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Abnormal Psychology

by: Glen Hackett

Abnormal Psychology PSY 3230

Glen Hackett
GPA 3.8

David Kelly

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This 45 page Class Notes was uploaded by Glen Hackett on Wednesday September 23, 2015. The Class Notes belongs to PSY 3230 at Middle Tennessee State University taught by David Kelly in Fall. Since its upload, it has received 26 views. For similar materials see /class/213039/psy-3230-middle-tennessee-state-university in Psychology (PSYC) at Middle Tennessee State University.

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Date Created: 09/23/15
Chapter 10 Sexual ampGender Identity Disorders What is normal and abnormal Normative Data Cultural considerations Sexual disorders Involve distress to the individual impairment in functioning or harm to others must have 1 of these 3 things to be classified as a sexual disorder Most sexual and gender identity disorders involve distress to the individual impairment in functioning or harm to others Gender Identity Disorder a person39s biological gender is not consistent with the person39s gender identity Feels trapped in the body of the wrong sex oDistress Must distinguish from Transvestic fetishism finding cross dressing as sexually exciting Intersex individuals Not the same as quotintersex individualsquot hermaphrodites Prevalence Rare Male Female 31 Causes Biological Possible geneticbiological contributions suggested in some twin studies Hormones might play a role oIn vitro exposure Brain structure abnormalities Gender identity seems to stabilize between 18 months and 3 years Parental Reinforcement Treatment oPsychosocial Treatment May be tried if person does not want surgery oIncrease adaptation oSex Reassignment Surgery Psychological assessment and counseling o1 2 years in opposite sex role Hormone therapy oSurgery 75 satisfied 7 regret Better adjustment for female to male SEXUAL DYSFUNCTIONS Sexual dysfunctions are associated with l Impairment in one or more of three stages of sexuality desire arousal and orgasm OR 2 Pain associated with sex Also must cause distress Classifications Psychological factors oPsychological and medical conditions Chapter 10 Sexual ampGender Identity Disorders Lifelong vs acquired Generalized vs Specific Sexual desire disorders 1 Hypoactive sexual desire di rd r an individual has no interest in any type of sexual activity Decreased frequency of sexual fantasies and sexual activity Increases with age for men decreases for women 2 Sexual aversion disorder an individual has no interest in sex and is often repulsed by the idea of sex Fear panic or disgust concerning sex 10 20 may have panic attacks Sexual arousal disorders 1 Male erectile disorder inability to have and maintain an erection 2 Female sexual arousal disorder problems having adequate lubrication Problem is arousal not desire ED is the main reason men seek treatment Orgasm disorders 1 Inhibited orgasm an inability to achieve orgasm despite adequate sexual desire and arousal 0 Rare in adult males 8 delayed or absent Most common complaint of adult females o25 report difficulty reaching orgasm 20 report regular orgasms 2 Premature ejaculation ejaculation occurring well before the man and his partner Wishes it to Most prevalent male sexual dysfunction Common in younger inexperienced males Sexual pain disorders 1 Dyspareunia pain during sexual intercourse which is not due to a medical condition Adequate sexual desire arousal orgasm 2 Vaginismus a condition in females where the pelvic muscles in the outer third of the vagina undergo involuntary spasms when intercourse is attemptedVery painful ASSESSING SEXUAL BEHAVIOR Three major aspects Interviewing medical evaluation psychophysiological assessment Chapter 10 Sexual ampGender Identity Disorders 1 InterviewingIncluding written questionnaires o Sexual attitudes o Behaviors o Sexual response cycle o Relationship issues o Physical and mental health 2 M d39 al examination Physical condi i ns Medication side effects 3 Psychophysiological assessment involves measures of blood flow Exposure to erotic material Sexual arousal response oMeasures of blood flow CAUSES OF SEXUAL DYSFUNCTION Biological contributions Diabetes kidney disease neurological problems and vascular problems can all cause or contribute to sexual disorders Medication side effects Alcohol and drugs Psychological contributions to sexual disorders o Distractions Performance Anxiety o Arousal Cognitive processes o Negative affect Social and cultural contributions Negative views of sex Negative or traumatic experiences Relationship problems Lack of communication Interaction of psychological and physical factors TREATMENT OF SEXUAL DYSFUNCTION Psychosocial treatments Education Masters and Johnson treatment techniques Psychosocial Intervention o Education Eliminate performance anxiety o Sensate focus and Non demanding pleasuring o Specific techniques for each disorder Chapter 10 Sexual ampGender Identity Disorders Other techniques depend on the particular problem being treated Medical treatments o Erectile Dysfunction Viagra o Combined with CB39I39 Surgical procedures Female Sexual Dysfunction o Few options little progress PARAPHILIAS Unusual sexual attractions to inappropriate people such as children or ob39ects such as clothing Often multiple paraphilias May co occur with other disorders oMood or anxiety disorder Substance a use oMuch more common in males 90 95 Fetishism sexual attraction to nonliving objects o Sexual attraction to nonliving objects Inanimate o I139actile Causes distress or impairment Voyeurism sexual arousal is derived from observing unsuspecting individuals undressing or naked Risk increases the arousal Exhibitionism sexual arousal and gratification from exposing one39s genitals to strangers Compulsive out of control o Risk amp shock value add to sexual arousal Transvestic fetishism sexual arousal is associate with cross dressing o Many are married other paraphilias II39elephone scatologia o Frotteruism Sexual masochism and Sexual sadismaesuffering or inflicting pain Sexual masochism Suffering pain or humiliation Sexual sadism Inflicting pain or humiliation Pedophilia sexual attraction to children o 90 of perpetrators are male Incest Sexual attraction to one s own children o Tends to occur more often as child enters puberty Causes of paraphilia Inappropriate arousalfantasy Chapter 10 Sexual ampGender Identity Disorders Low levels of arousal to appropriate stimuli Social Deficits Low suppression of urgesdrive Psychological treatment of paraphilias oPsychosocial Intervention Target deviant sexual behavior and fantasies Marital therapy Covert sensitization Coping skills and relapse prevention Covert sensitization reducing unwanted behaviors by having clients imagine very aversive consequences of the behaviors Coping skills 70 98 improve in the best treatment centers Medical treatments for pedophilia Chemical castration most drugs reduce testosterone Used for dangerous sexual offenders Efficacy Greatly reduce desire arousal and fantasy High relapse when discontinue Chapter 15 Cognitive Disorders 1 Cognitive disorders are primarily problems with impaired memory attention perception and thinking Profound changes in behavior and personality Most develop later in life Cognitive disorders typically occur later in life and may be divided into three classes Delirium dementia and amnestic disorder Delirium characterized by confusion and disorientation that is often a temporary condition that can last for hours