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LECT 2. BEHAVIOUR MEDICINE.pptx. .
- 1. BEHAVIOR MEDICINE One ofthe major application of behavioural science is to provide behaviour medicine to people Mrs Tafadzwa
- 2. Definition of behaviormedicine • Behavioral medicine is the interdisciplinary field concerned with the development and integration of the behavioral and biomedical science, knowledge and techniques relevant to health and illness.
- 3. Examination of Bio-psychosocial Contextsof Problems • Behavioral medicine examines the broad bio- psychosocial context of the following problem areas. • Etiology • Host Resistance • Disease Mechanism • Patient-Decision Making • Compliance • Intervention
- 4. Etiology • How docritical life events, characteristics behavior and personality organization predispose an individual to physical illness, a person with anxious personality are more prone to hypertension.
- 5. Host resistance • Howare the effects of stress mitigated by resistance resources like coping style, social support and certain personality traits. • Persons with good coping skills can manage stressful situations without much negative effects on their health.
- 6. Disease mechanism • Howis human physiology altered by stressors, particularly those arising from maladaptive behavior. For instance what effects are produced in immune, gastrointestinal, and cardiovascular system due to stress.
- 7. Patient-Decision Making • Whatare the processes involved in the choices individuals make with respect to matters such as hazardous life-styles, excessive smoking and consumption of alcohol, seeking of health-care and adherence to preventive regimens.
- 8. Compliance • Which factorslike biomedical, behavioral, self-regulative, cultural, social and interpersonal (physician-patient relationship) determine compliance with medical advice
- 9. Intervention • How effectiveare psychological like health education and behavior modification in altering unhealthy life-styles and in the direct reduction of illness and illness behavior at individual and community levels.
- 10. Techniques Used inBehavioral Medicine • Self Monitoring • Stimulus Control • Self-Control of Internal States
- 11. Self-monitoring • The patientis given instructions to maintain comprehensive daily record of fluctuation of symptoms • Self-monitoring helps the patient to receive immediate feedback regarding factors that contribute to an increase and/or decrease of symptoms. • It can also help the patient to develop internal performance standards that guide behavior change.
- 12. Stimulus control • Thepatient learns to identify the cues in the environment that foster adaptive or maladaptive behavior and then alter the environment and behavior routines. • This method is especially useful in treatment of obesity, addictive behaviors and insomnia.
- 13. Self-control of internalstates • Both relaxation training and biofeedback procedures are used to achieve self-control of internal states, like anxiety.
- 14. Applications of behavioralmedicine • Behavioral medicine techniques have been applied to such diverse topics as alcohol and tobacco use, exercise, AIDS, diabetes, hypertension, stress and immunization. • It can also be applied to diverse health problems like cancer, heart disease, infections and pain. • Headaches • Chronic Pain
- 15. Headaches • Relaxation trainingand biofeedback techniques are commonly used for the treatment of headaches. • In case of migraine headaches, thermal biofeedback training is used more commonly.
- 16. Chronic Pain • Chronicpain is generally described as pain that persists for more than 6 months and has little likelihood of remission. • Treatment of chronic pain involves reconditioning through physical therapy (Hydrotherapy), exercises, cognitive restructuring, reprogramming the patient’s environment and addressing vocational issues.
- 17. Psychophysiological disorders/ pschosomaticillneses • According to ICD-10 psychophysiological disorders are physical problems that have a known or suspected pathophysiological mechanism and may be influenced by psychological factors. • Asthma • Insomnia • Raynaud’s Disease • Gastrointestinal Disorders
- 18. Asthma • Asthma isa complex disorder of bronchial tubes caused by hyperactivity to various stimuli like exercises, cold air, respiratory infections. • Behavioral treatment of asthma includes EMG Biofeedback and relaxation training to help patients overcome fear and panic.
- 19. Insomnia • Insomnia isa subjective feeling of not having obtained enough sleep along with objective verification of sleeping difficulties and/or daytime fatigue. • Behavioral medicine specialists emphasize on sleep hygiene behavior: including avoidance of caffeine, alcohol before sleep, avoidance of daytime napping and maintenance of regular sleep schedule.
- 20. Raynaud’s disease • Thisdisease is characterized by episodic attacks of vasospasm in finger and/or toes due to the lack of blood flow to the periphery, the tips become cold. • Relaxation therapy and thermal biofeedback are carried out in an effort to increase the flow of blood to the periphery.
- 21. Gastrointestinal disorders • Theseinclude problems associated with stomach and intestines: peptic ulcers, irritable bowel syndrome, ulcerative colitis and Crohn’s disease. • The intervention includes stress management, assertiveness training, relaxation and biofeedback.
