PSYC 407 exam 3

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behavioral medicine
study of factors affecting medical illness
Behavioral ideas applied to the prevention, diagnosis, and treatment of medical problems.
health psychology
factors related to the promotion and maintenance of health
Practitioners look at factors that promote and maintain health.
Thought of as a subfield of behavioral medicine.
How did present focus on behavioral medicine and health psychology change from a century ago?
used to be infectious illnesses, now psychological factors
What two ways (pathways) do psychological factors influence biological processes?
Psychological factors can influence basic biological processes that leads to illness.
Long-standing behavior patterns may put people at risk for disease
List psychological factors and lifestyle habits that influence AIDS
Immune system directly affected by stress
Behavior patterns put one at risk to get it
List psychological factors and lifestyle habits that influence cancer
• Terminal cancer patients with social support live longer
• To be more optimistic by thinking about benefit finding
o Look for ways life had improved after getting cancer
List psychological factors and lifestyle habits that influence heart disease
• Hypertension- high blood pressure- Major risk factor for stroke, heart disease and kidney disease, Causes wear and tear of blood vessels, Makes heart work harder
• Psychological and behavior risk factors for CHD- Stress, Poor coping skills, Low social support, Lifestyle factors, Anger is a big one, Type a behavior pattern, Impatience, accelerated speech, motor activity
List psychological factors and lifestyle habits that influence chronic pain
• These reactions seem to be a result of psychological factors- Anxiety- Depression
• Determining factor is sense of control
Describe the three stages of GAS.
Phase 1 - alarm response (sympathetic arousal) to immediate threat
Phase 2 - resistance (mobilized coping and action)
Phase 3 - if stress too long, exhaustion (chronic stress, permanent body damage)
Describe Selye's original rat study that led to the GAS model
Injected rats with extract that caused ulcers and atrophy of immune system tissues.
The control group who received injections of saline only developed the same lesions.
The injection process was harmful enough to produce the same results and Selye called that nonspecific reaction STRESS.
Describe the biology of stress.
Activates the sympathetic branch of the ANS
Activates the HPA axis, producing cortisol
hippocampus responsive to cortisol and helps turn off stress response
Chronic stress may kill cells in hippocampus and cause permanent damage to the brain
Primate researchers studying stress found what biological markers that were related to which kind of status in the group?
High cortisol is associated with low social status
Low social status - fewer lymphocytes and immune suppression
Dominant males benefit from predictability and controllability; subordinates were bullied and had less access to resources
How might primate research on social status apply to humans?
stress is influenced by psychosocial factors
When a person is aroused, the person might feel excitement, stress, anxiety, or depression. What sorts of interpretations of a stressful event are associated with each kind of stress response?
if you feel prepared for challenge, excited
if you feel unprepared and feel pressure to work harder, stress
if you become tense and irritable because you have less sense of control; You worry incessantly , anxious
Individuals who ALWAYS see life as threatening fear never having control and lose hope, depressed
Discuss the social factors in chronic pain
A strong social support system can reduce pain and a lack of social support can increase pain.
chronic fatigue syndrome
Lack of energy, marked fatigue, pain, low-grade fever
Most common in females
Incidence increasing in Western countries
Considerable impairment may occur
what are out-of-date explanations for chronic fatigue syndrome ?
Previously attributed to viral infection, immune problems, depression, exposure to toxins
What is the current thinking about the etiology of chronic fatigue syndrome?
High-achievement oriented lifestyle
Fast paced lifestyle combines with stress and illness
Previous stress and instability
Psychological misinterpretation of lingering symptoms of illness (unable to function at usual high level) that is worsened by activity and improved by rest.
endogenous opioids
Endorphins and Enkephalins: occur naturally in body

Brain uses them to shut down pain
what is the relationship between endogenous opioids and self-efficacy?
People w/ high self-efficacy have higher tolerance for pain; increase secretion of endogenous opiates when confronted with painful stimulus
Describe the animal experiment that indicates a direct link between immunity and the brain.
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Describe the use of biofeedback in the management of stress-related disorders.
Patient learns to control bodily responses
Used with chronic headache and hypertension
Describe the use of meditation in the management of stress-related disorders.
Transcendental meditation (TM)
Describe the use of relaxation in the management of stress-related disorders.
