Exam 1 Flashcards
definition of health
A state of complete physical, mental, and social well-being and not just the absence of disease or infirmity
psychology
the study of the mind and behavior ⇒ embraces all aspects of the human experience from the functions of the brain to the actions of nations, from child development to care for the aged
health psychology
the aggregate of special educational, scientific, and professional contributions of the discipline of psychology to the promotion/maintenance of health, prevention/treatment of disease, the identification of etiologic and diagnostic correlates of health, illness, and related dysfunction, and the analysis and improvements of the health care system and health policy formation
health psychology goals (4)
- Promote and maintain health
- Prevent and treat illness
- Understand etiology and diagnosis
- Improve health care system and policy
what is the solution to the problem of ill health in America?
individual responsibility and social responsibility through public legislation and private volunteer efforts
BPS Model (BPSM)
biopsychosocial model
1. biological systems => immune, hereditary
2. psychological systems => personality, interests, competitiveness
3. proximate social systems => family, athletics, friends, school
4. distal social system => government, state legislature
things patients consider (5)
- how long they wait to see you
- How readily they disclose their symptoms
- What they want in terms of the visit or treatment
- How your knowledge of them affects your diagnosis
- How they will comply with your prescribed treatment
who were the people of Roseto?
Italian American immigrant community with less heart disease than most of the rest of America due to culture, habits, and emotional safety => went away as they Americanized
Trepanning
Drilled holes in the skull for patient with headaches or epilepsy where evil spirits need to be released => medical and religious
imhotep
god of medicine 2670 BCE famous for his skills when we lived as a doctor (Egypt)
ancient egyptian medical practices
Physicians, surgeons, and spiritualists (invoke supernatural forces => Human excretions, hippo fat, specialized tools for surgeries like fractures and cysts, spiritualists treated with incantations
Ebers papyrus
medical classifications and treatments c. 1550 BCE (Egypt)
ancient middle eastern medicine
Mesopotamia ⇒ Iraq, syria, turkey, and iran
- If a patient died the doctors hand may be cutoff, Gods and astrology, Mesopotamian tablets c. 650 BCE: lists medical conditions and treatments
Regulation of medical practice
ancient india medical practices
docs used incantations, surgery, vital energy channels, and points on the body important for different function
Ayurveda
life wisdom with the 5 elements (space, air, fire, water, earth)
- health was based on individual element balance and illness is due to elemental excess so treatments like detoxification, herbs, food, yoga, meditation combated this (India)
Ayurveda health categories (3)
- Vata dosha (movement): space (lightness) and air (coldness, dryness, mobility)
- Pitta dosha (transformation): fire (heat, illumination), water (fluidity)
- Kapha dosha (binding): water, earth (stability, solidity)
- someone dominant dosha is what shapes their body and personality
what is special aboutn ancient china?
moves away from ancient health practices of spiritualism to health
ancient chinese medical practices
Medicine became separate from religion and magic c 400 BCE, Grading systems of medical professionals , Vital energy channels and points on the body important for different functions , Nei Ching c. 479 BCE ⇒ chi and its path
traditional chinese medicine
5 basic elements: fire, water, earth, wood, metal, Health based on individual elemental balance, Health also based on balance between complementary forces yin and yang, Treatment inlide hearbs, tai chi, and acupuncture and focus on restoring elemental balance and energetic flow
Asklepios (Greek) and Aesculapius (Roman)
god of medicine with temples for treatment => psyche/soul became the domain of philosophers, body is its slave
Empedocles
philosphopher who came up with 4 elements => Air, earth, fire, and water, psych is in the heart (Greek)
Plato and Aristotle
philosophers (Plato came first) with rationale and irrational souls, localization of psych functions => Did the soul control the body or did the body control the soul? (Greek)
What is special about roman and greek medicine?