or days Other symptoms oConfusion disorientation impaired though Develops rapidly and may last for hours or days Other symptoms attention memory and language fields o Often signals the presence of a medical condition causing brain dysfunction Causes Many causes including o Drug intoxication Medications Illicit drugs o Poisons Withdrawal from drugs o Head injurybrain trauma Fever Infections Treatment and prevention Often seen in emergency rooms Highest prevalence o Older adults Medical patients Treat underlying medical problems Preventions o Proper medical care Educate patients on proper medication use Dementia gradual deterioration of brain functioning that affects judgment memory language and other cognitive processes o Affects multiple areas o Judgment and other cognitive processes o Memory o Language oMultiple causes May or may not be reversible Initial and middle stages Memory impairment o Visuospatial skills deficits Agnosia Failure to recognize objects Facial agnosia Chapter 15 Cognitive Disorders 2 Delusions o Depression Behavioral problems Later sta e Continued cognitive decline oAssistance with activities of daily living Help with independence Basic daily tasks oDeath inactivity other illnesses Pneumonia Statistics Onset oAny age Most common in the elderly o Prevalence 5 over age 65 20 40 over age 85 oWomen gt men Longer lifespan Alzheimer39s disease is one type of dementia with the predominant cognitive deficit being memory impairment Orientation judgment and reasoning are also affected Develop gradually 4 Tnte39l39ler39tua39l functioning goes downhill in the late afternoon and evenings Diagnosis of Alzheimer39s disease Increasingly accurate using brain scans Progression Nature and progressions of the disease Deterioration Early and later stages slow During middle stages rapid o Post diagnosis survival 8 years Onset 60 s or 70 s Early onset Before 65 Statistics o 5 millions Americans About 50 of dementia is due to Alzheimer s Higher in women then men o Role of Estrogen or other hormones Lower in those with higher education Cognitive reserve theory Causes of Al zneimer39 s o Early unsupported views Aluminum Smoking Chapter 15 Cognitive Disorders 3 Biological quottangles and plaquesquot in the brain Neurofibrillary tangles Tangled brain fibers due to defective tau protein Amyloid plaques contain amyloid protein that appears to cause cell deathClusters of neurons with damage to the dendrites oContain Amyloid protein causes cell death Cortical atrophy When brain shrinks and there is a loss of mass Cell death in the brain Genetic influence Alzheimer39s disease runs in families Gene mutations on various chromosomes Deterministic genes rare Presenilin l Presenilin 2 Susceptibility genes more common capoE 4 Chromosome 19 Late onset Alzheimer s oHigher prevalence in families with Alzheimer s Medical treatment there is no cure for Alzheimer s and the individual deteriorates until death Some drugs help with symptoms by preventing breakdown of acetylcholineAricept Exelon Gives temporary improvement oWorks best in early to mid stages Memantine for late stages oBlocks glutamate over excitation of brain Antidepressants amp Antipsychotics for psychological and behavioral problems oAll are only modestly effective for short periods Memantine blocks glutamate over excitation of brain Other drugs are used for behavioral problems Vascular dementia progressive brain disorder caused by injury or blockage of the blood vessels that provide the brain with oxygen and other nutrients Prevalence and onset oOnset is often sudden Stroke oVariable impairments Chapter 15 Cognitive Disorders 4 DSM IV Criteria Cognitive Disturbances Identical to Alzheimer s uObvious Neurological signs Greater motor problems nWeakness in limbs Significant impairments Prevalence 15 in age 70 75 15 in age 80 or older Men gt Women Most will require formal nursing care Other medical conditions that may lead to dementia include AIDS head trauma Parkinson s disease and extreme Vitamin deficiency Substance Induced Persisting Dementia o Drug use plus poor diet Alcohol inhalants sedatives o Brain damage may be permanent Psychological and social factors in dementia o Influence onset and course Lifestyle factors may contribute to vascular or other types of demetia o Poor diet Lack of exercise Stress Medical treatment for dementias Medical Treatment Early intervention is critical Three areas of focus o Prevention Delaying onset Symptom management Multidimensional Treatment Focus on slowing the progression Psychosocial treatments Focus on enhancement Dementia patients Families Caregivers o Cognitive stimulation Teach adaptive skills Help caregivers cope Chapter 7 Mood Disorders Mood Disorders Two broad categories Depression amp Mania DEPRESSIVE DISORDERS Major depression extremely depressed mood state that lasts at least 2 weeksUsually feel very negative worthless and suicidal Other possible symptoms Cognitive symptoms suicidal feels worthless oPhysical Dysfunction sleep energy appetite Anhedonia inability to experience pleasure ptoms may be different in adolescents may show as rebellion anger and self destructive behavior DurationAverage of 4 episodes lifetime 4 5 months Diagnoses of depressive disorders Major d or ive di rd r single episode Where they have an episode and never have another one Major depressive disorder recurrent two or more major depressive episodes separated by a period of at least 2 months during which the person was not depresse Dysthymic disorder A persistently depressed mood that continues for at least 2 years during which the person cannot be symptomrfree for more than 2 months at a time Median duration 5 years but may last 20 30 years Double Depression The individual suffers from both dysthymic disorder and occasional major depressive episodes Poor prognosis Other things that may or may not be seen in mood disorders Psychotic features oHallucinations or delusions Mood congruent hears voices that go along with feelings of negativity or mood incongruent just hear voices that don t have any significance Seasonal affective disorder Melatonin oOnly happens certain times of the year Fall amp Winter Postpartum onset mood disorder Only diagnosed if severe oWomen may get after giving birth Chapter 7 Mood Disorders BIPOLAR DISORDERS The individual experiences quotmaniaquot becomes extremely active requires very little sleep may develop grandiose plans may experience ongoing euphoria for no reason Other possible symptoms oImpulsivity Irritabilityagitation oPoor judgment Diagnosis of Bipolar Disorder requires a duration of 1 week or a hospitalization for mania Hypomanic episode a less severe and less disruptive version of a manic episode Diagnoses Bipolar l Disorder a major depressive episode alternates with a full manic episode Bipolar ll Disorder a major depressive episode alternates with a hypomanic episode Cyclothymic Disorder a milder version of bipolar disorder It tends to be more chronic Onset and duration of Bipolar Disorders Duration is usually chronic but treatable Suicide attempts are fairly common May be over diagnosed in youth Other Possible Features of Bipolar Disorder May or may not have psychotic features Suicide attempts are fairly common during the depressed phase Psychotic features oMay or may not have psychotic features Rapid Cycling Pattern At least 4 manic or depressive episodes within one year Prevalence of Mood Disorders Unipolar and Bipolar CAUSES OF MOOD DISORDERS Biological There appears to be a biological vulnerability for mood disorders Twin studies concordance rates