Textbook Notes (362,768)
Canada (158,052)
Psychology (4,729)
Chapter 9

Chapter 9.pdf

14 Pages
Unlock Document

Western University
Psychology 2030A/B
David Vollick

Abnormal  Psychology  Chapter  9:   Physical  Disorders  and  Health  Psychology     Introduction   • Some  major  contributing  factors  to  illness  and  death  in  this  country  are   psychological  and  behavioural   • Psychological  and  social  factor  are  very  important  to  many  additional   disorders   • Biological,  psychological,  and  social  factors  are  implicated  in  the  cause  and   maintenance  of  every  disorder   • Researchers  have  isolated  stress  due  to  economic  uncertainty  as  the   principle  cause  of  plummeting  ages  of  life  expectancy  for  Eastern  Europe   • Behavioural  medicine,  knowledge  derived  from  behavioural  science  is   applied  to  the  prevention,  diagnosis,  and  treatment  of  medical  problems.   This  is  interdisciplinary.  Develop  new  treatments  and  preventative  strategies   • Health  Psychology  is  not  interdisciplinary,  and  it  is  usually  considered  a   subfield  of  behavioural  medicine.  They  study  psychological  factors  that  are   important  to  the  promotion  and  maintenance  of  health   • Psychological  and  social  factors  influence  health  and  physical  problems  in   two  distinct  ways:   o First,  they  can  affect  the  basic  biological  processes  that  lead  to  illness   and  disease   o Second,  long-­‐standing  behaviour  patterns  may  put  people  at  risk  of   developing  certain  physical  disorders   o Sometimes  both  of  these  avenues  contribute  to  the  etiology  or   maintenance  of  disease   • 50%  of  deaths  from  the  10  leading  causes  of  death  today  can  be  traced  to   behaviours  common  to  certain  lifestyles     The  Nature  of  Stress   • Selye  theorized  that  the  body  goes  through  several  stages  in  response  to   sustained  stress   o Alarm  –  response  to  immediate  danger  or  threat   o Resistance  –  we  mobilize  various  coping  mechanisms  to  respond  to   the  stress   o Exhaustion  –  if  stress  is  too  intense  or  lasts  to  long  our  bodies  suffer   permanent  damage  or  death   • Selye  called  this  sequence  the  general  adaption  syndrome  (GAS)   • Stress,  physiological  response  to  a  stressor     The  Physiology  of  Stress   • Stress  activates  the  sympathetic  nervous  system,  which  mobilizes  our   resources  during  times  of  threat  or  danger   • The  endocrine  system  increases  when  we  are  stressed,  primarily  through   activation  of  the  HPA  axis   • CRF  is  secreted  by  the  hypothalamus  and  stimulates  the  pituitary  gland,   which  then  activates  the  adrenal  gland  which  secretes  cortisol  (stress   hormone)   • The  hippocampus  is  very  responsive  to  cortisol.  When  stimulated  by  this   hormone  during  HPA  axis  activity,  the  hippocampus  helps  to  turn  off  the   stress  response,  completing  a  feedback  loop  between  the  limbic  system  and   the  various  parts  of  the  HPA  axis   • This  loop  may  be  important  for  several  reasons   • Increased  levels  of  cortisol  in  response  to  chronic  stress  may  kill  nerve  cells   in  the  hippocampus,  and  overtime,  the  ability  to  turn  off  the  stress  response   decreases   • These  findings  indicate  that  chronic  stress  leading  to  chronic  secretion  of   cortisol  may  have  long-­‐lasting  effects  on  physical  function,  including  brain   damage   • This  physiological  process  may  also  affect  our  susceptibility  to  infectious   disease  and  our  recovery  from  it  in  other  pathopysiological  systems     Contributions  to  the  Stress  Response   • Baboons  are  investigated  because  their  primary  sources  of  stress,  like   humans,  are  psychological  rather  than  physical   • Social  hierarchy  with  dominant  members  at  the  top  and  submissive  members   at  the  bottom   • It  has  been  discovered  that  dominant  males  in  the  baboon  hierarchy   ordinarily  have  lower  resting  levels  of  cortisol  than  subordinate  males   • However,  cortisol  levels  rise  more  quickly  in  the  dominant  males  than  in  the   subordinate  males   • They  found  an  excess  secretion  of  CRF  by  the  hypothalamus  in  subordinate   animals,  combined  with  a  diminished  sensitivity  of  the  pituitary  gland   • In  addition,  their  HPA  system  is  less  sensitive  to  the  effects  of  cortisol  and   therefore  less  efficient  in  turning  off  the  stress  response   • The  most  important  factor  in  regulating  stress  physiology  seems  to  be  a   sense  of  control     Stress,  Anxiety,  Depression,  and  Excitement   • Relationship  between  emotional  and  physical  disorders  is  very  strong   • The  same  types  of  stress-­‐related  psychological  factors  that  contribute  to   psychological  disorders  may  also  contribute  to  the  later  development  of   physical  disorders  and  that  stress,  anxiety,  and  depression  are  closely  related   • Which  one  you  experience  may  depend  on  your  sense  of  control  at  the   moment  or  how  well  you  think  you  can  cope  with  the  threat  or  challenge  you   are  facing   • If  you  are  under  too  much  pressure  you  may  becomes  tense  and  irritable  or   develop  a  headache  or  an  upset  stomach.  This  is  what  stress  feels  like.   • If  something  really  is  threatening  and  you  believe  that  you  can  d  little  about   it,  you  may  feel  anxiety   • As  your  body  prepares  for  the  challenge,  you  worry  about  it  incessantly.  Your   sense  of  control  is  considerably  less  than  id  you  were  stressed   • Psychological  factors  –  like  a  sense  of  control  and  confidence  that  we  can   cope  with  stress  or  challenges,  called  self-­‐efficacy  –  seem  to  differ  and  thus   lead  to  different  feelings     The  Immune  System  and  Physical  Disorders   • Exposure  to  cold  viruses  is  a  necessary  factor  in  developing  a  cold,  but  the   level  of  stress  you  are  experiencing  at  the  time  seems  to  play  a  major  role  in   whether  the  exposure  results  in  a  cold   • Stress  actually  increases  the  risk  of  infection,  particularly  of  the  upper   respiratory  tract   • The  effect  of  stress  on  susceptibility  to  infections  is  mediated  through  the   immune  system,  which  protects  the  body  from  any  foreign  materials  that   may  enter  it   • Evidence  links  several  stressful  situations  to  lowered  immune  system   functioning   • Depression  lowers  immune  system  functioning,  particularly  in  the  aged   • Depression  can  also  lead  to  poor  self-­‐care  and  a  tendency  to  engage  in  more   risky  behaviours   • Chronic  stress  may  be  more  problematic  for  the  immune  system  than  acute   or  sudden  stress  because  the  effects  are,  by  definition,  longer  lasting     A  Brief  Overview   • The  immune  system  identifies  and  eliminates  foreign  materials,  called   antigens   • Also  targets  the  body’s  own  cells  that  have  become  aberrant  or  damaged  in   some  way   • The  immune  system  has  two  main  parts:  the  humoral  and  the  cellular   • White  blood  cells,  called  leukocytes,  do  most  of  the  work   • They  surround  identifiable  antigens  and  destroy  them   • They  also  signal  lymphocytes,  which  consist  of  B  cells  and  T  cells   • B  cells  operate  within  the  humoral  part  of  the  immune  system,  relapsing   molecules  that  seek  out  antigens  with  the  purpose  of  neutralizing  them   • The  B  cells  produce  antibodies,  which  combine  with  the  antigens  to   neutralize  them   • After  the  antigens  are  neutralized,  memory  B  cells  are  created  so  that  the   next  time  that  antigen  is  encountered,  the  immune  system  response  will  be   even  faster   • T  cells  