Health Psychology

subfield of health psychology

Stress

• stressor: conditions/events perceived as challenging, threatening, or demanding.

  • eustress: positive stress that pushes people to achieve and accomplish goals.

  • distress: negative stress leading to burnout and overwhelm. [ACEs]

physical consequences caused by stress: hypertension, headaches, blood cells don’t produce as fast, causing sickness (inmune suppression)

• (theory I) General Adaptation Syndrom (GAS): has 3 stages

  1. alarm: person recognizes a stressor and cause the reaction

  2. resistance: person confronts stressor + attempts to cope with it

  3. exhaustion: stress subsides; most possibilities to get sick.

     • responses: avoidance, learned helplessness, displaced agression, burnout.

• tend and befriend: stress response where, instead of fighting or fleeing, people seek social support and care for others. contrasts fight or flight response.

  • tend: wanting to take care of others

  • befriend: seeking support from others

• coping strategies used to fight distress:

  • problem focused coping: attempting to reduce stress by working towards a solution (studying for a test that is stressing you out)

  • emotion focused coping: reducing stress by seeking distractions (meditating, going on walks, working-out, sleeping)

  • appraisal focused coping: reducing stress by practicing self-defeating attitudes, putting a positive spin on things (practicing motivational talk and affirmations)

we tend to use emotion-focused coping when we can’t control a situation; problem-focused coping when we can control.

Positive Psychology

• judging happiness — our subjective well-being is based on many factors

  • biology: physical health, influence of neurotransmitters

  • cognitive: optimism v pessimism

  • social: social pressure (social norms), affiliation

    • relative deprivation: the perception that we are worse than others.

• broaden & build theory: positive emotional experiences tend to broaden awareness + encourage new actions and thoughts

  • resilience: the personal strength that helps most.

  • post traumatic growth: some people experience positive growth and change after they experience a traumatic event.

Classifying Psychological Disorders

• psychopathology: study of mental disorders, different types of maladaptive behavior associated with various disorders.

• timeline of psychologists and disorders:

  • early civilization: demonology

  • ancient greece; hyppocrates/”disorders were physical not supernatural”

  • medieval europe: demonology pt.2

  • the enlightment: back to physical causes, although causes were wrong.

• clinical diagnosis is based on the U.S. book — Diagnosis and Statistical Manual of Mental Disorders (DSM)

  • current edition: DSM-5 (description of disorders, symptoms of disorders, other criteria + diagnosis for disorders.)

  • other editions: 1st (1952) freudian psychodynamic approach — DSM-3 (1930) biochemical subs psychodynamics — DMS-5 (2013) some disorders added, others removed, new/improved diagnosis.

• International book: International Classification of Mental Disorders (ICD), published by World Health org.

• 7 approaches that explain psychological disorders:

  1. psychodynamic: unconscious thought + experiences

  2. behaviorist: maladaptive learned associations (stimuli + responses)

  3. humanistic: lack of social support + being unable to fulfill’s one’s potential

  4. cognitive: maladaptive thoughts

  5. evolutionary: behaviors + mental processes that inhibit survival

  6. biological: psychological + genetic factors

  7. sociocultural: social norms, cultural dynamics/influences (negatie all)

• biopsychological approach: assumes that any psychological problem potentially involves a combination of biological, psychological and sociocultural factors

• diathesis-stress model: the comparison of nature v. nurture withing the potential of developing a psychological disorder.

  • diathesis: biological vulnerability to a particular psychological disorder

  • stressor: environmental events that trigger the onset of the behavior

  • protective factors: steps that can be taken to decrease the likelihood of the disorder parenting itself (e.g. improving coping skills, temperamental resilience, etc)

Depressive and Bipolar Disorders

• depressive disorders: isn’t a disorder itself but encompasses multiple disorders

  • major depressive disorder: (the disorder in depression) sustainable depressive mood, lack of pleasure in activities you’d normally enjoy, change in appetite/weight, sleep disturbances

    • diagnosing: must have at least 5 symptoms for over 2 weeks, one symptom has to be sustained depressed mood/diminished interest in activities.

  • persistent depressive disorder: mild, long-lasting, has been going on for + 2 years.

    • fatigue, low self-esteem, feelings of hopelessness.

• Bipolar and Related Disorders: involve moving from depressive episodes to manic episodes (hyper, euphoric/irritable episodes)

  • Bipolar I: severe manic episodes, not as high of depressive episodes but still has them.

