Physical Disorders and Health Psychology

Chapter 9 Physical Disorders and Health Psychology psychosomatic medicine- psych factors affect physical wait on lookal medicine- applied to prevention, diagnosis and treatment of medical problems health psychology- psych factors that are consequential to the maintenance and promotion of health opsych and accessible factors (1) affect biological processes (2) long-standing expression patterns put ppl at risk for certain disorders o50% of deaths from top 10 leading causes in US can be traced to lifestyle behaviors poor eating habits, smoking, overleap of exercise, General Adaption Syndrome (GAS)- Selye oalarm- response to immediate d ire or threat oresistance- mobilize coping mechanisms to respond oexhaustion- body suffers permanent damage chronic line whitethorn cause permanent body damage and contribute to disease stress= physiological response to stressor HPA Axis ohypothalamus- pituitary gland- adrenal gland oimportant for stress ocortisol= stress hormone baboon case study odominant males get less stressful lives due to predictability + controllability olower males experience stress from bullying, higher cortisol levels osense of control important stress, anxiety, depression colligate osimilar central physiological processes oself-efficacy sense of control and confidence that one can cope with stress or challenges stress can lead to decreased resistant strategy functioning oincreased rates of infectious diseases, mono, colds, flu, Immune system oeliminates antigens- foreign maerials, bacteria, viruses, parasites o2 main parts hum ad-lib B cells, antibodies neutralize antigens cellular T cells, destroy viral infections + cancerous processes owhite pedigree cells do most of the work (leukocytes) microphages= first line of defense autoimmune disease oimmune system overactive, attacks body cells rheumatoid arthritis- too many suppressor gene T cells, body subject to invasion by antigens HIV- human immunodeficiency virus ?AIDS-related complex first minor health problems before AIDS diagnosis w. pneumonia, cancer, dementia, wasting away syndrome ? treated w/ highly active antiretroviral therapy reducing stress, social support, CBT help psychoneuroimmunology (PNI) opsych influences on neurological responding implicated in immune response Cancer psychoncology- psych influences in development of cancer otherapy can help treatment to reduce stress, improve mood, alter important health behaviors, supportive relationships reduce cancer recurrence and destruction influence support + development of cancer obenefit finding- deepening spirituality, changes in life priorities, closer ties to others, enhanced sense of purpose opsych procedures important to manage stress especially w/ children who undergo surgery Cardiovascular problems ocompromise heart, blood vessels and control mechanisms cardiovascular disease ostrokes ocerebral vascular accidents- temporary blockages of blood vessels to encephalon cause temporary/ permanent damage o hypertension- high blood bosom, risk factor for other heart probs blood vessels constrict, heart works harder, pressure inhering hypertension- no verifiable physical cause silent killer blacks more(prenominal) at risk than whites genetic influences anger + hostility increase blood pressure ocoronary heart disease heart disease in 1 cause of death in western cultures blockage of arteries supplying blood to heart brawniness chest infliction plaque deficiency of blood to a body part heart attack- death of heart tissue when artery clogged stress, anxiety, anger contribute (+lack of coping skills and low social support) myocardial stunning- heart failure as a result of severe stress oType A behavior pattern excessive competitive reason, sense of pressured for time, impatience, high E, angry come forwardbursts at risk for CHD (although cultural diffs significant) oType B behavior pattern more relaxed, less relate astir(predicate) deadlines, seldom pressured, Reserve capacity mod el associations among environments of low socioeconomic status, stressful experiences, psychosocial resources, emotions and cognitions increase risk for CHD Pain o sharp-worded- follows an injury, disappears once injury heals ochronic- begins w/ acute episode but does not go away osubjective term spite vs. pain behaviors= manifestations of exp oemotional component= suffering oseverity of pain doesnt predict reaction b/c of psych factors Phantom off tally pain oppl who have lost an arm or leg feel excruciating pain in the missing limb operant control of pain pain behavior under control of social consequences oie critical family members may become sympathetic gate control system of pain onerve impulses from mad stimuli travel to spinal column then to brain odorsal horns of spinal column= gate osmall fibers open gate, large fibers close brain inhibits pain oendogenous opiods- innate(p)ly exist within body endorphins oshut down pain, runners high after exercise, men and women exp p ain differently omen