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Chapter

Week 9 (part 2).docx

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Department
Psychology
Course Code
PSYC 3390
Professor
Mary Manson

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Week 9 - Chapter 10 - Health Problems and Behaviour Behavioural Medicine – and interdisciplinary field that focuses on the role that psychological factors play in the occurrence, maintenance, and prevention of medical problems Health Psychology is a psychological subspecialty within behavioural medicine that deals with psychology’s contributions to the diagnosis, treatment, and prevention of psychological components of medical problems  Psychological factors that may predispose an individual to physical illness (critical life events, personality)  The ways in which the negative effects of stress can be reduced or buffered by personal resources (coping styles, social supports, personality traits) Psychophysiological Disorders “all in your head” – view psychological factors important for any health problem Psychological Factors in Health and Disease - the way our bodies reach to stress and to challenged by infectious or toxic agents such as viruses and bacteria Stress and the Stress Response - a stress response involves a cascade of biological changes that prepares the organism for the flight-or-fight reaction - begins in the hypothalamus which stimulates the sympathetic nervous system (SNS), which causes the inner portion of the adrenal glands to secret adrenaline and nonadrenaline. These circulate through the blood causing an increase in heart rate, also getting the body to metabolize glucose more rapidly - the hypothalamus also releases a hormone called “coticotoprin-releasing hormone” (CRH), travelling in the blood which stimulates the pituitary gland which secrets adrenocorticotrophic hormone (ACTH) which induces the adrenal cortex (outer portion of the adrenal gland) to produce the stress hormones called “glucocorticoids” – the stress glucocorticoid is called coritsol - Cortisol prepares the body for fight or flight and inhibits the innate immune response (if an injury occurs, the body’s inflammatory response is delayed - Downside to cortisol – if the response is not shut off it can damage brain cells, especially in the hippocampus – stress is bad for your brain. Chronic cortisol release may stunt growth. The brain has receptors that detect cortisol, which send feedback messages designed to dampen the activity of the glands involved in the stress response (HPA axis – the hypothalamic-pituitary-adrenal axis), if the stressor remains, the HPA axis stays active and cotisol release continues – short term cortisol production is highly adaptive, a chronically overactive HPA axis, with high levels of circulating cortisol, may be more problematic Biological Costs of Stress - Allostatic Load (biological cost of adapting to stress) – low when we are not experiencing stress o Major stressors and daily stressors (diathesis stress model) - Any stress may tend to aggravate and maintain certain disorders such as migraine headaches - Over 36,000 Canadians found that even after accounting for various socioeconomic factors (age, gender, income, education, marital status), a diagnosis of posttraumatic stress disorder was correlated with a wide range of physical illnesses, including cancer, cardiovascular disease, pain, respiratory illness, etc. Stress and the Immune System - link between stress and physical illness involves diseases (like colds) that are not directly related to nervous system activity - stress may cause overall vulnerability to disease by compromising immune functioning. - “escape first, heal later” longer term stress might compromise the body’s ability to heal and fight infections - association between stressful circumstances and diminished immune reactivity which makes a person more susceptible to infections o substantial individual differences in type of reactivity to stress - immune comes from Latin immunis, which means “exempt”, the immune system protects the body against such things as viruses and bacteria (linked to a police force), if too weak, cannot function effectively, and the body succumbs damage from invading viruses and bacteria. If it is too strong, and unselective, it can turn on its own normal cells (autoimmune diseases such as rheumatoid arthritis and lupus) - front line of defence for the immune system is the white blood cells (leukocytes or lymphocytes) are produced in bone marrow and stored in various places throughout the body, the spleen and lymph nodes – 2 important types o B-cell which matures in the bone marrow, produces specific antibodies that are designed to respond to specific antigens – foreign bodies such as viruses and bacteria, as well as internal invaders such as tumours and cancer cells o T-cell matures in the thymus, important for endocrine gland (circulate through the blood and lymph systems in an active form, each t-cell has receptors on its surface that recognize a specific antigen, but are unable to recognize antigens by themselves. They become activated when immune cells called “macrophages” detect antigens and start to engulf and digest them. To active T-cells, the macrophages release a chemical known as interleukin-1 (a class of chemicals called cytokines – chemical messengers that appear to be of crucial importance for health). With the help of macrophages, the t-cells become more activated and are able to destroy antigens - When immune system is stimulated, b-cells and t-cells become activated and multiply rapidly, mounting various forms of counterattack - B-cells are different in structure than t-cells, when a b-cell recognizes an antigen, it begins to divide and to produce antibodies that circulate in the blood, the process is facilitated by cytokines that are released by the t-cells. Production of antibodies takes 5+ days. Response of the immune system is much more rapid if the antigen ever appears in the future, because the immune system has a memory of the invader - Protective activity of b and t cells is supported and reinforced by other specialized components of the system, natural killer cells, macrophages, and granulocytes - Immune systems