Psychology 407 - Health Psychology
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Week 6:
CHRONIC DISEASE
OVERVIEW:
I. MEDICAL VS. HEALTH MODEL OF CHRONIC DISEASE
II. Models of Pain and Chronic Pain
III. Pain Conditions
A. ARTHRITIS
B. HEADACHE
C. CHRONIC PAIN
IV. DIABETES
I. MEDICAL MODEL VS. HEALTH MODEL
II. PAIN AND ARTHRITIS
A. GENERAL DEFINITION OF:
NOCICEPTION...... ..PAIN......... SUFFERING
Renal Dialysis ex
No pain sensation people ex.
Leprosy ex.
B. MODELS OF PAIN
MELZAK’S GATE CONTROL THEORY (TENS UNITS) SENSORY-DISCRIMINATIVE
EMOTIONAL-MOTIVATIONAL
CENTRAL
connective tissue therapist ex. Tom W. injury/dowl tx
(MY CORNEAL ABRASION., JOSH/BROKEN NOSE, NECK BREAK)
JOSH "HAIR PAIN"; STUDENT’S PAIN MEMORIES.)
CTH kids no pain meds
phantom pain.
C. DISEASES OF PAIN
1. ARTHRITIS.
OSTEOARTHRITIS
(SHAPING KID KNEE AT CARRIE TINGLEY)
RHEUMATOID Arthritis
2. DISEASE OF MINORITIES AND WOMEN. A. LUPUS (SYSTEMIC ) rheumatic disease
Affects women (8X men), 140,000 prev.
Unknown cause. Genetic disposition?
Musculoskeletal disorder/inflammatory
Nervous sys; kidneys; lungs, heart,blood
B. Sickle Cell Anemia. ("sick as hell anemia")
FIBROSITIS (FIBROMYALGIA)
TRIGGER POINTS
SPINDLES (HUBBARD/GIVERTZ RESEARCH)
(CHRONIC FATIGUE SYNDROME?)
D. CAUSAL MODELING AND PAIN:
PAIN AND DEPRESSION
PAIN AND HELPLESSNESS
D. HEADACHE
1. VASCULAR
2. MUSCULAR
3. MIXED.
4. TREATMENT
BIOFEEDBACK
EXERCISE STUDY (FITTERLING ET AL)
Truck driver study
Allergy
CAFFERGOT
E. CHRONIC PAIN SYNDROME.
Pain/suffering > 6 mos
No known current biological cause
Passive "coping"
Secondary gain/sympathy
"sick role"
Martin Rapid Intv.
Miss. HA woman (anx)
1. ETIOLOGY
2. PAIN AND DEPRESSION
TREATMENT OF PAIN/CHRONIC PAIN SYNDROME
MEDICAL MODEL
PHARMACOLOGICAL
SURGICAL
BEHAVIORAL MODEL (FORDYCE)
COGNITIVE-BEHAVIORAL TREATMENT
(TURK; KEEFE)
F. CANCER PAIN AND TREATMENT
G. ALTERNATIVE TREATMENT OF PAIN
FISH OILS, FASTING AND PRAYER...
III. DIABETES
Estimated Deaths X Disease
A. TYPES
1. IDDM (TYPE 1) Juvenile Onset (Juvenile Diabetes)
Insulin Dependent.
Most Severe Symptoms and Health Outcomes
Early Onset
2. NIDDM (TYPE II) Adult Onset
Non Insulin Dependent
Less Severe
Overweight/Overfat/Underexercise Related
10-yr Age Adjusted Incidence of Diabetes X Weight
B. PATHOPHYSIOLOGY
Pancreas (Insulin) Insufficiency
Purpose of Insulin
Insulin sensitivity
glucose intolerance
Glucose (sugar) overload (hyperglycemia)
(MD "taste test")
Metabolic Outflow/breakdown Dysfunction
(exercise)
C. EPIDEMIOLOGY
WOMEN
Older Adults
Overweight/Overfat (Western World)
Native Americans/Indians
PIMA INDIANS
(50% PREVALENCE OVER AGE 35)
D. TREATMENT
1. IDDM
Adolescent Girls -- complex regimen
glucose monitoring (dextrometer)
insulin injection
insulin pump
avoidance of simple carbo’s (sugar)
diet higher in complex carbos, lower in fat
regular exercise
personal hygiene
2. NIDDM (TYPE 11)
Diet
Exercise
Regular Glucose Checks
Adolescent Diabetes: Treatment Study
Weight Change X Group @ 6 Months
1. IDDM
Blood Glucose Change at 6 months X Group
E. EXAMPLES
Eddie Williams Baseball Player (UT)
MOM: INSULIN SHOCK;
TREATMENT BY EXER/DIET.
CHARLIE AND BIKING IN NM.