chronic diseases v. infectious diseases & psychology

chronic diseases v. infectious diseases & psychology

April 21st, 2010

An interested coworker was asking me yesterday why psychology is considered “useful” in chronic disease prevention but not in infectious diseases. I thought this might make a good, quick blog topic. The quick answer is that chronic diseases (like cancer, for example) are highly influenced by lifestyle and behavioral choices, where as infectious diseases typically aren’t. For example, people continue to smoke, overeat, refuse to exercise, etc. (lifestyle choices) even though they know these are significant risk factors for cancer. So why do people do it? That’s where the psychology part comes in. The answer of course is not so simple to understand what motivates people to self-destructive behavior, but that is where psychology and public health begin to overlap.

On the other hand, infectious diseases like influenza for example (the common flu) really don’t have so much to do with your lifestyle choices, at least not significantly. You can do “all the right things” and still get the flu. Infectious diseases are more determined by biology than psychology, you can’t always control whether or not you will be exposed to a virus (an infectious disease) but you can control lifestyle choices that lead to chronic diseases.

APA

I learned last week that I have been accepted by the American Psychological Association (APA) as an Associate Member - I'm pretty happy about that! This is as a result of my completion of my MA degree in an applied psychology field in May. I was a Graduate Student Affiliate from 2006 - 2009 and I was a Student Affiliate way back during my undegrad days (hehe) 1993-1995.

I'm happy about reaching the Associate Member status, as this was something I targeted as a career goal for myself back during my undergraduate days. Though I thought it would have happened much sooner (hehe again), but these things have their own ways of working out I suppose.

Maybe now I can get an APA journal to publish one of my articles and stop rejecting them!!

The following is from a "debate" I had online with a psychometrician regarding the notion of IQ vs. MI theory:

I would instead argue that the reason why Gardner’s MI theory has not found any traction in the scientific community is that it in many ways argues against the foundations of the scientific community. Think of it as one big system (i.e. the Matrix, if you will) - the western scientific world has invented this notion of IQ and call it “g” for general intelligence. But it is not a general intelligence, it is measuring specific intelligences such as logical-mathematical and linguistic types of intelligences. Then we have devised standardized tests like those you are referring to: GRE, SAT, LSAT, etc. and what are these standardized tests expected to measure…the “g” which as previously stated is not really a general test of intelligence but rather a test of narrowly defined intelligence based on logical-mathematical and linguistic forms of intelligences.

And then what do we do? Proceed to set up university programs at prestigious universities like Harvard or Stanford and the like, and then recruit those students that have scored high on these standardized tests that are measuring logical-mathematical and linguistic types of intelligences. And then these students go on and perform “shockingly” well (meaning that they are getting good grades) in a system designed to produce these types of results. And now we have an entire scientific community made up of these individuals such as yourself. Knowing that, why WOULD the scientific community support a different notion of IQ that largely discredits them? It’s all a self-contained system, so of course one aspect of said system will correlate with another aspect of the system. But that is all it is, a closed system. As Gardner would say, so what if one paper and pencil test correlates to another paper and pencil test!

Systematic Desensitization as a treatment for phobias: Part II

Another factor to be considered before applying this treatment method is the overall emotionall wellness of the client. This is why it is necessary to first conduct a psychological or clinical evaluation of the client including any past medical or psychiatric history to determine if the subject is an ideal candidate for this treatment method. If the client has other psychological conditions, particularly those that would compound the symptoms of a simple phobia then this treatment method may not be the most effective. Ideally, the client will have no major psychological issues, particularly any serious clinical issues including personality disorders that might otherwise complicate the treatment methods for the simple phobia.

