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Define Psychosomatic Disorders
What does this definition imply?

A group of disorders whose etiology is at least in part related to emotional factors
Implies: A dualism that does not exist (Physical and mental factors interact for all disorders


Give 6 examples of "Classic" Psychosomatic Disorders

1. Peptic Ulcer
2. Ulcerative Colitis
3. Rheumatoid Arthritis
4. Asthma
5. Essential Hypertension
6. Migraines


Name some disorders that are now considered to have psychosomatic elements

1. Almost any disorder
2. Heart disease
3. Infectious diseases
4. Cancer


Why might someone develop one disorder and not another?

1. Genetics: predisposition
2. Environment
3. Learning expectancy (example study on PMS women convinced they were premenstrual and developed symptoms)
and Conditioning: Little Albert


Give an example of a genetic vulnerability

Salt sensitive (Dahl) Rats


What is the bacteria that causes ulcers?

Helicobacter Pylori


Why does stress matter i the development of ulcers?

Even though Helicobacter Pylori is associated with ulcers 3/4 of us have this bacteria and only 1/10 will develop ulcers
20% don't respond to anti bacterial treatment
10-20% of ulcer patients don't have H. pylori infection


What was the experiment on the development of ulcers using monkeys and electric shocks called? Describe it. What were the results? Why are these results important?

Executive Monkey Studies
-2 monkeys
-Electric Shock every 20 seconds
-Response from one monkey (the executive monkey) pressing a bar prevents shock for both monkeys

Most dramatic results with 6 hours on 6 hours off
Executive Monkey died during the experiment
Executive Monkey developed ulcers, control monkey did not

Important because previous experiments suggest that having control over the situation reduces stress so you would think that the monkey with control would have less stress but this is not what they found.

Possibly the role of the ANS turning system on and off? Acidity higher during off period (See lecture to clarify)


What 3 tubes did subjects have in a "Biofeedback" experiment?

1. pH meter
2. Injected Bicarbonate sodium ( pH neutralizer)
3. Water release (wash pH meter)


What are Generalizations about Personality patterns and Ulcers (for Ulceritive Colitis)?

Ulcerative Colitis:
1. More Education same income
2. More compliant
3. Obedient as a child
4. Childhood memories happy
3. Helpless when ill
4. Conflict = rebellion vs. compliance
5. Compliance to prevent loss


What are some risk factors of Heart Disease (that can be modified)

How much of the variance do all these factors combined account for?

What were the only risk factors that were consistent across areas?

1. Hypertension
2. High serum cholesterol
3. Cigarette smoking
4. Weight
5. Physical activity

about 25%

1. Hypertension
2. High serum cholesterol


Stress & Heart disease: What was the experiment they did with monkeys? What were the results?

Put monkeys in strange situations (group members replaced on a regular basis) affecting dominance hierarchy (stressful)

Significant thickening of the arteries: Effects most pronounced in higher-rank monkeys


What type of job strain increases chances of Heart Disease? by how much?

A demanding job with little control

23% more likely


In individuals who had already had a heart attack what did the observe when they they had to do public speaking (stressful)

Less oxygen to the heart during stressor vs. physical exercise


What personality type is associated with increased risk of heart disease? What are it's characteristics

Coronary prone behavior pattern/personality: Type A personality

1. Extreme competitiveness
2. Striving for Achievement
3. Aggressiveness
4. Impatience
5. Hyper-alertness
6. Negative emotions


Who is the guy who keeps rolling a boulder up a hill?



What's the problem with the Type A personality?

it doesn't predict heart disease very well (overall effect size less than 1%)


What did the Type A personality used to be referred to as? and now? Why?

"hurry up" personality
Now: "pissed off" personality

Because hostility was found to be an important aspect of the profile


What were the two Pennsylvania towns studied? What were the results?

Bangor: Typical American town
-More modern, less traditional
-male/female gender roles overlap
Roseto: Italian immigrants:
-Defined gender roles & family structure
-Society mutually supportive and gregarious

People in Roseto more resilient to heart attacks than those in Bangor


Can lifestyle change or reverse coronary heart disease?

Dean Ornish:
Diet and lifestyle changes changed as much as 40% the volume of arteries and veins


What are the Immune System Basics?

1. Antigen: antibody generator
2. First line of defence: skin, mucus membranes, stomach acid
3. If these systems breached: Immune system attacks the invaders
4. White blood cells (Lymphocytes): make up much of the immune system


Name 6 specific types of lymphocytes and their functions

1. Helper T-cells: turn the system on
2. Macrophages: trap invading antigen, presents the antigen to other lymphocytes
3. B-lymphocytes: produces antibodies which attack antigens
4. Cytotoxic T-lymphocytes: destroys antigens
5. Natural killer cells: attacks foreign cells
6. Suppressor T-cells: turns off system


Where are lymphocytes located?

1. blood
2. spleen
3. thymus
4. lymph nodes


Where was there a nuclear accident in 1979? What were the effects?

Three mile island

No one was affected by radiation

They had health problems (more prescriptions, upper resiratory infections, high blood pressure/hypertension, compromised immune system) related to the Stress Response to the accident


In the West Point Military Academy study, who was more likely to develop Mononucleosis?

1. if they had fathers who were overachievers
2. if they had poor academic performance
3. if they were highly motivated toward a military career


What is the relationship between stress and cancer? individuals are at greater risk if?

Stress does not cause cancer
Stress impairs immune system function and natural killers cells that suppress tumor growth

Greater risk if:
1. Fatigued
2. Helpless
3. Inability to express negative emotions
4. inability to cope with stress
5. loss of a significant relationship in the preceding 5 years


How are Depression and Immunity related?
What are the 2 explanations?

Depression is related to:
1. Reduced response of lymphocytes to mitogens
2. Reduced natural killer cell activity
3. Altered white blood cell populations

1. Activation of the hypothalamic-pitutary-adrenal axis and the sympathetic nervous system
2. association with specific behaviours: Depressed people sleep less, exercise less, have poorer diets, smoke more etc...


What are Generalizations about Personality patterns and Ulcers (for Peptic Ulcers)?

Peptic Ulcer:
1. Larger Family
2. Unpleasant childhood memories
3. Overburdened then ill
4. Sustained Loss
5. Resentment at having to be independent