are debilitating and
constitute a disorder. Generally, events likely to evoke posttraumatic stress
disorder (PTSD) are those that invoke feelings of fear, helplessness, or horror.
These events might include experiencing serious injury or the threat of death
or witnessing others being seriously injured, threatened with death, or
actually dying. Combat, sexual assault, and natural or man-made disasters
are common causes of PTSD.
8.7.1 Symptoms and Signs
Most commonly, patients have frequent, unwanted memories replaying the

triggering event. Nightmares of the event are common. Much rarer are
transient waking dissociative states in which events are relived as if
happening (flashback), sometimes causing patients to react as if in the
original situation (eg, loud noises such as fireworks might trigger a flashback
of being in combat, which in turn might cause patients to seek shelter or
prostrate themselves on the ground for protection).
Patients avoid stimuli associated with the trauma and often feel emotionally
numb and disinterested in daily activities. Sometimes the onset of symptoms
is delayed, occurring many months or even years after the traumatic event.
PTSD is considered chronic if present for more than 3 months. Depression,
other anxiety disorders, and substance abuse are common in patients with
chronic PTSD.
In addition to trauma-specific anxiety, patients may experience guilt because

of their actions during the event or because they survived when others did
not.
8.7.2 Diagnosis of Posttraumatic Stress Disorder

With exclusion of other causes, affirmative answers to the following
questions confirm the diagnosis:
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1. Has the patient experienced or witnessed an overwhelming
traumatic event?
2. Was the patient's response one of intense fear, helplessness, or
horror?
3. Does the patient constantly relive the event in any of the
following ways?
 Having recurrent, intrusive disturbing memories
 Having recurrent disturbing dreams (eg, nightmares)
 Acting or feeling as if the event were happening again (eg, in
hallucinations or flashbacks)
 Feeling intense psychologic or physiologic distress when reminded of
the event (eg, by its anniversary or sounds similar to those heard during the
event)
4. Does the patient persistently avoid stimuli associated with the
event, as evidenced by 3 or more of the following?
 Avoiding thoughts, feelings, or conversations associated with the event
 Avoiding activities, places, or people that trigger memories of the
event
 Being unable to remember significant parts of the event (dissociative
amnesia)
 Feeling detached or estranged from other people
 Having limited emotional response (restricted affect)
 Viewing the future as foreshortened (eg, not expecting to have a
career or to marry)
5. Is the patient experiencing ≥ 2 of the following symptoms of
increased arousal (not present before the event)?
 Difficulty sleeping
 Irritability or angry outbursts
 Lack of concentration
 Increased startle response
 Hypervigilance
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6. Have symptoms lasted for more than 1 month?
7. Have symptoms caused substantial distress or interfered with
functioning?
8.7.3 Treatment
 Exposure therapy or other psychotherapy, including supportive

psychotherapy
 SSRI or other drug therapy
If untreated, chronic PTSD often diminishes in severity without disappearing,
but some people remain severely impaired. The primary form of
psychotherapy used, exposure therapy, involves exposure to situations that
the person avoids because they may trigger recollections of the trauma.
Repeated exposure in fantasy to the traumatic experience itself usually
lessens distress after some initial increase in discomfort. Stopping certain
ritual behaviors, such as excessive washing to feel clean after a sexual
assault, also helps.
Drug therapy, particularly with SSRIs is effective. Drugs with mood-stabilizing
effects, such as valproate, carbamazepine and topiramate, can help reduce
arousal, nightmares, and flashbacks.
Because the anxiety is often intense, supportive psychotherapy plays an

important role. Therapists must be openly empathic and sympathetic,
recognizing and acknowledging patients' mental pain and the reality of the
traumatic events. Therapists must also encourage patients to face the
memories through desensitizing exposure and learning techniques to control
anxiety. For survivor guilt, psychotherapy aimed at helping patients
understand and modify their self-critical and punitive attitudes may be
helpful.
John H. Greist, MD; James W. Jefferson, MD(2007)
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Think of a real case that you suspect
In this lecture, we may be how
have learnt traumatic. How would
human adjustment is related to stress. We have
better
also adjusting help?
examined posttraumatic stress disorder.