- 22. Health promotion • Healthpromotion activities aim at reducing the risk of developing disease. • It includes: exercise adherence smoking cessation weight management stress management medication adherence AIDS prevention
- 23. Exercise adherence • Physicalactivity is recognized as an accepted form of treatment for a variety of disorders like: • diabetes • obesity • hypertension • coronary heart disease • depression, and • chronic pain.
- 24. Smoking cessation • Behavioralstrategies for smoking cessation include use of self- monitoring and administration of rewards. • Relaxation training is incorporated to combat the physiological arousal that may result from craving. • Efforts are also made to eliminate the settings associated with smoking.
- 25. Weight management anddiabetes • Behavioral medicine research emphasizes on weight reduction, diet restriction and exercise to aid in diabetic control. • The role of stress and efficacy of stress management techniques in controlling blood glucose is also being examined.
- 26. Stress management • Theaim of stress management programs is to teach the individuals to cope with daily demands in an effective manner. • Physical relaxation like progressive muscle relaxation is used: yoga, meditation, or biofeedback assisted feedback
- 27. Medication adherence • Thebehavioral medicine specialist focuses on enhancing patient’s understanding about the need for and benefit of medication.
- 28. AIDS prevention • AIDSprevention efforts include use of educational programs emphasizing the importance of abstinence from high-risk behaviors.
- 29. summary • Behavioral medicineis the diverse field concerned with the development and integration of the behavioral and biomedical techniques relevant to health and illness. • It uses a wide variety of behavioral techniques based on conditioning both classical and operant, and cognitive behavioral therapy.
Editor's Notes
- #13 Self monitoring, stimuli control and self control of internal states
- #14 Tension (psychogenic) headache, Trigeminal neuralgia, Cluster headaches, and migraines. Classic migraine is unilateral, affecting one side of the head, especially over the forehead. In common migraine there is no prodromal phase (no aura), both sides of the head may be affected and GI symptoms such as nausea and vomiting may occur.
- #15 Precipitated by stress, e.g. pressure at work or a family argument. Some migraine sufferers experience their attacks after a period of stress, e.g. when on holiday or at weekends. Certain foods have been reported to precipitate migraine attacks, e.g. chocolate and cheese. Migraine headaches may also be triggered by hormonal changes. In women, migraine attacks may be associated with the menstrual cycle.
- #16 Cognitive Restructuring is a useful tool for understanding and turning around negative thinking. It helps us put unhappy, negative thoughts "under the microscope", challenging them and in many cases rescripting the negative thinking that lies behind them. In doing this, it can help us approach situations in a positive frame of mind.
- #18 EMG = Electromyograph. Biofeedback is the process of gaining greater awareness of many physiological functions primarily using instruments that provide information on the activity of those same systems, with a goal of being able to manipulate them at will. Some of the processes that can be controlled include brainwaves, muscle tone, skin conductance, heart rate and pain perception.
- #19 Sleeping in dark rooms, avoiding TV, and extreme temperatures
- #20 Deep relaxation is a skill that teaches you how to recognize signs of stress in your body and how to reduce them before they reach the level of painful muscles and headache. These techniques work best to prevent headaches. However, they can be helpful if you use them as soon as you notice a headache starting, rather than during a full-blown attack.
- #21 Eg Japanese Prime Minister Nshinzo Abe
- #22 Genetics and epigenetics
- #23 Individuals may begin an exercise program but find it difficult to adhere. Use positive reinforcement, use feedback and social support and focus on identifying the impediments to maintenance of exercise
- #24 Friend or group support and or family Use positive reinforcement, use feedback and social support and focus on identifying the impediments to maintenance of exercise Would you be willing to cut down from 20 to 15 cigarettes a day and make a note of how hard or easy this is for you? That way you will learn more about what will work best when you try to quit completely.
- #25 Some people eat more and more and want to loss more and more Stress make some people to eat more hence weight gain The law of effect says that if some random actions are followed by a pleasurable consequence or reward, such actions are strengthened and will likely occur in the future. Positive reinforcement
- #26 During stress, blood vessels become constricted, lessening the warm blood flow. Biofeedback temperature training helps us improve our body-mind interaction with the goal of increasing our self regulation skill to enable ourselves to affect our stress response, which we can measure as an increase in skin temperature.
- #27 Pts must know the Why, when, how of medication and for what. Patients sometimes have second thoughts about continuing medications after they have been feeling better for a while, particularly if there are some unpleasant side effects.
- #28 And be not conformed to this world: but be ye transformed by the renewing of your mind, that ye may prove what is that good, and acceptable, and perfect, will of God. (Romans 12:2)
- #29 And be not conformed to this world: but be ye transformed by the renewing of your mind, that ye may prove what is that good, and acceptable, and perfect, will of God. (Romans 12:2) The law of effect says that if some random actions are followed by a pleasurable consequence or reward, such actions are strengthened and will likely occur in the future.