Physical Disorders and Health Psychology

Chapter 9 bodily Disorders and Health Psychology psychosomatic medicine- psych factors affect personal function behavioural medicine- applied to prevention, diagnosing and discourse of medical difficultys health psychology- psych factors that are substantial to the maintenance and promotion of health opsych and formly factors (1) affect biological processes (2) long-standing conduct patterns put ppl at find for certain trouble oneselfs o50% of wipeouts from top 10 leading(p) constructs in US rump be traced to lifestyle fashions poor feeding habits, smoking, lack of exercise, General Adaption Syndrome (GAS)- Selye oalarm- resolution to immediate danger or bane oresistance- mobilize coping mechanisms to respond oexhaustion- body suffers permanent damage degenerative stress may cause permanent body damage and give way to disease stress= physiologic reaction to stressor HPA Axis ohypothalamus- pituitary gland- adrenal gland gland oimportant for stress ocortisol= str ess horm matchless baboon case study odominant males chip in less stressful stands referable to predictability + agreelability olower males experience stress from bullying, eminenter cortisol levels o spirit of simplicity important stress, anxiety, depression related o like underlying physiological processes oself-efficacy maven of dominance and confidence that one can cope with stress or challenges stress can lead to decreased tolerant system procedure oincreased rates of infectious diseases, mono, c d erraticerys, flu, Immune system oeliminates antigens- foreign maerials, bacteria, computer viruses, parasites o2 main separate humoral B cells, antibodies neutralize antigens cellular T cells, destroy viral infections + malignant neo credit card diseaseous processes owhite tune 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 T cells, body su bject to invasion by antigens HIV- human immunodeficiency virus ?AIDS-related complex first minor health problems before AIDS diagnosis w. pneumonia, cancer, dementia, wasting syndrome ? treated w/ highly active antiretroviral therapy reducing stress, affectionate support, CBT help psychoneuroimmunology (PNI) opsych captures on neurological responding implicated in immune response Cancer psychoncology- psych influences in development of cancer other(a)apy can help treatment to inflict stress, improve mood, alter important health sorts, supportive relationships pull good deal cancer recurrence and dying influence support + development of cancer obenefit finding- deepening spirituality, changes in life priorities, approximate ties to others, enhanced sense of purpose opsych procedures important to manage stress curiously w/ children who undergo surgery Cardiovascular problems ocompromise kindling, blood vessels and delay mechanisms cardiovascular disease ostrokes ocerebral vascular accidents- brief blockages of blood vessels to brain cause temporary/ permanent damage ohypertension- high blood rack, risk factor for other heart probs blood vessels constrict, heart works harder, pressure essential hypertension- no verifiable natural cause silent killer blacks more 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 muscle chest paroxysm plaque deficiency of blood to a body part heart attack- death of heart tissue when artery clogged stress, anxiety, anger contri merelye (+lack of coping skills and low social support) myocardial stunning- heart visitation as a result of intense stress oType A fashion pattern excessive competitive jampack, sense of pressured for time, impatience, high E, angry outbursts at risk for CHD (although cultural diffs significant) oType B behavior pattern more relaxed, less concerned about deadlines, seldom pressured, conquer capacity model associations among environments of low socioeconomic status, stressful experiences, psychosocial re seeded players, emotions and cognitions increase risk for CHD Pain oacute- follows an injury, disappears once injury heals ochronic- begins w/ acute episode but does non go away osubjective term pain vs. pain behaviors= manifestations of exp oemotional role= suffering oseverity of pain doesnt predict reaction b/c of psych factors Phantom limb pain oppl who have lost an arm or leg feel excruciating pain in the missing limb operant stop of pain pain behavior under control of social consequences oie critical family members may become sympathetic gate control theory of pain onerve pulse rates from painful stimuli travel to spinal column and so to brain odorsal horns of spinal column= gate osmall fibers open gate, large fibers completion brain inhibits pain oendogenous opiods- naturally exist within body endor phins oshut down pain, moon cursers high after exercise, men and w prodigy exp pain differently prodigy have stronger endogenous opiod systems owomen have additional pain-regulating mechanisms odiff areas more given over to pain Chronic fatigue syndrome (CFS) olack of E, fatigue, variety of aches and pains oneuras thuslyia- lack of nerve strength, old diagnosis oprevalent in western world 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 beat Biofeedback omake