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82 Cards in this Set
- Front
- Back
Voodoo Death
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May die as consequence of learning you are cursed.
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Psychophysiological
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Identifiable disturbances (lesions) in body structures and functions and are not feigned. Requires dualist view of mind and body as separate entities subject to different flaws.
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Engel
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Biopsychosocial, psych characteristics and societal forces must be invoked to explain many diseases.
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Behavioural Therapy
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Behaviours may increase risk of disease, control these behaviours.
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Behavioural Medicine
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Behaviour modification to treatment of disease.
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Health Psychology
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Any application of psychological methods and theories to understand origins of disease, responses to disease and determinants of good health.
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Psychological Factor Affecting Medical Condition (ICD Axis 1)
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1. Correlated with development of, exacerbation of, or delayed recovery from medical condition.
2. Interfere with treatment 3. Risk to their health 4. Precipitate symptoms of conditions * Particular psych factor should be specified (Could be axis I and II or not meet threshold for diagnosis) |
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Mechanism
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Defined by symptoms (subjective reports of internal states) One of principle determinants of illness is disease
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Disease
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Marked by signs, objective indications of an underlying disease process, observable either directly or indirectly by a test.
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Lesions
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Specific disturbances of bodily tissue.
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Symptoms
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Can be influenced by other factors that influence perception. May influence perception of attention to or tolerance of bodily signals.
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Behaviour
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Discrete and potentially observable act.
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Psychological Process
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Is not observable directly but may be interfered reasonable on basis of phenomena that are.
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Behaviours that Promote Disease
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Expose body tissue to pathogenic substances.
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Psychological Variables
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Perceptual schemata and emotions as influences of body tissues can be consequence of psychological process.
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Body Systems Responsive to Psych Variables
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Endocrine System
Autonomic System Immune System |
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Endocrine System
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- Organs that manufacture hormones
- Secrete into bloodstream - Hormones cause certain changes |
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Hypothalamic-Pituitary-Adrenal Axis (Endocrine)
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Hypothalamus responsive to psychological influence, when activated can cause pituitary to secrete ACTH, when tissues stimulated they secrete cortisol.
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Cortisol
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Hormone. suppresses inflammation, mobilizes glucose from liver, high cardio tone, produces immune system changes and inhibits other endocrine structures.
- Promotes survival - Maladaptive when prolonged/exaggerated |
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Autonomic Nervous System
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Little awareness or direct control
- Sympathetic - Parasympathetic |
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Sympathetic NS
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Emanate from middle regions of spinal cord. Prepares for action
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Parasympathetic NS
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End regions of spine. Applies the breaks.
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Immune System
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Defend body against antigens (internal pathogens) or external disease causing forces.
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Nonspecific Immune Responses
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Granulocytes and monocytes identify invading antigens and destroy them by engulfing and digesting (phagocytosis).
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Cellular Immunity
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Based on T-lymphocytes antigen presented to T-lymphs by macrophages which causes T-cells to proliferate (reproduce) and circulate.
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Helper T Cells
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Secrete lymphokines, control responses of other types of T cells.
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Killer (K) T Cells
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Attack foreign or mutated cells directly.
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Memory T Cells
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Stored in body in anticipation of next time it needs "building up immunity"
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Humoral Immunity
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Antigens presented by macrophages to B-lymphocytes . B-cells reproduce (reinforced by lymphokine secretion from helper T cells).
- Some remain as memory B-cells. - Others become plasma cells, secreting antibodies called immunoglobulins that neutralize antigens by clumping, rupturing or presenting them to phagocytic cells. |
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Psychoneuroimmunology
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Study of mind-brain-immune system interactions.
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3 Pathways Psychosocial Variables can Influence Immune Activity
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1. Direct action of CNS on organs and structures of immune system
2. Secondary consequence of hormonal changes 3. Changes in behaviour that reflect personal characteristics/adaptations to changing life conditions |
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Downregulation
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Reduced effectiveness of immune system (may be due to high levels epinephrine, norepinephrine and ACTH).
- Can cause long term health consequences |
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Selye Phases of General Adaptation Syndrome
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Adaptation to demands placed on body is reason for stress (first def of stress)
1. Alarm: mobilizes defences if challenge persists 2. Resistance: Actively cope with challenge through immune and neuroendocrine changes of continues 3. Exhaustion: Energy is depleted. Succumb to disease. |
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Stressor
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Event that can bring about the characteristic set of changes
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Transactional Model
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Stress as property of neither stimulus or response but ongoing series of transactions between the individual and their environment.
- People constantly evaluate what is happening to them |
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Appraisals
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Evaluations, appraisal of threat.
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Primary Appraisal
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Sets stage for further events that may or may not lead to stress. "Is it a threat to me?"
