Behavioral Medicine Course

Tuesday 4-7pm at Briarwood

Preliminary Outline

Drs. Peter Trask and Steven Schwartz

WeekTopic

1.Peter, SteveIntroduction to Behavioral Medicine

-- goals and aims of the course, history, definitions of beh. med./psychosomatic med.

-- biology of stress reactions

2.PeterChronic Pain

-- include gate control theory, acute v. chronic pain, self-management of pain, CBT model, therapy

3.PeterCancer

-- include smoking cessation

4.SteveCardiovascular Disease

-- include hypertension, Type A, depression, lifestyle

5.Peter, SteveDiabetes and Asthma

-- include issues of comliance

6.PeterGastrointestinal Disorders

-- Crohn’s, IBS, GI reflux

7.SteveTransplants

8.PeterPsychosomatic illnesses

9.SteveStructure and Authority of Hospitals

-- politics, medical subculture

10.SteveConsultation/liaison Work

11.Peter, SteveResearch in Medical Settings

12.SteveFinancial Efficacy of Psychologists in Medical Settings

-- marketing of psych. services in hospitals

13.PeterEthics in Medical Settings

14.TBA

Note: Throughout the course we need to include gender differences, ethnic/racial differences, incidence/prevalence of disease, biological and physiological issue about disease and tx., psychological factors contributing to disease outcomes, case examples, and visual demonstrations.

Structure of class:

Class will be reading intensive and in seminar style. The class itself will consist of 30-60 minutes of lecture, and then class discussion with several (3-4) pointed questions on each topic being a source for focusing the discussion to get students to think about the disease and issues.

Grading:

Grading will be based on class participation, a paper which can either be a literature review of a disease or topic area, or a study proposal in NIH format that includes bibliography and copies of all measures along with a proposed budget outlining personnel and costs.

Text: Handbook of Clinical Psychology in Medical Settings (HCPMS) (1991). J. J. Sweet, R. H. Rozensky, & S. M. Tovian (Eds.). New York: Plenum.

Syllabus

1.Required reading:

Ch. 1 from HCPMS: Clinical Psychology in Medical Settings: Past and Present

Pomerleau, O.F., & Brady, J. P. (1979). Introduction: The scope and promise of behavioral medicine. In O. F. Pomerleau and J. P. Brady (Eds.), Behavioral Medicine: Theory and Practice (pp. xi-xxvi). Baltimore: Williams and Wilkins.

Asterita, M. F. (1985). The physiology of stress. (pp. 7-34). New York: Human Sciences Press.

Additional readings:

Epstein, L. H. (1992). Role of behavior theory in behavioral medicine. Journal of Consulting and Clinical Psychology, 60, 493-498.

Frankenhaeuser, M. (1991). Mini series: Behavioral medicine an international perspective. Annals of Behavioral Medicine, 13, 197-204.

Boone, J. L., & Christensen, J. F. (1997). Stress & disease. In M. D. Feldman and J. F. Christensen (Eds.), Behavioral medicine in primary care: A practical guide. (pp. 265-276). Stamford, CT: Appleton & Lange.

Baum, A., & Grunberg, N. E. (1991). Gender, stress, and health. Health Psychology, 10, 80-85.

Asterita, M. F. (1985). The physiology of stress. (pp. 168-184). New York: Human Sciences Press.

Asterita, M. F. (1985). The physiology of stress. (pp. 185-195). New York: Human Sciences Press.

Gatchel, R. J. (1994). Psychophysiological disorders: Past and present perspectives. In R. J. Gatchel and E. B. Blanchard (Eds.) Psychophysiological disorders: Research and clinical applications. (pp. 1-21). Washington, DC: American Psychological Association.

Belar, C. D., & Deardorff, W. W. (1995). Clinical health psychology in medical settings: A practitioner’s guidebook. (pp. 1- 11). Washington, DC: American Psychological Association.

Belar, C. D., & Deardorff, W. W. (1995). Clinical health psychology in medical settings: A practitioner’s guidebook. (pp. 13-37). Washington, DC: American Psychological Association.

Rodin, J., & Salovey, P. (1989). Health psychology. Annual Review of Psychology, 40, 533-579.

2.Required reading:

Ch. 23 from HCPMS: Chronic Pain: Psychological Assessment and Treatment

Turk, D. C. (1996). Biopsychosocial perspective on chronic pain. In R. J. Gatchel and D. C. Turk (Eds.). Psychological approaches to pain management: A practitioners handbook. (pp. 3- 32). New York: Guilford.