1. How is stress related to human adjustment?
2. To cope or not to cope with stress is a decision one
makes. Discuss.
3. Explain post traumatic stress disorder in relation to
human adjustment.
3. How can stress be managed?
4. How can a counsellor know if the client has Acute
Stress Disorder?
5. PTSD is a human adjustment disease. Discuss.
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9. MENTAL HEALTH AND ADJUSTMENT

1. Relate adjustment to mental illness and wellness
2. Explain maladjustment
3. Evaluate your personal mental health in relation to adjustment
9.1 Introduction
You may wonder why mental health was not covered under physical health.
That is an age old controversy of body soul and mind. Never mind the
chunking. I hope separating them will help you understand them better. This
topic looks at mental health as falling under psychological factors that
influence human adjustment. Have you ever linked mental illness to
adjustment? Could lack of proper adjustment lead to mental illness? How do
we adjust to the behaviours of our mentally ill relatives?
9.2 Abnormal Behavior and Adjustment
Abnormal behavior may be defined as over action or thinking that is

statistically rare in the population, counter to the prevailing cultural and /or
sub-cultural norms, and usually harmful to the well-being of oneself or
others. Abnormal behavior may be caused by biological factors such as
illness of the brain, stroke or senility; or psychosocial factors such as trauma,
neurosis bad learning or a combination of conditions both organic and
functional. Abnormal behavior is classified by DSM into various categories to
facilitate management case and treatment of the patients. These categories
are broadly listed below.
1. Schizophrenic disorders which include catatonic, paranoid and
disorganized schizophrenia.
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2. Adjustment disorders –where an individual’s response to stress may be
intense so as to disrupt normal functioning e.g acute depression.
3. Mood disorders which may include unipolar, bipolar and mania all
which are emotion related problems.
4. Anxiety disorders such as phobic disorders, panic disorders, obsessive
compulsive disorders and generalized anxiety disorders.
5. Psychoactive substance use disorders such as addition and resulting
withdrawal symptoms.
6. Personality disorders such as antisocial histrionic and dependent
personality disorders.
7. Sexual disorders such as sexual dysfunction, pedophilia, zoophilia
voyeurism, fetishism etc.
8. Dissociative disorders such as multiple personality disorders.
There is need for members of the families of the mentally ill to be aware of
the illness and to adjust accordingly. Besides mental health professional need
to be culturally sensitive as they after assistance to clients or patients with
abnormal behavior. This is due to subjectivity of the definition of abnormal
behavior.
9.3 Anxiety Disorders
Everyone periodically experiences fear and anxiety. Fear is an emotional,

physical, and behavioral response to an immediately recognizable external
threat (eg, an intruder, a runaway car). Anxiety is a distressing, unpleasant
emotional state of nervousness and uneasiness; its causes are less clear.
Anxiety is less tied to the exact timing of a threat; it can be anticipatory
before a threat, persist after a threat has passed, or occur without an
identifiable threat. Anxiety is often accompanied by physical changes and
behaviors similar to those caused by fear.
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Some degree of anxiety is adaptive; it can help people prepare, practice, and
rehearse so that their functioning is improved and can help them be
appropriately cautious in potentially dangerous situations. However, beyond
a certain level, anxiety causes dysfunction and undue distress. At this point,
it is maladaptive and considered a disorder.
Anxiety occurs in a wide range of physical and mental disorders, but it is the
predominant symptom of several. Anxiety disorders are more common than
any other class of psychiatric disorder. However, they often are not
recognized and consequently not treated. Left untreated, chronic,
maladaptive anxiety can contribute to or interfere with treatment of some
physical disorders.
9.3.1 Etiology of anxiety disorders
The causes of anxiety disorders are not fully known, but both mental and
physical factors are involved. Many people develop anxiety disorders without
any identifiable antecedent triggers. Anxiety can be a response to
environmental stressors, such as the ending of a significant relationship or
exposure to a life-threatening disaster. Some physical disorders can directly
produce anxiety; they include the following:
 Hyperthyroidism
 Pheochromocytoma
 Hyperadrenocorticism
 Heart failure
 Arrhythmias
 Asthma
 COPD
Other physical causes include use of drugs; effects of corticosteroids,
cocaine, amphetamines, and even caffeine can mimic anxiety disorders.
What do you think is COPD in this

context?
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Withdrawal from alcohol, sedatives, and some illicit drugs can also cause
anxiety.
9.3.2 Symptoms and Signs
Anxiety can arise suddenly, as in panic, or gradually over many minutes,

hours, or even days. Anxiety may last from a few seconds to years; longer
duration is more characteristic of anxiety disorders. Anxiety ranges from
barely noticeable qualms to complete panic. The ability to tolerate a given
level of anxiety varies from person to person.
Anxiety disorders can be so distressing and disruptive that depression may

result. Alternatively, an anxiety disorder and a depressive disorder may
coexist, or depression may develop first, with symptoms and signs of an
anxiety disorder occurring later.
9.3.3 Diagnosis of anxiety disorders
 Exclusion of other causes

