Psychological Factors Affecting Physical Conditions

8/2/2019 Psychological Factors Affecting Physical Conditions

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Psychological Factors AffectingPhysical Conditions

Prepared by: Myrna B. Alarcio


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The effect of the psychological on thephysical, prior to the arrival on thephilosophical front of scientific rationalism,

would have been labeled a mind/bodyproblem. Prescientific humanity, led by theirphilosophers and religious leaders, consideredmind and body to be independent entities.

The dichotomy between the mind and bodywere elaborated by the philosophy of ThomasAquinas, Platos rabble of the senses,Berkeleys Mentalism, and Ren Descartes

DualismGalileo and Newton provided the kind of early

scientific thinking that brought medicine andpsychology to their modern interpretation of

min/body relationships the mind and bodyfunction as a unit.


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Interactions BetweenPsychological and PhysicalFunctioning

In1883, the publication of Kraeplins textbook on

psychiatry gave recognition of the influence of somatic(bodily) changes on mental activities.

the acceptance of influence in the opposite direction thatis, the mind influencing physical disease was a muchlater concept.

in the 1960s, a much broadened way of thinkingdeveloped about the influence of psychic factors on bodilyprocesses.

Physiological psychologists, aided by the development of

sensitive electronic instruments that could measurephysiological responses, (e.g. blood pressure, pulse rate,and bodily temperature) demonstrated that thoseresponses, once thought to be involuntary, could bebrought under voluntary control.

In 1991, studies conducted in Pittsburgh and in Salisbury,England, led to the conclusion that high levels of


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Models of Psychological-PhysicalInteraction

Diathesis-Stress Model

- states that human disorders, both physicaland mental, result from the presence of adiathesis, or vulnerability, may result from

genetics for example, schizophrenia) or fromearlier physical disease (e.g. whooping cough ininfancy).

- that predisposition is provoked by a

stressor; that is, a disturbing bodily invader, inthe case of a physical disorder, or a disturbingearly life emotional experience, in the case of apsychological disorder (e.g. psychophysiologicaldisorders, defined as disorders in whichpsychological events , such as cognitions and


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The General Adaptation Syndrome

- describes the sequential way which the

individual psychologically and physically responds tostressful events. Selye identifies 3 stages of theorganisms response to a stressor event:

alarm phase arouses the individuals defenses

resistance stage all the resources of theindividual are employed defensively

stage of collapse decompensation, thetensions produced by the stressor cannot be

reduced, and there is a likelihood that those tensionswill now combine with a vulnerability in the body,and a psychophysiological disorder will develop

- once developed, the disorder may remain as a

lifetime weakness of the individual that flares up


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3/5/12Psychoneuroimmunology

- The study of how psychological factors affect thenervous systems role in the immune response

- Research unmistakably indicates thatpsychological factors directly affect healththrough changes in the immune system

- negative mood, hostility, and interpersonalconflict are associated with declines in immunesystem functioning, while positive mood,optimism, and social support are associated withincreases in immune system functioning


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The Role of Stress inPsychophysiological Disorders

Autonomic Reactions and Stress

- Walter Cannon postulated that in order tosurvive, our primitive ancestors had need ofbodily reactions that would respond their life-

and-death struggle (fight-or-flight pattern) andidentified the autonomic nervous system as themechanism that prepared the individual tomake either of those responses.

- the autonomic system responds to externalevents that threaten the individual by initiatinga whole series of physiological changes


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The Immune System

- The bodys alarm reaction, in itself, does

not cause infection or disease, but over time itreduces the bodys defenses by impairing thefunctioning of the immune system.

Physical Effects of PsychologicalStressors

- one explanation of the way in whichpsychological tensions cause or contribute to

the development of physical disease is thatsome physiological changes of thepsychologically intense alarm reaction mayimpair the effective working of the immune

system.


