Health Psychology Chapter 6 PDF

**Course**: Health Psychology **Instructor**: **Chapter**\# 6 **Lecture**\# 25- 30 Contents ======== - Specific Physical Ailments and Unhealthy Lifestyles - Risk factors, prevention, rehabilitation, and psychological interventions: - Overview of common diseases such as Coronary heart...

**Course**: Health Psychology **Instructor**: **Chapter**\# 6 **Lecture**\# 25- 30 Contents ======== - Specific Physical Ailments and Unhealthy Lifestyles - Risk factors, prevention, rehabilitation, and psychological interventions: - Overview of common diseases such as Coronary heart disease (CHD), - Cancer, Pain, AIDS, Diabetes Mellitus, - Obesity and eating disorders: Bulimia and Anorexia Nervosa, - Substance abuse disorders: Smoking and drinking, - Arthritis **Tylor book: Coronary heart disease (CHD**) is a general term that refers to illnesses caused by atherosclerosis, the narrowing of the coronary arteries, the vessels that supply the heart with blood. When the vessels become narrowed or closed, the flow of oxygen and nourishment to the heart is partially or completely obstructed. Temporary shortages of oxygen and nourishment frequently cause pain, called angina pectoris, that radiates across the chest and arm. When severe deprivation occurs, a heart attack (myocardial infarction) can result. CHD is a major chronic disease: Millions of Americans live with the diagnosis and symptoms. Because of its great frequency and the toll it takes on middle-aged and older people, understanding heart disease has been a high priority of health psychology. 1. Coronary heart disease is the number one killer in the United States. It is a disease of lifestyle, and risk factors include cigarette smoking, obesity, and high cholesterol, low levels of physical activity, chronic stress, and hostility. 2. Coronary proneness is associated with hostility, depression, and hyper reactivity to stressful situations, including a slow return to baseline. These exaggerated cardiovascular responses to stress may be partly genetically based, and may be aggravated by a conflict tridden social environment, especially in the early family. 3. Efforts to modify excessive reactivity to stress and hostility through training in relaxation and stress management may have promise for reducing morbidity and mortality due to CHD. 4. Cardiac rehabilitation helps CHD patients obtain their optimal physical, medical, psychological, social, emotional, vocational, and economic status. Components of these programs typically include education about CHD, drug treatments, nutritional counselling, supervised exercise, stress management, and, under some circumstances, psychological counselling and/or social support group participation. 5. Patients who have had heart attacks (MI) often have difficulty managing the stress reduction aspects of their regimens, and sometimes marital relations can be strained as a result of the changes forced on patient and spouse by the post-MI rehabilitative regimen. **Pain: Tylor book** Cancer ====== Cancer is a set of more than 100 diseases that have several factors in common. All cancers result from a dysfunction in DNA---that part of the cellular programming that controls cell growth and reproduction. Instead of ensuring the regular, slow production of new cells, this malfunctioning DNA causes excessively rapid cell growth and proliferation. Unlike other cells, cancerous cells provide no benefi t to the body. They merely sap it of resources. Psychosocial factors appear to be related to the onset and progression of cancer, especially depression and avoidance coping. Cancer can produce physical and psychosocial problems, including debilitating responses to chemotherapy, strain in the social network, job stress, and adverse psychological responses such as depression. CBT, family therapy, and support groups are among the tools to manage these problems. AIDS ==== Acquired immune deficiency syndrome (AIDS) was first identified in the United States in 1981. It results from the human immunodeficiency virus (HIV) and is marked by the presence of unusual opportunistic infectious diseases. Gay men and intravenous needle sharing drug users have been the primary risk groups for AIDS in the United States. More recently, AIDS has spread rapidly in minority populations, especially minority women. Heterosexually active adolescents and young adults are also at risk. Primary prevention, through condom use and control of the number of partners, is the main approach to controlling the spread of AIDS. Such interventions focus on providing knowledge, increasing perceived self-efficacy to engage in protective behaviour, changing peer norms about sexual practices, and developing sexual negotiation strategies. Many people live with asymptomatic HIV seropositivity for years. Exercise and active coping may help prolong this state. Drugs such as HAART enable people with HIV infection to live longer, healthier lives, making HIV infection a chronic