 Assessment of severity
Deciding when anxiety is so dominant or severe that it constitutes a disorder
depends on several variables, and physicians differ at what point they make
the diagnosis. Physicians must first determine, by history, physical
examination, and appropriate laboratory tests whether anxiety is due to a
physical disorder or drug. They must also determine whether anxiety is
better accounted for by another mental disorder. An anxiety disorder is
present and merits treatment if the following apply:
 Other causes are not identified
 Anxiety is very distressing
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 Anxiety interferes with functioning
 Anxiety does not stop spontaneously within a few days
Diagnosis of a specific anxiety disorder is based on its characteristic
symptoms and signs. Clinicians usually use specific criteria of the Diagnostic
and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-
IV-TR), which describes the specific symptoms and requires exclusion of other
causes of symptoms.
A family history of anxiety disorders (except acute and posttraumatic stress

disorders) helps in making the diagnosis because some patients appear to
inherit a predisposition to the same anxiety disorders that their relatives
have, as well as a general susceptibility to other anxiety disorders. However,
some patients appear to acquire the same disorders as their relatives
through learned behavior.
9.3.4 Treatment of anxiety disorders
Treatments vary for the different anxiety disorders, but typically involve a
combination of psychotherapy and drug treatment. The most common drug
classes used are the benzodiazepines and SSRIs.
9.4 Panic Attacks and Panic Disorder
A panic attack is the sudden onset of a discrete, brief period of intense

discomfort, anxiety, or fear accompanied by somatic or cognitive symptoms.
Panic disorder is occurrence of repeated panic attacks typically
accompanied by fears about future attacks or changes in behavior to avoid
situations that might predispose to attacks. Diagnosis is clinical. Isolated
panic attacks may not require treatment. Panic disorder is treated with drug
therapy, psychotherapy (eg, exposure therapy, cognitive-behavioral
therapy), or both.
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Panic attacks are common, affecting as many as 10% of the population in a
single year. Most people recover without treatment; a few develop panic
disorder. Panic disorder is uncommon, affecting 2 to 3% of the population in
a 12-month period. Panic disorder usually begins in late adolescence or early
adulthood and affects women 2 to 3 times more often than men.
9.4.1 Symptoms and Signs of panic attacks
A panic attack involves the sudden onset of at least 4 of the 13 symptoms

listed below. Symptoms usually peak within 10 min and dissipate within
minutes thereafter, leaving little for a physician to observe. Although
uncomfortable, at times extremely so, panic attacks are not medically
dangerous. The symptoms can be classified into two categories; cognitive
and somatic.
Cognitive
(a). Fear of dying

(b). Fear of going crazy or of losing control
(c). Feelings of unreality, strangeness, or detachment from the self
(depersonalization)
Somatic
a) Chest pain or discomfort
b) Dizziness, unsteady feelings, or faintness
c) Feeling of choking
d) Flushes or chills
e) Nausea or abdominal distress
f) Numbness or tingling sensations
g) Palpitations or accelerated heart rate
h) Sensations of shortness of breath or smothering
i) Sweating
j) Trembling or shaking
Panic attacks may occur in any anxiety disorder, usually in situations tied to
the core features of the disorder (eg, a person with a phobia of snakes may
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panic at seeing a snake). In pure panic disorder, however, some of the
attacks occur spontaneously.
Most people with panic disorder anticipate and worry about another attack
(anticipatory anxiety) and avoid places or situations where they have
previously panicked. People with panic disorder often worry that they have a
dangerous heart, lung, or brain disorder and repeatedly visit their family
physician or an emergency department seeking help. Unfortunately, in these
settings, attention is focused on physical symptoms, and the correct
diagnosis often is not made. Many people with panic disorder also have
symptoms of major depression.
Diagnosis
Panic disorder is diagnosed after physical disorders that can mimic anxiety
are eliminated and symptoms meet diagnostic criteria stipulated in the
Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-
TR).
9.4.2 Treatment of panic attacks
 Often antidepressants, benzodiazepines, or both