shifts to natural explainations from spiritual ones (same as in China)
Hippocrates
asserts disease is due to natural causes, father of western medicine, hippocrates oath, humoral theory based on on elements c. 400 BCE
Blood, black bile, yellow bile, and phlegm (Greek)
Galen
physician and writer, continued humoral theory but also noticed in surgery that disease could be localized, soul is the slave of the body => soul is in the head (Greek)
According to galen Air, Earth, Fire, and Water correlate to which of his 4 elements
- A = blood
- E = black bile
- F = yellow bile
- W = phlegm
dark ages period
(500-1500 CE) long pause in western inquiry, llumination from intellectualism was snuffed out from the church, Left theoriests of the human body and soul hiding in the shadows, Many people were dying from the plague as well took away stability for intellectual inquiry
the renaissance period
(1300-1500 CE) Rebirth of inquiry and culture from religion centered to human centered
Da vinci (1452-1519)
anatomy through art
Vesalius (1515-1564)
physician and artist, 7 volumes about human body, anatomical pathology
the scientific revolution (person + 4 techniques)
- Descartes (1956-1650) body analogous to a machine, separate soul, dualism
- Microscopy
- Cell theory and microbes discovery
- Germ theory
- Phrenology
what was speical about the scientific revolution
we wanted to localize personality to parts of the brain
- identified criminals and undesirables
present and near future medical technology
- pathology
- genetics
-microbiome - neuroscience
- dualism
- monism
neuroscience
localization and physiology of psychological function based on minimally invasive technology
- Flow of chemical and electrical activity
- Increasingly precise locations in the brain
dualism
body and soul
monism
body alone
major social factors of infectious disease (3)
- Poor, overcrowded housing
- Lack of clean, public water supply
- Lack of waste control
most deadly diseases past and present
past: pneumonia, tuberculosis, diarrhea, enteritis
present: heart disease, cancer, strokes => diabetes, obesity, arthritis, chronic health conditions overall
what was child mortality in the 1900s?
30% under childen age 5 => became 2% by 1997
factors changing infectious morbidity and mortality
- Improvements in sanitation and hygiene
- Vaccinations
- Discovery of antibiotics ⇒ prescribed for previous life threatening bacterial infections
what outbreak happened in London later?
cholera
stress
occurs when an individual perceives that environmental demands tax or exceed their capacity ⇒ process of an individual response (perception)
- first coined in bridge engineering
stressors
refers to the experience or circumstance that provokes a response => Can reside in the individual or can come from conflict with family members or from the community
stress sources
community, family, self, physical, psychological
acute vs chronic stress
short lived vs extended periods of time
appraisal (lazarus) => primary vs secondary vs reappraisal
subjective experience
1. Primary appraisal: initial judgment about relevance and significance ⇒ such as am I in trouble
2. Secondary appraisal: when we determine something is stressful ⇒ what can I do about it
3. Reappraisal: evaluate our response ⇒ how did things go and whats next
stressor characteristics (5)
negative, ambiguous, uncontrollable, overwhelming, important
system
collection of coordinated body parts and the chemicals they produce
Sympathetic nervous system
the neural connection to many parts of the body and results in mental alertness, pupil dilation, rapid breathing, increased energy, sweating, dry mouth, stalled digestion, urination, and bowel emptying
parasympathetic
brings restoration after stress
Sympathetic adrenal medullary (SAM)
core of the adrenal gland and a collection of cells that sit above the kidneys ⇒ release chemicals into the bloodstream to activate the sympathetic nervous system
- nervous and hormonal systems
- epinephrine and norepinephrine
Epinephrine
adrenaline to activate fight or flight, above the kidneys ⇒ signal stimulated by the adrenal medullary
Norepinephrine
increases alertness and attention
and another signal stimulated by the adrenal medullary
what is fight or flight?
provides urgent energy needed for survival, the body increases oxygen and blood flow to muscles, and stops other processes
- Parasympathetic calms the body down afterward
Homeostasis
state where the body has reached balance again
HPA Axis
- comes from Selye
- Hypothalamus (head) => corticotropic releasing hormone
- Pituitary (head) => adrenocortitoctropic hormone
- Adrenal(kidney) => cortisol
- acts as a negative feedback system
cortisol
released from the adrenal gland which calms the body system down and stimulates the release of glucose to feed muscle cells
- trvels back up to the hypothalamus and pituitary gland for calm
- high cortisol can cause weight gain, acne, and fatigue
does HPA or SAM work faster?
