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Lecture 17

Psychology 46-322 Lecture 17: Notes on Health-Related Disorders

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Lecture 17 on Health-Related Disorders Chronic Illness  More than 10% of kids experience chronic illness  This group very heterogeneous in age of onset, limitations associated with illness, severity, duration, etc.  Chronic illness is not one disorder, and is associated with many facets  Causes distress on the child and the family (disrupts family routine, costs money, changes interaction as a family)  Chronic means at least 3 months with significant symptoms (most are over the life course or very long time)  Prevalence is actually increasing o Our treatments are getting better o We have more and more infant who are surviving  Used to be called psycho-somatic illnesses, but now recognize more chronic illness has psychological component Adjustment  Kids who are chronically ill have a hard time concentrating on other things in life  Is dynamic and ongoing  you are well-adjusted this week doesn’t mean you will be next week  Factors that predict adjustment o Severity of the illness (varies within illnesses) o Symptoms vary in severity over time o Predictability of the illness (If things are predictable, they are less stressful) o Level of stress predicts adjustment for the child and family o Perception of the illness o The degree of functional impairment Asthma  10% kids are diagnosable and number is growing  Symptoms vary between children  Disease factors o Very heritable, tied up with the immune system functioning o Environmental triggers (vary in different people) might include cold air, cigarettes, exercise o Increased rates of respiratory infections o Kids who are stressed have more asthmatic episodes  3 types of asthma: o Swelling in the respiratory system; coughing because of the mucus, narrowing of the passages o Narrowing of the air passages (Reduces lung functioning and more visits in the emergency room) o Disrupts learning, inhalers cause hyperactivity Treatment  Environmental control  removing the allergy in the environment (ex. stuffed animals or pets), smoking parents (they must quit; smokes is in their clothes and hair thus smoking outside doesn’t solve the problem)  Meds  children get meds at least temporarily, or treat the allergies o Inhaled steroids to reduce swelling, bronchodilators to push tissues back (long or short acting)  **kids with asthma usually outgrow with age  Avoid infections  Coping and self-management (ex. teaching kids what to do when the asthmatic episode happens and coping strategies)  Some meds have side effects: reduce growth, bronchodilators also cause hyperactivity and attention problems (some with chronic asthma look like they have ADHD) Cancer  A disease categorized by proliferation of malignant cells (cells grow the way they should not grow)  Most common type  acute lymphoblastic leukemia (ALL)  In 1960s, 1% of survival rate for 5 years; now is 88% in 5 years (most will survive to 5-year mark, and most survive beyond that)  Most treatments are very invasive (ex. chemo and radiation); many are painful as well  To treat cancer is to destroy cancer cells, but it's collateral damage  Massive tissue loss (part of central nervous system)  healthy cells around the damaged cells are destroyed as well  Cancer used to be a short term illness and most of the time the kids die  Now it's long term treatment and they tend to survive (re-characterized as chronic illness) Diabetes  One of the most common chronic illnesses in humans, increasing prevalence largely due to obesity  Problem is not only causing intermediate damage, but damages the kidneys, the heart, the eyes, the brain  Management o Enhanced testing  self-management for presence of sugar (multiple times per day) o Increasing protein, keep track of sugar and limiting sugar including sugar in fruit and vegetables, goo
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