CHAPTER 9 Flashcards
At the turn of the 20th century, infectious diseases were the leading causes of death, but over the years, advancements in healthcare reduced the annual death toll from infectious diseases. Instead, the focus has shifted toward understanding the substantial impact of psychological and behavioral factors on health and well-being.
Psychological and Social Factors That Influence Health
Psychological and social factors wield a significant influence over an individual’s health. This influence stems from the intricate interplay between biological, psychological, and social elements. These factors not only affect mental health but also exert a tangible impact on brain structure, neurotransmitter functions, and gene expression. Stress, lifestyle choices, and the presence or absence of social support all play pivotal roles in overall health outcomes.
The Impact of Psychological and Social Factors on Health
Various physical disorders are strongly influenced by psychological and social factors. For instance, endocrinological disorders like diabetes are closely linked to lifestyle choices and the stress an individual experiences. Cardiovascular disorders are profoundly affected by chronic stress, specific behavior patterns, and even social isolation. Immune system disorders, notably AIDS, demonstrate the role of psychological stress in disease progression. While these disorders have identifiable physical causes, it is crucial to recognize the substantial contribution of psychological and social factors in their development and progression.
Physical Disorders Influenced by Psychological and Social Factors
The field has evolved from its earlier iteration as “psychosomatic medicine” to encompass a broader understanding of the interplay between biological, psychological, and social factors in all types of disorders. Throughout its history, the field has reached key milestones, including the recognition of the powerful mind-body connection and the realization that mental and emotional well-being significantly impact physical health.
The Evolution of the Field
Psychosocial factors play a pivotal role in both the etiology and treatment of physical disorders. Notably, research has unveiled the potential of reducing stress levels to improve overall health and longevity. The presence of a robust social network has proven instrumental in supporting healthy aging and promoting general well-being. Understanding the complex interplay of psychological and social factors in health is of paramount importance. These insights are not confined to mental health but extend to physical health as well. They emphasize the necessity of a holistic approach to healthcare, recognizing that psychological and social factors are integral components of overall well-being. Further research and awareness in this field are vital for improving health outcomes and advancing the understanding of the mind-body connection.
The Role of Psychosocial Factors in Health
_________ ____________is defined as the application of behavioral science to healthcare. It involves a multidisciplinary approach, with psychologists, physicians, and health professionals collaborating to integrate behavioral factors into health treatment and prevention strategies. This field recognizes the critical role of behavioral and psychological factors in healthcare, emphasizing their importance in diagnosis, treatment, and prevention.
Behavioral Medicine
__________ _______________is introduced as a specialized domain within psychology. It focuses on studying how psychological factors can be utilized for health promotion and maintenance.
Health Psychology
_______ _______________play a key role in analyzing healthcare systems and policies, aiming to enhance their effectiveness.
Health psychologists
The relevance of________ ____________ extends to understanding how the mind can contribute to both health improvement and the etiology of diseases.
Health Psychology
Delves into how psychological and social factors exert an influence on health. It highlights their profound impact on biological processes and behavior patterns, underlining their contribution to the origination and perpetuation of diseases. This emphasizes the critical link between our mental state, social environment, and physical well-being.
Psychological and Social Factors
Genital herpes and AIDS are explored as examples of diseases influenced by psychological and social factors. Psychological and behavioral elements play a significant role in the spread of genital herpes and the recurrence of herpes symptoms. Stress is discussed as a direct influencer of the immune system, potentially promoting disease progression in AIDS. Additionally, the text delves into behavioral risk factors associated with AIDS.
Diseases Influenced by Psychological and Social Factors
The relationship between lifestyle factors and prevalent causes of death, such as heart disease, cancer, and diabetes. Smoking is recognized as a leading preventable cause of death. It is significant to comprehend how psychological factors can impact physical disorders and diseases. Stress, as well as the neurobiological aspects of the stress response, emerges as pivotal areas for research and intervention in the context of health and healthcare. Understanding these links between the mind and the body is essential for improving overall well-being and public health outcomes.
