Terms in this set (106)

-Ancient Greeks were among the earliest civilizations to identify the role of bodily factors in health and illness
-They developed a humoral theory of illness
-Disease resulted when the four humors or circulating fluids of the body-blood, black bile, yellow bile, and phlegm were out of balance
-Goal of treatment was to restore balance among the humors
-Also believed that the mind was important: they described personalty types associated with each of the four humors:
-Blood being associated with a passionate temperament
-Black bile with sadness
-Yellow bile with an angry disposition
-Phlegm with a laid-back approach to life

By Middle Ages: supernatural explanations explanations for illness
-Disease was regarded as God's punishment for evildoing, and cure often consisted of driving out the evil forces by torturing the body
-Later this form of therapy was replaced by penance through prayer and good works
-The church was the guardian of medical knowledge and as a result, medical practice assumed religious overtones
-Functions of the physician were typically absorbed by priests, and so healing and the practice of religion become virtually indistinguishable

By Renaissance: great strides were made in understanding the technical bases of medicine
-Advances include: the invention of the microscope in the 1600's and the development of the science of autopsy, which allowed medical practitioners to see the organs that were implicated in different diseases
-As the science of cellular pathology progressed, the humoral theory of illness was put to rest
-Medical practice drew increasingly on laboratory findings and looked to bodily factors rather than the mind as bases for health and illness
-In an effort to break with the superstitions of the past, practitioners resisted acknowledging any role for the mind in disease processes
-Focuses primarily on organic and cellular pathology as a basis for their diagnoses and treatment recommendations
-The idea that specific illnesses are produced by people's internal conflicts was perpetuated in the work of Flanders Dunbar in the 1930's and Franz Alexander in the 1940's
-Unlike Freud, these researchers linked patterns of personality, rathe than a specific conflict, to specific illnesses
-Dunbar and Alexander also maintained that conflicts produce anxiety, which becomes unconscious and takes a physiological toll on the body via the autonomic nervous system
-The continuous physiological changes eventually produce an actual organic disturbance
-EX: Repressed emotions resulting from frustrated dependency and love-seeking needs were though to increase the secretion of acid in the stomach, eventually eroding the stomach lining and producing ulcers
-Dunbar and Alexander's work helped shape the emerging field of psychosomatic medicine by offering profiles of particular disorders believed to be psychosomatic in origin, that is, caused by emotional conflicts
-Disorders include: ulcers, hyperthyroidism, rheumatoid arthritis, essential hypertension, neurodermatities (skin disorder), colitis, and bronchial asthma
-Researchers now believe that a particular conflict or personality type is not sufficient to produce illness
-Rather, the onset of disease is usually due to several factors working together, which may include a biological pathogen (such as viral or bacterial infection) couples with social and psychological factors, such as high stress, low social support, and low socioeconomic status
-Nervous system: complex network of interconnected nerve fibers
-Made up of the central nervous system, which consists of the brain and the spinal cord, and the peripheral nervous system, which consists of the rest of the nerves in the body, including those that connect tot he brain and spinal cord
-Sensory nerve fivers provide input to the brain and spinal cord by carrying signals from sensory receptors; motor nerve fibers provide output from the brain or spinal cord to muscles and other organs, resulting in voluntary and involuntary movement
-The peripheral nervous system is made up of the somatic nervous system and the autonomic nervous system
-Regulation of the autonomic nervous system occurs via the sympathetic nervous system and the parasympathetic nervous system
-Sympathetic nervous system: prepares the body to respond to emergencies, to strong emotions such as anger or fear, and to strenuous activity. Plays an important role in reaction to stress
-Parasympathetic nervous system: controls the activities of organs under normal circumstances and acts antagonistically to the sympathetic nervous system
-When an emergency has passed, the parasympathetic nervous system helps to restore the body to a normal state
-Limbic system: plays an important role in stress and emotional responses
-Amygdala and hippocampus are involved in the detection of threat and in emotionally charged memories
-Neurotransmitters regulate nervous system functioning
-Parasympathetic functioning is a counterregulatory system that helps restore homeostasis following sympathetic arousal
-Epilepsy, Parkinson's disease are the most common
-Cerebral palsy, multiple sclerosis, and Huntington's disease also affect substantial numbers of people
-Epilepsy: disease of the central nervous system affecting more than 3 million people in the US
-Often idiopathic, which means that no specific cause for the symptoms can be identified
-Symptomatic epilepsy may be traced to harm during birth, severe injury to the head, infectious disease such as meningitis or encephalities, or metabolic or nutritional disorder
-Risk for epilepsy may also be inherited
-Epilepsy is marked by seizures, which range from barely noticeable to violent convulsions accompanied by irregular breathing and loss of consciousness
-Cannot be cured, but it can often be controlled through medication and behavioral interventions designed to manage stress