Additional readings:

Turk, D. C., & Rudy, T. E. (1988). Toward an empirically derived taxonomy of chronic pain patients: Integration of psychological assessment data. Journal of Consulting and Clinical Psychology, 56, 233-238.

Tunks, E. (1996). Comorbidity of psychiatric disorder and chronic pain. In J. N. Campbell (Ed.), Pain 1996- An updated review. (pp. 287-296). Seattle: IASP Press.

Tyrer, S. P. (1996). Psychological and psychiatric assessment of patients in pain. In J. N. Campbell (Ed.), Pain 1996- An updated review. (pp. 495-504). Seattle: IASP Press.

Keefe, F. J. (1996). Cognitive-behavioral approaches to assessing pain and pain behavior. In J. N. Campbell (Ed.), Pain 1996- An updated review. (pp. 517-523). Seattle: IASP Press.

Merikangas, K. R., Angst, J., Isler, H. (1990). Migraine and psychopathology: Results of the Zurich Cohort Study of young adults. Archives of General Psychiatry, 47, 849-853.

Reesor, K. A., & Craig, K. D. (1988). Medically incongruent chronic back pain: Physical limitations, suffering, and ineffective coping. Pain, 32, 35-45.

Tan, S. Y. (1982). Cognitive and cognitive-behavioral methods for pain control: A selective review. Pain, 12, 201-228.

Polatin, P. B. (1996). Integration of pharmacotherapy with psychological treatment of chronic pain. . In R. J. Gatchel and D. C. Turk (Eds.). Psychological approaches to pain management: A practitioners handbook. (pp. 305- 328). New York: Guilford.

Klapow, J. C., Slater, M. A., Patterson, T. L., et al. (1995). Psychosocial factors discriminate multidimensional clinical groups of chronic low back pain patients. Pain, 62, 349-355.

Turner, J. A., & Jensen, M. P. (1993). Efficacy of cognitive therapy for chronic low back pain. Pain, 52, 169-177.

3.Required reading:

Ch. 20 in HCPMS: Integration of Clinical Psychology into Adult and Pediatric Oncology Programs

Nuland, S. B. (1994). The malevolence of cancer (pp. 202-221). How we die: Reflections on life’s final chapter. New York: Alfred Knopf.

Additional readings:

Anderson, B. L., Anderson, B., & deProsse, C. (1989). Controlled prospective longitudinal study of women with cancer II: Psychological outcomes. Journal of Consulting and Clinical Psychology, 57, 692-697.

Fawzy, F. I., Fawzy, N. W., Arndt, l. A., & Pasnau, R. O. (1995). Critical review of psychosocial interventions in cancer care. Archives of General Psychiatry, 52, 100-113.

Holland, J. F. (1998). Biology of cancer for the psycho-oncologist. In J. C. Holland (Ed.), Psycho-oncology (pp. 16-23). New York: Oxford University.

Andersen, B. L., Kiecolt-Glaser, J. K., & Glaser, R. (1994). A biobehavioral model of cancer stress and disease course. American Psychologist, 49, 389-404.

Holland, J. C. (1998). Societal views of cancer and the emergence of psycho-oncology. In J. C. Holland (Ed.), Psycho-oncology (pp. 3-15). New York: Oxford University.

Travis, C. B. (1988). Breast cancer: Risk factors. Women and health psychology: Biomedical issues, (pp. 203-228). Hillsdale, NJ: Lawrence Erlbaum Associates.

Travis, C. B. (1988). Breast cancer: Detection and management. Women and health psychology: Biomedical issues, (pp. 229-256). Hillsdale, NJ: Lawrence Erlbaum Associates.

4. Required reading:

Ch. 21 in HCPMS: Cardiovascular Disorders: Hypertension and Coronary Heart Disease

Frasure-Smith, N., Lesperance, F., & Talajic, M. (1993). Depression following myocardial infarction: Impact on 6-month survival. JAMA, 270, 1819-1825.

Scheidt, S. (1996). A whirlwind tour of cardiology for the mental health professional. In R. Allan and S. Scheidt (Eds.), Heart and mind: The practice of cardiac psychology (pp.15-62). Washignton, DC: American Psychological Association.

