Psychophysiological

Disorders
Stress and health
Psychological 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.