SAM does => HPA is a hormonal response compared to a nerve response
Who is Selye and what did he discover?
fathered stress research and did experiments on rats while conducting post mortem analysis to see what changes occurred to their organs
- adrenal hypertrophy, thymus atrophy, gastric ulceration
- he also came up with the GAS
general adaptation syndrome
Alarm, resistance, exhaustion which can result in disease or death if gone on for too long
allostasis and allostatic load
differing from normal equilibrium balance through change; cost of allostasis
how do relationships affect allostatic load?
we respond to nurturance and social affiliation to produce oxytocin, vasopressin, and endorphins (& dopamine) from the pituitary gland give us a sense of wellbeing and reward
- women engage in this more and get more benefit
- we all produce oxytocin (more common in females for bonding) and vasopressin (more common in males for bonding)
What did James lange believe
physiological response over emotional response => body is triggered first
what did Cannon-bard and Lazarus believe
cognitive response over physiological response => conscious is triggered first
what did DeLouix believe?
physiological vs emotional stress response depends because sometimes the body reacts faster and other times the cognitive process causes reactions later
questionnaire measurement considerations for stress (8)
- stressor inclusion
- stressor intensity
- stressor duration
- experimental control vs ecological validity
- physiological variables
- physiological outcomes
- psychosocial and behavioral outcomes
- frequency of measurement
experimental control vs ecological validity
things that happen in real life may need to be sacrificed to fully control the stressor in a study and make it the same across individuals
psychosocial and behavioral outcomes
how does life produce more stress for certain people such as in vocation
adult life questionnaire examples
Holmes and Rahe
spouse death, divorce, marital separation, jail, pregnancy, children leaving, changing residence, vacation, eating habits
adolescent life questionnaire examples
Yaeworth; Holmes and Rahe
parent death, sibling death, friend death, parent divorce, losing jobs, change in physicality, starting a job, sibling marriage
hassles and uplifts scale
DeLongis, Folkman, and Lazarus
smaller events in our lives that tend to occur more frequently; The sum of both your hassles and sum of your uplifts for a given time period gives you a rating
time sampling
trades questionnaires or combines questionnaires with short frequent inquiries at certain times of the day over a phone call or a time slot
physiological measurement examples (2)
biochem assays => epinephrine/norepinephrine (blood), cortisol (blood and saliva)
polygraph devices to measure SAM => respiration, blood pressure, Galvanic skin response (sweat/conductance), heart rate
how does stress negatively affect health (2)
- direct physiological => SAM, HPA, chronic activation
- behavior and illness => sleeping, eating, smoking, drinking, drugs, medical attention, treatment adherance, changes in social life
stress physical health associations (9)
- cardiovascular disease (CVD)
- gastrointestinal
- Immunity
- Cancer
- blood and sugar and fat
- Growth
- reproduction
- Aging
- Pain
cardiovascular disease
(individual differences, intermediate CVD, advanced CVD)
#1 casue of death b/c cholesterol can accumulate which obstructs blood flow and bulges inward => Plaque can rupture into the lumen or arterial opening which triggers the body’s repair response that involves clotting to seal the wound
- Increased blood pressure
- Arterial damage
- Increased plaque formation
- Inflammation and coagulation
ischemia
inadequate blood supply to an organ which reduces blood flow
angina
chest pain
infarction
tissue dies due to a lodged blood clot
atherosclerosis
thickening of the arteries which makes them less flexible and less able to respond to changes in blood pressure => more damage likely
gastrointestinal stress
exacerbate ulcers and IBS, SAM shuts down digestion making stomach lining vulnerable, diarrhea, constipation, HPA stimulates/suppresses appetite
immunity stress response
sometimes increases and sometimes decreases depending on the type of stress response and duration
cancer and stress
highly mixed studies but animal research finds tumor initiation, growth, metastasis, and may act through immune system defenses, DNA repair, or cellular aging
blood sugar and fat stress response
increased blood sugar and fats from released storage, increases insulin resistance and diabetes due to blockage by cortisol, higher sugar and fat in blood contributes to CVD/damaged nerves
growth stress response
reduced growth hormone from pituitary gland due to neural and cortisol input (cortisol blocks calcium uptake), reduced bone growth and increased bone weakness, digestive problems
psychogenic dwarfism
extreme chronic stress can inhibit growth in children
reproduction and stress
reduces reproductive hormones, disrupts gamete production, sex drive, interferes with sex performance, misscarriages
Aging and stress
stress speeds up aging due to telomere shortening, hippocampal problems and memory problems from cortisol inhibiting insulin/glucose entry, stress response declines, prolonged effects, resting chemicals are higher
what lifestyle factors are telomeres associated with
food, sleep, exercise, tobacco/alcohol, etc.
