Health Psych Lecture 2-10

Strategies for Preventing Injuries

1) Active strategies- Require people to engage in some kind of action to prevent injuries from occurring, or to decrease the harm resulting from such injuries (they require you to do something) * Helmet use- should decrease harm if you experience collision. * Seatbelt, turning off cell phone before driving, pool alarms 2) Passive strategies- Change people's environment. Don't have to do anything the environment changes and don't require people to do things (these are easier and tend to be more effective- but can't be applied to all things) [Can't take away all cell phones to prevent texting/driving so need active strategies] * Air bag- part of environment. Nobody has to install their own. * Child protective safety caps on medicine so child can't accidentally open and ingest pills. 3) Providing education- If you knew something was bad, a concern it could be helpful. --> Challenge on relying on providing education to reduce risky behavior - it could normalize it, it's a trigger (showing video on suicide could lead to unintentional effects), it could be limiting. * Sometimes we have education and it's insufficient (people know things are bad and still do it)

Models of the Stress Response

1) Cannon's Fight-or-Flight Response (earliest model) - When we are confronted by a stressor, your body reacts physiologically and that arousal is leading you to either fight off the threat or to run from it (flee.) -- Increase in adrenaline --Increase of heart rate and breathing rate. * Challenge- developed on the assumption that there is an immediate stressor. Many stressors are constant, persistent, long term. (bad job, poor relationship) Therefore, probably inadequate to explain lots of different stressors we experience. 2) (Selye's) General Adaptation Syndrome- ongoing stress overtime can lead to health consequences. A) Alarm Stage - body mobilizes to fight off a threat. This is fight or flight. I'm going to respond in this way. (increase in physiological resources to fight off threat.) B) Resistance Stage- Body continues to fight off a threat (diverts resources) While your body is devoting resources to this part of body, your body is taking away from digestive system for example (not focusing on feeling hungry) , immune system (only worried about immediate things) , and reproductive system. -- When body is under conditions of stress, it's letting your body do fight and flight by diverting resources (worry about adrenaline, heart rate, muscle tension) C) Exhaustion stage - Body's resources are depleted (can't keep doing it any longer- worn out and susceptible)

Types of Social Support

1) Emotional support - describing issues of caring, concern, comfort to a person (feeling sad, lonely, depressed - are their people who can help you feel better?) 2) Belongingness support - availability of social companionship (do you feel part of a group/community? Something to do over weekend?) 3) Instrumental (tangible) support - concrete assistance, such as financial aid, material resources, or needed services (something practical) 4) Informational (appraisal) support - advice and guidance about coping with a problem (continue in relationship not going well? How do I think about/conceptualize problem?) 5) Esteem (validational) support - Affirmation of self-worth (feeling good about yourself) [About you're a worthwhile person] Matching hypothesis- Individuals benefit from receiving the type of social support that fits their problem. (not the type of social support not relevant to their problem) All of these different types of support are valuable and we need all of them.

Explaining the religion/spirituality-health link

1) Healthier behaviors? → lead to better health outcomes. Because i'm going to church on Sunday i'm not going to drink/smoke. Some religions have prohibitions on the use of alcohol or other types of behaviors. [Not having sex with multiple partners] 2) Social support? - Religious organizations are providing social support? For people with restricted social outlets this can be a time to interact. If someone is sick churches may organize meals/support for this person. May form relationships with people who share similar views and see world in similar ways and be a valuable social outlet. Sense of meaning? → particularly true for helping people understand tragic events. (afterlife, things only happen for a reason) Can take horrible events and help them develop a meaning in them which can help them come to terms with particular losses. More adaptive coping? Following a loss/tragedy people might try and make some good from it (start scholarship in child's name, sign up to be a blood donor, donate) These are ways they can feel less lost, lonely during times of major stressors and explains why they may be able to bounce back from difficult experiences. Stavrova, 2015 (DISCUSS) - Higher religiosity regions correlated with better health outcomes. In countries where religion is social norm, religious individuals have better health than non-religious individuals. So, benefits of religion on health depend on social norms/where you live. Most research found type of religion doesn't matter. Question: Are effects same for people finding religion later in life?

Risk factors for intentional injury

1) Individual differences- Personality type differences Psychological disorders- most commonly linked with suicide. People who are clinically depressed are at substantial risk of committing self harm/suicide. Anxiety often precursor to non-suicidal self-injury (coping strategy for anxiety.) * People who are truly depressed/clinically depressed have difficulty carrying out suicide (requires coming up with strategy/plan to do so.) These people are often paralyzed with their ability to do things. However, the throws of depression are more risky. Concerning to get a little help to give people motivation to commit suicide but not enough help to prevent suicide. * Maybe treatments are giving people enough motivation to actually follow through with suicide. 2) Impulsivity- People who carry out assault/domestic violence. -- Oftentimes it's not a planned thing. Often impulsive acts (I'm angry and will bring a gun to school, somebody snaps) Maybe accidental in a sense of people not thinking about. A momentary thing in terms of anger. This can have big consequences. Includes self-harm and other directed harm. 3) Perfectionism- May take a small thing and beat themselves up over it. Highly perfectionist is highly correlated with suicide, non-suicidal self injury. 4) Substance abuse- Linked with all kinds of intentional injuries. Cases of overdose → people not good at judging how much is too much. Maybe have stockpiled drugs to allow them to do it. Impairs decision making, judgement → may make things more likely to occur. * Substances can increase levels of impulsivity (if high, very drunk, etc) * Substance abuse as blame for behavior. Stopping substance abuse is hard. * Substance abuse in case of addiction is extremely expensive. Big factor leading to assumptions about these links is that stress in a person can increase risk of behaving violently. People addicted to drugs/alcohol may have trouble holding down a job, finding money to maintain the habit. *Substance abuse also big factor in predicting unintentional injury.

