INTRODUCTION

Definition: Psychology is the scientific study of human behavior in all its different forms, especially in relation to the social environment. It is concerned with the study of normal behaviour, in contrast to psychiatry or psychological medicine which is that branch of medicine dealing with diagnosis and treatment of abnormal behaviour in psychologically disturbed patients. Psychology is, therefore, related to psychiatry, as physiology to medicine.

Prologue: Psychology’s Roots Prescientific Psychology Is the mind connected to the body or distinct? Are ideas inborn or is the mind a blank slate filled by experience?

Prologue: Psychology’s Roots Psychological Science Is Born Empiricism Knowledge comes from experience via the senses Science flourishes through observation and experiment

Prologue: Psychology’s Roots Wilhelm Wundt opened the first psychology laboratory at the University of Liepzig (c. 1879)

Prologue: Psychology’s Roots Structuralism used introspection (looking in) to explore the elemental structure of the human mind

Prologue: Psychology’s Roots Functionalism focused on how behavioral processes function- how they enable organism to adapt, survive, and flourish

Prologue: Psychology’s Roots Psychological Science Develops Wundt--German philosopher and physiologist James--American philosopher Pavlov--Russian physiologist Freud--Austrian physician Piaget--Swiss biologist

Prologue: Psychology’s Roots Definition of Psychology The science of behavior (what we do) and mental processes (sensations, perceptions, dreams, thoughts, beliefs, and feelings)

Prologue: Psychology’s Roots Goals of Psychology Describe Explain Predict Control

Fields of Psychology: General Psychology: Is the branch of psychology which studies the main psychological principles that govern the behaviour of normal individuals. Experimental Psychology: Is that branch of psychology which depends upon experimental and quantitative methods in its investigations.

Child Psychology: Is that branch which studies the psychological growth and development of the child from conception to maturity. Analytical Psychology (Psychoanalysis): This branch was established by Sigmund Freud. It searches about analysis of deep rooted conflicts and unconscious material that can be unmasked through free association. Many schools later developed which differ from classic psychoanalysis in theory and practice.

Comparative Psychology: This branch studies animal psychology comparing it with both child and adult human psychology. It also includes the study of beliefs, habits and behaviour of primitive cultures (Primitive Psychology). Applied Psychology: Includes the following branches:

C. Industrial Psychology A. Medical Psychology B. Educational Psychology: Is concerned with the application of psychological principles to the problems of education of children. C. Industrial Psychology Commercial Psychology:. Occupational Psychology: Vocational Psychology: D. Criminal Psychology:

Methods of Study of Psychology

1) Case history method: In this method a systematic investigation of a person’s life history, personal, social, educational and occupational background is made to detect the environmental factors responsible for the patient’s symptoms. 2) Introspective method or (Subjective method): This is the observation of one’s own internal experience.

3) Objective method: This is the observation and recording of the outward manifest behaviour of the individual. 4) Developmental method: This aims at tracing the mental and emotional development of the individual from birth up to adulthood and senility. The influence and interaction of heredity and environment is considered in forming the personality and development of mental illness or behaviour disorder.

5) Experimental method: One of the many conditions in a situation is changed (experimental variable) and the effect on some activity of the individual (reaction) is measured. All other conditions are controlled and the results then can be attributed to the influence of the experimental variable.

MODELS OF HEALTH AND ILLNESS

There are two main models each of them had its roots, history, characteristics and justifications: A) The biomedical model. B) The rise of the biopsychosocial model.

There are two main models each of them had its roots, history, characteristics and justifications: A) The biomedical model. B) The rise of the biopsychosocial model.

A) The Biomedical Model: 1- Dualistic: Physical and psychosocial processes are separate and disease is not influenced by the latter. 2- Mechanistic: The body is like a machine and disease occurs when the normal operation of the body machine is disputed by a foreign agent.

3- Reductionistic : Ignores the complexity of factors focusing only on physical systems. 4- Disease Oriented: Health is defined as absence of disease and efforts rarely go beyond the elimination of disease. This model is enhanced by Germ Theory of diseases in which each pathogen causes a specific disease.

Advantages of the Biomedical Model

1)Development of medications that destroy pathogens. 2)Development of vaccines to protect against viral diseases as polio- and small pox .... etc. 3) Medical technology to diagnose disease (X-rays, and new imaging devices). 4)New surgical procedures (and anesthetics) to reduce complications and save lives. 5)Improved public hygiene and better sanitation.

B) The Rise of the Biopsychosocial Model

Due to the mentioned above changing pattern of illness and the escalating cost of health care, the biomedical model is challenged. However, rather than a new approach the biopsychosocial model is, The biopsychosocial model represents a better alternative for dealing with life style diseases because it takes biological as well as psychosocial factors into account. It, also, fits with systems theory and the concept of homeostasis and feedback.

