Health Psychology Exam 2 Study guide
Health Psychology Exam 2 Study guide Psyc 400
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This 14 page Study Guide was uploaded by Samantha Riley on Thursday March 3, 2016. The Study Guide belongs to Psyc 400 at Humboldt State University taught by Carrie Aigner in Winter 2016. Since its upload, it has received 78 views. For similar materials see Health Psychology in Psychlogy at Humboldt State University.
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Date Created: 03/03/16
PSYC 400: HEALTH PSYCHOLOGY Study Guide for Exam #2 I. Chapter Five: Defining, Measuring and Managing Stress a. Physiological Stress Response i. The body physically responds to stress through the nervous systems. ii. In an over stressful situation, the body will go into “fight or flight” where certain, unnecessary body functions will temporarily shut down in favor of 1. Increased respiration 2. Increased heart rate a. For increased blood flow to the outer limbs b. Parts of the Nervous System related to Stress Response i. The sympathetic nervous system mobilizes body’s resources in time of stress ii. The parasympathetic nervous system promotes relaxation in non-stressful times iii. Neuroendocrine System 1. Pituitary Glands produce ACTH a. Stimulates Adrenal Glands 2. Adrenal Glands a. Produces cortisol and epinephrine c. Basic findings of the Kiecolt-Glaster (2003) Study on neuroendocrine function and divorce i. Couples who got divorced within 10 years had a 34% higher starting point for epinephrine levels in their first year of marriage ii. What is the alternative explanation? 1. The first year of marriage is difficult for the majority of people, so the in possible-pre-existing stress could have built on that. iii. What are some important variables to control for in the study? 1. Socioeconomic status 2. Age 3. Current Health 4. Education levels d. Selye’s General Adaption Syndrome i. Describes how we respond to long term stress 1. Some people do not come down to homeostasis after stressors occur a. You can go through 3 stages: b. When a stressor hits, you spike into alarm c. Those with problems with stress will go through a stage of resistance d. Eventually you will hit an exhaustion stage where you give out in some way i. Emotional Breakdown ii. Get sick iii. ETC. e. You can cycle through these stages numerous times throughout life f. Drawbacks: i. Doesn’t take into predisposed stress balance ii. Effects of stress of mother during gestation iii. Individual differences 1. Different perceptions of stress 2. Different Support systems 3. Coping differences e. Lazarus and Folkman’s Model of Stress i. Primary appraisal = initial appraisal of an even as positive, neutral, or stressful ii. Secondary appraisal = appraisal of ability to cope with potential stressor 1. “Can I handle this?” iii. The perception of the stressor is key to this model f. Basic findings in the “Why the modern world is bad for your brain” article i. Multi-tasking leads to increased cortisol and adrenaline 1. It is not actually affective in getting things done a. Efficiency comes from doing one thing at a time ii. Spikes in dopamine in the nucleus accumbens in the brain when we check email, send/receive text iii. “Hyper-immediacy’ is novelty-seeking 1. Need to respond immediately 2. Nucleus accumbens = reward center of the brain 3. Hits from hyper-immediacy and multitasking actually seem to lead to higher levels of stress iv. How doe these findings relate to the unit on stress? 1. Because we think we are trying to accomplish more all at one time, we trigger our stress reactions. 2. The over-rewarding of our brain also decreases the functions of the parasympathetic nervous system to calm us when we need it to. g. How does poverty contribute to stress and disease? i. Exposure to violence and trauma from a young age ii. Poverty is related to stress which increases changes of 1. Diabetes 2. CVD 3. Cancer 4. Substance Abuse iii. Regular exposure to racial or minority stress iv. There is a lack of access to safe outdoor space v. Lack of control; feeling of hopelessness vi. Anxiety about money, shelter, etc. h. What is the state of the evidence for emotional disclosure in the Pennebaker study? i. Found to relate to several health outcomes including 1. Improved immune functioning 2. Less anxiety levels 3. Improved stress levels 4. Fewer physician visits 5. Fewer physical symptoms ii. How does emotional disclosure compare to simply ‘venting’ one’s emotions? 