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Secondary Appraisal
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"Can I do anything?" If feel helpless, increased stress.
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Problem Focused Coping
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Identify and rectify threat
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Emotion Focused Coping
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Diverting thoughts or activities (drugs)
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Appraisal Focused Coping
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What you can do to change way you think about situation.
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Variables that can Play Mediating Roles
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1. Social Status
2. Controllability 3. Social Support |
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Social Status
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Relative position in social hierarchy , top people live longer. May effect longevity through some stress related physiological effects which it correlates.
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Controllability
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Internal locus of control (see as masters of own destiny) external locus of control (buffeted by random events of the world).
- Internal locus protects against harmful effects of stress on health. |
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High Strain Jobs
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High demands with low control, increase risk of morbidity and mortality due to cardio disease.
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Social Support
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Extent to which an individual feels connected to other people in meaningful ways.
- Less deaths in those with many social affiliations, especially in men. |
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Social Support Benefits Comparable to...
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magnitude of harmful effects of smoking.
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Absence of Social Support
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Seems to make existing disease worse
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Main Stressor that predicted Cold Symtpoms
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Long standing difficulties associated with work and with interpersonal relationships were main stressors.
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Ulcers
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Erosion of lining of stomach, caused (at least in part) by bacterium.
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3 Causes of ulcers (Only seen in animals)
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- Brain regulated stomach, in stress induced sympathetic arousal, blood flow diverted away from stomach lining.
- Hyper-secretion of digestive acid because psych stress - Slow rhythmic contractions differ from frequent contractions in feeding cycle. |
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Weiss and Predictability of Stress
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More ulcers in rats who couldn't predict shock
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Weiss and controllability
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Shocked rates that couldn't control showed most ulcers.
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Diathesis-Stress
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Adhesion of H.Pylori more than doubled in saliva samples taken during stress exposure.
- Stressful conditions may play a role in effectiveness in the bacteria that can cause ulcers. |
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Ischemic Heart Disease
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Blood supply to brain interrupted leading to myocardial infarction.
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Vasculature
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Network of arteries, arterioles, capillaries, venules and veins.
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Lumen
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Opening of blood vessels
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Systole
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Left ventricle pumping blood into major arteries
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Diastole
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Pump at rest
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Cardiac Output
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Amount of blood pumped by heart.
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Total Peripheral Resistance
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Diameter of blood vessels
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Blood pressure
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Consequence of cardiac output and total peripheral resistance.
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Arrhythmias
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Disturbances in normal pumping rhythm of heart
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Artherosclerosis
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Buildup of deposits (plaque) on walls of blood vessels. Narrows arteries.
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Controllable Risk Factor
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High blood pressure and smoking
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Protective Factor
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Exercise, prevents artherosclerotic buildup.
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Hypertension
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high level of resting bp
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Stress Reactivity Pradigm
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Many cardio functions responsive to changing psych conditions.
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Cardiovascular Reactivity
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Increase in risk for cardio disease, how much individuals cardio function changes in response to psych stimulus.
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Osler's Type A Personality
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Heart attacks associated with a particular type of personality. Twice as likely to die from heart disease. Hostility
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Hostility
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- Affect (respond with anger and contempt)
- Cog/attitudinal (cynical view of others) - Behavioural (aggressiveness and antagonism) |
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Psychophysiological Reactivity Model
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Hostile people at risk because exaggerated physical reaction during stress.
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Psychosocial Vulnerability Model
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Demanding life causes higher risk
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Transaction Model
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Create bad environment increase vulnerability.
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Health Behaviour Model
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More likely to engage in unhealthy behaviour
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Constitutional Vulnerability
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Link between hostility and poor health as result of 3rd variable
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Depression and Heart Attacks
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- May be severity of cardio disease that leads to depression
- Toxic effects of antidepressants - Depression may be related to smoking or high bp - Depression may effect extent people follow treatment - Inflammatory mechanisms - Alterations in autonomic and neuroendocrine regulation of heart associated with depression |
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Risk Factors for Heart Attacks That Impact Most
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- High blood lipids
- Smoking - Psychosocial |
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2 Classes of Intervention
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1. Management of stress and related problems
2. Interventions directed toward specific psychosocial variables |
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Generic Stress Management
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Address either physiological arousal resposnse or behaviours and thought processes believed to play a role eliciting arousal.
-Relaxation Training. |
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Cognitive Behavioural Treatment
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Identify thinking types that promote stress. New ways of thinking and counteract stress.
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Recurrent Coronary Prevention Project
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Two assignments of conditions. Standard counselling and type A counselling.
- Emphasize and encourage social support - Develop new ways of appraising and coping - Emotional communication - New ways of interacting with others |