Lifestyle Factors and Leading Causes of Death
Hans Selye’s groundbreaking experiments with rats, which inadvertently led to the identification of the physiological problems associated with stress. Selye observed that the daily injections he administered to rats were causing health issues and realized that these health problems were related to a nonspecific physiological reaction. This also introduces the term “stress” to describe this reaction, marking the birth of stress physiology.
Hans Selye’s Observations
According to _________ _________ __________, the body goes through three stages in response to sustained stress: alarm, resistance, and exhaustion. It is emphasized that chronic stress can lead to permanent bodily damage or contribute to the development of diseases. This concept revolutionized our understanding of how stress impacts the body’s physiological processes.
General Adaptation Syndrome (GAS)
Highlights the evolution of Selye’s theory in later years, with a focus on the confirmation and elaboration of the link between chronic stress and health problems. It underscores the enduring relevance of Selye’s work and its contributions to stress physiology.
The Modern Understanding of Stress
________ is defined as a physiological response to stressors, aligning it with the context of health and biology. A comparison is also drawn between this physiological perspective of stress and stress in engineering and everyday life.
Stress
__________ is recognized as a physiological response to stressors, and its profound influence on health underscores the need for continued research and awareness in this vital area of study.
Stress
Elucidating how the _________ _________ ________ primes the body for immediate action during threatening situations. It emphasizes the heightened strength and mental activity experienced during the stress response, illustrating the body’s readiness for action.
The Role of the Sympathetic Nervous System
With a special emphasis on the hypothalamic-pituitary-adrenocortical (HPA) axis. It explores the significance of neuromodulators and neuropeptides secreted by glands into the bloodstream to convey messages within the body.
The Endocrine System’s Role in Stress
introduces the concept of ________ __________, with a primary focus on cortisol. It elaborates on the intimate relationship between cortisol and the stress response, shedding light on the hormone’s critical role.
Stress Hormones
It emphasizes the role of the hippocampus in managing emotional memories and its vulnerability to cortisol. This section underscores the complex interplay between these systems.
The HPA Axis and the Limbic System
delves into the feedback loop between the limbic system and the HPA axis, highlighting how it functions in response to stress. It also addresses the potential repercussions of chronic stress and elevated cortisol levels, including hippocampal cell death.
Feedback Loop and Chronic Stress
explores the long-lasting consequences of chronic stress, such as brain damage and impaired problem-solving abilities. It discusses the link between hippocampal cell death and conditions like posttraumatic stress disorder and depression, emphasizing the far-reaching effects on mental health.
The discussion concludes by underscoring the importance of comprehending the physiological effects of stress and their potential implications for both physical and mental health.
Implications for Physical Function and Mental Health
It mentions the studies by Sapolsky and his research on baboons in Kenya, setting the stage for a deeper exploration.
Contributions to the Stress Response
it explains how baboons, akin to humans, establish social hierarchies. It elaborates on the challenges faced by subordinate animals, including bullying and limited access to resources, underlining the significance of social rank in baboon societies.
Baboons in Social Hierarchies
delves into Sapolsky’s research on cortisol levels in dominant and subordinate baboons. It explains cortisol secretion’s role in stress and its potential long-term effects. This section also discusses the differing cortisol responses to emergencies between dominant and subordinate males.
Cortisol Levels and Social Hierarchy
It highlights the excess secretion of CRF by the hypothalamus in subordinate animals, diminished pituitary gland sensitivity in subordinates, and the continuous cortisol secretion in response to chronic stress.
Causes of Cortisol Differences
elucidates the ________ ___________ of chronic stress on subordinate males, including immune system suppression and a heightened risk of cardiovascular issues. It underlines the detrimental impact of long-term stress on well-being.
Health Implications
discusses the positive effects of being at the top of the hierarchy, emphasizing the role of predictability and controllability in reducing stress. It underscores the importance of a sense of control in regulating stress physiology.
The discussion concludes by emphasizing the significance of understanding the role of psychological and social factors in the stress response. It underscores the implications for both human and animal well-being and health, reinforcing the interconnectedness of psychological and social factors with the stress response.