Bipolar Identical 667 fraternal 189 oUnipolar Identical 456 fraternal 202 Chapter 7 Mood Disorders Possible biochemical imbalance Depression Possibly low levels of serotonin oAlso theory that serotonin may be involved in regulating levels of norepinephrine and dopamine Psychological Stressful life events Learned Helplessness Cognitive distortions Depressive cognitive triad Negative cognitions about the self world Social and Cultural Dim n i oInterpersonal relationship disruption can trigger depression People who lack social support are more likely to develop depression an ave relapses Woman are more likely to seek professional help for depression than men TREATMENT Antidepressant medications Most commonly used are SSRIs Selective Serotonin Reuptake Inhibitors oMay take 4 6 weeks for effectiveness oNegative side effects oWarnings for use with adolescents Wellbutrin targets dopamine A few medications target both norepinephrine and serotonin A few antidepressants target other neurotransmitters Other Biological Treatments for Depression ECT electroconvulsive therapy is used to treat severe depression especially when medications do not work ECT effectiveness and side effects 6 to 10 treatments oHighly effective for severe depression Few side effects except for memory oRelapse is common Transcranial Magnetic Stimulation May help moderate but not severe cases Medications for bipolar disorder Chapter 7 Mood Disorders Lithium Naturally occurring salt First substance found to help relieve mania Can make you feel lethargic and low energy Newer drugs Depakote amp other mood stabilizers oMost frequently prescribed High efficacy oExcept increased suicide risk 1 oAbilify amp other antipsychotic drugs Psychological Treatments for Depression Cognitive Therapy Interpersonal Therapy focuses on resolving problems in existing relationships and building skills to develop new relationships Combined medication and psychological treatments For bipolar Family therapy oIncrease medication compliance SUICIDE Suicide is the eighth leading cause of deaths in the United States Males are 4 to 5 times more likely to commit suicide than females although females are 3 times more likely to attempt suicide than men Risk factors for suicide oFamily history Low serotonin levels oMental or physical illness Alcohol Past suicidal behavior Feeling hopeless Recognizing and treating people at risk for suicide The most important risk factor for suicide is a severely stressful life event such as rejection or failure Other signs to look for Talking about suicide or not being around oIsolating oneself Giving away possessions Having a detailed plan Chapter 6 Somatoform and Dissociative Disorders SOMATOFORM DISORDERS Group of disorders related to a preoccupation with health or body appearance Preoccupation with health or body appearance More often to be treated in hospitals or doctors office medical setting One type of somatoform disorder is Hypochondriasis severe anxiety about the possibility of having a serious disease despite medical reassurance that this is untrue Focus on bodily symptoms oLittle benefit from medical reassurance High co occurance with anxietymood disorders oStrong disease conviction Misperceptions of symptom High trait anxiety Causes oGeneral biological predisposition oFamilial history of illness oModelinglearning o other factors stressful life events benefits of illness Treatment Cognitive Behavioral Therapy Identify and challenge misinterpretations o Symptom creation Stress reduction Therapy is more effective than medications but both are only marginally helpful SSRIs may help if depressed or anxious Somati ati n disorder t nd d history of multiple physical complaints before age 30 and substantial impairment in social or occupational functioning How it differs from hypochondriasis Don t feel like they have 1 life threatening problem I139hey just have a list of aches and pains and think of themselves as just being sick a lot Causes oHistory of family illness or injury oDependent personality traits oTending to express psychological problems and stress through physical symptoms Treatment oReduce frequency of help seeking behaviors o Gatekeeper physician o Reduce visits to numerous specialists o Conditioning Chapter 6 Somatoform and Dissociative Disorders 0 Reward positive health behaviors o Cognitive behavioral interventions o Stress reduction 0 Conversion Disorder Physical malfunctioning such as blindness or paralysis but with no organic pathology to account for it Symptoms could be blindness paralysis of a body part mutism deafness apparent seizures or any other physical malfunctioning The person is not malingering faking Causeszcan be from traumatic experience Possible genetic Vulnerability to stress Freud39s views o39I39rauma conflict experience Repression Conversion to physical symptoms Secondary gain Other causes Familysocialcultural oLimited disease knowledge Family history of illness Treatment Similar to those for somatization disorder o II39reat effects of trauma Remove secondary gains o Reward positive health behaviors Body Dysmorphic Disorder preoccupation with some imagined defect in appearance despite reasonably normal appearance Often centers around facial features but could relate to any part of the body Influenced by cultural standards of attractiveness I mpaired social and occupational functioning o Fixation or avoidance of mirrors Suicidal ideation and behavior o Influenced by cultural standards of attractiveness Plastic surgery is usually NO39I39 helpful Statistics o About equal in females and males o Onset early 20 s 0 Chronic course if untreated o Not clear if any genetic cause or whether mostly psychological Similarities with 0CD Intrusive thoughts Rituals Age of onset and course Chapter 6 Somatoform and Dissociative Disorders Causes and TreatmentzTreatment is similar to 0CD Medications SSRIs and i and i r 39nn Factitious Disorder physical symptoms are faked and under voluntary control as in malingering but there is no good reason for producing the symptoms other than to receive increased attention as a sick person Also called Munchausen39s Syndrome Related disorder is quotFactitious Disorder by Prox This is where someone makes someone else sick usually child DISSOCIATIVE DISORDERS Disorders in which individuals feel detached from themselves or their surroundings Their experience of their own identity or consciousness may be altered They may experience Depersonalization Don t feel like yourself Feel strange Instead of being in my body I feel like I n taking a step back and don t feel like my normal self Derealization Things around you seem unreal You know they are real but they don t feel that way Depersonalization or derealization can sometimes be seen in other disorders Depersonalization Disorder individual experiences severe and frightening feelings of unreality and detachment to the extent that normal functioning is disturbed Little is known about the underlying cause or the best treatment Prozac was not helpful in one study No real medications that we know of to work Dissociative Amnesia involves two possible types of memory loss due to psychological reasonsztotally due to psychological reasons Generalized amnesia Global amnesia Wakes up one day and has no idea who they are and nothing about their life Lots of times they just travel More rare than other types Selective or localized amnesia Can t remember a particular event Usually a traumatic event and cannot remember anything about it Sometimes the memory does eventually come back and they will suddenly