Studied by 18 people
Flashcard for Umich Chang Psych 270
Behavioral medicine
Knowledge derived from behavioral science is applied to prevention, diagnosis and treatment of medical problems
Health psychology
Study of psychological factors that are important to the promotion and maintenance of health. Recommend improvements in healthcare systems/health-policy
How do psychological and social factors influence health (2 ways)
1.) Affects biological processes that lead to illness, 2.) long standing behavior patterns may put people more at risk
Gentian Herpes example (textbook)
Caused by a virus but symptoms can flare up during stressful periods, spreads because people do not reduce their risk by changing behavior
General adaptation syndrome
The sequence of reactions to sustained stress. These stages are alarm resistance and exhaustion which may lead to death
What is AIDs
An epidemic reaching everywhere causing a lot of death. People infected with AIDS have decreased immune system activity which leads to death by other diseases. Treatment has been found to be somewhat effective in preventing the progression of the disease.
AIDS and psychological factors
Found that ppl with higher confidence and strong social support were less likely to progress into the disease, also found that ppl who received mental health treatment ad less herpes antibodies
Cancer and psychosocial influences
Found that patients who received therapy after diagnosis both lived longer and had had a reduced risk of recurrence. potentially causes people to adhere to medical treatment better and reduces stress hormone.
Relationship between stress and the hippocampus
Stress may kill nerve cells in the hippocampus
Baboon stress experiment
Baboons live in a social hierarchy with the ones on the bottom experiencing more stress. Found that subordinate animals continually secreted cortisol and a weakened immune system and at higher risk of heart disease.
Relationship between sense of control and mental state
Our sense of control impacts how we interpret they physical sensation of our emotions.
How does the immune system work
Identifies antigens and leukocytes destroy the foreign substance by creating antibodies. other cells such as memory B cells help with increased response to next exposure and helper t increase antibody production
Psychoneuroimmunology
The study of psychological influences on the neurological responding implicated in our immune response
Psychophysiological disorders
True physical illness influenced by psychological factors
Hippocrates mind and body
Emotions such as anxiety can exacerbate sickness
Galen mind and body
Influence of personality and illness, theory of temperament
Descartes mind & body
Mind-body dualism where the mind interacts at the pineal gland, world of mind and body works together
Modern view mind and body
Mind and body are one, without mind where is intentionality, motivation, will
Three definitions of stress
1.) Stress as a consequence of a stressor
2.) Change in major life experience = stress
3.) Stress = stimulus x appraisal (is it a threat and can we control it)
Examples of stressors
Major life events (ex: death of a loved one)
Chronic hassles & uplifts
Excessive or multiple workload
Transitional stress
Associated with conflict across important development periods
Acculturative stress
Associated with conflict assimilating or maintaining one’s racial or ethnic identity (often confounded with SES
What is cardiovascular disease?
Issues with the control of the heart and blood vessels, issues can often cause strokes (CVAs) that lead to brain damage and loss of function.
What is hypertension?
Blood vessels become narrower which leads to increased blood pressure. This increased pressure causes tears in the vessels which can lead to disease
What is essential hypertension?
Hypertension with no specific. Verifiable physical causes
Connection between stress and hypertension
Sympathetic branch gets activated which restricts blood vessels and overtime stress may be a prime part of essential hypertension.
Two psychological factors that doubles the risk of hypertension
Hostility (and ability to control anger) and a sense of time urgency
What is coronary heart disease
Blockage of arteries supplying blood that can lead to death of cells and even heart attacks.
Relationship between stress and CHD
Stress, anxiety and danger has been implicated in CHD, it was found that stress-reduction procedures prevent future heart attacks
Type A personality and CHD
Many studies have shown that those with Type A personalities are at a higher risk or CHD. However, the connection is a bit tricky and doesn’t account for people with both types.
Acute pain
Pain that follows an injury and disappears once the injury heals or is treated
Chronic pain
Pain does not decrease even after injury is healed or treatment has been given. Pain is described by pain behaviors (ex: limping, avoiding activities)
Relationship between chronic pain and psychological factors
Those with stress responses, anxiety and generally less of a sense of control were more likely to experience chronic pain, people with positive outlooks had less severe pain.
Phantom limb pain
People who have lost a limb feel sensation in that limb, despite knowing there isn’t a limb there.
Gate control theory of pain
Nerve impulses from painful stimuli make their way to the brain, where the dorsal horns of the spinal cord act as a gate determining which stimuli gets through to the brain. Conversely the brain sends signals back to the gate letting it know which to let in/out.