 Often nondrug measures (eg, exposure therapy, cognitive-behavioral
therapy)
Some people recover without treatment, particularly if they continue to
confront situations in which attacks have occurred. For others, especially
without treatment, panic disorder follows a chronic waxing and waning
course.
Patients should be told that treatment usually helps control symptoms. If

avoidance behaviors have not developed, reassurance, education about
anxiety, and encouragement to continue to return to and remain in places
where panic attacks have occurred may be all that is needed. However, with
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a long-standing disorder that involves frequent attacks and avoidance
behaviors, treatment is likely to require drug therapy combined with more
intensive psychotherapy.
Many drugs can prevent or greatly reduce anticipatory anxiety, phobic

avoidance, and the number and intensity of panic attacks:
1. Antidepressants: The different classes—SSRIs, serotonin-
norepinephrine reuptake inhibitors (SNRIs), serotonin modulators,
tricyclics (TCAs), and monoamine oxidase inhibitors (MAOIs)—are
similarly effective. However, SSRIs and SNRIs offer a potential advantage
of fewer adverse effects in comparison with other antidepressants.
2. Benzodiazepines: These anxiolytics work more rapidly than
antidepressants but are more likely to cause physical dependence and
such adverse effects as somnolence, ataxia, and memory problems.
3. Antidepressants plus benzodiazepines: These drugs are sometimes
used in combination initially; the benzodiazepine slowly tapered after the
antidepressant becomes effective.
Panic attacks often recur when drugs are stopped. Different forms of
psychotherapy are effective. Examples include exposure and cognitive-
behavior therapies.
(a) Exposure therapy, in which patients confront their fears, helps diminish
the fear and complications caused by fearful avoidance. For example,
patients who fear that they will faint during a panic attack are asked to spin
in a chair or to hyperventilate until they feel faint, thereby learning that they
will not faint during an attack.
(b) Cognitive-behavioral therapy involves teaching patients to recognize

and control their distorted thinking and false beliefs and to modify their
behaviour so that it is more adaptive. For example, if patients describe
acceleration of their heart rate or shortness of breath in certain situations or
places and fear that they are having a heart attack, they are taught the
following:
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i. Not to avoid those situations
ii. To understand that their worries are unfounded
iii. To respond instead with slow, controlled breathing or other methods
that promote relaxation
In this lecture, we have covered human adjustment as it relates to abnormal
behaviour. We have discussed anxiety disorders and panic attacks.

1. How is abnormal behavior related to human adjustment?
2. Explain anxiety disorders in relation to human
adjustment.
3. How can panic attacks and disorders be managed by a
counselor?
4. Explain exposure therapy.
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10. EMERGING ISSUES AND RESEARCH IN PSYCHOLOGY OF HUMAN
ADJUSTMENTS

1. Identify areas of research in psychology of adjustment
2. Demonstrate ability to formulate hypotheses in the identified areas
3. Identify emerging issues in psychology of adjustment
4. Relate the study of adjustment psychology to real life issues in the world today
10.1 Introduction
In all aspects of academics and various fields of study, so far, a lot has been
done in terms of research. From the beginning of this module, we have come
across a number of studies that earlier researchers carried out in relation to
psychology and adjustment. The crucial question at this juncture is that is
that all? What more could we add? Is there a knowledge gap that we could
fill? How about new innovations and discoveries?
These are some questions that we shall ask ourselves as we look into this
last chapter.
10.2 Emerging Issues in psychology of human adjustment
Kenya, as a nation is going through a rebirth at this point in time. Kenyans

had to vote for or against a draft constitution. Looking at the new
constitution as an emerging issue, what adjustment is required at individual,
community and national level?
After 2007 presidential elections, Kenya as a country went through a trying
time. There was violence and riots which resulted in loss of lives and
property. Currently, efforts are underway to bring the perpetrators to book.
Nothing of such magnitude and intensity had occurred in Kenya before.
Looking at this whole situation as an emerging issue, how does psychology of
adjustment come in?
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There is tremendous growth in higher education in Kenya today. This is
evidenced by 38 recognized universities in the country. This is a major
change not only in the choices of where to study, but also which field of
study. The change is also implied in the minimum qualifications for various
job titles. Adjustment is hereby necessitated not just by job hunters, but also
by career counsellors.
As far as technological advancement is concerned, one needs not over
emphasize the difference between the world today and the world ten years
ago. This ranges from mobile phones to solar powered internet booths in
villages. There is a shift from cash transactions to plastic money and
electronic money transfers. Young people have discovered new ‘hobbies’
such as spending time on ‘facebook’, as well as wearing earphones as part of
their daily outfit. Who needs to adjust to what, as far as technology is
concerned?
These are but just a few of emerging issues that students of psychology of
adjustment need to look into.
Think about the issues raised above, and any

