-Spread of moderation (Inactive, sedentary lifestyle + high fat foods)

-Genetics 30% of the cause

-Biological factors([image]Initiation and maintenance of eating)

Bulimia Nervosa 

-Binge eating: out of control eating, excessive amounts of food followed by rapid purging  

-compensatory behaviors: purging, excessive exrcise, fasting

-Episodes 2x/week for 3 months

-self esteem, determined by weight and body shape

-involves fear of gaining weight  

-B.N clinical depression 

-vomiting, laxative abuse 

-most within 10% of normal weight 

-seizures 

-kidney faliure

-fuck up your teeth

comorbity with anxiety, mood disorders(50-70%), substance abuse 

Anorexia Nervosa

-Overly successful weight loss

-15% below expected weight

-intense fears: gaining weight, losing control of eating

-Relenteless pursuit of thinness

-Often begins with dieting 

-Restricting-limit calories with diet/ fasting

-Binge-eating-puring about 50%

-Associated features:body image disturbance, pride in diet and control, rarely seek treatment 

-Food Binges

-No compensatory behaviors

-Experimental diagnostic category 

-Many are obese, Older, more psychopathy

-concerned about shape and weight 

-Social Dimensions: thinness=success and happiness

-Ideal body Size standards

-Media standards

-Social and gender standars

-CBT

-Interpersonal 

-possible medications 

-Weight restoration

-Psychoeducation(learn about food, weight, nutrition, health

-Traget dysfunction attitudes like body shape, control, thinness=worth

-Family prognosis, poorer than bulimia 

Sleep Disorders 

1. Dyssomnias 

-Quantity

-Quality

-Sleep Onset 

-Abnormal Behvaior

-Physiological events

Polysomnographic (PSG) Evaluation

-detailed Histroy

-Sleep hygiene and efficiency

-EEG, EOG, EMG

-Actigraph

-Sleep Efficiency(SE)

-Pain, physical discomfort

-Delayed temperature rythm

-Light noise, temp

-Stress

-Anxiety 

The Dyssomnias:  Hypersomnia 

-Hypersomnia:sleeping too much, excessive sleepiness, causes problems in life

-Primary hypersomnia: rare, not related to other condition 

-39% of a family history, asscoiated with exposure to viral infections, mono, and influenza 

Narcolepsy 

- daytime sleepiness

=cataplexy-cataplexic attacks

-REM sleep 

 -triggered by strong emotion 

-sleep paralysis

-hypnagogic hallucinations 

-typically improves overtime 

-daytime sleepiness persists without treatment 

-Narcolepsy: stimulants 

-Cataplexy: Antidpressants, GHB

-Abnoral events during sleep or transition between sleep and waking 

- types REM and NREM 

The Parasomnias:  Nightmare Disorder 

-REM sleep 

-INvolves dreams: distressing and disturbing

disrupt sleep cause awakening, interfer with functioning 

-more common in children 

-Non REM sleep 

-more common in children 

-piercing scream

-signs of elevated arousal like sweating

-person looks upset

-difficult to awaken 

-little memory of the event 

-Somnambulism, non rem sleep

-usually during first few hours

-person must leave bed

-usually resolves on its own

- related condition: nocturnal eating syndrome- person eats while asleep 

-Tabacco

-overweight

-alcohol use 

-infections

-pollution 

-carcinogens

-radiation 

- dont smoke

-healthy diet

-maintain healthy weight

-protection from sun

-avoid risky behavoirs

-take early detection seriosuly 

-get immunized 

-examines relationship between psychologial behavior and health/illness

-Focus is on wellness and prevention of illness 

- many causes of death are related to behavior and lifestyle, rather than infection

-how do we get people to engage in healthy behavior  

-Psychological factors influence bio process: stress and the immune system 

- Behavior patterns increase disease: unprotected sex and AIDS, Tobacco use and cancer 

50% of leading causes of death are linked to behaviors

-smoking

-poor eating habbtis

-lack of exercise

-poor injury control

-seatbelts 

-understand the determinants of health behavior 

-understand how indivduals go about changing their behavior 

-develop intervention to change behavior 

- information only approaches

- useful but simple behaviors(seat belt use)

-Almost never effective for complex behavior change like diet, exercise, condom use

- conventional wisdom approaches 

-What individuals who need to change their behavior think will work

-Fear appeals do not change behavior 

- behavioral medicine: prevention and treatment of disease from interedisiplinary perspective 

-health psych: focused more on health and promotion of policy 

eating habits, excercise, smoking, treatment compliance 

-repeated warning are not enough 

=programmatic efforts needed

-AIDS prevention, safe sex, highly preventable by changing behaviors 

-smoking: public health campaign

-Obesity and diet: ban sale of oversized sodas/ taxing junk food

Stress and the Stress Response 

(def of stress) 

event that precipitates stress response, variability in stress response

Responses to Stress

(Phase 1) 

-social status

-low vs hisgh status

- high cortisol, less HDL cholesterol, weak immune system 

-predictability

-controllablility 

-stress

-precieved uncontrolablilty

-low social support

-negative afect

-perceptions of situation and response( self efficacy )

- Autoimmune diease

-imbalance in cell types

-overactvity

-attacks normal cell

ex: HIV

-Immune response is affected by psychological factors 

-Course from HIVis variable

-Median time 7.3 to 10 yrs

-most die within 1 yr of diagnosis 

-15% survive 5+ yeeras

-stress of diganosis can be devastating

-HAART(meds)