Systems Theory Can be applied to internal bodily subsystems as well as external systems within which a person’s live.

Homeostasis: Recognizes that optimum functioning depends on balance among the elements of a system. Many of the body’s systems are homeostatic and illness can result from disequilibrium in them.

In the biopsychosocial model health is defined as: “Freedom from illness, as homeostatic balance and as optimal physical, mental and social functioning”.

STRESS IN BIOPSYCHOSOCIAL MODEL

Definition: Stress, in biopsychosocial model, refers to the cognitive appraisal of external events in relation to one’s coping resources and its physiological responses in the individual.

Components of Stress: It has three components: 1) The External Components: The environmental events that precede the recognition of stress (Stressors). It involves: a) Environmental circumstances as natural disasters. b) Changing life events as losing a job. c) Chronic conditions as crowding and poverty.

2) The Internal Components: It is the emotional and physical response of the body to stressors (Strain). Objectively measured by hormonal assay and polygraphic monitoring. It passes through three stages: a) Alarm: Fight and flight, by release of sympathetic and pituitary catecholamines. b) Resistance: Persistence of high levels of hormones to adapt. c) Exhaustion: Energy reserve is exhausted and breakdown occurs. Parasympathetic division dominate with low arousal resulting in depression and even death.

3) The Interaction between the Two Components: Cognition: The term cognition can be used to refer to the entire range of mental processes from input stimuli to output response.

Cognitive Appraisal (Cerebral Activity) 1) Primary Appraisal: That deals with determination of an event as either: a) Eustress, good, benign and positive uplift capable to produce optimum arousal for task performance (effort facilitation), or b) Stressful, harmful or threatening hassles produce higher arousal related to distress and deterioration of performance.

2) Secondary Appraisal: That deals with determination of one’s coping resources as either: Sufficient: Successful coping. b) Insufficient: Vulnerability. Coping: refers to the effort required to manage specific demands of a particular situation. Vulnerability: refers to individual’s lack of actual resources to cope with a situation (exceeding one’s ability).

Illness: is related to stress appraised as harm or threat with insufficient coping resources resulting in much distress than effort. Our actions are not determined by circumstances and events as they exist but as they are perceived or interpreted by the individual. Distress: refers to anxiety, boredom and dissatisfaction. It is experienced as negative emotion.

Physiological Responses to Stress: Based on effort and distress (Hypothalamo-hypophyseal). 1) Effort with distress: Which leads to increase of both catecholamine and cortisol secretions and results from daily hassles. 2) Effort without distress: Which leads to an increase of catecholamine and suppression of cortisol secretion. It is a joyous state with successful coping and positive emotions.

3) Distress without Effort: Which leads to increased cortisol secretion and possibly catecholamine secretion. The pattern typically found in depression. It is defined as helplessness.

3) Distress without Effort: Stress Mediators: These are factors capable of increasing or decreasing the effects of stress. Buffers: They are mediators that protect from the unhealthful effects of stress they “turn the stress-volume down” under conditions of high stress. Through two mechanisms:

1) Direct: that counteracts the physiological responses itself 1) Direct: that counteracts the physiological responses itself. It ameliorates the physical effects of stress and establishing homeostasis by reducing arousal after stress 2) Indirect: that influence transaction affecting cognitive appraisal (primary or secondary). Thus reducing the evaluation of threat and increasing the beliefs in coping abilities.

Some of the studied stress mediators are

1- Type A and B Behaviour patterns. 2- Social support. 3-Personal control. 4- Hardiness. 5-Exercise activity level. 6- Sense of humor. 7- Spiritual support.

1) Type A and B behaviour

a) Non competitive. b) Enjoys the process as much as the goal. c) Patient. d) Little anger and hostility. a) Competitive. b) Goal striving without joy. c) Time urgency, impatient. d) Angry urgency hostile. e) Higher reactivity with rapid response to threat. f) Take more activities thus increasing number of stresses.

Managing Stress

Stress is an inextricable part of living, particularly in our fast-paced, technological world. It cannot be removed from our lives. Some stress is necessary for arousal and may actually be good. Therefore our objective must be to learn how to live with stress while minimizing its unhealthful consequences. That is the goal of stress management not to eliminate stress, but to learn to live compatibly with it.

Applying the Biopsychosocial Model

I. Arousal Management: It attempts to affect physiological responses to stress by targeting the endocrine and autonomic nervous system. It seeks to reestablish homeostasis by reducing arousal after encountering stress.