1. Evidence shows that Catharsis actually increases the emotions you are trying to let out 2. Emotional Disclosure works better a. People report less stress and improved mood after i. What is the state of the evidence on problem vs. emotion i. Problem focused coping is generally better 1. Problem focused = positive association with good health 2. Emotion focused = negative associated with good health j. Concepts you should know: • Central Nervous System – All the neurons within the brain and spinal cord • Peripheral nervous system – The nerves that lie outside the brain and the spinal cord • Somatic Nervous System – The part of the PNS that serves the skin and voluntary muscles • Sympathetic Nervous System - A division of the autonomic nervous system that mobilizes the body’s resources in emergency, stressful, and emotional situations • Autonomic Nervous system - The part of the peripheral nervous system that primarily serves internal organs • Parasympathetic Nervous System - division of the autonomic nervous system that promotes relaxation and functions under normal, non-stressful conditions • Pituitary gland - An endocrine gland that lies within the brain and whose secretions regulate many other glands • Adrenal glands - Endocrine glands located on top of each kidney that secrete hormones and affect metabolism • Cortisol - A type of glucocorticoid that provides a natural defense against inflammation and regulates carbohydrate metabolism • Epinephrine - Naturally occurring neurochemicals whose effects resemble those of the opiates • Adrenocorticotropic (ACTH) hormone - A hormone produced by the anterior portion of the pituitary gland that acts on the adrenal gland and is involved in the stress response • Allostasis - The concept that different circumstances require different levels of physiological activation; Maintaining an appropriate level of sympathetic activation under changing circumstances (Smooth transition between parasympathetic and sympathetic systems) • Social support - Both tangible and intangible support a person receives from other people • Cognitive Behavioral Therapy - A type of therapy that aims to develop beliefs, attitudes, thoughts, and skills to make positive changes in behavior • Allostatic Load - Prolonging activation of the responses if sympathetic activation is maladaptive and can lead to health problems • Fight or flight response o Occurs when the body is under stress. It will shut down certain unnecessary functions and increase others to prepare you to either fight or flee. § Comes from activation of the sympathetic division of the autonomic nervous system • Adrenal and Pituitary glands get activated • Release of cortisol, adrenaline, epinephrine, etc • Increases heart rate • Sweat glands get activated • Respiratory rates increase • Problem vs Emotion focused coping • Diaphragmatic Breathing o Full and even breathing deeply into your diaphragm o Associated with relaxation o Can change the body’s physiology § Helps to calm anxiety § When inhaling, the diaphragm is pushed down, the lungs fill and the stomach protrudes • Mindfulness Meditation o Has roots in Buddhism and Tibetan Meditation § The form practiced in psychology today was developed by Jack Kornfield et al. o Often used for anxiety, trauma, and PTSD o The basic idea is to not fight the anxiety § You should calmly observe its presence and then let it pass § It does not emphasize change, unlike CBT • Progressive Muscle Relaxation o Helps to identify the tension we carry and release it by each muscle group o It is recommended that someone seeking treatment be seen for 10 sessions o A full session would go through releasing each muscle group • Emotional Disclosure o Expressing emotions and investigating the events that caused the emotions o More controlled and thoughtful way of expressing emotions through talking or writing about it • Expressive Writing o Developed by Pennebaker o Write stream of consciousness o Has been found to lead to less stress and more improved moods II. Chapter Six: Understanding Stress and Disease a. How does the immune system interact with the neuroendocrine system in regards to stress response? i. Stress lowers the ability of immune system to fight diseases 1. linked to cardiovascular disease due to increased blood pressure 2. Relates to diabetes in how our bodies process sugars 3. increases likelihood of a. over eating b. drug use c. insomnia d. etc. ii. Cortisol depresses immune function 1. Slows phagocytosis a. The attacking of foreign particles by the immune system b. Immune system gets less efficient iii. Stress can alter health-related behaviors that can in turn, result in suppressed immune function 1. Smoking 2. Drinking 3. Poor Sleep 4. Medication adherence b. How can immune suppression be classically conditioned? i. Example: 