PSC 126 MBH Midterm 3

What are the best treatments for mild depression?

Counseling, excersize, stress resilience techiques

Describe how the meditative methods of behavior change work.

Quiet Contemplation: key way of clarifying your values. Helps you motivate to accomplish your most desired outcome Guided Imagery: First imagery "inner child" helps you mentally visit yourself as a child who is going through a disturbing event. In the second kind of guided imagery, imagery to the "inner advisor" you personify your inner wisdom and values Visualization: through visualization, you actually practice "seeing" yourself performing or functioning in the way you want

Describe the "stimulus control" strategy for treating sleeplessness.

Reinforce your bed as a sleep stimulus by limiting any non-sleep behaviors in or around bed. For example 1. The bed only for sleep, relaxation, and sex. Don't read, eat, watch television, study, or catch up on work in bed (or in the bedroom) 2. Go to bed only when you are feeling drowsy 3. If you have not fallen asleep within ten to fifteen minutes after you get into bed, get out of bed, leave the bedroom, and read something dull somewhere else in the house until you are drowsy. 4. Make sure the conditions in your bedroom are optimal for sleep. You room should be dark and quiet, your room should be the right temperature (a room that is either too warm or too cool can interfere with sleep) your nightclothes and sheets should not be binding and your bed should be comfortable and supportive

What aspect or core feature of worry causes the most stress and anxiety?

uncertainty -- we need to have a sense of control in our world

What medical conditions are mind-body interventions helpful for?

Outcome reviews have found these interventions significantly helpful both for specific diseases and for symptoms such as pain (headaches, back pain, muscle pain, and surgical pain)

How is anxiety related to common medical illnesses?

Over 50% of the people who use medical care have anxiety or depressive disorders, but they only make up 15% of the population. They seek medical care not so much for the symptoms, but for fear of what the symptoms actually mean.

What is the sleep disturbance that occurs in people with chronic pain (e.g. fibromyalgia)?

Pain increases significantly as sleep decreases. In one study that has been repeated twice with the same results, normal volunteers who were deprived of deep-stage sleep for a period of only several days developed muscle aches and pains similar to fibromyalgia, a common muscular pain disorder caused by hypersensitivity of the pain system. Those aches and pains were relieved when the volunteers' sleep was allowed to return to normal.

Why are behavioral medicine interventions effective in treating medical problems?

Patients are taught to quiet their over arousal and to become aware of their thinking and bodily responses to typical stressful situations. They are then taught how to consciously re-create new, healthier automatic responses that in line with their reflective values about how they would most like to be in such situations. The process involves empowering patients, giving them a sense of personal control to react to stress as they most deeply would want to respond.

What types of medical patients are more likely to have mental or stress disorders?

Patients who have gastrointestinal pain, atypical chest pain, chronic pain, or unexplained neurological symptoms are more likely to have mental or stress disorders.

What is the impact of lack of sleep on workplace outcomes?

People who suffer from insomnia are often simply too tired to perform their assigned tasks effectively. Not only do sleep-deprived people cause more accidents at work, but their ability to accomplish necessary tasks falls, with a loss of productivity called "presentation"

What are the 3 dimensions of explanatory style?

1. INTERNAL/EXTERNAL DIMENSION -- Whether you believe you have control over the things that are happening in your life 2. THE STABLE/UNSTABLE DIMENSION -- whether you believe a repeated event will always turn out the same way or it can be changed 3, THE GLOBAL/ SPECIFIC DIMENSION -- whether you view a specific bad event as fairly isolated or you generalize it to encompass other events

What are the 4 core principles of stress resilience?

1. a sense of empowerment and personal control 2. a sense of connectedness and acceptance 3. a sense of meaning and purpose 4. hope

What are the deep, underlying universal values behind the four core principles?

1. caring love -- the kind that empowers both the person who loves and the one being loved 2. responsible free will -- feeling in charge of what happens in your own life 3. Integrity - being the way you want to be; acting out of your own core values 4. growth -- enjoying a challenge and loving always getting wiser and more capable.

What is the prevalence of major depression in the US?

7% of women and 3% of men; #s are higher in the winter

What is the link between insomnia and depression?

70-90 percent of all depressed patients have insomnia, and people with insomnia are thirty-five times more likely to develop depression as people who sleep well. A well designed study of almost 8,000 adults found that those with successfully treated insomnia had only 1.6 times the risk of subsequently developing clinical depression when compared to people who had never suffered with insomnia. Over time, about 40% of untreated chronic insomniacs develop major depression or anxiety disorders.

What is the role of the mesolimbic system in clinical depression?

A normally pleasent experience instead becomes punishing. In other words, it is a disorder to the pleasure center in the brain.

What is the most common psychological disorder in high-volume users of medical care?

Anxiety and depressive disorders

What is unrealistic optimism?

An underestimation of possible bad outcomes and an overestimation of possible good outcomes

What is CRH and how is it involved in the link between stress and depression?

