Behavior Disorders Exam 3

chapters 9-13

Behavior Medicine

knowledge derived from behavioral science is applied to prevention, diagnosis, and treatment of medical problems 

Health Psychology

subfield of behavioral medicine involving study of psychological factors that promote and maintain health as well as health care systems and health policy 

T/F: psychological factors influence biological processes

T: an example would be stress response

T/F: risky behaviors DO NOT cause or contribute to physical disorders and disease

F: risky behaviors do cause/contribute to physical disorders and disease

50% of the leading cause of death in the US are linked to what?

behavioral/lifestyle patterns

what are the leading cause of death in the US?

smoking

excessive drinking

eating habits

lack of exercise

ineffective injury control

Stress increases …

vulnerability for developing physical and mental health problems

Selye’s General Adaptation Syndrome (GAS) is…

the theory of stress repsonse

Selye’s General Adaptation Syndrome (GAS) includes

alarm response

resistance

exhaustion 

Resistance

attempt to cope with stress 

Exhaustion

body suffers damage

Alarm Response

response to immediate threat or danger

Chronic Stress can contribute to …

lasting bodily damage and disease

Stress activate the …

hypothalamic-pituitary-adrenocortical (HPA)

Hypothalamus releases … and stimulates … 

corticotropin-releasing factor (CRF)

pituitary gland 

higher levels of stress ______ immune system function

decrease

ex) you are more likely to catch a cold if you have been under more stress in the past year

early life stress contribute to _____ in adulthood

inflammation

What are the 3 top sources of stress for college students?

academics - 51.8%

finances - 41%

intimate relationships - 36%

AIDS

is caused by HIV

symptoms may appear years after infection

• may take as long as a decade to progress to full-blown AIDS

AIDS-related complex

minor symptoms such as weight loss and fever

AIDS treatment

highly active antiretroviral therapy (HAART) but its not a cure

What is the primary source of transmission for AIDS in the US?

same-sex sexual activity among men

What is the primary source of transmission for AIDS in the other parts of the world?

heterosexual sex

High stress and low social support exacerbate ______ progression

AIDS

Cognitive-behavioral stress management

seeks to reduce and improve immune functioning

actual outcomes:

• reduced levels of anger, anxiety, and stress

• increased T-helper cells

Psycho-oncology

the study of psychological factors in cancer

Psychological and bevaioral contributions to the etiology and course of cancer

perceived lack of control

maladaptive coping responses

stressful life events

life-style risk behaviors 

Psychosocial treatments for cancer improve:

health habits

treatment adherence

endocrine function

stress response/coping

may increase likelihood of remission and decrease mortality

cardiovascular disease problems

heart attack, hypertension (high blood pressure) and stroke (interrupted blood flow to brain)

Risk factors of Cardiovascular disease

personality, coping style, and level of stress ==> blood pressure

stress, anxiety, anger, inadequate coping skills, lack of social support, and type A behavior pattern (especially hostility and time urgency)

Features of pain

may be acute or chronic

may include pain behaviors (limping, complaining, avoiding certain activitis)

Chronic Pain

pain may be worsened by low perceived control, negative emotions, poor coping skills and low social support

pain behaviors may be increased by compensation (paid time off), social reinforcement (sympathy)

What Gender has additional pain-regulation mechanisms?

Women - may have evolved to facilitate childbirth

Endogenous opioids

pain-inhibiting natural chemical that may be increased by exercise

Chronic Fatigue

lack of energy and does not improved with adequate sleep

may have aches and pains or low fever

often severe enough that is difficult to work

cause is largely unknown but may be a response to stress

Is chronic fatigue more common in women or men?

women 

Chronic fatigue treatment

medications are generally ineffective but CBT may be helpful

• includes increasing activity, regulating rest, stress reduction

Biofeedback

monitor and control bodily responses

• like heart rate, blood pressure, muscle tension, EEG rhythms

increase sense of control

improves patient’s ability to control bodily processes

Relaxation and Medication

progressive muscle relaxation

transcendental medication (TM) focuses attention on a repeated mantra

increased sense of control and mastery

may improve headache, hypertension, acute and chronic pain

Medication may _______ efficacy of comprehensive stress reduction programs

decrease - high relapse when stopped and tolerance may be built over time

_______ about teh seriousness of a pshyical condition can be helpful

Denial - especially helpful at early stages of disease but later ist more helpful to face the situation and process emotions fully 

What is teh leading cause of death from ages 1-45

accidents

• broad programmatic efforts are needed (seatbelts, helmets)

How can AIDS be prevented?

changing behaviors

broad programs that address info, motivation, skills, norms, and policy and legislation are most effective

What prevented smoking in China?

capitalization on family relationships

Stanford Three Community Study

Goal: reduce risk factors for coronary heart disease (CHD)

3 different communities got either:

• no interventions

• media blitz

• media blitz plus face-to-face intervention (highest benefit)

What is needed to consider “normal” vs “abnormal” sexual behavior?

normative (common/average) facts and stats

cultural considerations

gender differences in sexual behavior and attitudes 

M vs W: acceptability if casual or premarital sex

men > women 

M vs W: attitudes toward masturbation

no gender difference (generally accepting)

M vs W: # of sexual partners

men > women

M vs W: attitudes towards same-sex sexual behaviors

no gender difference (generally accepting)

M vs W: rates of masturbation

men > women

M vs W: views toward sexual satisfaction

no gender difference (important for both)

M vs W: sexual self schema

women tend to be more embarrassed, conservative, and self conscious about sex

What influences development of sexual orientation 

genes 

34-39% in men 

18-19% in women (stronger environment influences in women)