  • Bipolar II: less severe manic episodes, major depressive episodes.

biological approach in bipolar disorders: norepinephrine (increases arousal, boosts mood, scarce in depressive episodes—overabundant during manic episodes) and seratonin (scarce during depression—increases when depression fades)

Anxiety Disorders

• anxiety: normal feeling, not the disorder

• anxiety disorders: are more intense, happen more often, interferes in life — characterized by fear/anxiety with related disturbances.

  • generalized Anxiety Disorder (GAD): prolonged experiences of nonspecific anxiety or fear.

    • symptoms: restlessness, fatigue, irritability, sleepdisturbances

    • biological approach: genetics & neurotransmitters, GAD typically caused by genetic predispositions and low levels of GABA (an inhibitory neurotransmitter)

  • specific phobia: excessive fear/anxiety toward a specific thing/situation.

    • person with this tends to avoid a stimulus

    • behavioral: impact of learned behaviors, specific phobias may be learned through classical or operant conditioning.

    • evolutionary: survival assistance, specific phobias often form towards potentially dead stimuli such as snakes, spiders, or heights.

    • socio-cultural: societal factors & social learning, specific phobias may also be formed due to observational learning or cultural views.

  • agoraphobia: fear of being in a situation where there is no easy escape/possible help.

    • often brought by specific social situations

    • can lead to avoid: crowds, open, or enclosed areas.

    • cognitive approach: irrational thought processes, maladaptive thoughts on the dangers of these situations can bring on the disorder.

  • panic disorder: panic attacks happening out of nowhere.

    • biological, cognitive + emotional effects

    • symptoms: accelerated heart rate, sweating, trembling, chest pain, nausea

    • humanistic approach: examining conditions of worth, can cause incongruence in a person’s life, leading to panic disorder.

  • social anxiety disorder: intense fear of being judged, criticized, or watched by others.

    • psychodynamic approach: repressed and unconscious conflict, this disorder may arise due to a repressed negative experience or unconscious conflict.

socio-cultural approach in anxiety: (DSM-V) differences in culture can lead to differences in disorders. (e.g. ataque de nervios in carribean or iberian descent; taijin kyofusho in japan)

Obsessive-Compulsive and Related, Trauma and Stressor Related, Substance and Addictive, and Feeding and Eating Disorders (first two in quiz)

• obsessive-compulsive and related disorder (OCD): cause repetitive thoughts (obsessions), distress, and compulsive behaviors — TOC en español

  • obsessions: thoughts —cause anxiety, fear of something negative will happen

  • compulsions: behaviors—behaviors, intrusive repetitive.

• OCD cycle: obsession—anxiety—compulsion—relief (short term)

  • causation can be explained with diathesis-stress model

• trauma and stressor related disorder: exposure to traumatic or stressful event with subsequent psychological distress.

  • post-traumatic stress disorder: reliving the traumatic event, emotional distress (hyperviligence, severe anxiety)

  • biological and cognitive effects: insomnia, physical effects of stress, amnesia in some (not all) cases

  - lasts more than a month or develops six or more months after the event.

• Substance & Addictive Disorders: pattern of repeated substance use or general behaviors to the point of interfering a person’s ability to function.

  • cycle of addiction: tolerance—withdrawal (discomfort)—relapses—dependence

• Feeding and Eating Disorders: altered consumption or absorption of food that impairs health/psychological.

  • long term consequences: cardiovascular, gastrointestinal, kidney damage, bone, teeth, skin completions.

  • sociocultural: different cultures may explain why.

  • Anorexia Nervosa: intense fear to gain weight, lead to extreme weight loss.

  • Bulimia Nervosa: binge eating disorder; excessive exercise, self induced vomiting, strict eating, shame + disgust. anxiety + depression involved.

Personality Disorders

Cluster A [“odd, suspicious, and excentrinc”]

• Paranoid Personality Disorders: distrust + suspicion of others, leads to difficulty working with others, anxiety, and aggressive behavior.

• Schizoid Personality Disorder: lack of interest in social relationships, emotional detachment, indifference towards others opinions, odd interests/obsessions.

• Schizotypal Personality Disorder: extreme social discomfort, worried about being judged and that everyone dislikes them, try socializing but tend to make people uncomfortable by acting oddly (rambling, discussing unusual topics like conspiracy theories, not responding in conversations, talk to themselves.