1. UCS: Drug à UCR: Suppressed Immune Function 2. NS: Sugar Solution paired with UCS: Drug 3. CS: Sugar Solution à CR: Suppressed Immune Function c. How is stress linked to depression? i. Major Stress event increases risk for depression 1. About 25% of those who have major stress event will develop depression in the next few months ii. Stress also inhibits recovery 1. Longer duration = greater severity of depressive episode iii. Major life stress may sensitize people to depression iv. Higher risk for people with genetic vulnerability to depression v. Certain cognitive and coping styles may make people more prone to both stress and depression 1. EX: a. Rumination, b. Negative thinking d. What do we know about marital conflict and stress? i. Marital conflict can lead to slower wound healing ii. How about stress and caregiving for patients with Alzheimer’s disease? 1. People with higher levels of support will heal faster 2. Caregivers of people with Alzheimer’s experience slower wound healing and lowered immune function e. Sheldon Cohen’s research on stress and the development of the common cold. i. People with higher stress were more likely to become ill 1. Duration of stressor important a. Chronic stress = > One month i. Led to development of cold b. Acute = < One month i. Did not lead to development of cold f. What are the main findings of the INTERHEART study? i. Risk factors for acute myocardial infarction 1. Include a. Smoking b. Diabetes c. Hypertension d. Abdominal Obesity e. Exercise f. Alcohol Intake ii. 90% of AMI cases could be predicted through the above risk factors g. How does stress impact HIV infection i. Stress can suppress the Immune system of an HIV infected person, which can lead to the development of AIDS ii. Herpes simplex virus (HSV)? 1. The immune system cannot fight off the bacteria that are causing the virus, resulting in breakouts. h. Main ideas from the video on stress i. The people who were closer to the top of the hierarchy had lower stress levels than the people closer to the bottom of the hierarchy. ii. Stress inhibits dopamine, which makes your surroundings less pleasurable iii. A mother’s stress levels can inhibit her child’s health iv. Stress affects the way the body stores fat v. Stress can impair our ability to remember things i. Concepts you should know: • Psychoneuroimmunology – A multidisciplinary field that focuses on the interactions among behavior, the nervous system, endocrine system, and the immune system • Lymphatic System – A system that transports lymphs through the body • Lymphocyte – White blood cells found in lymph that are involved in the immune function a. T-Cells – The cells of the immune system that produce immunity b. B-Cells – A variety of lymphocytes that attack invading organisms c. Natural Killer (NK) Cells – A type of lymphocyte that attacks invading organisms • Phagocytosis – the process of engulfing and killing foreign particles • Antibodies – protein substances produced in response to specific invader or antigen, marking it for destruction and thus creating community to the invader • Autoimmune Diseases – disorders that occur as a result of the immune system’s failure to differentiate between body cells and foreign cells, resulting in the bodies attack and destruction of it’s own self • Pro-inflammatory Cytokines – A chemical secreted by the immune system that promotes information and is associated with feelings of sickness, depression, and social withdrawal • Diathesis-stress model – A theory of stress that suggests that some individuals are vulnerable to stress related illnesses because they are genetically predisposed to those illnesses • Chapter Seven: Pain j. What is the IASP definition of pain? i. An unpleasant sensory AND emotional experience associated with actual or potential tissue damage, or described in terms of such damage k. What are the different types of pain? i. Somatic 1. skin and musculoskeletal tissue a. Ex: Postsurgical pain, injury due to excessive activity or stretching 2. Described as aching a. Ex: Headache ii. Visceral 1. injury to internal organs a. Bowel (impaction, constipation), indigestion, tumor progression 2. Described as a. Pressure-like b. Deep c. Squeezing iii. Neuropathic 1. injury to spinal cord or peripheral nerves a. Can occur in feet, legs, hands, toes 2. Described as a. Burning b. Shooting c. Stabbing i. “Pins and Needles” iv. Acute 1. Begins suddenly 2. Usually sharp in quality 3. It serves as a warning of disease or threat to the body a. Has an adaptive function i. Ex: moving a hand away from a hot surface 4. Ex: Surgery, buns or cuts, childbirth 5. Usually occurs for <6months a. Not a definite