Physical Disorders and Health Psychology

The Mind-Body Connection: Sobering Facts Chapter 9 Physical Disorders and Health Psychology • Leading Causes of Death (1900) –Treatable Medical Conditions •Leading Causes of Death (1993) –Disorders of Lifestyle / Behavior Psychosocial Factors That Influence Biology • Historical Developments –Second revolution in public heath –Early terminology •Psychosomatic Medicine •Psychophysiological disorders –New fields of study •Behavioral Medicine •Health Psychology • Psychological & social factors influence health & physical problems in 2 distinct ways – They can affect the basic biological processes that lead to illness & disease – Longstanding behavior patterns may put people at risk to develop certain physical disorders • The Nature and Role of Stress –Selye’s Serendipitous Find – 1936 Stages of Stress – General Adaptation Syndrome (GAS) •The body goes through several stages in response to sustained stress –Alarm –Resistance ALARM EXHAUSTION RESISTANCE –Exhaustion 1 • Body’s Response to Stress –Hypothalamus –Limbic system –Hippocampus is very responsive to cortisol •When stimulated by cortisol during HPA axis activity, the hippocampus turns off the stress response •Increased levels of cortisol in response to chronic stress may kill nerve cells in the hippocampus • What Influences the Stress Response? –A sense of control – A sense of predictability •Baboon studies • The Immune System and Physical Disorders –Stress and the Immune System –Depression also lower immune system functioning –Leukocytes •Lymphocytes –B cells Body’s Response to Stress HPA AXIS Hypothalamus Corticotropin Releasing Factor (CRF) •Operate in cellular branch •Killer T Cells directly destroy viral infections & cancerous processes •Memory T Cells speed future responses to the same antigen •T4 cells = Helper T Cells •Suppressor T cells Adrenal Pituitary • The Immune System: An Overview – Identifies and kills antigens – Identifies and kills body’s own cells that became aberrant or damaged • Two Main Divisions –Humoral and Cellular •Types of cells which function as agents –Leukocytes (White blood cells) •Macrophages –Surround & destroy antigens –Signal Lymphocytes The Immune System First Line of Defense MACROPHAGES •Operate in humoral branch •Produce immunoglobulins •Create memory B cells –T cells CORTISOL CELLULAR BRANCH HUMORAL BRANCH Killer T Cells T Cells B Cells Other T Cells Memory B Cells 2 Physical Disorders Influenced by Psychosocial Factors –Autoimmune Disease –Suppressed immune function •Psychosocial Link to Disease –Psychoneuroimmunology (PNI) – AIDS – Cancer – Cardiovascular Diseases – Chronic Pain – Chronic Fatigue Syndrome •The object of study is Psychological influences on the neurological responding implicated in our immune response •Adler, 1974 –– brain & immune system don’t operate independently of each other Psychosocial Factors and Cancer Psychosocial Factors and AIDS •Scope of the AIDS Epidemic •Factors that extend survival in AIDS • The Field of Psychoncology –Landmark study by Speigel et al., 1989 •Psychological Factors Influence –Robust & strong immune system – Course and also the Development –Psychological factors – Response to Aversive Medical Treatment •Stress–reduction procedures – Treatment & recovery from cancer in children Psychosocial Factors and Cardiovascular Diseases Nature of Problems •Heart, Blood Vessels, and Control Mechanisms • Major Kinds of Disease – Stroke (CVA) – Hypertension (High Blood Pressure) – Coronary Heart Disease • Strongly Influenced by Lifestyle Factors Essential Hypertension •“The Silent Killer” • No verifiable physical cause (the majority) • High Blood Pressure (> 160 / 95) •Influenced by psychological & lifestyle factors –Strong relationship between levels of social support & blood pressure –Anger & hostility have been associated with increases in blood pressure 3 Coronary Heart Disease • Number one cause of death in U.S. • Blockage of arteries supplying blood to the heart muscle •Types: –Angina –Atherosclerosis –Ischemia –Myocardial Infarction (Heart Attack) •Psychological Factors Psychosocial Factors and Chronic Pain The nature of chronic pain • Two kinds of clinical pain • –Acute Pain –Chronic Pain •Experience of Pain –Pain –Pain behaviors –Suffering •Psychological and Social Dimensions –Pain severity does not predict one’s reaction –Pre-existing anxiety & personality problems –Social support network –Type A and B Behaviors – Chronic Negative Emotions • –Gate Control Theory •Nerve impulses from painful stimuli make their way to the spinal column, & from there to the brain –Dorsal horns of the spinal column •The brain sends signals (excitatory or inhibitory) back down the spinal cord that may affect the gating mechanism –Endogenous Opioids (“Endorphins”) •Act like neurotransmitters to shut down pain, even in the presence of marked tissue damage or injury Psychosocial Treatment for Physical Problems • Psychosocial Factors in CFS Biological Dimensions Available Treatments • The Nature of Chronic Fatigue (CFS) – Unexplained fatigue – Variety of physical symptoms •Subjective memory impairment, sore throat, muscle or joint pain, headache etc. – Most common in women – Often debilitating •Sharpe’s 1997 Model •Prevention Efforts –Injury Control – Biofeedback –AIDS Prevention – Relaxation Procedures (PMR) –Smoking cessation – Meditation (TM & Relaxation Response) – Hypnosis – Comprehensive Stress Management •China study –Stanford Three Community Study •Media blitz on CHD 4