pain and stress
decreased pain perception in short term but increased pain perception chronically
research challenges (7)
- Differences in stage of disease and lack of identification and access at early stages
- Differences in disease subtypes
- Differences in types of stressors, including frequency and duration
- Differences in timing of stress to disease process
- A disease process may be very slow and thus difficult to follow ⇒ decreased participation and continued funding
- Lack of control in human studies ⇒ disease and stressor variability
- Animal models may not be applicable to humans
Psychoneuroimmunology (PNI)
how a psychological experience effects immune functioning and nervous functioning
complement immunity
collection of circulating proteins that complement antibodies (another set of proteins used by the immune system)
- damage invaders, attract immune cells to a site, bind to invaders and tag them
Leukocyte types; where they are found
- phagocytes: eat invader cells
- lymphocytes: cells of the lymph that attack and destroy invaders
- scattered throughout blood vessels, tissues in interstitial fluid, and lymphatic system
lympathic system components
cardiovascular and lymph where smooth muscles help move the fluids from the body to the neck where they drain into the veins of the cardiovascular system
nodes
(swelling) located along the vessels where immune system cells gather and filter cellular waste, dead cells, and pathogens
- invader cells or cancer cells may be brought here so immune systems can destroy them
lymth
colorless liquid that passes from the blood into the tissues and into the lymph vessels before going back to the blood vessels
- moved by your body movements and its muscles but not pumped
what does lymph do?
Carries cellular waste, dead cells, and pathogens and transports white blood cells
Organs of the immune system (5)
- Tonsils: lymph nodes at the junction of your oral cavity and throat
- Thymus gland: behind your sternum and site of maturation for some immune cells
- Spleen: behind your stomach and is a hybrid of cardiovascular and lymph systems
- Bone marrow: source of immune stem cells ⇒ some mature and some are sent to the thymus gland
- Intestines: fats are transported from the small intestine to the lymph system before entering the blood => High amounts of fat gives lymph and plasma a milky appearance
Non-specific immunity components
- barriers like the skin
- complement proteins labeling pathogens
- phagocytosis where macrophages will eat cells that are labeled
- toxins using chemical warfare from complement proteins and immune cells
- inflammation
- cytokines
inflammation defense system
triggered by complement proteins, cytokines, and immune cells
- Making blood vessels dilate, producing redness, leak plasma which causes swelling to bring immune cells to the affected area
cytokines
chemical messages that moves another cell to act within and beyond the immune system
- Very important for the coordinated action the immune system can take against an invader
major functions of nonspecific immunity (5)
- Block entry of pathogens
- Recognize non-self materials
- Congregate at site of wound or infection and release toxins and ingest pathogens
- Stimulate inflammation
- Communicate the news of invasion to other immune cells
specific immunity major players (3)
lymphocytes: white blood cells produced in bone marrow and travel throughout the lymphatic system
- T cells, B cells, Natural killer cells which have receptors specific to particular pathogens (cellular memory)
T cells
(T = thymus where they finish maturing) destroy pathogens or the body’s own cells that have been taken over by viruses and also send signals to help control the immune systems response to threats
B cells
(B = bone marrow where they finish maturing) make proteins called antibodies to fight pathogens
Natural killer cells
recognize specific targets through the genetic code and will attack these certain targets
- finish maturing in the bone marrow
Major functions after pathogen interaction (4)
- Lymphocyte production ⇒ make copies of themselves to increase disease fighting cells
- Antibody production ⇒ pathogen identification and tagging and communicate information about the pathogen
- Communication (cytokines) ⇒ activation of other cells
- Recognition ⇒ memory
deficiency (2 subcategories)
persons may be born a certain way or they can be acquired by infection
- congenital (birth defects) or acquired
autoimmunity
immunity directed at the self by a trigger
Asthma
excessive inflammatory response in the lungs and air passages
Anaphylaxis
a substance is encountered (bee sting or peanuts) which triggers antibody formation but antibodies linger and when the substance is encountered again the antibodies trigger a systemic inflammatory response
Type 1 Diabetes
partly due to genes that result in immune cells attacking the pancreas and destroying cells that make insulin
Multiple Sclerosis
attack on the myelin surrounding nerve fibers which prevents them from successfully and quickly transmitting signals
PNI connections (3)
- Stress => emotion, physiology, behavior
- Central nervous system => brain and spinal cord
- Autonomic nervous system => sympathetic and parasympathetic NS
immunology
the immune system made up of cells and cytokines
what does the sympathetic NS innervate?