The Psychological Benefits of Dominance
the focus shifts to a contemporary study involving over 47,000 individuals across 17 countries. The study examines the intricate links between mental disorders and chronic physical conditions. Findings suggest that mental disorders significantly increase the risk of developing physical health issues, reinforcing the connection between psychological and physical well-being.
The Study by Scott and Colleagues
delves into the commonalities among feelings of ________, ________, and ___________. It explores the critical role played by one’s perception of control and coping abilities in determining the emotional state experienced. Relevant studies by Barlow and Suárez are referenced, adding credibility to the discussion.
The Link Between Stress, Anxiety, and Depression
explains the continuum of feelings that spans from excitement to stress, anxiety, and depression. It highlights how one’s perception of control and coping capabilities can influence which emotional state is encountered. The interconnectedness of these emotional states becomes apparent in this section.
The discussion concludes by summarizing the strong relationship between psychological and physical health. It underlines the existence of a continuum of emotions and the significant role of perceived control and coping in determining where one falls on this continuum. These insights have far-reaching implications for understanding and managing stress and its impact on both mental and physical health. The interconnectedness of these emotional states underscores the importance of a holistic approach to health and well-being.
Continuum of Feelings
It details the bodily sensations linked with excitement and emphasizes the positive outcomes of feeling well-prepared and confident in the face of a challenge.
Effects of Excitement
shifts the focus to the negative aspects of pressure and a lack of resources, which can lead to stress.
The physical symptoms associated with stress, such as tension, irritability, headaches, and upset stomach, are discussed. The section also distinguishes between the pressures of life’s demands and genuine threats.
Pressure and Stress
Discusses the transition from pressure to anxiety when confronted with threatening situations. It highlights how anxiety can result from feeling that aspects of life are beyond one’s control, leading to incessant worry.
Anxiety and Loss of Control
Characterizes depression as a state of hopelessness and the loss of the desire to cope. It mentions individuals who perpetually perceive life as threatening. The emotional continuum from excitement to depression is outlined, highlighting the contrasting states of mind.
Depression and Perceived Threat
Explores the underlying physiological similarities across these emotional states. It references the pattern of sympathetic arousal and neurotransmitter activation, underlining the key role they play. Differences in blood pressure, influenced by the sense of control, are explained.
Physiology of Emotional States
emphasizes the critical importance of self-efficacy, defined by Bandura, in shaping our emotional states. It underscores the marked differences in feelings based on one’s self-efficacy. Relevant studies, such as those by Bandura and Taylor, are referenced to validate these claims.
It underscores the significance of understanding emotional responses to stress and challenges. It also highlights the importance of enhancing self-efficacy and coping abilities as a means to foster healthier emotional states and ultimately promote better physical health. The mind-body connection is a central theme throughout this exploration, reinforcing the concept that emotional well-being is intricately linked to physical health.
Role of Self-Efficacy
This discussion delves into the intricate relationship between stress and susceptibility to infections, highlighting the pivotal role stress plays in immune system functioning. The introduction emphasizes the real-world implications of how stress can significantly affect our vulnerability to illnesses and sets the stage for in-depth exploration.
Stress and the Immune Response
explores the tangible connection between stress and the common cold, drawing upon Sheldon Cohen’s influential research.
It delves into the details of Cohen’s study and uncovers the direct link between stress levels and the likelihood of contracting a cold. Furthermore, it investigates the nuanced role stress intensity and social interactions play in determining susceptibility to colds, all while spotlighting the protective influence of a positive and optimistic cognitive style.
The Common Cold and Stress
extends the examination to various stressors that lead to increased rates of infectious diseases.
It highlights the rapid immune system response to stress and details the connection between psychological stress and the severity of the flu. The discussion turns to the role of stress hormones in triggering cytokine interleukin-6 and subsequent inflammation.
Stress and Infections
It emphasizes the impact of early-life stress on inflammation in adulthood and the interplay between psychological disorders, immunity, and physical health. The section underscores the role of depression in diminishing immune system functioning, underscoring the importance of maintaining a sense of control in life’s events.
Long-Term Effects of Stress
highlights the challenges posed by chronic stress on the immune system, particularly examining its effects on individuals caring for chronically ill family members. It underscores the long-term implications of such chronic stressors.
