Final Flashcards
How soon do people generally recognize symptoms before actually getting sick?
Half a day to a full day
What factors influence symptom recognition?
Individual difference/personality Cultural difference Situational factors Stress Mood
How do individual differences effect symptom recognition?
Personality impacts your psychological disposition and therefore your health
Hypochondriacs and neuroticism automatically assume the worst case
People with depression and anxiety get sick more often but deny getting sick
How do cultural differences affect symptom recognition?
Difference in emotional responses
Certain cultures talk about illness more than others
Ex. Asia does not talk about being sick and goes to work sick
Some look for symptoms while others ignore them
What is medical students disease?
Learn about disease in med school
Students paying attention begin showing these symptoms
Changes every lecture and students believe they have begun expressing what they are learning
What is an illness representation (schéma)?
A patients own implicit common sense belief about their illnesses
Begins as soon as symptoms appear or you get diagnosed
What you know about the disease and its symptoms
What are the five distinct components of illness schémas?
Identify(label) Consequences Causes Duration Cure Well defined schémas are less stressful as they have these five components
What occurs as you go higher up in the medical chain?
Less likely to have an answer
What are the three models of illness?
Acute: bacterial or viral, short duration
Chronic: multi-factorial, long duration
Cyclic: alternating periods of activity
What other factors can influence the interpretation of symptoms?
Lay referral network: input from friends, family, and peers
Internet: background info, lifestyle modification
How does age influence the use of health services?
Infants and the elderly are more likely to use health services that those in late adulthood
How does gender influence the use of health services?
Women tend to seek help more because they have kids and are more proactive about their health
How does socio-economic status influence the use of health services?
Those who have more money tend to use the system less but see specialists more
Those who have less money are more likely to express illness more and seek general care
How does culture influence the use of health services?
Visible minorities more commonly visit a physician
The language barrier is sometimes a déférant for visiting health services
Minorities seek fewer visits to specialists
Perceived quality of care
How does social psychological influence the use of health services?
Your beliefs about the system effects your level of care
Individuals attitudes and beliefs about symptoms and health care
Health belief model states predictors include: perceived threat to health and belief of efficacy of interventions
Why might a person seek the use of health services for emotional disturbances?
Individuals report physical symptoms which are triggered by psychological drivers
- university disease
- inappropriate assessment by physician
- limited access to psychologists
What are worried we’ll individuals?
Individuals that place over emphasis on symptoms due to heightened self-care
Hypervigilant and constantly worried
End up using the system a lot for small things
What are somaticizers?
Individuals who express symptoms after personal emotional insult
Get dumped and feel terrible so go to the doctor for these symptoms, display physical symptoms with an emotional root
Why do people deny their symptoms having a psychological root?
Medical disorders are perceived as more legitimate than psychological disorders
Allowed more access to benefits and secondary gains
Tests occur faster if medical based
What are secondary gains?
Downstream benefits arising from the illness
- time off/rest
- removal of responsibility
- medical symptoms vs psychological symptoms
What is delay behaviour?
Patients live with one or more potentially serious symptoms without proper care
Delay is defined as the time between recognition and treatment
What are the periods of delay behaviour?
Appraisal delay: realize symptom is serious
Illness delay: realize symptom implies and illness
Behavioural delay: time between recognition and treatment
Medical delay: time between appointment and treatment
What are some predictors of delay behaviour?
Elderly appear to delay less Lack of regular physician Personal views/fears about medical cares Frequency of occurance of the symptoms Personal safety assessment of the symptom
What are the different factors about the personal safety assessment of the symptoms?
Highly visible
Degree of pain
Degree of change
Incapacitating
Why would treatment delay occur after the primary visit?
Curiosity satisfies by the first visit
Fear/alarm of symptoms and diagnosis
What is patient consumerism?
Patients want to be involved and are more active in decision making process
What is the structure of the health care delivery system? What are some disadvantages?
Primary health care providers are the first point of entry, gatekeepers deciding where you belong
Secondary providers are usually specialists
Disadvantages: require a referral, many don’t have a primary physician
What is CAM?
Complementary and alternative medicine
Include massage therapy, chiropractic care, acupuncture, etc
More holistic approach that gives people a sense of control
Who are the main users of CAM?
Female, middle aged, highly educated with multiple chronic issues
Generally paid out of pocket so used by more wealthy
What are some examples of barriers to care?
Poor communication: doctor doesn’t listen
Use of jargon
Baby or simplistic talk
Elderspeak
Nonperson treatment
Stereotypes of patients: cultural stereotypes, sexism
What is treatment nonadherence?
