Download acute disorders

A
abstinence violation effect
A feeling of loss of control that results when one has violated self-imposed rules, such as not to
smoke or drink.
acupuncture
A technique of healing and pain control developed in China in which long, thin needles are
inserted into designated areas of the body to reduce discomfort in a target area of the body.
acute disorders
Illnesses or other medical problems that occur over a short period of time, are usually the result of
an infectious process, and are reversible.
acute pain
Short-term pain that usually results from some specific injury.
acute stress paradigm
A common current way of studying stress is to take people into the laboratory, expose them to
short-term stressful events, and then observe the impact of that stress on their physiological,
neuroendocrine, and psychological responses.
addiction
The state of physical or psychological dependence on a substance that develops when that
substance is used over a period of time.
adherence
The degree to which an individual follows a recommended health-related or illness-related
recommendation.
adrenal glands
Two small glands, located on top of the kidneys, that are part of the endocrine system and
secrete several hormones, including cortisol, epinephrine, and norepinephrine, that are involved
in responses to stress.
aerobic exercise
High-intensity, long-duration, and high-endurance exercise, believed to contribute to
cardiovascular fitness and other positive health outcomes. Examples are jogging, bicycling,
running, and swimming.
aftereffects of stress
Performance and attentional decrements that occur after a stressful event has subsided; believed
to be produced by the residual physiological, emotional, and cognitive draining in response to
stressful events.
AIDS (acquired immune deficiency syndrome)
Progressive impairment of the immune system by the human immunodeficiency virus (HIV); a
diagnosis of AIDS is made on the basis of the presence of one or more specific opportunistic
infections.
alcoholism
State of physical addiction to alcohol that manifests through such symptoms as stereotyped
drinking, drinking to maintain blood alcohol at a particular level, experiencing increasing
frequency and severity of withdrawal, drinking early in the day and in the middle of the night, a
sense of loss of control over drinking, or a subjective craving for alcohol.
allostatic load
This concept refers to the fact that physiological systems within the body fluctuate to meet
demands from stress, a state called allostasis.
angina pectoris
Chest pain that occurs because the muscle tissue of the heart is deprived of adequate oxygen or
because removal of carbon dioxide and other wastes interferes with the flow of blood and oxygen
to the heart.
anorexia nervosa
A condition produced by excessive dieting and exercise that yields body weight grossly below
optimal level, most common among adolescent girls.
appraisal delay
The time between recognising that a symptom exists and deciding that it is serious.
appraisal support
Includes helping an individual to understand a stressful event better and what resources and
coping strategies may be mustered to deal with it. Through such exchange of appraisals, the
individual facing a stressful event can determine how threatening the stressful event is likely to be
and can profit from suggestions as to how to offset the stressful aspects of the event.
assertiveness training
Techniques that train people how to be appropriately assertive in social situations; often included
as part of health behaviour modification programmes, on the assumption that some poor health
habits, such as excessive alcohol consumption or smoking, develop in part to control difficulties in
being appropriately assertive.
at risk
State of vulnerability to a particular health problem by virtue of heredity, health practices, or family
environment.
atherosclerosis
A major cause of heart disease; caused by the narrowing of the arterial walls due to the formation
of plaques that reduce the flow of blood through the arteries and interfere with the passage of
nutrients from the capillaries into the cells.
autoimmunity
A condition in which the body produces an immune response against its own tissue constituents.
avoidant (minimising) coping style
The tendency to cope with threatening events by withdrawing, minimising, or avoiding them;
believed to be an effective short-term, though not an effective long-term, response to stress.
B
behavioural assignments
Home practice activities that clients perform on their own as part of an integrated therapeutic
intervention for behaviour modification.
behavioural delay
The time between deciding to seek treatment and actually doing so.
behavioural immunisation
Programmes designed to inoculate people against adverse health habits by exposing them to
mild versions of persuasive communications that try to engage them in a poor health practice and
giving them techniques that they can use to respond effectively to these efforts.
behavioural inoculation
See behavioural immunisation.
biofeedback
A method whereby an individual is provided with ongoing specific information or feedback about
how a particular physiological process operates, so that he or she can learn how to modify that
process.
biomedical model
The viewpoint that illness can be explained on the basis of aberrant somatic processes and that
psychological and social processes are largely independent of the disease process; the dominant
model in medical practice until recently.
biopsychosocial model
The view that biological, psychological, and social factors are all involved in any given state of
health or illness.
blood pressure
The force that blood exerts against vessel walls.
body image
The perception and evaluation of one’s body, one’s physical functioning, and one’s appearance.
breast self-examination (BSE)
Monthly practice of checking the breasts to detect alterations in the underlying tissue; a chief
method of detecting breast cancer.
broad-spectrum cognitive-behavioural therapy
The use of a broad array of cognitive-behavioural intervention techniques to modify an
individual’s health behaviour.
buffering hypothesis
The hypothesis that coping resources are useful primarily under conditions of high stress and not
necessarily under conditions of low stress.
bulimia
An eating syndrome characterised by alternating cycles of binge eating and purging through such
techniques as vomiting or extreme dieting.
