Chapter 7 - Psychological Factors Affecting Medical Conditions Flashcards Preview

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Flashcards in Chapter 7 - Psychological Factors Affecting Medical Conditions Deck (91):
1

dualistic

mind and body is viewed as separate entities, subject to different laws

2

what perspective emerged in the 1970s

realization that many, perhaps all, disease states are influenced directly/indirectly by social or psychological factors

3

behavioral medicine

refers to application of the methods of behaviour modification to the treatment or prevention of disease ex. psychological techniques to control pain in patients

4

health psychology

application of psychological methods and theories to understand the origins of disease, individual responses to disease, and the determination of good health

5

what is the key criterion to be diagnosed

must have medical condition that is adversely affected by psychological/behavioural factor

6

what is the exclusion criterion to be diagnosed

factors should not be better explained by another mental disorder

7

How do we rule in a psychological or behavioural factor?

1) evidence of identified factor influencing course of condition
2) factor interferes with the treatment of the medical condition
3) factor poses additional risk to the health of the individual
4) factor influences the pathophysiology of the disorder

8

mechanism

activity of a living system that mediates the influence of an antecedent factor on disease

9

what is illness defined by

defined by symptoms which are subjective reports of internal states

10

what is disease defined by

defined by signs which are objective indications of an underlying disease process, either directly by a person with appropriate training or indirectly through a specific test

11

lesion

when a sign involves disturbance in bodily tissue or normal functioning of a bodily system

12

why is the distinction between illness and disease important?

alerts us about the various mechanisms by which psychological factors may contribute to ill health

13

how can psychological factors influence ilness

affect our perception of, attention to, or tolerance of bodily signals

14

what can psychological influences on bodily tissues (via lesions) be?

can be the effects of behaviours (ex. smoking) or psychosocial variables (ex. emotions, interpretation of experience)

15

what three mechanisms are responsive to psychosocial factors?

endocrine system, autonomic nervous system and immune system

16

what are several endocrine organs known to be highly responsive to?

psychosocial variables - best known system is HPA axis (releases cortisol in response to a variety of psychosocial influences ex. stress)

17

endocrine system

organs that manufacture hormones and secrete them into the bloodstream

18

cortisol

highly active hormone - suppresses inflammation, mobilizes glucose from the liver, increases cardiovascular tone, produces immune system changes and inhibits other endocrine structures

19

are cortisol features used as a defense mechanism

yes

20

what are the short term responses in cortisol

promote immediate survival and inhibit unnecessary activity but they are maladaptive when prolonged/exaggerated

21

what is there evidence for regarding cortisol

suppress immune system function, enhance the development of atherosclerosis and contribute to neuronal damage in brain

22

does cortisol play a role in increasing the production of fat cells

yes

23

does cortisol contribute to neuronal damage in the brain that may be associated with dementia

yes

24

what are two parts of the ANS system

Sympathetic branch and parasympathetic system

25

sympathetic branch

produces changes that prepare the body for vigorous action; dangerous if prolonged

26

parasympathetic branch

returns the body to a more balanced state that is within the body's tolerance

27

why are effects of the ANS so fast?

because they don't reply on blood stream, instead rely on speed of nervous conduction

28

what part of a second endocrine subsystem is the sympathetic system part of

sympathetic-adrenal medullary (SAM) axis

29

what does the SAM axis do

1) Stimulates release of epinephrine and norepinephrine
2) Associated with "adrenalin rush", increased energy and body activation

30

immune system

comprises a network of cells and organs that defends the body against external, disease causing forces or internal pathogens (antigens)

31

how does the immune system perform its function

through a variety of white blood cells

32

where are immune cells produced and stored in

several organs including thymus gland, the lymph nodes, bone marrow and small intestine

33

what are the three categories of immune response

nonspecific, cellular, humoral

34

nonspecific immune responses

circulating white cells (granulocytes and monocytes) identify invading antigens and destroy them by a process of engulfing and digesting called phagocytosis

35

antigens

substance that is recognized as foreign to the body

36

cellular immunity

blood cells called T-lymphocytes create immune episode to foreign body and are altered as a result - responsible for "building up immunity"

37

helper t-cells

secrete substances called lymphokines that control responses of other types of t-cells

38

killer t-cells

attack foreign or mutated cells directly

39

suppressor t-cells

inhibit the actions of both the helper cells and the natural killer cells, thereby providing negative feedback mechanism

40

memory t-cells

stored in the body in anticipation of the next time it needs to counter the same threat

41

humoral immunity

invading antigens are targeted by B-lymphocytes

42

psychoneuroimmunology

study of mind-brain-immunesystem interactions

43

3 ways psychosocial variables can influence immune acitivity

1) direct action of CNS on organs and structures of the immune system
2) secondary consequence of the hormonal changes
3) changes in behaviour that reflect personal characteristics or adaptations to changing life conditions