Understanding the Scientific Method

1) Propose a question (a hypothesis) A testable prediction about the conditions under which an event will occur. 2) Choose a research method (can use different ones for the same question) 3) Collect data 4) Analyze data 5) Develop (revise) a theory An organized set of principles used to explain observed phenomena. Theory is basically why do you get this result? What's happening to explain relationship b/w variables.

Additional Effects of Stress

1) Psychological Well-Being - Stress makes you feel worse. Higher levels of anxiety, depression, loneliness. Lots of psychological disorders impacted by stress. High levels of stress do worse regarding psychological disorders. 2) Posttraumatic Stress Disorder (PTSD) - Characterized by severe flashbacks, recurrent feelings of panic. Repeatedly experiencing the events that cause the initial trauma. Even in conditions you are safe, people who have PTSD have recursive memory, intrusive thoughts/behavior, etc. -- Triggered by military/war. Trouble sleeping, fear of leaving house (triggered by different things) -- PTSD can also be triggered by car accidents (fear of the car again or being in particular situation), sexual assault (that situation can trigger that situation/response), major cataclysmic event (terrorist attack, fire, etc.) --Small triggers (the date approaching) can be something that reminds you. 3) Memory and Cognition- During times of stress people experience difficulty of remembering information that happens (can worry in terms of taking tests. Info you know doesn't come back to you.) People experiencing stress also can have trouble concentrating. Distracted state of cognition doesn't help cognition. 4) Behavioral- In times of stress people have loss of appetite, may sleep less, may start using substances * In some cases these behavioral choices can lead to further stress (return from addiction can trigger subsequent behavior.) Triggers for people returning from unhealthy behavior: H(unger) A(nger) L(onely) T(ired) More likely to relapse when hungry, angry, lonely, tired.

The religion/spirituality health link

1) Psychological well-being 2) Major health problems (cancer, stroke, heart disease) - leading causes of death tend to be lower for people with religious/spiritual beliefs 3) Recovery from surgery - quicker 4) Longer life expectancy - People who never attended services live to 75, people who attend monthly live to 80, weekly live to 82, more then weekly 83 * These findings are pretty consistent regardless of religion. [Hummer et al., 1999] But not always - when your religious beliefs specifically prevent medical treatment/care (in these cases you don't see a benefit)

Sources of Stress

1) Relationships- many people experience conflict in their relationships (romantic partners, roommates, friends, etc.) Prevailing cause of ongoing stress. 2) School/work - A lot to do, things aren't going well. I'm about get fired. 3) Environmental Factors- Environment of living in poverty is extremely stressful. Associated with wide range of stressful events: [higher rates of regular/routine violence, poor healthcare, small expenses such as car breaking down (can't get to work so im gonna get fired?), cold winter (can't afford to turn heat on), noise pollution, crowded living conditions] 4) Cataclysmic Events- Natural disasters. Hurricanes, bombings, earthquakes, fires. One time thing but can have ripple effects that are substantial. Garfin et al., 2015 (DISCUSS) - No difference between Boston and New York for acute stress from Boston Marathon Bombings. ** Results reported sensitization as opposed to habituation. Questions: Is technology/social media good in these events → reduce anxiety? How much can you identify with the situation? → school shootings while in college Does the nature of the event play a role? 5) Internal pressures- January term with friends or should I do this internship? Really want to lose this weight but tempted to eat brownies Drink to fit in at parties Should have vaccination but I hate shots.

Measuring Stress

1) Self-report inventories - Asked if you experienced events and each one associated with points 1A) Major Life Events - Divorce (high points), pregnancy (high points), retirement, death of close friend speeding ticket (low points.) These are all relatively rare events. Many of these are co-mingled: If you experience divorce, might have to return to work or change in living circumstances. These were the earliest ways people looked at stressors. [one challenge- people interpret them in different ways] 1B) Daily hassles and Uplifts - Traffic jams, people feeling frustrated/late, oversleeping, losing your wallet, misplacing your ID. - How often do you have uplifts- watch movie, have coffee w/ friend, etc. 2) Physiological Measures (non-self report): Blood pressure, heart rate, cardiovascular heart rate, cortisol (hormone that measures stress.) These don't require self-report. However, people might show higher blood pressure when getting tested (freaking out in moment.) Use of physiological measures in itself can create stress.

