LECT 2. BEHAVIOUR MEDICINE.pptx. .

Behavioral health

1. BEHAVIOR MEDICINE One of the major application of behavioural science is to provide behaviour medicine to people Mrs Tafadzwa

2. Definition of behavior medicine Behavioral medicine is the interdisciplinary field concerned with the development and integration of the behavioral and biomedical science, knowledge and techniques relevant to health and illness.

3. Examination of Bio-psychosocial Contexts of Problems Behavioral medicine examines the broad bio- psychosocial context of the following problem areas. Etiology Host Resistance Disease Mechanism Patient-Decision Making Compliance Intervention

4. Etiology How do critical life events, characteristics behavior and personality organization predispose an individual to physical illness, a person with anxious personality are more prone to hypertension.

5. Host resistance How are the effects of stress mitigated by resistance resources like coping style, social support and certain personality traits. Persons with good coping skills can manage stressful situations without much negative effects on their health.

6. Disease mechanism How is human physiology altered by stressors, particularly those arising from maladaptive behavior. For instance what effects are produced in immune, gastrointestinal, and cardiovascular system due to stress.

7. Patient-Decision Making What are the processes involved in the choices individuals make with respect to matters such as hazardous life-styles, excessive smoking and consumption of alcohol, seeking of health-care and adherence to preventive regimens.

8. Compliance Which factors like biomedical, behavioral, self-regulative, cultural, social and interpersonal (physician-patient relationship) determine compliance with medical advice

9. Intervention How effective are psychological like health education and behavior modification in altering unhealthy life-styles and in the direct reduction of illness and illness behavior at individual and community levels.

10. Techniques Used in Behavioral Medicine Self Monitoring Stimulus Control Self-Control of Internal States

11. Self-monitoring The patient is given instructions to maintain comprehensive daily record of fluctuation of symptoms Self-monitoring helps the patient to receive immediate feedback regarding factors that contribute to an increase and/or decrease of symptoms. It can also help the patient to develop internal performance standards that guide behavior change.

12. Stimulus control The patient learns to identify the cues in the environment that foster adaptive or maladaptive behavior and then alter the environment and behavior routines. This method is especially useful in treatment of obesity, addictive behaviors and insomnia.

13. Self-control of internal states Both relaxation training and biofeedback procedures are used to achieve self-control of internal states, like anxiety.

14. Applications of behavioral medicine Behavioral medicine techniques have been applied to such diverse topics as alcohol and tobacco use, exercise, AIDS, diabetes, hypertension, stress and immunization. It can also be applied to diverse health problems like cancer, heart disease, infections and pain. Headaches Chronic Pain

15. Headaches Relaxation training and biofeedback techniques are commonly used for the treatment of headaches. In case of migraine headaches, thermal biofeedback training is used more commonly.

16. Chronic Pain Chronic pain is generally described as pain that persists for more than 6 months and has little likelihood of remission. Treatment of chronic pain involves reconditioning through physical therapy (Hydrotherapy), exercises, cognitive restructuring, reprogramming the patient’s environment and addressing vocational issues.

17. Psychophysiological disorders/ pschosomatic illneses According to ICD-10 psychophysiological disorders are physical problems that have a known or suspected pathophysiological mechanism and may be influenced by psychological factors. Asthma Insomnia Raynaud’s Disease Gastrointestinal Disorders

18. A sthma Asthma is a complex disorder of bronchial tubes caused by hyperactivity to various stimuli like exercises, cold air, respiratory infections. Behavioral treatment of asthma includes EMG Biofeedback and relaxation training to help patients overcome fear and panic.

19. I nsomnia Insomnia is a subjective feeling of not having obtained enough sleep along with objective verification of sleeping difficulties and/or daytime fatigue. Behavioral medicine specialists emphasize on sleep hygiene behavior: including avoidance of caffeine, alcohol before sleep, avoidance of daytime napping and maintenance of regular sleep schedule.

20. Raynaud’s disease This disease is characterized by episodic attacks of vasospasm in finger and/or toes due to the lack of blood flow to the periphery, the tips become cold. Relaxation therapy and thermal biofeedback are carried out in an effort to increase the flow of blood to the periphery.

21. Gastrointestinal disorders These include problems associated with stomach and intestines: peptic ulcers, irritable bowel syndrome, ulcerative colitis and Crohn’s disease. The intervention includes stress management, assertiveness training, relaxation and biofeedback.

22. Health promotion Health promotion activities aim at reducing the risk of developing disease. It includes: exercise adherence smoking cessation weight management stress management medication adherence AIDS prevention

23. Exercise adherence Physical activity is recognized as an accepted form of treatment for a variety of disorders like: diabetes obesity hypertension coronary heart disease depression, and chronic pain.

24. Smoking cessation Behavioral strategies for smoking cessation include use of self-monitoring and administration of rewards. Relaxation training is incorporated to combat the physiological arousal that may result from craving. Efforts are also made to eliminate the settings associated with smoking.

25. Weight management and diabetes Behavioral medicine research emphasizes on weight reduction, diet restriction and exercise to aid in diabetic control. The role of stress and efficacy of stress management techniques in controlling blood glucose is also being examined.

26. Stress management The aim of stress management programs is to teach the individuals to cope with daily demands in an effective manner. Physical relaxation like progressive muscle relaxation is used: yoga, meditation, or biofeedback assisted feedback

27. Medication adherence The behavioral medicine specialist focuses on enhancing patient’s understanding about the need for and benefit of medication.

28. AIDS prevention AIDS prevention efforts include use of educational programs emphasizing the importance of abstinence from high-risk behaviors.

29. summary Behavioral medicine is the diverse field concerned with the development and integration of the behavioral and biomedical techniques relevant to health and illness. It uses a wide variety of behavioral techniques based on conditioning both classical and operant, and cognitive behavioral therapy.