operate  in  the  cellular  branch  of  the  immune  system   • They  don’t  produce  antibodies   • One  subgroup,  called  killer  T  cells,  directly  destroy  viruses  and  cancerous   processes   • Then  memory  T  cells  are  created  to  speed  future  responses  to  the  same   antigen   • Helper  T  cells  enhance  the  immune  system  response  by  signaling  B  cells  to   produce  antibodies  and  telling  killer  T  cells  to  destroy  the  antigen   • Suppressor  T  cells  suppress  the  production  of  antibodies  by  B  cells  when   they  are  no  longer  needed   • We  should  have  twice  as  many  helper  T  cells  as  suppressor  T  cells   • With  too  many  helper  T  cells,  the  immune  system  may  attack  the  body’s   normal  cells  rather  than  antigens   • When  this  happens,  we  have  what  is  called  an  autoimmune  disease   • There  are  many  connections  between  the  nervous  system  and  the  immune   system   • These  findings  have  generated  a  new  field  known  as   psychoneuroimmunology,  or  PNI,  which  is  simply  means  the  object  of  study   is  psychological  influences  on  the  neurological  responding  implicated  in  our   immune  response   • Behavioural  changes  in  response  to  stressful  events,  may  also  suppress  the   immune  system     AIDS   • Once  a  person  is  infected  with  HIV,  the  course  of  the  disease  is  quite  variable   • After  several  months  to  years  with  no  symptoms,  patients  may  develop   minor  health  problems  such  as  weight  loss,  fever,  and  night  sweats,   symptoms  that  make  up  the  condition  known  as  AIDs-­‐related  complex  (ARC)   • The  median  time  from  initial  infection  with  HIV  to  the  development  of  full-­‐ blown  AIDs  has  been  estimated  to  range  from  7.3-­‐10  years   • Most  people  with  AIDS  die  within  1  year  f  diagnosis   • Highly  active  antiretroviral  therapy  (HAART)  seem  to  suppress  the  virus  in   those  infected  with  HIV,  even  in  advanced  cases   • This  does  not  seem  to  be  a  cure;  the  virus  is  seldom  ever  eliminated.  But   rather  lies  dormant  in  reduced  numbers   • Efforts  to  boost  the  immune  system  may  contribute  to  the  prevention  of  AIDs   • Importance  of  psychological  factors  like  cognitive  coping  in  regulating   emotional  reactions  to  the  emergence  of  symptoms  among  those  infected   with  HIV   • In  order  for  medication  like  HAART  to  exert  any  positive  effect  in  patients   with  HIV,  patients  have  to  be  compliant  with  taking  their  medications   • Those  who  had  undergone  the  psychosocial  stress-­‐reduction  procedures  did   not  show  substantial  increases  in  anxiety  and  depression  and  actually   demonstrated  increases  in  their  immune  system  functioning  as  measured  by   such  indices  as  helper  T  and  killer  T   • A  follow-­‐up  showed  less  disease  progression  in  the  stress-­‐reduction  group  2   years  later   • Cognitive-­‐behavioural  stress-­‐management  program  may  have  positive   effects  on  the  immune  systems  of  individuals  who  are  already  symptomatic   • Psychological  interventions  to  bolster  the  immune  system  might  possibly   increase  survival  rates  and,  in  the  most  optimistic  scenario,  prevent  the  slow   deterioration  of  the  immune  system   • It  is  not  clear  why  they  are  effective  but  possibilities  are  that  stress  reduction   procedures  may  give  patients  a  greater  sense  of  control,  decrease  their   hopelessness,  build  active  coping  responses,  change  negative  cognitions,  help   them  use  social  support  networks  more  effectively,  or  some  combination  of   these  factors     Cancer   • The  development  and  course  of  different  varieties  of  cancer  are  also  subject   to  psychosocial  influences   • This  has  resulted  in  a  new  field  of  study  called  psycho-­‐oncology   • Those  who  received  therapy  