Common Causes of Intentional Injury (1)

1) Suicide - The leading cause of intentional injury. [leading cause of death in many age groups] : Firearm, suffocation (hanging) , poisoning (opiods) * Age (teenagers, middle-aged men) - highly correlated with economic anxiety * Middle age men may be more likely to own firearms * Middle age men may be more likely to become addicted to pain meds (opiods) * Gender (attempts, death by) - women have more attempts, men have more successful suicides (men are much more likely to use a gun which is almost always fatal) 2) Non-suicidal self-injury - Deliberate, self-inflicted destruction of body tissue (cutting, burning, etc) * Tends to be caused by other psychological factors (distraction, self-punishment in some way.) But it's not intended to lead to death. * Need to be dealt with to get rid of underlying issues of why this was chosen. 3) Homicide and assault- Often by person known to the victim (people are usually killed/assaulted by people they know.) Often not a random crime. * In top five leading causes of death for ages 10 to 44. * Cause of nearly 50% of deaths of Black males ages 15 to 44 (carry disproportionate impact of cause of death depending on who you are) (impacting specific communities/people much more than others)

Explanations for Alcohol Abuse

1) Tension-Reduction Theory- People drink alcohol to cope with or regulate negative moods (used as a mood regulation.) Then it becomes more and more then just having glass wine after work. 2) Social Learning Theory - People learn attitudes and behaviors by watching others Watching other people in terms of drinking: People who drink older/more mature (cool for teenagers), makes things more fun (parties), tension reducing- they can model that its a way to regulate moods. * Bourgeois & Bowen, 2001 (DISCUSS) - Social norms contribute to alcohol use/abuse. People assume that their friends show more approval of it then they are (pluralistic ignorance, Appearance/reality effect) People who don't drink in HS - more influenced? 3) Personality- * Harm avoidance decreases risk * Extraversion increases risk (extraverts spend more time in social settings, with other people, fitting in with other people is more important) 4) Biological/Genetic Factors 4A) Reduced sensitivity to alcohol? (they need to drink more to experience the same effects- they are consuming lots and lots of alcohol. People that drink alcohol have more harmful effects if they're sensitive) 4B) Increased reward of alcohol? (for some people alcohol feels better/more rewarding than for other people. Individual differences in how much things taste rewarding/good. If alcohol feels great for you you might be at greater risk of abusing it.) 4C) Increased risk of developing dependence? (some people when they drink become dependent on it and find it hard to stop psychological and physical. Are people who abuse alcohol more likely to depend on it?)

Factors Contributing to Smoking (1)

1a) Social learning- Try out a new identity - Smoking associated with rebellion (independent, its forbidden; can do what I want; I'm different) * I'm cool, i'm mature, i'm older. 1b) Peer pressuring & modeling - "All the cool kids smoke," People imitate this behavior. Smoke at parties so you want to fit in. 1c) Parents - Having parents smoke increases kids risk of smoking Cigarettes are accessible * Hard for parents to prohibit it if they're doing it themselves * Parents model that behavior; kids my imitate it * Role of genes: parents who smoke have genetic pre-disposition? (biological underpinning) 2) Media influence - Rules about how much smoking can be shown in a movie before it's rated R. Dal Cin et al., 2007 (DISCUSS) - Finding: People who identify more with a protagonist who smokes increases intentions for smokers/smoking related thoughts. * Smoking: Negative consequences are long term (therefore, it's harder to show the negative consequences) vs. alcohol: Negative consequences are now * In movies, smoking used as a crutch to illustrate something- they're cool, they're badass, also used as a way of managing stress

Treating Substance Abuse (2)

3) Cognitive-Behavioral Approaches- Understand thoughts and behaviors that lead to substance use * What are thoughts/behaviors that are driving it? * Understand thoughts/behaviors that lead to substance abuse- then you can stop it. * Understand the underlying concept. A) Stimulus Control- Learn to understand (and then avoid) situations that trigger substance abuse (Ex: going to a frat party, whenever i'm with this person this is what I do so they can be a trigger.) "I only smoke when I'm drinking" B) Response Substitution- Develop new ways of handling triggers (know when I'm stressed, I crave cigarettes.) * What can you do that's different? Different way of handling things that make you want to abuse the substance 4) Public Health Approaches - Large scale government changes (bans, taxes, warning labels, etc.) - Can be used as preventative strategies as well as to decrease addiction. * Tax increases could reduce smokers tendencies * Banned smoking in certain areas can make it easier to quit * Warning labels can be a trigger and serve as motivation --> Ban smoking in buildings - lead to less smoke. Easier to get people to quit. 5) Self-Help Programs - 12 step programs (such as Alcohol Anonymous is the best example) These programs are widely used and thought to be effective. * How do you get people to effectively quit? Maybe some are not official by trained doctors/psychologists. Walitzer et al., 2009 (DISCUSS) - Randomized clinical trial. People who drop out of AA- aren't there to give you data. However, this is randomized. * Randomized way therapist recommended people to go to AA * Looked at abuse tendencies and AA attendance * 12 step people better at making sure people who go then the MOV approach Self report issues? Which of these approaches are best? Their could be a combination.

Common Causes of Intentional Injury (2)

4) Intimate partner violence (IPV) - Aggression committed by a current or former romantic partner. (subset of domestic violence- violence within the home such as child abuse/neglect) * May not always lead to death but can cause significant harm 5) Child abuse and neglect- Can include physical, sexual, emotional abuse and/or neglect (sexual abuse- taking pornographic pictures of child) - doesn't have to be physical * Can be difficult to determine child abuse/neglect - their may not be evidence of what happens. * Maybe lack of resources- child not having coat/adequate food * Children are bad witnesses/may not tell people. May not know what's normal. Can be difficult to self-report or they may not know the consequences. * Child identified being at risk. What's the bar of removing a child from his/her home and where do they go? Limited number of foster care families. * Parents didn't ever report child as missing. Was found wrapped up in rug. Parents were dealing with issues of addiction. Judgements we make of what is abuse/neglect differ with the amount of financial resources. When do you make decisions that something is beyond what is safe and where do you put children? 5) Sexual violence- Sexual activity without consent. Range from self directed to directed by others. Range from whether they're within the home, in relationship, etc.