A patient does not follow prescribed treatment: 26%
Antibiotics: 1/3
Lifestyle changes: %80
What is creative non adherence?
Patients modify and/or supplement prescribed treatment
Ex. I forgot to take a pill this morning so I am just going to take 2 tonight
What are some causes of treatment non-adherence?
Poor communication
Perceived satisfaction: higher adherence with positive experience
Treatment regimen: complexity
Type of treatment: medical=high, vocation=lower, social/psych=lowest
What is the placebo effect?
Any medical procedure/agent that produces an effect in a patient because of its therapeutic intent and not its specific nature, whether chemical or physical
Patients will report therapeutic effect
How does the placebo effect work?
Not simply a psychological phenomena
Indirect psychological responses
May reduce anxiety or lower stress response
Pain areas are dampened by placebo in anticipation and during pain
What factors influence placebo effect?
Interaction with health care provider/researcher
Patient characteristics: optimist vs pessimist, anxious people show higher placebo effect
Physical appearance and administration of the placebo
What are the two classifications of pain?
Acute: caused by soft tissue damage such as infection or inflammation
Chronic: linked to long term illness or disease, may have no apparent cause and be difficult to assess or diagnose, can trigger other issues
What are the types of chronic pain?
Chronic benign: 6 months +, intractable to treatment (low back pain)
Recurrent acute pain: series of intermittent episodes (migraine, tmj)
Chronic progressive: 6 months +, increasing severity (rheumatoid arthritis)
What are some factors that can influence symptoms of pain? Why do these make pain difficult to study?
Cultural differences: some report sooner and more intensely, linked to cultural norms
Gender: women more sensitive, with menstrual cycle an indirect contributor as it is linked to différents in emotional processing of pain
Coping style: carastrophizing heightens pain, resilience and positive emotions lower pain
Describe verbal reports used to assess pain
Pt use experience and vocal to describe pain
Ex. Throbbing vs shooting vs dull pain
Pain catastrophizing questionnaire
McGill pain questionnaire
What is the pain catastrophizing scale?
13 questions interested in the thoughts and feelings you have when you are in pain
Each describes a different thought or feeling that may be associated with pain
Uses degrees like not at all to all the time
Describe pain behaviour as a way of measuring pain
Observable behaviours that arise from pain
1) facial and audible expressions of distrust
2) distortions in posture and fait
3) negative affect
4) avoidance of activity
What is nociception?
The system that carriers signals of damage and pain to the brain
Nociceptive neutrons have cell bodies in dorsal root ganglia
Can detect mechanical, thermal, and chemical stimuli
Polymodal nociception
Describe nociception transmission
Bidirectional axons synapse in dorsal horn of spinal cord
Signals continue to the brain where it’s processed
What are the different types of peripheral nerve divers through which nociception occur?
A delta fibre: small, myliented fibers, first and sharp pain rapidly affecting sensory aspects of pain and opening gate
C fibers: unmyelinated fibers, secondary silk or aching pain, affects motivation and affective elements of pain, opens gate
A beta fibre: large, myelinated, information about vibration and position, concurrent stimulation can suppress pain from c fibres, closes gate
What is the traditional model of pain?
Pain resumed from transmission of pain signals to the brain
Degree of pain was dictated by tissue damage
What is the gate control theory of pain?
Proposed that psychological factors contributed to pain experience
Neural pain gate can open/close to modulate pain signals to the brain
Fibres as well as physical, emotional, or cognitive factors open and close gate
What open and close the pain gate for the three different factors?
Physical: extent and inappropriate activity level open, medication and counter stimulation close
Emotional: anxiety, worry, tension, depression open, positive emotions, relaxation close
Cognitive: focus on pain/boredom opens, distension or life activities close
What are some weakness of the gate control theory?
Unable to explain phantom limb pain
Neuromatrix theory: felt representation of a unified physical self, genetically determined initially, neurosigniture can give rise to pain
How does the body manage pain?
Natural pain suppression system of the body
Produces endogenous opioids: beta endorphins, proenkephalin, prodynorphins
Acute stress and physical activity reduces sensitivity to pain
What are some traditional pain management techniques?
Pharmacological: pain medications
Surgical: lésions of pain fibers
Sensory techniques: counterirritation, exercise
What are some psychological pain-management techniques?
Biofeedback Relaxation Hypnosis Acupuncture Distraction
How is the management of chronic pain different from actifs pain?