Progressive muscle relaxation
Differentiate use, abuse, dependence, and intoxication.
use- ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational, or occupational functioning.
abuse- Defined by how significantly it interferes with the user's life
dependence- parallel to addiction, Includes tolerance and withdrawal
Intoxication- A physiological reaction to ingested substances of getting high or drunk
Define tolerance and withdrawal.
tolerance: require greater amounts of
the drug to produce the same effect
withdrawal: responds physically in a
negative way when the substance
is no longer ingested.
5 main categories of substances and define each. Be able to list the drugs discussed in the text under the appropriate category.
Depressants: result in behavioral sedation & can induce relaxation (include alcohol, sedative & hypnotic drugs in families of barbiturates;Seconal, or benzodiazipines; Valium, Zanax)
Stimulants: cause us to be more active & alert and can elevate mood (amphetamines, nicotine, caffeine)
Opiates: produces analgesia temporarily 9reduce pain) and euphoria. (heroin, codeine, and morphine)
Hallucinogens: alter sensory perception & can produce delusions, paranoia, and hallucinations. (cannabis, LSD)
What are the initial effects of drinking and the later effects (as you drink more) of alcohol on the body and brain?
initial- decreases CNS activity and level of physiological arousal. But initial effect seems like stimulation. Feeling of well-being Reduced inhibitions, become more outgoing
Inhibitory brain centers suppressed
later- Continued drinking depresses brain area that impede normal functioning Motor coordination Slurred speech Slowed reaction time confusion
What are the alcohol intoxication and withdrawal symptoms?
Tremors
Nausea and vomiting
Anxiety
Transient hallucinations
Agitation
Insomnia
Withdrawal delirium at its worst
The long-term disease risks of alcohol?
Consequences could include: pancreatitis, liver disease, cv disorders, and brain damage.
What are the effects of cocaine use?
Blocks dopamine reuptake
Euphoria
Feelings of power and confidence (short term)
Increased blood pressure/pulse
Insomnia
Decreases appetite
Paranoia
What are the effects of withdrawal of nicotine?
Dysphoria
Insomnia
Irritability
Anxiety
Diff. concentrating
Increased appetite
What are the effects of intoxication and withdrawal of Caffeine?
DSM-5 criteria for caffeine intoxication- Restlessness, Insomnia, Diuresis, Muscle twitching, Rambling thought or speech, Psychomotor agitation, Significant distress or impairment in functioning
Withdrawal: Headache, Drowsiness, Unpleasant mood, Irritability
What group uses inhalants the most and what do they get out of it?
boys 13-15, effects similar to alcohol intoxication
What are some possible negative effects of cannabis?
Feeling of well-being can change to mood swings, paranoia, hallucinations
Impairment in motivation not uncommon
What's the purpose of NA and AA?
Use of "higher power" to help overcome your shortcomings and SOCIAL SUPPORT; not judging; 12 steps
Discuss the psychological causes of substance abuse
Role of positive reinforcement: pleasurable feelings of drugs

Negative reinforcement; escape from physical pain, stress, panic, anxiety

Opponent-process theory Why the crash after drug use fails to keep people from using: an increase in positive feelings is followed by increase in negative feelings; strengthened with use (tolerance)

Role of expectancy effects -Expectancies influence drug use and relapse

After stopping use, cravings can develop. Cravings triggered by stuff associated with use
What is a medical model?
substance abuse is a disease
What is controlled drinking?
Some evidence that some abusers can become social drinkers. Mixed results but it may be an alternative treatment for some.
What are the impulse-control disorders discussed in the chapter?
Intermittent explosive disorder, Kleptomania, Pyromania
List the sexual dysfunction disorders
Hypoactive sexual desire disorder, Female and male orgasmic disorder, Premature ejaculation, Genito-pelvic pain/penetration disorder (GPPP, may include vaginismus),
List the paraphilic disorders
fetishistic disorder, voyeuristic disorder, exhibitionistic disorder, transvestic disorder, sexual sadism disorder, sexual masochism disorder, pedophilic disorder, incest
What are the differences between homosexual and heterosexual problems in a context of sexual dysfunction?
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What are the differences between male and female problems in a context of sexual dysfunction?
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Do married couples see sexual dysfunction as a problem?
