Summary theme 9: Sickness and Health
Content
Psychology..............................................................................................................................................2
Stress as a stimulus.............................................................................................................................2
Coping.................................................................................................................................................3
Personalities and coping.................................................................................................................3
Social support.....................................................................................................................................3
Stress management............................................................................................................................4
Symptom perception..........................................................................................................................4
Physiology of stress................................................................................................................................5
The nervous system classification.......................................................................................................5
The autonomic nervous system..........................................................................................................5
Smooth muscles.................................................................................................................................6
Hypothalamic-pituitary-adrenal axis..................................................................................................7
The adrenal gland...............................................................................................................................8
Anatomy of abdominal organs.............................................................................................................10
Surface landmarks............................................................................................................................10
Abdominal regions + surface projections of abdominal organs........................................................10
Embryology...........................................................................................................................................11
Physiology of the gastro-intestinal system...........................................................................................12
Architecture and function.................................................................................................................12
Digestive enzymes and juices...........................................................................................................13
Absorption of nutrients: in small intestine by enterocytes...............................................................13
Regulation of the gastrointestinal tract............................................................................................16
Digestive organs and their function..................................................................................................16
Oral cavity and the oesophagus....................................................................................................16
The stomach.................................................................................................................................18
Small intestine..............................................................................................................................20
Large intestine..............................................................................................................................20
Histology...............................................................................................................................................21
Layers and functions of the digestive system...................................................................................21
Cells of the stomach.........................................................................................................................21
Histology of the small intestine........................................................................................................22
IBD........................................................................................................................................................23
1
, Pathophysiology...............................................................................................................................23
Malabsorption..................................................................................................................................24
Diarrhoea..........................................................................................................................................25
History of stress....................................................................................................................................26
The role of the industrial revolution (18 th/19th century)...................................................................26
Late 20th century concepts of stress.................................................................................................27
The definition of stress.....................................................................................................................27
Psychology
Stress as a stimulus
= certain life events trigger a stress response
- Major life events
- Multiple “hassles”
The model of stress
Appraisals: interpretation of life events a person makes
- Primary: the quality and nature of certain events
Is this relevant to me?
Is this something I have to deal with?
What is at stake?
Is it positive, negative or neutral?
- Secondary: assessing resources and ability to cope with the situation
How am I going to deal with this?
What can I use to help me?
2
,Coping
= ways to deal with a (stressful) situation
Different kinds of coping:
- Problem-focused coping: to decrease the amount of stressor
- Emotion-focused coping: to manage the emotional response
- Avoidant-focused coping: avoidance of the stressor
Personalities and coping
Five factor model:
1. Agreeableness
2. Conscientiousness helps effective problem solving optimism
3. Extroversion
4. Neuroticism related to stress and illness
5. Openness
Personality types:
Type A Type B Type C Type D
Characteristics Competitive Easy-going Cooperative High negative
Impatient Social Appeasing affectivity
Easily angry and Flexible Compliant Social inhibition
annoyed Relaxed Passive Pessimistic
Achievement Even mood Stoic Worry
oriented Unassertive
behaviour Self-sacrificing
Time-urgent
Disease risk High risk for Low risk of Higher cancer Higher risk for
cardiovascular stress risk cardiovascular
disease disease
Social support
Type Characteristics Outcome
3
, Emotional - Empathy - Reassurance
- Caring - Sense of
- Concern comfort
Esteem - Positive regard - Builds self-
- Encouraging worth
- Positively comparing - Sense of
competence
- Being valued
Tangible/instrumental Direct assistance with Reduces strain/worry
financial or practical aid
Informational support - Advice - Communication
- Suggestions - Self-efficacy
- Feedback - Self-worth
Network Welcoming Sense of belonging
Support Shared experience Affiliation
Stress management
- Stress management training
- CBT = cognitive behavioural therapy
- ERP = exposure response prevention
- ACT = acceptance commitment therapy
- Mindfulness
- Prevention
Symptom perception
- Subjective: differs per person
- Objective: visible and measurable
Influenced by:
- Society
- Gender
- Life stage
- Personality
- Cognitions + coping
Can lead to delay in seeking health care less effective treatment