Chronic pain can develop maladaptive coping strategies
Control strategies of different as chronic pain involved physiological, psychological, social, and behavioural components
Chronic pain induces individual, familial, and societal challenges
What is the neurotic triad and which traits belong to it?
Personality traits can influence the experience of pain
Chronic pain pts show elevated scores in three areas known at neurotic triad:
Hypochondriacs, hysteria, and depression
What is the osycontin story?
OxyContin is a time release formulation of oxycodon
Similar to morphine
Used to modulate severe pain but hard a high abuse liability, addiction potential, and synergistic effects with alcohol
One of the most popular street drugs
Recently banned
What factors influence chronic illness?
Genetics (Alzheimer’s, MS)
Environmental (cancer, asthma)
Lifestyle (CVD,HIV,goût)
Previous injury or prolonged strain (lower back pain, tinnitus)
Who are chronic conditions more common in?
Women
Lower income
Seniors
Certain ethnic subpopulations (aboriginal people)
What is the prevelence and impact of chronic illness?
58% of population has one 81% in elderly population 2/3 of Canadian health spending More than 63% of death globally Staggering economic consequences
What psychological contributions does quality of life help determine?
Depression
Anxiety
Distress
Stress (contributor)
What are the components of quality of life?
Physical functioning
Psychological status
Social functioning
Disease or treatment-related symptomology
What does quality of life assessments determine?
Gauge the extent to which normal life activities have been compromised
Why is evaluating quality of life useful?
Population norms can be established
Allows for a comparative analysis across conditions between countries
What is WHOQOL-BREF?
QofL assessment tool developed by WHO in 1991
Comprised of 26 items
Physical health, psychological health, social relationships, and environment
What are the two summary domains and 8 health concepts of the SF-36?
Physical health overall: physical functioning, role physical, bodily pain, general health
Mental health overall: vitality, social functioning, role social, mental health
What can cause quality of life to fluctuate?
Characteristics of the illness: acute phase vs symptom free of managed phases
Acute changes in symptoms: progression of illness, flare-ups
Age related changes over time: elderly vs under 35
Culture
What are the emotional phases of chronic illness?
Denial: helps control emotional response but may interfere with treatment
Anxiety: elevated self vigilance, may interfere with treatment
Depression: increase symptoms, risk of suicide, difficult to diagnose, increases with severity of illness
Define self concept and self esteem
Self concept: stable set of beliefs about ones qualities and attributes
Self esteem: general evaluation of self concept
What is self concept a composite of?
Physical image: poor body image linked to low self esteem and higher rates of depression and anxiety
Achieving self: jobs and hobbies contribute to self esteem/concept, may be used as motivator
Social self: social interaction helps with self esteem, source of info and support
Private self: increased dépendance on others, loss of an inrealized dream
Define avoidant coping and active coping
Avoidant: may cause psychosocial distress
Active: less psychological distress, better overall outcomes
How do people cope with chronic illness?
Chronic illness can be considered a chronic stressor
Avoidant or active coping
Social support can provide positive reinforcement
Multiple coping strategies are more effective
What are some goals of physical rehabilitation?
Use your own body as much as possible Sense changes in environment Learn new physical management skills Learn a necessary treatment regimen Learn how to control expenditure of energy
What is benefit finding?
Acknowledgement of positive effects of chronic illness
Positive emotion can be seen with chronic illness
Reevaluating of priorities
Strengthening of relationships
Realization of ones abilities
Lifestyle changes
What are some types of psychological interventions for chronic illness?
Individual therapy (medical vs psychotherapy): more likely episodic and therapist must understand illness Brief psychotherapeutic interventions: may help calm over reactions Patient education: internet, writing Relaxation, stress management, exercise: mindfulness based stress reduction, combine with other interventions Social support interventions (support group) Family support
Describe death in infancy or childhood
Infant mortality is high (5.1 per 1000)
Location and socio-economic status may be contributors
Primarily sudden infant death syndrome
Others include accidents or cancer
Children have a poor understanding of death until age 9-10
Describe death in middle age
More realistic and fearful May be triggered by death of parent or friend Premature death: - before 79 - not emotional/financially/socially ready - sudden vs prolonged death - declining rates - gender differences
Describe death in old age
Typically die of degenerative diseases
Elderly women: financial and psychological distress
Elderly men: lower education and widowhood
Women live longer
What doe patients hope for on death?
Free from avoidable suffering for pts, family, caregivers
Factors include: pain and symptom management, clear decision making, preparation for death, completion
What is euthanasia and when do people request it?