-Cerebral Palsy
-Chronic, nonprogressive disorder marked by lack of muscle control
-It stems from brain damage caused by an interruption in the brain's oxygen supply, usually during childbirth
-In older children, a severe accident or physical abuse can produce the condition
-Apart from being unable to control motor functions, those who have the disorder may also have seizures, spasms, mental retardation, difficulties of sensation and perception, and problems with sign, hearing, and/or speech

-Parkinson's Disease
-Have progressive degeneration of the basal ganglia, a group of nuclei in the brain that control smooth motor coordination
-The result of this deterioration is tremors, rigidity, and slowness of movement
-Men are more likely than women to develop the disease
0Although the cause of Parkinson's is not fully known, depletion of the neurotransmitter dopamine may be involved
-Parkinson's patients may be treated with medication, but large doses, which can cause undesirable side effects, are often required for control of the symptoms

-Multiple Sclerosis
-Degenerative disease can cause paralysis and occasionally blindness, deafness, and mental deterioration
-Early symptoms include numbness, double vision, dragging of the feet, loss of bladder or bowel control, speech difficulties, and extreme fatigue
-Symptoms may appear and disappear over a period of years, after that, deterioration is continuous
-Multiple sclerosis is an autoimmune disorder, so called because the immune system fails to recognize its own tissue and attacks the myelin sheath surrounding the nerves

-Huntington's Disease
-Hereditary disorder of the central nervous system
-Characterized by chronic physical and mental deterioration
-Symptoms include involuntary muscle spasms, loss of motor abilities, personality changes, and other signs of mental disintegration
-Test is available that indicates not only if one is a carrier of the gene but also at what age one will succumb to the disease

-Polio
-Poliomyelitis is a viral disease that attacks the spinal nerves and destroys the cell bodies of motor neurons so that motor impulses cannot be carried from the spinal cord outward to the peripheral nerves or muscles
-Depending on the degree of damage that is done, the person may be left with difficulties in walking and moving properly, ranging from shrunken and ineffective limbs to full paralysis

-Paraplegia and Quadriplegia
-Parapelgia is paralysis of the lower extremities of the body it results from an injury to the lower portion of the spinal cord
-Quadriplegia is paralysis of all four extremities and the trunk of the body; it occurs when the upper portion of the spinal cord is severed
-People who have these conditions usually lose bladder and bowel control and the muscles below the cut area may lose their tone, becoming weak and flaccid

-Dementia
-Serious loss of cognitive ability beyond what might be expected from normal aging
-The may be the result of a brain injury, or progressive, resulting in long term decline
-Although dementia ii far more common the geriatric population, it may occur at any stage of adulthood
-Memory, attention, language, and problem solving are affected early in the disorder and often prompt diagnosis
-Some of these disorders are due to congenital defects, that defects present at birth, and others, to infection
-The major threats to the cardiovascular system are due to lifestyle factors, including stress, diet, exercise, and smoking

