psy

Rates of obesity and diabetes in the U.S.

1 in 3 kids will develop type 2 diabetes, 10% of adults have type 2 diabetes, and more than 1/3 of adults have prediabetes.

Be familiar with the risk factors for motor vehicle accident death

more than 32,000 Americans died from motor vehicle related injuries and 2 million were injured in 2013, they account for the greatest number of all injury deaths. Risk factors for MVA death- no seat belts, carseats or boosters, drunk driving, speeding, distracted driving. 16% of all mva crashes in the us involved a distracted driver. Drivers under thirty have the highest portion.

Sociocultural factors that contribute to obesity

people eat more when with others, culture influences foods and tastes, oversized portions, lack of healthy foods, food advertising.

Mood regulation is another theory of what contributes to obesity

people eat to make themselves feel better as a way to deal with anxiety or depression more common in women, but mixed evidence in research = stress does not lead everyone to overeat

Internal-external hypothesis on causes of obesity

people ignore internal cues like hunger and satiety and pay attention to external cues like taste smell etc. Research shows little support for this theory though, people of 'normal weight' (whatever the **** that is) are not particularly good at interpreting internal signals for hunger etc.

Understand quality vs. intensity of pain

quality- dull vs sharp or constant vs throbbing. Intensity- how much pain on a scale of 1-10

Know the difference between pain threshold and tolerance

threshold is the point at which a stimulus is first perceived as painful. Physiologically determined. Tolerance is the point at which a person can't stand anymore pain. Influenced by attitudes and motivations

Restraint theory is a theory for why people overeat/are obese

when people are trying to lose weight, they ignore internal signals and use cognitive rules to limit their intake (ie. I can't eat ice cream ever)

Know about the physical and psychological consequences of binge drinking and alcohol abuse

• Effects on neuropsychological functioning (e.g., memory loss, disorientation) • Promotes formation of fat deposits on .... heart muscle • Liver damage • Increased risk of cancers of the mouth, esophagus, liver, and breast. • Fetal alcohol syndrome ( Birth Defects ) • Decreased estrogen levels, menstrual disturbances, and increased risk of miscarriages in women • Decreased testosterone levels, impotence, and lowered fertility in men

Understand the details of the different losses of serious illness

1. Threats to self-image- Disfigurement from cancer (e.g. mastectomy) burns, amputations. View of self as weak and incompetent. Stigma 2. Loss of body integrity- Shock, disowning, and denial. Initial reaction of dissociation "Not my body". Integration (adjusting to altered body image) takes time 3. Threats to cognitive functioning- Strokes, asthma, high BP, diabetes can be assoc. with decrease in cognitive functioning Ex Disorientation in the ICU/CCU ("cardiac delirium") 4. Loss of independence- Reliance on others for basic needs and daily care. Can lead to depression. Financially dependent on others. Working to resist becoming totally dependent is the best adjustment. Loosing independence 5. Strained relationships- Hospitalization/treatments involves separation. Stress on loved ones. Loss of role in family 6. Interruption or change of occupation: School or career on hold. Identity assoc. with work or school. Adjustment possible à different job with same company 7. Threatened future: Long range and short-term goals. Finding meaning in life and living fully with what you have Know how family members are involved in the early stages for a patient with a serious illness (i.e., in the CCU/ICU)

Be familiar with the variation in suicide risk across different demographic groups

10th overall leading cause of death in the United States, with more than 41,000 suicides occurring in the US (2013) Risk varies- Age: 12-24, 25-34 (2nd leading cause of death) Gender- Women have more suicidal thoughts and more likely to attempt and men 4x more likely to die from suicide. Populations at risk-American Indian/Alaskan natives, rural populations

Be familiar with the rates of childhood obesity

33% of children are overweight, and 17% of children are obese in the U.S. 1 in 3 kids in the US will develop type 2 diabetes

What percentage of the U.S. is overweight/obese

73.65 of the adult population is overweight and 42% of the adult population is obese.