Risk factors for intentional injury (2)

5) Social influence- More common within adolescents/young adults. Palo Alto CA video: A suicide cluster (groups of students at risk who have experienced proportionally more suicides over the last decade then expected) Particularly salient in terms of adolescents and young adults 6) Modeling- Modeling in terms of suicidal ideation (13 reasons why, celebrity suicide, media) or people right around you. Suicide more likely when you've heard about a suicide at your school for example. Grow up in community where everyone owns a gun or theres a gang- can model that sort of behavior -- Domestic violence of all types is modeled. People who experience abuse as child are more likely to abuse their own children. Suicide contagion- Palo Alto clip Concern because when a community experiences a suicide, how do people react/respond in ways that don't create contagion. Plant tree, bench in persons honor. Memorial services discussing how much they liked the person. That behavior in some cases led people who were on the edge themselves to think that if I commit suicide people will do the same for me/think about me positively. Is attention being paid to death by suicide lead it to be carried out by others?

Risk factors for intentional injury (3)

7) Poverty- Clearly linked to intentional injury * Higher rates of child abuse/neglect, homicide, and neglect (self directed injury not linked with poverty) * Explanations for link between poverty and other intentional injury? → Stress. Will I/kids have enough food? Can I get a different job if i get fired? Health insurance? * Poverty can lead people to do more intentional injury * Make choices about engaging in crime/gun violence. * If I go to jail will I be able to get a job in the future/have stable finances? May also have social influence. More ready access to drugs/fire arms. Social influence your seeing is other people doing this behavior (makes it seem legitimate, and a possibility) 8) Access to firearms- Linked with suicide, partner violate. Allows homicide to happen at a high rate. * Highly correlated with intentional injury. * States with high levels of suicide rates have very relaxed gun control laws, more access to firearms. * If in a state with laid back gun control laws it's significantly more likely to be successful suicide attempt. [Difficult to disentangle correlation from causation.]

Epidemiological Research Methods

A branch of medicine that studies and analyzes the patterns, causes, and effects of health and disease. Ex: Rates of measles around the world.

Health Action Process Approach (EDIT)

A stage model of two distinct stages Motivation stage: Evaluate risk of behavior, potential outcomes from change, and self-efficacy for making a change (can I do it) Volition stage- (what are risks of tobacco, will I be ostracized or supported if I do make this change?) [11:10]

Quasi-experiments

A study in which there are distinct groups of people in different conditions, but the people were not randomly assigned to the groups. (didn't get to assign the groups.) Babys breast fed as opposed to formula fed have a bunch of different benefits. Therefore, hospitals promote breastfeeding (women who choose to breastfeed may be different then women who do not.) However, maybe breastfeeding is a proxy measure for being more nurturing. -Hard to make causational conclusions from quasi-experiments since didn't get to choose conditions.

Benefits of Social Support- Coping with illness (2) & Recovering from surgery (3)

A very clear finding. Atzema et al., 2011 - 75.3% of married men go to hospital within 6 hours of chest pain. 67.9% single, 68.5% divorced, 70.8% widowed men * Married men are more likely to have someone say chest pain is a problem and should go to hospital. * Having other people in social network and have you cope can give you greater chance of living (if get to hospital faster) Recovering from surgery (Instrumental (tangible) support) - going to help take you places, do these things for you Practical in the moment I am getting help. People are validating me, caring about me (emotional support). People with good social support network might take care in following recommendations following surgeries. Information/appraisal support: People recover faster in hospital if they have a roommate who's just had your same surgery in the hospital is better. Belongingness support/part of same group: - Someone who has identified with something you've experienced can help in some way. - They can relate to you/help push your recovery.

The power of nicotine (prevents stopping smoking)

Addiction - A condition in which a person has a physical and psychological dependence on a given substance. (nicotine is very easy to become addicted to - nobody believes they'll be addicted. They say they'll just smoke at night, with friend, etc and then they'll stop. But then they have trouble stopping.) Tolerance- Body no longer respond at the same level to a particular dose, but rather need larger and larger doses to experience the same effects. ("a few cigarettes" isn't enough anymore) Have positive feeling of taking in nicotine and your body needs more for same effect Withdrawal- If a person stops using a substance, they experience unpleasant symptoms such as irritability, difficulty concentrating, fatigue, nausea, and weight gain [You feel bad, when stop it's really hard.] [Can be true for alcohol, tobacco, etc.] challenge of quitting- Most people want to quit

Risk of Injury Across the Lifespan (2) - Adulthood

Adulthood - Accidents, heart disease, suicide less prevalent (real overall differences compared to younger ages) 25 to 34 - Poisoning (unintentional overdose- not suicide), car accident (driving error, mishap), homicide All 3 of these are preventable. 35 to 44 - Poisoning, car accident, suicide 65 and older - Falls (falling, hitting your head), car accidents, suicide

Defining alcohol abuse

Alcohol use Disorder- A medical condition that is characterized by both alcohol abuse and dependence, and occurs when drinking causes a person distress or harm (inability to hold a job, marriage problems caused by drinking, domestic violence, etc) - this is serious problem in terms of things that require rehabilitation, treatment, etc)