-Atherosclerosis
-The major cause of heart disease is atherosclerosis, a problem that becomes worse with age
-Caused by deposits of cholesterol and other substances on the arterial walls, which form plaques that narrow the arteries
-These plaques reduce the flow of blood through the arteries and interfere with the passage of nutrients from the capillaries into the cells- a process that can lead to tissue damage
-Damaged arterial walls are also potential sites for the formation of blood clots, which can obstruct a vessel and cut off the flow of blood
-Atherosclerosis is associated with several primary clinical manifestations:
-Angina pectoris: chest pain which occurs when the heart has insufficient supply of oxygen or adequate removal of carbon dioxide and other waste products
-Myocardial infarction: heart attack, which results when a clot has developed in a coronary vessel and blocks the flow of blood to the heart
-Ischemia: condition characterized by lack of blood flow and oxygen to the heart muscle
-Congestive heart failure: occurs when the heart's delivery of oxygen rich blood is inadequate to meet the body's needs
-Arrhythmia: irregular beatings of the heart, which can lead to a loss of consciousness and sudden death

-Rheumatic Fever: bacterial infection that originates in the connective tissue and can spread to the heart, potentially affecting the functioning of the heart valves
-People are particularly vulnerable to endocarditis, the inflammation of the membran that lines the cavities of the heart

-Blood Pressure
-Force that blood exerts against the blood vessel walls
-Chronically high blood pressure, called hypertension, is the consequence of too high a cardiac output or too high a peripheral resistance

Clotting Disorders:
-Clots can sometimes develop in the blood vessels
-Most likely to occur if arterial or venous walls have been damaged or roughened because of the buildup of cholesterol
-A clot can have serious consequences if it occurs in the blood vessels leading to the heart or brain, because it will block the vital flow of blood to these organs
-When a clot occurs in a vein, it may become detached and form an embolus, which can become lodged in the blood vessels to the lungs, causing pulmonary obstructer
-Death is a common consequence of these conditions
-Asthma: severe allergic reaction typically caused by a foreign substance, including dust, dog or cat dander, pollens, and fungi
-An asthma attack can also be touched off by emotion stress or exercise
-These attacks may be so serious that they produce bronchial spasms and hyperventilation
-Asthma rates are especially high in low income areas, and psychosocial stressors may play a role in aggravation an underlying vulnerability
-Children who have a lot of infectious disorders during childhood are less likely to develop allergies, suggesting that exposure to infectious agents plays a protective role against developing allergies
-The improved hygiene of industrialized countries may actually be contributed to the high rates of allergic disorders currently seen

-Hay Fever
-Seasonal allergic reaction to foreign bodies, including pollens, dust, and other airborne allergens, that enter the lungs
-These irritants prompt the body to produce substances called histamines, which cause the capillaries of the lungs to become inflamed and to release large amounts of fluid
-The result is violent sneezing among others

-Viral Infections
-Respiratory system is vulnerable to infections, especially the common cold, a viral infection of the upper and sometimes the lower respiratory tract
-The infection that results causes discomfort, congestion, and excessive secretion of mucus
-The incubation period for a cold, the time between exposure to the virus and onset of symptoms, is 12-72 hours, and the typical duration is a few days
-Secondary bacterial infections may complicate the illness
-These occur because the primary viral infection causes inflammation of the mucous membrane, reducing the ability to prevent secondary infection
-Bronchitis, an inflammation of the mucosal membrane inside the bronchi of the lungs
-Large amounts of mucus are produced in bronchitis, leading to persistent coughing
-Serious viral infection of the respiratory system is influenza, which can occur in epidemic form
-Flu viruses attack the lining of the respiratory tract, killing healthy cells
-A common complication is secondary bacterial infection, such as pneumonia

-Bacterial Infections:
-Respiratory system is vulnerable to bacterial disorders, including strep throat, whooping cough, and diphtheria
-Usually, these disorders do no cause permanent damage to the upper respiratory tract
-The main danger is the possibility of secondary infection, which results from lowered resistance
-However, these bacterial infections can cause permanent damage to other tissues, including heart tissues

-Chronic Obstructive Pulmonary Diseases
-Fourth leading killer of people in the US
-COPD is much more common and nearly as deadly as lung cancer
-Not curable, but preventable
-Main cause is smoking