C
cardiac invalidism
A psychological state that can result after a myocardial infarction or diagnosis of coronary heart
disease, consisting of the perception that a patient’s abilities and capacities are lower than they
actually are; both patients and their spouses are vulnerable to these misperceptions.
cardiac rehabilitation
An intervention programme designed to help heart patients achieve their optimal physical,
medical, psychological, social, emotional, vocational, and economic status after the diagnosis of
heart disease or a heart attack.
cardiopulmonary resuscitation (CPR)
A method of reviving the functioning of heart and lungs after a loss of consciousness in which the
patient’s pulse has ceased or lungs have failed to function appropriately.
cardiovascular system
The transport system of the body responsible for carrying oxygen and nutrients to the body and
carrying away carbon dioxide and other wastes to the kidneys for excretion; composed of the
heart, blood vessels, and blood.
catecholamines
The neurotransmitters epinephrine and norepinephrine that promote sympathetic nervous system
activity; released in substantial quantities during stressful times.
cerebellum
Part of the hindbrain responsible for the coordination of voluntary muscle movement, the
maintenance of balance and equilibrium, and the maintenance of muscle tone and posture.
cerebral cortex
The main portion of the brain, responsible for intelligence, memory, and the detection and
interpretation of sensation.
chronic benign pain
Pain that typically persists for 6 months or longer and is relatively intractable to treatment. The
pain varies in severity and may involve any of a number of muscle groups. Chronic low back pain
and myofascial pain syndrome are examples.
chronic illnesses
Illnesses that are long lasting and usually irreversible.
chronic pain
Pain that may begin after an injury, but which does not respond to treatment and persists over
time.
chronic progressive pain
Pain that persists longer than 6 months and increases in severity over time. Typically it is
associated with malignancies or degenerative disorders such as skeletal metastatic disease or
rheumatoid arthritis.
chronic strain
Stressful experience that is a usual but continually stressful aspect of life.
classical conditioning
The pairing of a stimulus with an unconditioned reflex, such that over time, the new stimulus
acquires a conditioned response, evoking the same behaviour; the process by which an
automatic response is conditioned to a new stimulus.
clinical thanatology
The clinical practice of counseling people who are dying on the basis of knowledge of reactions to
dying.
cognitive-behaviour therapy
The use of principles from learning theory to modify the cognitions and behaviours associated
with some behaviour to be modified; cognitive-behaviour approaches are used to modify poor
health habits such as smoking, poor diet, and alcoholism.
cognitive costs
An approach to the study of stress that emphasises how stressful events tax perceptual and
cognitive resources, draw off attention, or deplete cognitive resources for other tasks.
cognitive restructuring
A method of modifying internal monologues in stress-producing situations; clients are trained to
monitor what they say to themselves in stress-provoking situations and then to modify their
cognitions in adaptive ways.
colleague orientation
Physician orientation toward gaining the esteem and regard of one’s colleagues; fostered by any
health care provider arrangement that does not involve direct reimbursement of physicians by
patients.
comprehensive intervention model
A model that pools and coordinates the medical and psychological expertise in some well-defined
area of medical practice so as to make all available technology and expertise available to a
patient; the pain management programme is one example of a comprehensive intervention
model.
confrontative (vigilant) coping style
The tendency to cope with stressful events by tackling them directly and attempting to develop
solutions; may ultimately be an especially effective method of coping, although it may produce
accompanying distress.
contingency contracting
A procedure in which an individual forms a contract with another person, such as a therapist,
detailing what rewards or punishments are contingent on the performance or nonperformance of
some target behaviour.
control-enhancing interventions
Interventions with patients who are awaiting treatment for the purpose of enhancing their
perceptions of control over those treatments.
controlled drinking skills
Training in discriminating blood alcohol level so as to control extent of drinking; may also include
coping skills for dealing with situations that are high risk for high alcohol consumption; see also
placebo drinking.
conversion hysteria
Viewpoint originally advanced by Freud that specific unconscious conflicts can produce physical
disturbances symbolic of the repressed conflict; no longer a dominant viewpoint in health
psychology.
coping
The process of trying to manage demands that are appraised as taxing or exceeding one’s
resources.