time frame though v. Chronic 1. Persists despite the fact that the injury may have healed 2. Not adaptive a. Results in pain management behaviors 3. Ex: low back pain, arthritis, nerve damage l. How is pain processed? i. Nociception 1. Process of perceiving pain 2. Nociceptors are sensory receptors that perceive painful stimuli including a. Heat, Cold, Cutting, Burning m. Afferent i. Sensory Neurons 1. Relay information from sense organs to brain a. Some areas (hands) have more receptors and are more sensitive i. Why? 1. You explore the world with your hands 2. You need the hands more for survival n. Info routed to the Dorsal Horn of the spinal cord and relayed to different areas of the brain for processing i. Ex: Somatosensory cortex in the cerebral cortex o. Descending pathways i. Originates in the brain ii. Emotion processing centers are activated and can alter our experience of pain 1. Emotion usually accompanies pain 2. Explains how two people can have different perceptions of pain for the same injury iii. Triggers release endogenous opioids 1. Painkillers a. Such as endorphins p. What is the role of the thalamus in pain perception? i. Acts as a relay center for incoming sensory information and outgoing motor information q. What is the role of the somatosensory cortex in pain perception? i. Receives and processes sensory input from the body r. What are the comorbid factors associated with chronic pain? i. Depression ii. Anxiety iii. Substance Abuse s. The Gate Control Theory of Pain i. Theory of pain holding that structures in the spinal cord act as a gate for sensory input that is interpreted as pain t. What are the physiological influences in experiencing pain? i. Anxiety 1. Raised Heart Rate 2. Raised Blood Pressure u. Research examining physiological predictors of surgical outcomes i. Higher levels of anxiety before surgery was predictive of less ability to heal after ii. Lower levels of anxiety before surgery predicted better healing v. What are the most common chronic pain conditions in the US? i. 30% of people have Chronic Pain ii. Most common = headache and lower back pain 1. Back Pain a. 80% of people in the US have back pain at some time b. Common Causes: injury or stress to muscle, nerve and ligament i. Worse with aging ii. Affects 90% of pregnant women w. What are some examples of non-narcotic pain medication? i. NSAIDs (Non-steroidal anti-inflammatory drugs 1. Ex: Advil, Aleve, Asprin ii. COX-2 Inhibitors iii. Acetaminophen 1. Ex: Tylenol iv. How do they work? 1. NSAIDs a. Appear to block the synthesis of prostaglandins (chemicals that make you more aware of pain), which changes your perception of pain. b. Not very well for pain that occurs without inflammation 2. COX-2 Inhibitors a. Increased heart attack risk b. Two types of this drug have been withdrawn from the U.S. market. 3. Acetaminophen a. Can be a good substitute for Asprin, but too much can be fatal x. What are neuropathic pain medications? i. Used for nerve pain ii. When are they prescribed? 1. When it is the nerves that are damaged in order to dull the nerve pain y. How can psychology be useful in pain management? i. Cognitive Behavioral Therapy can be used to alter pain behaviors and the way people cope with pain z. What are pain behaviors? i. Behaviors that are indicative of pain aa. What are reinforcers of pain behavior? i. Actions or incidences that encourage pain behavior bb.What is behavior modification, as applied to pain management? i. Changing the way someone reacts to and copes with pain cc. Pain behavior i. Actions associated and indicative of pain 1. Complaining 2. Linmping 3. Staying in Bed 4. Not going to work 5. Etc… dd.Pain reinforcers i. Attention from family ii. Relief from responsibilities iii. Medication ee. Behavior modification i. Rewarding positive behavior ii. Ignoring of pain behaviors ff. What might CBT for pain management look like? i. Alter dysfunctional cognition 1. E.G. catastrophizing ii. Activities pacing iii. Behavioral modification iv. Teach adaptive coping strategies gg. Trends in opioid prescribing in the US over last 10 years i. They are being prescribed more often and for longer periods of time ii. What are the consequences associated with this? 1. Addiction is hard to recognize, so doctors are not always able to monitor their patients to help them from getting addicted. 