disease. Stress aggravates virtually all illnesses and cancers, no exception. For the most part, cancer survivors respond to day-to-day stressors much as other people do. Nonetheless, stress can increase the likelihood of depression and exacerbate physical symptoms, and thus, interventions directed to stress management can be helpful. Diabetes Tylor Book =================== Type I diabetes is an autoimmune disorder characterized by the abrupt onset of symptoms, which result from lack of insulin production by the beta cells of the pancreas. The disorder may appear following viral infection and probably has a genetic contribution. The most common early symptoms are frequent urination, unusual thirst, excessive fluid consumption, weight loss, fatigue, weakness, irritability, nausea, uncontrollable craving for food (especially sweets), and fainting. These symptoms are due to the body's attempt to find sources of energy, which prompts it to feed off its own fats and proteins. By-products of these fats then build up in the body, producing symptoms; if the condition is untreated, a coma can result. Type I diabetes is a serious, life-threatening illness accounting for about 10 percent of all diabetes Stress may precipitate Type I diabetes in individuals with a genetic risk and rates of this disorder are on the rise, jumping 23 percent just in the last few years. In Type I diabetes, the immune system falsely identifies cells in the pancreas as invaders and, accordingly, destroys these cells, compromising or eliminating their ability to produce insulin. Type I diabetes usually develops relatively early in life, earlier for girls than for boys. Its management involves monitoring blood sugar levels and controlling diet, among other health habits. Unfortunately, especially with young Type I diabetes patients, adherence can be poor. Health psychologists can help in the design of interventions to improve selfmanagement. The health psychologist, has an important role to play in the management of Type I diabetes, by developing the best ways of teaching the complex treatment regimen, ensuring adherence, developing effective means for coping with stress, helping the diagnosed diabetic develop the self-regulatory skills needed to manage the treatment program, and helping the family coordinate their efforts with a minimum of strain (Sood et al., 2012). Obesity and Eating disorders: Tylor book ======================================== Obesity is an excessive accumulation of body fat. Generally, fat should constitute about 20--27 percent of body tissue in women and about 15--22 percent in men. Obesity is now so common that it has replaced malnutrition as the most prevalent dietary contributor to poor health worldwide (Kopelman, 2000), and it will soon account for more diseases and deaths in the United States than smoking. Stress affects eating, although in different ways for different people. About half of people eat more when they are under stress, and half eat less (Willenbring, Levine, & Morley, 1986). Stress also influences what food is consumed. People who eat in response to stress usually consume more low calorie and salty foods, although when not under stress, stress eaters show a preference for high-calorie foods (Willenbring et al., 1986). Anxiety and depression figure into stress eating as well. One study found that stress eaters experience greater fluctuations in anxiety and depression than do nonstress eaters. Overweight people also have greater fluctuations in anxiety, hostility, and depression than do normal individuals (Lingsweiler, Crowther, & Stephens, 1987). People who eat in response to negative emotions show a preference for sweet and high-fat foods. Obesity has been linked to cardiovascular disease, kidney disease, diabetes, some cancers, and other chronic conditions. Cause of obesity include genetic predisposition, early diet, a family history of obesity, low SES, little exercise, and consumption of large portions of high calorie food and drinks. Ironically, dieting may contribute to the propensity for obesity. Eating disorders, especially anorexia nervosa, bulimia, and bingeing, are major health problems, especially among adolescents and young adults, and health problems including death commonly result. **Anorexia nervosa** is an obsessive disorder amounting to self-starvation, in which an individual diets and exercises to the point that body weight is grossly below optimum level, threatening health and potentially leading to death. Most sufferers are young women, but gay and bisexual men are also at risk. **Bulimia** is characterized by alternating cycles of binge eating and purging through such techniques as vomiting, laxative abuse, extreme dieting or fasting, and drug or alcohol abuse (Hamilton, Gelwick, & Meade, 1984). **Bingeing** appears to be caused at least in part by dieting. A related eating disorder, termed binge eating disorder, characterizes the many individuals who engage in recurrent binge eating but do not