lympth structures like Spleen, thymus, bone marrow, lymph nodes, lymphocytes
what does the vagus nerve innervate?
lymph structures => T cells > macrophages of the spleen = reduced inflammation
hypothalamus lesions do what?
decrease some immune functions => hypothalamus stimulation increases immune functions
what neurotransmitter receptors are found on immune organs and lymphocytes?
epinephrine, norepinephrine, and dopamine
nociceptors
peripheral pain sensory neurons that can activate the immune cells
when does psycho-neuro overpower the immune system?
SNS, vagus n., hypothalamus, neurotransmitters
when is immuno system > psycho-neuro?
when cytokines are activated => which affect neurotransmitters and turn on/off pain receptors
- cytokines stimulate SAM and HPA activity and nociceptors and the hypothalamus to make us sleepy
classical conditioning of the immune system
the unconditioned stimulus (US) brings an unconditioned response (UR) and the continued stimulus (CS) causes a conditioned response (CR)
- ex women who receive chemotherapy have immunosuppression when entering the hospital
acute stress is linked to what?
some increase in non-specific immunity
chronic stress is linked to what?
decreased immunity both specific and non specific
how does stress affect viral recovery?
when you are more stressed you suffer from worse symptoms and have a higher viral count
how does stress affect vaccinations?
when you are more stressed out you develop less antibodies
how does viral reactivation get affected by stress?
stress will cause lifelong viruses like epstein barr or herpes to reactivate
how does stress affect healing and recovery?
it slows wound healing down as well as recovery in general
how do acute stressors affect us
Increase in non-specific immune responses and Decreases in specific immune response
how do brief naturalistic stressors affect us
Some decreases and some increases in non specific responses; Decrease in specific cellular response/lymphocyte production, but increase in specific antibody responses
how do event sequence stressors affect us?
some decreases, some increases, and some that didn’t change
how do chronic stressors affect us?
Very little change in immune cell numbers but wide spread decreases in function and evidence for viral reactivation; Decreases in nonspecific and specific alongside viral reactivation
how does severe trauma affect us?
No consistent changes
how did people on questionnaires get affected by stress?
Decreases in immune function for older (+55) and ill (HIV/aids), not young and healthy; Young and healthy individuals are unaffected or resilient ⇒ older and chronic health condition were more vulnerable
how are people affected globally by stress?
