9- Physical Disorders and Health Psychology

psychosomatic medicine

The study of how psychological and social factors affect physical disorders used to be distinct and somewhat separate from the remainder of psychopathology. Early on, the field was called ____

second revolution in public health

The shift in focus from infectious disease to psychological factors has been called the ___

behavioral medicine

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

behavioral medicine

This is an interdisciplinary field in which psychologists, physicians, and other health professionals work closely together to develop new treatments and preventive strategies

health psychology

not interdisciplinary; Practitioners study psychological factors that are important to the promotion and maintenance of health; they also analyze and recommend improvements in health-care systems and health policy formation within the discipline of psychology

Smoking

the leading preventable cause of death in the United States

sustained stress

Selye theorized that the body goes through several stages in response to ___

alarm

The first phase is a type of ___ response to immediate danger or threat

resistance

With continuing stress, we seem to pass into a stage of ___, in which we mobilize various coping mechanisms to respond to the stress.

exhaustion

Finally, if the stress is too intense or lasts too long, we may enter a stage of ___, in which our bodies suffer permanent damage or death

general adaptation syndrome (GAS)

the idea that chronic stress may inflict permanent bodily damage or contribute to disease has been confirmed and elaborated on in recent years

Hans Selye

proponent for GAS

stress

physiological response of the individual to a stressor.

hypothalamic-pituitary-adrenocortical (HPA) axis

activity of the endocrine system increases when we are stressed, primarily through activation of the ____

corticotropin-releasing factor (CFR)

is secreted by the hypothalamus and stimulates the pituitary gland

cortisol

the pituitary gland (along with the autonomic nervous system) activates the adrenal gland, which secretes, among other things, the hormone

stress hormones

Because of their close relationship to the stress response, cortisol and other related hormones are known as the ___

hippocampus

when stimulated by this hormone during HPA axis activity, the ___helps to turn off the stress response, completing a feedback loop between the limbic system and the various parts of the HPA axis

self-efficacy

a sense of control and confidence that we can cope with stress or challenges

immune system

the effect of stress on susceptibility to infections is mediated through the ______, which protects the body from any foreign materials that may enter it.

antigens

The immune system identifies and eliminates foreign materials, called ___, in the body.

humoral and cellular

The immune system has two main parts:

leukocytes

White blood cells, called ___, do most of the work.

macrophages

one of the body’s first lines of defense: They surround identifiable antigens and destroy them; signal lymphocytes

B cells

operate within the humoral part of the immune system, releasing molecules that seek antigens in blood and other bodily fluids with the purpose of neutralizing them.

immunoglobulins

The B cells produce highly specific molecules called ____that act as antibodies, which combine with the antigens to neutralize them.

memory B cells

After the antigens are neutralized, a subgroup called _____ are created so that the next time that antigen is encountered the immune system response will be even faster.

T cells

lymphocytes that operate in the cellular branch of the immune system; don’t produce antibodies

killer T cells

directly destroys viral infections and cancerous processes

memory T cells

are created to speed future responses to the same antigen.

T4 cells/ helper T cells

they enhance the immune system response by signaling B cells to produce antibodies and telling other T cells to destroy the antigen.

suppressor T cells

suppress the production of antibodies by B cells when they are no longer needed.

autoimmune disease

With too many T4 cells, the immune system is overreactive and may attack the body’s normal cells rather than antigens. When this happens, we have what is called an ____

• rheumatoid arthritis

• AIDS

examples of autoimmnue diseases

human immunodeficiency virus (HIV)

directly attacks the helper T cells, lymphocytes that are crucial to both humoral and cellular immunity, thereby severely weakening the immune system

psychoneuroimmunology

the object of study is psychological influences on the neurological responding implicated in our immune response.

AIDS-related complex (ARC)

After several months to several years with no symptoms, patients may develop minor health problems such as weight loss, fever, and night sweats—symptoms that make up the condition known as

highly active antiretroviral therapy (HAART)

Clinical scientists have developed powerful new combinations of drugs referred to as ___ that suppress the virus in those infected with HIV, even in advanced cases

psychoncology

the discovery that the development and course of different varieties of cancer are subject to psychosocial influences .This has resulted in a new field of study called

oncology

study of cancer

cardiovascular system

consists of the heart, blood vessels, and complex control mechanisms for regulating their function

cerebral vascular accidents (CVAs) or strokes

are temporary blockages of blood vessels leading to the brain or a rupture of blood vessels in the brain that results in temporary or permanent brain damage and loss of functioning.

Raynaud’s syndrome

lose circulation to peripheral parts of their bodies such as their fingers and toes, suffering some pain and continual sensations of cold in their hands and feet.

hypertension

is a major risk factor not only for stroke and heart disease but also for kidney disease

essential hypertension

hypertension that have no specific verifiable physical cause

160 over 95 mmg

Blood pressure is defined as high by the World Health Organization if it exceed ___

systolic blood pressure

pressure when the heart is pumping blood

diastolic blood pressure

pressure between beats when the heart is at rest

diastolic pressure

Elevations in _____ seem to be more worrisome in terms of risk of disease.

hypertension

has been called the “silent killer” because there are few—if any—symptoms and most people don’t know they have it.

sympathetic branch

When the ____ of the autonomic nervous system becomes active, one consequence is the constriction of blood vessels, which produces greater resistance against circulation; that is, blood pressure is elevated

Sodium and water regulation,

one of the functions of the kidneys, is also important in regulating blood pressure.