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Describe the sexual desire dysfunctions.
male hypoactive sexual desire disorder & female sexual interest/arousal desire disorder: apparent lack of interest in sexual activity or fantasy
Describe the sexual arousal disorders and any gender differences that may be there.
males: erectile disorder (difficulty attaining or maintaining erections)
female sexual interest/arousal disorder (little or no desire to have sex)
men usually feel more impaired by it and such problems tend to accompany with aging but with women could decrease
Describe the orgasmic disorders
inability to achieve orgasm despite adequate sexual desire and arousal, either orgasms occurs at inappropriate time or it does not occur. --> female orgasmic disorder (never or almost never reach orgasm); delayed ejaculation (males achieving orgasms with great difficulty or not at all); premature ejaculation (occurs well before the man and partner wish it to)
How common are orgasmic disorders for women?
approx 80% do not achieve orgasm with every sexual encounter
How common are orgasmic disorders for men?
approx 8% report having delayed ejaculation or none during sexual interaction
21% for premature ejaculation
What are the defining features of the sexual pain disorder?
severe anxiety or even pani attacks in anticipation of possible pain during intercourse; vaginismus: pelvic muscles in outer thrid of vagina undergo involunatry spasms when intecourse is attempted; sensations of ripping, burning, or tearing during attempted intercourse --.difficulty with vaginal penetration during intercourse
List some medical and psychological reasons for sexual dysfunctions
negative affect & expectancies, inaccurate and under-reporting of arousal, perceived lack of control -->attentional focus on public consequences of not performing or other nonerotic issues--> increased autonomic arousal -->increasingly efficient focus on consequences of not performing etc.
~associated with socially transmitted negative attitudes about sex, current relationship difficulties, & sexual activity anxiety
Describe performance anxiety
These anxieties cause your body to launch a response called "fight or flight." Stress hormones like epinephrine and norepinephrine are released in a series of reactions that were actually designed to prepare your body to run or confront a threat. Of course, your partner isn't a threat, which is why this response is so counterproductive to intimacy
What is a sexual social script
we all operate by certain scripts that reflect social and cultural expectations and guide our behavior. ex:person learning that sexuality is dirty, forbidden, etc, is more vulnerable to develop sexual dysfunction later in life
What are the treatments for the sexual dysfunctions?
psychosocial treatment successfull. Varios drugs such as Viagra (erectile dysfunction)
Paraphilic Disorders
paraphilia, fetishism, frotteurism, voyeurism, exhibitionism, sexual sadism, and sexual masochism.
paraphilia
sexual attraction to innapropriate people, such as children, or innapropriate objects, such as articles of clothing
fetishism
sexual attraction to nonliving objects
frotteurism
typically in crowded bus or subway, ex: women experience jostling and pushing from behind, a male with fotteuristic arousal pattern rubbing up against them until he is stimulated to the point of ejaculation. victims cant escpa eeasily, act usually succesful.
voyeurism
sexual arousal achieved by viewing unsuspecting person undressing or naked
exhibitionism
sexual gratification from exposing ones genitals to unsuspecting strangers
sexual sadism
sexual arousal associated with inflicting pain or humiliation
sexual masochism.
sexual arousal associated with experiencing pain or humiliation
covert sensitization
repeated mental reviewing of aversive consequences to establish negative associations with behavior
What are the criteria for a diagnosis of gender dysphoria?
dissatisfaction with ones natal sex & sense that one is opposite gender (ex: a woman trapped in a mans body)
How much does genetics contribute to the vulnerability to experience gender dysphoria?
...genetics contribute about 62% to vulnerability in experiencing gender dysphoria for their twin sample
Name the clusters and the disorders (and the disorders within each cluster).
Cluster A (odd or eccentric disorders): Paranoid Personality disorder, Schizoid Personality disorder, Schizotypal Personality disorder
Cluster B (dramatic, emotional, or erratic disorders): Antisocial personality disorder, borderline personality disorder, histrionic personality disorder, narcissistic personality disorder
Cluster C (anxious or fearful disorders) : Avoidant personality disorder, dependent personality disorder, Obsessive-Compulsive personality disorder
personality disorder
persistant pattern of emotions, cognitions, and behavior that results in enduring emotional distress for the person affected/or others--> difficulties with work and relationships
What are the gender differences in the prevalence of certain personality disorders?