coping outcomes
The beneficial effects that are thought to result from successful coping; these include reducing
stress, adjusting more successfully to it, maintaining emotional equilibrium, having satisfying
relationships with others, and maintaining a positive self-image.
coping style
An individual’s preferred method of dealing with stressful situations.
coronary heart disease (CHD)
A general term referring to illnesses caused by atherosclerosis, which is the narrowing of the
coronary arteries, the vessels that supply the heart with blood.
correlational research
Measuring two variables and determining whether they are associated with each other. Studies
relating smoking to lung cancer are correlational, for example.
cost containment
The effort to reduce or hold down health care costs.
cost-effectiveness
The formal evaluation of the effectiveness of some intervention relative to its cost and the cost of
alternative interventions.
costs of coping
The depletion of internal or external resources that occurs in response to attempting to manage
stressful events.
counter-irritation
A pain control technique that involves inhibiting pain in one part of the body by stimulating or
mildly irritating another area, sometimes adjacent to the area in which the pain is experienced.
craving
A strong desire to engage in a behaviour or consume a substance, such as alcohol or tobacco,
which appears, in part, to occur through the conditioning of physical dependence on
environmental cues associated with the behaviour.
creative nonadherence
The modification or supplementation of a prescribed treatment regimen on the basis of privately
held theories about the disorder or its treatment.
D
daily hassles
Minor daily stressful events; believed to have a cumulative effect in increasing the likelihood of
illness.
death education
Programmes designed to inform people realistically about death and dying, the purpose of which
is to reduce the terror connected with and avoidance of the topic.
delay behaviour
The act of delaying seeking treatment for recognised symptoms.
denial
A defense mechanism involving the inability to recognise or deal with external threatening events;
believed to be an early reaction to the diagnosis of a chronic or terminal illness.
depression
A neurotic or psychotic mood disorder marked especially by sadness, inactivity, difficulty with
thinking and concentration, a significant increase or decrease in appetite and time spent sleeping,
feelings of dejection and hopelessness, and sometimes suicidal thoughts or an attempt to commit
suicide.
detoxification
The process of withdrawing from alcohol, usually conducted in a supervised, medically monitored
setting.
diabetes
A chronic disorder in which the body is not able to manufacture or utilise insulin properly.
diagnostic-related groups (DRGs)
A patient classification scheme that specifies the nature and length of treatment for particular
disorders; used by some third-party reimbursement systems to determine the amount of
reimbursement.
dieticians
Trained and licensed individuals who apply principles of nutrition and food management to meal
planning for institutions such as hospitals or for individuals who need help planning and managing
special diets.
direct effects hypothesis
The theory that coping resources, such as social support, have beneficial psychological and
health effects under conditions of both high stress and low stress.
disease prototypes
Organised concepts of specific diseases based on their origins, duration, symptoms, and
treatment; believed to guide the interpretation of symptoms.
discriminative stimulus
An environmental stimulus that is capable of eliciting a particular behaviour; for example, the sight
of food may act as a discriminative stimulus for eating.
distraction
A pain control method that may involve either focusing on some stimulus irrelevant to the pain
experience or reinterpreting the pain experience; redirecting attention to reduce pain.
double-blind experiment
An experimental procedure in which neither the researcher nor the patient knows whether the
patient received the real treatment or the placebo until precoded records indicating which patient
received which are consulted; designed to reduce the possibility that expectations for success will
increase evidence for success.
E
emotional support
Indications from other people that one is loved, valued, and cared for; believed to be an important
aspect of social support during times of stress.
endocrine system
A system of ductless glands that secrete hormones into the blood to stimulate target organs;
interacts with nervous system functioning.
endogenous opioids
Opiate-like substances produced by the body.
epidemiology
The study of the frequency, distribution, and causes of infectious and noninfectious disease in a
population, based on an investigation of the physical and social environment. Thus, for example,
epidemiologists not only study who has what kind of cancer, but also address questions such as
why certain cancers are more prevalent in particular geographic areas than other cancers are.
etiology
The origins and causes of illness.
euthanasia
Ending the life of a person with a painful terminal illness for the purpose of terminating the
individual’s suffering.
experiment
A type of research in which a researcher randomly assigns people to two or more conditions,
varies the treatments that people in each condition are given, and then measures the effect on
some response.
F
fear appeals
Efforts to change attitudes by arousing fear to induce the motivation to change behaviour; fear
appeals are used to try to get people to change poor health habits.
fight-or-flight response
A response to threat in which the body is rapidly aroused and motivated via the sympathetic
nervous system and the endocrine system to flee or attack a threatening stimulus; the response
was first described by Walter Cannon in 1932.
