Abnormal Psych Tulane Final Chapter 9

Front 1

Impact of Social and Psychological Factors on Health

Back 1

1) The 10 leading causes of death in the U.S. can be traced to lifestyle choices
2) Integrative Model: Biological, psychological, and social factors all tangle to effect disease
(a) Psychological Factors
(i) Influence biological processes
 Behavior patterns increase disease risk

Front 2

Shift of Medical Focus

Back 2

1) The Beginning of the 20th century had a focus on treatment and prevention of infectious diseases, which has lowered mortality rates
2) Public Health Model: Prevention, intervention for level problems, and focused intervention in the case of disease

Front 3

Impact of Behavioral Medicine on Psychological Medicine

Back 3

1) Behavioral Medicine
(a) Knowledge developed from behavioral sciences was applied to prevention, diagnosis, and treatment of medical problems
(i) Interdiciplinary: psychologists, physicians, and other allied health professionals work together
(b) Subfields
(i) Health Psychology: a study of psychological factors that are important to promotion and maintenance of good health
 Oriented to preventing diseases or disorders

Front 4

What is Stress

Back 4

1) Stress disrupts basic biological processes, which may lead to physical disorders and diseases
(a) Nature of Stress
(i) Stressor: Any event that evokes a stress response
(ii) Stress: The physiological response of the individual

Front 5

Stress Response and General Adaptation Syndrome

Back 5

(b) Stress Reponse and General Adaptation Syndrome
(i) Phase 1: Alarm response
 Sympathetic arousal, where the body expends energy to protect itself
(ii) Phase 2: Resistance
 Coping or the person taking action
(iii) Phase 3: Exhaustion, where there is the potential for permanent damage

Front 6

Physiology of Stress

Back 6

2) Physiology of Stress
(a) Sympathetic Nervous System Activation
(i) Neuromodulators and neuropeptides
(ii) Hypothalamic-Pituitary-Adrenocortical (HPA) axis activation
 Stress hormones are directly released into the blood stream
 This includes cortisol
(b) Limbic System Activation
(i) The hippocampus helps to turn off the stress response
(c) Chronic stress damages the hippocampus, slows down recovery and maintains the HPA loop
(i) Can cause PTSD or Dementia

Front 7

Psychological And Social Factors in Stress Psychology

Back 7

(a) Psychological Vulnerabilities
(i) Stress
(ii) Perceive situations as uncontrollable
(iii) Low levels of social support
(iv) Negative affect
 Sadness, anxiety, dysphoria
(b) Perceptions of Situations and one’s response
(i) Level of self-efficacy
 “I will be okay” or “I can handle whatever happens”

Front 8

Stress and the Immune Response

Back 8

(a) Immune system branches
(i) Humoral: blood and other body fluids
(ii) Cellular: protects against viral or parasitic infections

Front 9

Function of the Immune Response

Back 9

(i) Identify and eliminate antigens (foreign material)
 Leukocytes: white blood cells
• Marcophages: First line of dense. They surround and destroy antigens and signal lymphocytes

Front 10

Lymphocytes (B Cells)

Back 10

 B Cells: Produce antibodies
i. Immunoglobulin: Neutralizing antibodies
ii. These cells retain a memory of the neutralizing antibodies so as to responder faster to the threat next time it appears

Front 11

Lymphocytes "Killer Cells"

Back 11

i. Killer: Directly destroys antigens
ii. Helper: Signals B cells and other T cells to act
iii. Suppressor: Suppresses antibodies when they are no longer needed
iv. Memory: Remembers the antigen so as to initialize a faster response the next time the antigen appears

Front 12

Autoimmune Disease

Back 12

 Imbalance in cell types. There are too many Helper T cells, which has the system attacking itself and its normal, healthy cells
• Rheumatoid arthritis and AIDS
 Immune response is affected by psychological factors
• Psychoneuroimmunology (PNI): The study of psychological influences of neurological responses

Front 13

Nature of AIDs

Back 13

(a) The diseases course from HIV varies from person to person
(i) Median time from initial infection to AIDs is about 7.3-10 years
(b) In developing countries, most die within 1 year of diagnosis
(i) 15% survive 5+ years
(c) The stress of receiving the diagnosis can be devastating
(d) Highly Active AntiRetroviral Therapy (HAART)
(i) A powerful treatment, but not a cure and has severe side effects

Front 14

AIDs Stress Reduction Program

Back 14

(a) AIDs progression is faster with high stress and low social support
(b) The goal of reduction programs is to develop resources for reducing stress and to boost the immune system
(c) Many outcomes have increased patients’ T-helper cells, lowered their antibodies, and enhanced their psychological adjustment