What is pain

A combination of emotional and sensory discomfort. Can range from mild discomfort to acute unbearable agony. Associated with actual or potential tissue damage. A subjective experience

Know about active versus passive strategies for preventing injuries

Active vs. Passive strategies- An airbag (passive), is there until it is needed, whereas drivers and passengers must remember and be willing to put on seat belts (active) passive are more successful than active in preventing unintentional injuries. Why? No thought process behind it- its automatic

Know the stages of serious illness

Acute- survival is primary to focus, Rehab- goal is recovery to highest level of health and functioning, adjustment to limitations, Chronic condition- Goal is long-term coping with limitations, Terminal phase- illness have progressed to the point were cure is impossible

Genetic contributions to Obesity

Adopted twins are more similar to biological parents, twins weights correlated even though apart, genetic factors predict 40-70% of BMI, genes influence how and how much people eat, and metabolism. Complex interaction among genes and environmental factors.

Recommended physical activity amount for a week

Adults 150 min of moderate intensity activity or 75 minutes of vigorous activity a week, r a combo of both along with 2 days of strength training weekly.

Chronic pain and the types

All types last more than 6 months, and can have devastating physical and emotional effects. Costs greater than $500 billion a year. Common types of chronic pain are chronic benign- unresponsive to treatment (e.g. low back pain) Recurrent acute- intermittent episodes of pain (e.g. migraines) Chronic progressive- increases in severity overtime (e.g. cancer pain) Phantom limb pain is another example of chronic pain

Understand the rates of chronic illness in adults and children

As many as 1 in 2 Americans have a chronic condition. About 18% of children have a chronic illness/condition.

Bulimia nervosa, definition, health consequences, and treatment

At least two bulimic (binge-purge) episodes a week for at least 3 months. lack of control over eating. Health consequences- electrolyte imbalance, tooth decay, inflammation of the esophagus. Risk factors for bulimia- High cortisol levels (stress hormone), family issues, low self-esteem, impulsivity, depressed, family dynamics. Treatment- encouragement of the value of treatment, cognitive-behavioral approaches

Know about the Jill Bolte Taylor TED talk shown in class

Blood vessel in left half exploded, brain deteriorated in ability to process jnfo walk talk read write or recall any of life infant in a women's body. Pain behind left Eye couldn't speak or understand language 1. 8 years to recover gold ball sized hemorrhage pressing on her language centers and lost her left hemisphere talking writing walking language etc 2. We can choose moment by moment who we are and can find inner peace. You know choosing how we want to live in the left hemisphere here I am as an individual as here I am in the right hemisphere connecting with individuals found peace in right hemisphere. 'Lala land' peaceful one with everyone connected peace in right hemisphere

Alcohol Use Disorder

DSM-V anyone meeting any 2 of the 11 criteria a diagnoses of AUD mild moderate or severe: - Physical and psychological addiction/cravings -effects on other aspects of life (work, school, social, physical, interpersonal problems, etc.) - tolerance -withdrawal symptoms (nausea, sweating, shaking)

Poor diet consequences

Diets high in cholesterol lead to Atherosclerosis and coronary artery disease. Diets high in saturated fats increase risk of heart disease. Diets high in sodium affect blood pressure and cardiovascular disease.

Understand the concept of relapse

Fall back to previous behavior after successfully changing the behavior. Alcoholism and smoking have relapse rates of 50% and higher. Relapses tend to occur during periods of high stress and people and palces associated with the behavior. Lapse is just like one slip relapse is returning to bad habit for an extended period of time.

Normalizing

Hiding symptoms so as to appear like everyone else, trying to maintain a normal routine. Helps counteract.. identity spread

Know the difference between intentional and unintentional injury

Injuries result from events that can be predicted and prevented rather than accidents. 2.5 million people were hospitalized due to injuries in 2014. 26.9 million people were treated in an emergency department for injuries in 2014 an d$671 billion in med care costs 2013. Unintentional injuries are the leading cause of death in every age group from 1 and 44, whereas in the older groups it doesn't rank quite as high. Malignant neoplasms and heart disease are leading for 44 + motor vehicle accidents, falls, poisoning. Intentional injuries are like suicide and homicide.