Ending the life of a person who is suffering from a painful terminal illness
Request when:
- experiencing distress or fatigue
- in pain or suffering
- feel they are a burden to their family
Legalized in Netherlands, Belgium, luxemburg
Physician aid in dying legal in 3 states
What are living wills?
Advance directives indicating that extraordinary measures should not be taken
Many physicians are unaware or disregard
What is kubler-Ross’s five-stage theory for adjustment to dying?
Denial: may provide some benefit, long term may affect therapy
Anger: why me, difficult for family
Bargaining: trading good behaviour for good health
Depression: realize lack of control, anticipatory grief
Acceptance: calm arrives, make preparations
What are some alternative to hospital care?
Hospice care
Home care
Describe hospice care
Acceptance of death in a positive manner
Focus on improving QofL not cure illness
Pain management, emotional support, palliative care
Personalize setting, unrestricted family visits
Describe home care
Still require regular contact with medical staff
Increased responsibility for family members
Psychological benefits for patients
Personal choice is returned to patient/family
What are four major chronic disorders?
Heart disease
Stroke
Hypertension
Diabetes
What do the four major chronic disorders have in common?
Involve circulatory and/or metabolic system
May be comorbid disorders
Have modifiable risk factors
Non communicable diseases
Describe prevelence or coronary heart disease in Canada
2nd cause of death
1/5 deaths
Disease of modernization
Mostly premature deaths
What is coronary heart disease?
Cause by atherosclerosis- narrowing of coronary arteries
Lowers oxygen supply to heart
Temporary shortage cause angina pectoris
Severe deprecation causes myocardial infraction
Considered to be a systemic disease due to inflammatory process
What mediates CHD?
An inflammatory process
Proinflammatory cytokines IL-6 is involved when inflammation is high
Stimulates a process that fades atherosclerotic plaques
What is a strong predictor of CHD?
Level of C-reactive protein (CRP) in the blood stream
Not sure if cause or indicator
Produced in liver
Elevation can be caused by weight gain or low physical activity
What are some other risk factors of CHD?
High BP Diabetes Cigarette smoking Obesity High serum cholesterol Low physical activity
What is metabolic syndrome?
When an individual has three or more of the following:
- obesity centered around waist
- high bp
- low levels of HDL
- difficulty metabolizing blood sugar
- high levels of triglycerides
Refers to your ability to break down food
How does cardiovascular reactivity contribute to CHD?
Damaging endothelial cells: causes lisons and things enter causing stuff to stick
Facilitates the deposit of lipids
Increases inflammation
Development of atherosclerotic lesions
How does acute stress affect CHD?
Can cause angina or heart attack
May be due to emotional stress, anger, extreme excitement, negative emotions, sudden bursts of activity
Reactivity or coping to stress with hostility increases risk factor
Who is CHD more common in and what is it linked to?
More common with low socio-economic status and males
Linked with: higher rates of physical inactivity, smoking, elevated cholesterol, being overweight
Genetics are also an important factor
Why do we eat too much?
Serving size and food access has increased
Social context
Stress
Describe CHD in women
Leading cause of mortality in women but less is known
Occurs later in life by recovery rates are lower
Fewer are referred to cardiologist or return to work
Younger women are protected via high levels LDL
Estrogen diminishes SNS arousal
After menopause, increases due to weight gain, increased bp and cholesterol and triglycerides
Why is CHD higher in women?
Less media messaging and education
Less counselling about lifestyle
Less likely to use pharmacotherapy
More likely to be misdiagnosed, look for other things
How are CHD and hostility related?
Anger and hostility are risk factors
May act as potential risk factors, predictors for survival, potential trigger for heart attack/angina
Hostility linked to higher levels of proinflammatory cytokines and to metabolic syndrome
Response to stress is heightened and lasts longer
What is the most dramatic hostility?
Cynical hostility: suspiciousness, resentment, antagonism, distrust of others
How does cardiovascular reactivity affect CHD?
In some individuals, stress causes: vasorestriction in peripheral areas of the heart, simulataneous increases heart rate
Trying to transfer increased blood volume through constricted blood vessels
Eventually produces atherosclerotic lesions and plaque formation
Change in catecholamines may indirectly alter resilience of blood vessels
How is depression related to CHD?
Strong link between depression and metabolic syndrome
Depression just before coronary event is linked to inflammation
Linked to elevated CRP
Treatment for depression may improve long term recovery from coronary events
Why might people delay getting treatment for heart disease?
Denial of episode
Interpret as mild symptoms
Self-treatment
Who do we seek delay in for CHD treatment?