CRH is the corticotropin-releasing hormone, the neuropeptide that activates the adrenal gland in responses to stress. Long lasting CRH and norepinephrine abnormalities can clearly be triggered by traumatic events early in life that turn in the gene for CRH. The activated brain CRH then causes the nervous system to be excessively sensitive to stimuli and, in essence, to remain on guard for danger, even after the trauma is long gone

Outcome studies show that which treatments for depression are best?

Combined counseling and medication is ideal, but in severe cases if one needs to be forfeited it should be the counseling.

What are the 4 basic elements of behavior change?

Create awareness of How your smaller self is reacting with suboptimal, often automatic thoughts That fact that you are in charge of you- you can chose to respond any way you really desire Use deep relaxation, imagery, or meditation to let go of old thought and get centered in the present moment Clearly determine in explicit, specific terms what you wholly desire your new thinking and behavior to be Clarify your deeper wisdom and values- a response you would greatly admire Consider writing this out in great detail Experimentally practice your new behavioral response

What are the biochemical causes of depression?

Deficient functions of dopamine, seratonin, norepinepherine Genetic vunerability to depression

What is the link between depression and social support?

Depression is more prevalent in people with poor social support However, being depressed also tends to make people not want to be around you

Why does depression increase the risk of heart disease?

Depression seems to magnify risk factors associated with heart disease -- it makes risky factors (like diabetes) even riskier. It causes more smooth muscle spasms and blood clots. In increases blood clots through its increase of seratonin, which in turn affects platelets making them adhere to each other more aggresively.

There are 2 main reasons why we sleep. Describe the repair and restorative aspects of sleep.

During deep stages of sleep is when most growth hormone is secreted. This is needed for repair for the microinjuries (such as those from muscles) we all sustain daily. Growth hormone deficiency, which occurs with loss of deep stages of sleep, causes aches and symptoms similar to depression. Also during sleep is when restoration occurs for many of the neurotransmitters that keep the nervous system running well. For example, sleep deprivation causes a decrease in central nervous system serotonin, norepinephrine, and dopamine, which then can also worsen pain, depression, and anxiety.

How does explanatory style relate to optimism and pessimism?

Explanatory style can be either optimistic or pessimistic, but it is not the same as optimism and pessimism. Optimism and pessimism are broad personality traits that characterize the expectations that either good or bad things will happen in the world. Explanatory style taps into those tendencies to become a way we explain events that happen in our lives.

How can you help yourself if you are depressed? If a loved one is depressed?

Helping myself Do not wait to get treated Be active and exercise See realistic goals for yourself Break up large tasks Confide in a trusted friend or relative Expect your mood to improve gradually Postpone important decisions Positive thinking will replace negative thoughts Continue to educate yourself in depression Helping others Offer emotional support Talk to him or her Never dismiss feelings but point out realities Never ignore comments about suicide Invite them out for walks Provide assistance in getting to doctor's appointments Remind them that the depression will lift

What is the stress hormone explanation for why depression increases the risk of heart disease?

High norepinepherine causes damage to the lining of the blood vessels, allowing any cholesterol that is present to build up at a faster rate. Increased serotonin leads to platelets binding together more aggressively = increased risk of blood clots.

Is there research linking explanatory style with immune functioning?

In Seligman's study, he measured the disease- fighting cells in the blood of 300 people whose average age was 71. The optimists had the healthier immune systems. At harvard, they studied first year law students. The optimistic ones had stronger immunity mid semester (more helped T cells and greater natural killer cell response) than those who were not.

What are 3-4 major issues causing stress in non-resiliant people?

Issues of personal worth: low self-esteem, uncertain identity Aloneness Blaming, victimization, and feeling "forced" Demanding that things be different than they are Threat, worry, and negative expectation Perfectionism of giving up

How strong a risk factor for heart disease is depression?

Its a major risk factor, comparable to smoking

What are recommended techniques for reducing worry and anxiety?

Learn to solve problems, create wiser and more rational ways of thinking, quiet physical stress by paying attention to your breathing especially as you feel the "letting go" as you exhale, use relaxation and meditative methods to get to a focused state, tap your head or body in alternating sides to "scramble" the automatic memory, let go of catastrophizing, focus on what's going on right now, set aside a worry period and try to think of solutions, get enough sleep, exercise regularly, keep in mind that many anxiety disorders may also need a course of medication.

Why are mental or stress disorders often ignored and untreated in medicine?

Most patients and physicians focus largely on the associated physical problems, and patients are often reluctant to bring up mental issues, even if the mental issues are causing the most suffering

What are some problems associated with conducting research on the effectiveness of behavioral medicine interventions?

One significant problem is that there are several potential variations in the way they are done; another is the need to tailor such interventions to the individual. One person may do better with muscle relaxation, but another with cognitive reframing. Men often need a more direct approach, while women need a more supportive approach.

Why do pessimists have more health problems?