Additional readings:

Ch. 27 “Coronary Atherosclerotic Disease”

Williams, R. B. (1996). Coronary-prone behaviors, hostility, and cardiovascular health: Implications for behavioral and pharmacological interventions. In K. Orth-Gomer and N. schneiderman (Eds.), Behavioral medicine approaches to cardiovascular disease prevention (pp. 161-168). Mahwah, NJ: Lawrence Erlbaum.

Chesney, M. A. (1996). New behavioral risk factos for coronary heart disease: Implications for intervention. . In K. Orth-Gomer and N. schneiderman (Eds.), Behavioral medicine approaches to cardiovascular disease prevention (pp. 169-182). Mahwah, NJ: Lawrence Erlbaum.

Matthews, K. A. (1989). Interactive effects of behavior and reproductive hormones on sex differences in risk for coronary heasrt disease. Health psychology, 8, 373-387.

Polefrone, J. M., & Manuck, S. B. (1987). Gender differences in cardiovascular and neuroendocrine response to stressors. In R. C. Barnett, L. Biener, & G. K. baruch (Eds.), Gender and stress, (pp. 13-38). New York: Free Press.

Salkovskis, P. M. (1992). Psychological treatment of noncardiac chest pain: The cognitive approach. American Journal of Medicine, 92 (suppl 5A), 114s-121s.

Katon, W. J. (1990). Chest pain, cardiac disease, and panic disorder. Journal of Clinical Psychiatry, 51 (5, suppl), 27-30.

Beitman, B. D., Basha, I., Flaker, G., DeRosear, L., Mukerji, V., & Lamberti, J. W. (1987). major depression in cardiologu chest pain patients without coronary artery disease and with panic disorder. Journal of Affective Disorders, 13, 51-59.

Serlie, A. W., Duivenvoorden, H. J., Passchier, J., Ten Cate, F. J., Deckers, J. W., & Erdman, R. A. M. (1996). Empirical psychological modeling of chest pain: A comparative study. Journal of Psychosomatic Research, 40, 625-635.

Jacobs, S. C. & Sherwood, J. B. (1996). The cardiac psychology of women and coronary hear disease. In R. Allan and S. Scheidt (Eds.), Heart and mind: The practice of cardiac psychology (pp.197-218). Washignton, DC: American Psychological Association.

Hackett, T. P., Rosenbaum, J. F., & Tesar, G. E. (1988). Emotion, psychiatric disorders, and the heart. In Cariovascular Medicine (3rd. ed.) (pp. 1883-1900).

Ketterer, M. W., Kenyon, L., Foley, B. A., et al. (1996). Denial of depression as an independent corrleate of coronary artery disease. Journal of Health Psychology, 1, 93-105.

5. Diabetes required readings:

Ch. 26 in HCPMS: Diabetes: Clinical Issues and Management

Polonsky, W. H. (1993). Psychosocial issues in diabetes mellitus. In R. J. Gatchel and E. B. Blanchard (Eds.), Psychophysiological disorders: Reseearch and clinical applications (pp. 357-381). Washington, DC: American Psychologial Association.

Additional readings:

Dunbar-Jacob, J., Burke, L. E., & Puczynski, S. (1995). Clinical assessment of management of adherence to medical regimens. In P. M. Nicassio and T. W. Smith (Eds.), Managing chronic illness: A biopsychosocial perspective (pp. 313-349). Washington, DC: American Psychological Assocation.

Wing, R. R., Nowalk, M. P., & Guare, J. C. (1988). Diabetes mellitus. In E. A. Blechman and K. D. Brownell (Eds.), Handbook of behavioral medicine for women (pp. 236-252). New York: Pergamon.

Asthma required readings:

Ch. 27 in HCPMS: Psychological Theory, Assessment, and Interventions for Adult and Childhood Asthma

Bender, B. G., & Creer, T. L. (1993). Asthma. In R. J. Gatchel and E. B. Blanchard (Eds.), Psychophysiological disorders: Reseearch and clinical applications (pp. 151-203). Washington, DC: American Psychologial Association.

Additional readings:

6.Required readings:

Ch. 28 in HCPMS: Psychological Characteristics and Treatment of Patients with Gastrointestinal Disorders

Whitehead, W. E. (1992). Behavioral medicines approaches to gastrointestinal diosorders. Journal of Consulting and Clinical Psychology, 60, 605-612.

Additional readings:

Tollefson, G. D., Tollefson, S. L., Pederson, M., Luxenberg, M., & Dunsmore, G. (1991). Comorbid irritable bowel syndrome in patients with generalized anxiety and major depression. Annals of Clinical Psychiatry, 3, 215-222.