Acute pain

Lasts less than 6 months, common types of acute pain are broken bones and a wound, can cause anxiety and distress but these should go away when pain resolves.

Describe the aspects of the emotional challenges of serious illness

Maintaining identity- Integrating past, present, and future self. Maintain relationships with others that make you feel valued and loved. Stay emotionally healthy- Avoid repression of emotion. Developing anxiety or depression possible. Explaining illness or injury (personal beliefs)-Understanding the unanswerable "why did this happen to me?" Struggling with self-blame. As many as half of cancer patients blame themselves. Dealing with stressful medical experiences-Hospitalization ( depersonalization ) Medical treatments ( can cause nausea, vomiting, pain )Communicating with medical professionals ( information giving and receiving ). Dealing with pain and possibility of death- Anxiety-provoking, fear of unknown, worry about family. Psychological Interventions- Patient education, Relaxation training, Stress management, Exercise, Social support/family support, Support groups, Therapy including music or art therapy, Giving information about what to expect

Problem drinking

May not experience withdrawal but still have social, psychological, and health problems due to drinking

Understand the advantages of optimism and benefit-finding

Optimism and benefit-finding- Optimism and benefit-finding associated with, Better coping strategies, Lower levels of distress, Finding meaning, Less negative mood, More adaptive health behaviors, Immune functioning improved (e.g., helper T cells, and natural killer cell activity)Still necessary to express all emotions, both positive and negative

Know about the risks/consequences of obesity

Overall outcomes of obesity are increased risk of heart disease and stroke, increased death rates for all cancers, early mortality and increased chance of type 2 diabetes. Obesity is a leading cause of preventable deaths in the U.S.

Understand and be able to describe how psychological factors influence pain (i.e., anxiety, depression, perceived control, expectations, distraction)

Personality: for example, neuroticism associate with greater perception of pain and communication about pain. Age- As people get older, there is a progressive increase in reports of pain and a decrease in tolerance to pain. Individual differences (cont.) Sociocultural factors-Groups differ greatly in their norms for the degree to which suffering should be openly expressed and the form that pain behaviors should take. Ex-study of chronic back pain sufferers in 6 countries-> Mexico japan America Italy New Zealand and Colombia Which reported/expressed most suffering? Least? Most- America least- Colombians and Mexicans. Gender- Women report more frequent episodes of pain than men, including more migraines, tension headaches, pelvic pain, facial pain, lower back pain. Laboratory‚ studies generally show women have lower threshold and tolerance than men. Relationship between psychological factors and chronic pain- Distress magnifies pain experience, Depression Affects coping, emotional effects of pain. Prevalence of pain in depressed primary care patients = 69% Depression and pain combined lead to greater impairment in social, work and functioning. Anxiety: magnifies pain, interferes with relaxation. Relationship between psychological factors and chronic pain Distraction-can lessen perceptions of pain. Sense of control ability to control aspects of pain can improve coping. Expectations: Patients' expectations can affect pain and healing. Providers' positive/negative expectations can influence patients' perceptions of pain. Placebo effect: The measurable, observable, or felt improvement in health that's not attributable to actual treatment, placebos can stimulate the release of endogenous opioids

Alcoholism

Physical and psychological addiction to alcohol, experience withdrawal when attempt to stop

Understand the meaning of the term addiction

Physical and psychological dependance on a substance

Know about prevention of smoking and techniques for this

Preventing smoking- Potential routes -Social influence -Films of non-smoking peers with techniques to deal with social press can reduce smoking rates for as long as 4 years -Life skills training -encourage self-esteem and coping enhancement -as well as social skills in adolescents Has shown success in the reduction of smoking onset overtime. - Social engineering Restrict tobacco -marketing heavy taxation banning smoking in particular places. -Labeling tobacco products with large, graphic health warnings

Know about prevention and treatment of obesity

Preventing- should begin in childhood, encouraging children to get regular physical activity and eat healthy foods, limiting screen time, not labeling food as good and bad. Treating- Eating less (DON'T LISTEN TO THIS IT IS JUST FOR THE EXAM) setting short term goals, self-monitoring, social support, exercising more, short-term goals, reminders/prompts, making changes to fit with lifestyle/daily routine, short 10 min chunks, daily exercises in home.