remember Selective amnesia is far more common than generalized amnesia Chapter 8 Eating Disorders Bulimia nervosa Primary characteristic is binge eating Binge Excessive amounts of food out of control eating May attempt to compensate for binge eating by engaging in purging excessive exercise or fasting Self esteem amp self worth based or body weight or shape Subtyped into purging Ineffective and nonpurging categories oMost are within 10 of normal weight MedicalPsychological problems due to binge eating and purging o Erosion of dental enamel Electrolyte imbalance Cardiac arrhythmia o Seizures Digestive system problems Anxiety 75 Social phobia and generalized anxiety oMood disorders 50 70 Substance abuse 37 both alcohol and drugs Anorexia nervosa Individual has an intense fear of being overweight and goes to great extremes in the pursuit of thinness o Often begins with dieting Is at least 15 below expected body weight o Fears losing control of eating Distorted view of own body image Diagnostic criteria Body weight less than 85 of what is expected for the person s height and weight An intense fear of gaining weight or becoming fat even though seen by most people as being underweight A disturbance in body image Medical consequences Amenorrhea stopping of menstrual cycle Sensitivity to cold temperatures o Electrolyte imbalance Cardiovascular problems Weakening bones Subtypes of anorexia nervosa restricting type and binge eatingpurging type Chapter 8 Eating Disorders Associated features Pride in self control perfectionistic May hide food and pretend to eat oRarely seeks treatment Associated psychological disorders oAnxiety OCD oMood disorders 33 60 Anxiety and mood disorders are most common Substance abuse oSuicide Prevalence 90 to 95 of individuals with eating disorders are female CAUSES Biological aspects Eating disorders tend to run in families Twin studies Fraternal twins 9 Identical twins 23 Biochemical imbalances in the brain may play a role Low serotonin related to binge eating Psychological dimension Low sense of personal control bingers oLow self confidence both Distorted body image anorexics Preoccupation with food and appearance both Interpersonal dimension oPoor family communications tend to sweep problems under the rug Power struggles Cultural aspects Cultural values and standards in the media and elsewhere Treatment Medical treatment of eating disorders Anorexia Forced feeding if necessary No demonstrated efficacy of drugs Bulimia Chapter 12 Personality Dis orders Personality disorders enduring maladaptive patterns of perceiving and thinking about the environment and oneself These patterns are exhibited in a wide range of contexts and cause significant functional impairment or stress Enduring and pervasive predispositions Perceiving oRelating Thinking Inflexible and maladaptive oDistress Impairment There are a number of dimensions upon which normal personality characteristics can be rated Openness to experience Conscientiousness Extraversion Agreeableness When our personality characteristics become maladaptive or cause distress to ourselves or others then we refer to a personality disorder Prevalence of PDs oPrevalence 05 25 may be closer to 10 Outpatient 2 10 oInpatient 10 30 Development of PDs Origins and course Begin in childhood Chronic course That s just the way I amquot High comorbidity high rate of other problems DSM IV organizes various personality disorders into three primary clusters A Odd or eccentric B Dramatic emotional or erratic C Anxious or fearful Cluster A Odd or eccentric personality disorders Paranoid personality disorder a pervasive distrust and suspiciousness of others without any justification Other primary characteristics Clinical Description Mistrust and suspicion Pervasive oUnjustified Few meaningful relationships oTense EQE psychotic Cause is unclear Chapter 12 Personality Dis orders Treatment Schizotypal personality disorder a pervasive pattern of peculiar ideas eccentric behavior and deficits in interpersonal relationships Other primary characteristics oClinical Description Peculiar ideas and beliefs oodd and eccentric Behavior o Appearance Socially isolated oSuspicious Related to schizophrenia Causes Related to schizophrenia Some symptoms are similar but milder No break with realityquot oHigher rate among relatives of schizophrenics Treatment oTreatment of comorbid depression Mhltidimensional approach Social skill training Antipsychotic medications Schizoid personality disorder a pervasive pattern of indifference to social relationships and a restricted range of emotional experience and expression Other primary characteristics Clinical description Appear to be neither enjoy nor desire relationships Limited range of emotions oAppear cold detached oAppear unaffected by praise criticism Unable or unwilling to express emotion Little is known about the cause oLimited research Precursor childhood shyness Treatment oUnlikely to seek on own except if crisis oFocus on relationships oSocial skills therapy oNo research supported treatments Cluster B Dramatic emotional or erratic Chapter 12 Personality Dis orders Antisocial personality disorder a pervasive pattern of irresponsible behavior and violation of the rights of others Other primary characteristics Clinical description Social Predatorsquot oViolate rights of others Irresponsible o Impulsive Deceitful Noncompliance with social norms o Lack a conscience empathy and remorse Must be at least 18 years old The individual must be at least 18 years old before this is diagnosed Below the age 18 it is called a quotconduct disorderquot Family history of Inconsistant parental discipline o Variable support CriminalityAntisocial behavior Overlap with psychopathy Causes Family history of Inconsistant parental discipline Variable support CriminalityAntisocial behavior Gene environment interaction o Genetic predisposition Environmental triggers oReinforcement of antisocial behaviors Alienation from good role models o Poor occupationalsocial function Treatment Unlikely to seek on own High recidivism Behavior may improve after age 40 o Early intervention Parent training Prevention Rewards for pro social behaviors Skills training Borderline personality disorder a pervasive pattern of unstable self image poor interpersonal relationships and mood swings beginning in early adulthood Other primary characteristics o Very poor self image I mpulsivity Chapter 12 Personality Dis orders Fear of Abandonment Suicidal gesturesSelf mutilation Comorbid disorders Depression 24 74 o Suicide 6 Bipolar 4 20 o Substance abuse 67 Eating disorders o 25 of bulimics have BPD Causes o Genetic component Runs in families o Higher concordance for identical twins Early childhood experience Neglect 39I39rauma Abuse Treatment oHighly likely to seek treatment 0 Antidepressant medications o Psychotherapy oCope with events that trigger self harm o Identify and control emotions LLL r hass L Histrionic personality disorder a pervasive pattern of excessive emotionality and attention seeking Other primary characteristics Overly dramatic Impulsive and attention seeking o Appearance focused I mpressionistic don t analyze stuff very deeply Causes o Little Research Treatment Problematic interpersonal behaviors o Attention seeking Long term consequences of behavior Narcissistic p r naiity disorder a pervasive pattern of grandiosity hypersensitivity to the criticism of others and lack of empathy for others Other primary characteristics Exaggerated and unreasonable sense of self importance oLack of sensitivity and compassion for others Can