ps440 Unit 5 DP

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450 words, double spaced,

Stress, Health, and Anxiety Disorders

Proceed with this week’s Discussion by locating one credible source to answer the following question.

According to the psychological perspective and research, how can early childhood stressful experiences (e.g., neglect, abuse, or lack of a secure attachment) influence the developmental of behavioral problems?

Next, referring directly to the textbook, briefly explain all three elements of the Integrated model.

Last, select one form of an anxiety disorder and explain how one of the elements of the integrated model can be used to explain the origins of that disorder. Anxiety disorders to choose from include generalized anxiety disorder, panic disorder, social anxiety phobia, specific phobia, separation anxiety disorder, selective mutism, and agoraphobia.

The strongest answer will refer to the textbook and concepts from the Reading material.

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CHAPTER 7 Physical Disorders and Health Psychology Chapter Outline Psychological and Social Factors That Influence Health Health and Health-Related Behavior The Nature of Stress The Physiology of Stress Contributions to the Stress Response Stress, Anxiety, Depression, and Excitement Stress and the Immune Response Psychosocial Effects on Physical Disorders • • • • • • AIDS Cancer Cardiovascular Problems Chronic Pain Chronic Fatigue Syndrome Psychosocial Treatment of Physical Disorders • • • • • • • • • • • Biofeedback Relaxation and Meditation A Comprehensive Stress- and Pain-Reduction Program Drugs and Stress-Reduction Programs Denial as a Means of Coping Modifying Behaviors to Promote Health Abnormal Psychology Live Videos • • • • Social Support/HIV: Orel The Immune System: Effects of Stress and Emotion Cancer: Education and Support Groups Web Link Student Learning Outcomes* Demonstrate knowledge and understanding representing appropriate breadth and depth in selected content areas of psychology: 〉 Biological bases of behavior and mental processes, including physiology, sensation, perception, comparative, motivation, and emotion (APA SLO 1.2.a (3)) (see textbook pages 251–257) Use the concepts, language, and major 〉 Identify antecedents and consequences of theories of the discipline to account for behavior and mental processes (APA SLO psychological phenomena: 1.3.b) (see textbook pages 257–270) Identify appropriate applications of psychology in solving problems, such as: 〉 Origin and treatment of abnormal behavior (APA SLO 4.2.b) (see textbook pages 270–278) *Portions of this chapter cover learning outcomes suggested by the American Psychological Association (2007) in their guidelines for the undergraduate psychology major. Chapter Student Learning Outcomes* coverage of these outcomes is identified by APA Goal and APA Suggested Learning Outcome (SLO). Psychological and Social Factors That Influence Health 〉 What is the difference between behavioral medicine and health psychology? 〉 How are immune system function, stress, and physical disorders related? At the beginning of the 20th century the leading causes of death were from infectious diseases such as influenza, pneumonia, diphtheria, tuberculosis, typhoid fever, measles, and gastrointestinal infections. Since then, the percentage of yearly total deaths from these diseases has been reduced greatly, from 38.9% to 5.5% (Table 7.1). This reduction represents the first revolution in public health that eliminated many infectious diseases and mastered many more. But the enormous success of our healthcare system in reducing mortality from disease has revealed a more complex and challenging problem: At present, some major contributing factors to illness and death in this country are psychological and behavioral. • • In Chapter 2, we described the profound effects of psychological and social factors on brain structure and function. These factors seem to influence neurotransmitter activity, the secretion of neurohormones in the endocrine system, and, at a more fundamental level, gene expression. We have repeatedly looked at the complex interplay of biological, psychological, and social factors in the production and maintenance of psychological disorders. But psychological and social factors are important to a number of additional disorders, including endocrinological disorders such as diabetes, cardiovascular disorders, and disorders of the immune system such as acquired immune deficiency syndrome (AIDS). These and the other disorders discussed in this chapter are clearly physical disorders. They have known (or strongly inferred) physical causes and mostly observable physical pathology (for example, genital herpes, damaged heart muscle, malignant tumors, or measurable hypertension). Contrast this with the somatoform disorders discussed in Chapter 5: In conversion disorders, for example, clients complain of physical damage or disease but show no physical pathology. In the fourth edition, text revision, of the Diagnostic and Statistical Manual (DSM-IV-TR), physical disorders such as hypertension and diabetes are coded separately on Axis III. However, there is a provision for recognizing “psychological factors affecting medical condition.” The study of how psychological and social factors affect physical disorders used to be distinct and somewhat separate from the remainder of psychopathology. Early on, the field was called