Health Psychology: Chapter 13

Cognitive Behavioral Treatments

Helps treat hypertension

• Biofeedback

• Progressive muscle relaxation

• Hypnosis

• Meditation

• Deep breathing and imagining

• Anger Management

Biological Reactivity to Stress

Plays a role in the development of CHD and CVD

• Cumulative effects lead to the damage of the endothelial cells (lining of BV)

• Reflected in a prolonged recovery period

• Chronic and acute stress is linked to CHD

• Negative emotions (hostility, anxiety, and depression) also increase risk

Hostile Emotions

• Linked with higher incidence of CHD and metabolic syndrome

• Leads to interpersonal conflicts and reduced social support

• Is a social manifestation of cardiovascular reactivity

Cynical Hostility

Suspiciousness, resentment, frequent anger, antagonism, and distrust

Hostile Individuals

• Show a weak antagonistic response to sympathetic activity

• Show larger and linger-lasting BP responses

Depression

Affects the development, progression, and mortality from CHD

Linked to risk factors for:

• CHD

• Metabolic Syndrome

• Inflammation and likelihood of a heart attack

• Heart failure among the elderly and mortality after coronary artery bypass graft surgery

Treated with CBT

Management of Heart Disease

Stress Management, Treating Depression, Social Support

Stress Management

Patients are taught to recognize stressful situations and avoid or manage it

Social Support

Feel that someone genuinely cares

• Predicts exercise tolerance

• Targeted for intervention in recovery

• Less likely to smoke

Problems of Social Support

Primary relationships are threatened

• Conflict over changes in lifestyle can increase marital strife

Cardiac Invalidism

Cardiac Invalidism

Patients and their spouses see the patients abilites as lower than they actually are

• Consequence of MI

• Family has an important role in follow-up care

Evaluation of Cardiac Rehabilitation

• Patients risk of heart disease can be reduced by interventions that target weight, BP, smoking, and quality of life

• Psychosocial treatments for psychosocial issues should be added to standard cardiac rehabilitation programs

Metabolic Syndrome

A cluster of conditions that occur together and they increase your risk of heart disease, stroke, and diabetes

Helps predict MI when identified

Diagnosed when a person has

• Obesity centered around the waste

• High BP

• Abnormal cholesterol such as low levels of HDL “good cholesterol”

• Difficulty metabolizing blood sugar

• High levels of triglycerides

Stroke

Results from a disturbance in blood flow to the brain

Some occurs when blood flow to localized area of the brain is interrupted, which can result from arteriosclerosis or hypertension

Can also be caused by cerebral hemorrhage

Cerebral Hemorrhage

Bleeding caused by the rupture of a blood vessel in the brain

Stroke Risk Factors

Overlap heavily with heart disease

• High BP, heart disease, diabetes, sickle cell disease, lack of physical activity, poor diet, excessive alcohol, cigarettes, high RBCs

Stroke Likelihood

• Increases with age

• Occurs more often in women

• Occurs more often in black Americans and pacific islanders

Stroke Acute Triggers

• Negative emotions and anger

• Sudden change in posture in response to a startling event

Left Brain Damage

Patients react to their disorder with anxiety and depression

Right Brain Damage

Patients may seem indifferent to their situation. A condition known as alexithymia

Interventions with Stroke Patients Approaches

• Medication

• Psychotherapy- including treatment for depression

• Cognitive Remodel Training to restore intellectual functioning

• Movement therapies- like training in specific skill development

• Structured stimulating environment to challenge the stroke survivors capabilities