t take criticism oArrogant Chapter 12 Personality Dis orders Causes Deficits in early childhood Empathy or caring about others Treatment oHypersensitivity to evaluation Cluster C Anxious or fearful Avoidant personality disorder a pervasive pattern of social discomfort fear of negative evaluation and shyness Other primary characteristics Extreme sensitivity to opinions Avoids most relationships Interpersonally anxious Fearful of rejection Causes Early parental rejection oInterpersonal isolation and conflict Treatment oSimilar to social phobia Increase social skills oReduce anxiety Importance of therapeutic alliance o is 1 Dependent p r naWity disorder a pervasive pattern of dependent and submissive behavior Other primary characteristics oRely on others for major and minor decisions Feelings of inadequacy Causes oLittle research Early experience Death of a parent Rejection Treatment Caution Dependence on therapist Gradual increases in oIndependence Personal responsibility oConfidence Chapter 11 SubstanceRelated Disorders Substance related disorders problems associated with using and abusing drugs that alter patterns of thinking feeling and behaving 0 Effects are wide ranging both psychologically and physically Substance dependence Addiction occurs when the individual displays tolerance andor withdrawal Other aspects of substance dependence Depressants substances that result in behavioral sedation and include alcohol barbiturates and benzodiazepines Alcohol influences a variety of neurotransmitters Withdrawal from alcohol dependence may cause delirium tremens Other long term consequences of alcohol dependence Fetal alcohol syndrome Trends in alcohol use Use Most adults light drinkers or abstainers oheavy alcohol use has declined in the past 20 years Current use 50 males gt females college aged are at higher risk for binge drinking Progression of alcohol related disorders Fluctuations in involvement Spontaneous remission 20 Chapter 11 SubstanceRelated Disorders Course of abuse variable course of dependence progressive for most Other depressant substances Sedative hypnotic or anxiolytic drugs barbiturates or benzodiazepines Includes barbiturates and Benzodiazepines o Increase GABA Dangerous when combined with alcohol Effects similar to alcohol o Impaired judgement Impaired function o Addictive Stimulants elevate activity alertness and mood Included in this group are amphetamines cocaine nicotine and caffeine Nature of stimulants Increase alertness and energy Elevate activity and mood May contribute to anxiety or panic attacks Amphetamines psychological and other effects o Effects of amphetamines up o Elation Reduced fatigue o Crash Extreme fatigue o Depression oCNS effects of amphetamines o Increase release and block reuptake o Norepinephrine oDopamine Amphetamines stimulate the central nervous system by increasing release and blocking the reuptake of norepinephrine and dopamine Symptoms from continued use Psychological effects Behavioral symptoms Anxiety tension anger Impairment judgment and functioning Long Term Hallucinations and delusions paranoia Physiological symptoms Blood pressure heart rate appetite seizures Designer drugs and Methamphetamine oMDMA Ecstasy Effects similar to speed Methamphetamine o Purified crystallized form of speed Longer half life Incredible potential for dependence Chapter 11 SubstanceRelated Disorders Both have long term risks Cocaine derived from the coca plant Blocks dopamine reuptake Effects Blocks dopamine reuptake o Euphoria Feelings of power and confidence short term o Insomnia Decreases appetite o Paranoia 0 Highly Addictive o Psychological dependence o Physical tolerance develops oWithdrawl craving apathy and anhedonia Prevalence o Statistics Second most frequently abused illegal drug o 1 of every 200 people older than 12 have used o 17 of users also used crack Nicotine Stimulates nicotinic receptors in the midbrain reticular formation and limbic system pleasure pathway Psychological and physical effects Effects of Nicotine o Stimulates nicotonic receptors in the midbrain reticular formation and limbic system pleasure pathway o Sensations of relaxation wellness pleasure Can cause a variety of physical problems Highly addictive o Relapse rates alcohol and heroin Withdrawal from nicotine may include irritability anxiety restlessness and trouble concentrating Caffeine Caffeine affects adenosine and dopamine Affects adenosine and dopamine o Dependence Withdrawal both psychological and physical Psychological and physical effects Chapter 11 SubstanceRelated Disorders Opioids family of substances that include naturally occurring opiates as well as synthetic variations such as methadone Opiates addictive substances such as heroin opium and morphine derived from the opium poppy Effects oLow doses Euphoria oDrowsiness Slow breathing oMedical use to treat pain High doses fatal Withdrawal and other risks 13 days Nausea and vomiting Chills omuscle aches Insomnia High mortality rates oIncreased HIV risk if injected Hallucinogens substances that may produce delusions hallucinations and altered sensory perception LSD is one of the most common hallucinogens but there are others such as mescaline PCP and psilocybin Psychological effects Effects Altered sensory perceptions Hallucinations oDepersonalization Adverse effects oTolerance can occur if taken frequently Withdrawal symptoms uncommon Marijuana the dried parts of the cannabis or hemp plant Most frequently used drug Psychological effects Alter sensory perception hallucinations variable individual reactions Euphoria oIn higher doses hallucinations oTolerance questionable Withdrawal and dependence are uncommon Adverse effects Chapter 11 SubstanceRelated Disorders Amotivational syndrome and learning problems Causes of substance related disorders oFamily and genetic influences Based upon twin family and adoption studies oAbuse and dependence influenced by genetic vulnerability Environmental events influence use Biological may have a biological vulnerability to substance abuse and dependence but it must be triggered by environmental events oPleasure or reward centers of the brain Dopamine pathways midbrain amp frontal cortex oAmphetamines amp cocaine stimulate dopamine in these areas opiates stimulate dopamine both directly and indirectly by inhibiting GABA Actions of hallucinogens are not well understood Many chemically resemble neurotransmitters oCannabinoids eg THC in marijuana alter mood Some of the most addictive drugs stimulate the quotpleasure pathwaysquot in the brain by increasing the effects of dopamine in those areas Psychological dimensions motivation to use drugs to obtain pleasurable experience or to reduce unpleasant feelings oPositive reinforcement Repeated pairings with rewards Negative reinforcement Escape from unpleasantness Tension reduction oCravings when trying to stop Environmental triggers Expectancy effect Social amp Cultural dimensions quotMoral weaknessquot vs the quotdisease modelquot Exposure to dru s oFamily Peers Media Societal Views Moral weakness Disease model drug addiction is a disease and needs to be treated accordingly Integrative model Treatment of substance related disorders Chapter 14 Developmental Disorders 1 Developmental psychopathology the study of how disorders arise and change with time tt nti n deficithyperactivity disorder the individual displays inattention overactivity and impulsivity Related problems50 have problems as adults 0 Inattention persists o Hyperactivity impulsivity decline Prevalence3397 of school aged children 52 worldwide