Benefits of Social Support- Life Expectancy (4)

All different kinds of social support are associated with greater life expectancy. Williams et al., 1992 - heart disease patients and people either married or lived with close confidant [82% of heart disease patients who are married/have a close confidant live at least five years after diagnosis, compared to only 50% of those without such support] However, is this really a marriage effect? - are people married more likely to have health insurance (so better treatment)/financial resources to pay for it? People with heart disease who are married find out early? People married nicer? Spiegel et al., 1989 - (random assigned women to attend social support group or not to. All treatment was same) Breast cancer patients who attended a social support group live an average of 36.6 months following diagnosis compared to 18.9 months for those who don't. -- More recent research has not typically replicated these findings. -- One explanation: People have options of social support following a serious diagnosis (online social support?) -- Now there's more treatment available which outweighs social support? -- Could be that cancer is more common now (people who have cancer live longer with it- more survivors. There are other sources of support so now it is less valuable.) Beller & Wagner, 2018 - Degree of loneliness and degree of social isolation (I don't have people to do things with (have dinner with, drive to airport)) People at the maximum level of loneliness were more likely to have died then people who experienced relatively low levels. Really about feeling connected vs. feeling socially isolated. * It's not that being alone or lonely is the same thing. Can feel not lonely when alone and feel lonely when surrounded by lots of people. It's about do I feel close/connected to people around me?

Descriptive Research Method Type (2)

Archival research: Researchers use already-recorded behavior Abel & Kruger, 2010- Rate facial expression on rookie baseball cards and then look at how old the men were when they died. Smiling predicts longevity

Positive States

Associated with experiencing better health outcomes Extraversion- outgoing, social, do new things, meet new people Positive affect- Generally happy/in a good mood Optimism- Expect good things to happen, positive expectations for future Overall: People like people who are optimistic/positive. Can manage stress better (more likely to find someone who can drive them places, bring them things, etc) since they have a bigger network of people. If something bad happens, people who are optimistic don't worry too much- ex: if lose dating partner you'll find someone better Pessimistic people- i'll die alone!

Descriptive Research Method Type (5)

Behavioral genetics: Examines the relative impact of genetic factors versus environmental factors on health and behavior (lots of research shows that genes matter: smoking/alcohol, cancer, diabetes, obesity, etc.) [Correlation b/w biological vs. adopted children. Identical vs. fraternal twins. Ways researchers can look at role of genes vs. environment. Epigenetics: The study of how non-genetic factors influence whether genes are expressed (how environmental factors can change gene expression.) Meta-analysis: A statistical procedure in which researchers combine data from multiple studies in order to determine overall trends. [Use strengths and weaknesses from individual studies, they help even out differences]

Explaining the alcohol-consequences link

Both of these are correct. Physiological Effects - Impaired information processing and reduced self-awareness (lead people less able to do things, to do dumb things, etc) [Impaired so reaction time is slowed- get in car crash] [When drunk less likely to think about possible consequences/digesting information] Alcohol Myopia - Individuals can't engage in cognitive processing regarding long-term consequences of their behavior, and instead base decisions primarily on the most salient and immediate cues. [If drunk/have unprotected sex, might get someone pregnant/have STD. People can't think long term which is a big problem] EXAMPLE: Canada. College men. One group sat in room and drank seltzer water for 30 mins Other group gave them vodka tonics (got drunk) After this, they showed the men a video (that we watched in class) How dumb would it be to have sex in this situation? → everyone drunk/sober says it would be dumb What would you do? → Men who are sober would say no and men who are drunk would say they would. Not good at thinking of long term consequences when drunk. Can't run this study with women: if run it with women and they're pregnant- then you'd be exposing baby alcohol (not approved by IRB) -Dating profiles to women: Evaluate which men would like long term relationship Drunk women chose the men that don't sound appealing (been around)

Explaining the Social Support-Health Link

Buffering Hypothesis - Social support provides a buffer from such daily life stress, and thus is particularly beneficial to health during times of stress. [Things going poorly you need it where things going well you don't need it] *Direct Effects Hypothesis - Social support benefits health regardless of level of stress [High or low] At every level of stress low and high, it's always good to have more social support Conclusions- There are probably elements of both of these that are right. * During times of high stress, social support really particularly matters.

Common Causes of Unintentional Injury (2+3)

Car accidents At first a lot of reluctance for things like cell phone laws. Drews et al., 2008 (DISCUSS) - Passenger with you in the car vs. talking on the cell phone. Passengers in car were more sensitive to road conditions. Talking on the phone was more dangerous. Falls - For little kids, often stairs, falling out of crib Adolescents, young adults- falls often on stairs, out of window/balcony, stairs. - For adolescents and young adults, falls often a result of substance abuse/alcohol (I was really drunk and fell of balcony) -Falls tend to be a result of losing balance for old people.

Emotion-focused Coping

Changing how you think about the stressor (within) [not changing/confronting the thing itself] [Ex: I've gotten C's before it's not the end of the world I don't care about this class] A) Approach focused (vigilant) coping - Writing/venting about the problem, finding some benefits, using humor. Includes thinking about it. Writing, keeping journal, using humor. These are all good B) Avoidance (minimizing) coping: Denying or avoiding thinking a problem (at the end of the semester it'll all just click and be fine.) Or I won't think about it - won't go to class, won't do hw, etc.