G
general adaptation syndrome
Developed by Hans Selye, a profile of how organisms respond to stress; the general adaptation
syndrome is characterised by three phases: a nonspecific mobilisation phase that promotes
sympathetic nervous system activity; a resistance phase, during which the organism makes
efforts to cope with the threat; and an exhaustion phase, which occurs if the organism fails to
overcome the threat and depletes its physiological resources.
gout
A form of arthritis produced by a buildup of uric acid in the body, producing crystals that become
lodged in the joints; the most commonly affected area is the big toe.
grief
A response to bereavement involving a feeling of hollowness and sometimes marked by
preoccupation with the dead person, expressions of hostility toward others, and guilt over death;
may also involve restlessness, inability to concentrate, and other adverse psychological and
physical symptoms.
guided imagery
A technique of relaxation and pain control in which a person conjures up a picture that is held in
mind during a painful or stressful experience.
H
hardiness
An individual difference characterised by a sense of commitment, a belief in personal control, and
a willingness to confront challenge; believed to be a useful resource in coping with stressful
events.
health
The absence of disease or infirmity, coupled with a complete state of physical, mental, and social
well-being; health psychologists recognise health to be a state that is actively achieved rather
than the mere absence of illness.
health behaviours
Behaviours undertaken by people to enhance or maintain their health, such as exercise or the
consumption of a healthy diet.
health belief model
A theory of health behaviours; the model predicts that whether a person practices a particular
health habit can be understood by knowing the degree to which the person perceives a personal
health threat and the perception that a particular health practice will be effective in reducing that
threat.
health habit
A health-related behaviour that is firmly established and often performed automatically, such as
buckling a seat belt or brushing one’s teeth.
health locus of control
The perception that one’s health is under personal control, is controlled by powerful others such
as physicians, or is determined by external factors including chance.
health maintenance organisation (HMO)
An organisational arrangement for receiving health care services, by which an individual pays a
standard monthly rate and then uses services as needed at no additional or at greatly reduced
cost.
health promotion
A general philosophy that maintains that health is a personal and collective achievement; the
process of enabling people to increase control over and improve their health. Health promotion
may occur through individual efforts, through interaction with the medical system, and through a
concerted health policy effort.
health psychology
The subarea within psychology devoted to understanding psychological influences on health,
illness, and responses to those states, as well as the psychological origins and impacts of health
policy and health interventions.
helplessness
The belief that one is powerless to effect change in one’s environment.
holistic health
A philosophy characterised by the belief that health is a positive state that is actively achieved;
usually associated with certain nontraditional health practices.
home care
Care for dying patients in the home; the choice of care for the majority of terminally ill patients,
though sometimes problematic for family members.
hospice
Institution for dying patients that encourages personalised, warm, palliative care.
hospice care
An alternative to hospital and home care, designed to provide warm, personal comfort for
terminally ill patients; may be residential or home based.
human immunodeficiency virus (HIV)
The virus that is implicated in the development of AIDS.
hypertension
Excessively high blood pressure that occurs when the supply of blood through the blood vessels
is excessive, putting pressure on the vessel walls; a risk factor for a variety of medical problems,
including coronary artery disease.
hypnosis
A pain management technique involving relaxation, suggestion, distraction, and the focusing of
attention.
hypothalamus
That part of the forebrain responsible for regulating water balance and controlling hunger and
sexual desire; assists in cardiac functioning, blood pressure regulation, and respiration regulation;
has a major role in regulation of the endocrine system, which controls the release of hormones
including those related to stress.
I
illness delay
The time between recognising that a symptom implies an illness and the decision to seek
treatment.
illness representation (or schema)
An organised set of beliefs about an illness or type of illness, including its nature, cause, duration,
and consequences.
immunity
The body’s resistance to injury from invading organisms, acquired from the mother at birth,
through disease, or through vaccinations and inoculations.
immunocompetence
The degree to which the immune system functions effectively.
infant mortality rate
The number of infant deaths per thousand infants.
informational support
The provision of information to a person going through stress by friends, family, and other people
in the individual’s social network; believed to help reduce the distressing and healthcompromising effects of stress.
ischemia
Deficiency of blood supply to the heart due to obstruction or constriction of the coronary arteries;
often associated with chest pain.
J
John Henryism
A personality predisposition to cope actively with psychosocial stressors; may become lethal
when those active coping efforts are unsuccessful; the syndrome has been especially
documented among lower income Blacks at risk for or suffering from hypertension.