Cluster B [“dramatic, emotional and eratic”]

• Antisocial Personality Disorder: agains society (not avoiding it), aggressive + ruthless/clever con artist, disregard for rights + wellbeing of others, no empathy or guilt, often manipulative; often referred to as psychopaths or sociopaths (e.g. Ted Bundy)

• Histrionic Personality Disorder: excessive emotionally and attention seeking, may act seductive for attention, tend to be disloyal to partner, excessive focus on physical appearance, can even result in suicidal due to lack of attention.

• Narcissistic Personality Disorder: grandiose thinking about themselves and need of admiration, thinks they are the shit and everyone has to think so too, feelings of envy.

• Borderline Personality Disorder: instability in relationships, self-image, and emotional reactions, impulsive, may show clinginess + withdrawal at same time.

Cluster C [“anxious and fearful”]

• Avoidant Personality Disorder: extreme fear of intimacy, excessive self doubt + embarrassment, results in avoidance of social situations.

• Dependent Personality Disorder: pattern of emotional neediness (clinginess), excessive need to be taken care of by others + fear of abandonment, can lead to avoidance of responsabilities + fears of abandonment.

• Obsessive-Compulsive Personality Disorder: preoccupation with order, perfectionism and interpersonal control.

- OCD: specific; OCPD: generally obsessive-perfectionist.

Dissociative, Schizophrenic Spectrum, and Neurodevelopmental Disorders

• Dissociative Disorders: these are characterized by disconnections (aka dissociations) from consciousness, memory, identity, emotion, perception…

  • Dissociative Identity Disorder (DID): presence of at least 2 distinct identities/personalities, lead to impaired memories.

  • Dissociative Amnesia: inability to remember parts of the past; may forget events, info, or period of time; have no idea how the person ended there.

- causes of Dissociative Disorders: both disorders are often brought by trauma (defense mechanism)

• Schizophrenic Spectrum Disorders: psychotic symptoms; psychosis is a detachment from reality.

  • Schizofrenia: the most prevalent of these disorders, very bad mental illness—causes distress.

    • symptoms: positive (something added); negative (something removed)—issues in one/+ of these 5:

      1. Delusions: persistent of false beliefs (positive symptoms)

         persecution (e.g. being spied on)

         grandeur (e.g. advisor to world leader, president, king)

         bizarre (e.g. living without essential organ)

      2. Hallucinations: sensory experience without any external sensory stimuli (positive)

      3. Disorganized Speech: incoherent speech/a derailment of thoughts (positive)

         world salad: stiring together words with no sense.

      4. Disorganized Motor Behavior: disorganized/abnormal motor behavior + physical (positive/negative)

         Catatonia: bizarre posture/complete lack of mobility.

      5. Negative Symptoms: lack of typical behavior (negative)

         Catatonia Stupor: lack of movement (life threatening)

         Flat Affect: lack of emotion (inappropriately emotions/ no emotions at all)

         Avolition: significant decreases an absence of purpose activity (e.g. stare at wall for hours)

    • to get diagnosed for schizofrenia: 2-5 symptoms, at least one being—delusions, hallucinations, disorganized speech.

      - spectrum disorders: have significant variation in symptoms severity

- biological: genetic predisposition, neurotransmitters.

• Neurodevelopmental Disorders: these disorders begin during the developmental period and involve deficits that affect social, intellectual, academic/occupational functioning.

  • Autism: affects communication + behavior. Repetitive behavior + impairments of social interaction.

    • struggles: responding to social cues, nonverbal communication, developmental of social interactions.

    • symptoms: repetitive behaviors (e.g. phrases), restricted-overly focused interests, difficult communication, extreme sensitive to sensory stimulation.

  • ADHD: inattetion, hyperactive + impulsive behaviors.

    • inattetion: lack focus, chronic, disorganized

    • hyperactivity: fidgeting running around, general resentlessness.

    • impulsive actions: interrupting throwing objects.

Treatment of Mental Disorders: Intro and the Socio-cultural Approach

• History

  • Ancient times: trephinina (drilling holes in the skull to release evil spirits)

  • Medieval Europe: exorcism (ritual to drive evil spirits away)

  • Early USA: imprisonment (treated inhumanely)

- hypnosis: disorders were caused by a dysfunction of frontal lobe

1900s: lobotomy (surgery to damage or remove frontal lobe—Egas Moniz)

1800s: reform movements, better treatment, asylums + hospitals

late 1900s: increased effective medication led to deinstitutionality of massive amounts of people

• Psychoparmathology: treatment using prescribed medication. (pharmatheuticals)

  • psychiatrist: medical doctor who can prescribe medications for disorders.