Learning Theories [Won't be asked for these definitions]

Classical Conditioning - Learning that occurs when a previously neutral stimulus comes to evoke the same response as another stimulus with which it is is paired. [Ex: Pairing a light to food. Dog will start salivating after its been paired with food repeatedly.] [Sometimes people react in negative ways to being in dentist office- was previously a neutral stimulus] People can automatically show pre-existing associations. Operant Conditioning - Behaviors can be increased or decreased as a function of the consequences of engaging in them (reward and punishment) -People trying to lose weight set up system where if they lose 5 pounds they'll treat themselves to something. This motivates them. -People motivated to avoid speeding due to speeding tickets. Observational Learning/Modeling- Watching someone else engage in a particular behavior and seeing or hearing its consequences. [Kids may learn to smoke by watching their parents smoke.] [Observational learning can lead to positive or negative health behavior] Portanova et al., 2015 (DISCUSS) - CPR survival rates on T.V. compared to real life [archival data.] Millions of people are (observational) learning that this is how often survival happens. [What is the role of the media in terms of representing the real world?]

Critiques of Learning Theories

Cognition can undermine learning (antabuse built on classical conditioning. Alcohol problem so that if they drink they'll feel sick and stop taking antabuse.) [They blame it on the antabuse not the alcohol] Behavior is motivated purely by reward/punishment (not internally driven) --> Most people are not internally driving the speed limit. Only drive speed limit the second they see the police officer.

Internal Validity

Confidence that the effects on the dependent variable were caused by the independent variable. In many studies we've described we don't have such confidence. 1) (To increase internal validity) Use a placebo (neutral treatment) Treatment: Informing women about their level of activity. 2) Avoid experimenter expectancy effects (that the experimenters beliefs aren't driving the behavior) Important that the experimenter doesn't know the condition and CAUSE the DV.

External Validity

Confidence that the same results would be obtained again 1) Use a representative (not convenience) sample - Don't poll people who are different/non representative. 2) Make participation convenient 3) Replicate the study with different populations/locations - Make sure the study can work more generally not just in one population 4) Create high mundane realism - Make sure study resembles thing in the real world. Ex: Women cleaning hotel rooms.

Distinguishing correlation and causation

Correlation shows a relationship between variables, but not that one variable causes the other. - Flossing-life expectancy study

Descriptive Research Method Type (4)

Developmental studies: Examine how people change over time (very common) Longitudinal studies: Follow a single group of people over time. (have advantages) Sbarra & Nietert, 2009 (25 year follow-up): 65% of those always married, always single, widowed were alive. 50% of those who were separated/divorce were still alive. Their question was how does this influence life expectancy. Suicide? Financial stress/pressure? Can look at these people over time and see how it changes. Cross-sectional studies: Compare people of different ages at the same point in time. (examine different people in 20s, 30s, 40s) However, their can be limitations (people in 70s tend to look negatively on gay marriage, living through something traumatic can stay with people. Don't want to measure generational/ societal changes.

The Role of Personality

Different people do different things → different kinds of health outcomes

Consequences of Alcohol Use

Direct effects - Liver damage, brain damage, some types of cancer Indirect effects** - Accidents, homicides, suicides, sexually-transmitted diseases (as well as sex in general- unprotected) (these are things that wouldn't normally happen) , falls, and burns (people not being conscious of what they are doing. [all can happen after a night of binge drinking. Health psychologists more concerned about these since they are consistent, widespread, and short term/immediate]

Internal locus of control/hardiness

Do you believe your own decisions/behaviors impact your own outcomes? -- People that do experience better health outcomes -- People low in internal locus of control/hardiness- "no matter how long I try I'll never get it." Peterson & Seligman, 1987 - look at newspaper interviews given after wins/losses of baseball games -- Those guys were too good for us (external attributions) vs. we don't care who pitches for Tigers b/c we are again on our batting stride (people who make internal attributions live longer) Personality influences how much we attribute internally/externally

Understanding Injury/Types of Injury

Injury is a leading fundamental topic in health psychology (it's the leading cause of death in most ages across the lifespan) Injury is preventable (unlike some things such as genetic factors that lead to diabetes, etc) Types of injury: Unintentional injuries ("accidents") - person who experienced the injury did not mean for it to happen (ex: car accident) Intentional injuries- The person who caused the injury meant for it to happen; intentional injuries are caused by violent behavior directed towards other (e.g. assault, homicide) or the self (e.g., suicide, non-suicidal self-injury) * These types are not equally likely to occur across the lifespan. Injury varies tremendously due to its prevalence and causes of injury (intentional or unintentional)

