Chapter 9 Physical Disorders and Health Psychology Flashcards
Behavioral medicine
- psychology applied to prevention, diagnosis, and treatment of illness
- This is an interdisciplinary field in which psychologists, physicians, and other health professionals work closely together to develop new treatments and preventive strategies.
Health psychology
- psychology of being healthy; system level interventions
- Is not interdisciplinary
- A subfield of behavioral medicine
Psychological and social factors influence health and physical problems in two distinct ways
- They can affect the basic biological processes that lead to illness and disease
- Long-standing behavior patterns may put people at risk to develop certain physical disorders.
- Sometimes both these avenues contribute to the etiology or maintenance of disease.
Selye theorized that the body goes through several stages in response to sustained stress.- General adaptation syndrome (GAS)
- Alarm
- Resistance
- Exhaustion
* go through stages in response to sustained stress
Alarm
- response to immediate danger or threat
2. Phase 1: Alarm response (sympathetic arousal)
Resistance
- mobilize various coping mechanisms to respond to the stress
- Phase 2: Resistance (mobilized coping and action)
Exhaustion
- our bodies suffer permanent damage or death
2. Phase 3: Exhaustion (chronic stress, permanent damage)
Stress
the physical response to the stressor
Stressor
a factor that increases the “load” (psychological, emotional, physical) on a person
Physiology of Stress
Sympathetic nervous system activation
HPA axis and other hormones like cortisol are released
Hippocampal control of stress response via cortisol feedback
Stress and the Immune system: clear link between stress and immune system
stress, negative emotion linked to duration of induced cold; colds, herpes, monocuclosis are all linked to stress
- marital discor, relationship problems, job loss, bereavement all linked to lowered immune function
- effects can occur as rapidly as 2 hours post-onset of stressor
stress hormones
cortisol and other related hormones with a close relationship to the stress response
corticotropin-releasing factor (CRF)
1 of the neurohormones; is secreted by the hypothalamus & stimulates the pituitary gland
Self-efficacy
A sense of control and confidence that we can cope with stress or challenges
-Bandura
Immune system
- Protects the body from any foreign materials that may enter it.
- The effect of stress on susceptibility to infections is mediated through the immune system
Chronic stress
- last longer
2. early stressful events, preexisting stress, emotional instability
Antigens
- foreign materials entering the body (viruses, bacteria, parasite, donated organs
- Can be any of a number of substances, usually bacteria, viruses, or parasites.
leukocytes
white blood cells; most of the work
Macrophages
- A type of leukocytes that surrounds identifiable antigens and destroys them
- leukocytes; might be considered 1 of the body’s first lines of defense:They surround identifiable antigens & destroy them; signal lymphocytes
Lymphocytes
- consist of two groups, B cells & T cells; signaled by macrophages
B cells
- operate w/in the humoral part of the immune system, releasing molecules that seek antigens in blood & other bodily fluids w/ the purpose of neutralizing them; produce immunoglobulins
- Lymphocytes that operate within the humoral part of the system and circulate in the blood and bodily fluids
T cells
- don’t produce antibodies; operate in the cellular branch of the immune system
- have several subgroups: helper T cells signal B cells to keep producing antibodies and trigger killer T cells to directly attack antigens
Killer T cells
- subgroup of T cells, that directly destroys viral infections and cancerous processes
- This subgroup targets viral infections within the cells by directly destroying the antigens
Memory T cells
- created to speed future responses to the same antigen
immunoglobulins
- (Assess your knowledge of the immune system by matching components of the immune system w/ their function in the body: macrophages, B cells, immunoglobulins, killer T cells, suppressor T cells, memory B cells)
- Highly specific molecules that act as antibodies. They combine w/ antigens to neutralize them.
Memory B Cells
- (Assess your knowledge of the immune system by matching components of the immune system w/ their function in the body: macrophages, B cells, immunoglobulins, killer T cells, suppressor T cells, memory B cells)
- These are created so that when a specific antigen is encountered in the future, the immune response will be faster.
Helper T cells/ T4 cells
- enhance the immune system response by signaling B cells to produce antibodies & telling other T cells to destroy the antigen
Suppressor T cells
- suppress the production of antibodies by B cells when they are no longer needed.
- shut down the immune functions when the attack ends
Autoimmune disease
happens when the immune system attacks the body, treating tissues and organs as antigens 9 when there are too many help T cells)
Psychoneuroimmunology/PNI
- the study of the connections between the mind and the immune system
- the object of study is psychological influences on the neurological responding implicated in our immune response
AIDS-related complex (ARC)
- Once a person is infected with HIV, the course of the disease is quite variable.