L
lay referral network
An informal network of family and friends who help an individual interpret and treat a disorder
before the individual seeks formal medical treatment.
learned helplessness
A response to helplessness in which an individual not only learns to cease responding in an
environment in which helplessness was initially experienced but also ceases to respond in new
environments in which adaptive responses are possible.
life-skills-training approach
A smoking-prevention programme characterised by the belief that training in self-esteem and
coping skills will boost self-image to the point that smoking becomes unnecessary or inconsistent
with lifestyle.
lifestyle rebalancing
Concerted lifestyle change in a healthy direction, usually including exercise, stress management,
and a healthy diet; believed to contribute to relapse prevention after successful modification of a
poor health habit, such as smoking or alcohol consumption.
living will
A will prepared by a person with a terminal illness requesting that extraordinary life-sustaining
procedures not be used in the event that the ability to make this decision is lost.
longitudinal research
The repeated observation and measurement of the same individuals over a period of time.
lymphatic system
The drainage system of the body; believed to be involved in immune functioning.
M
managed care nonadherence
The failure to comply fully with treatment recommendations for modification of a health habit or
illness state.
matching hypothesis
The hypothesis that social support is helpful to an individual to the extent that the kind of support
offered satisfies the individual’s specific needs.
medical delay
Delay in treating symptoms that results from problems within the medical system, such as faulty
diagnoses, lost test results, and the like.
medical students’ disease
The relabeling of symptoms of fatigue and exhaustion as a particular illness resulting from
learning about that illness; called medical students’ disease because overworked medical
students are vulnerable to this labeling effect.
medulla
Section of the hindbrain responsible for the control of reflex activities of the body.
metabolic syndrome
Metabolic syndrome is a pattern of risk factors for the chronic health problems of diabetes, heart
disease, and hypertension, characterised by obesity, a high waist to hip ratio, and insulin
resistance. Metabolic syndrome is exacerbated by inactivity, overeating, age, and hostility.
mind-body relationship
The philosophical position regarding whether the mind and body operate indistinguishably as a
single system or whether they act as two separate systems; the view guiding health psychology is
that the mind and body are indistinguishable.
modeling
Learning gained from observing another person performing a target behaviour.
monitoring/blunting
The degree to which people deal with threat by scanning the environment for threat-relevant
information (monitoring) or by ignoring threat-relevant information (blunting).
morbidity
The number of cases of a disease that exist at some given point in time; it may be expressed as
the number of new cases (incidence) or as the total number of existing cases (prevalence).
mortality
The number of deaths due to particular causes.
myocardial infarction
Heart attack produced when a clot has developed in a coronary vessel, blocking the flow of blood
to the heart.
N
negative affectivity
A personality variable marked by a pervasive negative mood, including anxiety, depression, and
hostility; believed to be implicated in the experience of symptoms, the seeking of medical
treatment, and possibly also illness.
nervous system
The system of the body responsible for the transmission of information from the brain to the rest
of the body and from the rest of the body to the brain; it is composed of the central nervous
system (the brain and the spinal cord) and the peripheral nervous system (which consists of the
remainder of the nerves in the body).
neurotransmitters
Chemicals that regulate nervous system functioning.
nociception
The perception of pain.
nonspecific immune mechanisms
A set of responses to infection or disorder that is engaged by the presence of some biological
invader.
nurse-practitioners
Nurses who, in addition to their training in traditional nursing, receive special training in primary
care so they may provide routine medical care for patients.
O
obesity
An excessive accumulation of body fat, believed to contribute to a variety of health disorders,
including cardiovascular disease.
occupational therapists
Trained and licensed individuals who work with emotionally and/or physically disabled people to
determine skill levels and to develop a rehabilitation programme to build on and expand these
skills.
operant conditioning
The pairing of a voluntary, nonautomatic behaviour to a new stimulus through reinforcement or
punishment.
osteoarthritis
A form of arthritis that results when the articular cartilage begins to crack or wear away because
of overuse of a particular joint; may also result from injury or other causes; usually affects the
weight-bearing joints and is common among athletes and the elderly.