Pessimism can result in unwarranted fear, guilt and shame. It can cause depression. Physical illness is made even worse when paired with a pessimistic explanatory style.

What are the main ways in which the health of pessimists and optimists is different?

Pessimism itself is a stressor, whereas optimism stimulates the immune system and kicks the body's health response into gear. Optimists have different hormonal compositions, such as higher levels of tesosterone. Blood flow is also infuenced by attitudes and emotions, so pessimists have an increased risk of atherosclerosis. Optimists, though, have a decreased risk of stroke. Additionally, optimists respond better after recieving cardiovascular procedures. Optimists have been shown to respond better to cancer treatments. Optimists are better able to fight infections such as the flu and mono.

How do pessimists and optimists explain bad things that happen to them?

Pessmists attribute their problems to personal inadequacies that underlie everything they do. Optimists usually view a setback as a one-time thing attributable to bad luck, some external factor, or at least to a specific cause than can be remedied. Optimists take broad credit for good outcomes and attribute bad outcomes to mostly external factors. Pessimists take person broad credit for bad outcomes and attribute good outcomes to other external factors.

What are the 4 steps in changing old destructive patterns and habits?

Practice conscious awareness: "I can respond as I choose" Half the solution is won with the realization that you are no longer a victim Develop and practice relaxation and meditative skills. Let go of old thoughts and get mindfully centered Clarify deep values and wisdom. Ask yourself how you want to be- then write your answer in great detail and in positive, not negative terms Visualize (experience with imagery) being the new way. You will need several repetitions for each situation you want to change. The new style then becomes easier, almost like a habit

What are the typical ways of thinking that cause distress that can be modified by cognitive restructuring?

The "shoulds" - how does the situation fit with what "should" be true? These often create anger Issues of worth- what does the situation mean about my worth and value? These may cause self-depression Threat- am i likely to lose something of value because of this situation? These cause fear and defensiveness Force- Am i feeling forced to do something I do not want to do? These also cause anger and resentment

What is somaticizing?

The body's way of turning mental stress, usually anxiety, into physical manifestations.

Why do optimists have better physical health outcomes?

The impact of optimism on health may be due to the tendency to take control, proactively engage in improving their conditions, attend to health threats, and engage in health-promoting behaviors They focus on problems and work to solve them rather than avoiding these problems

What is the integrated approach to treating chronic insomnia?

The integrated approach to chronic insomnia involved combining both medication and behavioral reconditioning.

What was the main finding of the study comparing three different stress-reductions programs for patients?

The talk only group did not experience any change in physical or mental symptoms, and their frequency of using the healthcare system did not change. The two experimental groups significantly reduced both symptoms and utilization. The third group, which combined experimental methods (relaxation and visualization) with good ideas, was twice as effective as the group that focused primarily on meditation alone.

What is explanatory style?

The way in which people perceive or explain events in their lives, especially the bad ones. It is a habitual way of thinking about things when all other factors are equal and when there is no clear-cut right or wrong answers.

What 4 factors determine whether stress is positive or destructive?

The way you see and regard stress: is it an opportunity or an intolerable burden Whether you can see both the pros and the cons- and whether you can create solutions (which requires a healthy brain) Whether you see differences of opinions as "us vs. them" or as "we'" (separate or connected) Whether you have mental or behavioral tools and principles that enable you to deal well with stress

What is the most important thing to visualize?

What you want TO do rather than what you want NOT to do

How does worry affect the heart and circulatory system?

Worry has been shown to have significant effects on the heart and circulatory system as a whole. Worry has been related to high blood pressure in a number of studies - arteries to the skin, kidneys, intestines, and muscles were tightly contracted, causing significant increases in blood pressure (monkeys in study were worried constantly about not being able to avoid the shocks even though none were delivered = constant worrying caused high blood pressure).

What is the difference between worry. fear and anxiety?

Worry is either a form of increased vigilance against threats, a form of problem solving, or a way to rehearse potentially unpleasant events. It differs from fear because fear causes physical changes like increased heart rate Fear usually occurs in response to an external threat. It causes a sense of avoidance and an attempt to escape Anxiety can be present even without external stimulus and is the result of threats perceived to be uncontrollable or unavoidable. Anxiety may help a person generate energy and attention to cope with a difficult situation, but when it is excessive, it may become destructive and be classified as an anxiety disorder (affects about 20% of population). Has emotional, cognitive, somatic, and behavioral components

How do antidepressant medications affect brain cells and neurotransmitters?

can cause regrowth to the damaged cells can increase gray matter in the PFC

What are the primary symptoms in major depression?

little interest in doing things feeling down, depressed, or hopeless trouble falling or staying asleep, sleeping too much feeling tired or having little energy poor appetite or overeating feeling bad about yourself trouble concentrating moving or speaking slowly/being fidgety thinking you would be better off dead.

in what ways can depression increase mortality?

suicide increases the risk of developing medical illness Those who become depressed from the sickness tend to become even sicker, requiring more medication and days in the hospital reduces chances of survival