Psychophysiological Disorders Thomas G. Bowers, Ph.D.


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Psychophysiological Disorders Thomas G. Bowers, Ph.D.

  1. 1. Psychophysiological Disorders Thomas G. Bowers, Ph.D. Penn State Harrisburg
  2. 2. Psychophysiological Disorders <ul><li>Relatively new field of health psychology </li></ul><ul><li>Refers to physical symptoms or diseases that are caused by or worsen by psychological factors </li></ul><ul><li>Formally referred to as psychosomatic disorders </li></ul>
  3. 3. Psychophysiological Disorders <ul><li>In contrast to hypochrondrical and conversion disorders, there is often physiological damage to the body </li></ul><ul><li>Also tends to be involuntary </li></ul>
  4. 4. Psychophysiological Disorders <ul><li>Some examples </li></ul><ul><ul><li>1. Asthma </li></ul></ul><ul><ul><li>2. Hypertension </li></ul></ul><ul><ul><li>3. Gastritis </li></ul></ul><ul><ul><li>4. Irritable bowel syndrome </li></ul></ul><ul><ul><li>5. Headaches </li></ul></ul>
  5. 5. Psychophysiological Disorders <ul><li>New fields developing </li></ul><ul><ul><li>Behavioral Medicine </li></ul></ul><ul><ul><li>Health Psychology </li></ul></ul>
  6. 6. Psychophysiological Disorders <ul><li>Important Concepts </li></ul><ul><li>Stress </li></ul><ul><ul><li>Selye (1936) </li></ul></ul><ul><ul><li>General adaptation syndrome (GAS) </li></ul></ul><ul><ul><li>Described biological adaptation to prolonged sustained physical stress </li></ul></ul>
  7. 7. Cardiovascular Disorders <ul><li>Frequent source of morbidity and mortality </li></ul><ul><li>Essential hypertension </li></ul><ul><ul><li>“High blood pressure” </li></ul></ul><ul><ul><li>90% is “essential” </li></ul></ul><ul><ul><li>Not attributable to physical cause </li></ul></ul><ul><ul><li>Many are unaware of the difficulty </li></ul></ul>
  8. 8. Cardiovascular Disorders <ul><li>Essential hypertension </li></ul><ul><li>systolic/diastolic </li></ul><ul><li>120/80 mm hg </li></ul><ul><li>Must be elevated over a period of time - Repeated physician visits </li></ul>
  9. 9. Cardiovascular Disorders <ul><li>Essential hypertension </li></ul><ul><li>Associated with renal failure, increased risk of stroke, artherosclerosis, myocardial infarction (heart attack) </li></ul><ul><li>Could be triggered by chronic restriction of renal blood flow, calcification of arteries, inelasticity of vascular system </li></ul>
  10. 10. Cardiovascular Disorders <ul><li>Flight or fight response to adrenal stimulation </li></ul><ul><ul><li>Rapid, but brief increase in respiration, heart rate, increased blood supply to extremities, reduced blood supply to torso. </li></ul></ul><ul><ul><li>Blood pressure temporarily increases </li></ul></ul><ul><ul><li>Why does this increase become permanent? </li></ul></ul>
  11. 11. Cardiovascular Disorders <ul><li>Stress - Unexpressed Hostility Link </li></ul><ul><ul><li>Hokanson and associates </li></ul></ul><ul><ul><li>Frustration has blood pressure increase </li></ul></ul><ul><ul><li>Opportunity to express aggression or anger yields blood pressure decrease </li></ul></ul>
  12. 12. Cardiovascular Disorders <ul><li>Risk Factors </li></ul><ul><ul><li>Diatheses models </li></ul></ul><ul><ul><li>Isolation is a risk factor </li></ul></ul><ul><ul><li>Sensitivity to salt </li></ul></ul><ul><ul><li>Family history </li></ul></ul><ul><ul><li>Lack of exercise </li></ul></ul><ul><ul><li>Smoking </li></ul></ul><ul><ul><li>Obesity </li></ul></ul>