Chronic Stress and Immune Function
It elucidates how B cells produce antibodies, known as immunoglobulins, which serve to neutralize antigens. The creation of memory B cells, enabling swifter future responses, is highlighted, as well as the mechanism of inoculations and vaccines for disease prevention.
Humoral Immune System
emphasizing the roles of T cells, especially killer T cells, in directly combating viruses and cancer cells. It underscores the significance of memory T cells for future immune responses and delineates the functions of T4 (helper) and suppressor T cells in immune regulation.
Cellular Immune System
Section 3 shifts focus to autoimmune diseases and their connection to T cells. It introduces the human immunodeficiency virus (HIV) and its detrimental impact on helper T cells, underscoring the implications of an imbalance between helper and suppressor T cells in the context of AIDS.
Autoimmune Diseases and AIDS
explores the intriguing historical observations of cancer patients experiencing remission after viral infections. It highlights the development of immunotherapy as a revolutionary approach to cancer treatment and underscores its significance in modern cancer research.
Immune System and Cancer
uncovers connections between the nervous system and the immune system. It underscores the impact of psychological influences on immune responses and reveals the molecular pathways that link stress to the onset of diseases.
Psychoneuroimmunology (PNI)
Mental and emotional aspects that impact health, including stress, emotions, and cognition.
Psychological Factors
A model that considers the influence of biological, psychological, and social factors on health and illness.
Biopsychosocial Model
Diseases related to hormonal imbalances, like diabetes.
Endocrinological Disorders
Health issues affecting the heart and blood vessels.
Cardiovascular Disorders
Diseases impacting the immune system, such as AIDS.
Immune System Disorders
A field focused on the relationship between psychological factors and physical health.
Psychosomatic Medicine
An approach that integrates biological, psychological, and social factors in understanding diseases.
Biopsychosocial Approach
The cause or origin of a disease or condition.
Etiology
Interpersonal relationships that play a role in overall well-being.
Social Networks
attacks the immune system and opportunistic infections develop uncontrollably.
AIDS (ACQUIRED IMMUNO DEFICIENCY SYNDROME)
AIDS methods of transmission:
● Intravenous drug use
● Sexual activity
After several months to several years with no symptoms, patients may develop minor health problems such as weight loss, fever, and night sweats.
AIDS-related complex (ARC)
Psychological factors that influence progression of AIDS:
- impacts immune system functioning, investigators have begun to examine whether these psychological factors influence the progression of HIV
● STRESS & LOW SOCIAL SUPPORT
- Associated with a faster progression to disease (Leserman, 2008; Leserman et al., 2000)
● DEPRESSION
- strongly associated with decreased adherence to the drug regimen (Gonzalez, Batchelder,
Psaros, & Safren, 2011)
May have positive effects on the immune systems of individuals who are already symptomatic
- In a study conducted, those who received psych intervention showed greater immune system functioning compared to those who didn’t *
- Psychological treatments focus on strengthening the immune system and gaining a sense of control *
Cognitive-Behavioral Stress-Management (CBSM)
- Abnormal cell growth produces malignant tumors.
- Different cancers have different rates of recovery and mortality.
CANCER
buffers stress and slows disease progression
SUPPORTIVE RELATIONSHIPS
may contribute to the development of cancer, probably through changes in immune function & through regulating the activity of cancer causing viruses, deoxyribonucleic acid (DNA) repair processes, and the expression of genes that control the growth of tumors
Use of inappropriate coping responses (such as denial)
is the study of psychosocial factors involved in the course and treatment of cancer.
- Psychosocial treatments may prolong life, alleviate symptoms, and reduce depression and pain
PSYCHONCOLOGY
CARDIOVASCULAR PROBLEMS
STROKE (CEREBRAL VASCULAR ACCIDENTS)
HYPERTENSION
CORONARY HEART DISEASE (CHD)
Blockage or rupture of blood vessels in the brain
STROKE (CEREBRAL VASCULAR ACCIDENTS)
Constriction of blood vessels at organs and extremities puts extra pressure on the heart, which
eventually weakens.