BoyszGirls 31 OnsetzAge 3 or 4 Genetic and biological factors Genetics appear to be a strong influence Multiple genes may contribute Familial component Parent or sibling with ADIID increases likelihood o Genes associated with Dopamine may play a role Other neurotransmitters Norepinephrine GABA Serotonin may also be involved o Neurobiological Contributions Abnorma activity in several areas of the brain oAllergens and food additives Mixed evidence Maternal smoking and pregnancy complications increase risk Psychological problems may develop as a result of ADHD Negative Feedback 39139eachers Parents o Peer Rejection o Poor Self image Treatments Biological eRitalin amp other drugs Goals Reduce impulsivity and hyperactivity Improve attention Stimulants affect dopamine and norepinephrine Effective for 70 Ex Ritalin Adderall other Medications Strattera norepinephrine reuptake inhibitor Clonidine o Effects of Medications 0 Improve compliance oDecease negative behaviors Do not affect learning and academic performance oBenefits are not lasting following discontinuation Chapter 14 Developmental Disorders Behavioral interventions Behavioral Treatment Reinforcement Programs Reward Appropriate behaviors oPunish Inappropriate behaviors Parent Training oEstablish a routine oCombine y i 39 to 39 quot quot 1 Learning Disorders characterized by academic performance that is substantially below what would be expected given one39s age IQ and education Not due to sensory deficits Reading disorders mathematics disorder writing disorder Prevalence510 in the United States Causes oGenetic and neurobiological contributions May be a number of causes including genetic factors or mild brain impairment Treatment Educational intervention oSpecific skills instruction Compensatory skills Tic disorders tics are involuntary motor movements that occur suddenlyAnxiety related or other reasons Tourette39s disorder is one type of tic disorder which involves motor problems as well as vocal symptoms such as grunts yelps or coprolalia Causes and treatment Autistic disorder autism characterized by impairment in social interactions and communication Also a restricted pattern of behavior interests and activities is seen One of the Pervasive Developmental Disorders Clinical Description 1 Impairment in social interactions Few to no friends Rarely play interactively Rarely ever make eye contact 2 Communication problems 13 never acquire speech oEcholalia or other unusual speech 3 Restricted Patterns Behaviors oInterests Activities Maintenance of sameness oStereotyped and ritualistic behaviors Chapter 14 Developmental Disorders 3 Statistics 1 in every 500 births 1 in every 100 for autism spectrum disorders Occurs worldwide Onsetsymptoms appear before 36 months o Autism and Intellectual Functioning 40 55 have intellectual disability o Indicators of prognosis Language ability and IQ Causes Bad parenting is not a cause Genetic influences Familial component 5 10 risk of second child with autism Multiple genes are probably involved o Risk factors Mothers age flu during pregnancy oVaccinations Mercury a risk Asperger39s disorder unusual behaviors and impairment in social relationships but not language delays Also less cognitive impairment o Clinical Description Significant social impairments o May have stereotyped behaviors Restricted and repetitive May be obsessed with obscure facts Highly verbal No severe delays Language o Cognitive Higher risks in families with autism Treatment of Pervasive Developmental Disorders o Psychosocial 39I39reatments Behavioral approaches seem to work best o Skill building Reduce problem behaviors o Communication and language training Increase socialization Early intervention is critical Drugs sometimes help decrease agitation Intellectual Disability 1 DSM IV diagnostic criteria must have quotsignificantly below average intellectual functioningquot two or more standard deviations below the mean on a standardized intelligence test 2The second criterion mandates quotimpairments in adaptive functioningquot in areas such as communication social and academic skills and self care Chapter 14 Developmental Disorders 4 3 The final criterion for intellectual disability is that onset must occur before 18 years of age 39 d Mil IQ500r 55 70 Moderate IQ3540 to 5055 o Severe Iq2025 to 3540 o Profound IQBelow 20 25 Prevalence rates o Prevalence 1 3 90 of those are mild cases Causes Hundreds of known causes Genetics Environmental such as deprivation or abuse Infections accidents or other brain damage Down syndrome the most common chromosomal cause of intellectual disability It results from the presence of a third chromosome on the 21st pair o Extra 21st chromosome Physical symptoms o Increased prevalence of Alzheimer s Risk increases with maternal age The degree of intellectual disability with Down syndrome can vary widely Also the degree of behavioral problems varies from person to person Cultural familial int ll tual di ability is the presumed cause of up to 75 of cases of intellectual disabilit Nearly 75 of intellectual disability is not associated with biological cause Mild levels impairments Cultural familial ID o Abuse Neglect o Social deprivation TREATMENT of intellectual disability involves teaching skills necessary for independent functioning o Skill instruction depending on abilities Independence amp Productivity Task analysis Living and self care Communication training Behavioral management o Employment and supportive interventions Prevention Identifying high risk families For persons with mild intellectual disability specific learning deficits are remediated and support is provided for community living For those with severe disabilities more extensive resources are required Chapter 14 Developmental Disorders quotAdaptive skills trainingquot Task analysis quotCommunication trainingquot Supported living and employment Prevention programs Chapter 13 Schizophrenia ampOther Psychotic Disorders Schizophrenia is characterized by cognitive and emotional dysfunctions that include hallucinations and delusions behavior and inappropriate emotions Schizophrenia is just one type of psychosis disorganized speech and POSITIVE SYMPTOMS of schizophrenia refer to active types of abnormal behavior Delusions ex reme disorders of thought contentGross misrepresentations of reality Delusions of grandeur May think you re a famous historical figure or believing that famous people are talking about you or a singer is singing a song just for you Delusions of persecution Believing that people are out to get you actively monitoring and tracking you Hallucinations experiences of sensory events without environmental stimulation Most common Auditory hallucinations own vs others voice NEGATIVE SYMPTOMS of schizophrenia indicate the absence of normal behavior25 experience these Avolition Apathy can t get started doing things and don t want to do anything Anhedonia Things that you used to enjoy doesn t anything No more enjoyment Affective flattening Emotions are flattened and don t feel emotional connections DISORGANIZED SYMPTOMS of schizophrenia include rambling speech inappropriate affect and erratic behavior Disorganized speech Disorganized and illogical speech loose associations Inappropriate affect Catatonia Immobility waxy flexibility wild agitation like Statue Schizophrenia subtypes Paranoid type may have hallucinations and delusions but cognitive abilities and affect are intact Delusions and hallucinations oGrandeur or persecution Intact cognitive skills oIntact affect Little to no disorganized behavior oBest Prognosis