-Powerful, but not a cure

-severe side effects 

-

- exacerbation of AIDS progression(high stress, low social support)

-Goals: reduce stress, boost immune system 

-Outcomes: Increased T-helper cells, lower antibodies, ehnhanced psychological adjustment 

- perceived lack of control

-poor coping responses(denial) 

-stressful life events

-life style risk behaviors 

- immune function 

-viral activity 

-DNA repair processes 

-Gene expression 

-African Americans=2x greater risk 

-risks: salts, fluid volume, sympathetic arousal, stress leve , expressed anger, hostility 

-blockage of arteries supplying blood to the heart muscle 

-Angina pectoris=chest pain

-Atherosclerosis=artery plaque 

-Ischemia=reduced blood supply from blockage

-Mypcardial infarction=heart attack 

-stress, anxiety, anger

-poor coping skills

-low social support 

-driven, high achieving, workaholic

-anger

-Negative affect

-Impatience

-Accelerated speech

- motor activity 

Types of Pain 

Chronic 

Types of Pain 

(Actue) 

gone within one week 

-Clinical Distinction: pain vs pain behaviors 

Chronic Pain 

(Psyc and social factors) 

- severity of pain does not predict reaction to it : 

-percieved control 

-negative emotion

-poor coping skills

-low social support

-compensation 

-socail reinforcement 

-Gate Control Theory: hypervigilance vs inhibitory signals 

-Endogenous opioids

-Associated with self-efficacy

-Gender differences

-Types of pain

-regulating mechanisms

-treatment response 

- lack of energy, marked fatigue, pain, low grade fever

female>male 

-increasing in western countries 

-not related to immune problems, depression, viral infections 

-Causes: lifestyle, stress, fast paced 

-Treatment: meds are ineffective, CBT is promising 

-Biofeedback: monitor and control bodily responses, heart rate, blood pressure, muscle tension, EEG rhythms

-INcrease sense of control 

-Efficacy: chronic headace, hypertension 

-relaxation and meditation

-progressive muscle relaxation, TM

-Drugs: high repalse when stopped, tolerance, withdrawl

coronary bypass surgery and optimists: quicker recovery time, faster return to normal activities, stronger quality of life, less likely to use denial 

-Value of denial may depend of timing: initial diagnosis, later stages 

Alfred Kinsey: one of the best know sex researchers, based on self-report data

William Masters and Virgina Johnson: published data on masterbation, oral, and sex 

Sexual and Gender Identity Disorders 

(what is normal)

"Normal" = 15 or more partners (lifetime)

-Similar in Britain and France 

-Homosexual sex: M=2.3% ever and 1.1% only 

-Sex active does last past 80 

-At age 70-79 50% of men are active and 36% of females are active 

- decreases are due to health problems 

-Masturbation: 3x higher in men 

-men are more permissive, gap is shrinking 

-no diff in:Acceptability of homosexuality

-show more sexual desire and arousal 

-self concept includes power, independence and aggression 

- emphasize committment in a relationship 

-sexual beliefs are shaped by cultural, situation, and social factors 

-genetic component

homosex in twins: mono=50%

dy=16-22%

no specific genes 

-biology interacts with enviro 

- feels trapped in the body of the wrong sex

-assumes identity of the desired sex 

- biological 

-in vitro exposure: higher levels of testosterone or estrogen 

-gender identity: 18-36 months of age

-parental reinfrocement 

-gender nonconformity: may be reinforced by mother 

-sex reassignment 

-required 1-2 years in opposite sex role

-hormone therapy 

-finally surguery, which is more difficult in biological females 

-75% satisfied

-better adjustment female-to-male 

-males

-females

-herms

-merms

-ferms 

-prevalence in some is 1.7% 

-Treatment= increase adaptation 

-desire: hypoactive desore

-arousal 

-Orgasm: inhibited orgasm 

-Dyspareuia: pain associated with sex 

-it is the most prevalent class of disorder in U.S 

-must be seen as distressing 

-little or no interest in sexual activity 

-decreased frequency 

-higher prevalence in females 

-little interest in sex

-extreme fear, panic, disgust 

-25% meet criteria for panic disorder

females>males 

-male erctile disorder

-female sexual arousal disorder: difficult maintaining adequate lubricaton 

*problem is arousal not desire

*prevalence may increase with age 

* ED is the main reason men seek treatment 

Inhibited Orgasm 

(orgasm disorder) 

-female and male orgasmic disorder 

-adequate desire and arousal 

-unable to achieve orgasm 

-rare in adult males 

-most common complaint of adult females 

- declines with age

-more common in young inexperienced males 

Dyspareunia 

(pain disorder) 

extreme pain during intercourse 

-adequate sexual desire, arousal, orgasm 

-must rule out medical reasons 

Causes of Sexual Dysfunctions 

-"anxiety" vs. "distraction" 

-social and cultural contributions 

-poor interpersonal relationships 

-lack of communication 

- sexual attraction and arousal 

-socially inappropriate people and/or objects 

- sexual attraction to nonliving objects 

-inanimate 

-Transvestic Fetishism: sexual arousal via crossdressing , (males may show highly masculine compensatory behavior) 

observing an unsuspecting individual undressing or naked 

-risk is necessary for arousal 

-exposure of genitals to unsuspecting strangers

-complusive out of control 

-thrill and risk are necessary for sexual arousal 

-sadism: inflicting pain or humiliation 

-masochism: suffering pain or humiliation