Understand the types of pain measurement

Psychophysiological measures- EMG measures electrical activity of muscles. EEG measures electrical changes in the brain. Autonomic activity (e.g. heart rate, respiration, blood pressure, and skin temperature) Behavioral measures- observation of pain behaviors. Self-report measures- Verbal or written descriptions of pain from the patient

Understand the involvement of family members/loved ones in chronic illness

Research in Coronary Care Unit (CCU) has shown that family- Hover around the patient and health care professionals, Seek info about the patient's status, Track the patients progress, Garner resources- whatever the patient needs, they will get. Important to remember -> providing support and caregiving can be stressful for family members

Anorexia nervosa and definition, health consequences, and treatment

Self-starvation, BMI chronically lower than 18, disturbed body image, intense fear of weight gain. Health consequences- Slowed thyroid function, Heart arrhythmias, Low blood pressure, Dry and yellowed skin, Anemia, Brittle bones, effects on reproduction (amenorrhea, difficulty conceiving, complications of pregnancy, problems with breast feeding). Risk factors for anorexia- genetics,more likely to be depressed, anxious, and low in self-esteem, chronic overreaction to stress, personality characteristics, (perfectionism), family interactions (more conflict, less nurturance). Prevention of eating disorders are interventions focusing on healthy eating exercise and healthy body image, critiques of the thin ideal. Treatment is restoring body weight, cognitive-behavioral, family therapy.

Social factors and chronic illness

Social isolation is a problem-Anger, frustration, and irritable mood can contribute to driving away those who care most, But. . . Families and friendships can also become even stronger. Normalizing, and identity spread.

Physical inactivity and other environmental factors that lead to obesity

Spending hours on screens, relying on cars instead of walking, lack of PE in school, lack of neighborhood sidewalks and safe recreation places, fewer physical demands at home because of modern conveniences and technologies, not getting recommended physical activity amount for a week.

Be familiar with the relevant psychosocial issues for older adults with a chronic illness

Stereotypes of elderly- alienated, unproductive, burden to family and society. Older adults can be productive and independent- working, volunteering, going back to school, fulfilling family obligations, recreation. Chronic illness in old age- Older age, 92% of older adults have a chronic illness ¼ have a mental health disorder. Declines in own health, and energy, but also those of spouses, and friends. Family members can help (physical care, emotional support) many older adults want to "age at home" Independence and control is crucial even in a nursing home -- Example nursng home plant study rodin et al.

Understand how pain can be influenced by the placebo effect (know about the video on "sham knee surgery" shown in class)

Study of osteoarthritis patients who had placebo knee surgery compared to those who had actual surgery: Over the course of the 24 months after the surgery pain scores went down at similar levels for both groups( Moseley et al 2002) Placebo effect surgery. Took two years for study to be completed. Some patients got real surgery some got fake, but they didn't know. For everyone group fake or genuine everyone felt that it had improved, something had happened to change what was going on inside their knee. Cases where the feeling about the surgery influences the results just as much as the surgery itself. Placebo effect surgery. Took two years for study to be completed. Some patients got real surgery some got fake, but they didn't know. For everyone group fake or genuine everyone felt that it had improved, something had happened to change what was going on inside their knee. Cases where the feeling about the surgery influences the results just as much as the surgery itself. What do you think of the findings? Mind is powerful, self-fulfilling prophecy. Maybe fixated on it psychologically, and after surgery was able to not fixate on it and helped get him better. Trick brain that you're in pain baby cries when you react