Preventing Substance Abuse

Early research- simply tell people about the consequences (heroin can lead to overdoses) * DARE Program- tell people about these things and the consequences: shown to be completely ineffective 1) Social Influence Programs- Now used more commonly and shown to be more effective. Building social norms rather then for resistance. Emphasize immediate consequences- WIll you have yellow teeth? Emphasize manipulation of advertisement- They just want more money Emphasize accurate social norms opposing substance use- "everyone drinks" - not true Led by slightly older student models- who are valuable and focus on immediate consequences. [Going to be really expensive, ads are tricky and designed to con you, you might think everyone supports it but they're not] 2) Life Skills Training Approaches- Trying to give people ability to resist (feel better about yourself.) Trying to give people strategy for resistance. * Increase self-esteem and social competence * Provide strategies for resisting persuasive appeals - cigarette companies want my money * Teach skills for verbal and nonverbal communication- everyone has tried this before (how do you resist these kinds of pressures? Trying to give you skills to say no in ways that feel okay. "If I drink I vomit") 3) Mass Media Approaches- PSA's online, billboards, etc. * Therealcost.gov - try to talk to teenagers about the IMMEDIATE consequences of smoking (yellow teeth, expensive) 4) Government-Based Approaches- Basically means laws, regulations, rules that restrict alcohol, smoking, drugs in some kind of way. * Banning sales of a particular substance * Banning sales based on age * Banning use in particular settings * Banning advertising * Raising taxes- particularly good at reducing smoke. Raising it makes it harder for young people. Ex: Can't advertise cigarette smoking on TV Ex: Requiring warning labels on cigarette ads (US doesn't require this) Ex: Minimum age to purchase Ex: Can't smoke on plane, in restaurant, in dorms, etc. Setodji et al., 2018 (DISCUSS) - Send kids to fake convenience store. Having tobacco powerwall behind the cashier reduced consumption (perceived smoking norms)

Critiques of Theories of Reasoned Action/Planned Behavior

Fail to include a person's current or past behaviors (where you are right now) Ignore other factors (e.g., race, gender, socioeconomic status) - people from different backgrounds may prioritize connections with their family to a different extent, eating patterns linked to cultural background. -Can be harder for certain genders to engage in a behavior. -If you lack financial well being to join gym or get to grocery store to buy healthy food at cheap cost, it can be hard to really act on strong intentions. -May only show correlations (not causation) (People may justify the behavior they are doing) Your behavior may lead you to develop other friends that engage in the same behavior and therefore are supportive of it. -Combining components from several different models may better predict health behavior.

Conscientiousness

Hardworking, motivated, persistent. These people are associated with numerous positive health outcomes. * Might be better at maintaining employment (could give them health insurance) * Conscientious people know they're supposed to floss, eat breakfast, etc. Deary et al., 2008 (DISCUSS) - children more intelligent/dependable live longer? -- 55 year longitudinal study. -- More intelligent/conscientious children early in life were predictive of their health outcomes. -- Don't get to randomly assign where children live- all factors co-mingled to create these expectations. Marshmellow study - Can eat one now or a bowl of them in 15 minutes. Kids that did not eat marshmellow experienced a thousand better health outcomes (delaying gratification) -- If you're a kid growing up where circumstances aren't clear, your right play is not to delay. -- Basically all white, highly educated sample [kids of Stanford professors] -- Perhaps these circumstances create personality in some way?

Problem-Focused Coping

Have a tendency to confront and change the stressor. You're recognizing the stressor and trying to fix it/confront it in some way. ** Can include seeking assistance (ex: getting a tutor) , going to office hours, making a plan (to confront and change stressor) such as form study group, do more practice problems, and devote more time to it. Tice & Baumeister, 1997 (DISCUSS) - What are the effects of procrastination on health outcomes? Gave students questionnaire about procrastination, recorded when they handed in assignment. ** Non-procrastinators early seemed better. (less due in beginning → not doing much.) Procrastinators later seemed worse (and had much more stress) since everything due at once → negative health outcomes.** What's driving the effect. Procrastinators → more risk taking? Defensive-pessimism- When someone says they know they'll do badly on something and totally convinced about it. This in facts motivates them to perform better and they tend to succeed. In between optimists and pessimist. [If you tell them it's going to go great it totally screws them up] Challenge: They have to play through negatives/failures in order to succeed.

Features of experimental design

Independent variable(s): The factor that is studied to see if and how it will influence attitudes and/or behavior. Dependent Variable(s): The measured outcome of a study. Random assignment: a research technique in which every participant has an equal chance of being subjected to either of the conditions. (don't let people choose)

Risk of Injury Across the Lifespan (know how it changes across lifespan) (1)

Infancy and childhood: Younger than 1 - Unintentional suffocation (Sudden Infant Death Syndrome- child stopping breathing while sleeping) , homicide (death at the hands of parents or caregivers- intentional- child abuse/neglect), car accident (usually result of some inadequate car restraint system (seat-belt, car seat, etc) Ages 1 to 4 - Drowning (open pool- not gated, no adequate supervision as well as bathtubs- parent leaves and child slips, lake, river, ocean), car accident, homicide Ages 5 to 9 - Car accident, drowning, fire/burns (kids start exploring in terms of matches, tall enough to reach stove) Ages 10 to 14- Suicide (suicide used to be not as prevalent as it is now), car accident, homicide (typically not at the hands of parents/family members- could be violent/deliberate act from stranger, neighborhood violence, school shootings, gang warfare (could be accidental)) [across the lifespan you see different factors in terms of leading causes of death] Adolescence and young adulthood (15 to 24) - Accidents (by far- almost 50%), suicide (big part- intentional), homicide 73% of deaths during this age group are caused by injuries (intentional + unintentional) * Leading cause of fatal unintentional injuries is car accidents Unintentional poisoning (overdoses) is second (basically opiodes) Car accidents prevalent- learning how to drive. * Perceived invulnerability + risk taking + peer pressure + drugs Gould & Shaffer, 1986 (DISCUSS) - showed 4 tv films about suicide/suicidal behavior. --> More people committed suicide/injury after seeing the broadcasts during the two weeks before. --> Evidence that how you are portraying things can lead to unintentional negative consequences