P
pain behaviours
Behaviours that result in response to pain, such as cutting back on work or taking drugs.
pain control
The ability to reduce the experience of pain, report of pain, emotional concern over pain, inability
to tolerate pain, or presence of pain-related behaviours.
pain management programmes
Coordinated, interdisciplinary efforts to modify chronic pain by bringing together neurological,
cognitive, behavioural, and psychodynamic expertise concerning pain; such programmes aim not
only to make pain more manageable, but to modify the lifestyle that has evolved because of the
pain.
pain-prone personality
The belief that there is a constellation of personality traits that predisposes a person to
experience chronic pain.
palliative care
Care designed to make the patient comfortable, but not to cure or improve the patient’s
underlying disease; often part of terminal care.
parasympathetic nervous system
The part of the nervous system responsible for vegetative functions, conservation of energy, and
damping down the effects of the sympathetic nervous system.
passive smoking
Smoke inhaled by nonsmokers as a result of exposure to smokers; believed to cause health
problems such as bronchitis, emphysema, and lung cancer.
patient education
Programmes designed to inform patients about their disorder and its treatment and to train them
in methods for coping with a disorder and its corresponding limitations.
patient orientation
Orientation by physicians primarily toward the patient’s psychological and medical welfare;
fostered by private, fee-for-service care.
perceived stress
The perception that an event is stressful independent of its objective characteristics.
person-environment fit
The degree to which the needs and resources of a person and the needs and resources of an
environment complement each other.
pessimistic explanatory style
A chronic tendency to explain negative events as due to internal, stable, and global qualities of
the self and to attribute positive events to external, unstable, and nonglobal factors; believed to
contribute to the likelihood of illness.
phagocytosis
The process by which phagocytes ingest and attempt to eliminate a foreign invader.
physical dependence
A state in which the body has adjusted to the use of a substance, incorporating it into the body’s
normal functioning.
physical rehabilitation
A programme of activities for chronically ill or disabled persons geared toward helping them use
their bodies as much as possible, sense changes in the environment and in themselves so as to
make appropriate physical accommodations, learn new physical and management skills if
necessary, pursue a treatment regimen, and learn how to control the expenditure of energy.
physical therapists
Trained and licensed individuals who help people with muscle, nerve, joint, or bone diseases to
overcome their disabilities as much as possible.
physicians’ assistants
Graduates of 2-year programmes who perform routine health care functions, teach patients about
their treatment regimens, and record medical information.
pituitary gland
A gland located at the base of and controlled by the brain that secretes the hormones responsible
for growth and organ development.
placebo
A medical treatment that produces an effect in a patient because of its therapeutic intent and not
its nature.
placebo drinking
The consumption of nonalcoholic beverages in social situations in which others are drinking
alcohol.
placebo effect
The medically beneficial impact of an inert treatment.
placebo-prone personality
A constellation of attributes believed to predispose people to experiencing placebo effects;
although the idea of a placebo-prone personality is now largely discredited, some personality
characteristics do increase the likelihood that a person will show a placebo effect.
platelets
Carried by the blood; they clump together to block holes in blood vessels and are implicated in
blood clotting.
post-traumatic stress disorder (PTSD)
A syndrome that results after exposure to a stressor of extreme magnitude, marked by emotional
numbing, reliving aspects of the trauma, intense responses to other stressful events, and other
symptoms such as hyperalertness, sleep disturbance, guilt, or impaired memory or concentration.
preferred provider organisation (PPO)
A network of affiliated practitioners that has agreed to charge preestablished rates for particular
medical services.
premature death
Death that occurs before the projected age of 75.
primary appraisal
The perception of a new or changing environment as beneficial, neutral, or negative in its
consequences; believed to be a first step in stress and coping.
primary prevention
Measures designed to combat risk factors for illness before an illness ever has a chance to
develop.
private fee-for-service care
The condition under which patients privately contract with physicians for services and pay them
for services rendered.
problem drinking
Uncontrolled drinking that leads to social, psychological, and biomedical problems resulting from
alcohol; the problem drinker may show some signs associated with alcoholism, but typically,
problem drinking is considered to be a prealcoholic or a lesser alcoholic syndrome.
prospective research
A research strategy in which people are followed forward in time to examine the relationship
between one set of variables and later occurrences. For example, prospective research can
enable researchers to identify risk factors for diseases that develop at a later point in time.
psychological control
The perception that one has at one’s disposal a response that will reduce, minimise, eliminate, or
offset the adverse effects of some unpleasant event, such as a medical procedure.
psychosomatic medicine
A field within psychiatry related to health psychology that developed in the early 1900s to study
and treat particular diseases believed to be caused by emotional conflicts, such as ulcers,
hypertension, and asthma. The term is now used more broadly to mean an approach to healthrelated problems and diseases that examines psychological as well as somatic origins.
Q
quality of life
The degree to which a person is able to maximise his or her physical, psychological, vocational,
and social functioning; an important indicator of recovery from or adjustment to chronic illness.
