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Physical Disorders and Health

Psychology

Psychological and Social Factors that Influence

Health

• Psychological, Behavioral, and Social Factors
  • Are major contributors to medical illness and disease
  • Examples include AIDS, cancer, cardiovascular diseases
  • Recognize that psychological factors can affect medical conditions
• Psychological Approaches to Health and Disease
  • Behavioral medicine – Prevention, diagnosis, treatment of medical illness
  • Health psychology – Psychological factors involved in the promotion of health

Psychosocial factors directly affect physical health

Overview of Stress and the Stress Response

• Nature of Stress
  • Stress – Physiological response of an individual to a stressor
  • Stress responses vary from person to person
• The Stress Response and the General Adaptation Syndrome
  • Phase 1 – Alarm response (sympathetic nervous system arousal)
  • Phase 2 – State of resistance (mobilized coping and action)
  • Phase 3 – State of exhaustion (chronic stress, permanent damage)

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 social status is associated with fewer lymphocytes and immune suppression

 Dominant males benefit from predictability and controllability

 Vulnerabilities Operative in Mental Illness Contribute to Physical Illness

 Stress, perceived uncontrollability, low social support, negative affect

 Interpretation of Physiological Response and Situation Seems Critical

Responses to threats and challenges range on

a continuum from depression to excitement

Acquired Immunodeficiency Virus (AIDS)

• Nature of AIDS
  • Course from HIV to full blown AIDS is variable
  • Median time from initial infection to full-blown AIDS is 7.3 to 10 years or more
  • Stress of getting an AIDS diagnosis can be devastating
• Role of Stress Reduction Programs
  • Higher stress and low social support speed progression of disease
  • Reduce stress of diagnosis, improve immune system functioning
• AIDS is Influenced by Psychological, Behavioral, and Social Factors

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 or inappropriate coping responses (e.g., denial)
  • Overwhelming stressful life events
  • Life-style risk behaviors
  • Psychological factors also are involved in chemotherapy
• Cancer is Influenced by Psychological, Behavioral, and Social Factors

Cardiovascular Diseases: Coronary Heart

Disease (CHD)

• Coronary Heart Disease (CHD)
  • Blockage of the arteries supplying blood to the heart muscle
  • Angina pectoris – Chest pain from partial obstruction of the arteries
  • Atherosclerosis – Accumulation of artery plaque
  • Ischemia – Deficiency of blood supply because of too much plaque
  • Myocardial infarction – Heart attack involving death of heart tissue
• Psychological and Behavioral Risk Factors for CHD
  • Stress, anxiety, anger, poor coping skills, low social support, and lifestyleClassic
  • Type A Behavior Pattern – Particularly anger and negative affect

Chronic Pain

• Acute vs. Chronic Pain
  • Acute pain – Follows injury and heals within 1 month on average
  • Chronic pain – Does not decrease with healing and treatment
  • Severity of pain does not predict one’s reaction to it
• Pain: Some Clinical Distinctions
  • Subjective vs. overt behavioral manifestations of pain
• Psychological and Social Factors in Chronic Pain
  • The role of perceived control over pain and its consequences, negative emotion, poor coping skills, low social support, compensation
  • Social reinforcement for pain behaviors
• Gate Control Theory: An Integrative Account
• Endogenous Opiods: Our Body’s Response to Pain

A complex specific model of

chronic fatigue syndrome

Psychosocial Treatment of Physical Disorders

• Biofeedback: An Overview
  • Patient learns to control bodily responses
  • Used with chronic headache and hypertension
• Relaxation and Meditation
  • Progressive muscle relaxation
  • Transcendental meditation (TM)
• Comprehensive Stress Reduction and Pain Management Programs
  • More effective and durable than individual interventions alone

Results of the Stanford three community

study

Summary of Physical Disorders and Health

Psychology

• Psychological Factors Play a Major Role in Physical Disorders
  • Behavioral medicine and health psychology
• Psychological and Social Factors: Their Role in Illness and Disease
  • Several diseases are influenced by the effects of stress on immune function
  • Such influences interact with other psychological and social factors
• Long-Standing Patterns of Behavior and Life-Style Increase Risk for Physical Illness
• Psychosocial Treatments Aim to Prevent or Treat Physical Disorders
  • Comprehensive individual or community programs are best