health psych final exam

chapters 10-14

medical consequences of pain

it is the symptom that is most likely to lead an individual to seek treatment

pain ____ our lives

disrupts

psychological significance of pain

Depression and anxiety worsen the experience of pain

Patients fear pain when undergoing treatments

Inadequate relief from pain is the most common reason for euthanasia requests

interpretations of pain influences

The degree to which it is felt

How incapacitating it is

Beecher’s study of WWII injuries

to soldiers, pain means “Im alive”

to civilians it interupts activities

pain is influenced by

context

culture

gender

nociception

pain perception

three kinds of pain perception

mechanical

thermal

polymodal

mechanical nociception

mechanical damage to body tissue

thermal nociception

damage due to temperature exposure

polymodal nociception

general category of pain triggered by chemical reactions from tissue damage

_________ in peripheral nerves first sense injury

nociceptors

nociceptors in response release ____ ______ which travel to spinal cord

chemical messengers (substance p)

brain regions ________ the site of the injury and send messages back down spinal column

identify

two major types of peripheral nerve fibers

a delta

c fibers

a delta fibers

fast; pain is sharp

due to temp or pressure

c fibers

slow; pain is dull and aching

due to chemical changes following tissue damage

Landmark Study: D. V. Reynolds 1969

Electrical stimulation of a rat’s brain produced a high level of analgesia

The rat did not feel the pain of surgery

Conclusion: The brain can control the amount of pain experienced

opioids

substances like heroin or morphine, but they are produced by
the body; internal pain regulation system

acute pain

results from a specific injury

disappears when tissue is repaired

chronic pain

begins with acute episode

doesnt disappear with treatment

pain does not decrease with time

chronic pain often produces…

depression

Pain present in ____ of patients seeking care from physicians with primary symptoms of depression

2/3

what techniques work best with acute pain?

pain control

chronic pain involves more…?

secondary gain

pain management activities

pharmacological

surgical

sensory

biofeedback

relaxation

distraction

CBT techniques

denial and chronic illness

Keeps patient from dealing with full range of problems posed by illness

Denial can reduce days in intensive care

Denial can reduce side effects of treatment

During the rehabilitative phase, denial may have adverse effects…

High deniers at this time show less adherence to treatment regimen

what is common after diagnosis?

anxiety

anxiety is high when

Substantial lifestyle changes are expected

People feel dependent on health care professionals

____ to ____ inpatients suffer fromdepression

¼ to 1/3

caregivers are at risk for

distress, depression, declining health

avoidant coping is associated with _____ psychological distress

increased

Two studies compared quality of life in cancer patients with normal samples of people free of disease

Cancer samples had greater quality of life than non-ill samples

family is a ____ system

social; illness in one member affects lives of others

there is ____ on the caregiver

strain

the caregiver role typically falls on …

women; typically in 60s

us infant mortality rate

7.2 deaths per 1,000 births

#1 cause of death between ages 1-15 is…

accidents

#2 cause of death between ages 1-15 is…

cancer

young children less than 5 associate ____ with ____?

death with sleep

children ages 5 to 9

develop concepts of the finality of death

personify death as shadowy figure like a ghost

ages 9 or 10, death is seen as

universal and inevitable

ages 15-24 death is caused by (in order)

#1 unintentional injury (car accidents)

#2 homicide

#3 suicide

#4 heart disease

Cancer and AIDs account for remaining mortality

death of a ____ ____ is considered tragic

young adult

premature death is

death before projected age of 77

most people prefer what kind of death

sudden and painless

why is dying easier in old age

Initial preparation may have been made

Some friends and relatives have died

May have come to terms with issues of

• Loss of appearance

• Failure to meet all of life’s goals

what do elderly people typically die of

cancer

stroke

heart failure

physical decline

advantages of sudden death

Does not have to cope with

• Pain,

• Physical deterioration,

• Loss of mental faculties

Financial and other resources are not severely taxed

disadvantages of sudden death

• family members estranged

• poorly prepared to cope financially

kubler-ross 5 stages

1. denial

2. anger

3. bargaining

4. depression

5. acceptance

kubler-ross theory

there is no predetermined order of stages, some dont go through a stage, her work doesnt acknowledge anxiety

coronary heart disease

general term for illnesses caused by atherosclerosis

atherosclerosis

• Narrowing of the coronary arteries.

• These arteries supply the heart with blood.

angina pectoris

• Pain radiating across the chest and arms.

• Caused by a temporary shortage of oxygen to the heart.

myocardial infarction

heart attack

chd is the

leading cause of death in US (1 in 5 deaths)

chd is associated with

modernization; alterations in diet and reduction in physical activity levels

chd is the leading killer of which gender

women

Women have a ___% chance of dying from their first heart attack, compared to ___% for men.

50; 30

risk factors for chd

smoking

lack of exercise

family history

obesity

high cholesterol

metabolic syndrome

SES

minority status

metabolic syndrome

• Abdominal obesity

• Hypertension

• Low HDL (high-density lipoprotein) levels

• Difficulty metabolizing blood sugar

Development of CHD is associated with ________ ______ to stress.

cardiovascular reactivity

other psychological factors in chd

• Acute stress and negative emotions can precipitate sudden clinical events.

• Depression

• Type A personality/Hostility

hostility reflects

an oppositional orientation toward people, developing in childhood.

cynical hostility

• Characterized by suspiciousness, resentment, frequent anger, antagonism, and distrust of others.

• Individuals with cynical hostility often have difficulties with social support.

reasons for delay in treatment of heart disease

• Inability to accept they are having a heart attack.

• Interpreting symptoms as a mild disorder.

who delays in treatment of heart disease

• Older patients

• African American patients

• Patients who have consulted a physician or self-treated symptoms.

• Those with a history of angina or diabetes

what is hypertension

high blood pressure

prevalence of hypertension

1 in 4 us adults

hypertension lack of symptoms

One-third of those with hypertension are unaware they have it.

hypertension risk factor for other medicial problems like

kidney failure

stroke

cognitive difficulties

hypertension risk factors

• Age:

  • Prior to age 50, men are at greater risk.

  • After age 55, women and men have a 90% chance of developing it.

• Genetic factors.

• Obesity

• Lower SES

• Stress (especially low control)

• Hostility/Expressed anger

Hypertension in African Americans is linked to

stress due to discrimination

diabetes

common chronic disease

leading cause of death in us

what is diabetes

chronic condition of impaired metabolism due to insulin dysfunction

diabetes is associated with

• Thickening of the arteries due to buildup of wastes in the blood.

• High rates of CHD.

• Kidney failure.

• Nervous system damage.

• Leading cause of blindness among adults.

type 1 diabetes is ___% of all diabetes

5

type 1 diabetes

• Develops relatively early in life.

• Abrupt onset of symptoms.

• The pancreas doesn’t produce insulin.

type 2 diabetes

• ells lose the ability to respond fully to insulin (insulin resistance).

• The pancreas temporarily increases insulin production.

• Insulin-producing cells may eventually fail.

type 2 diabetes risk factors

• Overweight

• Little exercise

• High blood pressure

• Sibling or parent with diabetes

• Having had a baby weighing over 9 pounds at birth

• Member of a high-risk ethnic group (African Americans, Latinos, Native Americans, Asian Americans, and Pacific Islanders)

type 1 treatment

• Monitor glucose levels

• Regular insulin injections

• Strict dietary control

type 2 treatment

• Often unaware of health risks they face.

• Must reduce sugar and carbohydrate intake.

• Weight loss

• Exercise (helps use up glucose in the blood)

adolescents usually have what type of diabetes

type 1, more severe