-Pneumonia
-Two main types of pneumonia: lobar pneumonia and bronchial pneumonia
-Lobar pneumonia is a primary infection of the entire lobe of a lung
-Bronchial pneumonia, which is confined to the bronchi, is typically a secondary infection that may occur as a complication of other disorders, such as a severe cold or flu
-Not as serious pneumonia

Tuberculosis and Pleurisy
-Infectious disease caused by bacteria that invade lung tissue

Lung Cancer
-Disease of uncontrolled cell growth in tissues of the lung
-The most common symptoms are shortness of breath, coughing, and weight loss
-Smoking is one of the primary causes
Gastroesphageal reflux disease
-Also known as acid reflux disease, results from an abnormal reflux in the esophagus
-Commonly due to changes in the barrier between the esophagus and the stomach

Gastroenteritis, Diarrhea, and Dysentary
-Inflammation of the lining of the stomach and small intestine
-May be caused by excessive amounts of food or drink, contaminated food or water, or food poisoning
-Symptoms appear approximately 2-4 hours after the ingestion of food and include vomiting, diarrhea, abdominal cramps, and nausea
-Diarrhea, characterized by watery and frequent bowel movements, occurs when the lining of the small and large intestines cannot properly absorb water or digested food
-Chronic diarrhea may result in serious disturbances of fluid and electrolyte balance
-Dysentary is similar to diarrhea except that mucus, pus and blood are also excreted
-Although these conditions are only rarely life threatening in industrialized countries, they are among the most common causes of death

Peptic Ulcer
-Open sore in the lining of the stomach or the duodenum
-Once though to be primarily psychological in origin, ulcers are now believed to be aggravated by stress, but not caused by it

Appendicitis
-Common condition that occurs when wastes and bacteria accumulate in the appendix
-If the appendix ruptures and the bacteria are released into the abdominal cavity or peritoneum, they can cause further infection

Hepatitis
-Means "inflammation of the liver", and the disease produces swelling, tenderness, and sometimes permanent damage
-Other common symptoms are fatigue, fever, muscle, or join aches, nausea, vomiting, loss of appetite, abdominal pain, and diarrhea
-Several types of hepatitis
-Hepatitis A: caused by viruses, is typically transmitted through food and water
-It is often spread by poorly cooked seafood or through unsanitary preparation or storage of food
-Hepatitis B: more serious form, also known as serum hepatitis
-Caused by a virus and is transmitted by the transfusion of infected blood, by improperly sterilized blood, through sexual contact and through mother to infant contact
-Particular risk among intravenous drug users
-Symptoms are similar to those of hepatitis A but are far more serious
-Hepatitis C, also spread via blood and needles, is most commonly caused by blood transfusions
-Hepatitis D, is found mainly in intravenous drug users who are also carries of hepatitis B, necessary for the hepatitis D virus to spread
-Finally, hepatitis E resembles hepatitis A but is caused by a different virus
-Among the most common and problematic are sexually transmitted diseases, which occur through sexual intercourse or other forms of sexually intimate activity
-STD's include herpes, gonorrehea, syphilis, gential warts, chlamydia
-For women, a risk from several STDs is chronic pelvic inflammatory disease, which may produce severe abdominal pain and infections that may compromise fertility
-Other gynecologic disorders to which women are vulnerable include: vaginitis, endometriosis, cysts, and fibroids that may nontheless interfere with reproduction
-Women are vulnerable to disorders of the menstrual cycle, including amenorrhea, which is the absence of menses, and oligomenorrhea, which is infrequent menstruation
-The reproductive system is also vulnerable to cancer, indluing testicular cancer in men and gynecologic cancers in women
-Endometrial cancer is the most common female pelvic malignancy, and ovarian cancer is the most lethal

-10 percent of US couples have fertility problems, defined as the inability to conceive a pregnancy after 1 year of regular sexual intercourse without contraception
-Although physicians once believed that infertility has emotional origins, researchers now believe that infertility has emotional origins, researchers now believe that distress may complicate but does not cause infertility
-A variety of drug treatments have been developed, as have more invasive technology
-In vitro fertilization is the most widely used method of assistive reproductive technology, and the success rate for IVF is over 33 percent