No consistent changes
Meta analysis highlights (4)
- Acute stressors were associated with increased nonspecific immunity
- Chronic stress was associated with decreased immunity
- Age and illness made the immune system more vulnerable to stress effects
- No support here for appraisal being related to immunity
conclusions for stress immunity (6)
- Too simplistic
- Sometimes suppresses chronic and sometimes activates acute
- Can suppress some aspects but activate others
- Patterns of activation and suppression differ with stressors and individuals
- Much more research is needed to find consistent patterns among the effects
- Research is needed to link immune changes to disease
emotion focused coping functions
strategies that work to decrease negative emotions or increase positive emotions
- Used more often when it is believed change isn’t possible
problem focused coping functions
strategies that work to change or eliminate the source of stress
- it appears we cope best when we can change our strategies based on the particular event
preventative coping methods
strategies that reduce the likelihood of stressors or lessen their impact should they occur ⇒ proactive strategies
combative coping methods
strategies that are employed in the face of a stressor to eliminate it or lessen its impact
expressive writing
writing about traumatic experiences
- This confronts their related thoughts and emotions ⇒ reduces stress when writing is over but can raise anxiety during the activity
mindfulness-based stress reduction (MBSR)
these techniques focus the mind and gaining insight into one’s thought and more control over reactions to experiences
- Activates the prefrontal cortex which regulates negative emotions
self affirmations
affirming one’s values through self reflection
- Less distress, less stress physiology, and feel better about oneself
relaxation techniques definition
reduces tension and feelings of stress in the body
- Reduce stress physiology, inflammation, and blood lipids
benefits of positive coping (5)
- Avoid, reduce, or eliminate particular stressors
- Better adjustment physiologically to negative experiences
- Reduce stress responses
- Feel better about oneself
- Reduce the impact of stress on ones relationships
3 aspects of support
- Support type: the way in which a person helps you
- Support network size: how many people you have for support ⇒ individuals and social domains
- Support satisfaction: how supported you feel by your people ⇒ perceived quality
types of support (6)
- Emotional: comforting by listening, hugging, or being nearby
- Esteem: make us feel values, respected, and needed
- Tangible: help from goods and services provided ⇒ money, childcare, medical care, transportation, etc.
- Informational: the things we have learned from our people ⇒ jobs, parenting strategies, ideas for medical treatment, etc.
- Network: the connections we can access through our people ⇒ medical providers, job openings, etc.
- Invisible: given anonymously without a certain person overtly doing it
percieved support
a person’s belief of available support
- More stable over time, less related to context
- Most correlated with health outcomes and behaviors
- Low levels linked to CVD ⇒ plaque build up, cv reactivity, blood pressure
recieved support
what is actually provided in a situation
- More dependent on context and circumstances ⇒ can change with each event
- Effectiveness depends on the content and circumstances
- Mixed findings for relationship to health outcomes
- may lead to differences in the relationship between social support and health
Benefits of support (6)
- Lower likelihood of illness
- Speedier recovery from illness
- Slower disease progression
- Reduced chance of dying from serious illnesses
- Increased medical adherence
- Increased use of medical services
stress buffering
occurs during the stressor but lessens its harshness
- Affects experience appraisal
- Provides resources to deal with it
- Reduces physiological responses to stress
direct effects of stress buffering (6)
- Enhances self esteem
- Gives a sense of belonging
- Influences lifestyle and health behaviors
- Lower blood pressure, less atherosclerosis
- Lower circulating stress hormones ⇒ epinephrine and cortisol
- Better immune functioning ⇒ natural killer cell activity and resistance to viral infections
factors affecting use of suport (2)
- environmental factors
- the person themself
- people can learn to better recognize available support and be taught social skills including reduction of social anxiety
specific health risks for non-married people
CVD, infectious diseases, lung, and liver disease
which preceeds the other: health or marriage?
healthier people are more likely to get married
where do wives vs. husbands get their support?