have stronger endogenous opiod systems owomen have additional pain-regulating mechanisms odiff areas more prone to pain Chronic fatigue syndrome (CFS) olack of E, fatigue, variety of aches and pains oneurasthenia- lack of nerve strength, old diagnosis oprevalent in western humans and China Pain can kill you oincreases rate at which certain cancers metastasize ocan weaken immune system response by reducing natural killer cells opain stressvicious cycle Biofeedback o declare patients aware of special physiological functions that ordinarily not be consciously aware of heart rate, blood pressure, muscle tension in specific areas, electroencephalogram rhythms, patterns of blood flow (1) conscious awareness (2) learn to control them oinstill sense of control over pain progressive relaxation obecome sapiently aware of tension, relax specific muscle groups transcendental meditation ofocus attention on repeated syllable, or mantra relaxation response- silently repeat mantra to minimize distraction by closing mind to intruding thoughts Coping mechanisms oprescription drugs, reduced tackiveness over time odenial oimproved attitudes, realistic appraisals thru CBT 4 leading causes of death in Us oheart disease, cancer, stroke, respiratory disease AIDS prevention ocontraception ochanging high-risk behavior is only effective prevention strategy smoking is epidemic in china omyths baccy is symbol of personal freedom, important for social interactions, health effects can be controlled, important to economy, Stanford Three Community Study o1 community- assessed risk factors for CHD and smoking o2 community- media linebacker blitzing on risk factors o3 community- face to face interventions, most successful at reducing CHD risk factors Chapter 10 Sexual and Gender Identity Disorders gender personal identity disorder- psych dissatisfaction w/ ones biological put forward, disturbance in identity inner dysfunction- difficult to function while having se x, ie no orgasm paraphilia- stimulation due to inappropriate objects/ individuals ophilia- strong attraction opara- abnormal male female sex differences omen masturbate more and admit it ofemales associate sex w/ romance + intimacy rather than male physical gratification omen have diff attitude toward casual premarital sex omen show more cozy thirst/arousal omens self-concept characterized more by power, independence, aggression owomens sex beliefs are more plastic/ changeable women emphasise relaitonships sexual self schemas- core beliefs about sexuality Cultural differences oSambia in Papua New Guinea adolescent boys encouraged to engage in homosexual oral sex b/c semen valued wtf Homosexuality omight run in families, genetic component? odifferential hormone exposure in utero ogreater probably of cosmos left handed or ambidextrous o time-consuming ring finger than index ofraternal birth order hypothesis- from each one additional older brother increased one and only(a)s of b eing gay by one third Gender identity disorder oa persons physical gender is not consistent with persons sense of identity phone tapper in a body of the wrong sex otranssexualism odifferent from transvestic fetishism- sexually on fire(p) by wearing clothing of opposite sex odifferent from intersex individuals- hermaphrodites, born(p) with ambiguous genitalia, hormonal or physical abnormalities oautogynephilia- when gender identity disorder begins with strong sexual attraction to fantasy of oneself as a female, then progresses to become a woman ogenetic component suspected gender nonconformity oboys behaving femininely or females behaving masculinely sex reassignment surgery controversial to directly alter gender identity to counterbalance physical anatomy oin order to qualify, must live in opposite sex role for 1-2 yrs to be sure omust be stable psychologically, financially, socially ogynecomastia- issue of breasts intersex individuals- born w/ physical charactersitics of both sexes o5 sexes males females herms merms- more male than female but have some(prenominal) femal genitalia ferms- ovaries but possess some male genitalia Sexual dysfunction oinability to become aroused or reach orgasm o3 stages of sexual response cycle desire, arousal, orgasm opremature ejaculation vaginismus- painful contractions in vagina during attempted penetration olifelong or acquired ogeneralized or situational odue to psych factors or medical condition Hypoactive sexual desire disorder olittle or no involvement in any type of sexual activity sexual aversion disorder othought of sex or brief casual touch may lambast fear, panic or disgust male erectile disorder and female sexual arousal disorder oproblem is not desire, problem is physically becoming aroused inhibited orgasm oinability to achieve orgasm despite adequate desire and arousal (common in women) ofemale orgasmic disorder- difficulty reaching orgasm retarded ejaculation- cumming delayed oretrograde ejaculation- sh oot back into bladder rather than forward premature ejaculation- more common, 20% of