44

What 3 ways is the term stress used

1) to refer to a stimulus or property of external world
2) to refer to a response
3) refer to a transaction that mediates stimulus and response

45

alarm (first phase)

body mobilizes its defence

46

resistance (second phase)

actively copes with the challenge through immune and neuroendocrine changes

47

exhaustion (third phase)

energy is depleted and resistance can no longer be maintained

48

general adaptation syndrome (GAS)

first formal description and definition of stress - according to this model, stress is inferred from a set of bodily changes that is defined by a response

49

what are the three phases of GAS

alarm, resistance and exhaustion

50

what must happen in GAS

some event must occur to set off adaption effectts

51

transactional model of stress

stress is an ongoing series of transactions between an individual and their environment

52

appraisals

constantly evaluating what is happening to them

53

primary appraisal

asks the question "is this a threat to me?"

54

secondary appraisal

if yes, primary appraisal is a threat, then engages in problem-focused coping or emotion-focused coping

55

final step in transaction model

"is my coping effective?" - if yes, stress is minimized. if no - appraisal of threat is confirmed - leads to disease or stress effects

56

why is the transactional model of stress useful

1) the way we perceive a threat plays a role in the physiological response to it
2) it helps organize how we think about psychosocial factors influencing disease

57

social status that influence disease

individual's relative position within a social hierarchy matters

58

controllability

ability to control potentially stressful events

59

internal locus control

see themselves as masters of their own destiny

60

external locus control

see themselves as being buffeted by the random events of the world

61

what is high strain and external locus of control been shown to be associated with

increased risk of morbidity and mortality due to cardiovascular disease

62

social support

extent to which an individual feels connected to other people in meaningful ways

63

what does the absence of social support worsen

existing disease

64

what are the reasons the effects of social support are unclear

1) may be associated with material support in times of stress
2) may be a mean of discovering or testing coping strategies
3) a way of altering stress appraisals

65

ischemic heart disease

blood supply to the hear becomes compromised which leads to myocardial infarction and stroke

66

myocardial infarction and stroke

blood supply to the brain is interrupted, leading to death of neural tissue

67

potential years of life lost (PYLL)

a measure calculated by subtracting age of death from an individual's life expectancy - than any other cause except cancer and accidents

68

what does the cardiovascular system provide to the body

nutrients and oxygen to all the tissues in the body and serves as a highway for the elimination of waste products

69

vasculature

extensive branching network of arteries, arterioles, capillaries, venues and veins

70

two numbers that express blood pressure

systolic blood pressure/diastolic blood pressure

71

cardiac output

amount of blood pumped by the heart

72

total peripheral resistance

the diameter of the blood vessels

73

arrhythmias

disturbances in the normal pumping rhythm of the heart or from compromised supply of blood to the heart itself

74

atherosclerosis

buildup of deposits, known as plaques on the walls of the blood vessels

75

atherogenesis

atherosclerotic plaques are complex structures built up from matter deposited on arterial linings over a course of a lifetime - primarily lipids

76

hypertension

high level of resting blood pressure

77

stress reactivity paradigm

reaction to stress is important to understanding CVD

78

cardiovascular reactivity

degree of change in cardiovascular function change in response to a psychologically significant stimulus

79

Type A

people who appear to be aggressively involved in a chronic struggle to achieve more and more in less and less time

80

3 components of Type A that increase CVD

1) affective features
2) cognitive/attitudinal dimension
3) behavioural dimension

81

affective features

tendency to respond to situations with anger and contempt

82

cognitive/attitudinal dimension

tendency to view others with a cynicism and to impute bad intentions to them

83

behavioural dimension

direct and subtle aggressiveness and antagonism

84

5 models of CVD

1) psychophysiological reactivity model
2) psychosocial vulnerability model
3) transactional model
4) Health Behaviour model
5) constitutional vulnerability model

85

Psychophysiological Reactivity model

hostile people at a greater risk due to experiencing greater physiological responses to stress

86

psychosocial vulnerability model

hostile people experience more demanding interpersonal lives than others

87

transactional model

hostile people construct an antagonist and unsupportive world, worsened by lack of social support and increased interpersonal stress

88

health behaviour model

hostile people engage in more unhealthy behaviours and less health behaviors

89

constitutional vulnerability model

link between hostility and poor health outcomes is the result of this - genetics + personality + disease risk

90

two classes of intervention

1) generic approaches to management of stress
2) interventions for specific psychosocial variables

91

what do specific interventions target for Type A

personality traits and associated behaviours