Front 15

Cancer: Psychosocial Influences

Back 15

(a) Psychoncology: The study of psychological factors and their relationship to cancer
(i) Psychological and Behavioral Contributions
 Perceived lack of control
 Poor coping responses
 Stressful life events
 Life-style risk behaviors
(ii) Impacts
 Immune function
 Viral activity
 DNA repair processes
 Gene expression

Front 16

Cancer: Psychosocial treatments

Back 16

(i) They improve health habits, treatment adherence, endocrine function, and encourage more functional stress response/ coping

Front 17

Hypertension

Back 17

(a) Cardiovascular disease
(i) Heart, blood vessels, and regulatory mechanisms are involved
(b) Hypertension
(i) Increases the risk for stroke or cerebral vascular accidents (CVAs), heart disease, kidney disease
(ii) Taxes the blood vessels
(iii) 27.6% of people 35-64 have this disease
 African Americans have 2x the risk of developing it
 About 90% of cases have no identifiable cause
• Considered a “silent killer”
(iv) Causes to avoid
 Salk intake, fluid volume, sympathetic arousal, stress level, expressed anger, and hostility

Front 18

Coronary Heart Disease

Back 18

(a) Coronary Heart Disease (CHD): Blockage of the arteries that supply blood to the heart
(i) Angina pectoris: chest pain due to partial obstruction
(ii) Atherosclerosis: plaque (fatty substances) clog the arteries
(iii) Ischemia: Deficient blood supply due to plaque buildup in the arteries
(iv) Myocardial infarction: heart attack and death of heart tissue
(b) Psychological and Behavioral Risk Factors
(i) Stress, anxiety, and anger
(ii) Poor coping skills
(iii) Type A Behavior Pattern

Front 19

Chronic Pain

Back 19

(a) Types
(i) Acute: about a month in duration
(ii) Chronic: does not decrease over time
(iii) Clinical distinction: pain vs. pain behaviors
(b) Psychological and Social Factors
(i) Severity of pain does not predict one’s reaction to it
(c) Biological Aspects
(i) Gate Control Theory: Different nerve bundles send different kinds of pain signals
 Hypervigilance (stress) vs. Inhibitory signals (relaxed)
(ii) Endogenous opioids: endorphins that shut down pain
 Associated with self-efficacy
(iii) Gender differences
 Types of pain
 Regulating mechanisms are estrogen dependent
2) Treatment response, based on the gender there are different requirements

Front 20

Chronic Fatigue Sydnrome

Back 20

(a) Nature of Chronic Fatigue (CF)
(i) Lack of energy, marked fatigue, pain, low grade fever
(b) More females afflicted than males
(i) Generally an adult onset
(ii) Incidence increasing in Western countries
(c) No apparent cause, though it could be related to a few different disease
(i) Lifestyle factors; high achievement and fast paced,
(ii) Stress , illness, psycholigcal misinterpretation of after effects
(d) Treatment
(i) Medications are ineffective, though CBT is promising

Front 21

Psychosocial Treatments of Medical problems

Back 21

1) Biofeedback: The patients monitoring and controlling their bodily responses
(a) Muscle tension, heart rate, blood pressure, EEG rhythms
(b) Increased sense of control
(c) Efficacy: chronic headache, hypertension
2) Relaxation and Meditation
(a) Progressive muscle relaxation
(b) Transcendental meditation ™
(i) Developmental relaxation response
(c) Increased sense of control and mastery

Front 22

Handling Comprehensive Problems

Back 22

(a) Monitor and identify stressful
(i) Times, intensity, triggers
(b) Monitor somatic symptos, cognitive therapy, increasing coping strategies
(i) More effective and individual components

Front 23

The Value of Coping

Back 23

1) Denial as a Means of Coping
(a) Coronary Bypass Surgery and Optimists
(i) Quicker recovery time, stronger quality of life, less likely to use denial
(b) Value of denial may depend on timing
(i) Better with the initial diagnosis, but less useful at later stages of the disease

Front 24

Effects of Drug Treatments

Back 24

1) Drugs and Stress Reduction Programs
(a) Medication may decrease efficacy of comprehensive programs
(i) Facilitates initial pain reduction, but the patient develops rebound headaches
(ii) High relapse probability when the medication is stopped
(iii) Tolerance, the patient needs a higher and higher dosage of the medicine to obtain relief
(iv) Withdrawal, the patient may have unpleasant side effects when the drug withdraws