W4: Health psych Flashcards
How does stress affect heath?
Physiologically:
* Increases blood pressure
* Changes blood comparison
* Release of stress hormones
* Suppression of immune system
Behaviourally
* Less sleep/rest
* Less exercise
* Less healthy food eaten
* Increased physical tension
* Less social support
Placebo vs nocebo effect
Placebo effect: A positive effect results not from any active treatment, but purely from patient’s belief in or expectations of treatment
* E.g. Sugar pills/capsules, injections surgery
Nocebo effect: can bring about pain or discomfort → give a negative effect though nothing actually happening at all
Process of pain
Stimulation at local tissue site (noxious stimulation) → physical stimulation
Chemical released → inflammation and activation of nerve endings
Nerves transmit message to spinal cord (via nociceptors), then to brain
Ravens through many brain regions
How is pain a construct (psychological) of the brain?
The same nociceptive (physical) input can be manipulated to create more or less pain
Negative mood causes came input to be more ‘painful’ (and positive mood can buffer)
Pain can be generated without nociceptive input (e.g. Rubber hand Illusion)
Limitations: think treatment of chronic health conditions; targeting psychological (vs physical) processes
Mechanisms of Placebo (Expectancy Theory, Conditioning)
Expectancy theory: what you expect to happen, often will happen
Conditioning (Operant and Classical): the experience of benefits previously when taking a placebo pill (for example), we get conditioned to think that this will happen again
Ethics of placebo
Deception
* The idea that people are not being aware of their medical treatment → taking a sense of agency away from the individual
* Despite the person knowing that it is a placebo, it still works, but to some extent → so not as effective of an effect as when the person doesn’t know that it’s a placebo
Informed consent for clinical trials
What is the role of the vagus nerve?
Used by the brain to convesy messages to many part of the body (e.g. heart, lungs, digestive tract, vocal chords, etc.) and convey fight or flight messages to the body
Why is the gut considered a second brain?
Because there is an enteric nervous system, which is located in the GI tract:
* Capable of organising and functioning without the brain
* Produce 50% of dopamine and 90% of serotonin –> responsible for mood and pleasure –> control cravings and eating behaviours
How can gut health impact mental health?
Gut microtobia (via complex pathway) stimulate the body’s immune resposne; activate the HPA (hypothalamus-pituitary-adrenal) axis –> HPA equivalent to stress response
Studies have shown that the gut controls emotions and learning ability –> gut-brain connection
Development of Disorders of brain-gut interactions (DGBIs)
DGBIs have 32 individual diseases, with IBS (irritable bowel symdrome) being the most commons
Development:
* Presense of anxiety / depression at the start can preduct diagnosis of IBS in 12 years later
* DGBIs was previously labelled as FGIDs; can predict elevate anxiety/depression in 12 years
Psychological treatments for GI disorders
- Psychological therapies
- E.g. CBT, hypnosis, mindfull relaxtion therapy, psychodynamic therapy
- Reliable, moderate effect of GI symptoms and associated psychological distress
- Benefits last up to 1 year post therapy
Mechanism of psychotherapy
Psychological therapy can decrease:
* Catastrophizing - tendency to exaggerate negative experiences
* GI-specific anxiety
* Visceral hypersensitivity
* Negative appraisal
* External locus of control → agency, responsibility
Psychological therapy can increase
* Reinterpretation of pain symptoms
* Non-reactivity (mindful mindset)
* Brain activity in pain processing centres
GI treatment for psychologcal disorders
Because of brain- gut (microbiome - brain - gut) connections, changing gut could directly impact mental health
Probiotics, dietary changes, faecal microbiota transplants
Need experimental work to differentiate between correlation and causation, and understand mechanisms of action
* Randomised control trials
* Human (vs animal) studies
Caveat of GI treatment
Need more scientific evidence to show efficacy of any treatment
Don’t want to increase stigma around mental health issues (or physical health issues)
Need more scientific research, and understanding of mechanisms of action
All interventions need to recognise the context in which health occurs
