Psyc 412 1st Edition Lecture 24Outline of Last Lecture I. Coronary Heart DiseaseII. HypertensionOutline of Current Lecture I. StrokeII. Diabetes III. Hostility Current Lecture- Stroke: condition that results from a disturbance in blood flow to the braino third major cause of death in the U.S.o Risk factors for stroke: overlap with those for heart disease high blood pressure, heart disease, cigarette smoking, high red blood cell count and transient ischemic attacks negative emotions, sudden change in posture to a startling event and psychological distresso Consequences of stroke: stroke affects all aspects of life: personal, social, vocational and physical:- motor problems- cognitive problems- emotional problems- relationship problemso Types of rehabilitative interventions: psychotherapy cognitive-remedial training movement therapies  use of structured, stimulating environments to challenge capabilities- Diabetes: a chronic condition of impaired carbohydrate, protein and fat metabolismo insufficient secretion of insulin or insulin resistanceo one of the leading causes of death in the U.S.o Cells of the body need energy to function: glucose is the primary source of energy insulin is a hormone produced by pancreas insulin acts as a “key” to permit glucose to enter cells without insulin, cells don’t get the glucose they need hyperglycemia: when glucose stays in the bloodo Types of Diabetes: Type I Diabetes (10% of all diabetes):- abrupt onset of symptoms- immune system falsely identifies cells in the pancreas as invaders and destroys them- pancreas doesn’t produce insulin- develops relatively early in life Type II Diabetes:- cells lose ability to respond fully to insulin (known as insulin resistance)- pancreas temporarily increases insulin production- insulin-producing cells may give outo Health implications of diabetes: leading cause of blindness among adults kidney failure foot ulcers eating disorders nervous system damageo Stress and Diabetes: Type I and Type II are sensitive to stresso Problems in self-management: managing Type I Diabetes:- Type I patients need to:o monitor glucose levels throughout the dayo take immediate action when needed adherence: self-management programs are low in adherence managing Type II Diabetes:- Type II patients :o often unaware of health risks they faceo must reduce sugar and carbohydrate intakeo encouraged to achieve normal weighto encouraged to exercise: helps use up glucose in the blood- improving adherenceo Diabetes prevention: Diabetes is a major public health problem lifestyle intervention and medication can greatly reduce the incidence of diabeteso Interventions with Diabetics: cognitive-behavioral interventions to improve adherence to their regimen weight control improves glycemic control self-management and problem-solving skills social skills training behavior modification pharmacological therapyo Special problems of adolescent Diabetics: adolescents usually have Type I, which is more severe relations with family: parents may restrict activities, thus infantilizing the adolescent and increasing dependence adherence: health psychologist can be very helpful with adherence- How is Hostility measured?o Structured Interview for Type A personalityo Cook-Medley