Chapter 7 Flashcards
What is Health Psychology?
Any application of psychological methods and theories to understand:
- origin of disease
- responses to disease
- determinants of good health
What is Behavioural Medicine?
Applying behaviour-changing strategies to the treatment or prevention of a disease.
Ex. Using psychological techniques to control pain in patients undergoing medical procedures
What is a “mechanism” ?
Mechanism: how something causes an effect in the body. It explains the process linking a cause to an outcome
- ex. Someone w AIDS may die of pneumonia; virus decreases immune system competence
How is Illness different from Disease
An illness is defined by symptoms: subjective reports of internal states
A disease is marked by signs: objective indications of a disease that can be tested or seen
What is a lesion? What is their role?
Lesions are physical changes or damage in body tissues caused by disease, injury, or other harmful processes.
- they can appear in different forms, such as ulcers, tumors, or scar tissue
- they are objective signs of a disease
Lesions indicate that something is wrong in the body
Psychological Influence on Illness
Our thoughts, feelings, and psychological state can affect how we:
- perceive symptoms
- pay attention to symptoms
- tolerate bodily symptoms
Psychological Influence on Disease
Repeated harmful behaviors (e.g. smoking, poor diet) cause lesions over time (e.g. lung damage, hardened arteries)
Psychological factors influence:
1. endocrine system: cortisol release—>inflammation
2. autonomic NS: automatic functions (heartbeat)
3. immune system: can be weakened by stress
how psych factors contribute to physical disease: endocrine, autonomic ns, immune system
HPA axis: translates psychological experiences (e.g. stress, trauma, emotions) into physical changes in the body.
1. HPA axis:
- Stress stimulates the hypothalamus
- Hypothalamus tells the pituitary gland to release ACTH
- ACTH stimulates the cells in the adrenal cortex
- These cells release cortisol
2. Long term/excessive exposure to cortisol causes lesions:
- Weakened immune function
- Inflammation & tissue damage
3. Cortisol Sustains SNS Activity:
- Prevents the PSNS from inhibiting the stress response
- Prolonged SNS activity further stimulates the HPA axis
4. Immune System is affected (stress-induced):
- Reduced T-cell proliferation
- Chronic SAM axis activation weakens immune defences
- Chronic immune suppression increases inflammation and vulnerability to disease
The Sympathetic-Adrenal Medullary (SAM) Axis and stress
The immediate response to stress. HPA Axis is the prolonged, slower response.
SAM axis steps:
1. The brain perceives a stressor
2. Hypothalamus activates SNS
3. SNS fibres stimulate the adrenal medulla
4. The adrenal medulla releases (nor)epinephrine
5. The adrenaline released (epin) activates the fight/flight
Three Pathways of Psychosocial Influence on Immunity
- Direct CNS influence: CNS directly affects immune organs
- Hormonal Pathway: cortisol suppress immune responses
- Behavioral Pathway: Stress causes unhealthy behaviours that weaken immunity (e.g. poor diet)
Explain what is meant by “psychological stress”
Psychological stress refers to an individual’s emotional, cognitive, and physiological response to perceived threats, challenges, or demands that exceed their coping resources.
1. There’s a response to a perceived issue
2. This issue exceeds the persons coping resources
Stress can result from external events, internal conflicts, or a combination of both, affecting mental and physical health.
What are the 3 approaches to conceptualizing psychological stress?
- Physiological Model: stress is a response
- General Adaptation Syndrome (GAS)
- Environmental Model: stress is a stimulant
- Social Readjustment Rating Scale (SRRS)
- Cognitive-Appraisal Model: stress is a transaction
Describe Selye’s 3 phases of stress in the General Adaptation Syndrome (GAS)—stress as a response
Stress is a response that adapts to demands placed on the body. When the demands are placed, we go thru 3 stages:
Phase 1: Alarm
- the body mobilizes its defences.
Phase 2: Resistance
- if the challenge persists, we go through resistance
- the body copes through immune/endocrine changes
Phase 3: Exhaustion
- if the challenge persists, exhaustion follows
- energy is depleted and resistance can’t be maintained
- lesions occur: organism may succumb to a disease
Describe Holmes & Rahe’s Social Readjustment Rating Scale (SRRS)—stress as a stimulus
They define stress as external events/conditions (stressors) that require adaptation
The SRRS ranks life events based on their potential stress impact
Describe Lazarus & Folkman’s Cognitive Appraisal Model—stress as a transaction
Stress results from the ongoing interaction between individuals and their environment
People constantly evaluate what is going on around them, and they do this through 2 primary appraisal processes:
1. Primary Appraisal: Evaluating whether an event is a threat or challenge
2. Secondary Appraisal: Assessing their ability to cope with the stressor
People use coping strategies to deal with this stress:
1. Problem-focused coping: addressing the stressor directly
2. Emotion-focused coping: managing emotional responses
What are the 4 psychosocial determinants of disease?
- Social Status
- Controllability
- Social Support
- Personality (Alexithymia)
Describe the mechanism by which social status is a determinant of disease
Social Status: an individual’s rank in the social hierarchy
How does it contribute?
1. Chronic stress from soc ineq —> HPA axis dysregulation
2. HPA dysregulaiton —> increased risk of heart diseases
Describe how controllability is a determinant of disease
Controllability: perceived control over life events/stressors
Internal locus of control: you have control over external shit
- Linked to better coping
External locus of control: outcomes are determined by fate
- Linked to higher stress and depression
Describe how social support is a determinant of disease
High social support: reduces stress reactivity, inflammation
Low social support: higher SNS+HPA axis activation
Describe how personality is a determinant of disease
Alexithymia: a personality trait characterized by:
1. Difficulty identifying and describing emotions
2. Inability to differentiate emotions from bodily sensations
3. Limited imagination
4. Externally oriented thinking
Associated with higher SNS activation as Alexithymia impairs stress coping
Describe the disease processes resulting in gastric ulcers
Gastric Ulcer: an erosion of the stomach lining that happens when the protective mucosal barrier is overwhelmed by digestive fluids (especially HCl)
- Stress increases acid secretion and decreases blood flow to the mucosal lining
- This can weaken the mucosal lining
How do instances of Helicobacter pylori suggest psychosocial stress influences the risk of gastric ulcers?
Many ulcers involve HPylori infections
But only a minority of those infected develop ulcers
Suggests other factors (psychosocial stress) modulate risk
Describe the disease processes resulting in coronary heart disease (Cardiovascular Disease)
Cardiovascular Disease: develops from the buildup of plaques in the arteries which reduce blood flow to the heart
- Chronic endothelial damage and inflammation allows lipids to stick to the artery walls, forming plaques that narrow the passage
- Stress can lead to increased heart rate, elevated bp and turbulent blood flow—all of which damage the vessel lining and accelerate plaque formation
- SNS activation and the SAM axis activation directly increase cardiac output, contributing to hypertension
How do psychosocial processes contribute to disease?
Psychological processes in question:
- stress perception
- external locus of control
- negative affect
- chronic life stressors
Stress contributes to disease by:
- dysregulating the HPA axis (lowers immunity to infections)
- increasing SNS activation (cardiovascular disease)
* increases acid secretion and diverts blood flow (ulcers)
