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Chapter 14

Abnormal Psych Chapter 14 Health Psychology.docx

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Psychology 2030A/B
David Vollick

Chapter 14: Health Psychology Health Psychology: Defining the Field -health psychology- uses the principles and methods of psychology to understand how attitudes and behaviours influence health and illness -health psychologists- study how people develop positive and negative health habits, how stress and health are related, and which psychological variables affect the onset and treatment of medical illness -health- defined by the World Health Organization as a state of mental, social, and physical well- being, not just the absence of illness -Related fields of study • Behavioural medicine- interdisciplinary field (not just psychology) that studies the relation between behavioural and biomedical science and • Medical psychology- the study and practice of psychology as it relates to health, illness, and medical treatment -biopsychosocial model- complex interactions among biological, psychological, and social factors determine health -biomedical model- explains illnesses solely as biological processes The Mind-Body Relationship -mind-body dualism- by Rene Descartes holds that the mind and body function independently -Freud linked the mind and body to explain hysteria (now known as conversion disorder), a condition in which he believed that unconscious psychological conflicts caused unexplained physical complaints -associations between psychological conflicts and physical illness that implicated theANS (psychological conflicts produce anxiety, which causes the nervous system to create an organic problem) Psychological Influences on Health -psychological variables and social factors affect physical health -similarly, medical illness can affect psychological health and social functioning -anxiety and depression more common among people with medical illness The Role of Stress in Physical and Mental Health Defining Stress -stress= any negative emotional experience that is accompanied by biochemical, physiological, cognitive, and behavioural responses that attempt to change or adjust to the stressor -stressor= any event that produces tension or another negative emotion such as fear and that prepares the organism for a fight or flight response (physical, environmental, interpersonal- social, psychological) -perceived stress is more likely if an event has a negative outcome, but positive outcomes can also produce stress (ex. Planning for a big trip) -stress is more likely if the event is perceived as uncontrollable or when it has an impact on a major area of life -after a stressful event, and interactive appraisal process occurs in which a person assesses whether he or she has the resources or coping skills to deal with the event 1. Primary appraisal- assess potential harm or threat 2. Secondary appraisal- identify available skills to cope with or overcome the possible negative outcomes -coping strategies: 1. Problem-focused coping- involves taking action to manage a problem that is creating stress 2. Emotion-focused coping- when a person focuses on managing emotional distress that results from a stressor rather than trying to change the situation that creates stress -forms of stress 1. Acute stress- occurs when a potentially threatening event and the associated reaction last for only a brief time (ex. Burglary) 2. Chronic stress- develops when a threatening event continues over time as with chronic illness, excessive work demands, or long-term poverty 3. Daily hassles- occur day to day (coffee pot breaks, dog has an accident) 4. Major life events- affect the way a person lives, such as starting college, beginning marriage or being diagnosed with a major illness -results in a stress reaction- symptoms of a fight or flight response; adaptive vs. detrimental responses Measuring Stress • acute stress paradigm- measures acute stress; short-term stress is created in the lab and its effect on physiological, neuroendocrine, and psychological responses is measured • social readjustment rating scale (SRRS)- measures the impact of life events -generalizes well to real life -reliance on people’s recall of events may introduce memory bias -does not consider individual differences or differentiate the impact of positive and negative life events • hassles scale- measures the frequency and severity of day-to-day stressors • uplifts scale- assesses day-to-day events that counteract the negative effects of stress The Impact of Stress on Health -stress can impact health indirectly and directly Physiology of Stress -fight-or-flight response= increased sympathetic nervous system activity (increased BP and HR); continual physical stress responses could impair a person’s ability to fight illness -general adaptation syndrome (GAS)= three stages 1. alarm- body mobilizes to meet a threat 2. resistance- individual attempts to cope with or resist the threat 3. exhaustion- continues efforts to overcome the threat deplete physical resources; become increasingly vulnerable to illness (hypertension, cardiovascular disease, diabetes, arthritis) -both do not address psychological and social variables that affect the appraisal process -stress response affect two major systems: 1. Sympathetic-adrenomedullary system (SAM)- the “revved up” feeling; increased adrenal gland stimulation results in the secretion of epinephrine and norepinephrine -continuous and long-term SAM activation can suppress immune functioning and produce changes in BP and HR 2. Hypothalamic-pituitary-adrenocortical (HPA) axis- during stress, the hypothalamus increases production of corticotrophin-releasing factor (CRF) which causes increased secretion of adrenocorticotropic hormone (ACTH) and increased cortisol -repeated HPAstimulation can change daily cortisol patterns, compromising immune functioning and impairing memory and concentration Stress and the Immune System 1. Specific immune system- responses protect us against specific infections and diseases (natural-breast milk vs. artificial-vaccines) 2. Nonspecific immune system- responses offer general protection against infections and diseases in four different ways • Anatomical barriers- skin and mucous membranes in the nose and mouth prevent microbes form getting into the body • Phagocytosis- leads to the production of more white blood cells that destroy invaders (T-lymphocytes- killer cells and helper cells; natural killer cells) • B-lymphocytes- secrete antibodies or toxins into the blood to kill invading bacteria and viruses • Inflammation- at the site of infection, produces swelling and increased blood flow, allows more white blood cells to move in and attack pathogens -psychoneuroimmunology- study of the relations among social, psychological, and physical responses -stress suppresses the ability of the immune system to function adequately and increases people’s susceptibility to bacteria and viruses -stress increases epinephrine and cortisol levels and this decreases the activity of the helper T- cells and lymphocytes that are important for killing bacteria The Psychological Impact of Stress -stress and poorer immune functioning are associated with increases in negative moods including depression, anxiety, hostility, and anger -depressed= disrupted immune response, increased inflammation, reduced NK cell activity, a lower lymphocyte response, and more white blood cells -depression, alcoholism, and eating disorders linked to increased HPAactivity Moderators of Stress -stress moderators- variables that affect how stress is experienced and how it affects health and other aspects of functioning -typeAbehaviour pattern- linked to increased risk of coronary heart disease; describes behaviours that are associated with consistent strivings for achievement, impatience and time urgency, and aggressiveness toward others -other personality characteristics: • Negati
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