Psychophysiological Disorders and Health Psychology

Question 1

psychophysiological disorders

Answer 1

• genuine physical illness with identifiable medical explanations in which psychological factors play a significant role (ex consider the link between high blood pressure and stress; in general, you’d be hard pressed to find an illness that stress doesn’t make worse)
• formerly known as psychosomatimc disorders (in which the psyche/mind is having an unfavourable effect on the some/body)
• are in contrast to somatic symptom disorders
• important to remember that there is a nature vs nurture interplay in physical health conditions too

Question 2

somatic symptom disorders

Answer 2

• also called somatoform disorders

- physical symptoms without identifiable medical explanations, manifestation of psychological problems

Question 3

behavioural medicine

Answer 3

• interdisciplinary field of behavioural science as applied to the prevention, diagnosis and treatment of medical problems
• based upon the mind-body link and prevention is a key component

Question 4

health psychology

Answer 4

• study of psychological factors that promote and maintain health
• based upon the mind-body link and prevention is a key component

Question 5

CVD

Answer 5

(cardiovascular disease)
-an excellent example of a psychophysiological disorder; a genuine physical disease with a medical explanation, but in which psychological factors play a huge role
-about 45% of all deaths are somehow related to cardiovascular functioning
-CVD is the leading cause of death in Canada
-behaviours such as smoking, lack of exercise, poor diet and alcohol can promote CVD
-CVD can be minimized by altering lifestyle
-mental health also impacts ability to cope; worry an anxiety can lead to CVD
-mood disorders are also more present with chronic illness
(overall, brain physiological and psychological wellbeing can impact the rest of health)

Question 6

stress

Answer 6

of all the biological, psychological and social factors that impact physical heath, stress is the major one

• occurs in response to our environment
• can be thought of in terms of stressors (stimuli one finds stressful) and response (coping, emotional upset/calmness)

Question 7

hans seyle’s General Adaptation Syndrome

Answer 7

• also called the stress response
• alarm phase (ANS fight/flight response), resistance phase (damage occurs or organism adapts to stress and the flooding or cortisol), exhaustion phase (organism suffers irreversible damage)
• seyle notice that rats who sustained stress from injection of saline or chemicals would develop ulcers in adrenal glands (phase 1 in and of itself could produce ulcers in rats, phase 2 depends on coping, duration, intensity and adaptability

Question 8

nervous system

Answer 8

• CNS (brain and spinal cord)
• PNS (connects CNS to the organs, limbs and everything else)
• PSN further subdivided into somatic (motor and sensory function) and autonomic (sympathetic: flight/flight, activated by stress; parasympathetic: rest and digest, suppressed by stress)

Question 9

stressor categorization

Answer 9

• major vs minor (death of loved one vs stuck in traffic)
• acute vs chronic (failing an exam vs unpleasant workload); should take into account allostatic load (amount of wear and tear in the body from chronic physiological stress)
• psychogenic vs neurogenic (self-induced (worry, anxiety) vs physical stress (ex from an injury))
• controllable/predictable vs uncontrollable/unpredictable (it’s easier to come with things you can see coming)

Question 10

stress: accounting for individual differences

Answer 10

• people respond to events differently, largely because people perceive events differently; not every one of say 100 ppl who see something tragic will react the same, or associate the same meaning with the event)
• not all ppl have the same resources/coping strats
• we all have stressors, and some of them are needed (like to wake up in the morning and get things done) but a lot of the unpredictable, devastating stress might be subjective (depending upon whether one perceives it as really unpredictable)

Question 11

coping

Answer 11

• the major kinds/fundamental approaches are problem-focuses or emotion focuses
• problem/solution focused (in which the indv takes direct, head-on action to solve a problem or seek a solution) is the most adaptive when the indv can actually do something about the situation (p useless way to cope with say someone being dead tho)
• emotion focused (addressing the response to the problem instead of the problem itself by taking efforts to reduce negative emotional rxns to a stressor) is most adaptive when the sitch is uncomfortable and there’s no direct solution to the stressor
• studies show that unhealthy coping mechs, such as denial and avoidance, are the lest effective strats (over the long term)

Question 12

goodness of fit hypothesis

Answer 12

-the adaptability of a particular coping response depends on how ideal the match is btw the situation and what’s ideally required in the coping method selected (ex, emotional focused coping such as mourning won’t help world leaders solve coronavirus, but problem focused coping isn’t a great way to mourn a lost loved one)

Question 13

social readjustment rating scale

Answer 13

• measurement of stress by psychiatrists thomas holmes and richard rahe
• consists of 43 life events to which scores called “life change units” are assigned; if score exceeds 300, the indv is at risk for an illness
• not perfect, and bases on questionable retrospective self-report research, but in spite of that is actually pretty predictive; see correlation btw total scores and illness such as heat attack, onset of leukemia, colds/flus
• psychological factors such as perceptions and cognition, as well as how an indv responds and reacts to stress may also contribute to onset of illness