- After several months to several years with no symptoms, patients may develop minor health problems such as weight loss, fever, and nigh sweats- symptoms that make up the condition known as AIDS-related complex (ARC)
What are psychosocial effects on AIDS
- stress and lack of social support speed progression of the disease
- stress reduction decreases viral load, increases immune function
- Not clear whether interventions will increase survival time
Cancer
- Category of often-fatal medical conditions involving abnormal cell growth and malignancy
Oncology
study of cancer
Psychosocial effects on Cancer
psychological factors may contribute to development of cancer; positive effects of cancer diagnosis (resilience)
Psychoncology
Study of psychological factors involved in the course and treatment of cancer
Cardiovascular system
- consists of the heart, blood vessels, & complex control mechanisms for regulating their function
Cardiovascular disease
Afflictions in the mechanisms, including the heart, blood vessels, and their controllers, responsible for transporting blood to the body’s tissues and organs. Psychological factors may play important roles in such diseases and their treatments.
Strokes/Cerebral vascular accidents (CVAs)
Temporary blockage of blood vessels supplying the brain, or a rupture of vessels in the brain, resulting in temporary or permanent loss of brain functioning
Hypertension
- associated with premature mortality
- most cases have no clear cause
- Sympathetic arousal contributes to high BP; link to stress
- (hostility and time urgency strongly linked to high BP, but constructive expression of anger helps)
- relationship between social support and high BP is moderated by loneliness, depression, self efficacy
- Major risk factor for stroke and heart and kidney disease that is intimately related to psychological factors. Also known as high blood pressure.
Essential hypertension
High blood pressure with no verifiable physical cause, which makes up the overwhelming majority of high blood pressure cases.
Systolic blood pressure
- the pressure when the heart is pumping blood
Diastolic blood pressure
- the pressure b/w beats when the heart is at rest.
Coronary heart disease (CHD)
blockage of major arteries
- stress, anxiety, anger, poor coping skills, low social support all linked to CHD
- stress-reduction interventions improve heart function, reduce mortality
- Type A personalities are 2x as likely to develop CHD
- chronic negative emotions contribute
Myocardium
- Heart muscle
2. heart muscle that’s arteries are blocked during coronary heart disease
Angina pectoris/angina
Chest pain result from partial obstruction of the arteries
Atherosclerosis
Occurs when a fatty substance or plaque builds up inside the arteries and causes an obstruction
Ischemia
Name for deficiency of blood to a body part caused by the narrowing of the arteries by too much plaque.
Myocardial infarction/heart attack
- The death of heart tissue when a specific artery becomes clogged with plaque.
- death of heart tissue when a specific artery becomes clogged w/ plaque
Myocardial stunning
- Is basically heart failure
2. heart failure caused by stress
Type A behavior pattern
Cluster of behaviors including excessive competitiveness, time-pressured impatience, accelerated speech, and anger, originally thought to promote high risk for heart disease
Type B behavior pattern
Cluster of behaviors including a relaxed attitude, indifference to time pressure, and less forceful ambition; originally thought to promote low risk for heart disease
There are two kinds of clinical pain
Acute pain and chronic pain
Acute pain
Pain that typically follows an injury and disappears once the injury heals or is effectively treated
Chronic pain
- pain that persists over time, even when an injury has healed or has been treated
-largely a psychological and social problem
(intensity of pain does not predict reactions
- negative emotions, poor coping, low SS, secondary gains all predict worse reactions (operant conditioning)
- Positive emotions, good coping, sense of control all predict better reactions - Enduring pain that does not decrease over time; ay occur in muscles, joints, and lower back, and may be caused by enlarged blood vessels or degenerating or cancerous tissue. Other significant factors are social and psychological.
Pain behaviors
- include changing the way one sits or walks, continually complaining about pain to others, grimacing, &, most important, avoiding various activities, particularly those involving work or leisure
- Observable manifestations of the private experience of pain. These may include wincing or other facial expressions, verbal complaints of distress, and avoidance of activities that increase pain sensations
Suffering
An emotional component of pain
-sometimes accompanies pain and sometimes does not
Phantom limb pain
- people who have lost an arm or leg feel excruciating pain in the limb that is no longer there.
Operant control of pain behavior
the behavior clearly seems under the control of social consequences
-Have an uncertain relation to the amount of pain being experienced
Gate control theory of pain
- accommodates both psychological & physical factors; nerve impulses from painful stimuli make their way to the spinal column & from there to the brain.
Dorsal horns of the spinal column
acts as a “gate” & may open & transmit sensations of pain if the stimulation is sufficiently intense (part of gate control theory)
Small fibers
Specific nerve fibers (A-delta and C fibers) that work along with large fibers determine the pattern & intensity of the stimulation; tend to open the gate, thereby increasing the transmission of painful stimuli,
Large fibers
Specific nerve fibers (A-beta fibers) that work along with small fibers determine the pattern & intensity of the stimulation; tend to close the gate
Endogenous (natural) opioids
Substances occurring naturally throughout the body that function like neurotransmitters to shut down pain sensation even in the presence of marked tissue damage. These may contribute to psychological problems such as eating disorders.