psychosomatic medicine (Alexander, 1950), which meant that psychological factors affected somatic (physical) function. The label psychophysiological disorders was used to communicate a similar idea. Such terms are less often used today because they are misleading. Describing as psychosomatic a disorder with an obvious physical component gave the impression that psychological (mental) disorders of mood and anxiety did not have a strong biological component. As we now know, this assumption is not viable. Biological, psychological, and social factors are implicated in the cause and maintenance of every disorder, both mental and physical. The contribution of psychosocial factors to the etiology and treatment of physical disorders is widely studied. Some of the discoveries are among the more exciting findings in all of psychology and biology. For example, we described briefly in Chapter 2 that lowering stress levels and having a rich social network of family and friends is associated with better heath, living longer, and less cognitive decline as one ages (Cohen & Janicki-Deverts, 2009). Remember, too, the tragic physical and mental deterioration among elderly people who are removed from social networks of family and friends (Hawkley & Capioppo, 2007). Table 7.1 The 10 Leading Causes of Death in the United States in 1900 and in 2007 (Percentage of Total Deaths) 1900 Percentage 2007 Percentage 1. Pneumonia and influenza 11.8 1. Coronary heart disease 25.4 2. Tuberculosis 11.3 2. Malignant neoplasms (cancer) 23.2 3. Diarrhea, enteritis, and ulceration of the intestines 8.3 3. Stroke and other cerebrovascular diseases 5.6 4. Diseases of the heart 8.0 4. Chronic lower respiratory diseases 5.3 5. Intracranial lesions of vascular origin 6.2 5. Accidents (unintentional injury) 5.1 6. Nephritis (kidney disease) 5.2 6. Alzheimer's disease 3.1 7. Accidents (unintentional injury) 4.2 7. Diabetes mellitus 2.9 8. Cancer and other malignant tumors 3.7 8. Influenza and pneumonia 2.2 9. Senility 2.9 9. Nephritis (kidney disease) 1.9 10. Diphtheria 2.3 10. Septicemia 1.4 Other* 36.1 Other* 23.9 1900 Percentage 2007 Percentage *Includes hemophilia, blood transfusion, perinatal exposure, transmission within health-care settings, and risk not reported or identified. Source: Figures for the world adapted from UNAIDS (2009, November), AIDS epidemic update. Figures for the U.S. adapted from Centers for Disease Control and Prevention (2010), Diagnosis of HIV infection and AIDS in the U.S. and dependent areas, 2008 (HIV Surveillance Report, Volume 20). Health and Health-Related Behavior The shift in focus from infectious disease to psychological factors has been called the second revolution in public health. Two closely related new fields of study have developed. In the first, behavioral medicine(Agras, 1982; Meyers, 1991), knowledge derived from behavioral science is applied to the prevention, diagnosis, and treatment of medical problems. This is an interdisciplinary field in which psychologists, physicians, and other health professionals work closely together to develop new treatments and preventive strategies (Schwartz & Weiss, 1978). A second field, health psychology, is not interdisciplinary, and it is usually considered a subfield of behavioral medicine. Practitioners study psychological factors that are important to the promotion and maintenance of health; they also analyze and recommend improvements in health-care systems and health policy formation within the discipline of psychology (Feuerstein, Labbe, & Kuczmierczyk, 1986; Stone, 1987; Taylor, 2009). Psychological and social factors influence health and physical problems in two distinct ways (▪ Figure 7.1). First, they can affect the basic biological processes that lead to illness and disease. Second, long-standing behavior patterns may put people at risk to develop certain physical disorders. Sometimes both these avenues contribute to the etiology or maintenance of disease (Kiecolt-Glaser & Newton, 2001; Miller & Blackwell, 2006; Schneiderman, 2004; Taylor, Repetti, & Seeman, 1997; Williams, Barefoot, & Schneiderman, 2003). Consider the example of genital herpes. There's a chance that someone you know has genital herpes and hasn't told you about it. It's not difficult to understand why: Genital herpes is an incurable sexually transmitted disease. Estimates indicate that more than 50 million Americans—about 20% of the entire population—have been infected by the herpes simplex virus affecting either oral or genital areas (Brentjens, Yeung-Yue, Lee, & Tyring, 2003). Because the disease is concentrated in young adults, the percentage in that group is much higher. The virus remains dormant until it is reactivated periodically. When it recurs in the genital region, infected individuals usually experience any of a number of symptoms, including pain, itching, vaginal or urethral discharge, and, most commonly, ulcerative lesions (open sores) in the genital area. Lesions recur approximately four times each year but can appear more often. Cases of genital herpes have increased dramatically in recent years, for reasons that are as much psychological and behavioral as biological. Although genital herpes is a biological disease, it spreads rapidly because people choose not to change their behavior by simply using a condom. ▪ Figure 7.1 Psychosocial factors directly affect physical health in two ways. Stress also plays a role in triggering herpes recurrences (Chida & Mao, 