It consists of both pharmacological and behavioral techniques that prevent or reduce the physiological responses. These therapies include: a) Medication b) Relaxation Training c) Exercise

II. Transaction Management: It attempts to affect the appraisal of stressors by targeting the environment and the cognition (C.N.S) when facing stress. It seeks to reduce the potential for arousal to occur in the first place. There are two types depending on circumstances and changeability of stress or:

1) Problem focused coping : If the problem is changeable. 2)Emotion focused coping: If the stressful stimulus cannot deal with easily or the situation is perceived as unchangeable. Two type of cognitive intervention:

a) Distracting oneself from the stressful situation: as reading or recreation. b) Changing cognitive appraisal: as altering the perception of stress or learning to tolerate or accept. It is called cognitive redefinition (Taylor 1983).

Psychoneuroimmunology

Introduction: The immune system recognizes, responds to and remembers substances that threaten health (antigens). The immune system has two branches according to mechanism of action: like navy and foot army

The humoral branch like navy because it operates through B cell that circulates in the blood b) The cellular branch like foot army because it operates through T cell that can leave the blood stream and more through the tissues. Memory B cells and T cells remain to provide immunity (B cells from bone marrow and T cells from thymus gland). The immune has also two responses: according to type of lymphocyte

A) Non-specific Response

Where non-specific lymphocytes are the front line Both Natural Killers (Nk-cells) that destroy tumors and viruses. Macrophages that attack bacteria and pass information about the antigen to specific Helper T cells. Specific Response Where specific lymphocytes used the information passes few macrophages to produce T Killer cells and B cells become plasma cells that secrete antibodies.

Definition: Psychoneuroimmunology is the field concerned with relationships among the mind (psycho), the nervous and endocrine systems (neur) and the immune system (immunology). The central idea is that psychosocial factors can influence immune responses through the brain as a master regulator for bodily system.

The Role of the Brain: The immune system for the body like an army to the nation and the brain is the leader, who communicate with it they: 1. The hypothalamus, locus ceruleus, and the limbic system: are areas of the brain that are most related to immune function. Activity in different brain regions can regulate the homeostasis of the immune system by either enhancing or inhibiting it.

2. The brain also communicates directly with individual lymphocytes 2. The brain also communicates directly with individual lymphocytes. Lymphocytes have receptor sites on their surfaces for certain hormones and the neurotransmitter catecholamine. 3. The autonomic nervous system: the sympathetic nervous system fibers provide a direct link between the brain and the lymphocytes, spleen and thymus.

4. Activation of the hypothalamic-pituitary-adrenal connection: this is the same general pathway for physiological response to stress. 5. Feedback from hormones and other chemicals produced by lymphocytes and macrophages. 6. Classical conditioning as one mechanism where psychosocial factors affect the immune system

ADDICTION Biopsychosocial Model

Definitions: 1- General: Addiction involves devoting oneself to a habit, appetite or behaviour but it does not exclude choice and responsibility. 2- Specific: Addiction, to psychoactive substance is based on their ability to affect the brain’s homeostasis. Trials have failed to solve this problem on international or national level. Proper confrontation, now, should be planned on individual basis.

I. The biomedical model of addiction

This model defines addiction as a disease characterized by physical dependence (tolerance and withdrawal), and focuses on biological factors only. - Tolerance: Increased doses are required to achieve the desired effect. - Withdrawal: Uncomfortable symptoms due to discontinuation of substance after prolonged use. Labeling addiction as a disease reduces blaming, guilt, stigma and encourage abusers to enter treatment.

II. The biopsychosocial model of addiction

This model is comprehensive and takes into account the role of the brain, motivation, learning and social influences.

The Brain: Responsible for pleasure and pain or Reward and punishment - Limbic system: The median forebrain bundle runs through the hypothalamus. - Hypothalamus : Having centers for primary drives as thirst, hunger, aggression and sex. These primary drives generate mild feeling of discomfort that push one for satisfaction which is experienced as reduced discomfort or pleasure (Reward).

- Neurotransmitters: Two of them: P1 substance: message of pain. Endorphins: block pain and produce pleasure. - Genetic predisposition: in some people in their brains to certain psychoactive substances.

Motivation: The use of substance is a motivated choice People decide to use a substance according to their expectations that pleasure will outweigh painful consequences. They may not be aware about this process. People who experience little stimulation should be vulnerable to use a stimulant like cocaine, while those who have too much arousal should be vulnerable to use a sedative like valium. Both try to improve their mood through “self regulation” of the brain.

Learning

Classical conditioning: Explains the relapses after long periods of substance by exposure to cues. Cues: They are conditioned stimuli which are used to enjoy the pleasant response of the drug.

Operant conditioning: Explains how use can become abuse by contiguity of reinforcement (timing). The reward (pleasure) of the drug are immediate while punishments (complications) come later.

Avoidant conditioning: Explains the abuse is maintained. Use of the substance is now reinforced by its ability to allow one to avoid the punishment it has caused.

Social Influences: People are influenced by the environment in which they live: 1. Availability, legibility and cost of substance. 2. Advertising and modeling. 3. Peer pressure. 4. Laws and customs.