PSYC 316 Book Notes Chapter 8
PSYC 316 Book Notes Chapter 8 PSYC 316
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This 7 page Bundle was uploaded by Sara Karikomi on Friday October 16, 2015. The Bundle belongs to PSYC 316 at Northern Illinois University taught by Simon Jencius in Fall 2015. Since its upload, it has received 43 views. For similar materials see Intro-Psycpathology in Psychlogy at Northern Illinois University.
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Date Created: 10/16/15
Chapter 8 Disorders Featuring Somatic Symptoms I Factitious Disorder 1 Malingering intentionally faking an illness to achieve an external gain such as nancial compensation Munchausen Svndrome the popular name for factitious disorder a More about Munchausen Syndrome Dr Phil 1 httpswwwyoutubecomwatchvTGEaeFFWng Factitious Disorder a disorder in which an individual fakes or induces physical or psychological symptoms to assume the desired role of a sick person a Diagnosis Factitious Disorder is common among individuals who 1 receive extensive treatment for medical issues as children 2 hold a grudge against the medical profession 3 have worked in the medical eld as a nurse lab technician or medical aide b Factitious Disorder Imposed on Another also known as Munchausen Syndrome by Proxy l Caretakers or parents make up or induce physical illness in their children leading to repeated painful diagnostic tests medication and even surgery 2 More about Munchausen Syndrome by Proxy a httpswwwyoutubecomwatchvestWByOdOk B Conversion Disorder 1 Conversion Disorder disorder in which physical symptoms affect voluntary motor and sensory functions but the symptoms are inconsistent with known medical conditions a Glove Anesthesia conversion symptom in which numbness begins abruptly at the wrist and extends evenly to the ngertips Real neurological damage however is rarely as abrupt or evenly spread out C Somatic Symptom Disorder 1 Individual becomes excessively distressed concerned and anxious about their bodily symptoms Their lives are greatly and disproportionately disrupted by the symptoms Somatization Pattern the individual experiences a large and varied number of bodily symptoms a Briauet s Svndrome individuals suffering from somatization patterns of somatic symptom disorders experience longlasting physical ailments that typically have little or no physical basis 1 httpwwwmountsinaiorgpatientcarehealthlibraryd1seasesandconditionssomatizationdisorder Predominant Pain Pattern the individual s primary and bodily problem is the experience of pain What Causes Conversion and Somatic Symptom Disorders a Psvchodvnamic View 1 Electra Complex Freud s belief that all girls experience sexual feelings for their fathers and feels that they must compete with their mothers for his attention 2 Primary Gain the gain achieved when somatic symptoms keep internal con icts out of an individual s awareness 3 Secondary Gain the gain achieved when somatic symptoms elicit a kind caring response from others or when the symptoms excuse the individual from engaging in unpleasant activities b The Behavioral View 1 Behavioral theorists believe that conversion and somatic symptom disorder symptoms bring rewards to the sufferers the symptoms may excuse the individual from unpleasant activities or draw attention from others c The Coqnitive View 1 Some cognitive theorists believe that conversion and somatic symptom disorders serve as a way for individuals to communicate emotions that are dif cult to express verbally d The Multicultural View 1 Most western clinicians argue that somatic reactions are inferior ways of dealing with emotions 2 Studies have found high rates of stresscaused bodily symptoms in nonwestern medical settings throughout the world while people in Latin America display the greatest number of somatic reactions a In the US Hispanic Americans when facing stress display more somatic reactions than other populations D How Are Conversion and Somatic Symptom Disorders Treated many therapists focus on what causes the disorders and provide insight apply exposure and drug therapies l Psvchodvnamic TheraDv a Therapists help the somatic symptom sufferers become aware of their underlying fears and try to resolve them 1 Awareness and resolution eliminates the need to convert anxiety into physical symptoms Behavioral TheraDv a Exposure treatments are used to expose the clients to the stressful events that triggered their physical symptoms 1 Exposure should help the individual to become less anxious over the course of repeated treatments thus more able to deal with the upsetting situations directly instead of developing the physical symptoms Bioloqical TheraDv a Antianxiety drugs or antidepressants 1 Help reduce anxiety in individuals suffering from conversion and somatic symptom disorders 4 Other Therapies a thsical Svmntoms rather than the causes are addressed Techniques including suggestion reinforcement or confrontation are applied in treatment 1 Suggestion Therapists who use this approach offer emotional support and attempt to persuade them or convince them through hypnosis that their physical symptoms will soon disappear 2 Reinforcement Therapists employing this approach arrange the removal rewards for a client s symptoms and increase rewards for healthy behaviors 3 Confrontation This approach forces patients out of the role of a sick person The therapist tells them that there is no medical basis to their symptoms II Illness Anxiety Disorder A Illness Anxiety Disorder 1 Illness Anxiety Disorder previously known as Hypochondriasis is marked by chronic anxiety about health individual is convinced that they have or are developing a serious medical illness even though the somatic symptoms are absent a Illness anxiety disorders can