  13. 13. Cardiovascular Disorders <ul><li>Coronary Heart Disease </li></ul><ul><ul><li>1. Angina pectoris - periodic chest pains </li></ul></ul><ul><ul><li>2. Myocardial infarction - heart attack </li></ul></ul>
  14. 14. Cardiovascular Disorders <ul><li>Coronary Heart Disease </li></ul><ul><ul><li>Risk factors </li></ul></ul><ul><ul><ul><li>1. Age </li></ul></ul></ul><ul><ul><ul><li>2. Sex (males higher risk) </li></ul></ul></ul><ul><ul><ul><li>3. Cigarette use </li></ul></ul></ul><ul><ul><ul><li>4. Hypertension </li></ul></ul></ul><ul><ul><ul><li>5. Serum cholesterol </li></ul></ul></ul><ul><ul><ul><li>6. EKG abnormalities </li></ul></ul></ul><ul><ul><ul><li>7. Diabetes </li></ul></ul></ul>
  15. 15. Cardiovascular Disorders <ul><li>Coronary Heart Disease </li></ul><ul><ul><li>Behavioral Factors </li></ul></ul><ul><ul><ul><li>Type A behaviors </li></ul></ul></ul><ul><ul><ul><li>Intense, competitive, driven </li></ul></ul></ul><ul><ul><ul><li>Urgency, aggressiveness, hostility </li></ul></ul></ul><ul><ul><ul><li>Associated with CHD </li></ul></ul></ul>
  16. 16. Asthma <ul><li>Tightness in chest, wheezes, coughs, possible panic </li></ul><ul><li>Emotionality often implicated </li></ul><ul><li>Irritants also play an important factor </li></ul><ul><li>Some allergies </li></ul><ul><li>Commonly associated with infections </li></ul>
  17. 17. Psychotherapy for Psychophysiological Disorders <ul><li>Progressive relaxation training </li></ul><ul><ul><li>May include yoga, mediation and similar methods </li></ul></ul><ul><li>Biofeedback </li></ul><ul><ul><li>Effective, but some evidence of placebo effects as well </li></ul></ul>
  18. 18. Psychotherapy for Psychophysiological Disorders <ul><li>Behavioral interventions </li></ul><ul><ul><li>Weight management </li></ul></ul><ul><ul><li>Exercise encouragement </li></ul></ul><ul><ul><li>Smoking cessation </li></ul></ul><ul><li>Psychoanalytic methods </li></ul><ul><ul><li>Have actually been demonstrated to reduce blood pressure </li></ul></ul>
  19. 19. Psychotherapy for Psychophysiological Disorders <ul><li>Cognitive therapies </li></ul><ul><ul><li>Not as thoroughly researched to date </li></ul></ul><ul><ul><li>Some data suggests affective expression, managing thoughts and so on are helpful </li></ul></ul><ul><li>Management of Type A behavior </li></ul><ul><li>Stress Management </li></ul><ul><ul><li>Also includes social skill training </li></ul></ul><ul><ul><li>Environmental changes </li></ul></ul>
  20. 20. Medical Conditions Affected By Psychological Factors <ul><li>Many complex, difficult to treat disorders </li></ul><ul><li>Includes diabetes, hypertension, renal disease, many neurological disorders </li></ul><ul><li>Psychoneuroimmunology </li></ul><ul><ul><li>Positive spirit and outlook associated with survival </li></ul></ul><ul><ul><li>Uncertain why this may be the case </li></ul></ul>
  21. 21. Medical Conditions Affected By Psychological Factors <ul><li>Breast cancer </li></ul><ul><ul><li>Remarkably high incidence in western societies </li></ul></ul><ul><ul><li>Early detection is very important </li></ul></ul><ul><ul><li>Text describes breast self exam method fairly well </li></ul></ul>