Elederlt and those who have initial symptoms checked by doctor delay longer
Daytime attack or presence of family members increases delay
What is the initial treatment for CHD?
Coronary artery bypass graft
Hospitalization with monitoring
Assessment of anxiety, depression, PTSD
Home care with rehabilitation
What is the cardiac rehabilitation for CHD?
Education, lifestyle modification
Goal is to produce relief from symptoms, reduce severity of disease, limit progression
Promote psychological and social adjustment
Restore self efficacy
What is the pharmacotherapy for CHD?
Antiplatelet agents: asprin
Beta-adrenergic blocking agents
Statins - target LDL (ex. Lipitor, creator)
Describe the diet and activity side of CHD management
Lower cholesterol level, lose weight
Reduce smoking, alcohol consumption
Exercise
Return to work
Describe the stress management aspect of CHD treatment
Stress is a proven trigger and contributor
Treatment programs are lacking
Patients show inability to lower stress
How does depression affect the management of CHD?
An issue throughout all phases
May impact response to treatment
Improve QofL and perceived health
Describe how social support affects management of CHD?
Spouse or family significantly improves recovery
Disconnect with caregiver (overbearing)
Cardiac invalidism: pt and spouses see abilities as lower than they actually are
What is hypertension?
Occurs when supply of blood through vessels is high
Puts pressure on arterial walls
Also occurs in response to peripheral resistance to blood flow in the small arteries of the body
Define systolic and diastolic pressure
Systolic: force generated by contraction of heart
Diastolic: pressure in the arteries when the heart is relaxed
Describe mild, moderated, and severe hypertension
Mild: systolic between 140-159
Moderate: systolic between 160-179
Severe: systolic pressure above 180
What are some risk factors of hypertension?
Genetic link >50 men are at great risk Cultural differences Low socio-economic status Dietary sodium intake (35% higher) Emotional factors (anger, hostility, family environment) Chronic stress (work, life, environment)
What are some typical interventions of hypertension?
Low sodium diet Reduced alcohol consumption Weight reduction and exercise Reduced caffeine intake Diuretics: reduced blood volume via excretion of Na+ Beta-adrenergic blockers: decrease cardiac output and plasma renin activity Cognitive behavioural therapy Anger management
What are some issues with hypertension?
Many individuals are unaware they have it
Symptom less disease early on
High rage of non-adherence to therapy
WhT is a stroke?
Disturbance in blood flow to the brain:
- to a localized area of the brain (ischemic)
- cerebral hemorrhage (bleeding)
What occurs to those who have strokes?
15% die 10% recover completely 25% minor disability 40% moderate-severe disability 10% long-term care
What are some warning signs of a stroke?
Weakness Trouble speaking Vision problems Headache Dizziness
What are some consequences of a stroke?
Motor deficits
Cognitive problems
- left brain: lower intellect, difficulty learning new tasks
- right brain: hampered visual feedback, feel crazy
Emotional problems:
- left brain: anxiety depression
- right brain: seemingly indifferent
What is diabetes?
Chronic condition of insufficient secretion of insulin or insulin resistance
Insulin is produced by the beta cells of the pancreas and mediates entry of glucose into the cell
What is type 1 diabetes?
Insufficient secretion of insulin Immune system attacks beta cells Develops earlier in life Accounts for 10% Insulin dependent
What is type II diabetes?
Insulin resistant Developed later in life Related to obesity and diet More someone in men Related to socio economic factors Preventable
What are some health implication of diabetes?
Thickening of arteries causing CHD
Shorter life expectancy
Depression
Sexual dysfunction due to low blood flow (some get feet and hands amputated due to this)
What is involved in the deadly quartet?
Diabetes
Interabdominal body fat
Hypertension
Elevated lipids
What is psychoneuroimmunology?
The interaction among behavioural, neuroendocrine, and immunological processes of adaptation
Study of interaction between psychological processes and the nervous and immune systems of the human body
What is the immune system implicated in?
Infection
Allergies
Cancer
Autoimmune disorders
What is natural immunity?
Defence against variety of pathogens
Largest group of cells is granulocytes
Includes neutrophikes and macrophages which are phagocytes
Broad first défense which congregate at site of injury or infection and release toxic substances
What do macrophages do?
Release cytokines which lead to inflammation, fever, and promote wound healing
What do natural killer cell do?
Slightly more specialized
Recognize viral infections or cancer cells
Lyse cells by releasing toxic factors
Important in signaling potential malignancies
Limits early phases of viral infections
What is specific immunity?