HYPERTENSION
- no specific verifiable physical cause (close to 90% of cases)
- runs in families and likely is subject to marked genetic influences
● STRESS is a major contributor to essential hypertension
Essential Hypertension
emerges as an important contributor to cardiovascular health
SOCIAL SUPPORT
a way of communicating love and support significantly decreased blood pressure (Holt-Lunstad, Birmingham, & Light, 2008)
Warm Touch
has a stress-buffering effect and can prevent the outbreak of the symptoms of a viral infection and reduce the severity of the symptoms
HUGGING
long-term study identified two psychological factors, each of which almost doubles the risk of
hypertension
HOSTILITY & SENSE OF TIME URGENCY / IMPATIENCE
- Blockage of arteries supplying blood to the heart muscle (myocardium)
- We inherit a vulnerability to CHD & other factors such as diet, exercise, and culture contributes to our cardiovascular status.
CORONARY HEART DISEASE (CHD)
Chest pain resulting from partial obstruction of the
arteries
ANGINA / ANGINA PECTORIS
occurs when a fatty substance or plaque builds up inside the arteries and causes an obstruction.
ATHEROSCLEROSIS
deficiency of blood to a body part caused by the narrowing of the arteries by too much plaque.
ISCHEMIA
death of heart tissue when a specific artery becomes clogged with plaque.
MYOCARDIAL INFARCTION or HEART ATTACK
- excessive competitive drive
- a sense of always being pressured for time,
impatience - incredible amounts of energy that may show
up in accelerated speech and motor activity,
and angry outbursts - more than twice as likely to develop CHD *
Type A behavior pattern
- more relaxed
- less concerned about deadlines
- seldom feels the pressure or, perhaps, the
excitement of challenges or overriding ambition.
Type B behavior pattern
________ ____________as in major depressive episodes, is particularly implicated in cardiovascular damage.
SEVERE DEPRESSION
impaired the pumping efficiency of the heart, putting these individuals at risk for dangerous disturbances in heart rhythm (arrhythmias)
ANGER
- social inhibition and heightened negative emotions
Type D personality
- Pain is not in itself a disorder, yet for most of us it is the fundamental signal of injury, illness, or disease
- Typically involves joints, muscles, and tendons, particularly in the lower back; may result from enlarged blood vessels, tissue degeneration, or cancerous tumors.
CHRONIC PAIN
2 KINDS OF CLINICAL PAIN:
ACUTE PAIN
CHRONIC PAIN
typically follows an injury and disappears once the injury heals or is effectively treated, often within a month. typically follows an injury and disappears once the injury heals or is effectively treated, often within a month.
Acute Pain
- may begin with an acute episode but does not decrease over time, even when the injury has healed or effective treatments have been administered
CHRONIC PAIN
- overt manifestations of experienced pain
- include changing the way one sits or walks, continually complaining about pain to others,
grimacing, and, most important, avoiding various activities, particularly those involving work or leisure.
PAIN BEHAVIOR
- emotional component of pain
- sometimes accompanies pain and sometimes does not (Fordyce, 1988; Liebeskind, 1991)
SUFFERING
- whether or not he or she can deal with the pain and its consequences in an effective and
meaningful way - When a positive sense of control is combined with a generally optimistic outlook about the future, there is substantially less distress and disability
GENERAL SENSE OF CONTROL OVER SITUATION
- predict who will suffer chronic pain (Flor & Turk, 2011; Taylor, 2009)
- profile of negative emotion such as anxiety and depression, poor coping skills, low social support, and the possibility of being compensated for pain through disability claims predict most types of chronic pain
PRE-EXISTING ANXIETY & PERSONALITY PROBLEMS
- Individuals who lost a limb feel excruciating pain in the limb that is no longer there.
- changes in the sensory cortex of the brain may contribute to this phenomenon (Flor et al., 1995;
Katz & Gagliese, 1999; Ramachandran, 1993
PHANTOM LIMB PAIN
For example, family members who were formerly critical and demanding may become caring and sympathetic. Behavior clearly seems under the control of social consequences.
OPERANT CONTROL
- nerve impulses from painful stimuli make their way to the spinal column and from there to the brain.