engage in the compensatory purging behaviour to avoid weight gain (Spitzer et al., 1993). Obesity and eating disorders have been treated through diets, surgical procedures, drugs, and cognitive-behavioural (CBT) approaches. CBT includes monitoring eating behavior, modifying the environmental stimuli that control eating, gaining control over the eating process, and reinforcing new eating habits. Relapse prevention skills help in long-term maintenance. Cognitive-behavioural techniques can produce weight losses of 2 pounds a week for up to 20 weeks, maintained over a 2-year period. Increasingly, interventions are focusing on weight gain prevention with children in obese families and with high-risk adults. Smoking and drinking ==================== Alcoholism accounts for thousands of deaths each year through cirrhosis, cancer, fetal alcohol syndrome, and accidents connected with drunk driving. Alcoholism has a genetic component and is tied to sociodemographic factors such as low SES. Drinking also arises in an eff ort to buffer the impact of stress and appears to peak between ages 18 and 25. Most treatment programs for alcoholism begin with an inpatient "drying out" period, followed by the use of cognitive-behavioural change methods including relapse prevention. The best predictor of success is the patient. Alcoholics with mild drinking problems, little abuse of other drugs, and a supportive, financially secure environment do better than those without such supports. Smoking accounts for more than 443,000 deaths annually in the United States due to heart disease, cancer, and lung disorders. Theories of the addictive nature of smoking focus on nicotine and nicotine's role as a neuroregulator. Attitudes toward smoking have changed dramatically for the negative, largely due to the mass media. Attitude change has kept some people from beginning smoking, motivated many to try to stop, and kept some former smokers from relapsing. Smoking is highly resistant to change. Even after successfully stopping for a short time, most people relapse. Factors that contribute to relapse include addiction, lack of effective coping techniques for dealing with social situations, and weight gain. Smoking prevention programs are designed to keep youngsters from beginning to smoke. Many of these programs use a social influence approach and teach youngsters how to resist peer pressure to smoke and help adolescents improve their coping skills and self-image. Many programs for stopping smoking begin with some form of nicotine replacement, and use CBT to help people stop smoking. Interventions also include social skills training programs and relaxation therapies. Relapse prevention is an important component of these programs. Arthritis ========= A set of diseases known as autoimmune diseases, in which the body falsely identifies its own tissue as foreign matter and attacks it. The most prevalent of these autoimmune diseases is arthritis, and it is also one of the most common causes of disability. Arthritis has been with humankind since the beginning of recorded history. Ancient drawings of people with arthritic joints have been found in caves, and early Greek and Roman writers described the pain of arthritis (Johnson, 2003). Arthritis means *"inflammation of a joint";* it refers to more than 100 diseases that attack the joints or other connective tissues. Although it is rarely fatal, arthritis ranks second only to heart disease as the most wide spread chronic disease in the United States today. Psychologists speculated that there might be a "rheumatoid arthritis personality." This personality type was said to be perfectionistic, depressed, and restricted in emotional expression, especially the expression of anger. Recent research now casts doubt on the accuracy of such a profile, at least as a cause of arthritis. Stress may play a role both in the development of rheumatoid arthritis and in its course. Social relationship distress may especially contribute to the development of the disease (Anderson, Bradley, Young, McDaniel, & Wise, 1985) and/or its course (Parrish, Zautra, & Davis, 2008). The spouse appears to play a critical role in the rheumatoid arthritis experience, and accurate perceptions of fatigue, pain, and physical limitations by the spouse are critical to successful disease management. including biofeedback, relaxation training, problem-solving skills training, a focus on reducing negative expectations, and pain-coping skills training. Targeting catastrophizing thoughts and improving self-efficacy may be particularly beneficial. An enhanced sense of self-efficacy that one can manage the disease may be largely responsible for the success of CBT interventions with rheumatoid arthritis. Recently, mindfulness interventions have been used with RA patients, and patients with depression appear to be especially benefitted. Coordinating these behavioural interventions with the use of drug therapies to control pain provides the most comprehensive approach