Question 14

assessment of daily experiences

Answer 14

• measure of stress created by stone and neale that considers it may not be that the devastating life events that really matter so much as the chronic daily grind
• indvs rated a nd reported daily experiences at the end of each day (relating to work, family, finances, etc)
• observed that an increase in undesirable events and decrease in desirable events preceded respiratory infections

Question 15

daily hassles scale

Answer 15

• a measurement of stress based upon the connection between daily hassles and poor psychological and physiological adjustment
• crude, but predictive

Question 16

brief college hassles scale

Answer 16

• measurement of stress that looks at academic, interpersonal, and financial hassles
• crude, but predictive

Question 17

stress and work

Answer 17

• stress can be context specific
• job stress is impacted by personality and/or stressful occupation (ex doctors, lawyers) and is linked to depression and absences
• job spillover is when a job comes home with you and impacts your family life (potentially indirectly stressing your family)
• extreme job burnout can lead to reduced performance, cognitive impairment, depression and cardiovascular disease

Question 18

student health

Answer 18

• in canada, the predictors of less positive health status in students are poorer child-parent relationships, low interest and achievement in school, lower self-esteem, and being female
• the top health problems in students are allergy, back pain, sinus infection, depression, and strep throat
• the top five factors interfering with academic performance are stress, cold/flu/sore throat, sleep difficulties, concern for troubled friend/family member, and internet use/computer games

Question 19

brief COPE questionnaire

Answer 19

• specific measure designed to assess stress in students
• lists several coping strategies and respondents ranked how frequently they used those strategies on a scale of 1 (not at all) to 4 (a lot)

Question 20

poor coping

Answer 20

• we know for certain that while denial and avoidance might cause short term gain, they always produce long term pain
• as well, rumination (lingering on an emotional preoccupation) prolongs the stress response and is consequently linked with poorer health consequences; there are also two types of rumination, trait (which makes someone less likely to be adaptable and more likely to have prolonged stress rxn more often/poorer psychological outcomes in general) and state (one time as opposed to general tendency)
• hostile personality is also associated with poorer outcomes

Question 21

stress-illness link

Answer 21

• why does stress only produce illness in some? why does it cause illness and not just psychological problems? and why one psychophysiological disorder and not another?
• can be moderated to a degree with coping (if we have goodness of fit/if the strategy is appropriate to the stressor), a basic social support network (having few friends/relatives increases mortality),
• extra points if the social support is not only structural (present) but also function (higher quality supports linked to decreased arterial plaques), emotional (feeling cared for), and instrumental (actually providing assistance)

Question 22

somatic weakness theory

Answer 22

• a biological theory of stress-illness link similar to the stress-diathesis model
• reckons that if you’re born with a weak organ/system, stress could tip the balance

Question 23

specific-reaction theory

Answer 23

• a biological theory of stress-illness link
• the idea that many physiological responses are idiosyncratic (unique to you in some regard) and it might be that the body systems you have are most responsive/receptive to stress are the very ones most likely to be impacted by that stress

Question 24

altered immunity

Answer 24

????

Question 25

prolonged exposure to stress horones

Answer 25

• a biological theory of the stress-illness link
• the flight or flight response (which is primarily related to gluccocorticoids like cortisol) is really helpful/adaptive in the short term, but bodies/brains aren’t built to marinate in it long term

Question 26

hypothalamic-pituitary-adrenal axis and stress

Answer 26

• high lvls of catecholamines (DA, epinephrine, NA) prepare the body and mind for fight/flight
• limbic system is closely located to hypothal
• stress also activates the sympathetic nervous system and the HPA axis, leading to release of cortisol from adrenal glands
• short term, this increases blood sugar and suppresses inflammation
• long term, decreases immunity, reduces bone formation (which could result in osteoporosis), damages hippocampus (it’s important in mem, but also part of a negative feedback loop and if damaged cannot brake leading to further increases in cortisol); continued exposure desensitizes negative feedback and the stress response isn’t shut off

Question 27

stress and immunity

Answer 27

• we intentionally expose ppl to a cold virus and find that stress makes a meaningful difference in response
• with exposure to cold virus, chance of exposure relates to higher levels of stress with the intensity of stress relating to severity of infection
• the quality and quantity of your relationships also affects the chance of infection
• positivity and optimism protect against developing a cold

Question 28

psychological theories of stress

Answer 28

considers cognitive and behavioural factors:

• chronic stress can occur based on how we perceive life experiences (if I generally see life as a terrible thing, I’m more likely to pick up negative coping strategies)
• our perception of events (including past and future) can stim the HPA axis and sympa NS, leading to secretion of stress hormones
• negative emotions (anger, resentment, regret, worry) can keep the body in a constant state of arousal/emergency, which prolongs things

