Psychophysiological Disorders Stress and health Psychological Factors Affecting Medical Condition (V coded on Axis I) Behavioral medicine and health psychology
Psychosomatic or somatopsychic? • Western cultures have tended to offer psychosomatic explanations of certain illnesses. • Asian cultures have often offered somatopsychic explanations. • Perhaps as a result, Americans may be more reluctant to report physical symptoms than are Japanese or Koreans.
Psychophysiological Disorders and DSM-IV • Listed in “Other conditions” on Axis I: Not a mental disorder • Diagnosis is Psychological Factors Affecting Medical Condition • Remember that Axis III, General Medical Conditions, may impinge on any DSM-IV diagnosis. • Medical conditions have psychological consequences
Psychological Factors Affecting Physical Condition • Mental disorder • Psychological symptoms • Personality traits or coping style • Maladaptive health behaviors • Stress-related physiological response • Which is it? The Hmong sudden-death syndrome (Sudden Unexplained Nocturnal Death Syndrome, or SUNDS)
The culprit: Stress • Stress apparently exacerbates many medical conditions • On the other hand, good attitudes may prevent or help heal diseases • Lazarus (1966) and the subjectivity of stress definition • Coping strategies • Problem-focussed coping: Action • Emotion-focussed coping: Distraction
How do you cope? • Stressor : An upcoming Abnormal Psychology exam • Follow a careful study plan • Complain about the teacher expecting too much work • Escape/avoid studying by going for pizza • Focus attention on another course
Coping scales on COPE • Active coping: I’m concentrating on preparing for the exam • Suppress competing activities: I’m ignoring soc and bio for now • Planning: I’m trying to figure out a study schedule • Restraint: I’m holding off on studying so I don’t peak too soon • Social support: My friends agree that Young is a stinker.
More coping strategies from COPE • Positive reframing: Failure is an important learning opportunity • Religion: God loves me even if I fail. • Acceptance: Que sera, sera. • Denial: Abnormal just isn’t important. • Behavioral disengagement: Why bother? I don’t care if I pass or not. • Humor : To do well would be abnormal. • Self-distraction: Pizza and a movie will get it off my mind.
Theories of stress and illness • Somatic weakness • Specific reaction pattern (ANS) • Anger-in theory: Alexander (1950) • Cognitive appraisal patterns • Hostility and anger • Cognitive: Beliefs • Affective: Impatience • Volitional: Choices to act • Correlational research: What causes what?
Treatments • Pharmacology • Biofeedback • Behavior change, eg diet • Relaxation training • Cognitive restructuring • Stress management • Relaxation training, cognitive restructuring, plus behavior skills training and environmental changes: Social support.