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Mediating Influences on the Effects ofStressors

Lifestyle

- Aspects of how one chooses to live ones life havebeen related to the development of psychophysiologicalillnesses. People differ in what they eat, how much theyeat, and in their manner of eating. Powerfully,

Explanatory Style

- people differ in the way in which they lifes eventsexplain in and what they expect from life. It has beensorted out by 2 principal types: pessimistic andoptimistic.


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Personality Traits

Hardiness, in a study of a group of executives ofhigh-stress jobs found the 3 aspects of the traitidentified stress-resistance individuals, thosewhom stress produced minimal health changes:openness to change, a sense of involvement or

commitment to their jobs; and feelings of being incontrol of their lives.

Hopelessness, has been studied extensively as a

factor in vulnerability to illness. The persistenceand severity of diseases as different as cancerand influenza have been related to depression orfeelings of hopelessness.


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Psychological Factors in SpecificPhysical Disorders

Coronary Disease

Friedman and Rosenman described Type Apersonalities as aggressive, competitive, hostile,feeling pressured by time, and always striving to

succeed.

However, Type B individuals as relaxed andopposite in many ways to Type B. personalities.Diagnoses of the personality types are madeeither on the basis of a stress-type interview or bya self-administered questionnaire.

Two levels of research have been directed at theType A concept: prospective studies that predictrisk of heart attack from a personality assessment

and research that attempts to pinpoint what it isin a Type A personality that increases risk of


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Predicting Coronary Heart Disease fromPersonality Assessments

The Western Collaborative Study

Researchers tested first for personality type,and then followed 3,200 males and monitored their

medical status for the next 8 years. They found thatmen with Type A personalities had more than twice asmany heart attacks as did those men who had been

judged to be Type B.

The Framingham-Massachusetts Study

Researchers studied a population of 1,600 menand women white-collar workers, who had beenclassified as Types A or B. They found 3 times as manycases of coronary heart disease among Type A menand 2 times as many among Type A women thanamong Type B men and women.


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o Characteristics of the Type A Personalitythat Cause Coronary Heart Disease

Hostility

Several researchers have followed a leadprovided in the writings of the psychoanalyticallyoriented Franz Alexander, who related high bloodpressure to the way in which individuals dealt with theiraggression. They found that when hostility was felt butnot expressed overtly, the frequent results was highblood pressure, inhibited hostility and a Type Apersonality.

Chronic Negative Emotion

Other research has indicated that negativeemotions such as anxiety and depression, not justanger, are the link between Type A personality and heartdisease.


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o Essential Hypertension

- Medical findings indicate that in 90 to 95percent of hypertensive patients, there is nopreexisting physical cause. Thus, almost allpatients with high blood pressure are diagnosedwith essential hypertension.

- essential means the absence of knownphysical causes

- This is not to say, however, that there is anabsence of physical correlates of high bloodpressure.

- The first advice of a doctor to anoverweight patient with high blood pressureis, Lose some weight or Let me suggesta diet.

- Even ranted the resence of otentiall


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Suppressed Rage

Anger is a strong emotion. Its immediate effectson the body are, in time, usually reduced by its

open expression, assuming there is no physicalviolence against others that may produce othernegative results.

A study by Esler and others reports that

individuals with hypertension who also exhibitsigns of suppressed hostility frequently havepersonalities that are overly submissive, overlycontrolled, and guilt-laden.

Social Support and Negative Emotion

Research has found strong links between a alackof social support, loneliness, depression, andother negative emotions and hypertension.

It is theorized that negative emotions might be

responsible for the relationship between socialsu ort and h ertension. That is low levels of


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o Cancer

The possibility of a relationship in cancer is mostoften greeted with skepticism.

This results from the concrete nature of cancersphysical growth, increasing in size each day, orspreading in minute cells that travel throughoutthe body.

Another factor may be the well-known emphasismedical science gives to biological treatment andits effectiveness in many cases.

When we think of cancer, we think immediately ofradiation, chemotherapy, or even surgery.

We do not often consider the influence ofpsychotherapy, although it can indeed be helpfulin dealing with the knowledge that one hascancer.


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Emotional Inhibition

In 1946, Thomas administered a series ofpersonality tests to a group of medical students.

