Physical Disorders and Health Psychology

Chapter 9 Physical Disorders and wellness Psychology psychosomatic medicine- psych factors affect physical guide conductal medicine- employ to prevention, diagnosing and treatment of medical problems health psychology- psych factors that are important to the alimentation and promotion of health opsych and mixer factors (1) affect biological processes (2) long-standing behavior ensamples hurl ppl at try for certain disorders o50% of terminations from top 10 leading brings in US can be traced to lifestyle behaviors poor eating habits, smoking, deprivation of exercise, General Adaption Syndrome (GAS)- Selye oalarm- receipt to immediate danger or threat oresistance- pull together coping mechanisms to respond oexhaustion- form suffers standing(prenominal) damage chronic emphasise may ca utilization permanent personify damage and contribute to infirmity puree= physiological response to var.or HPA Axis ohypothalamus- pituitary secretor- adrenal gland oimportant for str ess ocortisol= stress hormone baboon case study odominant males beget little(prenominal) stressful lives due to predictability + containlability o turn away males experience stress from bullying, advanceder cortisol levels o experience of bidding important stress, anxiety, depressive disorder related osimilar underlying physiological processes oself-efficacy sense of break and confidence that one can cope with stress or challenges stress can lead to hangd immune system functioning oincreased range of infectious distempers, mono, colds, flu, Immune system oeliminates antigens- foreign maerials, bacteria, viruses, parasites o2 main parts humoral B cells, antibodies neutralize antigens cellular T cells, destroy viral infections + cancerous processes owhite blood cells do most of the work (leukocytes) microphages= first line of defense autoimmune unsoundness oimmune system overactive, attacks body cells rheumatoid arthritis- too m either suppressor T cells, body subject to i nvasion by antigens HIV- human immunodeficiency virus ?AIDS-related difficult first minor health problems before AIDS diagnosis w. pneumonia, cancer, dementia, waste syndrome ? treated w/ noblely active antiretroviral therapy reducing stress, social support, CBT uphold psychoneuroimmunology (PNI) opsych influences on neurological responding implicated in immune response cancer psychoncology- psych influences in development of cancer some otherapy can help treatment to abridge stress, improve inclination, shorten important health behaviors, supportive relationships reduce cancer recurrence and dying influence support + development of cancer obene extend finding- deepening spirituality, changes in life priorities, closer ties to others, intensify sense of purpose opsych procedures important to manage stress especially w/ children who undergo surgery Cardiovascular problems ocompromise breast, blood vessels and control mechanisms cardiovascular disease ostrokes ocerebral va scular accidents- temporary blockages of blood vessels to learning ability answer temporary/ permanent damage ohypertension- high blood pressure, risk factor for other nubble probs blood vessels constrict, heart works harder, pressure essential hypertension- no confirmable physical cause silent fling offer blacks to a greater extent 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 musclebuilder chest wound plaque deficiency of blood to a body part heart attack- death of heart tissue when artery block stress, anxiety, anger contribute (+lack of coping skills and low social support) myocardial stunning- heart failure as a result of unadulterated stress oType A behavior pattern luxuriant competitive drive, sense of pressured for time, impatience, high E, angry come to the forebursts at risk for CHD (although cultural diff s significant) oType B behavior pattern much relaxed, less concerned near deadlines, seldom pressured, Reserve might simulate associations among environments of low socioeconomic status, stressful experiences, psychosocial resources, emotions and cognitions increase risk for CHD put out 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 component= torture oseverity of pain doesnt predict reaction b/c of psych factors phantasma limb pain oppl who apply lost an arm or offset 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 painful stimuli travel to spinal column then to drumhead odorsal horns of spinal column= gate osmall fibers open gate, large fibers close brain inhibits p ain oendogenous opiods- naturally exist within body endorphins oshut d testify pain, runners high after exercise, men and w presage exp pain differently omen have unwaveringer endogenous opiod systems owomen have additive pain-regulating mechanisms odiff areas more prone to pain degenerative fatigue syndrome (CFS) olack of E, fatigue, variety of aches and pains oneurasthenia- 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 cycle Biofeedback omake patients witting of detail physiological functions that ordinarily not be consciously cognisant of heart rate, blood pressure, muscle tension in specific areas, encephalogram rhythms, patterns of blood hang up (1) conscious certifiedness (2) learn to control them oinstill sense of control over pain progressive remainder obecome acutely aware of te nsion, relax specific muscle groups transcendental meditation ofocus attention on repeated syllable, or mantra relaxation response- silently repeat mantra to minimize disturbance by closing mind to intruding thoughts Coping mechanisms oprescription drugs, reduced durability 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 tobacco is symbol of personal freedom, important for social interactions, health effects can be controlled, important to economy, Stanford Three Community canvas o1 community- assessed risk factors for CHD and smoking o2 community- media blitz on risk factors o3 community- showcase to face interventions, most successful at reducing CHD risk factors Chapter 10 internal and Gender Identity Disorders gender individuation disor der- psych dissatisfaction w/ ones biological ride, disturbance in identity internal disfunction- difficult to function while having excite, ie no orgasm paraphilia- rousing due to unlike objects/ individuals ophilia- strong attraction opara- abnormal male female sex differences omen lounge around more and admit it ofemales associate sex w/ move + intimacy rather than male physical triumph omen have diff attitude toward casual premarital sex omen show more informal disposition/ arousal omens self-concept characterized more by power, independence, aggression owomens sex beliefs are more plastic/ unsealed women emphasize relaitonships familiar self schemas- core beliefs about knowledgeableity pagan differences oSambia in Papua New Guinea adolescent boys encouraged to engage in homosexual oral sex b/c semen precious wtf Homosexuality omight run in families, genetic component? odifferential hormone photograph in utero ogreater probably of being left handed or bimanual o longer ring finger than index ofraternal birth order hypothesis- each additional older brother increased odds of being gay 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 elicit by wearing clothing of opposite sex odifferent from intersex individuals- hermaphrodites, born with indefinite fork, hormonal or physical abnormalities oautogynephilia- when gender identity disorder begins with strong sexual attraction to romance of oneself as a female, then progresses to graceful a woman ogenetic component suspected gender nonconformity oboys behaving femininely or females behaving masculinely sex reassignment surgery controversial to right off 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 shelter psychologically, financially, socially o gynecomastia- growth of breasts intersex individuals- born w/ physical charactersitics of two sexes o5 sexes males females herms merms- more male than female but have some femal genitalia ferms- ovaries but possess some male genitalia Sexual dysfunction oinability to become unrestrained or reach orgasm o3 stages of sexual response cycle desire, arousal, orgasm opremature ejaculation vaginismus- painful contractions in vagina during attempted acuteness 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 evoke fear, little terror 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- diff iculty reaching orgasm retarded ejaculation- cumming hold up 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 found for pain vaginismus- pelvic muscles in outer third of vagina involuntarily spasm oripping, burning, boisterous 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 appendage 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 blooper prescription drugs ?anti-hypertensive medications for high blood pressu re ?antidepressants ?SSRIs mess w/ arousal and desire elicit drugs- cocaine cigarettes opsych contributions anxiety- can increase or decrease desire distraction men who are dysfunctional report less sexual arousal inducing positive or contradict mood directly affects arousal performance anxiety, 3 parts ?arousal, cognitive processes, banish affect erotophobia- negative cognitive set about sexuality, viewed as negative or threating ? learned early in childhood from families, religious government activity ? early 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, massagi ng 1st phase no fork or boobs 2nd phase genitals but no sex or orgasm 3rd sex once aroused osqueeze technique- mash tip of penis to reduce arousal and gain control over ejaculation omasturbation training and porn omedical treatments oral medication (Viagra) injection of vasoactive nerve centres directly into the penis? surgery vacuum de debility therapy Paraphilia if exists, individuals normally exhibit eightfold paraphillic patterns oassociated w/ deficiencies in consensual adult sexual arousal, social skills, sexual fantasies frotteurism orubbing against someone in a crowded public place until rase 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 leve ls of edu transvestic fetishism osexual arousal from cross-dressing sexual sadism oinflicting pain or abjection 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 o disguised 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 chemical 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 os teal, gamble, set fires, pull out hair poly inwardness rib- using tenfold substances substance use oingestion of mind-altering substances in moderate amounts that does not thwart 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 aforementioned(prenominal) effect (tolerance) onegative physical response when substance no longer ingested (withdrawal) oNicotine is arguably most habit-forming drug in the world, more so than fruitcake 5 substance categories o(1) depressants- sedation + relaxation alcoholic drink o(2) stimulants- active + alert 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 centr al 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 GABA receptors anxiety influences glutamate system- excitatory, memory, blackouts withdrawal delirium- frightening hallucinations, body tremors liver disease, pancreatitis, cardiovascular disorders, brain damage dementia- exit of intellectual abilities Wernicke-Korsakoff syndrome- loss of muscle coordination, confusion, unintelligible speech fetal alcohol syndrome- when pregnant 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- imbibition occasionally, few consequences prodromal stage- drinking heavily, outward signs of a problem a uthoritative stage- loss of control, binges chronic stage- primary daily activities involve drinking odrinking at early age is predictive of later abuse alcohol link up to violent behavior oBarbiturates sedatives, help ppl sleep highly addictive overdosing felo-de-se influence GABA obenzodiazepines reduce anxiety highly prescribed in US alcohol amplifies effect oStimulants most commonly used psychoactive drugs in US amphetamine use disorders ?reduce longing ?narcolepsy, ADHD, methylphenidate ?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 omari juana oLSD Other drugs oSpecial K osteroids oPCP Family and genetic influence neurobiological influence o delight pathway in brain mediates experience of reward odopamine- pleasure oGABA- inhibitory NT Psych dimensions opositive reinforcement negative reinforcement- use drugs to cope/escape from defective feelings and difficult life circumstances oopponent-process theory- an increase in positive feelings get out 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 frugality in the face of temptation odisease model of dependence- drug dependence cause by an underlying physiological disorder cultural factors oacculturation- adapt to new-sprung(prenominal) culture omachismo neuroplasticity brains tendency to reorganize itself by forming new neural connections ocontinued use of substance. dec reased desire for nondrug experiences Treatment obiological agonist substitution- take 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 offset 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 entrust reward certain behaviors community reinforcement approach motivational interviewing- sympathetic and optimistic counseling CBT relapse prevention Impulse control disorders ointermittent volatile disorder- episodes where act on aggressive impulses serious assaults or destruction of attribute influenced by NT levels okleptomania re actual failure to resist urge to steal things not needed for personal use or monetary value high comorbidity with mood disorders opyromania irresistible urge to set fires pathological gambling otrichotillomania twist out ones hair from anywhere on body oothers impelled shopping-oniomania struggle picking self mutilation computer addiction Chapter 12 Personality Disorders spirit 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 work out model oextroversion- talkative + assertive vs passive and reserved oagree-ableness- kind believe 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 Cl uster B dramatic, emotional, erratic oantisocial (m)- irresponsible, reckless behavior oborderline (f) ohistrionic (f)- excessive emotionality and attention seeking onarcissistic Cluster C fearful, anxious oavoidant odependent oobsessive compulsive Biases ocriterion gender bias- criteria biased oassessment gender bias- assessment measures biased