Blanchard, E. B. (1993). Irritable bowel syndrome. In R. J. Gatchel and E. B. Blanchard (Eds.), Psychophysiological disorders: Reseearch and clinical applications (pp. 23-62). Washington, DC: American Psychologial Association.

Enck, P. & Whitehead, W. E. (1988). Gastrointestinal disorders. In E. A. Blechman and K. D. Brownell (Eds.), Handbook of behavioral medicine for women (pp. 178-194). New York: Pergamon.

Meissner, J. S., Blanchard, E. B., & Malamood, H. S. (1997). Comparison of treatment outcome measures for irritable bowel syndrome. Applied Psychophyiology and Biofeedback, 22, 55-62.

Walker, E. A., Roy-Byrne, P. P., katon, W. J., Li, L., Amos, D., & Jiranek, G. (1990). Psychiatric illness and irritable bowel syndrome: A comparison with inflammatory bowel disease. American Journal of Psychiatry, 147, 1656-1661.

Walker, E. A., Roy-Byrne, P. P., & Katon, W. J. (1990). Irritable bowel syndrome and psychiatric illness. American Journal of Psychiatry, 147, 565-572.

Whitehead, W. E., Bosmajian, L., Zonderman, A. B., Costa, P. T., & Schuster, M. M. (1988). Symptoms of psychological distress associated with irritable bowel syndrome: Comparison of community and medical clinic samples. Gastroenterology, 95, 709-714.

Whitehead, W. E., Winget, C., Fedoravicius, A. S., Wooley, S., & Blackwell, B. (1982). Learned illness behavior in patients with irritable bowel syndrome and peptic ulcer. Digestive Diseases and Sciences, 27, 202-208.

7. Required readings:

Additional readings:

8.Required readings:

Iezzi, A. & Adams, H. E. (1993). Somatoform and factitious disorders. In P. B. Sutker and H. E. Adams (Eds.), Comprehensive Handbook of Psychopathology (pp. 167-201). New York: Plenum.

Kellner, R. (1990). Somatization: Theories and research. Journal of Nervous and Mental Disease, 178, 150-160.

Kirmayer, L. J., Robbins, J. M., Dworkind, M., & Yaffe, M. J. (1993). Somatization and the recognition of depression and anxiety in primary care. American Journal of Psychiatry, 150, 734-741.

Barsky, A. J. (1988). The paradox of health. New England Journal of Medicine, 318, 414-418.

Additional readings:

Cioffi, D. (1991). Beyond attentional strategies: A cognitive-perceptual model of somatic interpretation. Psychological Bulletin, 109, 25-41.

Katon, W., Ries, R. K., & Kleinman, A. (1984). The prevalence of somatization in primary care. Comprehensive Psychiatry, 25, 208-215.

Johnson, C., Shenoy, R. S., & Langer, S. (1981). Relaxation therapy for somatoform disorders. Hospital and Community Psychitry, 32, 423-424.

Zoccolillo, M. & Cloninger, C. R. (1986). Somatization disorder: Psychologic symptoms, social disability, and diagnosis. Comprehensive Psychiatry, 27, 65-73.

Lipowski, Z. J. (1988). Somatization: The concept and its clinical application. American Journal of Psychiatry, 145, 1358-1368.

Ketterer, M. W. & Buckholtz, C. D. (1989). Somatization disorder. JAOA, 89, 489-499.

Morrison, J. & Herbstein, J. (1988). Secondary affective disorder in women with somatization disorder. Comprehensive Psychiatry, 29, 433-440.

Wickramasekera, I. (1989). Somatizers, the health care system, and collapsing the psycholigcla distance that the somatizer has to travel for help. Professional Psychology: Research and Practice, 20, 105-111.

9.Required readings:

Ch. 3 (The Structure and Authority of Hospitals) and 5 (Psychologists, Politics, and Hospitals) in HCPMS

Belar, C. D. (1995). Collaboration in capitated care: Challenges for psychology. Professional Psychology: Research and Practice, 26, 139-146.

Additional readings:

Mechanic, D. (1978). Medical sociology: A comprehensive text (2nd ed.), (pp. 95-117). New York: Free Press.

Lieberman, J. A., & Rush, J. A. (1996). Redefining the role of psychiatry in medicine. American Journal of Psychiatry, 153, 1388-1397.

Guze, S. B. (1998). Psychotherapy and managed care. Archives of General Psychiatry, 55, 561-562.