Chapter 13 Schizophrenia ampOther Psychotic Disorders 2 Disorganized type symptoms include disrupted speech and flat or inappropriate affect Marked disruptions Speech Behavior o Flat or inappropriate affect Hallucinations and delusions o Chronic Few Remissions Catatonic type unusual motor responses and odd mannerisms They may show echolalia or echopraxia Unusual motor responses o Odd mannerisms Echolalia Echopraxia Undifferentiated type includes the major symptoms of schizophrenia but do not fit in a particular subtype Do not fit into other subtypes oMajor symptoms of schizophrenia Residual type having had at least one episode of schizophrenia but no longer displaying the major symptoms except in very mild form o One or more past episodes No longer has major symptoms o Persistent less extreme symptoms Bizarre beliefs o Social withdrawal and inactivity Other disorders related to schizophrenia Schizophreniform disorder displaying symptoms of schizophrenia for only a few months Schizophrenic symptoms oLasts less than 6 months Associated with good premorbid functioning oMost resume normal lives Schizoaffective disorder symptoms of schizophrenia plus a mood disorder o Symptoms of schizophrenia plus a mood disorder Disorders are independent o Symptoms present at least 2 weeks in absence of mood disorder Prognosis similar to schizophrenia Persistent No improvement without treatment Other psychotic disorders Delusional disorder ea persistent belief contrary to reality in the absence of other schizophrenic symptoms Delusional but no other schizophrenia symptoms Types Erotomanic Chapter 13 Schizophrenia ampOther Psychotic Disorders 3 Grandiose Jealous Persecutory Somatic Rare Later age of onset average is in 40 s Prognosis is better than with schizophrenia Brief psychotic disorderaeone or more positive symptoms of schizophrenia for less than a month One or more positive symptoms oLast 1 month or less Usually precipitated o Extreme stress 39I39rauma Typically return to premorbid baseline Shared psychotic disorder delusions developing as a result of a close relationship with someone else who has delusions Delusions from relationship with delusional person o50 are female dyads Mother daughter o Sister sister Usually improves after separation Statistics Prevalence and course for schizophrenia o Prevalence 1 of population on average lifetime varies geographically 02 to 1 5 o Course Chronic Moderate to sever lifetime impairment Relapse and recovery Life expectancy less than average Suicide FemalezMale 11 Developmentonset oOnset is greatest in adolescence and early adulthood age 16 25 and declines with age o Prodromal phase 85 experience 1 2 years before serious symptoms Odd thinking and behavior Increased anxietyirritability Social withdrawal CAUSES OF SCHI ZOPHRENIA Genetic influences Inherited vulnerability Family twin and adoption studies Chapter 13 Schizophrenia ampOther Psychotic Disorders Neurobiological influences Dopamine hypothesis Evidence for and against the dopamine hypothesis Conclusion Dopamine may contribute to symptoms but not be the cause of schizophrenia Current theories People with schizophrenia also have abnormalities in the structure of the brain Virus theory of schizophrenia Psy h l 0i al and social influ n es role of the parents Environmental stress Family interactions TREATMENT OF SCHTZOPHRENTA Biological From the 1930s to the 1950s ECT or psychosurgery Starting in the 1950s Antipsychotic drugs Antipsychotic drugs are mostly dopamine antagonists Side effects extrapyramidal symptoms Chapter 5 Anxiety Disorders Anxiety Disorders Anxiety definition Future oriented Marked negative affect emotion Somatic symptoms of tension oApprehension about future danger or misfortune Fear oPresent oriented mood state marked negative affect Immediate fight of flight response to danger or threat oAbrupt activation of the sympathetic nervous system Anxiety and feat are normal and can be useful Both have some useful purposes Characteristics of Anxiety Disorders Pervasive and persistent symptoms of anxiety and apprehension oInvolve excessive avoidance and escapist tendencies Causes clinically significant distress and impairment Panic attack Abrupt experience of intense fearfulness accompanied by physical symptoms such as heart palpitations shortness of breath dizziness or chest pain Three types Situationally bound cued0nly happens during certain situations ie giving a public speech Unexpected uncued Has panic attacks randomly no predictability and nothing really causes it per say Situationally predisposed Combination of the other 2 More likely to have panic attacks in certain situations but will also have them randomly Panic disorder is when someone has a series of panic attacks CAUSES FOR ANXIETY AND PANIC Biological Increasingly strong evidence that people inherit the tendency to be anxious or experience panic Diathesis Stress Inherit vulnerabilities for anxiety and panic Stress and life circumstances activate vulnerability Biological causes and inherited vulnerabilities GABA and serotonin neurotransmitters More GABA means the calmer you are going to be So it helps to raise GABA and Seratonin Chapter 5 Anxiety Disorders Limbic systemCenter of the brain which deals with emotions and emotional responses Made up of Amygdala thalamus hypothalamus and hippocampus Behavioral inhibition system BIS is one particular brain circuit in the limbic system that responds to threat signals Another system is involved with panic statese The Fightflight System FFS causes us to produce an immediate alarm and escape or fight response Psy h I Hi al contributions to anxiety and panice Behaviorist view o Classical and operant conditioning and modeling Psychological Views oEarly experiences with 1ahi1ity A39 L391i1y Anxiety may arise from our thoughts Others believe anxiety arises from thoughts Others see childhood experiences as important Social Contributions ostressful life events trigger vulnerabilities Anxiety disorders tend to run in families Social factors Stressful life events are often the triggers for panic attacks or for general anxiety Anxiety disorders also tend to run in families Integrated Model Probably a combination of biological psychological and social factors help to determine Whether a person will develop anxiety problems Consistent with Diathesis Stress model Anxiety often occurs together with other disorders especially depression GENERALIZED ANXIETY DISORDER Uncontrollable worry and feelings of anxiety most of the time for at least 6 months Also at least 3 of the following symptoms restlessness fatigue problems concentrating irritability muscle tension sleep disturbance Chapter 5 Anxiety Disorders Symptoms must cause significant distress or impairment in social occupational or other important areas of functioning CausesTr atm nt for G n rali d Anxiety Disorder Biologicalpsychological causes Causes Psychologically sensitive to threat oFeels lack of control over life events Treatment Benzodiazepines are used less often now oSSRI antidepressants are more likely to be used oPsychological i 39 Cognit39 L L 39 learning coping skills Benzodiazepine drugs such as Xanax and Valium not used as much now as in the past antidepressant meds may help 1 therapy and Psychological treatments Cognitive therapy Therapy and learning coping skills Coping skills When you feel anxious find something you enjoy or something to take your mind off of it Relax them maybe get a pet Exercise Panic Disorder Recurrent unexpected panic attacks AND oSubstantial anxiety or concern about having another attack