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Physical Disorders and Health Psychology

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					Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Chapter 9
Physical Disorders and Health Psychology

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Physical Disorders and Health: An Overview
Psychological, Behavioral, and Social Factors  Major contributors to medical illness and disease  Examples include genital herpes, AIDS, cancer, cardiovascular diseases Psychological Approaches to Health and Disease  Behavioral medicine – Prevention, diagnosis, treatment of medical illness  Health psychology – Psychological factors in promotion of health DSM-IV and Physical Disorders  Coded on Axis III  Psychological factors can affect medical conditions

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

How Do Psychological and Social Factors Influence Medical Illness?
Two Primary Paths  Psychological factors can influence biological processes  Behavior patterns may put people at risk for disease  AIDS is an example of both forms of influence 50% of the Leading Causes of Death in the U.S.  Are linked to behavioral / lifestyle patterns

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Overview of Stress and the Stress Response
Nature of Stress  Stress – Physiological response of an individual  Stressor – Event that evokes the stress response  Stress responses vary from person to person The Stress Response and the General Adaptation Syndrome  Phase 1 – Alarm response (sympathetic arousal)  Phase 2 – Resistance (mobilized coping and action)  Phase 3 – Exhaustion (chronic stress, permanent damage)

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

The Biology of Stress
The Biology of Stress  Stress activates the sympathetic nervous system  Neuromodulators & neuropeptides – Like neurotransmitters  Stress activates the HPA axis, producing cortisol  The relation between the hippocampus and HPA activation Function of the Hippocampus in HPA-Stress Response Cycle  Hippocampus – Limbic system, responsive to cortisol  Hippocampus helps to turn off the HPA cycle  Chronic stress may damage cells in the hippocampus  Hippocampal cell damage can keep the HPA loop going

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Psychological and Social Factors: Their Relation to Stress Physiology
Primate Research: High and Low Social Status  High cortisol is associated with low social status  Low status – Fewer lymphocytes and weak immune system  High status – Benefit from stability and controllability Psychosocial Vulnerabilities Contribute to Physical Illness  Stress, perceived uncontrollability, low social support, negative affect Interpretation of Physiological Response and Situation Seems Critical  Self-efficacy

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

The Immune System: Overview and Its Functions
Divisions of the Immune System  Humoral branch – Blood and other bodily fluids  Cellular branch – Protects against viral / parasitic infections Function of the Immune System  Identify and eliminate antigens (i.e., foreign materials) Leukocytes are the primary agents

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Figure 9.5 An overview of the immune system.

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

The Immune System: Overview and Its Functions (cont.)
Leukocytes: Subtypes and Functions  Macrophages – First line of defense, destroy antigens, signal lymphocytes  Lymphocytes – B cells (humoral branch ) and T cells (cellular branch)  B cells produce antibodies, but T cells do not  Functional role of B cells, T cells, and memory cells Stress Dramatically and Quickly Alters Immune Function

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Acquired Immunodeficiency Virus (AIDS)
Nature of AIDS  Course from HIV to full blown AIDS is variable  Median time from infection to AIDS is 7.3 to 10 years  Most die within 1 year of diagnosis  15% of AIDS patients survive 5 years or longer  Stress of getting an AIDS diagnosis can be devastating Role of Stress Reduction Programs  High stress and low social support speed AIDS progression  Goals – Reduce stress, improve immune system function Psychological, Behavioral, and Social Factors Influence AIDS

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Cancer: Psychological and Social Influences
Field of Psychoncology  Study of psychological factors and their relation to cancer Psychological and Behavioral Contributions to Cancer  Perceived lack of control  Inadequate / inappropriate coping responses (e.g., denial)  Overwhelming stressful life events  Life-style risk behaviors  Psychological factors are also involved in chemotherapy Influenced by Psychological, Behavioral, and Social Factors