Sexual Dysfunction

involves desire, arousal, orgasm, or pain

must be present for 6+ months to meet criteria for diagnosis

must lead to impairment or distress to be considered a disorder

Human Sexual Response Cycle

1. desire phase

2. arousal stage

3. plateau phase

4. orgasm phase

5. resolution phase

cycle then goes back to 1

Male hypoactive sexual desire disorder

little or no interest in any type of sexual activity, including masturbations and fantasies

Female sexual interest/arousal disorder

reduced sexual interest, reduced sexual anxiety, fewer sexual thoughts, reduced arousal to sexual cues, reduced pleasure or sensations during almost all sexual encounters

Erectile disorder

difficulty achieving or maintaining an erection, sexual desire is usually intact, most common problem for which men seek treatment, prevalence increases with age

Premature ejaculation

ejaculation pccuring within about 1 min of penetration and before it is desired

Which sexual disorder is the most prevalent sexual dysfunction in adult males?

premature ejaculation - affect 21% of all adult males and most common in younger men with less sexual experience

Delayed ejaculation

treatment rarely sought

Female orgasmic disorder

marked delay, absence or decreased intensity of orgasm after normal arousal phase with almost all sexual activities

not explained by relationship distress or other significant stressors 

Genito-Pelvic Pain/Penetrations Disorder

difficulty with vaginal penetration during intercourse, associated with one or more of the following

• pain during intercourse or penetrations attempts

• fear/anxiety about pain during sexual activity

• tensing of pelvic floor muscles in anticipation of sexual activity

Assessing Sexual Behavior methods

detailed interviews

medical evaluation

• medication side effects

• physical conditions

psychophysiological assessment

• sexual arousal in repsonse to erotic material

Causes of sexual dysfucntions

biological contributors, psychological contributors, and social/cultural contributors 

Treatments for Sexual Dysfunctions

educations can be very effective

Medical Treatments fro Sexual dysfunctions

various procedures/treatments for men, but very few medical procedures exist for female sexual dysfunction

Paraphilic Disorders

misplaced sexual attraction and arousal

• focused on inappropriate people or objects

• often multiple paraphilic patterns or objects

• high comorbidity with anxiety, mood, and substance use disorders

is NOT a disorder unless it is associated with distress and impairment or harm or the threat of harm to others

Frotteuristic Disorder

persistent pattern of seeking sexual gratification from rubbing up against unwilling others

Fetishistic disorder

sexual attraction to nonhuman objects or highly specific focus on nongential body parts

voyeuristic disorder

observing an unsuspecting individual undressing, naked, or engaged in sexual activity for sexual gratification

exhibitionistic disorder

exposure of genitals to unsuspecting strangers for sexual gratification

transvestic disorder

sexual arousal associated with the act of wearing clothing of teh opposite sex

sexual sadism disorder

inflicting pain or humiliation to attain sexual gratification

sexual masochism disorder

suffering pain or humiliation to attain sexual gratification

Pedophilia

sexual attraction to prepubescent children

• vast majority are males

• associated features

  • incestuous males may be aroused by adult women 

  • male pedophiles are usually not aroused by adult women 

  • some try to rationalize the behavior 

Covert sensitization

imaging aversive consequences to form negative associations with the unacceptable behavior 

• treatment for paraphilic disorders

Orgasmic reconditioning

masturbation to appropriate stimuli

• treatment for paraphilic disorders

Gender dysphoria

gender identity (perception of being a man, a woman, gender fluid, nonbinary, or some other experience), is usually formed between 18-36 months of age

more common in males

Gender affirming surgery

must be psychologically/socially stable and live as desired gender first

most report satisfaction with surgical results

Substance use

taking moderate amounts of a substance in a way that doesn’t interfere with functioning 

Substance intoxication

physical reaction to a substance

Substance dependence

defined by tolerance and withdrawal

tolerance

needing more of a substance to get teh same effect or reduced effect from teh same amount

withdrawal

physical response when substances is discontinued after regular

depressants 

behavioral sedation

stimulants

increase alertness and elevate mood

Opiates

produce analgesia (pain relief) and euphoria

Hallucinogens

alters sensory perception

Psychological physiological effects of alcohol

CNS depressant

influences several NT systems

specific target is GABA (inhibitory)

Effects of chronic alcohol use

liver disease, pancreatitis, cardiovascular disease, and brain damage

withdrawal includes delirium tremens (hallucinatiosn and body tremors)

long terms use:

• dementia

• Wernicke-Korasakoff syndrome - confusion, loss of msucle coordination, and unintelligible speech 

Sedatives, Hypnotic, and Anxiolytic-Related Disorders

sedatives - calming

hypnotic - sleep inducing

anxiolytic - anxiety reducing

all have tranquilizing effects and act on GABA receptors in brain

Stimulants

includes caffeine (coffee, energy drinks, and soft drinks) and nicotine (tobacco)

• most widely consumed drugs an the US

ex) amphetamines

Amphetamines

produce elation, vigor, reduce fatigue, followed by extreme fatigue and depression

stimulate CNS by enhancing release and blocking reuptake of norepinephrine and dopamine

ex) ritalin or adderall for ADHD and methamphetamine (crystal meth)

Effects of cocaine

short-lived sensations of elevation, vigor, reduced fatigue

effects results from blocking the reuptake of dopamine 

Effects of smoking/nicotine

stimulate nicotine acetylcholine receptors in CNS resulting ins ensations of relaxation, wellness, pleasure

• smoking appears to help improve mood in short-term

• depression occurs more in those with nicotine dependence

What stimulant is used by over 85% of Americans ?

caffeine

Opiate

natural chemical in the opium poppy with narcotic effects

Opioids

natural and synthetic substances with narcotic effects

• low dose induce euphoria, drowsiness, and slowed breathing

• withdrawal symptoms can be lasting and severe