10. Required readings:

Wahl, C. W. (19 ). The technique of brief psychotherapy with hospitalized psychosomatic patients. International Journal of Psychoanalytic Psychotherapy, , 69-82.

Blacher, R. S. (1984). The briefest encounter: Psychotherapy for medical and surgical patients. General Hospital Psychiatry, 6, 226-232.

DeGood, D. E. (1983). Reducing medica patients’ reluctance to participate in psychological therapies: The initial session. Professional Psychology: Research and Practice, 14, 570-579.

Additional readings:

Ch. 6. Looking for psychological masquerade in the clinical setting. Distinguishing Psychological from Organic Disorders. pp. 88-135.

Morganstern, K. P. (19 ). Behavioral interviewing. In Behavioral Assessment (pp. 86-118).

Barrios, B. A. (19 ). On the changing nature of behavioral assessment. In Behavioral Assessment. (pp. 3-41).

Mechanic, D. (1978). Illness behavior. In Medical sociology: A comprehensive text (2nd ed.) (pp. 249-289). New York: Free Press.

Pace, T. M., Chaney, J. M., Mullins, L. L., & Olson, R. A. (1995). Psychological consultation with primary care physicians: Obstacles and opportunities in medical settings. Professional Psychology: Research and Practice, 26, 123-131.

Strain, J. J., Hammer, J. S., & Fulop, G. (1994). APM task force on psychosocial interventions in the general hospital inpatient setting: A review of cost-offset studies. Psychosomatics, 35, 253-262.

Belar, C. D. & Geisser, M. E. (1995). Roles of the clinical health psychologist in the management of chronic illness. . In P. M. Nicassio and T. W. Smith (Eds.), Managing chronic illness: A biopsychosocial perspective (pp. 33-57). Washington, DC: American Psychological Assocation.

Smith, T. W. & Nicassio, P. M. (1995). Psychological practice: Clinical application of the biopsychosocial model. . In P. M. Nicassio and T. W. Smith (Eds.), Managing chronic illness: A biopsychosocial perspective (pp. 1-31). Washington, DC: American Psychological Assocation.

Belar, C. D. & Deardorff, W. W. (1995). Clinical health psychology in medical settings: A practitioner’s guidebook (pp. 39-67). Washington, DC: American Psychological Association.

Belar, C. D. & Deardorff, W. W. (1995). Clinical health psychology in medical settings: A practitioner’s guidebook (pp. 69-99). Washington, DC: American Psychological Association.

Belar, C. D. & Deardorff, W. W. (1995). Clinical health psychology in medical settings: A practitioner’s guidebook (pp. 101-135). Washington, DC: American Psychological Association.

11.Required readings:

Ch. 16 in HCPMS: research in the Medical Setting: Implementing the Scientist-Practitioner Model

Additional readings:

Ray, W. J. (1996). Research designs in behavioral cardiovascular research. In R. Allan and S. Scheidt (Eds.), Heart and mind: The practice of cardiac psychology (pp.573-588). Washignton, DC: American Psychological Association.

The Scientist Practitioner. (pp. 3-37).

The Scientist Practitioner. (pp. 38-70).

12. Required readings:

Ch. 8 (Arguments for the Financial Efficacy of Psychological Services in Health Care Settings) & 9 (Marketing Psychological Services in Hospitals) in HCPMS

McDaniel, S. H. (1995). Collaboration between psychologists and family physicians: Implementing the biopsychosocial model. Professional Psychology: Research and Practice, 26, 117-122.

Additional readings:

Bray, J. H. & Rogers, J. C. (1995). Linking psychologists and family physicians for collaborative practice. Professinal Psychology: Research and Practice, 26, 132-138.

Rosen, J. C. & Wiens, A. N. (1979). Changes in medical problems and use of medical services following psychological intervention. American Psychologist, 34, 420-431.

Pomerleau, O. F. (1979). Behavioral medicine: The contributionof the experiemtnal analysis of behavior to medical care. American Psychologist, 34, 654-663.

Labott, S. M., Preisman, R. C., Popovich, J., & Iannuzzi, M. C. (1995). Health care utilization of somatizing patients in a pulmonary subspecialty clinic. Psychosomatics, 36, 122-128.

13. Required readings:

Belar, C. D. & Deardorff, W. W. (1995). Clinical health psychology in medical settings: A practitioner’s guidebook (pp. 137-171). Washington, DC: American Psychological Association.

Additional readings: