Physical Disorders and Health Psychology

Chapter 9 Physical Dis molds and Health Psychology psych iurotic medicine- psych factors change visible function lookal medicine- applied to legal profession, diagnosis and treat custodyt of medical examination problems wellness psychology- psych factors that be grand to the upkeep and promotion of health opsych and cordial factors (1) affect biological processes (2) long-standing doings patterns put ppl at bump for received disorders o50% of demolitions from top 10 leading causes in US low smell be traced to lifestyle deportments poor ingest habits, smoking, drop of exercise, General Adaption Syndrome (GAS)- Selye oalarm- response to neighbo noise(a) d peevishness or threat o jibeance- collect coping mechanisms to respond oexhaustion- personify suffers permanent modify chronic tensity may cause permanent body harm and contri howevere to disorder stress= physiologic response to stressor HPA Axis ohypothalamus- pituitary gland- adrenal gland gland o wei ghty for stress ocortisol= stress internal secretion baboon case study odominant manlys aim little buttock-wracking lives due to phoneability + checkerlability olower males experience stress from bullying, full(prenominal)er cortisol levels o sand of curtail important stress, misgiving, depression related o confusable underlying physiological processes oself-efficacy sense of control and confidence that one bum strive love with stress or ch altogetherenges stress bottom of the inning lead to rock-bottom immune system of districts functioning o improverd judge of infectious diseases, mono, colds, flu, Immune system oeliminates antigens- abroad maerials, bacteria, viruses, parasites o2 main parts hum spoken B cells, antibodies antagonise antigens cellular T cells, destroy viral infections + malignant processes owhite consanguinity cells do most of the conk (leukocytes) microph long times= introductory line of defense autoimmune disease oimmune system overacti ve, attacks body cells woebegone arthritis- too m either suppressor T cells, body subject to invasion by antigens HIV- human immunodeficiency virus ? aid-related complex first minor health problems before AIDS diagnosis w. pneumonia, pubic louse, dementia, wasting syndrome ? treated w/ highly active antiretroviral therapy reducing stress, accessible support, CBT help psychoneuroimmunology (PNI) opsych influences on neurological responding affect in immune response crab louse psychoncology- psych influences in development of cancer another(prenominal)apy can help treatment to deoxidize stress, cleanse belief, deviate important health behaviors, confirming relationships stretch cancer recurrence and demise influence support + development of cancer obenefit finding- add spirituality, changes in life priorities, closer ties to others, deepen sense of purpose opsych procedures important to fill in stress especially w/ children who tolerate operating theatre Cardiovasc ular problems ocompromise nubble group, face-to-face line of credit vessels and control mechanisms cardiovascular disease ostrokes ocerebral vascular accidents- temp blockages of railway line vessels to headland cause transient/ permanent damage ohypertension- high roue printing press, try factor for other flavour probs downslope vessels constrict, tenderheartedness works harder, bosom essential hypertension- no verifiable animal(prenominal) cause silent killer blacks much(prenominal) at risk than whites genetic influences anger + hostility increase blood pressure ocoronary heart disease heart disease in 1 cause of death in occidental cultures blockage of arteries provide blood to heart go through pectus spite plaque deficiency of blood to a body part heart attack- death of heart tissue when arterial blood vessel clogged stress, anxiety, anger contribute (+lack of coping skills and low social support) myocardial stunning- heart bereavement as a result of int emperate stress oType A behavior pattern profuse combative agitate, sense of pressured for time, impatience, high E, angry outbursts at risk for CHD (although cultural diffs significant) oType B behavior pattern more than(prenominal) slakeed, less come to active deadlines, seldom pressured, Reserve competency model associations among environss of low socioeconomic status, stressful experiences, psychosocial resources, emotions and cognitions increase risk for CHD Pain oacute- follows an injury, disappears one time injury heals ochronic- begins w/ acute result but does non go forth osubjective term aggravator vs. bruise behaviors= manifestations of exp oemotional fixings= suffering oseverity of annoying doesnt predict reaction b/c of psych factors shade limb pain oppl who have woolly an arm or leg ascertain excruciating pain in the abstracted limb operant control of pain pain behavior under control of social consequences oie critical family members may fit symp athetic gate control system of pain onerve impulses from painful stimuli travel to spinal anaesthesia column then to brain odorsal horns of spinal column= gate osmall fibers open gate, overlarge fibers close brain inhibits pain oendogenous opiods- by nature exist within body endorphins oshut d feature pain, kickoffs high after exercise, men and w announce exp pain differently omen have concentrateder endogenous opiod systems owomen have additional pain-regulating mechanisms odiff areas more prone to pain Chronic pall 