Psychology 2310A/B Lecture Notes - Irritable Bowel Syndrome, Fibromyalgia, Mental Disorder

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Psychophysiological Disorders
Changing Conceptions of Psychophysiological Disorders
Mind-body dualism: the mind and body are separate entities, subject to different
laws (Rene Descartes)
Traditional biomedical model: health constitutes the freedom from disease, pain,
or defect, thus making the normal human condition “healthy”
oThe biomedical model of health focuses on purely biological factors, and
excludes psychological, environmental, and social influences
Development of Psychosomatic Medicine
oEarly 20th century
oCertain illnesses were thought to be psychosomatic (eg, asthma, ulcers,
migraine headaches, arthritis, hypertension)
oFranz Alexanders Nuclear Conflict Theory
Problems with the Psychosomatic Model
oOutdated psychoanalytic ideas
oRetains mind-body dualism problem
oWeak research support
oLack of clinical applications
Current view in Health Psychology: Biopsychosocial Model
A general model or approach positing that biological, psychological (which entails
thoughts, emotions, and behaviors), and social factors, all play a significant role in
human functioning in the context of disease or illness
Holistic view: relating to or concerned with complete systems rather than with
individual parts
Systems approach
oBiological
oPsychological
oSociocultural
Stress-vulnerability-coping
DSM approaches
DSM-II – Psychophysiological Disorders
oReplaced “psychosomatic”
oNumerous specific disorders were listed
oEg, migraine headache, asthma, hypertension, arthritis, ulcers, Reynaud’s
disease
DSM-III, IV, & 5 – Psychological Factors Affecting Medical Condition
oAny medical condition may be involved
DSM-5 – Psychological Factors Affecting Medical Condition
A medical symptom or condition (other than a mental disorder) is present
This can include any type of medical condition:
Disease with clear pathophysiology
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oEg, diabetes, cancer, coronary disease
Functional syndromes
oEg, migraine, irritable bowel syndrome, fibromyalgia
Idiopathic medical symptoms
oEg, pain, fatigue, dizziness
Psychological or behavioural factors adversely affect this medical condition
Examples of psychological factors:
oDiagnosed mental disorders
oPsychological symptoms (non-diagnosable)
oPersonality traits or coping style
oMaladaptive health behaviors
oStress-related physiological response
How might psychological factors “adversely affect” a medical condition (according to
DSM-5)?
1. Influence the course of the illness
Development, exacerbation, delay recovery
2. Interfere with treatment of the illness
3. Constitute an additional health risk (eg, smoking)
4. Influence underlying pathophysiology, precipitating or exacerbating symptoms of the
illness (eg, stress)
Distinguished from Somatoform Disorders
Health Psychology: The Role of Psychology in Physical Health and Illness
Physiological effects of stress, depression, etc
Poor coping skills – affect stress levels
Relationship problems – lack of social support
Lifestyle behaviours – e.g., smoking, obesity, exercise
Cognitions about health and illness – attributions, attitudes, expectancies
Adherence to medical treatments
Doctor-patient relationship
Major Causes of Death Today
Cardiovascular Disease (Heart, Stroke)
Cancer
COPD (Chronic Obstructive Pulmonary)
Accidents
Diabetes
Infectious Diseases (e.g., AIDS)
Suicide
Homicide
NOTE: Psychological Factors can play a role in all of these
Stress – The HPA Axis
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