Having looked at the biological effects of stress we now consider the psychological effects. These fall into three categories - alarm and mobilisation, resistance, and exhaustion.

Alarm and mobilisation

First of all a person's resources for coping with the trauma are alerted and mobilised.  Typically involved at this stage are emotional arousal, increased attention, heightened sensitivity, greater alertness (vigilance), and determined efforts at self-control.  At the same time, the person undertakes various coping measures that may be task-oriented or defence-oriented, or even a combination of the two, in attempts to meet the emergency.  During this stage, symptoms of maladjustment may appear, such as continuous anxiety and tension, gastrointestinal upset (ulcers) or other bodily diseases, and lowered efficiency, signs that the mobilisation of adaptive resources is inadequate.

Resistance

If the trauma continues, a person is often able to find some means for dealing with it and be able to maintain some adjustment to life.  Trauma resistance may be achieved temporarily by concerted, task-oriented coping measures; the use of ego-defence mechanisms may also be intensified during this period.  Even in the resistance stage, however, indications of strain may exist. For example, psychophysiological symptoms such as acute stomach distress and mild reality distortions such as hypersensitivity to sounds during the late phases of this stage may occur.  In addition, the person may become rigid and cling to previously developed defences rather than trying to reevaluate the traumatic situation and work out more adaptive coping patterns.

Exhaustion

In the face of continued excessive trauma, a person's adaptive resources are depleted and coping patterns called forth in the stage of resistance begin to fail.  As the stage and exhaustion begins, the individual's ability to deal with continuing stress is substantially lowered and they may be employing exaggerated and inappropriate defensive measures to deal with the problems now facing.  The latter reactions may be characterised by psychological disorganisation and a break with reality, involving delusions and hallucinations.  These delusions appear to represent increasingly disorganised thoughts and perceptions along with desperate efforts to salvage psychological integration and self integrity by restructuring reality.  Metabolic changes that impair normal brain functioning may also be involved in delusional and hallucinatory behaviour.  Eventually the excessive stress continues, the process of the compensation proceeds to stage of severe psychological disorganisation perhaps involving continuous uncontrolled violence, apathy, stupor, and perhaps even death.