other emerging issues that you
believe concern this course. What are your
views and ideas? Discuss these with a
friend.
10.3 Research in psychology of adjustment
Research in psychology of adjustment is no different from any other research

in social science. Psychologists organize their ideas and findings into
theories. Here, a theory is defined as an integrated set of principles that
explain and predict observed events. A hypothesis, on the other hand is a
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testable proposition that describes a relationship that may exist between
events. A good theory will combine facts into a short list of predictive
principles, which are studied and either accepted or rejected.
Research in psychology of adjustment may either be co relational or
experimental. Co relational research is the study of the naturally occurring
relationships among variables, while experimental research studies seek
clues to cause-effect relationships by manipulating one or more factors
(independent variable), while controlling others or holding them constant.
These studies can be undertaken either in the field or in the laboratory. Field
research is done in natural, real-life settings outside the laboratory. When
two variables co relate, any combination of three explanations is possible.
Survey research is useful when carrying out a study of a large population.
Random sampling is employed so that every person in the population has an
equal chance of inclusion. The sample has to be representative and without
bias. Other factors that affect this type of study are order of questions,
response options and the wording of the questions.
10.3.1 Major Research Areas
Psychology of adjustment has many areas of research since change is
unavoidable, and life is dynamic. Major areas of research in psychology of
adjustment would include change brought about by events such as natural
disasters, growth and development, technological advancements, politics,
evolution, among others. Psychology of adjustment relates these changes
and transitions to their effects on the emotional well being, health, the quest
for peace, and in general, stress. So far, a lot of research has already been
done in resilience, which is quite close, and even synonymous to adjustment.
10.3.2 Defining Resilience
According to many developmental psychopathologists, who constitute the
major group conducting resilience research: “Resilience in an individual
refers to successful adaptation despite risk and adversity ” (Masten, 1994, p.
3). More specifically, resilience has been broadly defined as a “process,
capacity or outcome of successful adaptation or adjustment despite
challenges or threatening circumstances, good outcomes despite high risk
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status, sustained competence under threat and recovery from trauma” (p.
426, Masten, Best, & Garmezy, 1990). Most researchers have defined
resilience more narrowly by focusing on “resiliency factors” or protective
personality traits (see Wolin & Wolin, 1993 for a review). Often these
shorthand “factor labels’’ mask a more complex interaction between a
resilient youth and his/her environment. It is increasingly recognized that
resilient youth are active participants in creating their own environment
(Scarr & McCarty, 1983)— a reasonably radical concept that transcends
stimulus-response behaviorism and smacks of human agency (Bandura,
1989). Some researchers have attempted to describe these transactional
person/person interplays that buffer negative life events, such as between a
caring adult and a child (Rutter, 1992; Radke-Yarrow & Sherman, 1990;
Werner, 1993). Few resilience researchers have stressed resilience processes
that help an individual develop resilient reintegration after disruption by
stressors or challenges, yet these are commonly recognized by therapists
(Richardson, Neiger, Jensen, & Kumpfer, 1990).
Six major constructs are specified. Four are domains of influence and two are
transactional points between two domains. The four influence domains are:
the acute stressor or challenge, the environmental context, the individual
characteristics, and the outcome. Points for transactional processes are the
confluence between the environment and the individual and the individual
and choice of outcomes.
Therefore, resilience research on predictors are organized into these six
major predictors of resilience, namely:
1. Stressors or Challenges
These incoming stimuli activate the resilience process and create a
