Behavior Disorders Exam 3

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

How do several factors contribute to the etiology and maintenance of medical disorders

Two primary paths

Psychological factors influencing biological processes (stress response)

Risky Behaviors cause or contribute to physical disorders and disease

Health and Health related Behavior

50 % of the leading causes of death in the US are linked to behavioral/lifestyle patterns

- Smoking

- Excessive drinking

- Eating habits

- Lack of exercise

- Ineffective injury control

Stress

Increases vulnerability for developing physical and mental health problems

General adaptation syndrome: Theory of stress response

Alarm response: The response to immediate threat/danger

Resistance: Attempt to cope with stress

Exhaustion: Body suffers damage

Chronic stress can contribute to lasting bodily damage and disease

The Physiology of stress step 1

Stress activated the HPA axis

Physiology of stress step 2

HPA releases CRF and stimulated the pituitary gland

Physiology of stress step 3

Pituitary gland activated adrenal gland, and releasing cortisol (Stress hormone)

Physiology of stress step 4

Ordinarily, the hippocampus turns of the stress response, but can be damaged by excessive/ chronic stress

How does Cortisol influence stress

When cortisol is produced chronically, it can damage the hippocampus

- Having the benefits of having predictability and controllability in your life helps.

What does Higher levels of stress do

Higher levels of stress decrease the immune system function

- you are more likely to catch a cold if you have been under more stress

- Early life stress contributes to inflammation in adulthood

How does the immune system work

Identifies and eliminated foreign materials called antigens

- T cells work in the cellular branch, and destroy viruses and cancer cells

Psychoneuroimmunology

Psychological influences on the neurological component of immune response

AIDS

Caused by HIV, symptoms may appear years after infection

AIDS related complex

Minor symptoms such as weight loss and fever

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

- In the US, primary source of transmission is the same sex sexual activity among men, in other parts it's through heterosexual sex

Best treatment for AIDS

THe best cure is highly active antiretroviral therapy. HAART, this is not a cure however

Who is affected by Aids

With the exception of Asians, underrepresented groups are disproportionately affected by Aids.

Cognitive Behavioral Stress management and AIDS

High stress/low social support exacerbate AIDS

- CBT reduces stress, and improved immune functioning

- Increased T helper cells

Psycho-oncology

Study of the psychological factors in cancer

Psychological, and behavioral contributions to the etiology and course of cancer

-Perceived lack of control

- Maladaptive coping response

-Stressful life events

-Life-style risk behaviors

Cancer and psychosocial treatments

- Health habits

- Treatment adherence

- Endocrine function

- Stress response/coping

Spiegals Cancer study

Women with negative prognosis, when receiving group therapy lived twice as longer as those not receiving therapy

How does psychological treatments help

Improving health habits, improved response to stress, and immune function

- Improved adherence to medical treatment, improved endocrine functioning which helps immune system

Cardiovascular Disease

Problems include heart attack, hypertension, stroke

- Heightened responsivity to acute mentals tress has adverse effects on cardiovascular health

- Chronic stress and personality factors are important

Hypertension

high blood pressure, major risk for strokes, heart disease, kidney disease

- known as the silent killer because there are few symptoms

Psychological causes of hypertension

Hostility, and time urgency were two major factors

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Psychological risk factors for Cardiovascular disease

Personality, coping style, and level of stress have been used to explain individuals differences in blood pressure

Psychological and behavioral risk

Coronary heart disease includes stress, anxiety, anger, inadequate coping skills,

- Type A behavior patterns especially hostility and time urgency

Type A behaviors

Excessive competitive drive, impatient, incredible amounts of energy.