wives get it from their social support networks and husbands get support from their wives most of the time
women may be more sensitive to conflict which causes … (2)
- Greater risk of mortality and morbidity due to marital problems
- Greater immune and stress responses that last longer than husbands
marriage dissatisfaction associations (5)
- Higher blood pressure and heart rate
- Lower self reported general health and higher self reported symptoms
- Greater pain perceptions
- Greater inflammatory disease flare ups
- Ulcer development
which bodily systems does marriage quality impact? (3)
- immune
- endocrine
- cardiovascular
how can marital conflict impair health? (4)
- There are many opportunities for conflict
- Couples may not adapt physiologically, thus producing high stress responses each time
- Stress responses from couple-conflicts are slower to recover than from other sources
- The risks are greater for troubled, distressed couples chronically
how does early social support influence us? (2)
- Personality, social skills, self esteem, and general perception of social support
- Psychological characteristics influences our health behaviors and coping skills which reflects in our health
conflict
repeated displays of anger and aggression ⇒ emotional or physical
non-nurturant
emotionally cold and unresponsive
life stage symptoms of risky family (3)
- Childhood
- Linked to problems with children’s emotional expression, social competence, stress physiology regulation, and higher rates of illness - Adolescence
- Greater cigarette, alcohol, and drug use
- Risk in sexual behavior in adolescence from less parental supervision, greater time with peers, and attempts to compensate for poorer social competence and emotional regulation - Adulthood
- Diseases in adulthood ⇒ CV, lung, liver disease, and fractures
risky family health indicators (5)
- Higher blood pressure
- Higher CV reactivity to a lab challenge ⇒ greater ventricular mass
- Higher anger and hostility
- Higher SAM activity due partially to reduced parasympathetic regulation
- HPA dysregulation ⇒ changes in circadian patterns and greater responses to challenges
nurturant mothers result in… (3)
low HPA reactivity, faster HPA recovery, and less anxiety
what does repeated SAM activation do? (3)
- a more hostile personality that with increased interpersonal conflict will increase health risks
- HPA system changes may similarly link early experiences and health risks
- Poorer emotional/stress regulation and social competence (hostility) would negatively affect one’s ability to obtain and maintain social support
bereavement
the situation of having recently lost a significant person through death
grief
reaction to bereavement
psychological consequences of loss (6)
- Emotional distress
- Loneliness
- Changes in social ties and support
- Changes in living arrangements
- Changes in economic circumstances
- Changes in health habits
anhedonia
loss of pleasure
emotional reactions to loss
Depression, despair, distress
Anxiety, fear, dread
Anger, hostility, irritability
Anhedonia: loss of pleasure
Loneliness
Yearning, longing, pining
Shock, numbness
cognitive reactions to loss
Preoccupation with thoughts of deceased, intrusive ruminations
Sense of presence of deceased
Suppression, denial
Lowered self esteem
Self-reproach
Helplessness, hopelessness
Suicidal ideation
Sense of unreality
Memory, concentration difficulties
behavioral reactions to loss
Agitation, tenseness, restlessness
Fatigue
Overactivity
Searching
Weeping, sobbing, crying
Social withdrawal
physical reactions to loss
Loss of appetite
Sleep disturbances
Energy loss, exhaustion
Somatic complaints
T/F there are differences across cultures in emotion, cognitive, and somatic reactions after loss
F => May be differences in use of medical services and in presenting symptoms
mortality risk for spouse loss
Increased risk appears greatest for husbands
Increased risk appears to persist up to a year for wives and 2 years for husbands
- actual numbers are low with 5% widowers vs 3% married men over 55 dying in the first 6 months
mortality risk for child loss
- increased risk of death by suicide for both parents, but higher and more long lasting in mothers
- Mothers have increased risk of death by natural and unnatural causes lasting as long as 18 years after the loss
- Mothers at increased risk for psychiatric admission during first year after loss
- Mothers report poorer health than fathers
- Mothers health improves over time but fathers health declines
morbidity symptoms after bereavement (5)
- Increased illness and disability
- Increased use of medical services
- Decreased use of needed medical services
- Increased drug use
- Weight loss
somatic symptoms after bereavement (4)
Headaches
Dizziness
Indigestion
Pain
bereavement therapy
grief work with acceptance, experiencing grief, adjusting to changed environment, moving on
- Therapy is most effective for those asking and with pre-existing psychological conditions
- Social isolation, rumination, and pre-existing psychological issues associated with poorer outcomes
- Positive reappraisal and meaning making are beneficial
What are the 2 main types of study design in health research?
- Observational: studies where you observe your variables but don’t interject
- Experimental: studies where you change your variables and hold all other factors constant as much as possible
Study Types in Health Science
- systematic review and meta analysis
experimental: - randomized controlled trial
- quasi experiment => non randomly assigned
Observational: - cohort study => follows group of people
- case control study => compares histories of 2+ groups
- cross sectional survey => broad population
- case reports
hierarchy of evidence
- systematic reviews
- randomized controlled trials
- cohort studies
- case control studies
- case series, case reports
- editorials, expert opinion
peer review
independent experts read over a paper that has been submitted to a journal
impact factor
a measure of popularity in scientific journals which tells you how many times a journals paper has been mentioned in future papers relative to the journals volume of article output
secret behind science of stress
Some degree of stress can actually benefit people
Based on the Kolata article, how would you answer the question, is there a link between stress and cancer?