males sexual pain disorders odesire, arousal, orgasm present opain so severe that behavior interrupt odyspareunia- no medical reason found for pain vaginismus- pelvic muscles in outer third of vagina involuntarily spasm oripping, burning, tearing sensations during sex Assessing Sexual behavior o(1) interviews- and questionnaires o(2) thorough medical eval- rule out medical conditions o(3) psychophysiological assessment penile strain gauge- picks up changes as penis expands vaginal photoplethysmograph- measures light reflected from vaginal walls Causes of sexual disorders obiological contributions nuerological diseases diabetes arterial insufficiency- constricted arteries venous leakage- blood flows out too quickly for a good boner prescription drugs ?anti-hypertensive medicaments for high blood pressure ?antidepressants ?SSRIs bargain w/ arousal and desire elicit drugs- cocaine cigarettes opsych co ntributions anxiety- can increase or decrease desire distraction men who are dysfunctional proclaim less sexual arousal inducing positive or forbid mood directly affects arousal performance anxiety, 3 parts ?arousal, cognitive processes, negative affect erotophobia- negative cognitive set about sexuality, viewed as negative or threating ? learned primeval in childhood from families, religious authorities ? first sexual trauma, rape victims script theory- we all operate by following scripts that reflect social and cultural expectations and guide our behavior sexual myths/ misperceptions Treatment for sexual dysfunction education is very effective, dispel myths and ignorance about sexual response cycle otherapy, increase communication b/t dysfunctional partners osensate focus and nondemand pleasuring- exploring and enjoying each others bodies thru touching, kissing, hugging, massaging 1st phase no fork or boobs 2nd phase genitals but no sex or orgasm 3rd sex once aroused osqueeze technique- squeezing tip of penis to reduce arousal and gain control over ejaculation omasturbation training and porn omedical treatments oral medication (Viagra) injection of vasoactive substances directly into the penis? surgery vacuum device therapy Paraphilia if exists, individuals normally exhibit multiple paraphillic patterns oassociated w/ deficiencies in consensual adult sexual arousal, social skills, sexual fantasies frotteurism orubbing against someone in a crowded public place until point of ejaculation festishism operson sexually attracted to nonliving objects o(1) inanimate object o(2) source of specific tactile stimulation rubber o(3) body part foot voyeurism obeing aroused by observing unsuspecting individuals undressing or naked exhibitionism osexual gratification from exposing genitals to strangers orisk + anxiety can increase arousal oassociated w/ lower levels of edu transvestic fetishism osexual arousal from cross-dressing sexual sadism oinflicting pain or humil iation sexual masochism osuffering pain or humiliation hypoxiphilia- oself strangulation to reduce flow of oxygen to brain to enhance orgasm pedophilia osexual attraction to kids oincest when own family Psychological treatment ocovert sensitization- carried out in imagination of patient, associate sexually arousing images w/ reasons why behavior is harmful or dangerous orgasmic reconditioning opatients instructed to masturbate to usual fantasies but substitute more desirable ones just before ejaculation Drug treatments chemic castration- eliminates sexual desire + fantasy by greatly reducing testosterone levels ocyproterone acetate + medroxyprogesterone ouseful for dangerous sexual offenders who do not respond to alternative treatmens Chapter 11 Substance-related and Impulse-control disorders impulse control disorders- inability to resist acting on a drive or temptation osteal, gamble, set fires, pull out whisker polysubstance abuse- using multiple substances substance use oingest ion of psychoactive substances in moderate amounts that does not mollycoddle social, educational or occupational functioning intoxication- getting high or drunk oimpairs judgment, mood changes, lowered motor ability substance abuse ohow overmuch ingested is problematic addiction- substance dependence ophysiologically dependent on the drug requires increasing amounts to experience same effect (tolerance) onegative physical response when substance no longer ingested ( insularity) oNicotine is arguably most addictive drug in the world, more so than meth 5 substance categories o(1) depressants- sedation + relaxation alcohol o(2) stimulants- active + spry caffeine o(3) opiates- analgesia + euphoria morphine o(4) hallucinogens- alter sensory perception weed, LSD (5) other drugs- dont fit neatly into categories steroids Depressants odecrease central nervous system activity, reduce levels of physiological arousal omost likely to produce dependence, tolerance, withdrawal oalcohol reduces inhibition, motor coordination, reaction time, judgement esophagusstomachsmall intestinesbloodstreamheart (+other major organs) liver