lived  twice  as  long  on  the  average  as  the  control   group   • Brief  psychosocial  treatment  can  be  implemented  relatively  easily  in   oncology  clinics  everywhere   • Effectiveness  of  mindfulness-­‐based  stress  reduction  interventions  for   individuals  diagnosed  with  cancer  showed  improvements  in  fatigue,  stress,   mood  problems,  and  sleep  problems  and  increases  in  quality  of  life   • Also  beneficial  changes  in  biological  indices  of  immune  system  function   • Don’t  know  how  they  work  but  possibilities  include  better  health  habits,   closer  adherence  to  medical  treatment,  and  improved  endocrine  functioning   and  response  to  stress,  all  of  which  may  improve  immune  function   • Preliminary  evidence  even  showed  that  psychological  factors  may  contribute   not  only  to  the  course  but  also  to  the  development  of  cancer  and  other   diseases   • Any  different  types  of  cancer  require  invasive  and  painful  medical   procedures   • The  stress  and  anxiety  associated  with  repeated  painful  procedures  may  also   have  their  own  detrimental  effect  on  the  disease  process   • Children  coping  with  the  pain  of  surgery,  some  coping  strategies  are  better   than  others   o Distraction  as  a  way  of  coping  experienced  less  pain  and  distress   following  surgery   o Emotion-­‐focused  avoidance  as  a  way  of  coping  experienced  less  pain   and  distress  following  surgery   • For  younger  children  a  strategy  that  prompted  children  to  distract   themselves  and  focus  their  attention  externally  was  more  effective   • For  older  children,  the  distraction  intervention  was  equally  effective  as  an   alternative  strategy  where  children  were  prompted  to  direct  their  attention   toward  their  internal  sensations   • Breathing  exercises,  watching  films  of  exactly  what  happened  to  take  the   uncertainty  out  of  the  procedure,  and  rehearsal  of  the  procedure  with  dolls,   all  of  which  make  the  interventions  much  more  tolerable  and  therefore  more   successful  for  young  patient   • Some  psychological  procedures  have  also  been  demonstrated  to  be  effective   in  reducing  pain  among  adult  cancer  patients   • Unfortunately,  they  rarely  recommend  or  use  these  strategies  with  patients   Cardiovascular  Problems   • Many  individuals,  particularly  older  individuals  experience  strokes,  also   called  cerebral  vascular  accidents  (CVA)  which  are  temporary  blockages  of   blood  vessels  leading  to  the  brain  or  a  rupture  of  blood  vessels  in  the  brain   that  results  in  temporary  or  permanent  brain  damage  and  loss  of  functioning     Hypertension   • Hypertension  is  a  major  risk  factor  not  only  for  stroke  and  heart  disease  but   also  kidney  disease   • Blood  pressure  increases  when  the  blood  vessels  leading  to  organs  and   peripheral  area  constrict  forcing  more  and  more  blood  to  muscles  in  central   parts  of  the  body   • The  heart  muscles  must  work  much  harder  to  force  the  blood  to  all  parts  of   the  body,  which  causes  the  increased  pressure   • Majority  have  no  specific  verifiable  physical  cause  and  are  considered   essential  hypertension   • In  blood  pressure  readings,  the  first  value  is  called  the  systolic  blood   pressure,  the  pressure  when  the  heart  is  pumping  blood   • The  second  value  is  the  diastolic  blood  pressure,  the  pressure  between  beats   when  the  heart  rate  is  at  rest   • Elevations  in  diastolic  pressure  seem  to  be  more  worrisome  in  terms  of  risk   of  disease   • Blood  pressure  guidelines:   o Normal:  less  than  120/less  than  80   o Prehypertension:  120-­‐139/80-­‐89   o Stage  1  Hypertension:  140-­‐159/90-­‐99   o Stage  2  Hypertension:  at  or  greater  than  160/  at  or  greater  than  100   • Black  people  