-Menopause is not a disorder but because of a variety of noxious symptoms that can occur during the transition into menopause, including sleep disorders, hot flashes, joint pain, forgetfulness, and dizziness, some women choose to take hormone therapy, which typically includes estrogen or a combination of estrogen and progesterone
-HT was once though to reduce symptoms of menopause along with protecting against the development of coronary artery disease, osteoporosis, breat cancer, and Alzheiemer's disease
-But it is now believed that rather than protecting against these disorders, HT may actually increase some of these risks
-Women and doctors are rethinking the use of HT
-Genetic studies have provided valuable information about the inheritance of susceptibility to disease
-In humans, several types of research help demonstrate whether a characteristic is genetically acquired
-Studies of families, for example, can reveal whether members of the same family are more likely to develop a disorder, such as heart disease, than are unrelated individuals in a similar environment
-If a factor is genetically determined, family members will show it more frequently than will unrelated individuals
-Twin research is another method for examining the genetic basis of a characteristic
-If a characteristic is genetically transmitted, identical twins share it more commonly than do fraternal twins or other brothers and sisters
-This is because identical twins share the same genetic makeup, whereas other brothers and sisters have only partially overlapping genetic makeup
-Studies of adopted children also help identify which characteristics are genetic and which are environmentally produced
-Adopted children will not manifest genetically transmitted characteristics from their adoptive parents, but they may manifest environmentally transmitted characteristics
-For example, obesity, which is a risk factor for a number of disorders, including coronary artery disease and diabetes
-If twins reared apart show highly similar body weights then we would suspect that body weight has a genetic component
-If weight within a family is highly related, and adopted children show the same weight as their parents and any natural offspring, then we would look to the family diet as a potential cause of obesity
-For many attributes, including obesity, both environmental and genetic factors are involved
-Research like this has increasingly uncovered the genetic contribution to many health disorders and behavioral factors that may pose risks to health
-Such diseases as asthma, Alzheimer;s cysic fibrosis, muscular dystrophy, Huntington's disease have a genetic basis
-There is also genetic basis for coronary heart disease and for some forms of cancer, including some breast and color cancers
-This genetic basis does not preclude the important role of the environment, however
-Health psychologists have important roles to play with respect to genetic contributions to health disorders
-One question concerns whether people need to be alerted to genetic risks
-Many people think that genetic risks are immutable and that any efforts they might undertake to affect their health would be fruitless if genes are implication
-Some erroneous beliefs many deter health behavior change and information seeking about one's risk
-Genetic risk information may also evoke defensive processes whereby people downplay their risk
-Making people aware of genetic risk factors should be accompanied by educational information to offset their potential problems

-Another role for health psychologists involves genetic counseling
-Prenatal diagnostic tests are currently available that permit the detection of some genetically based disorders, including cystic fibrosis, muscular dystrophy, breast cancer, Huntington's disease
-Helping people whether to be screened and how to cope with genetic vulnerabilities if they test positive represents an important role for health psychologists
-People who have a family history of genetic disorders, those who have already given birth to a child with a genetic disorder, or those who have recurrent reproductive problems, such as multiple miscarriages, often seek such counseling
-In some cases, technological advances have made it possible to treat some of these problems before birth through drugs or surgery
-However, if the condition cannot be corrected, the parents often must make the difficult decision of whether to abort the pregnancy

-Families that share genetic risks may need special attention through family counseling
-Some of the genes that contribute to the development of breast cancer have been identified and tests are now available to determine whether a genetic susceptibilities are more likely to develop the disease at an earlier age; thus, these women are at high risk and need careful monitoring and assistance in making making treatment related decisions
-With whole genome testing becoming available to individuals, knowledge of genetic risks may increase
-Carriers of genetic risks may experience great distress
-Growing evidence suggests that people at risk for treatable disorders benefit from genetic testing and do not suffer long-term psychological distress
-People who are chronically anxious, may require special attention and counseling