disequilibrium or disruption in homeostasis in the individual or organizational
unit (e.g., family, group, community) being studied. The degree of stress
perceived by the individual depends on perception, cognitive appraisal and
interpretation of the stressor as threatening or aversive. The External
Environmental Context includes the balance and interaction of salient risk
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and protective factors and processes in the individual child’s external
environment in critical domains of influence (i.e., family, community, culture,
school, peer group). These change with age and are specific to culture,
geographic location, and historical period.
2. Person - Environment Interactional Processes
The second juncture of the Resiliency Framework (see Figure 1), includes
important transactional processes that mediate between a person and
his/her environment. Better understanding of ways that people consciously
or unconsciously modify their environment or selectively perceive their
environment, holds promise for prevention programs. In some cases, youth
living in high-risk environments may actively seek better environments for
themselves by going to a different school or choosing to live with a relative in
a better neighborhood, seeking positive prosocial friends. However, most
youth don’t have the option to leave a negative environment or
neighborhood. Resilient youth living in high drug and crime communities
seek ways to reduce environmental risk factors by seeking the pro-social
elements in their environment. They maintain close ties with pro-social
family members, participate in cultural and community events, seek to be
school leaders, and find non-drug using friends and join clubs or youth
programs that facilitate friendships with positive role models or mentors.
Unfortunately, much less resiliency research has been focused on person-
environment transactional processes than on internal self resiliency factors
(Masten, 1994). Considerable person-person or person-environment research
is potentially relevant, but it must be gleaned from applicable research
within psychology, anthropology, sociology and other related fields.
Potentially useful resiliency building processes have already been
summarized in more depth in Kumpfer and Bluth.
Some interactional processes that help these youth transform a high-risk
environment into more protective environment include:
1) Selective perception,
2) Cognitive reframing,
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3) Planning and dreaming,
4) Identification and attachment with pro-social people,
5) Active environmental modifications by the youth and
6) Active coping.
Caring others sought out by resilient youth facilitate positive life adaptations
and enhancement of protective processes by positive socialization or care
giving through:
1) Role modeling,
2) Teaching,
3) Advice giving,
4) Empathetic and emotionally responsive care giving,
5) Creating opportunities for meaningful involvement,
6) Effective supervision and disciplining,
7) Reasonable developmental expectations and
8) Other types of psychosocial facilitation or support.
As suggested by Coie and associates (1993) family prevention and
intervention research can be used to better understand these complex
person-environment processes by systematically varying transactional
processes within the program variations and testing the impact on youth.
3. Internal Individual Resiliency Factors
Children are not born equal. Some children are physically stronger and more
intellectually and physically endowed. Such physical and biological strengths
help to make a youth more resilient to life stresses. Biological invulnerability
variables do play a major role in resiliency. Temperament variables have
been found associated with risk and resiliency to drug use. According to the
Bio-psychosocial Model of Vulnerability to Drug Use (Kumpfer & DeMarsh,
1985), there are three major categories of biological characteristics to
consider in susceptibility to drug use: 1) genetic and biological factors, 2) in
utero factors, and 3) temperament and personality factors. Intellectual
capacity (I.Q.) has been widely studied in predicting resilience. In general,
most studies have found a protective effect of higher cognitive levels (Kandel
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et al., 1988; Long & Vaillant, 1984; Werner & Smith, 1982) or a risk effect for
low cognitive levels.
4. Internal Psychological Self Resiliency Factors

