PSYCH270 Exam 3 (UMich, Chang)

Psychosomatic medicine

Early name for the study of how psychological and social factors affect physical disorders (not used today, misleading)

Behavioral medicine

Interdisciplinary field that applies behavioral science to the prevention/diagnosis/treatment of medical issues

Health psychology

Non-interdisciplinary field; subsect of behavioral medicine; study of psychological factors important to the maintenance of good health

Stress physiology

Study of bodily reactions to stress

General Adaption Syndrome (GAS)

Proposed by Selye; sequence of response to sustained stress; alarm -> resistance -> exhaustion (leads to death/damage)

Stress hormones

Includes cortisol and other hormones that are related to stress

Hippocampus

Helps turn off stress response

Self-efficacy

One's own perception of having the ability to cope w/ stress/challenges; no sense of control -> depression/anxiety/etc.

Link between stress and immune system response

Stress level plays major role in immune response/severity of illness; stress -> higher rates of sickness; depression -> worse immune system functioning

Antigens

Foreign material that enters the body (bacteria, parasites, viruses, etc.); triggers immune system reaction

Autoimmune disease

Condition resulting from too many T4 cells; body attacks normal cells rather than antigens

Rheumatoid arthritis

Autoimmune disease where the immune system attacks itself' CBT can help relieve pain/stiffness

Psychoneuroimmunology (PNI)

Study of psychological influences on the neurological responding involved in immune system response

Link between behavior and health

Behavior patterns put people at risk of developing disorders; e.g. smoking, poor diet, stress (!!)

Link between mental state and disease susceptibility

Psychological characteristic/state -> CNS innervation, hormonal response, behavioral change -> disease susceptibility

AIDS-related complex (ARC)

Group of minor health problems (fever, weight loss, night sweats) that presents after HIV infection but before full onset of AIDS (remember: HIV is the virus that causes AIDS, while AIDS is a resulting condition!)

Psychological factors impacting HIV/AIDS

Strong social support and confidence in health providers -> stronger immune system; stress/depression -> faster progression of HIV

Psychonocology

Study of pychological factors involved in the course and treatment of cancer

Psychological/social factors impacting cancer

Reducing stress, improving quality of life, and supportive relationships between cancer patients (lessens stress) are all possible treatments for slowing cancer

Benefit finding

Experience of identifying positive outcomes in the face of adversity (e.g. found purpose even with breast cancer)

Cardiovascular disease

Diseases arising from afflictions in mechanisms such as the heart and blood vessels

Cerebal vascular accidents (CVAs)/strokes

Temporary blockages of blood vessels that results in temporary/permanent brain damage and loss of functioning

Hypertension

High blood pressure; major risk factor for strokes, heart disease, and kidney disease

Essential hypertension

Hypertension with no detectable physical cause; the majority of hypertension cases

Measuring blood pressure

e.g. 140/90; 140 = systolic blood pressure (measure of heart pumping blodo); 90 = diastolic blood pressure (pressure between beats when the heart is at rest)

Psychological factors impacting cardiovascular health

Personality, coping style, stress level, social support, loneliness, depression -> more issues; happiness, optimism -> less issues

Two important psychological factors impacting blood pressure

1. Hostility, particularly in interpersonal relations; 2. Sense of time urgency and impatience

Coronary heart disease (CHD)

Blockage of arteries supplying blood to the heart muscle; major cause of death in the West

Angina pectoris

Chest pain resulting from partial obstruction of arteries

Ischemia

Deficiency of blood to a body part caused by the narrowing of the arteries by too much plaque

Atherosclerosis

Occurs when fatty substance/plaque builds up inside arteries and causes an obstruction

Myocardial infarction/heart attack

Death of heart tissue when a specific artery becomes clogged with plaque

Factors impacting CHD

Stress (reduction can prevent heart attacks), anxiety, anger, poor coping skills, low social support

Type A behavior pattern

Group of behaviors such as competitiveness, time urgency, impatience, accelerated speech, and anger; originally thought to be more at risk for CHD

Type B behavior pattern

Group of behaviors such as being relaxed, indifference to time pressure, less forceful ambition; originally thought to be less at irsk for CHD

Behavior patterns and CHD

Some components of type A behaviors may lead to CHD; but evidence suggests chronic negative affect (stress, anxiety, depression, anger) may contribute as well; positive emotions/optimism reduce risk of CHD

Acute pain

Pain that typically follows an injury and disappears once the injury is healed/treated

Chronic pain

Enduring pain hat doesn't decrease over time even when the injury has been healed/treated; typically in muscles, joints, tendons, lower back

Pain behaviors

Behaviors resulting from pain (avoiding activities, changing way of sitting/walking, etc.)