-In some cases, genetic risks can be offset by behavioral interventions to address the risk factor
-One study found that being informed that one had tested positive for a gene implicated in melanoma and receiving counseling led to a better skin self examination practices at a 1 month follow up
-Thus health psychologists have an important role to play in research and counseling related to genetic risks, especially if they can help people modify their risk status and manage their distress
-AIDS, progressive impairment of immunity
-Cancer, which is now believed to depend heavily on immunocompromise

-Lupus:
-Skin rash on the face
-Affects mostly women
-It leads to chronic inflammation, producing pain, heat, redness, and swelling, and can be life threatening when it attacks the connective tissue of the body's internal organs
-Depending on the severity of the disease, it may be managed by anti-inflammatory medications or immunosuppressive medication

-Tonsillitis
-Inflammation of the tonsils that interferes with their ability to filter out bacteria

-Infectious mononucleosis
-Viral disorder marked by an unusually large number of monocytes, it can cause enlargement of the spleen and lymph nodes, as well as fever, sore through, and general lack of energy

-Lymphoma
-Tumor of the lymphatic tissue
-Hodgkin's disease, a malignant lymphoma, involves the progressive, chronic enlargement of the lymph nodes, spleen and other lymphatic tissues
-As consequence, the nodes cannot effectively produce antibodies, and the phagocytic properties of the nodes are lost
-If untreated, can be fatal

-Some chronic diseases, once though to be genetic in origin or unknown in origin, are now being traced back to infections
-The development of bacterial strains that are resistant to treatment has raised an alarm
-The overuse of antibiotics is an active contributor to the development of increasingly lethal strains
-Infectious agents have also become an increasing concern in the war on terrorism, with the possibility that smallpox and other infectious agents may be as weapons
-Inflmattory response that is protective against provocations ranging from mosquito bites and sunburn to gastritis in response to spoiled food is coming under increasing investigation as a contributor to chrnoic disease
-The destructive potential of inflammation is evident in diseases such as rheumatoid arthritis and multiple sclerosis, but inflammation also underlies many other chrnoic diseases including atherosclerosis, diabetes, Alzheimer's asthma, cirrhosis of the liver, some bowel disorders, and even more
-The first set of pathways by which stress leads to poor health, involves direct effects on physiology
-Stress alters biological functioning, and the ways in which it does so and how it interacts with existing risks or genetic predispositions determine what illnesses a person will develop
-Direct physiological effects include such processes as elevated blood pressure, a decreased ability of the immune system to fight off infection, and canges in lipid levels and cholersterol, among other changes

-Second set of pathways concern health behaviors
-People who live with chronic stress have poorer health havits than people who do not, and acute stress, even when it is short-term, often compromises health habits
-These poor health habits can include smoking, poor nutrition, little sleep, little exercise, and use of substances such as drugs and alcohol
-Over the long term, each of these poor health habits contributes to specific illnesses
-Ex: smoking causing lung disease
-Even in short term, changes in these health habits may increase physiological vulnerabilities and set the stage for longer term adverse health outcomes

-Third pathway is that stress affects psychosocial resources in ways that can adversely affect health
-Supportive social contacts are protective of health, but stress can make a person avoid these social contacts, or, worse, behave in ways that drives others away
-Optimism, self esteem, and a sense of personal control also contribute to good health, yet many stressors undermine these beneficial beliefs
-To the extent that time, money, and energy must be put into combating the stressor, these external resources are compromised as well, falling especially hard on people who have very little of those resources

-Fourth set of pathways: involves the use of health services and adherence to treatment recommendations
-People are less likely to adhere to a treatment regimen when they are under stress, and they are more likely to delay seeking care for disorders that should be treated
-They many not seek care at all