- Endorphins/enkephalins
Neurasthenia
- lack of energy, marked fatigue, a variety of aches and pains, & occasionally low-grade fever, but no physical pathology was discovered
Chronic fatigue syndrome (CFS)
- low energy, fatigue, body pain, fever, other vague/ nonspecific symptoms with no clear medical cause
- Better mental health more psychological outlook, less use of sedating medications all associated with better outcomes
- may be related to chronic stress: early stressful events, preexisting stress, emotional instability
- CBT seems to work well - Incapacitating exhaustion following only minimal exertion, accompanied by fever, headaches, muscle and join pain, depression, and anxiety.
Biofeedback
- Physiological monitoring to make patients aware of involuntary functions, gain (sense of) control
- Use of physiological monitoring equipment to make individuals aware of their own bodily functions, such as blood pressure or brain waves, that they cannot normally access, with the purpose of controlling these functions
Progressive muscle relaxation
- people purposely tense different muscle groups in a sequential fashion followed by relaxing each specific muscle group. In this way they learn to recognize tension in different muscle groups & how to reduce it
Transcendental meditation
- attention is focused solely on a repeated syllable (mantra)
Relaxation response
Active components of meditation methods, including repetitive thoughts of a sound to reduce distracting thoughts and closing the mind to other intruding thoughts, that decrease the flow of stress hormones and neurotransmitters and cause a feeling of calm.
Time-management training
- patients are taught to prioritize their activities & pay less attention to nonessential demands
Assertiveness training
- learn to stand up for themselves in an appropriate way
This subgroup targets viral infections within the cells by directly destroying the antigens
Killer T cells
A type of leukocytes that surrounds identifiable antigens and destroys them
Macrophages
Highly specific molecules that act as antibodies. They combine w/ antigens to neutralize them.
Immunoglobulins
Lymphocytes that operate within the humoral part of the system and circulate in the blood and bodily fluids
B Cells
These are created so that when a specific antigen is encountered in the future, the immune response will be faster.
Memory B Cells
These T cells stop the production of antibodies by B cells when they are no longer needed.
Suppressor T cells
Which of the following is not considered part of the experience of pain?
(a) The subjective impression of pain as reported by the patient
(b) Pain behaviors or overt manifestations of pain
(c) Cuts, bruises, & other injuries
(d) An emotional component called suffering
(c) Cuts, bruises, & other injuries
Some evidence shows that psychological factors may contribute to both the course & the _______ of cancer, AIDS, & other diseases, as well as treatment & recovery.
development
Psychosocial & biological factors contribute to the development of _______, a potentially deadly condition of high blood pressure, & to the development of _______, the blockage of arteries supplying blood to the heart muscle.
hypertension; coronary heart disease
Psychologists have found that behavior pattern “types” impact physical health. ___________ is associated with the development of illness to a greater extent than is _________.
type A (hard-driving, impatient), type B (relaxed, less concerned)
No confirmed evidence exists to show that there is a physical cause for the disease of ______ that often causes individuals to give up their careers & suffer considerably.
chronic fatigue syndrome
(Check your understanding of psychosocial treatment by matching the treatments to the correct scenarios or statements: biofeedback, meditation & relaxation, cognitive coping procedures,
denial, modify behaviors to promote health, Stanford 3 Community Study.)
Mary is often upset by stupid things other people are always doing. Her doctor wants her to realize her exaggeration of these events & suggests ________.
cognitive coping procedures
(Check your understanding of psychosocial treatment by matching the treatments to the correct scenarios or statements: biofeedback, meditation & relaxation, cognitive coping procedures,
denial, modify behaviors to promote health, Stanford 3 Community Study.)
Tyrone can’t seem to focus on anything at work. He feels too stressed. He needs __________, a way of minimizing intruding thoughts that he can do at work in a short amount of time.
meditation & relaxation
(Check your understanding of psychosocial treatment by matching the treatments to the correct scenarios or statements: biofeedback, meditation & relaxation, cognitive coping procedures,
denial, modify behaviors to promote health, Stanford 3 Community Study.)
Harry’s blood pressure soars when he feels stressed. His doctor showed him how to become aware of his body process to control them better by using _________.
biofeedback
(Check your understanding of psychosocial treatment by matching the treatments to the correct scenarios or statements: biofeedback, meditation & relaxation, cognitive coping procedures,
denial, modify behaviors to promote health, Stanford 3 Community Study.)
At a world conference, leaders met to discuss how to reduce the risk of childhood injuries, AIDS risks, & the number of smoking-related diseases. Professionals suggested programs involving teaching individuals how to __________.
modify behaviors to promote health
(Check your understanding of psychosocial treatment by matching the treatments to the correct scenarios or statements: biofeedback, meditation & relaxation, cognitive coping procedures,
denial, modify behaviors to promote health, Stanford 3 Community Study.)
Initially, strong ______ can help a patient endure the shock of bad news; however, later it can inhibit or prevent the healing process.
denial
(Check your understanding of psychosocial treatment by matching the treatments to the correct scenarios or statements: biofeedback, meditation & relaxation, cognitive coping procedures,
denial, modify behaviors to promote health, Stanford 3 Community Study.)
The _________ is 1 of the best-known efforts to reduce community disease risk factors.
Stanford 3 Community Study