begin at any age but usually develops equally in men and woman in early adulthood Behavioral Theorists individual learns to fear illness through classical conditioning or modeling 3 Coenitive Theorists individuals with illness anxiety disorder are excessively sensitive to and feel threatened by bodily symptoms which leads them to misinterpret their bodily cues 4 Treatments a Individuals suffering from illness anxiety disorders typically receive similar treatments as those with obsessivecompulsive disorder b Studies show that clients improve considerably when treated with the same antidepressant drugs that have helped those suffering from obsessivecompulsive disorder c Many also improve when behavioral approaches exposure and resnonse prevention are used III Psychophysiological Disorders Psychological Factors Affecting Other Medical Conditions A Traditional Psychophysiological Disorders 1 Ulcers lesions or holes that form in the wall of the stomach or duodenum 2 Asthma narrowing of the trachea and bronchi resulting in shortness of breath wheezing coughing and a choking sensation 3 Insomnia dif culty falling or staying asleep Muscle Contraction Headache also known as a tension headache a headache caused by narrowing of muscles that surround the skull 5 Migraine Headache severe headache that occurs on one side of the head and is often preceded by a warning sensation and sometimes accompanied by dizziness nausea or vomiting a Some medical professionals believe that migraines develop in two phases 1 blood vessels in the brain narrow causing reduction in the blood ow to parts of the brain 2 after narrowing the same blood vessels expand causing blood to ow through rapidly thus stimulating many neuron endings and causing pain Hypertension chronic high blood pressure Coronarv Heart Disease heart illness caused by blockage in the coronary arteries B What Factors Contribute to Psvchonhvsioloeical Disorders 1 Bioloaical Factors Autonomic Nervous System defects in this system may contribute to the development of psychophysiological disorders a If the ANS is stimulated too easily it may overreact to situations that most individuals may nd only a little stressful This leads to damage to certain organs which leads to psychophysiological disorders b Weak gastrointestinal systems may cause individuals to be prone to ulcers c Weak respiratory systems may cause individuals to be more prone to develop asthma 2 Psvcholoqical Factors many theorists believe that certain needs attitudes emotions or coping styles may cause individuals to overreact to stressors which increases their chances of developing psychophysiological disorders a Repressive Coping Style a reluctance to express discomfort anger or hostility 1 Individuals with repressive coping styles tend to experience a signi cantly sharp rise in blood pressure and heart rate in response to stress b Tvne A Person v personality characterized by hostility cynicism drivenness impatience competitiveness and ambition 1 Type A individuals interact with the world that produces continuous stress and often leads to coronary heart disease 2 Links between Type A personalities and heart disease may not be as strong as once believed but research suggests that many Type A characteristics hostility and time urgency may be strongly related to heart disease c Type B Personality personality style in which individuals are more relaxed less aggressive and less concerned about time 1 Type B individuals are less likely to experience cardiovascular deterioration 3 Sociocultural Factors The Multicultural Perspective Adverse social conditions may lead to psychophysiological disorders as they produce ongoing stressors that interact with the biological and personality styles a Poverty wealthier individuals have fewer psychophysiological disorders have better health in general and have better health outcomes than poorer individuals 1 Poorer individuals typically experience higher crime rates unemployment overcrowding other negative stressors and typically receive inferior medical care compared to wealthier individuals b Race and Psvchonhvsioloeicwnd other Health Problems a complicated relationship 1 African Americans have more psychophysiological and other health problems than white Americans They experience higher rates of high blood pressure diabetes asthma and are more likely to die of heart disease and stroke Many African Americans live in poverty which lead to the experience of high crime rates and unemployment that frequently results in poor health conditions a Other factors besides the environment must be at play in regards to the health statistics i African Americans physiological predisposition to risk of the development of high blood pressures ii Repeated experiences of racial discrimination may trigger stressors that raise blood pressure in African Americans 2 Similar trends were expected for Hispanic Americans as a high percent of Hispanic Americans also live in poverty are exposed to discrimination experience high rates of crime and unemployment and have inferior medical care a However the health of Hispanic Americans is at least as good and often better than white and African americans b Hispanic Americans have lower rates of high blood pressure high cholesterol asthma and cancer than white or African Americans c Hispanic Health Paradox refers to the positive health picture for Hispanic Americans in the face of economic disadvantage C New Psychophysiological Disorders 1 Are thsical Illnesses Related to Stress a Social Adiustment Rating Scale developed by Thomas Holmes and Richard Rahe this scale assigns numerical values to the stresses that most people experience throughout their lives 1 Life Change Units the most stressful event on the scale is the death of a spouse at 100 