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Psychology 2310A/B
Rod Martin

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” o The biomedical model of health focuses on purely biological factors, and excludes psychological, environmental, and social influences • Development of Psychosomatic Medicine o Early 20 century o Certain illnesses were thought to be psychosomatic (eg, asthma, ulcers, migraine headaches, arthritis, hypertension) o FranzAlexander’s Nuclear Conflict Theory • Problems with the Psychosomatic Model o Outdated psychoanalytic ideas o Retains mind-body dualism problem o Weak research support o Lack of clinical applications Current view in Health Psychology: Biopsychosocial Model • Ageneral 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 o Biological o Psychological o Sociocultural • Stress-vulnerability-coping DSM approaches • DSM-II – Psychophysiological Disorders o Replaced “psychosomatic” o Numerous specific disorders were listed o Eg, migraine headache, asthma, hypertension, arthritis, ulcers, Reynaud’s disease • DSM-III, IV, & 5 – Psychological FactorsAffecting Medical Condition o Any medical condition may be involved DSM-5 – Psychological Factors Affecting Medical Condition • Amedical symptom or condition (other than a mental disorder) is present • This can include any type of medical condition: • Disease with clear pathophysiology o Eg, diabetes, cancer, coronary disease • Functional syndromes o Eg, migraine, irritable bowel syndrome, fibromyalgia • Idiopathic medical symptoms o Eg, pain, fatigue, dizziness • Psychological or behavioural factors adversely affect this medical condition • Examples of psychological factors: o Diagnosed mental disorders o Psychological symptoms (non-diagnosable) o Personality traits or coping style o Maladaptive health behaviors o Stress-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 HPAAxis • Acomplex set of direct influences and feedback interactions among the hypothalamus, the pituitary gland (a pea-shaped structure located below the hypothalamus), and the adrenal (also called "suprarenal") glands (small, conical organs on top of the kidneys) • The interactions among these organs constitute the HP
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