GATE CONTROL THEORY OF PAIN
acts as a “gate” and may open and transmit
sensations of pain if the stimulation is sufficiently intense
DORSAL HORNS OF THE SPINAL COLUMN
- Formerly NEURASTHENIA, literally “lack of nerve strength” (Abbey & Garfinkel, 1991; Costa
e Silva & De Girolamo, 1990). - attributed to an extremely stressful environment, the changing role of women, and the rapid dissemination of new technology and information.
- ( Abbey and Garfinkel, 1991) the condition represents a rather nonspecific response to stress, and Heim and colleagues (2006) found a higher level of adverse early stressful events in people with CFS compared with non fatigued controls.
CHRONIC FATIGUE SYNDROME
- leads to lack of stamina, weakness, and increased feelings of depression and helplessness that in turn result in episodic bursts of long activity followed by further fatigue
CHRONIC INACTIVITY
that encourages patients to slowly increase and maintain their physical activities (such as aerobic exercise and housework) without leading to exertion has sustained benefits on CFS symptoms.
Behavioral Intervention
- Includes procedures to increase activity, regulate periods of rest, and direct cognitive therapy.
This treatment also includes relaxation, breathing exercises, and general stress-reduction
procedures. - Individuals who completed cognitive-behavioral therapy achieved substantial improvement in physical functioning at a 6-month follow up, a 5-year follow up indicates the gains were largely maintained.
Cognitive Behavioral Treatment
- is a process of making patients aware of specific physiological functions that, ordinarily, they would not notice consciously, such as heart rate, blood pressure, muscle tension in specific areas of the body, electroencephalogram rhythms (brain waves), and patterns of blood flow.
- the patient learns to control physiological responses that are visible on a screen.
- to reduce tension in the muscles of the head and scalp, thereby relieving headache, although no more successful than deep muscle relaxation procedures.
BIOFEEDBACK
people purposely tense different muscle groups in a sequential fashion followed by relaxing each specific muscle group.
PROGRESSIVE MUSCLE RELAXATION
a person silently repeats a mantra (focusing attention solely on a repeated syllable) to minimize distraction by closing the mind to intruding thoughts.
Relaxation response (Meditation)
appears to be effective for a range of problems, including stress, and especially anxiety and depression
Mindfulness meditation
Patients learn to monitor their stress, are taught deep muscle relaxation, which first involves tensing various muscles to identify the location of different muscle groups. Clients are then systematically taught to relax the muscle groups beyond the point of inactivity, that is, to actively let go of the muscle so that no tension remains in it.
Appraisals and attitudes are an important part of stress, and clients learn how they exaggerate the negative impact of events in their day-to-day lives.
A Comprehensive Stress- and Pain-Reduction Program
Some evidence suggests that chronic reliance on these medications lessens the efficacy of comprehensive programs in the treatment of headache and may make headaches worse because patients experience increased headache pain every time the medication wears off or is stopped (rebound headaches).
Drugs and Stress-Reduction Programs
Beginning with Sigmund Freud, mental health professionals have recognized the importance of reliving or processing intense emotional experiences to put them behind us and to develop better coping responses.
Denial as a Means of Coping
China has one of the most tobacco-addicted populations in the world. Approximately 320 million people in China are habitual smokers, a number that is greater than the entire population of the United States.
- Health professionals conducted the largest study yet reported of attempted behavior modification to promote health, wherein; the children’s intervention when their father’s smoking had some effect or somehow made them quit smoking for at least 6 months.
- Several myths that characterize Chinese smokers:
- The identification of smoking as a symbol of personal freedom.
- A perception that tobacco is important in social and cultural interactions.
- The perception that the health effects of smoking can be controlled through
reasonable and measured use. - The importance of tobacco to the economy.
Smoking in China
- One of the best-known and most successful efforts to reduce risk factors for disease in the
community. - It measured the effectiveness of media campaigns and community-wide health education plus a specific high risk intervention on cardiovascular risk factor levels.
- Rather than assemble three groups of people, investigators studied three entire communities in central California that were reasonably alike in size and type of residents between 1972 and 1975.
Stanford Three Community Study