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Cardiovascular Diseases: Hypertension
Cardiovascular Disease  Heart, blood vessels, and related regulatory mechanisms Hypertension – High Blood Pressure  Major risk factor – Stroke, heart disease, and kidney disease  Causes wear and tear of the blood vessels  Essential hypertension is the most common

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Cardiovascular Diseases: Hypertension (cont.)
Associated Features of Hypertension  Affects 26.7% of all adults between the ages of 35 and 64  African Americans are at greatest risk  Salt, fluid volume, sympathetic arousal, stress level  Expressed anger and hostility Influenced by Psychological, Behavioral, and Social Factors

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Cardiovascular Diseases: Coronary Heart Disease (CHD)
Coronary Heart Disease (CHD)  Blockage of arteries supplying blood to the heart muscle  Angina pectoris – Chest pain from partial obstruction  Atherosclerosis – Artery plaque (i.e., fatty substances)  Ischemia – Deficiency of blood supply (too much plaque)  Myocardial infarction – Heart attack, death of heart tissue

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Cardiovascular Diseases: Coronary Heart Disease (CHD)
Psychological and Behavioral Risk Factors for CHD  Stress, anxiety, anger  Poor coping skills, low social support  Type A Behavior Pattern Anger and negative affect Impatience, accelerated speech and motor activity Psychological, Behavioral, and Social Factors Influence CHD

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Pain: Psychological and Social Influences
Acute vs. Chronic Pain  Acute – Disappears within 1 month  Chronic – Does not decrease over time  Severity of pain does not predict one’s reaction to it Some Clinical Distinctions  Pain vs. pain behaviors Psychological and Social Factors in Chronic Pain  Perceived control over pain and its consequences  Negative emotion, poor coping skills  Low social support, compensation  Social reinforcement for pain behaviors Gate Control Theory Endogenous Opioids Gender Differences

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Chronic Fatigue Syndrome: Psychological, Behavioral, and Social Influences
Nature of Chronic Fatigue (CF)  Lack of energy, marked fatigue, pain, and low-grade fever  Most common in females  Incidence increasing in Western countries  Unrelated with viral infection, immune problems, depression Speculation About Causes  CF seems related to a high-achievement oriented lifestyle  Fast paced lifestyle combines with stress and illness  Psychological misinterpretation of after effects of illness Treatment  Medications are ineffective  Cognitive-behavioral interventions appear promising

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Psychological Treatment of Physical Disorders
Biofeedback: An Overview  Patient learns to control bodily responses  Used with chronic headache and hypertension Overview of Relaxation and Stress Management Procedures  Progressive muscle relaxation  Autogenic relaxation training  Transcendental meditation (TM) Comprehensive Stress and Pain Management Programs  More effective and durable than individual interventions

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Stressful Heart

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Modifying Behaviors to Promote Health
Life-Style Practices  Many health problems are linked to lifestyle and behavior  Behavioral risk factors are influenced by psychosocial factors  Prevention and intervention programs target behavioral risks Types of Life-Style Behaviors  Injury prevention – Repeated warnings are not enough  AIDS – Highly preventable by changing behaviors  China and smoking cessation programs  Diet, exercise, promotion of health and wellness  Stanford three community study

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Summary of Physical Disorders and Health Psychology
Psychological Factors Play a Major Role in Physical Disorders  Behavioral medicine and health psychology Psychosocial Factors: Their Role in Illness and Disease  Stress, immune function, and disease  Such influences interact with psychosocial factors Risk for Physical Illness  Related to long-standing patterns of behavior  Life-style factors Psychosocial Treatments  Aim to prevent and/or treat physical disorders  Comprehensive individual or community programs

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Exploring Physical Disorders

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Exploring Physical Disorders (cont.)

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Exploring Physical Disorders (cont.)

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Exploring Physical Disorders (cont.)

Abnormal Psychology: An Integrative Approach, 4th Edition, David H. Barlow Chapter 9: Physical Disorders and Health Psychology

Exploring Physical Disorders (cont.)


				
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