Men diagnosed tend to display traits characterized as more aggressive, structured, self assertive, and detached. --> antisocial personality disorder
Women present characteristics that are more submissive, emotional, insecure. --> dependent personality disorder & histrionic and borderline personality disorders
What are the differences between categorical and dimensional systems?
personality disorders are extreme versions of otherwise normal personality variations--> dimensions (problems of degree)
ways of relating that are different from psychologically healthy behavior --> categories (problems of kind)
What are some advantages and limitations of the categorical system?
advantages: convenience
disadvantages: using categories leads clinicians to view them as "real" things, some argue not real its just a way of relating to the world
What are some advantages and limitations of the dimensional system?
advantages: 1.) it would retain more information about each individual 2) it would be more flexible b/c it would permit both categorical & dimensional differentiation among individuals 3.) would avoid arbitrary decisions involved in assigning a person to a diagnostic category
The BIG-5 Theory
personality dimensions: Extroversion- talkative, assertive, active vs silent, passive, and reserved; Agreeableness- kind, trusting, and warm vs hostile, selfish, and mistrustful; Conscientiousness-organized, thorough, and reliable vs careless, negligent, and unreliable; Neuroticism- even tempered vs nervous, moody, and temperamental; Openness to experience- imaginative, curious, and creative vs shallow and imperceptive
What is the lifespan trajectory of antisocial pd like?
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Differentiate psychopath and antisocial pd.
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What are some brain-based explanations or models for antisocial pd.?
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DBT
involves helping people cope with stressors that seem to trigger suicidal behavior. weekly individual sessios provide support, and patients are taught how to identify and regulate their emotions, in final stage, clients learn to trust their own responses rather than depend on validation of others
What are the common comorbid disorders with BPD?
about 20% have major depression and 40% have bipolar disorder 25% bulimia 67% with at least one substance abuse disorder
Depressants
Behavioral sedation (e.g., alcohol, sedatives, anxiolytic drugs- benzodiazepines, barbiturates)
Sedatives - calming (e.g., barbiturates)
Hypnotic - sleep inducing
Anxiolytic - anxiety reducing (e.g., benzodiazepines)
Stimulants
Increase alertness and elevate mood (e.g.,amphetamines. cocaine, nicotine, caffeine)
Opiates
Produce analgesia and euphoria (e.g., heroin, morphine, codeine)
Hallucinogens
Alter sensory perception (e.g., cannabis,LSD)
Other drugs of abuse
Inhalants, Anabolic steroids, Medications
Intermittent explosive disorder
Rare condition and controversial
Characterized by frequent aggressive outbursts
Leads to injury and/or destruction of property
Few controlled treatment studies
Must rule out other personality disorders, psychosis, substance abuse
Research looking at influence of NTs on testosterone and disrupted family life.
Kleptomania
Failure to resist urge to steal unnecessary items
Seems rare, but it is not well studied
Starts w/tension followed by relief after stealing
Inability to delay gratification (research has found damage in brain part associated w/poor decision-making.
Highly comorbid with mood disorders
Also co-occurs with substance-related problems
Pyromania
Involves having an irresistible urge to set fires
Diagnosed in less than 4% of arsonists
Little etiological and treatment research
Hypoactive sexual desire disorder
Little or no interest in any type of sexual activity (difficult to assess, frequency?
Less than twice a month))
Masturbation, sexual fantasies, and intercourse are rare
Accounts for half of all complaints at sexuality clinics
Affects 22% of women and 5% of men suffer from low sexual interest
Female and male orgasmic disorder
No orgasm despite adequate sexual desire and arousal
Rare condition in adult males
Males tend not to report it because couples accomodate
common complaint of adult females
Premature ejaculation
Ejaculation occurring too soon
Most prevalent sexual dysfunction in adult males
Affects 21% of all adult males
Most common in younger, inexperienced males
May be the PERCEPTION of lack of control that is the problem
Problem tends to decline with age
Genito-pelvic pain/penetration disorder (GPPP)
Marked pain during intercourse; sexual behavior disrupted
Adequate sexual desire
Adequate ability to attain arousal and orgasm
Must rule out medical reasons for pain
vaginismus
Limited to females
Outer third of the vagina undergoes involuntary spasms
Complaints include
Feeling of ripping, burning, or tearing
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