No, stress does not cause cancer (not proven yet, mixed reviews). Proteins on cancerous cell surfaces turn off the immune response. It has some support from animal models
How do researchers think that MBSR may help people with heart disease?
What have they found so far?
MSBR has beneficial effects on anxiety and depression in patients with heart disease
Needs further study with patients who have cardiovascular disease
Why are these researchers studying MBSR? What have they found so far?
MSBR is linked to better sleep and reduced insomnia
What are the 7 ways Albin claims that dogs can help your health?
- Reduction in respiratory illnesses
- Cardiovascular health
- Anxiety
- Loneliness
- Rehabilitation
- Activity
- Less doctor visits
What is the take home message regarding resilience according to Carey?
People who have suffered from a couple of adverse life events are the most resilient
What does Hackman suggest are the 5 hacks for exam stress?
Hugs
Smile
Breathe
Sleep
Think
What is an ambivalent marriage? What was the relationship of marital quality and blood pressure in the BYU study?
Ambivalent marriage: when the relationship is not always terrible but also not always great ⇒ a partner may be unpredictable or negative ⇒ positive and negative feelings
- Marital quality and blood pressure showed that those in ambivalent relationships had higher systolic blood pressure readings during a given day ⇒ shows cardiovascular health may not be as robust for couples in ambivalent marriages
What are the BPS variables of the Ohio State study? If you were to create a drawing (figure) to model the relationships of these variables what would it look like?
Lack of sleep ⇒ the couples with 7+ hours of sleep had different tones with one another
- Ohio measured inflammation markers associated with heart disease, cancer, and other health problems
- Less sleep also meant higher levels of inflammatory proteins in the blood
Who was Elisabeth Kubler-Ross and what are contemporary thoughts about her stages of grief idea?
American doctors are skittish around seriously ill patients
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
“dos” and “don’ts” for providing support to a grieving friend. What does the author suggest we avoid, and what does she suggest we do?
Do:
Give a supporting role
Stay present, state the truth
Be willing to witness unbearable pain
Do recurring things
Be reliable
Tackle projects together
Run interference ⇒ gatekeeper
Follow their lead
educate/advocate
Love
Dont:
Don’t take a central role
Don’t talk about futuristic or omniscient things
Don’t try to fix it
Don’t make it about you
Anticipate don’t ask
How did doctors’ end-of-life treatment preferences differ from those gathered from non-medical people? Why might this be? How might this affect communication and treatment between doctors and patients?
If doctors were more honest about how treatments actually work/quality, then patients might make a different choice
Doctors: most say no they do not want treatments
- They did want pain medication
Non-medical: most say they want everything aside from some invasive stuff
- doctors know the effectiveness of interventions ⇒ TV shows make it look like treatments are more effective than they are (75% compared to 8%)
- People don’t return to the same quality of life ⇒ people end up comatose or dead more often than not
When facing end-of-life can you expect your doctor to know how to guide you through important questions and decisions? What is a palliative care specialist?
- The patient should take the lead with the suggestions of the doctors
- Your doctor may not feel comfortable doing it, but some doctors are ⇒ the doctor should tell you to get ready and do all that you can to prepare for the end by spending time with them
Palliative care specialist: tries to provide relief and comfort depending on the patients needs and stress from symptoms, pain, and anxiety after serious illnesses have occurred
- Palliative care can be at any time whereas hospice is when there is 6 months or less left to live
What are the 6 components experts recommend as part of the conversation about end-of-life?
- Start the conversation ⇒ the patient and their family should have the conversation amongst themselves before something goes wrong
2.Understand your situation ⇒ know the trajectory - Determine what matters the most to you ⇒ spend more time doing these things
- Express fears ⇒ lets doctors offer advice
- Discuss limits and trade offs ⇒ some care doesn’t improve quality of life
- Consider if hospice care is right for you