• Psychotherapy: treatment of mental health problems through interactions with a trained psychologist.

  1. individual therapy

  2. group therapy

• Therapeutic Alliance: established a trusting relationship between clients + therapist.

• Cultural Humanity: be open-minded + acknowledge differences in background.

Ethical guidelines need to be followed by therapists: nonmaleficience (not causing harm to others), showing fidelity + integrity in actions, showing respect to people’s rights + dignity.

• Biopsychosocial Approach: bio (biological approach); psycho (humanistic, psychodynamic, cognitive, and behavioral approaches); social (socio-cultural approach)

• socio-cultural approach: social factors that increase likelihood of developing a disorder—poverty, violence, economic/political inequality, social media use, etc.

Treatment of Mental Disorders: Therapy I

• Psychodynamic Theory: tries to help people uncover and understand their unconscious. This has evolved over time, moving away from Freud’s ideas but still on defense.

  • free association: saying what first comes to mind.

  • dream analysis: attempting to explain the meaning of the content of a person’s dreams.

  • hypnosis: has been shown effective in creating and relaxing feeling; helpful to anxiety + pain.

• Behaviorist Therapy: sees all behaviors as learned and aims to change ones that are causing issues. Involves applying principles of conditioning to address mental disorders + developmental disabilities.

  • Exposure Therapy: using classical conditioning to reduce connections between a situation where the person can’t excape.

    • flooding: full exposure to anxiety producing stimulus in a harmless + controlled situation where the person can’t escape.

    • systematic desensitization: the therapist helps create a “hierarchy of anxieties”

  • Aversion Therapy: condition client to avoid undesirable behavior by associating them with unpleasant experiences (e.g. treats alcoholism by creating a feeling of nausea)

  • Token Economies: “Tokens”are earned and can be exchanged for rewards. Technique based in Operant Conditioning. (e.g. teach appropriate social behavior + life skills for children with Autism Spectrum Disorder)

• Biofeedback Therapy: uses principles of conditioning to help clients regulate body systems that contribute to feelings of anxiety/depression. Measurement of brain’s electrical activity and physiological. (e.g. when stress a physiological response can be rising heart rate. Exercise and some relaxing techniques can help moderate those side effects.)

Treatment of Mental Disorders: Therapy II & Meditations

• Cognitive Therapy: based on idea disorders are caused by maladaptive/illogical thinking. May employ cognitive restructuring to change thought process Used for personality, eating, anxiety and depressed disorders. (Cognitive Triad on notebook!)

  • 2 techniques:

    1. Direct Behavioral Therapy: focuses on emotions + managing them. Used to treat Borderline Personality Disorder and more.

    2. Rational-Emotive Behavior Therapy: emphasizes helping clients to identify + change irrational beliefs + assumptions.

• Humanistic Therapy: Ideas of Carl Rogers, belief humans are driven to fill their unique + positive potential. Accounts for free will (unlike behaviorist + psychodynamic approaches)

  • Person Centered Therapy: believes the patient should determine the direction therapy goes. (therapist acts nonjudgemental facilitator/no advice given)—active listening + unconditional positive regard.

• Biopsychosocial (Bio): focuses on bio abnormalities + using pharmaceutical medications as a for of treatment. 4 types of treatment:

  1. Anti-Anxiety: drugs to reduce symptoms such as fear, tension, nervousness. treats OCD, PTSD, anxiety disorders, etc.

  2. Anti-Depressants: elevate mood affecting neurotransmitters—seratonin. treats depressive disorders + long-term anxiety.

     • SSIRs: inhibits the reputake of seratonin.

  3. Mood Stabilizers: reduce dramatic mood swings. treats bipolar.

     • Lithium Carbonate

  4. Antipsychotic Medication (2 generations)

     • gen 1: treat positive symptoms (delusions, halucinations, etc.)

     • gen 2: treats negative + positive symptoms (flat affect)

  • potential side effect: Tradive Dyskinesia (TD): caracterized by uncontrolled movements in face, tongue, arms, potentially legs too.

• Psychosurgery

  • Transcranial Magnetic Stimulation: a magnetic coil is used to influence brain’s natural electrical activity. This technique is non invasive.

  • Electroconvulsive Therapy: administering short-duration electric shocks that causes seizures (patient is unconscious.)