To develop a framework for understanding of self factors to resilience, the
internal individual factors have been reviewed in the child development and
child psychopathology literature. They have been organized into five major
overlapping domains: spiritual, cognitive, social/behavioral, emotional, and
physical. This organization maps reasonably well on the mind, body, and
spirit division of traditional wisdom. Luthar (1993) has distinguished three of
these five domains in her longitudinal study, namely social, emotional and
physical. Very few researchers have focused on the spiritual or affective
domain which is critical to the concepts of flexibility, perseverance,
hopefulness, optimism and the ability to bounce back after failure. A number
of longitudinal studies of positive life adaptation despite stressful or high-risk
environments (Garmezy, 1985; Luthar, 1991; Radke-Yarrow & Brown, 1993;
Werner & Smith, 1982, 1992) indicate that strength, hardiness and
competence are predictive of successful interactions with their
environments.
10.3.3 Constructs in Measuring Resilience

Resilience involves two central constructs, that is, risk or adversity, and
positive adaptation or competence. Whether resilience is conceived of as (a)
good outcomes despite adversity, (b) sustained competence under stress, or
(c) recovery from trauma (Masten, Best, & Garmezy, 1990), risk and
competence are the two key constructs that recur as pivotal components
embedded in the overall construct of resilience. In the existing research, a
range of strategies have been used to measure each of these constructs.
Risk Three broad approaches have been used to measure psychosocial risk in
empirical studies on resilience. The first involves multiple-item
questionnaires on adverse influences or experiences, exemplified in
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checklists of negative life events. The second involves single stressors of a
chronic or acute nature, such as child abuse, parental divorce, or parental
psychopathology. The third approach utilizes a collection of specific, discrete
risk indices primarily of a socio-demographic nature, such as poverty status
or large family size, that are aggregated to derive an overall estimate of
adversity experienced.
In resilience research, the use of multiple-item measures to assess risk
necessitates validation of the instruments (at the very least), in terms of
significant associations with relevant outcomes. The magnitude of statistical
associations with adjustment indices must be interpreted with caution, and
researchers need to indicate descriptively where on the broad continuum of
severity, the stressors faced by their particular subject population might fall.
In using checklists involving negative life events, investigators must be
attentive to potential measurement confounds in such instruments, as well
as to the heterogeneity of types of events sampled.
The use of multiple indices is an approach to operationalizing risk that merits
further examination in studying resilience. The simultaneous consideration of
several indices may provide the most comprehensive assessment of the
overall risk experienced by individuals facing adverse life circumstances. In
using this measurement approach, however, it is critical that researchers
carefully attend to whether components integrated within a composite risk
constellation, each do, in fact, represent high risks within the sample under
consideration.
10.3.4 Measuring Competence
As with the study of risk, concerns around measuring competence vary
depending on the approach used to operationalize the construct. There are
three broad approaches that have been used to assess competence in
resilience research, which are somewhat analogous to the strategies
employed to measure risk. The first approach involves continuous data on
multiple-item scales, such as those assessing competent behaviors in school,
or symptomatology. A second strategy is a categorical one that is based on
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the presence or absence of serious psychopathology. The third approach to
measuring competence involves the addition or integration of diverse
aspects of adjustment.
Specificity of competence measures is critical not only in terms of validity
vis-a-vis the particular risk measured, but is also a crucial concern in the
presentation of research findings on resilience. Resilience is not a one
dimensional construct: high risk individuals can function extremely well in
one behavioral domain yet display significant difficulties in other areas of
overt competence. Thus, when trends on resilience are based on two or three
circumscribed domains of competence, it is imperative that findings are
discussed in equally circumscribed terms, and do not imply resilient
functioning in some sweeping, across-the-board sense (Luthar, 1993).
Thus, when competence is measured via multiple-item scales (such as those
involving behavior ratings), it is often difficult to ascertain how the highest
levels of competence within the high-risk sample under study might compare
with those in low-risk groups, or in the general population. Ambiguities in this
context can be partially addressed by providing qualitative characterizations
of a subset of high and low-functioning individuals within the group being
examined. Other concerns with using this approach to measuring
competence include the need for specificity in selection of competence
indices vis-a-vis the particular risk under scrutiny, and specificity, as well, in
the discussion of findings in terms of the particular domains in which
resilience is identified.
Summary
There has been a range of measurement approaches used in empirically
studying the different components embedded with the construct “resilience”,
i.e., risk, competence, and the association between them. High risk
conditions have been studied in terms of multiple-item measures such as
those of negative life events, by single negative life experiences such as
child abuse, and by aggregations of a variety of socio-demographic risks.
From a measurement perspective, issues of potential concern with all three
113
of these approaches pertain to where, on some absolute “real-world” scale,
high risk as assessed within a particular sample might fall. Other potential
problems, which may apply more to some of these approaches than to
others, concern confounds of measurement, uncertainties regarding
underlying processes, and the validity of the measures used as indices of
risk. Analogous to the measurement of risk are three broad approaches that
have been used to measure competence in resilience research. The first
involves continuous measures of different domains of functioning, each
examined separately. In studies using this approach, the reference group for
gauging “high competence” has often been the high-risk sample itself; little
is known about how the resilient individuals within these samples compare
with individuals in the general population. The second strategy rests on the
absence of psychiatric disorders.
10.4 Ethics in Social psychological research
Achieving mundane and experimental realism sometimes requires deceiving

people with a plausible cover story. Since the ends do not always justify the
means, the American Psychological Association (1992) and the British
Psychological Society (1991) developed principles for guiding researchers.
These principles urge researchers to:
1. Tell potential participants enough about the experiment to enable their
informed consent (or to enable them to choose whether or not they want to
participate in the experiment).
2. Be truthful. They need not use deception to influence willingness to
participate.
3. Protect people from harm and significant comfort
4. Treat information about the individual participants confidentially
5. Fully explain the experiment afterward, including any deception except if it
would be distressing.
ACTIVITY: What interests you most about

change? Would you attempt to study it
and find out more114about it? How would
you go about this study?
In this lecture, we have looked at emerging issues in human adjustment. We have
also covered ethical issues and research in human adjustment.