Know about the different methods for treatment and management of pain

Surgery- Most drastic, often short lived benefits. Pharmacological methods: NSAIDS ibuprofen and aspirin, antidepressants, topical medications, severe acute pain or cancer pain may require opioids. Cognitive behavioral therapy- a multidisciplinary approach to pain management that combines physical, cognitive, and emotional interventions, effective in managing back pain. Guided imagery- conjure up an image to focus on, most effective combined with other techniques, thinking about something else or imagining self somewhere else. Relaxation- progressively relaxing different parts of the body, controlled breathing, meditation, working in combo with other methods for managing chronic pain. Biofeedback- a mechanical system whereby an individual is signaled by means of a light or buzzer to bring about particular behavior in the body for relaxation brining blood to body and slowing heart rate low evidence of success. Hypnosis- relaxation suggestibility and distraction effective for both acute and chronic pain. Acupuncture- Ancient Chinese technique in which fine needles are inserted under the skin can stimulate nerves associated with parts of body. Can work as placebo, cause distraction, or trigger endorphin release better for acute pain. PT exercise massage and use of heat and cold

Why is pain important to understand?

Symptom for which people are most likely to seek medical treatment - 80% of medical visits are for pain (National Center for Health Statistics). Very prevalent! 70-80% of people in the U.S. have back pain in their lifetime, daily arthritis pain - 40 million, and chronic headaches -- 45 million

Countries with the highest and lowest obesity rates

The U.S. and Mexico have the highest rates of obesity, South Korea, Japan and Switzerland have the lowest rates.

Be able to describe different pain behaviors

The actions that people carry out or emit when they are in pain. Some pain behaviors include distortions in posture or gait, facial expressions of distress, irritability, avoidance of activity, sounds of pain.

Be familiar with the neurochemical basis of pain (e.g., endogenous opioids)

The brain can control the amount of pain an individual experiences. The brain can transmit messages down the spinal cord to block pain signals. Neurotransmitters can increase or decrease the amount of pain experienced. Endogenous opioid's are opiate like substances produced within the body that regulate pain. These include endorphins which can be released during intense physical activity and regulate pain and heighten feelings of physical well being, and enkephalins which deaden pain sensations

Understand the concept of nociception and Nociceptors

The perception of pain; nerve endings that respond to pain stimuli. Involves mechanical pressure and thermal heat or cold and chemical secreted in damaged body tissues. Signal that something is wrong. Its possible to experience pain without nociception (e.g. phantom limb pain)

Be familiar with the different coping mechanisms used in dealing with a serious illness

Visualization- Relax and visualize body... fighting disease. Looking for meaning- What is the positive in this? What did I learn? Spirituality / religion- Can bring strength, hope, and understanding. Optimism and benefit-finding- Optimism and benefit-finding associated with, Better coping strategies, Lower levels of distress, Finding meaning, Less negative mood, More adaptive health behaviors, Immune functioning improved (e.g., helper T cells, and natural killer cell activity)Still necessary to express all emotions, both positive and negative.

Know about Phantom limb pain

When a patient has had an amputation, or damage to the peripheral nervous system, but still feels pain in the missing or damaged part of the body. Experienced by 65-85% of amputees. Cramping, shooting, burning, or crushing. Underlying mechanisms still being studied. Brain memory of pain remains even though nerves don't might be an explanations.

Identity spread

a person's limitations are over-generalized and spread to other unrelated areas

Binge drinking

five or more drinks in a row in 2 hours for men and four or more for women, a pattern of drinking that brings a persons BAC to .08 or higher

Be familiar with the Gate Control Theory of pain

(melzack and wall, 1965, 1982, 1988) biophysosocial theory of pain. Nociceptors transmit impulses that flow from the peripheral nervous system to the central nervous system through the dorsal horns of the spinal cords (substantia gelatinosa) Delta A fibers carry sharp pain sensations while C fibers slowly transmit dull aching pain. Not all pain signals carried by te nerve fibers reach the brain and are experienced as pain- A beta fibers can be activated like putting ice pack on strained ankles and close the gate. Emotions and cognitions influence the gate

Understand the most common causes of poisoning

(unintentional)- Age group 25-64-Peak age of death is 45-54 range. More than 28,000 deaths from Opioids (including prescription pain relievers and heroin) in 2014 Nearly 65 % of these deaths involve a prescription opioid. Every day, 300+ children in the United States (1-19) are go to the emergency department, and 2 children die, due to being poisoned.