Slower process but more specific
Lymphocytes have very specific receptors for one antigen
Once activated they divide to create a proliferative response
What is humoral immunity?
Mediated by b lymphocytes
Provide protection against bacteria
Neutralize toxins produced by bacteria
Prevent viral infection
What is cell mediated immunity?
Involves t lymphocytes from the thymus gland
Operates at the cellular level
Cytotoxic (Tc) cells response to specific antigens
Helper T (Th) cells enhance functioning of Tc cells, B cells and macrophages
How can immune function be assessed?
Studying distrabution among immune cells in blood samples which examine counts of T, B, and NK cells, and assesses the amount of circulating lymphokines or antibody level
OR
Examining the functioning of immune cells
What does assessing the functioning of cells include?
Activation
Proliferation
Transformation
Cytotoxicity of cells
What are some common assessments of immunocompetence?
Lymphocyte toxicity: how effective they are at killing based on lymphocyte level
Phagocytotic activity: how quickly phagocytes working
Mitogenic simulation technique
Antibody production to latent virus
Immune response to vaccine
Wound repair
How to short term stressor effect immune response?
Produce fight or flight
Elicit immune response to potential injury or infection
Increase in NK cells, large granular lymphocytes
Also leads to down regulation of specific immunity
How do longterm stressors affect immune function?
Causes both cellular and humoral down regulation
Stronger among elderly or those with other issues
Can impact other co-morbid issues
What are some effects of stress on the immune system?
Effect of stress on immune system can be delayed
Causes increased vulnerability to ID
May aggravate diseases associated with inflammatory processes
Anticipatory stress can compromise immune function by decreasing number of Th cells
Stress involving threat to self can increase proinflammatory cytokine activity
Optimism improves function
Social support increases NK activity
What is aids?
Acquired immune deficiency syndrome
What factors contributes to rise in AIDS?
High rates of extramarital sex
Low condom use
High rates of gonorrhea
What is HIV?
Human immunodeficiency virus
Attacks the helper T cells
Attacks macrophages of the immune system
Exchange of cell containing bodily fluids
Can be HIV positive but don’t have aids
Once you have AIDS, what happens?
Grows rapidly and spreads over first few weeks
Early symptoms include swollen gland and mild flu like
May be followed by asymptomatic period
Virus continues to Th cells making pts vulnerable
Progressive symptoms appear
What are the progressive symptoms of aids?
Chronic diarrhea Wasting Skeletal pain Blindness CNS impairment become apparent as virus enters brain and cells die, may lead to depression, amnesia, or mood swings
WhT is HAART?
Highly active antiretroviral therapy
Combination of antiretroviral medications
Must be taken religiously
Treatments may be complex
Depression may also be a contributor to non-adherence
Who is at risk for contracting HIV?
Aboriginals and minority populations
Adolescents and young adults
What are interventions for aids?
Focus around reducing risk related behaviours
Educate in safe sex practices, sterile techniques
Culturally sensitive interventions are effective
Self efficacy can lower risk related behaviours
Sexual negotiation skills are crucial in adolescents
What is the mechanism of cancer?
Results from a dysfunction in DNA
Causes excessive rapid cell growth and proliferation
Cancerous cells provide no benefit to body
Drains the body of essential resources
What are some risk factors of cancer?
Genetics
Diet
Lifestyle factors
Diet
How are depression and cancer linked?
Positively linked due to elevated endocrine response
Decreasing depression improves survival
How are stress and cancer related?
Avoidant or passive coping can further the disease
Psychological stress can lower efficacy of NK cells
What is arthritis and what are the types?
Inflammation of the joint
Most prevalent autoimmune disease
Types: rheumatoid arthritis, osteoarthritis, goût, lupus, ankylosing spondilitis
2/3 women and 3/5 under 65
What is rheumatoid arthritis?
Targets small joints of the hands, feet, wrists, knees, ankles, and neck
Immune system targets the thin membrane surrounding the joints causing bones to erode
Leads to inflammation, stiffness, pain
3x more in women and targets 25-50
What are some issues with rheumatoid arthritis?
Affects lifestyle and independence
Comorbidity with other chronic health conditions
Most common complication is depression
What is the treatment for rheumatoid arthritis?
Revolve around pain management
Exercise is essential to maintain mobility
CBT is useful in managing fatigue and is linked with improved outcome measures
What is osteoarthritis?
Most common form of arthritis
Affects men and women equally
Usually after 45
Loss of cartilage resulting in bone on bone