Loneliness, depression, and feelings of uncontrollability

are psychological mechanisms that may contribute to the association between hypertension and social support

warm touch

one study with married couples found that practicing a ____ (frequent affectionate touching) as a way of communicating love and support significantly decreased blood pressure

coronary heart disease (CHD)

is a blockage of the arteries supplying blood to the heart muscle

angina pectoris / angina

Chest pain resulting from partial obstruction of the arteries

atherosclerosis

occurs when a fatty substance or plaque builds up inside the arteries and causes an obstruction

ischemia

is the name for deficiency of blood to a body part caused by the narrowing of the arteries by too much plaque.

myocardial infarction / heart attack

is the death of heart tissue when a specific artery becomes clogged with plaque

myocardial stunning

evere stress, as in learning that a family member suddenly died, can lead on rare occasions to a condition called _____, which is basically heart failure

type A behavior pattern

excessive competitive drive, a sense of always being pressured for time, impatience, incredible amounts of energy that may show up in accelerated speech and motor activity, and angry outbursts

type B behavior pattern

more relaxed, less concerned about deadlines, and seldom feels the pressure or, perhaps, the excitement of challenges or overriding ambition

Meyer Friedman and Ray Rosenman

cardiologists who identified the types of behavior patterns

acute pain

typically follows an injury and disappears once the injury heals or is effectively treated, often within a month

chronic pain

, may begin with an acute episode but does not decrease over time, even when the injury has healed or effective treatments have been administered.

pain

the subjective experience reported by the patient

pain behaviors

overt manifestations of this experience,

suffering

emotional component of pain

phantom limb pain

people who have lost an arm or leg feel excruciating pain in the limb that is no longer there.

gate control theory of pain

According to this theory, nerve impulses from painful stimuli make their way to the spinal column and from there to the brain

dorsal horns of the spinal cord

acts as a “gate” and may open and transmit sensations of pain if the stimulation is sufficiently intense

small fibers

A-delta and C fibers

large fibers

A-beta fibers

small fibers

tend to open the gate, thereby increasing the transmission of painful stimuli,

large fibers

close the gate

endogenous opioids/endorphins/enkephalins

are distributed widely throughout the body, they may be implicated in a variety of psychopathological symptoms and conditions, including tolerance and dependence, eating disorders, and stress reactions

endogenous opioids/endorphins/enkephalins

They are commonly associated with the “runner’s high” that occurs after intense (and sometimes painful) physical activity

women

which gender experiences more migraine headaches, arthritis, carpal tunnel syndrome, and temporomandibular joint (TMJ) pain in the jaw?

men

which gender have more cardiac pain and backache

estrogen-dependent neuronal system

The female neurochemistry may be based on an ___ that may have evolved to cope with the pain associated with reproductive activit

neurasthenia

In the mid-19th century, a rapidly growing number of patients suffered from lack of energy, marked fatigue, a variety of aches and pains, and occasionally low-grade fever. No physical pathology could be discovered,; was called ___ meaning lack of nerve strength

chronic fatigue syndrome (CFS)

are almost identical to those of neurasthenia and have been attributed to various causes including viral infection

Epstein-Barr virus and XMRV

viruses associated with CFS

XMRV

a retrovirus with some similarities to HIV

biofeedback

process of making patients aware of specific physiological functions that, ordinarily, they would not notice consciously, such as heart rate, blood pressure, muscle tension in specific areas of the body, electroencephalogram rhythms (brain waves), and patterns of blood flow

progressive muscle relaxation

people purposely tense different muscle groups in a sequential fashion followed by relaxing each specific muscle group.

transcendental meditation

attention is focused solely on a repeated syllable, or the mantra

relaxation response

in which a person silently repeats a mantra to minimize distraction by closing the mind to intruding thoughts.

time-management training

patients are taught to prioritize their activities and pay less attention to nonessential demands

assertiveness training

in which patients learn to stand up for themselves in an appropriate way.

Stanford Three Community Study

One of the best-known and most successful efforts to reduce risk factors for disease in the community

killer T cells

this subgroup targets viral infections within the cells by directly destroying the antigens

macrophages

A type of leukocyte that surrounds identifiable antigens and destroys them.

immunoglobulins

Highly specific molecules that act as antibodies. They combine with antigens to neutralize them

B cells

Lymphocytes that operate within the humoral part of the system and circulate in the blood and bodily fluids.

memory B cells

These are created so that when a specific antigen is encountered in the future, the immune response will be faster

suppressor T cells

These T cells stop the production of antibodies by B cells when they are no longer needed.

c. Cuts, bruises, and other injuries

Which of the following is not considered part of the experience of pain?

a. The subjective impression of pain as reported by the patient

b. Pain behaviors or overt manifestations of pain

c. Cuts, bruises, and other injuries

d. An emotional component called suffering

development

Some evidence shows that psychological factors may contribute to both the course and the ________ of cancer, AIDS, and other diseases, as well as treatment and recovery.

hypertension; coronary heart disease

Psychosocial and biological factors contribute to the development of ________, a potentially deadly condition of high blood pressure, and to the development of ________, the blockage of arteries supplying blood to the heart muscle.