Psychophysiological Disorders

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Psychophysiological Disorders

• Thomas G. Bowers, Ph.D.
• Penn State Harrisburg

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Psychophysiological Disorders

• Relatively new field of health psychology
• Refers to physical symptoms or diseases that are
  caused by or worsen by psychological factors
• Formally referred to as psychosomatic disorders

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Psychophysiological Disorders

• In contrast to hypochrondrical and conversion
  disorders, there is often physiological damage to
  the body
• Also tends to be involuntary

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Psychophysiological Disorders

• Some examples
• 1. Asthma
• 2. Hypertension
• 3. Gastritis
• 4. Irritable bowel syndrome
• 5. Headaches

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Psychophysiological Disorders

• New fields developing
• Behavioral Medicine
• Health Psychology

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Psychophysiological Disorders

• Important Concepts
• Stress
• Selye (1936)
• General adaptation syndrome (GAS)
• Described biological adaptation to prolonged
  sustained physical stress

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Cardiovascular Disorders

• Frequent source of morbidity and mortality
• Essential hypertension
• High blood pressure
• 90 is essential
• Not attributable to physical cause
• Many are unaware of the difficulty

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Cardiovascular Disorders

• Essential hypertension
• systolic/diastolic
• 120/80 mm hg
• Must be elevated over a period of time - Repeated
  physician visits

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Cardiovascular Disorders

• Essential hypertension
• Associated with renal failure, increased risk of
  stroke, artherosclerosis, myocardial infarction
  (heart attack)
• Could be triggered by chronic restriction of
  renal blood flow, calcification of arteries,
  inelasticity of vascular system

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Cardiovascular Disorders

• Flight or fight response to adrenal stimulation
• Rapid, but brief increase in respiration, heart
  rate, increased blood supply to extremities,
  reduced blood supply to torso.
• Blood pressure temporarily increases
• Why does this increase become permanent?

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Cardiovascular Disorders

• Stress - Unexpressed Hostility Link
• Hokanson and associates
• Frustration has blood pressure increase
• Opportunity to express aggression or anger yields
  blood pressure decrease

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Cardiovascular Disorders

• Risk Factors
• Diatheses models
• Isolation is a risk factor
• Sensitivity to salt
• Family history
• Lack of exercise
• Smoking
• Obesity

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Cardiovascular Disorders

• Coronary Heart Disease
• 1. Angina pectoris - periodic chest pains
• 2. Myocardial infarction - heart attack

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Cardiovascular Disorders

• Coronary Heart Disease
• Risk factors
• 1. Age
• 2. Sex (males higher risk)
• 3. Cigarette use
• 4. Hypertension
• 5. Serum cholesterol
• 6. EKG abnormalities
• 7. Diabetes

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Cardiovascular Disorders

• Coronary Heart Disease
• Behavioral Factors
• Type A behaviors
• Intense, competitive, driven
• Urgency, aggressiveness, hostility
• Associated with CHD

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Asthma

• Tightness in chest, wheezes, coughs, possible
  panic
• Emotionality often implicated
• Irritants also play an important factor
• Some allergies
• Commonly associated with infections

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Psychotherapy for Psychophysiological Disorders

• Progressive relaxation training
• May include yoga, mediation and similar methods
• Biofeedback
• Effective, but some evidence of placebo effects
  as well

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Psychotherapy for Psychophysiological Disorders

• Behavioral interventions
• Weight management
• Exercise encouragement
• Smoking cessation
• Psychoanalytic methods
• Have actually been demonstrated to reduce blood
  pressure

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Psychotherapy for Psychophysiological Disorders

• Cognitive therapies
• Not as thoroughly researched to date
• Some data suggests affective expression, managing
  thoughts and so on are helpful
• Management of Type A behavior
• Stress Management
• Also includes social skill training
• Environmental changes

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Medical Conditions Affected By Psychological
Factors

• Many complex, difficult to treat disorders
• Includes diabetes, hypertension, renal disease,
  many neurological disorders
• Psychoneuroimmunology
• Positive spirit and outlook associated with
  survival
• Uncertain why this may be the case

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Medical Conditions Affected By Psychological
Factors

• Breast cancer
• Remarkably high incidence in western societies
• Early detection is very important
• Text describes breast self exam method fairly well