influences gamma aminobutyric acid receptors anxiety influences glutamate system- excitatory, memory, blackouts withdrawal delirium- frightening hallucinations, body tremors liver disease, pancreatitis, cardiovascular disorders, brain damage dementia- loss of intellectual abilities Wernicke-Korsakoff syndrome- loss of muscle coordination, confusion, unintelligible speech fetal alcohol syndrome- when gravid mothers drink, fetal growth retardation, behavior problems, learning difficulties, physical signs alcohol dehydrogenase- enzyme that breaks down alcohol 3 million ppl dependent in US ostages of alcoholism pre alcoholic- alcoholism occasionally, few consequences prodromal stage- drinking heavily, outward signs of a problem crucial stage- loss of control, binges chronic stage- primary daily activities involve drinking odrinking at early age is predi ctive of later abuse alcohol linked to violent behavior oBarbiturates sedatives, help ppl sleep highly addictive overdosing suicide influence GABA obenzodiazepines reduce anxiety highly prescribed in US alcohol amplifies effect oStimulants most commonly used psychoactive drugs in US speeding use disorders ?reduce appetite ?narcolepsy, ADHD, Ritalin ?stimulants illegally abused by college students no shit crystal meth MDMA- ecstasy ococaine use disorders alertness, euphoria, increase blood pressure + pulse, insomnia, loss of appetite paranoia, heart probs nicotine use disroders withdrawal- depression, insomnia, irritability, anxiety, increased appetite more prone to depression Opioids oopiate natural chemicals in opium poppy have narcotic effect odowners Hallucinogens ochange sensory perception osight, sound, feelings, taste, smell omarijuana oLSD Other drugs oSpecial K osteroids oPCP Family and genetic influence neurobiological influence opleasure pathway in brain mediates experienc e of respect odopamine- pleasure oGABA- inhibitory NT Psych dimensions opositive reinforcement negative reinforcement- use drugs to cope/escape from bad feelings and difficult life circumstances oopponent-process theory- an increase in positive feelings provide be followed shortly by an increase in negative feelings and vice versa cognitive factors oplacebo effect oexpectancy theory social dimensions opeer pressure omarketing omoral weakness model of chemical dependence- drug use is seen as a failure of self-control in the face of temptation odisease model of dependence- drug dependence cause by an underlying physiological disorder cultural factors oacculturation- adapt to new culture omachismo neuroplasticity brains tendency to reorganize itself by forming new neural connections ocontinued use of substance. decreased desire for nondrug experiences Treatment obiological agonist substitution- take a safe drug that has a chemical makeup similar to the addictive drug ? methadone inst ead of heroin ?cross-tolerance they act on same NTs substitution ?nicotine gum instead of cigs antagonist drugs- block or counteract effects of psychoactive drugs aversive treatment- prescribe drugs that make ingesting abused substance extremely unpleasant opsychosocial therapy inpatient facilities alcoholics anonymous- 12 steps controlled use- controversial covert sensitization- negative associations by imagining unpleasant scenes contingency management- decide on reinforces that will reward certain behaviors community reinforcement approach motivational interviewing- empathetic and optimistic counseling CBT relapse prevention Impulse control disorders ointermittent explosive disorder- episodes where act on aggressive impulses serious assaults or destruction of property influenced by NT levels okleptomania recurrent failure to resist urge to steal things not postulate for personal use or monetary value high comorbidity with mood disorders opyromania irresistible urge to set fire s pathological gambling otrichotillomania pulling out ones hair from anywhere on body oothers set shopping-oniomania skin picking self mutilation computer addiction Chapter 12 Personality Disorders personality disorders- enduring patterns of thinking about ones environment and self that are exhibited in a wide range of social and personal contexts oinflexible, maladaptive and cause significant impairment or suffering ohigh comorbidity Axis I= current disorder Axis II= chronic problem 5 Factor model oextroversion- talkative + assertive vs passive and reserved oagree-ableness- kind trusting vs hostile selfish conscientiousness- organized thorough, reliable oneuroticism- even tempered vs nervousness moody oopenness to experience- imaginative curious Cluster A odd or eccentric oparanoid oschizoid oschizotypal Cluster B dramatic, emotional, erratic oantisocial (m)- irresponsible, reckless behavior oborderline (f) ohistrionic (f)- excessive emotionality and attention seeking onarcissis tic Cluster C fearful, anxious oavoidant odependent oobsessive compulsive Biases ocriterion gender bias- criteria biased oassessment gender bias- assessment measures biased