By 1977, 48 of her subjects had developedcancer. Comparing their personality profiles withthose participants who had not developed cancer,she noted strong tendencies to repress intenseemotions in cancer patients.

She described them as having emotionallyinhibited personalities.

Rogentine and others reported that those cancerpatients who freely expressed negative emotionsabout the illness were more likely to survive thanthose who were emotionally restrained.

Later research indicated that cancer patients whoreceived group psychotherapy lived longer than

those receiving similar care but withoutpsychotherapy.


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Hopelessness in Cancer

subsequent research has focused onhopelessness as a factor in development of

cancer. 51 women who entered a clinic for acancer test were interviewed after medical examshad revealed suspicious in the cervix that had tobe investigated further before a diagnosis ofcancer could be made.

It revealed that 18 of them had sufferedsignificant losses in the preceding 6 months, towhich the interview further revealed, they hadresponded with feelings of hopelessness and aresultant sense of helplessness. Of the 18, 11 had

cancer diagnosis. Among the other 33, with nosuch preceding life experiences reported, only 8had cancer.

Other research with different types of cancer has

confirmed those earlier findings. One studyreported that upon the news of a cancer


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Overview on Causative Factors inPsychologically Affected PhysicalDisorders

The Biogenic Perspective

2 principal emphases: genetic influences andinvolvement of the bodys immune system

Current focus: diathesis-stress model, as a way ofthinking about the interaction between physicaland psychological factors.

Genetics

Family studies, twin studies, and animal breedingresearch lend strong support to the presence ofgenetic factors in psychosomatic disorders (e.g.hypertension, heart disease, cancer)

Genetic hypothesizing has suggested the somatic

weakness theory: genetic factors may create


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o Immune System

Defends the body against disease-causing foreignagents.

Much evidence from animal laboratoriesdemostrates that in animals such psychologicaltensions as, for example, those created by a

condition of helplessness, reduce itseffectiveness.

In that way, the bodys vulnerability to physicaldisease is increased.

Recent research is beginning to suggest thatpositive emotions has a boosting effect on theimmune system.


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The Psychodynamic Perspective

Today, the psychodynamic theorist attributespsychosomatic illness to some aspect of a

disturbed parent-child relationship, the samepattern that underlies other anxiety-baseddisorders.

Migraine patients were thought to be hard-

working, conscientious, or perfectionist whilehypertensive patients are believed to be covertlyangry.

Research failed to support them since individualswith those psychosomatic ailments could not be

grouped into similar personality types.

Their personalities were widely heterogeneous.Nevertheless, the relationship between the Type Apersonality and risk of heart attack, which fits theearlier psychodynamic conceptualization,suggests the possibility that there may yet be


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The Behavioral Perspective

Until recently, the rationale for consideringpsychosomatic symptoms to be the result of

conditioning, either respondent or operant, wasdifficult to establish. For one thing, autonomicresponses were considered to beyond voluntarycontrol. They, therefore, would not respond tooperant conditioning. Second to hypothesize

respondent conditioning as the cause of theillness would require frequent associationsbetween a neutral stimulus to be conditioned andsome unconditioned stimulus known to producethe response reflexively.

Behavioral scientists were able to condition asuppression of the immune system. While notunder conscious control, it is now understood thatlearning can result in decrease in immunefunctioning (e.g. the condition of learnedhelplessness).


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The Cognitive Perspective

Attempts at understanding differences in survivalrates of individuals who are HIV positive hasresulted in investigating coping styles.

Research indicates that using meaning-focused

coping results in positive cognitions and increasedsurvival rates.

That is, individuals who are HIV positive, butchoose to focus on obtaining goals, createmeaning in light of difficult experiences, and

acknowledge even small positive experiences livelonger than those who do not engage in suchtypes of cognitions.


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Treatment Approaches to PhysicalDiseases Affected by PsychologicalFactorsBiofeedback

Behavior Modification


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Relaxation Therapy

Psychosocial Support Groups

Documents

Psychological Factors Affecting Physical Conditions