Systematic Desensitization as a treatment for phobias

One of the topics that has interested me the most in psychology is the treatment of phobias. Perhaps this is because it is an area that we can point to and say that it is effective. I've read various research on the topic and the studies I've read have concluded that systematic desensitization is effective about 90% of the time for treating simple phobias. A simple phobia is one that is only triggered by a specific stimulus, for example, a fear of dogs or a fear of flying in an airplane. The reason that these phobias are easier to treat as opposed to say Generalized Anxiety Disorder or agoraphobia is because they can be treated with systematic desensitization using a combined method of biofeedback and relaxation techniques. Systematic desensitization is a mouthful, but the treatment approach is as you would expect. You gradually and systematically unlearn the phobia. I say unlearn because simple phobias are something learned through reinforcement and a reduction of anxiety by avoiding the stimulus that is causing the phobia. An example will make it clearer:

June is 7 years old and she comes into contact with a stray dog. June attempts to pet the stray dog and the dog bites her. June is frightened and runs away. The next time June sees a dog, June fears she may get bit again and so she avoids the dog. Each subsequent time June sees a dog she avoids it and each time she avoids a dog, her anxiety is reduced. It is this reduction in anxiety by avoiding the dog that produces the learned phobia. Many people think of the phobia as the fear of the dog. That is correct to a point. After all a phobia is defined as an irrational fear. However, the debilitating part of the phobia really has nothing to do with fear as it has to do with a reduction in anxiety. This is what keeps the phobia going, is the person's avoidance of the dog in this example that is reinforced through a reduction in anxiety.

So in using systematic desensitization we can step-by-step unlearn the client's phobic reaction. For example, lets say June comes to me in my office and asks me to cure her of her phobia. The first thing I'm going to do is hook June up to my biofeedback machine which measures heart rate, blood pressure and galvanic skin response. We will use these numbers to establish a baseline reading of her anxiety levels. Then I would ask June to imagine a scenario where she is walking in the park and she encounters a dog on a leash. Lets say that dog is a relatively non-threatening poodle. I would then ask June what her anxiety level is in this scenario based on a scale of 1-10, with 10 being the most anxious. As I note her self-reported anxiety, I would also note the biofeedback readings.

I would then ask June to imagine that the poodle is not on a leash, but is running towards her. Again I would note June's self-report of her anxiety level along with the biofeedback levels. After the poodle scenario, I would ask June to imagine the dog running towards her is a Rottweiler. You probably get the point now that we are trying to establish a hierarchy of June's phobia. Taking accurate biofeedback readings along with June's self reports to establish a baseline of her phobic hierarchy is a key first step.

More to come...

Multiple Intelligence Theory

I made reference to Multiple Intelligence Theory in my last post. If you've not heard of it, and I'm always surprised at the number of people that have not, you can go here - http://www.tecweb.org/styles/gardner.html

The reason that I say I'm surprised at the number of people that are not familiar with it is because it is one of the most profound concepts to come out of psychology in some time. Everyone knows about useless Freudian ideas like the Oedipus Complex or Penis Envy, but not the important stuff! Basically, Multiple Intelligence Theory states that our western way of thinking that intelligence is limited to verbal/quantitative is wrong. That in fact, there are other types of intelligences that don't readily show up on IQ tests. Now, before we get going down this path let me just make the disclaimer that my IQ has been tested and I'm in the 115-120 range. Einstein? No. But I'm above average, so this isn't some attempt fueled by bitterness to discredit IQ tests. And personally, I'm more of a traditional learner, what Gardner would call Logical-Mathematical. However, I also score very high in Gardner's Intrapersonal category and this too makes sense to me given my 15+ years of studying psychology now.

You may know of someone that maybe isn't good with numbers, but they are very good orators - Gardner would classify this type of intelligence as Linguistic. Although Linguistic is measured by traditional IQ tests (as is Logical-Mathematical). Some of his other categories include Visual-Spatial and Kinesthetic. Kinesthetic learners are those that learn better by moving or touching things - like an athlete, dancer or even surgeon.

The important thing to remember here is that we all are capable of learning given any of these methods, but we will have a preference or two when it comes to learning styles. Teachers, trainers and the like should be aware of these possible differences and not expect students (including adult students) to conform to one traditional standard.