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 inhering killer cells opain stressvicious roulette wheel Biofeed affirm omake patients aware of particular physiological functions that ordinarily not be certifiedly aware of heart rate, bloo d pressure, muscle tension in special(prenominal) areas, electroencephalogram rhythms, patterns of blood flow (1) conscious awareness (2) learn to control them oinstill sense of control over pain modernised relaxation obecome acutely aware of tension, relax specific muscle groups transcendental guess ofocus attention on repeated syllable, or mantra relaxation response- silently repeat mantra to minify distraction by closing sound judgment to intruding thoughts Coping mechanisms oprescription doses, reduced authorization over time odenial oimproved attitudes, realistic appraisals thru CBT 4 leading causes of death in Us oheart disease, cancer, stroke, respiratory disease AIDS pr neverthelesstion ocontraception ochanging high-risk behavior is only strong prevention strategy smoking is epiphytotic in china omyths tobacco is token of personal freedom, important for social interactions, health loads can be controlled, important to economy, Stanford Three Community Study o1 co mmunity- assessed risk factors for CHD and smoking o2 community- media blitz on risk factors o3 community- front to face interventions, most successful at reducing CHD risk factors Chapter 10 inner and informal practice Identity Disorders exciteual urge individualism disorder- psych dissatisfaction w/ ones biological wake up, disturbance in individuality versed disfunction- difficult to function plot having sex, ie no culmination paraphilia- stimulus due to inappropriate goals/ individuals ophilia- strong attractor opara- abnormal male feminine sex differences omen masturbate more and convey it ofemales associate sex w/ beg + intimacy rather than male somatic pleasure omen have diff attitude toward casual premarital sex omen show more intimate zest/ rousing omens self-concept characterized more by power, in colony, aggression owomens sex beliefs are more plastic/ shot women emphasize relaitonships informal self schemas- core beliefs about sexuality Cultural differences oSambia in Papua New Guinea adolescent boys boost to engage in homosexual oral sex b/c cum valued wtf Homosexuality omight run in families, genetic component? odifferential hormone word-painting in utero ogreater probably of being leftfield handed or ambidextrous olonger ring finger than index ofraternal birth order hypothesis- each additional older crony increased drolls of being audacious by one third Gender identity disorder oa persons physical grammatical sex activity is not consistent with persons sense of identity tapper in a body of the wrong sex otranssexualism odifferent from transvestite fetishism- sexually randy by wearing vesture of opposite sex odifferent from intersex individuals- hermaphrodites, natural with ambiguous genitalia, hormonal or physical abnormalities oautogynephilia- when sexual activity identity disorder begins with strong sexual attraction to hallucination of oneself as a female, then progresses to becoming a woman ogenetic compo nent suspected sexual practice nonconformity oboys behaving femininely or females behaving masculinely sex reassignment surgery polemical to directly alter gender identity to match physical flesh 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 intersex individuals- born w/ physical charactersitics of both sexes o5 sexes males females herms merms- more male than female but have virtually femal genitalia ferms- ovaries but possess slightly male genitalia Sexual dysfunction oinability to become aroused or while away sexual climax o3 stages of sexual response cycle desire, stimulant, orgasm o wrong interjection 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 interest in any type of sexual activity s exual aversion disorder othought of sex or brief casual touch may evoke fear, panic or rebuff 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- 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, 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 fellow memb er expands vaginal photoplethysmograph- measures light rebounded 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 medicates ?anti-hypertensive musics for high blood pressure ?antidepressants ?SSRIs mess w/ arousal and desire elicit drugs- cocain cigarettes opsych contributions anxiety- can increase or hang desire distraction men who are impaired report less sexual arousal inducing starry-eyed or damaging 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 earlyish in childhood from families, religious authorities ? early sexual trauma, rape victims script theory- we all operate by following scripts that reflect social and cultural expectations and guide ou r 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 genitals or boobs second phase genitals but no sex or orgasm third sex once aroused osqueeze technique- hug tip of penis to reduce arousal and gain control over ejaculation omasturbation training and porn omedical treatments oral medication (Viagra) injection of vasoactive shopping centers directly into the penis? surgery vacuum de wrong therapy Paraphilia if exists, individuals normally let out eightfold paraphillic patterns oassociated w/ deficiencies in accordant adult sexual arousal, social skills, sexual fantasies frotteurism orubbing against someone in a herd public place until point of ejaculation festishism operson sexua lly attracted to nonliving objects o(1) inanimate object o(2) source of specific tactile remark rubber o(3) body part pedestal 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 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 arousing images w/ reasons why behavior is harmful or dangerous orgasmic reconditioning opatients instructed to masturbate to usual fantasies but substitute more desirable ones right before ejaculation Drug treatments chemic castrat ion- eliminates sexual desire + fantasy by greatly reducing testosterone levels ocyproterone acetate rayon + medroxyprogesterone ouseful for dangerous sexual offenders who do not respond to alternative treatmens Chapter 11 Substance-related and inclination-control disorders impulse control disorders- inability to resist acting on a drive or temptation osteal, gamble, set fires, hustle out cop poly aggregate abuse- using multiple nerves substance use oingestion of psychoactive substances in moderate amounts that does not impair social, educational or occupational functioning intoxication- get high or drunk oimpairs judgment, mood changes, lowered motor ability substance abuse ohow much ingested is problematic addiction- substance dependence ophysiologically symbiotic on the drug requires increasing amounts to experience resembling effect (tolerance) onegative physical response when substance no longer ingested (withdrawal) oNicotine is arguably most addictive drug in the wor ld, more so than screwball 5 substance categories o(1) depressants- sedation + relaxation inebriant o(2) stimulants- active + sprightly 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 do dependence, tolerance, withdrawal o inebriant reduces inhibition, motor coordination, reaction time, understanding 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- harm of intellectual abilities Wernicke-Korsakoff syndrome- loss of muscle coordination, confusion, unintelligible speech fetal alc ohol syndrome- when pregnant mothers drink, fetal growth retardation, behavior problems, learning difficulties, physical signs alcohol dehydrogenase- enzyme that breaks downward(a) alcohol 3 million ppl dependent in US ostages of alcoholism pre alcoholic- intoxication occasionally, few consequences prodromal stage- drinking heavily, outward-bound signs of a problem crucial stage- loss of control, binges chronic stage- primary daily activities subscribe to drinking odrinking at early age is predictive of later abuse alcohol linked to violent behavior oBarbiturates sedatives, help ppl sleep highly addictive overdosing self-annihilation influence GABA obenzodiazepines reduce anxiety highly prescribed in US alcohol amplifies effect oStimulants most unremarkably used psychoactive drugs in US amphetamine use disorders ?reduce appetence ?narcolepsy, ADHD, Ritalin ?stimulants illegally abused by college students no shit crystal meth MDMA- ecstasy ococaine use disorders alertness, eupho ria, 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 chemical substances in opium poppy have narcotic effect odowners Hallucinogens ochange sensory perception osight, sound, feelings, taste, smell omarijuana oLSD another(prenominal) drugs oSpecial K osteroids oPCP Family and genetic influence neurobiological influence opleasure pathway in brain mediates experience of reward odopamine- pleasure oGABA- inhibitory NT Psych dimensions opositive supporting negative reinforcement- use drugs to cope/escape from bad feelings and difficult life circumstances oopponent-process theory- an increase in positive feelings testament 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 mo del 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 rude(a) culture omachismo neuroplasticity brains tendency to reorganize itself by forming new neural connections ocontinued use of substance. decreased desire for nondrug experiences Treatment obiological admirer 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 opposition drugs- block or counteract make of psychoactive drugs aversive treatment- prescribe drugs that make ingesting abused substance extremely tart opsychosocial therapy inpatient facilities alcoholics anonymous- 12 steps controlled use- controversial covert sensitization- negative associations by imagining tart scenes contingency manage ment- 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 devastation of property influenced by NT levels okleptomania recurrent 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 pulling out ones hair from anywhere on body oothers dogmatic shopping-oniomania skin picking self mutilation calculator addiction Chapter 12 Personality Disorders record 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 scathe or distress ohigh comorbidity Axis I= current di sorder Axis II= chronic problem 5 part model oextroversion- talkative + assertive vs supine and reserved oagree-ableness- kind trusting vs at loggerheads selfish conscientiousness- organized thorough, reliable oneuroticism- even tempered vs nervousness moody oopenness to experience- inventive curious flock 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 onarcissistic Cluster C fearful, anxious oavoidant odependent oobsessive compulsive Biases ocriterion gender bias- criteria non-white oassessment gender bias- assessment measures biased