LCUs b Problems with the Social Adiustment Rating Scale 1 The scale does not take into consideration the particular life stress reactions of certain populations a White American respondents were sampled predominantly b Research indicates that members of minority groups and white Americans differ in stress reactions to various kinds of life events c Women and men differ in their reactions to several life changing events 2 Psvchoneuroimmun0102v the area of study that ties stress and illness to the immune system l Immune System the body s network of cells and activities that identify and destroy antigens and cancer cells 2 Antigens the body s foreign invaders such as bacteria or viruses 3 Lymphocytes white blood cells that circulate through the lymph system and blood stream They help the body identify and destroy antigens and cancer cells b BiochemicalActivitv 1 High Norepinephrine activity has been found to contribute to decreased immune system activity 2 If stress continues for a long time Norepinephrine will travel to receptor sites on certain lymphocytes giving an Inhibitory Message that stops their activity which slows down immune functioning 3 When an individual is under stress adrenal glands release corticosteroids and other stress hormones 4 Cytokines proteins that bind to receptors throughout the body At moderate levels of stress these proteins help fight infection but if stress continues more corticosteroids are released and the increased production and dispersal of cytokines lead to chronic in ammation This can sometimes contribute to heart disease stroke and other illnesses c Behavioral Changes 1 Some individuals under stress may become anxious or depressed Some may develop an anxiety or mood disorder This may cause the individual to engage in behaviors poor sleep poor diet less exercise increased smoking or drinking that slow the immune system d Personalitv Stvle 1 Individuals who respond to life stress with optimism constructive coping and resilience will experience better immune system functioning 2 Those with the opposite personality are more susceptible to illness 3 Men with a general sense of hopelessness die at higherthanaverage rates from causes such as heart disease 4 Spiritual individuals tend to be healthier than those without spiritual beliefs e Social Sunnort 1 Individuals with fewer social supports and feel lonely seem to display poorer immune functioning when under stress 2 UCLA Loneliness Scale Medical students were given the scale and divided into high and low loneliness groups Those in the high loneliness group showed lower lymphocyte responses during a final exam 3 Some studies have found that patients with certain types of cancer who have social support in their personal lives or have supportive therapy have better immune system functioning and more successful recoveries than the cancer patients without social support or supportive therapy D Psvcholoeical Treatments for thsical Disorders Behavioral Medicine eld that combines psychological and physical interventions to treat and prevent medical issues Relaxation Training often combined with medication treatment relaxation training is useful in the treatment of high blood pressure headaches insomnia asthma diabetes postsurgery pain certain vascular diseases and the undesirable effects of some cancer treatments Biofeedback Training if patients can see continuous readings about their involuntary bodily activities they may be enabled to gradually gain control over them a Electromyograph EMG feedback was used to treat 16 patients experiencing facial pain partially caused by jaw muscle tension The muscle contractions were converted into a tone for the patients to hear After repeatedly listening to the tone they learned to relax their jaw muscles Meditation a technique of turning an individual s concentration inward to achieve a different state of consciousness that allows them to temporarily ignore stressors Practicing meditation has been reported to help people feel more peaceful engaged and creative It has also been useful in pain management and the treatment of high blood pressure heart problems asthma skin disorders diabetes insomnia and viral infections a Mindfulness Meditation paying attention to one s own feelings thoughts and sensations with detachment objectivity and no judgment This form of meditation has helped patients suffering from severe pain Hypnosis guided into a sleeplike suggestible state in which they can be directed to act or think in different ways With training some are able to induce selfhypnosis to help deal with pain Cognitive Interventions treatment in which individuals are taught new cognitive responses toward their ailments a SelfInstruction Training or Stress Inoculation Training therapists teach patients to identify and eventually get rid of unpleasant thoughts also known as Negative SelfStatements that keep emerging during pain episodes They learn to replace the unpleasant thoughts with Coping Self Statements Support Groups and Emotion Expression a Medically ill individuals bene t from support groups and therapies that guide them to become more aware of and express their emotions and needs b Research suggests that just discussing or writing down past and present emotions or situations may improve an individual39s health and their psychological functioning Combination Approaches a Psychological treatments have been found equally as effective in the treatment of physical problems 1 Relaxation and biofeedback training are just as helpful mores than placebo in treating high blood pressure headaches and asthma b Psychological interventions are usually most bene cial when combined with other psychological interventions and medical treatments
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