Psychophysiological DisordersStress and healthPsychological 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.