4
Content
Psychology..............................................................................................................................................2
Stress as a stimulus.............................................................................................................................2
Coping.................................................................................................................................................3
Personalities and coping.................................................................................................................3
Social support.....................................................................................................................................3
Stress management............................................................................................................................4
Symptom perception..........................................................................................................................4
Physiology of stress................................................................................................................................5
The nervous system classification.......................................................................................................5
The autonomic nervous system..........................................................................................................5
Smooth muscles.................................................................................................................................6
Hypothalamic-pituitary-adrenal axis..................................................................................................7
The adrenal gland...............................................................................................................................8
Anatomy of abdominal organs.............................................................................................................10
Surface landmarks............................................................................................................................10
Abdominal regions + surface projections of abdominal organs........................................................10
Embryology...........................................................................................................................................11
Physiology of the gastro-intestinal system...........................................................................................12
Architecture and function.................................................................................................................12
Digestive enzymes and juices...........................................................................................................13
Absorption of nutrients: in small intestine by enterocytes...............................................................13
Regulation of the gastrointestinal tract............................................................................................16
Digestive organs and their function..................................................................................................16
Oral cavity and the oesophagus....................................................................................................16
The stomach.................................................................................................................................18
Small intestine..............................................................................................................................20
Large intestine..............................................................................................................................20
Histology...............................................................................................................................................21
Layers and functions of the digestive system...................................................................................21
Cells of the stomach.........................................................................................................................21
Histology of the small intestine........................................................................................................22
IBD........................................................................................................................................................23
1
, Pathophysiology...............................................................................................................................23
Malabsorption..................................................................................................................................24
Diarrhoea..........................................................................................................................................25
History of stress....................................................................................................................................26
The role of the industrial revolution (18 th/19th century)...................................................................26
Late 20th century concepts of stress.................................................................................................27
The definition of stress.....................................................................................................................27
Psychology
Stress as a stimulus
= certain life events trigger a stress response
- Major life events
- Multiple “hassles”
The model of stress
Appraisals: interpretation of life events a person makes
- Primary: the quality and nature of certain events
Is this relevant to me?
Is this something I have to deal with?
What is at stake?
Is it positive, negative or neutral?
- Secondary: assessing resources and ability to cope with the situation
How am I going to deal with this?
What can I use to help me?
2
,Coping
= ways to deal with a (stressful) situation
Different kinds of coping:
- Problem-focused coping: to decrease the amount of stressor
- Emotion-focused coping: to manage the emotional response
- Avoidant-focused coping: avoidance of the stressor
Personalities and coping
Five factor model:
1. Agreeableness
2. Conscientiousness helps effective problem solving optimism
3. Extroversion
4. Neuroticism related to stress and illness
5. Openness
Personality types:
Type A Type B Type C Type D
Characteristics Competitive Easy-going Cooperative High negative
Impatient Social Appeasing affectivity
Easily angry and Flexible Compliant Social inhibition
annoyed Relaxed Passive Pessimistic
Achievement Even mood Stoic Worry
oriented Unassertive
behaviour Self-sacrificing
Time-urgent
Disease risk High risk for Low risk of Higher cancer Higher risk for
cardiovascular stress risk cardiovascular
disease disease
Social support
Type Characteristics Outcome
3
, Emotional - Empathy - Reassurance
- Caring - Sense of
- Concern comfort
Esteem - Positive regard - Builds self-
- Encouraging worth
- Positively comparing - Sense of
competence
- Being valued
Tangible/instrumental Direct assistance with Reduces strain/worry
financial or practical aid
Informational support - Advice - Communication
- Suggestions - Self-efficacy
- Feedback - Self-worth
Network Welcoming Sense of belonging
Support Shared experience Affiliation
Stress management
- Stress management training
- CBT = cognitive behavioural therapy
- ERP = exposure response prevention
- ACT = acceptance commitment therapy
- Mindfulness
- Prevention
Symptom perception
- Subjective: differs per person
- Objective: visible and measurable
Influenced by:
- Society
- Gender
- Life stage
- Personality
- Cognitions + coping
Can lead to delay in seeking health care less effective treatment
4