Type B behaviors

applies to people who are opposite of Type A

- Individuals are more relaxed, less concerned about deadlines, and feel more relaxed about ambitions

Chronic pain

A fundamental sign of injury, illness, and disease

- May begin with an acute episode

Gate Control theory of pain

Neurological processes, affect the degree to which pain is detected

- those with more negative emotions will influence the pain cycle more

Endogenous Opioids

Natural opioids that exists within the body, called endorphins

- Brain uses endorphins to shut down pain

Gender difference in pain

Females have additional pain regulation mechanisms that may have evolved to facilitate childbirth

- Men and Women experience different types of pain

Effects of Placebos

Placebos operate in a way in which they feel less pain

- Placebos have the ability of activating endorphins

- Placebo do have the power of changing the chemicals of the brain

Chronic Fatigue Syndrome

Lack of energy, and marked fatigue that does not improve with adequate sleep

- May have aches and pain or low fever

- more common in females than males

Causes of chronic fatigue syndrom

- Attributed to stressful environment

- Biological or viral cause has not yet been found

- Largely unknown however

- Found that someone with a relentless personality and pushing through fatigue can be attributed to this

Treatment of Chronic fatigue syndrome

Medications are generally ineffective

- CBT specific programs have been found to be effective

Biofeedback

The process of making patients aware of specific physiological functions that they would not realize consciously

Biofeedback functions

By becoming aware of these processes, people can learn how to control their responses better

Relaxation and meditation

Progressive muscle relaxation

- Transcendental meditation focuses attention on repeated mantra

- increase sense of control of mastery

- May improve headache, hypertension, and acute/chronic pain

Drug and stress reduction program

Evidence has shown that chronic reliance on medications and the overprescribing of them lessen the efficacy of these programs

Denial as a means of coping

In some circumstances, denial about the seriousness of a condition can be helpful

- it is later more helpful to face the situation and process the emotions fully

Modifying behaviors to promote health

Injury prevention, Aids prevention programs

Stanford three community study

goal was to reduce the risk factors for CHD

- most effective outcome from media blitz, and live intervention

Gender in understanding sexual attitudes

Women are more likely to report positive attitudes towards bisexual behavior

Gender difference in sexual behaviors

- Much higer percentage of men masturbate

- Men express more permissive behavior towards causal sex,

- and women are more likely to report they did not enjoy their experience

Potential reasons for gender difference in orgasm frequency

Stigmas, puts greater emphasis on male orgasm than women

- more women are dissatisfied with their appearance than man

The development of Sexual orientation

-Genes account for 34-39 percent in men

- genes account for about 18-19percent in women, so a stronger environmental influence in women

- Utero hormone exposure Is an environmental factor

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

Male Hypoactive sexual desire disorder

Little or no interest in any type of sexual activity, including masturbation and fantasies

Female sexual interest/arousal disorder

Reduced sexual interest, activity. Reduced pleasure or sensation during almost all sexual encounters

Erectile disorder

Difficulty achieving, or maintaining an erection

- Sexual desire is usually intact

- The prevalence increases with age

Premature ejaculation

Ejaculation occuring within 1 minute of penetration, and before it is desired

- Most common in younger men with less experience

Delayed ejaculation

Disorder is which a man achieves orgasm only with great difficulty

Female orgasmic disorder

Recurring delay or absence of orgasm after having a normal arousal phase

- not explained by any significant stressors

Genito pelvin pain/ penetration disorder

In females, difficulty with vaginal penetration during intercourse

- pain, fear of pain, tensing of pelvic fllor in anticipation of sexual activity

Myth Busts about sexual dysfunction

- They can occur at any age

- Treatment is always advisable if it is distressing

- erectile dysfunction is not the only treatable problem

Acessing Sexual Behaviors

-Detailed interviews

- Medical evaluations

- A psychophysiological assessment

Biological contributions to sexual dysfunctions

Physical disease, Chronic illness, Prescription medications

alcohol and drugs

Psychological contributors

People with sexual dysfunction are more likely to experience anxiety, and negative thoughts, however, can increase arousal in other cases

- decreased sexual arousal due to distraction

- experiencing a traumatic experience

Social and cultural contributors

Erotophobia: Many cultures can associate sexuality with negative feeling, anxiety, and threat

- traumatic sexual experiences

- Poor interpersonal relationships

- Lack of communication

Education (treatment)

Education alone can be effective

- Education about sexual responses, foreplay

- Sexual activity without needing to orgasm, learning more about sex, can decrease performance anxiety

Additional psychosocial procedures

Squeeze tenchniqe

masurbatory training

Use of dilators

Medical treatment of erecttile dysfunction

Viagra, testosterone, vascular surgery, vacuum device therapy

- Few medical procedures exist for female sexual dysfunction

Paraphilic disorder

Misplaced sexual attraction and arousal.