-Four routes: physiology, health behaviors, psychosocial resources, and health care- represent the most important pathways by which stress affects health
-Early life adversity in childhood can affect not only health in childhood, but also health across the lifespan into adulthood and old age
-Some of this work grew out of the allostatic load view of stress, which argues that major, chronic, or recurrent stress dysregulates stress systems, which, over time, produce accumulating risk for disease
-These early risks include low socioeconomic status, exposure to violence, etc
-Physical or sexual abuse in childhood increases health risks because abuse can result in intense, chronic stress that taxes physiological systems
-Risky families that are high in conflict or abuse and low in warmth and nurturance, produce offspring whose stress responses are compromised
-Difficulties include problems with emotion regulation and social skills
-Children who grow up in harsh families do not learn how to recognize other people's emotions and respond to them appropriately or regulate their own emotional responses to situations
-As a result, they may overreact to mild stressors

-Children who grow up in risky families also have difficulty forming good social relationships
-These deficits in emotion regulation and social skills can persist across the lifespan long into adulthood, compromising the ways in which people from risky families cope with stress
-Children from risky families can develop heightened sympathetic reactivity to stress, exaggerated cortisol responses leading to health risks, and/or an immune profile marked by chronic inflammation
-In a study, the more negative characteristics adults reported from their childhood, the more vulnerable they were in adulthood to many disorders, including depression, lung disease, cancer, heart disease, and diabetes
-Because children from risky families often have poor health habits, some enhanced risk for disease may come from smoking, poor diet, and lack of exercise
-Are effects reversible or permanent?
-Some factors, such as maternal nurturance in a high poverty environment, can be protective against the health risks usually found in high-stress areas
-Personality characteristics that each person brings to a stressful event influence how he or she will cope with that event
-Some people experience stressful events especially strongly, which increases their psychological distress, their physical symptoms, and their likelihood of illness
-Negative affectivity: pervasive negative mood marked by anxiety, depression, and hostility
-People high in negative affectivity express distress, discomfort, and dissatisfaction in many situations
-Related to poor health, including such chronic disorders as arthritis, diabetes, chronic pain, and coronary artery disease
-Also related to all cause mortality
-Psychological distress involving depression, anger, hostility, and anxiety may form the core of a disease prone personality that predisposes people high in negative affect to illness
-Neuroticism coupled with social inhibition and isolation is an especially toxic combination for health

-Negative affectivity is related to elevated levels of stress indicators such as cortisol, heart rate, inflammation, and risk factors for coronary heart disease
-A second link is poor health habits
-People high in negative affectivity also respond to treatment more poorly, which may hasten the course of illness or death
-Although negative affectivity can compromise health, it can also create a false impression of poor health when none exists
-People report more physical symptoms such as headaches and other pains, especially under stress
-One reason may be that negative effect leads people to worry, be more aware of their symptoms, and attribute their symptoms to poor heath
-But in other cases, there is no evidence of an underlying physical disorder
-People may use health service during stressful times more than people who are more positive
-They are more likely to get sick, but they are also are distressed, experience physical symptoms, and seek medical attention even when they are not sick
-Makes use of these various phases of education, skill acquisition, and practice
-First phase: participants learn what stress is and how it creates physical wear and tear
-Many students find reassurance in the fact that other students have experiences similar to their own
-Learn that stress is a process of psychological appraisal rather than a factor inherent in events themselves
-Self-monitoring: students are trained to observe their own behavior closely and to record the circumstances that they find most stressful
-They record their physical, emotional and behavioral reactions those stresses as they experience them and maladaptive efforts they undertook to cope with the events
-They learn to focus on what happens just before they experience feelings of stress
-By pinpointing exactly those circumstances that intiate feelings of stress, students can identify their trouble spots
-They are also trained to recognize and eliminate the negative self talk
-They also have take home assignments: stress diary where they record what events they find stressful and they respond to them
-Next stage involves skill acqusition and practice
-Include cognitive behavioral management techniques, time management skills and other stress reducing interventions (exercise)
-They then set several specific goals that they want to meet to reduce experience of college stress
-Specific behaviors to meet these goals are identified
-Goal setting is important because it forces the person to distinguish among stressful events to be avoided, tolerated or overcome
-It also forces the person to be specific and concrete about exactly which stressors need to be tackled
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