1. Relate technological advancement to adjustment
2. What aspect of human adjustment would you be
interested in researching?
3. Explain ethical considerations for research in human
adjustment.
4. What influence do individual differences have on
resilience?
For further reading, see the bibliography attached.
BIBLIOGRAPHY
Atwater, Eastwood (1990) Psychology of adjustment. New Jersey:

Eaglewood Cliffs
115
Barlow David (2002) Abnormal psychology. Australia: Wadsworth
Glantz, Meyer D. (Editor); Johnson, Jeannette L. (1999) Resilience and

Development: Positive Life Adaptations. USA: Kluwer Academic
Publishers, 1999. p 117.
http://site.ebrary.com/lib/kmethke/Doc?id=10047420&ppg=117
Lage, Gustavo A. (1991) Psychotherapy, adolescents and self-

psychology. Madison: International universities press
Napoli, Vince (1992) Adjustment and growth in a changing world. -4th

ed. New York: West Publishing
Shukla, K. C. (2009) Practical psychology. New Delhi: Commonwealth
Snyder, C. R.(1999) Coping : The Psychology of What Works. Cary, NC,

USA: Oxford University Press, 1999. p 93.
Statt, David A. (2004) Psychology and the world of work. Hampshire:

Palgrave
116

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KENYA METHODIST UNIVERSITY

FACULTY OF ARTS AND SCIENCES

ODLM MATERIALS FOR

By the end of this course, you should be able to:

Self Assessment Question (SAQ)

1. INTRODUCTION TO PSYCHOLOGY OF HUMAN ADJUSTMENT.................................9

1.2 Behavioral science and adjustment...................................................................9

1.3 Adjustment and values....................................................................................10

1.4 Adjustment and culture....................................................................................12

1.5 Adjustment and change...................................................................................12

2. THEORIES RELATED TO PSYCHOLOGY OF ADJUSTMENT.....................................18

2.2 Views of Life Transitions...................................................................................19

2.2.1 Metaphors from Classical Literature.............................................................19

2.2.2 Social Interaction Model................................................................................19

2.2.3 Predictable Overlapping Stages....................................................................20

2.3 Coping Attitudes and Skills..............................................................................21

3. ADJUSTMENT AND THE ROLE OF THE STUDENT.................................................24

3.2 Study behaviour...............................................................................................25

3.3 Study behavior in class....................................................................................28

4. PHYSICAL FACTORS INFLUENCING ADJUSTMENT................................................30

4.2 Adjustment and Health....................................................................................30

4.3 Emotions and adjustment................................................................................32

4.5 Positive thinking...............................................................................................37

4.6 Hope, Coping and Adjustment.........................................................................37

4.7 Personality and Adjustment.............................................................................38

5. LIFESTYLE AND HEALTH......................................................................................41

5.2 Eating Habits....................................................................................................41

5.3 Drug Use..........................................................................................................43

5.4 Escaping reality................................................................................................46

5.5 Levels of dependency......................................................................................47

5.6 Case study: 911 terrorist attacks and drug use...............................................48

5.7 Other Risk Factors for Drug Use.......................................................................50

6. ADJUSTMENT AND DEVELOPMENT.....................................................................53

6.2 Overview of Lifespan Development.................................................................53

6.4 Losing a Loved One..........................................................................................57

6.6 Changes in Living Arrangements.....................................................................59

7. SOCIAL FACTORS INFLUENCING ADJUSTMENT....................................................63

7.2 Adjustment and Interpersonal Relations..........................................................63

7.3 Need for consistency........................................................................................64

7.4 Groups and adjustment....................................................................................65

7.6 Friendship and living........................................................................................65

7.7 Somatoform and Facticious Disorders..............................................................66

7.8 Suicidal Behavior.............................................................................................67

8. PSYCHOLOGICAL FACTORS INFLUENCING ADJUSTMENT.....................................77

8.2 Stress and Adjustment.....................................................................................77

8.3 Stress and Perception......................................................................................78

8.4 The Decision to Cope.......................................................................................78

8.5 The Positive Side of Stress...............................................................................79

8.6 Acute Stress Disorder.......................................................................................79

8.7 Posttraumatic Stress Disorder..........................................................................81

9. MENTAL HEALTH AND ADJUSTMENT...................................................................85

9.2 Abnormal Behavior and Adjustment................................................................85

9.3 Anxiety Disorders.............................................................................................86

9.4 Panic Attacks and Panic Disorder.....................................................................89

10. EMERGING ISSUES AND RESEARCH IN PSYCHOLOGY OF HUMAN ADJUSTMENTS

10.2 Emerging Issues in psychology of human adjustment...................................93

10.3 Research in psychology of adjustment...........................................................94

10.4 Ethics in Social psychological research........................................................101

you to evaluate your understanding of the concepts presented. I expect

studying the relevant work. A summary of each lecture is also provided

Kindly, make sure that:

 You complete each lecture at a time before proceeding to the next on

 Refer to the suggested additional resources provided in the bibliography