Physical Disorders and Health Psychology:
• PsychologicalApproaches
o Behavioral medicine:
Knowledge derived from behavioral science is applied to prevention,
diagnosis, and treatment of medical problems
Interdisciplinary (psychologists, physicians, health professionals)
o Health psychology
Subfield of behavioral medicine
Not interdisciplinary
Study psychological factors that are important to the promotion and
maintenance of health; analyze and recommend improvements in health-
care systems and heath policy formation within the discipline of
psychology
• DSM 5 and Physical Disorders
o Physical disorders are coded in a diagnosis if they related to the treatment issue
• The Influence of Psychological and Social Factors:
o 2 Primary paths
Psychological factors influence
Behavior Patters (seatbelt, smoking, etc)
Things that Cause Changes in Psychology and Physical Disorders:
A. Stress:
Nature of Stress
o Stress: Physiological response of an individual
o Stressor: Event that evokes the stress response
o Variability: Stress responses vary from person to person
Hans Selye Stress Response & the GeneralAdaptation Syndrome
o Phase 1 – Alarm response
sympathetic arousal
o Phase 2 – Resistance
mobilized coping and action
o Phase 3 – Exhaustion
Chronic stress, permanent damage
SNS activation
Neuromodulators and neuropeptides
o CRF (corticotrophin releasing factor)
HPAaxis activation (recall from Mood Disorders)
o Limbic system activation
Hippocampus
Chronic stress may damage cells in the hippocampus, thus maintaining the HPA
loop o PTSD
o Dementia
Psychosocial Vulnerabilities
o Nature of stressors
o Perceived uncontrollability
Self-efficacy: one’s perceptions of this are critical in determining
response and effects of situations
o Low social support
o Negative affect
Experience of threats and challenges
B. Immune System
Stress lowers functioning of immune system
Immune system identifies and eliminates
i. Antigens
ii. Damaged/aberrant body cells
Immune system works through Leukocytes (WBCs)
i. Microphages (first line of defense)
ii. Lymphocytes
1. Humoral/B cells
2. Cellular/T cells
Immune disease needs proper balance of T cell types
i. Too many T4 cells => over-activity (auto immune disease)
1. Attacks normal body cells
ii. Too few T4 cells => lowered activity
1. “Opportunistic” infections
Psychoneuroimmunology
i. Study of psychological factors on immune response
C. HIV/AIDS
Course of HIV is variable along these CDC stages
i. Early ~1000 T4 cells/cmm
ii. Middle ~500 T4 cells/cmm
iii. AIDS if any of
1. 1 of 42 opportunistic infections, e.g. Kaposi’s sarcoma,
toxoplasmosis
2. T4 count < 200cells/µl
3. has hard to treat tuberculosis, or recurrent pneumonia
4. invasive cervical cancer
Targets
i. “Prefers” helper t4 cells
ii. Also “likes” neurons in the brain
HAART
i. Powerful, but not a cure
ii. Severe side effects Stress of diagnosis can be devastating
Exacerbation of AIDS progression
i. High stress
ii. Low social support
Goals:
i. Reduce stress
ii. Boost immune system
Outcomes:
i. Increased T-helper cells
ii. Lower antibodies
iii. Enhanced psychological adjustment
D. Cancer:
Uncontrolled growth of abnormal cells in the body
Psychosocial factors, such as marital disruption, chronic depression, low social
support, and high stress, have been linked with differential cancer onset, but these
findings are fairly inconsistent
More evidence for a relationship between psychosocial factors and cancer
progression
o Positive factors, such as social support and optimism
may contribute to a longer survival
o Negative coping factors, such as use of depressive coping mechanisms,
may contrib
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