2009; Goldmeier, Garvey, & Barton, 2008; Pereira et al., 2003). Stress-control procedures, particularly relaxation, seems to decrease recurrences of genital herpes, and the duration of each episode, most likely through the positive effects of such practices on the immune system (Burnette, Koehn, Kenyon-Jump, Huttun, & Stark, 1991; Pereira et al., 2003). Consider also the tragic example of AIDS. AIDS is a disease of the immune system that is directly affected by stress (Cohen & Herbert, 1996; Kennedy, 2000), so stress may promote the deadly progression of AIDS. This is an example of how psychological factors may directly influence biological processes. We also know that a variety of things we may choose to do put us at risk for AIDS—for example, having unprotected sex or sharing dirty needles. Because there is no medical cure for AIDS yet, our best weapon is large-scale behavior modification to prevent acquisition of the disease. Other behavioral patterns contribute to disease. Fully 50% of deaths from the 10 leading causes of death in the United States can be traced to behaviors common to certain lifestyles (Centers for Disease Control and Prevention [CDC], 2003b; Taylor, 2009). Smoking is the leading preventable cause of death in the United States and has been estimated to cause 20% of all deaths (CDC, 2007). Other unhealthy behaviors include poor eating habits, lack of exercise, and insufficient injury control (not wearing seat belts, for example). These behaviors are grouped under the label lifestyle because they are mostly enduring habits that are an integral part of a person's daily living pattern (Lewis, Statt, & Marcus, 2011; Oyama & Andrasik, 1992). Available evidence suggests that the same kinds of causal factors active in psychological disorders—social, psychological, and biological—play a role in some physical disorders (Mostofsky & Barlow, 2000; Uchino, 2009). But the factor attracting the most attention is stress, particularly the neurobiological components of the stress response. Hans Selye suggested in 1936 that stress contributes to certain physical problems. The Nature of Stress In 1936, a young scientist in Montreal, Canada, named Hans Selye noticed that one group of rats he injected with a certain chemical extract developed ulcers and other physiological problems, including atrophy of immune system tissues. But a control group of rats who received a daily saline (salty water) injection that should not have had any effect developed the same physical problems. Selye pursued this unexpected finding and discovered that the daily injections themselves seemed to be the culprit rather than the injected substance. Furthermore, many types of environmental changes produced the same results. Borrowing a term from engineering, he decided the cause of this nonspecific reaction was stress.As so often happens in science, an accidental or serendipitous observation led to a new area of study, in this case, stress physiology (Selye, 1936). Selye theorized that the body goes through several stages in response to sustained stress. The first phase is a type of alarm response to immediate danger or threat. With continuing stress, we seem to pass into a stage of resistance, in which we mobilize various coping mechanisms to respond to the stress. Finally, if the stress is too intense or lasts too long, we may enter a stage of exhaustion, in which our bodies suffer permanent damage or death (Selye, 1936, 1950). Selye called this sequence the general adaptation syndrome (GAS). behavioral medicine Interdisciplinary approach applying behavioral science to the prevention, diagnosis, and treatment of medical problems. Also known as psychosomatic medicine. health psychology Subfield of behavioral medicine that studies psychological factors important in health promotion and maintenance. The word stress means many things in modern life. In engineering, stress is the strain on a bridge when a heavy truck drives across it; stress is the response of the bridge to the truck's weight. But stress is also a stimulus. The truck is a “stressor” for the bridge, just as being fired from a job or facing a difficult final exam is a stimulus or stressor for a person. These varied meanings can create some confusion, but we concentrate on stress as the physiological response of the individual to a stressor. The Physiology of Stress In Chapter 2, we described the physiological effects of the early stages of stress, noting in particular its activating effect on the sympathetic nervous system, which mobilizes our resources during times of threat or danger by activating internal organs to prepare the body for immediate action, either fight or flight. These changes increase our strength and mental activity. We also noted in Chapter 2 that the activity of the endocrine system increases when we are stressed, primarily through activation of the hypothalamic–pituitary– adrenocortical (HPA) axis (see p. 46 in Chapter 2). Although a variety of neurotransmitters begin flowing in the nervous system, much attention has focused on the endocrine system's neuromodulators or neuropeptides, hormones affecting the nervous system that are secreted by the glands directly into the bloodstream (Chaouloff & Groc, 2010; Owens, Mulchahey, Stout, & Plotsky 1997; Taylor, Maloney, Dearborn & Weiss, 2009). These neuromodulating hormones act much like neurotransmitters in carrying the brain's messages to various parts of the body. One of the