2. Fatality can increase because opioids don’t mix well with other drugs a. They more often they are prescribed, the more opportunities there are for it to get mixed wrong. b. Because women are more often prescribed anti- anxiety drugs and pain medications, a 400% increase in overdoses have occurred in this population. hh.What professionals might be involved in the interdisciplinary treatment of pain? i. Physicians vi. Physical ii. Physician Therapists Assistants vii. Acupuncturists iii. Psychologists viii. Massage iv. Social Workers Therapist v. Nurses ix. Chiropractors x. Nutritionists ii. What is the visual analogous scale used for? i. Rating your pain by circling one number that best describes your pain on average or at the time asked. ii. Especially useful for children and elderly with cognitive problems jj. What are some alternative ways to assess individual’s pain level, when self-report may not be possible? i. Behavior Measures 1. Assess gait a. Ex: limping 2. Facial expressions a. Ex: grimaces 3. Posture 4. Dilated pupils 5. Poor assessment of pain may contribute to under-treatment in the elderly ii. Physiological Measures 1. Heart rate 2. Hand Surface temperature 3. Electromyography (EMG) – measures muscle tension a. Could distinguish those with low back pain vs. no back pain, but not level of pain 4. Not as accurate as Self-report or behavioral kk.Define • Endogenous opioids - any synthetic narcotic that has opiate-like activities but is not derived from opium. • Endorphins – naturally occurring narrow chemicals whose affects assemble those of the opiates • Nociceptors – sensory receptors in the skin and organs that are capable of responding to various types of stimulation that may cause tissue damage • Referred pain • Migraine headaches – recurrent headache pain originally believed to be cause by constriction and dilation of the vascular arteries but now accepted as involving neurons in the brainstem • Tension headaches – pain produced by sustained muscle contractions in the neck, shoulders, scalp, and face, as well as by activity in the central nervous system • Cluster headache – A type of severe headache that occurs in daily clusters for 4 to 16 weeks. Symptoms are similar to migraine, but duration is much briefer • Phantom limb pain – the experience of chronic pain and an absent body part • Tolerance – Use over time will cause you to need a larger dosage of a drug to reach the same reaction you’ve had with small dosages in the past • Dependence – Having a physiological need for a substance • Electromyography for pain assessment • Placebo: a. According to the placebo article you read for class, why are placebos getting more effective? i. Advertisements in favor of how well drugs work now and days have caused people’s expectancy of the drug’s capability to go up. SO when they are blindly given a placebo, they expect the medication to work better… giving more power to placebos. b. What is expectancy? i. It’s the thoughts associated with how someone perceives something should work ii. How does it relate to placebo? 1. Mental power lends itself to placebos because the more a person expects a drug to work, the more likely they will experience benefits – even from placebos. c. Understand the participant (or patient), experimenter (or clinician) and placebo characteristics that can influence placebo responding. i. The level of expertise of the doctor perceived by the patient ii. How friendly the doctor is iii. Presence of medical equipment iv. Personality factors 1. Optimism 2. Suggestibility 3. Social-desirability d. What factors of the placebo (color, shape, size, mode of administration) are related to greater placebo responding? i. Bigger Pills or larger dosages (more pills at a time) ii. Red = more energizing iii. Yellow = better antidepressant e. What is an active placebo? i. An active placebo has certain side-effects of the actual drug ii. Why are active placebos more effective? 2. They are more effective because of these side effects. If a person is experiencing some kind of side effect, they are more likely to believe that they actually took the real drug. f. What are the two main models of the placebo effect? i. Expectancy Model – 1. Does not require any prior experience with the stimuli a. The more a person expects that a drug will work, the more effective the placebo is. ii. Conditioning Model – 1. Doesn’t require any expectations 2. Partners the drug with something else and slowly weans the person off the drug until they are getting the same effect from just the conditioned stimuli as they were from the original drug. g. How common is the use of placebo in medicine? i. Placebo use is generally commonly used by physicians h. Define: i. Placebo – An inactive substance or condition that has the appearance of an active treatment and that may cause improvement or change because of people’s belief in the placebo’s efficacy
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