R
reactivity
Predisposition to react physiologically to stress; believed to be genetically based in part; high
reactivity is believed to be a risk factor for a range of stress-related diseases.
recurrent acute pain
Pain that involves a series of intermittent episodes of pain that are acute in character but chronic
inasmuch as the condition persists for more than 6 months; migraine headaches,
temperomandibular disorder (involving the jaw), and trigeminal neuralgia (involving spasms of the
facial muscles) are examples.
relapse prevention
A set of techniques designed to keep people from relapsing to priour poor health habits after
initial successful behaviour modification; includes training in coping skills for high-risk-for-relapse
situations and lifestyle rebalancing.
relaxation training
Procedures that help people relax, which include progressive muscle relaxation and deep
breathing; may also include guided imagery and forms of meditation or hypnosis.
renal system
Part of the metabolic system; responsible for the regulation of bodily fluids and the elimination of
wastes; regulates bodily fluids by removing surplus water, surplus electrolytes, and waste
products generated by the metabolism of food.
repression
A psychological defense by which individuals unable to deal with their own anxiety because of
threatening events push these impulses into the unconscious; as a coping style, repression
involves ignoring or not dealing fully with threatening events.
respiratory system
The system of the body responsible for taking in oxygen, excreting carbon dioxide, and regulating
the relative composition of the blood.
retrospective research
A research strategy whereby people are studied for the relationship of past variables or
conditions to current ones. Interviewing people with a particular disease and asking them about
their childhood health behaviours or exposure to risks can identify conditions leading to an adult
disease, for example.
rheumatoid arthritis
A crippling form of arthritis believed to result from an autoimmune process, usually attacking the
small joints of the hands, feet, wrists, knees, ankles, and neck.
role conflict
Occurs when two or more social or occupational roles that an individual occupies produce
conflicting standards for behaviour.
S
secondary appraisal
The assessment of one’s coping abilities and resources and judgment as to whether they will be
sufficient to meet the harm, threat, or challenge of a new or changing event.
secondary gains
Benefits of being treated for illness, including the ability to rest, to be freed from unpleasant tasks,
and to secondhand smoke. See passive smoking.
self-concept
An integrated set of beliefs about one’s personal qualities and attributes.
self-control
A state in which an individual desiring to change behaviour learns how to modify the antecedents
and the consequences of that target behaviour.
self-efficacy
The perception that one is able to perform a particular action.
self-esteem
A global evaluation of one’s qualities and attributes.
self-help aids
Materials that can be used by an individual on his or her own without aid of a therapist to assist in
the modification of a personal habit; often used to combat smoking and other health-related risk
factors.
self-observation and self-monitoring
Assessing the frequency, antecedents, and consequences of a target behaviour to be modified.
self-reinforcement
Systematically rewarding or punishing oneself to increase or decrease the occurrence of some
target behaviour.
self-talk
Internal monologues; people tell themselves things that may undermine or help them implement
appropriate health habits, such as "I can stop smoking" (positive self-talk), or "I’ll never be able to
do this" (negative self-talk).
separation anxiety
Feelings of fear or extreme distress that result from separation from someone important, usually
the mother.
set point theory of weight
The concept that each individual has an ideal biological weight that cannot be greatly modified.
smoking prevention programmes
Programmes designed to keep people from beginning to smoke, as opposed to programmes that
attempt to induce people to stop once they have already become smokers.
social engineering
Social or lifestyle change through legislation; for example, water purification is done through
social engineering rather than by individual efforts.
social influence intervention
A smoking-prevention intervention that draws on the social learning principles of modeling and
behavioural inoculation in inducing people not to smoke; youngsters are exposed to older peer
models who deliver antismoking messages after exposure to simulated peer pressure to smoke.
social-skills training
Techniques that teach people how to relax and interact comfortably in social situations; often a
part of health-behaviour modification programmes, on the assumption that maladaptive health
behaviours, such as alcohol consumption or smoking, may develop in part to control social
anxiety.
social support
Information from other people that one is loved and cared for, esteemed and valued, and part of a
network of communication and mutual obligation.
social workers
Trained and licensed individuals who help patients and their families deal with problems by
providing therapy, making referrals, and engaging in social planning; medical social workers help
patients and their families ease transitions between illness and recovery states.
socialisation
The process by which people learn the norms, rules, and beliefs associated with their family and
society; parents and social institutions are usually the major agents of socialisation.
somaticisers
People who express distress and conflict through bodily symptoms.
specific immune mechanisms
A set of responses designed to respond to specific invaders; includes cell-mediated and humoral
immunity.
stages of dying
A theory developed by Kübler-Ross that maintains that people go through five temporal stages in
adjusting to the prospect of death: denial, anger, bargaining, depression, and acceptance;
believed to characterise some but not all dying people.
stimulus-control interventions
Interventions designed to modify behaviour that involve the removal of discriminative stimuli that
evoke a behaviour targeted for change and the substitution of new discriminative stimuli that will
evoke a desired behaviour.