neurohormones, corticotropin-releasing factor (CRF), is secreted by the hypothalamus and stimulates the pituitary gland. Farther down the chain of the HPA axis, the pituitary gland (along with the autonomic nervous system) activates the adrenal gland, which secretes, among other things, the hormone cortisol.Because of their close relationship to the stress response, cortisol and other related hormones are known as the stress hormones. Remember that the HPA axis is closely related to the limbic system. The hypothalamus, at the top of the brain stem, is right next to the limbic system, which contains the hippocampus and seems to control our emotional memories. The hippocampus is responsive to cortisol. When stimulated by this hormone during HPA axis activity, the hippocampus helps to turn off the stress response, completing a feedback loop between the limbic system and the various parts of the HPA axis. This loop may be important for a number of reasons. Working with primates, Robert Sapolsky and his colleagues (see, for example, Sapolsky & Meaney, 1986; Sapolsky, 2000a, 2000b, 2007) showed that increased levels of cortisol in response to chronic stress may kill nerve cells in the hippocampus. If hippocampal activity is thus compromised, excessive cortisol is secreted and, over time, the ability to turn off the stress response decreases, which leads to further aging of the hippocampus. These findings indicate that chronic stress leading to chronic secretion of cortisol may have long-lasting effects on physical function, including brain damage. Cell death may, in turn, lead to deficient problem-solving abilities among the aged and, ultimately, dementia. This physiological process may also affect susceptibility to infectious disease and recovery from it in other pathophysiological systems. Sapolsky's work is important because we now know that hippocampal cell death associated with chronic stress and anxiety occurs in humans with, for example, posttraumatic stress disorder (see Chapter 4) and depression (see Chapter 6). The long-term effects of this cell death are not yet known. Contributions to the Stress Response Stress physiology is profoundly influenced by psychological and social factors (Kemeny, 2003; Taylor et al., 2009). This link has been demonstrated by Sapolsky (1990, 2000a, 2000b, 2007). He studied baboons living freely in a national reserve in Kenya because their primary sources of stress, like those of humans, are psychological rather than physical. As with many species, baboons arrange themselves in a social hierarchy with dominant members at the top and submissive members at the bottom. And life is tough at the bottom! The lives of subordinate animals are made difficult (Sapolsky calls it “stressful”) by continual bullying from the dominant animals, and they have less access to food, preferred resting places, and sexual partners. Particularly interesting are Sapolsky's findings on levels of cortisol in the baboons as a function of their social rank in a dominance hierarchy. Baboons at the top of the social hierarchy have a sense of predictability and control that allows them to cope with problems and maintain physical health; baboons at the bottom of the hierarchy suffer the symptoms of stress because they have little control over access to food, resting places, and mates. Remember from our description of the HPA axis that the secretion of cortisol from the adrenal glands is the final step in a cascade of hormone secretion that originates in the limbic system in the brain during periods of stress. The secretion of cortisol contributes to our arousal and mobilization in the short run but, if produced chronically, it can damage the hippocampus. In addition, muscles atrophy, fertility is affected by declining testosterone, hypertension develops in the cardiovascular system, and the immune response is impaired. Sapolsky discovered that dominant males in the baboon hierarchy ordinarily had lower resting levels of cortisol than subordinate males. When an emergency occurred, however, cortisol levels rose more quickly in the dominant males than in the subordinate males. Sapolsky and his colleagues sought the causes of these differences by working backward up the HPA axis. They found an excess secretion of CRF by the hypothalamus in subordinate animals, combined with a diminished sensitivity of the pituitary g ...
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School: Carnegie Mellon University




Stress, Health and Anxiety Disorders
Course Code:

How Early Childhood Stressful Experiences Influence the Development of
Behavioral Problems
Early life stress (ELS) is thought of to contribute to behavioral problems in
adversity. According to research, these problems are said to be influenced by the reduced
development of the brain, as a result of these stresses (Martin, 2015) . The study investigated the
volumes of amygdala and hippocampus in the brains of children exposed to ELS and those not
exposed to the same. In this regard, children that were exposed to different ELS forms such as
neglect, physical abuse, self-esteem issues and the like showed...

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Tutor went the extra mile to help me with this essay. Citations were a bit shaky but I appreciated how well he handled APA styles and how ok he was to change them even though I didnt specify. Got a B+ which is believable and acceptable.

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