Psychophysiological Disorders Thomas G. Bowers, Ph.D

Psychophysiological Disorders

Thomas G. Bowers, Ph.D.

Penn State Harrisburg


• 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


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

• Also tends to be involuntary


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


• New fields developing– Behavioral Medicine– Health Psychology


• Important Concepts

• Stress– Selye (1936)– General adaptation syndrome (GAS)– Described biological adaptation to prolonged

sustained physical stress

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


• Essential hypertension

• systolic/diastolic

• 120/80 mm hg

• Must be elevated over a period of time - Repeated physician visits


• 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


• 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?


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

yields blood pressure decrease


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


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


• 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


• Coronary Heart Disease– Behavioral Factors

• Type A behaviors

• Intense, competitive, driven

• Urgency, aggressiveness, hostility

• Associated with CHD

Asthma

• Tightness in chest, wheezes, coughs, possible panic

• Emotionality often implicated

• Irritants also play an important factor

• Some allergies

• Commonly associated with infections

Psychotherapy for Psychophysiological Disorders

• Progressive relaxation training– May include yoga, mediation and similar

methods

• Biofeedback– Effective, but some evidence of placebo effects

as well


• Behavioral interventions– Weight management– Exercise encouragement– Smoking cessation

• Psychoanalytic methods– Have actually been demonstrated to reduce

blood pressure


• 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

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

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

Documents

Psychophysiological Disorders Thomas G. Bowers, Ph.D