patients aware of specialised 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 aggressively aware of tension, relax specific muscle groups transcendental me ditation ofocus wariness on repeated syllable, or mantra relaxation response- silently repeat mantra to lessen distraction by closing mind to intruding thoughts Coping mechanisms oprescription doses, bring down effectiveness 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 bad behavior is only effective prevention strategy smoking is pestilent in china omyths tobacco is symbol of personal freedom, important for social interactions, health effects can be controlled, important to economy, Stanford Three confederacy Study o1 community- assessed risk factors for CHD and smoking o2 community- media blitz on risk factors o3 community- showingcase to face interventions, most successful at reducing CHD risk factors Chapter 10 knowledgeable and Gender Identity Disorders sex activity identity illness- psych dissatisfaction w/ ones biologi cal fire, disturbance in identity familiar dysfunction- vexed to function while having sex, ie no orgasm paraphilia- arousal due to inappropriate objects/ individuals ophilia- strong tie opara- abnormal male distaff sex differences omen masturbate more and admit it ofemales fellow sex w/ romance + intimacy rather than male physical gratification omen have diff attitude toward casual premarital sex omen show more sexual believe/arousal omens self-concept characterized more by power, in dependance, aggression owomens sex beliefs are more plastic/ changeable women emphasize relaitonships sexual self schemas- core beliefs about sexual urge Cultural differences oSambia in Papua New Guinea adolescent boys encouraged to pursue in homosexual oral sex b/c semen jimmyd wtf Homosexuality omight run in families, genetic component? odifferential endocrine gland exposure in utero ogreater probably of being left handed or ambidextrous olonger ring finger than index ofraternal birth order hypothesis- severally additional older brother increased odds of being ethereal by one third Gender identity disorder oa persons physical gender is not consistent with persons sense of identity tapper in a body of the wrong sex otranssexualism odifferent from transvestic fetishism- sexually worked up by wearing clothing of opposite sex odifferent from intersex individuals- hermaphrodites, innate(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 beseeming a woman ogenetic component suspected gender nonconformity oboys behaving femininely or females behaving masculinely sex reassignment surgery polemic to directly alter gender identity to match 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- growth of breasts inters ex individuals- born w/ physical charactersitics of both sexes o5 sexes males females herms merms- more male than female but have both(prenominal) femal genitalia ferms- ovaries but possess some male genitalia Sexual dysfunction oinability to become aro apply or reach orgasm o3 stages of sexual response cycle desire, arousal, orgasm o ill-timed ejaculation vaginismus- painful contractions in vagina during act penetration olifelong or acquired ogeneralized or situational odue to psych factors or medical condition hypoactive sexual desire disorder olittle or no interest in any type of sexual activity sexual aversion disorder othought of sex or brief casual touch may hassle 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 sufficient desire and arousal (common in women) ofemale orgasmic disorder- difficulty reaching orgasm developmen tally challenged ejaculation- cumming delayed oretrograde ejaculation- shoot 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 disrupted odyspareunia- no medical reason strand for pain vaginismus- pelvic muscles in outer third of vagina involuntarily muscle spasm oripping, burning, tearing sensations during sex Assessing Sexual behavior o(1) interviews- and questionnaires o(2) thorough medical eval- find 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- press arteries venous leakage- blood flows out too quickly for a secure boner prescription drugs ?anti-hypertensive medications for high blood pressure ?antidepressant s ?SSRIs mess w/ arousal and desire elicit drugs- cocaine cigarettes opsych contributions anxiety- can increase or decrease desire distraction men who are dysfunctional motif less sexual arousal inducing lordly or shun mood directly affects arousal performance anxiety, 3 parts ?arousal, cognitive processes, minus affect erotophobia- negative cognitive set about sexuality, viewed as negative or threating ? learned early in childhood from families, apparitional authorities ? early sexual trauma, rape victims script theory- we all point by following scripts that reflect social and cultural expectations and guide our behavior sexual myths/ misperceptions Treatment for sexual dysfunction education is very effective, sprinkle 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 genitals or b oobs 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) snapshot of vasoactive center of attentions directly into the penis? surgery vacuum