Severity and reaction of pain

Severity of pain doesn ot predict one's reaction to it; primarily the result of psychological factors the

Phantom limb pain

Pain in a limb that doesn't exist anymore; pain can be disconnected from injury/disease

Operant control of pain behavior

Behavior under control of social consequences; social factors influence how we experience pain (e.g. family becoming caring)

Gate control theory of pain

Accomodates both psychological and physical factors; the theory that nerve impulses from painful stimuli go to the brain, where a specific area opens and transmits pain signals if the stimulation is intense enough

Endogenous opiods (endorphins/enkephalins)

Naturally occuring substance in the body that functions like a neurotransmitter; shuts down pain even in presence of injury; may lead to psychological problems (e.g. eating disorders)

Gender differences in pain

Women suffer more from migraines, arthritis, TMJ, carpal tunnel; men suffer more from cardiac pain and backache

Effect of placebos

Placebos can spur chemical changes that reduce pain

Chronic fatigue syndrome (CFS)

Incapacitating exhaustion followed by minimal exertion; fever, headaches, muscle/joint pain, depression, anxiety; common in the West; CBT can help

Biofeedback

Use of physiological monitoring equipment to make people aware of their own bodily functions (those not normally accessible) with w/ the purpose of controlling these functions; effective treatment for tension

Progressive muscle relaxation

Treatment for physical disorders/pain; patients tense different muscle groups in a sequential fashion followed by relaxing each specific muscle group; patients learn to recognize tension in different groups and how to reduce it

Relaxation response

Meditation treatment; when a patient silently repeats a mantra to minimize distraction by closing the mind to intruding thoughts

Time-management training

For stress reduction; patients taught to prioritize activities and pay less attention to nonessential demands

Assertiveness training

For stress reduction; patients learn to stand up for themselves in an appropriate way

Effectiveness of pain medication

Pain medication is not overly effective; can lead to overuse/dependency

3 most common high-risk behaviors

Unhealthy eating habits, lack of exercise, smoking

Mood disorders

Group of disorders involving severe and enduring disturbances in emotionality; ranges from elation to severe depression

Major depressive episode

Most commonly diagnosed and severe form of depression; extremely depressed mood state that lasts 2+ weeks; includes feelings of worthlessness, disturbed physical functions, changes in eating/weight, loss of interest; main indicators are physical changes and behavioral/emotional shutdown

Anhedonia

Symptom of depressive episode; loss of energy and inability to engage in pleasurable activities or have any "fun"

Mania

Second fundamental state in mood disorders; finding extreme pleasure in every activity, abnormally exaggerated joy; hyperactive, less sleep, develop grandiose plan

Flight of ideas

Symptom of mania; individual trying to expres so many ideas at once

Hypomanic episode

Less severe version of a manic episode that doesn't cause marked impairment; ~4 days instead of a week

Unipolar mood disorder

Mood disorder that remains at one extreme of the depression-mania continuum

Bipolar mood disorder

Mood disorder where someone alternates between the ends of the depression-mania continuum

Mixed features

During an episode, when someone experiences both elation and depression/anxiety; requires the episode to be classified as mainly manic/depressive

Major depressive disorder

Mood disorder characterized by depression and absence of manic episodes

Recurrent

When 2 or more major depressive episodes occured and were separated by 2 or more months

Persisent depressive disorder (dysthmia)

Depressed mood that continues at least 2 years; patient cannot go symptom-free for more than 2 months; may have fewer symptom

Double depression

Severe mood disorder characterized by major depressive episodes and dysthmic disorder

Onset and duration of depression

Low risk until early teens; symptoms highest in young adults -> decrease across middle adulthood -> increased w/ older age; depression rates are increasing

Integrated grief

Grief that evolve from acute grief into a condition where an individual accepts the finality of a death and adjusts to the loss

Complicated grief

Grief w/ debilitating feelings of loss and emotions so painful that someone has trouble resuming a normal life; designated for further study