stress
Appraising events as harmful, threatening, or challenging, and assessing one’s capacity to
respond to those events; events perceived to tax or exceed one’s resources are perceived as
stressful.
stress carriers
Individuals who create stress for others without necessarily increasing their own level of stress.
stress eating
Eating in response to stress; approximately half the population increases eating in response to
stress.
stress inoculation
The process of identifying stressful events in one’s life and learning skills for coping with them, so
that when the events come up, one can put those coping skills into effect.
stress management
A programme for dealing with stress in which people learn how they appraise stressful events,
develop skills for coping with stress, and practice putting these skills into effect.
stress markers
Physiological changes, emotional reactions, or cognitive responses that are believed to be
indicative of the amount of stress an individual is experiencing; stress markers are indirect
measures of stress, because stress cannot itself be directly assessed.
stress moderators
Internal and external resources and vulnerabilities that modify how stress is experienced and its
effects.
stressful life events
Events that force an individual to make changes in his or her life.
stressors
Events perceived to be stressful.
stroke
A condition that results from a disturbance in blood flow to the brain, often marked by resulting
physical or cognitive impairments and, in the extreme, death.
sudden death syndrome
An abrupt loss of life, believed to be caused by the combination of a preexisting biological
weakness and an extremely stressful and unexpected event, producing feelings of extreme
hopelessness or helplessness.
sudden infant death syndrome (SIDS)
A common cause of death among infants, in which an infant simply stops breathing.
support group
A group of individuals who meet regularly and usually share some common problem or concern;
support groups are believed to help people cope because they provide opportunities to share
concerns and exchange information with similar others.
symbolic immortality
The sense that one is leaving a lasting impact on the world, as through one’s children or one’s
work, or that one is joining the afterlife and becoming one with God.
sympathetic nervous system
The part of the nervous system that mobilises the body for action.
systems theory
The viewpoint that all levels of an organisation in any entity are linked to each other hierarchically
and that change in any level will bring about change in other levels.
T
tangible assistance
Involves the provision of material support by one person to another, such as services, financial
assistance, or goods.
teachable moment
The idea that certain times are especially good for teaching particular health practices than
others; pregnancy constitutes a teachable moment for getting women to stop smoking.
terminal care
Medical care of the terminally ill.
testicular self-examination (TSE)
The practice of checking the testicles to detect alterations in the underlying tissue; a chief method
of detecting early testicular cancer.
thalamus
That portion of the forebrain responsible for the recognition of sensory stimuli and the relay of
sensory impulses to the cerebral cortex.
thanatologists
Those who study death and dying.
theory of planned behaviour
Derived from the theory of reasoned action, this theoretical viewpoint maintains that a person’s
behavioural intentions and behaviours can be understood by knowing the person’s attitudes
about the behaviour, subjective norms regarding the behaviour, and perceived behavioural
control over that action.
time management
Skills for learning how to use one’s time more effectively to accomplish one’s goals.
tolerance
The process by which the body increasingly adapts to a substance, requiring larger and larger
doses of it to obtain the same effects; a frequent characteristic of substance abuse, including
alcohol and drug abuse.
transtheoretical model of behaviour change
An analysis of the health behaviour change process that draws on the stages and processes
people go through in order to bring about successful long-term behaviour change. Stages include
precontemplation, contemplation, preparation, action, and maintenance. Successful attitude or
behaviour change at each stage depends on the appropriateness of intervention. For example,
attitude change materials help move people from precontemplation to contemplation, whereas
relapse prevention techniques help move people from action to maintenance.
treatment effectiveness
Formal documentation of the success of an intervention.
Type A behaviour syndrome
A behavioural and emotional style marked by an aggressive, unceasing struggle to achieve more
and more in less time, often in hostile competition with other individuals or forces; a risk factor for
coronary artery disease. Hostility appears to be especially implicated as the risk factor.
W
window of vulnerability
The fact that, at certain times, people are more vulnerable to particular health problems. For
example, early adolescence constitutes a window of vulnerability for beginning smoking, drug
use, and alcohol abuse.
withdrawal
Unpleasant physical and psychological symptoms that people experience when they stop using a
substance on which they have become physically dependent; symptoms may include anxiety,
craving, hallucinations, nausea, headaches, and shaking.
worried well
Individuals free from illness who are nonetheless concerned about their physical state and
frequently and inappropriately use medical services.
Y
yo-yo dieting
The process of chronically alternating between dieting and regular eating, leading to successive
weight gains and losses; over time, yo-yo dieters increase their chances of becoming obese by
altering their underlying metabolism.