are  much  more  likely  to  develop  hypertension  and  to  have   hypertensive  vascular  diseases  than  White  people   • Hypertension  runs  in  families  and  very  likely  is  subject  to  marked  genetic   influences   • Offspring  of  people  with  hypertension  are  at  twice  the  risk  of  developing   hypertension  than  children  of  parents  with  normal  blood  pressure   • Studies  examining  neurobiological  causes  of  hypertension  have  centered  on   two  factors  central  to  the  regulation  of  blood  pressure:  autonomic  nervous   system  activity  and  mechanisms  regulating  sodium  in  the  kidneys   • When  the  sympathetic  branch  of  the  ANS  becomes  active,  one  consequence  is   the  constriction  of  blood  vessels,  which  produces  greater  resistance  against   circulation;  that  is,  blood  pressure  is  elevated   • Retaining  too  much  salt  increases  blood  volume  and  heightens  blood   pressure   • Psychological  factors,  such  as  personality,  coping  style,  and,  again,  level  of   stress,  have  been  used  to  explain  individual  differences  in  blood  pressure   • Loneliness,  depression,  and  uncontrollability  are  psychological  mechanisms   that  may  contribute  to  the  association  between  hypertension  and  social   support   • Both  anger  and  hostility  have  been  associated  with  increases  in  blood   pressure     • The  ability  to  control  anger  by  expressing  these  feelings  constructively  is   associated  with  markedly  lower  blood  pressure  in  the  population   • General  stress  management  interventions  also  appear  effective  in  helping   control  high  blood  pressure  in  hypertensive  patients     • Individualized  cognitive-­‐behavioural  interventions  using  a  variety  of   techniques  appear  to  be  more  likely  to  be  effective  than  single-­‐component   interventions     Coronary  Heart  Disease  (CHD)   • Psychological  and  social  factors  are  implicated  in  CHD   • CHD  is  a  blockage  of  the  arteries  supplying  blood  to  the  heart  muscle   • Chest  pain  resulting  from  partial  obstruction  of  the  arteries  is  call  angina   pectoris   • Atherosclerosis  occurs  when  fatty  substance  or  plaque  builds  up  inside  the   arteries  and  causes  an  obstruction   • Ischemia  is  the  name  for  a  deficiency  of  blood  to  a  body  part  caused  by  the   narrowing  of  the  arteries  by  too  much  plaque   • Myocardial  Infarction  is  the  death  of  heart  tissue  when  a  specific  artery   becomes  completely  clogged  with  plaque   • We  inherit  a  vulnerability  to  CHD  and  other  factors  such  as  diet,  exercise,  and   culture  make  very  important  contributions  to  our  cardiovascular  status   • A  variety  of  studies  suggest  strongly  that  stress,  anxiety,  and  anger,  combined   with  poor  coping  skills  and  low  social  support,  are  implicated  in  CHD   • Stress-­‐reduction  procedures  may  prove  to  be  an  important  preventative   technique   • Evidence  that  existing  psychological  distress  can  be  effectively  reduced  by   such  interventions  and  that  this  may  also  have  a  positive  additional  effect  in   helping  the  patient  adhere  to  modifying  other  risk  factors  for  CHD   • Certain  groups  of  people  engage  in  a  cluster  of  behaviours  in  stressful   situations  that  seem  to  put  them  at  considerable  risk  for  CHD   • These  behaviours  include  excessive  competitive  drive,  a  sense  of  always   being  pressured  for  time,  impatience,  incredible  amounts  of  energy  that  may   show  up  in  accelerated  speech  and  motor  activity  and  angry  outbursts   • This  set  of  behaviours,  which  came  to  be  called  the  type  A  behaviour  pattern   • The  type  B  behaviour  pattern  also  described  applies  to  peo
More Less

Related notes for Psychology 2030A/B

Log In


Don't have an account?

Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.