nSymptoms and concern persists for 1 month or more PANIC DISORDER WITH AND WITHOUT AGORAPHOBTA Has panic attacks but doesn t associate it with a place Rare Could associate it with a situation or being under pressure etc Criteria for panic disorder must experience recurrent unexpected panic attacks AND then develop substantial anxiety or concern over the possibility of having another attack Agoraphobia Dread or avoidance of situationsevents Panic disorder with ag raph bia It is possible to have panic disorder without agoraphobia Causes of panic disorder and ag raph bia biological and psychological factors It is possible to have agoraphobia without having panic disorder as well Causes oCombination of biological and psychological factors Onset is often acute during a time of stress beginning in early adulthood Treatment Benzodiazepines ie Xanax Chapter 5 Anxiety Disorders 4 Antidepressant medications sometimes help SSRIs Prozac and Paxil preferred drugs Relapse rates are high following medication discontinuation Psychological treatments Cognitive Behavioral therapy highly effective best long term outcome therapy without medication Relaxation training Expand boundaries if agoraphobic Support groups SPECIFIC PHOBIA an irrational fear of a specific object or situation that interferes with the person s ability to function Four major subtypes 1 Animal type Animals and insects 2 Natural environment type Events occurring in nature ie heights storms 3 Situational type Public transportation or enclosed spaces ie planes 4 Blood injection einjury type Other efor those that don t fit in the 4 types Several ways phobias can develop Preparedness Frightening experience Observing others Repeated strong warnings Treatment of phobias all methods involve exposing the person to the thing that they re afraid of SOCIAL PHOBIA eshyness or any other type of phobia within a social situation Extreme and irrational anxietyshyness in social andor performance situations oMarkedly interferes with one s ability to function Onset is usually during adolescence Several ways that social phobia can develop Hereditary tendency Panic attack in a social situation Traumatic episodehighly negative or traumatic social experience Observational learningbeing around people who are social phobic gt5me Chapter 5 Anxiety Disorders Treatment Types of psychotherapy Cognitive behavioral treatment Exposure oRehearsal Role play in a group setting Cognitive behavior therapies are highly effective Medication SSRI Paxil FDA approved for social phobias OBSESSIVE COMPULSIVE DISORDER Two aspects of GOD Obsessions Intrusive and nonsensical thoughts images or urges that one tries to resist or eliminate Compulsions ritualistic behaviors such as checking excessive hand washing need to constantly arrange or clean things Compulsions are usually in response to obsessive thoughts It is possible to have obsessions without compulsions but most people with OCD have both Causes Biological predisposition interacting with psychological and cultural factors Biochemical imbalance may contribute to it Psychological and Cultural Factors Early life experiences and learning L LL Thought action fusion Treatment Prozac Zoloft and Paxil have all been approved for treatment of GOD and work for about 60 of patients SSRI s 60 benefit high relapse Exposure and response prevention therapy Cognitive behavioral therapy Exposure Response prevention Reality testing Highly effective 86 POSTTRAUMATIC STRESS DISORDER Originally seen more in combat veterans but can occur with any traumatic event oTrauma Exposure Extreme fright helplessness or horror Chapter 9 Physical Dis orders ampHealth Psychology Relationship of psychological and social factors to physical health Behavioral Medicine application of psychology to the prevention diagnosis and treatment of medical problems Health Psychology a sub field of behavioral medicine that addresses psychological factors important in the promotion and maintenance of health Psychological and social factors affect health by l Affecting the basic biological processes that lead to illness 2 Contributing to behavior patterns that may put people at risk to develop physical problems Smoking Poor eating habits oLack of exercise Insufficient injury control Seatbelts The nature of stress Stressor ostress response Individual variability Hans Selye39s General Adaptation Syndrome First phase alarm Second phase resistance Third phase exhaustion PHYSIOLOGY OF STRESS Sympathetic nervous system is activated fight or flight response HPA axis Corticotropin releasing factor CRF from the hypothalamus stimulates the pituitary gland which activates the adrenal gland to produce stress hormones such as cortisol The role of the hippocampus Turns off the HPA axis Baboons and humans oSocial Status Low vs high status Chapter 9 Physical Dis orders ampHealth Psychology High cortisol o Weak immune system Predictability Controllability Psychological and social factors in stress physiology Chronic stress may damage cells in the hippocampus Psychosocial Vulnerabilities Amount of chronic stress Perceived uncontrollability Low social support nNegative emotions amp unhappiness Perceptions of situation and response Self efficacy Bandura Feel like you can handle and situation that comes up confidence Immune response is affected by psychological factors Psychoneuroimmunology field which studies psychological influences on the nervous system which then affect the immune system Chronic stress weakens the immune system Stress reduction strengthens the immune system Benefits of stress reduction programs Training for HIV patients to strengthen immune system through meditation and cognitive therapy Psychoncology the study of psychological factors involved in the course and treatment of cancer Psychological and Behavioral Contributions Life style risk behaviors prevention Poor coping responses eg denial Helping patients amp family deal with stress Benefits of psychosocial treatments Health habits o Treatment adherence Stress responsecoping Cardiovascular diseaseiheart and blood vessels Psychology can influence health habits such as smoking and exercise Psychological and Behavioral Risk Factors Stress anxiety difficulty coping Low social support Type A and type B behavior Chapter 9 Physical Dis orders ampHealth Psychology 3 Type A Behavior Pattern Have higher rates of heart attacks oHurried Impatient Hostile Chronic Pain Two kinds of clinical pain acute and chronic Acute Disappears within 1 month Chronic Continues for months or even years Clinical Distinction Pain vs Pain Behaviors Pain behaviors How are they reactingdealing with the pain Psychological amp social factors in the experience of pain Severity of pain does not predict reaction to it oPerceived control Negative emotion Low social support oDistraction quotGate Control Theoryquot of pain incorporates psychological and physical factors Hyper vigilance vs inhibitory signals Endogenous opioids chemicals in the brain and other parts of the body which inhibit pain Endorphins oAssociated with self efficacy Exercise PSYCHOSOCTAL TREATMENT OF PHYSICAL DISORDERS Biofeedback individuals are taught to control physiological functions such as heart rate blood pressure brain waves and muscle tension Increase sense of control Efficacy oChronic headache oMuscle tension Relaxation and meditation Progressive muscle relaxation Sit down close your eyes flex feet muscles and relax then work your way up the body Feel relaxed after you finish Works well for insomnia


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