response to antigen invasion is intricately orchestrated, requiring the intact functioning of numerous components - The brain is centrally involved in the control of immune system events Psychological Factors and Immune Functioning - Aids is a disease of the immune system, after exposure the person is positive for HIV (human immunodeficiency virus) - Higher levels of stress hormones (cortisol), greater dissatisfaction with social support, was associated with more rapid transition from HIV positive status to AIDS - Relationship between stress and illness – causal inference concerning the role of stress in reducing immunocompetence - Immunosuppression can be caused by short term threats to our sense of well being or after the death of a spouse - Cytotoxicity (its power to eradicate antigen) was significantly diminished with induced negative self-evaluations, an effect that was especially strong for persons who were anxious and or dysphoric in mood before the experiment - Being exposed to a single stressful experience can enhance responsiveness to stressful events that occur later Psychoneuroimmunology - study of the interaction between the nervous system and the immune system - the nervous system and the immune system communicate in ways that we are only just beginning to understand - the brain influences the immune system and the immune system influences the brain - a persons behaviour and psychological states affect immune functioning but the status of immunologic defenses also feeds back to influences current mental states and behavioural dispositions by affecting the blood levels of circulating neurochemicals, which modify brain states Stress, Depression, and suppression of the Immune System - link between chronic stress and suppression of the immune system - strong association between dyphoric mood and compromised immune function, which is independent of specific situations or events that may have provoked depressed feelings (the state of being depressed adds something beyond any negative effects of the stressors precipitating this depressed mood) - depressed affect was associated with lowered numbers of white cells following challenge by a foreign protein, with lowered natural killer cell activity, and with lowered quantities of several varieties of circulating white cells - conditions associated with diminished immune function o psychological depression, sleep deprivation, marathon running, spaceflight, being the caregiver for a patient with dementia, death of a spouse - Immune responsiveness varies with normal, diurnal variations in mood - Natural killer cells are believed to play a key role in tumour surveillance and in the control of viral infections - Stress slows the healing of wounds by 24-40% Stress, Depression, and Increased Immune Responsiveness - link between stress and suppression of the immune system - chronic stress and depression may actually enhance certain immune system responses, not in a good way - chronic stress and depression may trigger the production of proiflammatory cytokines such as interleukin-6 - Higher levels of IL-6 are associated with being overweight, smoking and having a sedentary lifestyle - Pro-inflammatory cytokines like IL-6 could be key mediators in the link between psychosocial factors and disease - Chronic stress and depression can result in the immune systems going out of balance in ways that may compromise health – the potential for psychological factors well-being is becoming ever more apparent Lifestyle Factors in Health and Illness - death from heart disease is linked to lack of physical exercise - tobacco use contributes to over 37 000 deaths each year (16.6 percent of all deaths in Canada) - 23 percent of Canadians were obese in 2004, killing more than 8400 people across Canada that year - partial sleep loss for as little as one night is associated with elevated levels of cortisol the following evening - Lifestyle factors – habits or behaviour patterns presumably under our own control – play a major role in three of the leading causes of death in this country: coronary heart disease, automobile accidents, and alcohol related deaths Health, Attitudes, and Coping Resources - the brain influences the immune system - how you view problems, how you cope with challenges, and even your temperament may directly affect your underlying physical health Optimism - hopeless, helpless attitudes effect organic functioning - hopelessness accelerates progression of atherosclerosis, the underlying process leading to heart attacks and strokes - optimists are people who expect that good things will happen, may fare much better - the benefits of being optimistic outweigh the disadvantages - people with too little optimism experience psychological sense of helplessness which can be associated with poor health outcomes - advantages to seeing the glass half full rather than as half empty Negative Affect - negative emotions are associated with poor health - depression is associated with measurable and unmeasurable changes in immune functioning - people with major depression are at greater risk of having heart attack, also associated with increased mortality from all causes in medical inpatients - in women, depression heightens risk for osteoporosis, in men, study showed decline in muscle strength over a three-year period - anxiety also seems to be associated with the development of coronary heart disease in both men and women - chronic anger and hostility can be risk factors for coronary heart disease and death - an optimistic outlook on life as well as an absence of negative emotions, may have some beneficial health consequences - positive psychology –human traits and resources that might have direct implications for our physical and mental well-being - positive affectivity (the tendency to experience positive emotional states), compassion, gratitude, humour and spirituality are valuable - physiological benefits associated with forgiving people who have wronged us - laughter is associated with enhanced immune functioning o little evidence that humour and laughter have a significant effect on overall health - Placebo effect – a patient who believes treatment is going t
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