Endogenous (natural) opioids
The body produces endorphins which shuts down pain. People with a high self efficacy increased endogenous opioid production when presented with stimulus
Gender differences in pain
Women experience menstrual pain.,more headaches, arthritis, joint pain. Men experience more cardiac and back pain.Both have opioid systems but women have estrogen based system as well.
Placebo biological effect on the brain
Studies found that placebos have similar effects on brain activity as taking drug, people are actually feeling less pain. Perhaps due to activation of the opioid system.
What is chronic fatigue syndrome and what might cause it
People constantly feel tired with other pain, often lasts for many years. Theorized it has to do with adverse life events and responses to stress.
Sharpies model of CFS
Ppl who are achievement oriented undergo extreme stress and misinterpret feelings of fatigue as disease worsened by activity, believe they should be able to conquer those feelings but that leads to more feelings of helplessness
Relationship between pain and mortality
It has been found that rats who underwent surgery without pain medication had cancer that developed twice as fast as those without. Thus pain can cause increased rate of mortality.
Biofeedback plus clinical usage
Making patients aware of physiological functions that ordinarily they would not notice consciously. Study found biofeedback was as successful if not more than relaxation in reliving tension headaches.
Progressive muscle relaxation and relaxation response
PMR- people tense then relax specific muscle groups
Relaxation response - people repeat silent mantra (one syllable) that can reduce stress hormones.
3 steps of comprehensive stress and pain reduction program
Identify stressful events and practice deep muscle relaxation, make more realistic appraisals and attitudes, learn new coping skills.
Denial for coping
Denial may be useful immediately after diagnosis to help with shock but overtime denial of disease is harmful
AIDS prevention
Behavior changing programs targeted at all at risk groups. In Africa Aids is most common in heterosexual relationships so within partner change is important.
Smoking in china study
Children of smokers were given pamphlets to bring home to parents and right letters asking the parents to quit smoking. Found this to be effective in getting some people to quit smoking.
Stanford three community study
Measured CHD, one community was control, one experienced media blitz of dangers of heart disease and last one also got counseling. Found the third had the lowest risk factors than the other two.
Mediation vs moderation model
Mediation: idea of cause (stress → immune system → illness)
Moderation: idea of relative levels (Not ill stress = immune, ill stress > immune)
Essential hypertension
Chronic high blood pressure w/o known physical cause, more common in AA, difference in rates due to race/ethnicity
Asthema
Chronic inflammatory disease of the airway in the lungs, attacks precipitated or exacerbated by emotional or interpersonal factors
Tension headaches
Due to muscle contraction the neck. Rates typically higher in women than men
Obesity
Defined by societal/cultural norms but usually 20% overweight, may be genetic predisposition of decreased metabolism, dieting and exercising helps control weight
Insomnia
Problems initiating or maintaining sleep
Hypersomnia
Excessive sleepiness
Narcolepsy
Sudden irresistible episodes of sleep attacks
Sleep paralysis
Totally loss of muscle tone, possible link to alien abduction
Migraine headaches
Due to possible neurological and hormonal factors. Rates typically higher in women than men
major depressive episode
An extremely depressed mood state that lasts at least two weeks including feelings of worthlessness, disturbances in bodily activities, loss of interest and inability to experience pleasure
Depressive realism
People who are a little sad are more likely to view the word realistically
Manic episode
Finding extreme pleasure in every activity, becoming hyperactive, require little sleep and developing grandiose plans, speech becomes rapid
Hypomanic episode
Less severe version of manic episode that does not cause marked impairment and lasts less than a week.
Anhedonia
Loss of energy and inability to engage in pleasurable activities
Mixed features
Having an episode of both depression and mania at the same time. Requires specifying whether it is predominantly manic or depressive
Major depressive disorder (MDD)
Presence of depression in absence of manic or hypomanic episodes. More common in women
Risk factors for MDD
Sex differences emerging after 15, differences in coping with d repression (rumination vs action -focused), personality factors such as perfectionism, sociocultural factors, biological factors
What is recurrent depressive disorder
If an individual has two or more major depressive episodes separated by at least two months during which the individual was not depressed.
Persistent depressive disorder (dysthymia)
Shares many symptoms of major depressive disorder but may have fewer symptoms and depression remains relatively unchanged over long periods of time.
Double depression
Individuals who suffer both major depressive episodes and persistent depression.
Acute grief to Integrated grief
Acute grief is the normal grieving process we experience, may have symptoms similar to depression. Acute turns into integrated grief after time, where feelings recur at significant anniversaries.