- Has a high comorbidity iwth anxiety, mood, and substance use disorders

- Must be associated with distress, impairment, or harm/ threat 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 nongenital 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 the opposit esex

Sexual Sadism

Inflicting pain or humiliation to attain sexual gratification

Sexual masochism

Suffering pain or humiliation to attain sexual gratification

Pedophilia

Sexual attraction to prepubescent children

- Vast majority are males

- Male pedophiles are usually not aroused by adult women, some try to rationalize the behavior

Causes of paraphilic disorders

Deviant patterns of sexual arousal often occur in the context of other sexual and social problems

- Inability to develop adequate social relations with appropriate people

- early sexual fantasies reinforced through masturbation, explaining male having more disorders

Covert sensitization

treatment where patient imagines aversive consequences to form negative associations with the unacceptable behavior

Orgasmic Reconditioning

Masturbation to appropriate stimuli, strengthening patterns of sexual arousal

Drug treatment

The most pop drug is cyproterone acetate, eliminating sexual desire and fantasy by reducing testosterone

Medication

Medication that reduce testosterone may be used in some populations like sex offender

Gender Identity

Perception of being a man, a women, gender fluid, nonbinary

- Usually formed between 18-36 months of age

Gender Dysphoria

Diagnosis is relatively rare, but more common in males

- Psychological dissatisfaction with biological gender and disturbance in their sense of identity

- Associated with clinically significant distress/impairment in life

Defining Gender Dysphoria

The main goal is to live a life that they feel comfortable with, it is much more personal and much deeper than just sexual gratification

Supporting Transgender individuals

Administrating hormone to bring about secondary sex characteristics consistent with identity

Gender affirming surgery

Must be psychologically/socially stable and live as desired gender first for 1 to 2 years

- Most report satisfaction with surgical results

Disorders of Sexual development

Characterized by ambiguous genitalia, with documented hormonal or other physical differences

- Surgery, and hormonal replacement therpy has been standard treatment for many individuals with disorders of sexual development

Prevalence of drug use in college

1. Alcohol

2. Marijuana

3. Adderall

Psychoactive substances

Substances that alter mood behavior, or both

Substance use

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

Intoxication

this is our physiological reaction to ingested substances, getting drunk, getting high

Substance use disorder

Defines substance use disorder in terms of how significant the use interferes with the user life, their education, their job, or relationship with others

Substance dependence

Defined by tolerance and withdrawal

- Tolerance is needing more of a substance to get the same effect or reduced effect

- Withdrawal, physical response when substance is discontinued after regular use

Five main categories of substances

Depressants, Stimulants, Opiates, Hallucinogens, Inhalants

Depressants

Causes Behavioral Sedation,

Alcohol related disorder

Inhibitory centers are slowed, causes to feel better, however with increased drinking, it impedes our ability to function, motor coordination, and judgement

- Central nervous system depressent

Alcohol effects

the GABA system seems to be very sensitive to alcoho, GABA makes it much harder for neurons to communicate with one another

Effects of chronic alcohol use

Liver disease, pancreatitis, cardiovascular disease and brain damage

Withdrawal delirium

Frightening hallucinations and body tremors that result when a heavy drinker withdrawals from alcohol

Fetal alcohol syndrome

Problems in fetus from alcohol use during pregnancy, results in cognitive, behavioral, and learning problems in child

Wernicke Korsakoff syndrome

Confusion, loss of muscle coordination, and unintelligible speech, excessive alcohol use also may cause dementia