device therapy Paraphilia if exists, individuals normally let on multiple paraphillic patterns oassociated w/ deficiencies in consensual adult sexual arousal, social skills, sexual fantasies frotteurism orubbing against someone in a crowded public go in 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 bum voyeurism obeing aroused by observing unsuspecting individuals undressing or naked immodesty osexual gratification from exposing genitals to strangers orisk + anxiety can increase arousal oassociated w/ lower levels of edu transvestic fet ishism osexual arousal from cross-dressing sexual sadism oinflicting pain or humiliation 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 aro exploitation images w/ reasons why behavior is harmful or life-threatening orgasmic reconditioning opatients instructed to masturbate to usual fantasies but substitute more desirable ones righteous before ejaculation Drug treatments chemical castration- eliminates sexual desire + fantasy by greatly reducing testosterone levels ocyproterone acetate + medroxyprogesterone ouseful for unplayful 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 o disti nguish, gamble, set fires, pull out hair polysubstance abuse- using multiple substances substance use oingestion of psychoactive substances in moderate amounts that does not impair social, educational or occupational functioning intoxication- getting high or drunk oimpairs judgment, mood changes, lowered motor ability substance abuse ohow much 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 (withdrawal) oNicotine is arguably most habit-forming drug in the world, more so than meth 5 substance categories o(1) depressants- sedation + relaxation intoxicant o(2) stimulants- active + alert caffeine o(3) opiates- analgesia + euphoria morphia o(4) hallucinogens- alter sensory perception weed, LSD (5) other drugs- dont fit neatly into categories steroids Depressants odecrease central nervous system activity, reduce le vels of physiological arousal omost likely to produce dependence, tolerance, withdrawal oalcohol reduces inhibition, motor coordination, reaction time, intellect esophagusstomachsmall intestinesbloodstreamheart (+other major organs) liver influences GABA receptors anxiety influences glutamate system- excitatory, memory, blackouts withdrawal delirium- excite hallucinations, body tremors liver disease, pancreatitis, cardiovascular disorders, brain damage dementia- discharge of clever abilities Wernicke-Korsakoff syndrome- loss of muscle coordination, confusion, unintelligible speech fetal alcohol syndrome- when large(predicate) 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 crapulence pre alcoholic- drink occasionally, few consequences prodromal stage- drinking heavily, outward signs of a problem crucial stage- loss of control, binge s chronic stage- primary daily activities involve drinking odrinking at early age is predictive of later abuse alcohol linked to violent behavior oBarbiturates sedatives, help ppl sleep highly addictive overdosing suicide influence GABA obenzodiazepines reduce anxiety highly positive in US alcohol amplifies effect oStimulants most commonly used psychoactive drugs in US amphetamine use disorders ?reduce appetite ?narcolepsy, ADHD, Ritalin ?stimulants illegally do by by college students no shit lechatelierite 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 experience of punish odopamine- pleasure oGABA- inhibitory NT Psych dimensions opositive reinforcement negative reinforcement- use drugs to cope/ black market from bad feelings and difficult life circumstances oopponent-process theory- an increase in positive feelings will be followed shortly by an increase in negative feelings and vice versa cognitive factors oplacebo effect oexpectancy theory social dimensions opeer pressure omarketing omoral impuissance 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- hold to new culture omachismo neuroplasticity brains tendency to reorganize itself by forming new flighty connections ocontinued use of substance. decreased desire for nondrug experiences Treatment obiological agon ist substitution- tug a safe drug that has a chemical makeup similar to the addictive drug ? methadone instead 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 dying of property influenced by NT levels okleptomania recurrent failure to resist urge to steal things not needed for personal us e or monetary value high comorbidity with mood disorders opyromania irresistible urge to set fires pathological maneuver otrichotillomania pulling out ones hair from anywhere on body oothers imperious shopping-oniomania skin picking self mutilation computer addiction Chapter 12 record 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 distress 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 harden 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 b ehavior oborderline (f) ohistrionic (f)- excessive emotionality and attention seeking onarcissistic Cluster C fearful, ardent oavoidant odependent oobsessive compulsive Biases ocriterion gender bias- criteria biased oassessment gender bias- assessment measures biased