Complicated grief
Persistent intense symptoms of acute grief
Premenstrual dysphoric disorder (PMDD)
Women who suffer from severe and sometimes incapacitating emotional reactions during premenstrual period. Different than PMS because it involves a lot of impairment
Disruptive mood dysregulation disorder
Diagnosis for kids under 18, when the child has chronic negative moods such as anger and irritability w/o any accompanying mania. Developed to avoid diagnosis of bipolar which may not be accurate for these children.
Bipolar 1
Individuals experience both depression and mania but this type is characterized by full manic episodes (more mania than depression)
Bipolar 2
Individual alters between depressive and hypomanic episodes but usually doesn’t experience full blown manic episodes (more depression than mania)
Cyclothymic disorder
Chronic alternation of mood elevation that does not reach the severity of manic or major depressive episodes. Needs to last at least 2 years to be considered a disorder
Average onset/course of Bipolar
Onset usually in early adulthood. Bipolar is usually life long and often associated with death by suicide.
Stats on Mood disorders
Disorders tend to be chronic, women are twice as likely to have depression, more whites than blacks, common in Native Americans.
Do children experience depression
They can! Mood disorders in children and adults are very similar however depression does change with age. Children with depression have a higher likelihood of developing depression later in life.
Mood disorders in the elderly
A lot of elderly people experience depression, often co-morbid with anxiety disorders.
Depression cross culturally
somatic (physical) symptoms tend to be the same, emotional symptoms difficult to measure
Genetic factors in mood disorders
Family studies and twin studies show medium rate of heritability (20-40%), bipolar also increases likelihood of family member having a mood disorder.
Neurotransmitter system effect on mood disorders
Low levels of serotonin disrupts the mood system of norepinephrine and dopamine and may contribute to mood irregularities.
Endocrine system impact on depression
Old theory of HPA over activation, new theory that cortisol may damage neurons in the hippocampus and may even prevent new neurons from growing.
Sleep and circadian rhythms on mood disorders
Depressed people reach REM sleep more often and sometimes don’t reach deep sleep. Insomnia is common in both depression and bipolar disorder.
Stress and mood disorders
Depression - stressful life events are strongly related to the onset of mood disorders, but theses events often have context that makes them more or less impactful.
Bipolar- Stressful life events linked to depressive episodes, happy events can be linked to mania. After initial onset, there doesnt need to be stressful event for cycle to reoccur.
Learned helplessness theory of depression
People become anxious and depressed when they make an attribution that they have no control over the stress in their lives
Negative cognitive styles
People have cognitive errors and problems in thinking that lead to distorted view of self, world, future (cognitive triad)
Martial issues and mood disorders
Men have an increased risk of developing depression after a divorce, people married to a bipolar person have increased risk of emotional issues
Mood disorders in women
Depression and anxiety disorders are much more common in women. Perhaps due to social pressures, stronger but more fragile social network, perhaps ruminate more.
Antidepressants
Most common is SSRIs- works about half the time, thought to increase suicide risk but not a lot of evidence
MAO inhibitors - stops enzyme that breaks down certain neurotransmitters with major side effect interactions
tricyclic antidepressants - Used before SSRIs, blocks reuptake of certain neurotransmitters, has some major side effects
Lithium
often used as a mood stabilizing drug for people with bipolar but can have major side effects if done incorrectly. Fairly effective in reducing manic symptoms
Electroconvulsive therapy and transcranial magnetic stimulation
Safe and effective when patients don’t respond to drugs, induce seizure which may help regulate serotonin. TMS is when coils give pulse to specific area of the brain.
Cognitive - Behavioral therapy
Depressed patents recognize their thought processes, identify errors and correct them. Includes problem-solving skills and sometimes mindfulness
Interpersonal psychotherapy
Focuses on resolving problems in existing relationships and learning to form important new interpersonal relationships. Then they work through disputes/problems, fairly effective treatment.
Tripartite model of depression and anxiety
Depression - anhedonia, low positive effect
Common- Hugh negative effect
Anxiety - heightened physiological arousal
Maintenance treatment
Combination of continued psychosocial treatment, medication or both designed to prevent relapse following therapy
Stats on suicide
11 leading cause of death, most common among Whites and Native Americans, common in adolescence and in the elderly, men 4 times more likely to commit suicide females more likely to attempt)
Sex differences in suicide
Women are more likely to attempt, men are more likely to complete potentially due to difference in purchasing methods
Different types of suicide
Altruistic suicide - individual kills themself to protect family
Egoistic suicide - loses social support
Atomic suicides -result of marked disruptions
Fatalistic suicides - result from loss of control over ones own destiny
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Flashcard (31)