Be familiar with the 4 Es approach to injury prevention

- Engineering products to improve safety (e.g.) alerting sounds/cameras on cars backing up to reduce the risk of hitting a pedestrian. -Environmental modifications to reduce likelihood of injury (e.g. adding bike lanes to roadways) -Enforcement of laws/regulations to reduce injury risk (e.g. laws about mandatory use of child safety seats, speed limits) - Education to change attitudes, behaviors, beliefs (e.g., discourage impaired driving, promote child safety seats)

Know about how psychological factors lead to alcohol abuse

- Social cognitive factors like stress relief- tension reduction hypothesis -social learning theory of modeling others - Excuse for personal failures self-handicapping model. -Personality such as extraversion -low control and cautiousness associated with later alcohol abuse (longitudinal studies) -Biological/genetic factors like adopted children with alcoholic parent 4 x more likely to become a problem drinker

Stats of alcohol abuse

- Third leading cause of preventable death. - 14.5 million adult Americans (about 5% ) have an alcohol use disorder. - 1.7% adolescents (12-17) have an AUD. Approx. - 20% of college students meet the criteria for AUD. - 28% of traffic-related deaths related to alcohol. - More than 10% of U.S. children live with a parent with alcohol problems.

Know about reasons why people smoke and ways to quit smoking

- Why do people start smoking? -Many reasons including Genes, Peer and family influences, Major stressor, Self-image, Personality (risk-takers, extraverted) -Addiction leads to continued smoking. - Physical and psychological dependance on a substance. Nicotine creates physical dependence. -Fixed effect model smoking feels good, so people continue to smoke. - Nicotine regulation model must smoke to maintain a certain level of nicotine to feel good. -Affect regulation model smoke to help with mood regulation stay happy or keep from being sad, -Multiple regulation and biobehavioral model physiological + psychological and addiction

Know about treatment and prevention of alcohol abuse and smoking

-10 to 20% of alcoholics stop drinking on their own without formal treatment. -32% of alcoholics can stop with minimal help - Other treatment categories: -Behavioral/counseling -Build strong support system -goal-setting - skills to stop or reduce drinking - coping with or avoiding trigger. -Medications used in detoxification or recovery - Mutual support groups (i.e., alcoholics anonymous) - Prevention - Focus on youth/adolescents. -Challenging alcohol-related expectations. -Raising awareness of how alcohol influences health and well being, -Teaching.... Ways to say no. -Challenging perceived prevalence (addressing.... Social norms about how much drinking is really going on among their peers) -Prevention of drinking and driving. -Tougher drunk driving laws and penalties. -Mass media campaigns. - hosts/hostesses/friends intervening to recognize those too drunk to drive. - designated drivers

Be familiar with the rates of smoking in the U.S.

-14% U.S. adults smoke cigarettes (CDC). -Leading cause of preventable mortality. -Linked to numerous types of cancer, increased risk of developing heart disease and strokes, other major illnesses (lung, cardiovascular) - numerous pregnancy complications -ETS (environmental tobacco smoke) or secondhand smoke is a serious problem, Can cause heart disease and lung cancer, especially dangerous for children. -Synergistic effects of smoking- Heightens the negative effects of other risk factors in compromising health (Stress, physical activity, breast cancer risk, etc.) -Why do people start smoking? Many reasons including Genes, Peer and family influences, Major stressor, Self-image, Personality (risk-takers, extraverted)

Be familiar with the factors influencing engagement in health-compromising behaviors

-Adolescence is a vulnerable time for engaging in these behaviors because - the role of peer influence, - self-presentation, - can bring pleasure and fun, - multiple risky behaviors can be a response to coping with life stress, -risky health behaviors occur more often in low socioeconomic status individuals (SES)

Understand the risk factors for experiencing a fall

-Risk factors for falls- Lower body weakness, lack of vit D, balance problems, use of some medications, vision problems, home hazards. -Every second of every day in the United States an older adult falls. Leading cause of death and injury in age group 65+. 1/5 causes serious injury such as ..... Broken bones or head injury. Common injury from falls: Hip fractures.