Premenstrual dysphoric disorder (PMDD)

Clinically significant emotional problems that can occur during the premenstrual phase of the reproductive cycle of a woman

Disruptive mood dysregulation disorder

Condition where a child has chronic negative moods such as anger/irritability w/out accompanying mania; for those under 18

Bipolar I disorder

Alternation of major depressive episodes w/ full manic episodes

Bipolar II disorder

Alternation of major depressive episodes w/ hypomanic episodes (not full manic episodes)

Cyclothymic disorder

Chronic mood disorder characterized by alternating mood elevation and depression levels; not as severe as bipolar disorder but chronic (lifelong)

Onset and duration of bipolar disorder

Onset of Bipolar I is 15-18; onset for Bipolar II is 19-22

Lifespan and mood disorders

Depression is the same across all ages; all ages can be depressed

Familial and genetic influences

Disorders can be familial and reflect genetic vulnerabilities; around 40% genetic contribution to depression for women, 20% for men; close genetic relationship between anxiety and depression

Neurohormones

Hormones that affect the brain

Learned helplessness theory of depression

Seligman's theory that people become anxious/depressed when they think they have no control over stress in their lives

Arbitrary conference

Cognitive error (Beck); depressed individuals emphasizing negative rather than the positive; e.g. teacher thinking students are sleeping in class because he's a bad teacher

Overgeneralization

Cognitive error (Beck); depressed individuals overgeneralizing from small occurences; e.g. professor makes one negative comment, student assumes they'll fail despite other positive comments

Depressive cognitive triad

Thinking errors in depressed people in three areas: themselves, their immediate world, and their future

Negative schema

May develop after negative events in childhood; enduring negative cognitive belief system about some aspect about life

Factors contributing to onset/maintenance of depression

Marital relationships, gender, and social support

Gender influence on depression

70% of people w/ depressive disorders are women; women are encouraged to be passive -> sense of less control; women have lower self-esteems; women tend to put more emphasis on relationships -> higher risk; women blame themselves for being depressed; women experience societal misogyny, SA, abuse, etc. more

Genetic vulnerability and depression

Depression and anxiety may share a genetically determined vulnerability: an overactive neurobiological response to stressful life events -> tends to lead to more depression/anxiety

Four antidepressants for depressive disorders

SSRIs, mixed reuptake inhibitors, tricyclic antidepressants, monoamine oxidase (MAO)

SSRIs

Most commonly used; block presynaptic reuptake of serotonin; temporarily increases serotonin levels; includes Prozac/fluoxetine; may cause side effects

MAO inhibitors

Block the enzyme MAO; two serious consequences (certain foods can lead to hypertensive episodes, and common drugs are dangerous in combination w/ MAO inhibitors)

Tricyclic antidepressants

Includes Tofranil and Elavil; initially, they block reuptake of certain neurotransmitters, allowing them to pool in the synapse

Lithium carbonate

Another antidepressant, a common salt; serious side effects, must monitor dosage; effective in preventing manic episodes (bipolar disorder); mood-stabilizing drug

Mood-stabilizing drugs

Medication used to treat mood disorders that is effective in preventing/treating patholoigcal shifts in mood

Electroconvulsive therapy (ECT)

Biological treatment for severe depression; applies electrical impulses through brain to produce seizures; unknown why it's effective

Transcranial magnetic stimulation (TMS)

Another method for alerting electrical activity in the brain; places a magnetic coil over individual's head to generate a localized electromagnetic pulse

Cognitive behavioral therapy (CBT)

Treatement that identifies and alters negative thinking styles associated w/ psychological disorders; replaces negative thoughts w/ positive beliefs/attitudes and more adaptive behavior/coping styles

Interpersonal psychotherapy (IPT)

Brief treatment approach; emphasizes resolution of interpersonal problems and stressors (e.g. marital conflicts); negotiation -> impasse -> resolutionn

Maintenance treatment

Combo of continued psychosocial treatment, medication, or both to prevent relapse following therapy

Interpersonal and social rhythm therapy (IPSRT)

Approach that regulates circadian rhythms and helps cope with interpersonal conflicts

Statistics on suicide

11th leading cause of death in US; white and Native Americans have the highest suicide rates; suicide rates increase drastically at ages 20-24 and for the elderly; males are 4x more likely to die from suicide (not attempts); men choose more violent methods