Description
Anxiety and primary insomnia often co-exist in a "chicken-and-egg" cycle, where it seems impossible to determine whether the anxiety is causing the sleep disorder or the sleep disorder is causing the anxiety.
Research and describe the process of how anxiety and primary insomnia interact in a patient.
Why would it be difficult to determine which came first?
Use chapter 8 summary(uploadeddoc.) plus another scholarly source for in text citationDurand, V. M., Durand, V. M., & Barlow, D. H. (2016). Essentials of abnormal psychology(7th ed.). Australia: Wadsworth Cengage Learning.
Chapters Summary
Chapter Seven
Psychological and Social Factors That Influence Health
Psychological and social factors play a major role in developing and maintaining a number of physical disorders.
Two fields of study have emerged as a result of a growing interest in psychological factors contributing to illness. Behavioral medicine involves the application of behavioral science techniques to prevent, diagnose, and treat medical problems. Health psychology is a subfield that focuses on psychological factors involved in the promotion of health and well being.
Psychological and social factors may contribute directly to illness and disease through the psychological effects of stress on the immune system and other physical functioning. If the immune system is compromised, it may no longer be able to attack and eliminate antigens from the body effectively, or it may even begin to attack the body’s normal tissue instead, a process known as autoimmune disease.
Growing awareness of the many connections between the nervous system and the immune system has resulted in the new field of psychoneuroimmunology. Diseases that may be partly related to the effects of stress on the immune system include AIDS, cardiovascular disease, and cancer.
Psychosocial Effects on Physical Disorders
Long-standing patterns of behavior or lifestyle may put people at risk for developing certain physical disorders. For example, unhealthy sexual practices can lead to AIDS and other sexually transmitted diseases, and unhealthy behavioral patterns, such as poor eating habits, lack of exercise, or type A behavior pattern, may contribute to cardiovascular diseases such as stroke, hypertension, and coronary heart disease.
Of the 10 leading causes of death in the United States, fully 50% of deaths can be traced to lifestyle behaviors.
Psychological and social factors also contribute to chronic pain. The brain inhibits pain through naturally occurring endogenous opioids, which may also be implicated in a variety of psychological disorders.
Chronic fatigue syndrome is a relatively new disorder that is attributed at least partly to stress but may also have a viral or immune system dysfunction component.
Psychosocial Treatment of Physical Disorders
A variety of psychosocial treatments have been developed with the goal of either treating or preventing physical disorders. Among these are biofeedback and the relaxation response.
Comprehensive stress- and pain-reduction programs include not only relaxation and related techniques but also new methods to encourage effective coping, including stress management, realistic appraisals, and improved attitudes through cognitive therapy.
Comprehensive programs are generally more effective than individual components delivered singly.
Other interventions aim to modify such behaviors as unsafe sexual practices, smoking, and unhealthy dietary habits. Such efforts have been made in a variety of areas, including injury control, AIDS prevention, smoking cessation campaigns, and programs to reduce risk factors for diseases such as CHD.
Chapter Eight
Defining Eating Disorders
The prevalence of eating disorders has increased rapidly over the last half century. As a result, they were included for the first time as a separate group of disorders in DSM-IV.
There are two prevalent eating disorders. In bulimia nervosa, dieting results in out-of-control binge-eating episodes that are often followed by purging the food through vomiting or other means. Anorexia nervosa, in which food intake is cut dramatically, results in substantial weight loss and sometimes dangerously low body weight.
In binge-eating disorder, a pattern of binge eating is not followed by purging.
Statistics and Course for Eating Disorders
Bulimia nervosa and anorexia nervosa are largely confined to young, middle- to upper-class women in Western cultures who are pursuing a thin body shape that is culturally mandated and biologically inappropriate, making it extremely difficult to achieve.
Without treatment, eating disorders become chronic and can, on occasion, result in death.
Causes of Eating Disorders
In addition to socio-cultural pressures, causal factors include possible biological and genetic vulnerabilities (the disorders tend to run in families), psychological factors (low self-esteem), social anxiety (fears of rejection), and distorted body image (relatively normal-weight individuals view themselves as fat and ugly).
Treatment of Eating Disorders
Several psychosocial treatments are effective, including cognitive-behavioral approaches combined with family therapy and interpersonal psychotherapy. Drug treatments are less effective at the current time.
Obesity
Obesity is not a disorder in DSM but is one of the more dangerous epidemics confronting the world today. Cultural norms that encourage eating high-fat foods combine with genetic and other factors to cause obesity, which is difficult to treat.
Professionally directed behavior modification programs, possibly combined with drugs, are moderately successful, but prevention effort in the form of changes in government policy on nutrition seem to be the most promising.
Sleep Disorders
Sleep disorders are highly prevalent in the general population and are of two types: dyssomnias (disturbances of sleep) and parasomnias (abnormal events such as nightmares and sleepwalking that occur during sleep).
Of the dyssomnias, the most common disorder, primary insomnia, involves the inability to initiate sleep, problems maintaining sleep, or failure to feel refreshed after a full night’s sleep. Other dyssomnias include primary hypersomnia (excessive sleep), narcolepsy (sudden and irresistible sleep attacks), circadian rhythm sleep disorders (sleepiness or insomnia caused by the body’s inability to synchronize its sleep patterns with day and night), and breathing-related sleep disorders (disruptions that have a physical origin, such as sleep apnea, that leads to excessive sleepiness or insomnia).
The formal assessment of sleep disorders, a polysomnographic evaluation, is typically done by monitoring the heart, muscles, respiration, brain waves, and other functions of a sleeping client in the lab. In addition to such monitoring, it is helpful to determine the individual’s sleep efficiency, a percentage based on the time the individual actually sleeps as opposed to time spent in bed trying to sleep.
Benzodiazepine medications have been helpful for short-term treatment of many of the dyssomnias, but they must be used carefully or they might cause rebound insomnia, a withdrawal experience that can cause worse sleep problems after the medication is stopped. Any long-term treatment of sleep problems should include psychological interventions such as stimulus control and sleep hygiene.
Sample Solution