Question 29

cardiovascular disorders

Answer 29

• diseases involving the heart and circulatory system: hypertension (high BP), coronary artery disease (clogged or damaged arteries which impact blood flow to the heart), stroke (blockage/prevention of blood and oxygenation to the brain)
• many CVDs could be prevented by addressing known risk factors
• leading reason for hospitalization in canada, and costs us 22 billion annually
• canadians have limited awareness of the major causes (cholesterol and high BP)

Question 30

hypertension

Answer 30

• high BP (stress causes sympa NS activation, narrowing blood vessels and increasing BP)
• major risk factor for kidney disease, heart disease, stroke
• leading risk factor of death in the world, and only 1/5 of canadians who have it are receiving treatment
• most cases of essential/primary hypertension have no other apparent biological cause, earning them the title “silent killer” (bc you don’t feel it or even know you have it unless you regularly check your BP)
• blood pressure is measured systolic/diastolic in mmHg; normal is below 120/80, stage 1 hypertension is greater than 140/90 and stage 2 greater than 160/100
• non-modifiable risk factors: family history, age (below 64, males have higher risk, but greater for females after), race (africans more susceptible), kidney disease
• modifiable risk factors: stress, lack of exercise, unhealthy diet, obesity, alcohol, smoking, sleep apnea, diabetes, high cholesterol
• CV reactivity (extent to which heart r8 and BP increase w stress) a predisposing factor
• highly heritable

Question 31

coronary artery disease

Answer 31

• angina pectoris (periodic chest paint from insufficient oxygen supply (ischemia) to the heart due to cholesterol deposits (atherosclerosis) or constriction of blood vessels)
• myocardial infarction (heart attack, due to death of heart tissue)

Question 32

myocardial infarction triggers

Answer 32

• acute stress
• chronic stress
• anger
• physical exertion
• jobs with limited control
• highly demanding jobs

Question 33

coronary artery disease: diathesis-stress models

Answer 33

-caused by an interaction of predisposition and stress; risk factors historically didn’t include stress which left half of the CAD instances unexplained, underscoring how important stress is
psychological diathesis: type A personalities (intense, competitive, angry) are more likely to develop CAD; type D (distressed) personalities (predom negative affect, worry, irritable, gloomy) have increased risk of mortality
biological diathesis: cardiovascular reactivity reflects magnitude of physiological changes from baseline resting state in response to stress

Question 34

treatment of psychophysiological disorders

Answer 34

• lifestyle measures (exercise, healthy diet) can reduce cholesterol and BP
• medication can be used for severe cases, but unfortunately doesn’t meaningfully address the stress component (just the body’s response to it)
• psychotherapy to reduce anger, anxiety, depression and improve coping; CBT for systematic desensitization, exposures, behavioural rehearsals, and psychoanalytic for emotional/unconscious releases
• reducing risk factors (smoking, obesity)
• biofeedback (gain some degree of control over physiol responses by becoming aware of and trying to modify them in real time (ex consciously trying to slow heart rate or relax muscles)
• cardiac rehabilitation
• coping styles

Question 35

chronic pain

Answer 35

terms:

• suffering (emotional response to pain, varies by indv)
• pain behaviour (observable actions as’d with pain/suffering (moaning, clenched fists, irritability))
• pain severity doesn’t predict rxn (pain stim and pain experience isn’t a one one-to-one relationship)
• distraction can control acute and chronic pain
• lowered anxiety and increased optimism and sense of control can reduce sensation of pain
• meds don’t help much (opioids aren’t used outside of surgery/palliative care, v serious medical illness, bc while they seem innocent at first, causing euphoria and taking the edge off pain, they quickly lose effect as tolerance develops, and they suppress breathing at rel low doses so it’s easy to OD; withdrawal is also nasty (radical, intense pain and v high sensitivity)
• pain free existence likely not possible (nor functional), but we can reduce catastrophization (neg self statments and view of future), encourage patients to exercise a predetermined amt of time in spite of pain (vs until they feel pain), use relaxation training, and address beliefs/attitudes/expectations
• mindfulness (develop awareness of perceptions in an emotionally non-reactive/non-evaluative way, designed to reduce stress and feeling out of control)

Question 36

health gender differences

Answer 36

• women live longer but report being less healthy than men (esp in the later ages of life)
• women have sizeably lower rates of obesity/being overweight
• women experience more disabilities as compared to men due to poor health
• hormone replacement therapies appear to protect women from mortality (incidence of disease)
• critical determinants of health status are smoking and alcohol for men, and caring for a family, social support, and wealth for women
• the mortality rate gap btw men and women is decreasing, suggesting more deaths are just as’d with lifestyle

Question 37

socio-economic status and health

Answer 37

• low SES is as’d with higher rates of mortality from all causes (gross mortality), and ppl of lower SES are more likely to engage in behaviours that increase the risk dor disease (smoking, eating high fat diets, drinking alcohol)
• SES reflects a gradient of health status
• those with lower SES had significantly greater likelihood of presenting to ER and had higher mortality rate
• low SES also confers health disadvantages through the link to lower sense of perceived controllability