Creating Health Behavior Change (3)

Personalized Health-Promotion Messages- Theory and research suggest that different people respond more to personally relevant information. * Adopting healthier behaviors (smoking, alcohol use, condom use, eating and disordered eating. * Managing pain & illness- People vary tremendously on how much information they want to have. --Matching of information leads to lowest levels of anxiety. -- **More personalized messages about health behaviors result in more positive thoughts, more personal connections, stronger intentions to change behavior, and higher success rates of change.**

Theories of Reasoned Action/Planned Behavior (specifics)

Intention- Strength of actions that someone plans to take [Do I intend to do this? According to the model, attitudes and subjective norms lead to intentions and your intentions lead to behavior.] Attitudes : A person's positive or negative feelings about engaging in a particular behavior [How do i feel about using condoms, etc] -Feel good about myself going to gym so that's a positive attitude. -Negative attitude- might get injured. Subjective norms: Individuals' beliefs about whether other people would support them in engaging in such behavior, and whether they are motivated to follow the beliefs of these salient others (Am I in a friendship group where people will support me or not?) "People in my social world would be impressed/encouraging if I stick to an exercise plan." Perceived Behavioral Control (very similar to self-efficacy)- The extent to which a person believes that he or she can successfully enact a behavior. [do you have the ability to do this?] (I've tried but dropped out before, have 2 jobs so it's hard for me to do it.) Implementation intentions: Specific plans of how, where, and when to perform a behavior (lots of times people intend to do a behavior and then there's a gap between intention and whether you do it.) Relevant to political psychology. Implementation intention that can increase people's likelihood of voting- when they plan out where they will go vote, where they will park, etc. (much stronger predictor of behavior)

Factors Contributing to Smoking (3) - Positive Reinforcement

Many competing models. 1) Nicotine-based models - There is something about nicotine that is very rewarding · 1A) Nicotine-fixed effect model- Nicotine stimulates reward-inducing centers in the nervous system (it feels good, stimulates nervous system in positive ways) [Nicotine feels good is the whole model] · 1B) Nicotine regulation model- Smoking is rewarding only when the level of nicotine is above a certain "set point" in the body. [You only get the benefit when you get enough. Need to get more and more nicotine to reach the set point before you get the benefit/reward. Also says that set point changes over time] 2) affect regulation model- People smoke to attain positive affect or to reduce affect (smoking helps induce positive things and reduce negative things) * Nicotine stimulant- concentrate/study better. * If feeling anxious/stressed, smoking helps with relaxation/coping. Dahne et al., 2015 - For people low in social phobia (being at party isn't big deal) , smoking isn't a big deal. People high in social phobia (walking into party is anxiety provoking), having a cigarette reduces their anxiety. Smoking is important for them. This is example of affect regulation model. People may use it to manage positive and negative affect in their lives. [B/c nicotine feels good, were motivated to smoke to feel good, reduce feeling bad] 3) Combined Models- Try to combine both these types of models in same way 3A) Multiple Regulation Model - Smoking is initially used to regulate emotions, but over time how smokers feel becomes linked with how much nicotine they have in their blood (linkage in body at physiological level between how you feel and how much nicotine you have in your blood.) Classical conditioning- how you feel linked with amount of nicotine in your blood. This association builds up over time. 3B) biobehavioral model (similar to multiple regulation) - Nicotine leads to physiological effects that feel good, which leads people to become dependent (both physically and psychologically) on using nicotine to experience these positive effects * Need to figure out cigarette break, need nicotine with me * Dependent physically on having nicotine in order to feel good. Both these models include a physical/physiological factor as well as a psychological factor (the psychological feeling/affect and it becomes linked with the amount of nicotine in the body.)

Conclusions (value of matching)

Match the coping style with the problem. There are problems better handled with emotion and problems better with problem focused coping. [Ex: Problem focused coping are best for things that have a solution. Can take problem focused coping and reduce the amount of stress you have.] [Unsolvable problems cannot be solved by approach coping- Ex: losing a loved one, hating who you are working with on a project. Key is being able to use the right kind of solution.] Ex: If parents getting a divorce a strategy for fixing parents marriage won't be useful (simply talking it out will be most effective.)

Creating Health Behavior Change (2)

Message Framing: The way that a behavior is presented and shifts in wording can significantly impact persuasiveness of a message. Gain-framed: Focus on the positive outcomes that can be attained - or the negative outcomes that can be avoided - by adopting a behavior -- Detecting cancer early can save your life --Using condoms prevents the spread of HIV/STDs Loss-framed: Focus on the negative outcomes that may occur from failing to adopt a behavior --Failing to detect cancer early can cost you your life --Failing to wear a condom increases your risk of acquiring an STD Detweiler et al., 1999 (DISCUSS) - Strengths: random assignment to condition, an experiment (with controls), * Asking people actually on the beach (done in real world) Gain framed messages: if you do these things you'll avoid skin cancer. Do they maintain the behavior over time- long term effects? What types of people most susceptible to message framing? - age effect? Family history, social groups, demographics, etc.

Epidemiological Research Methods (2)

Natural experiments: Compares people in 2+ conditions but does not assign people to those conditions (very similar to quasi-experiments) [Ex: Men who join fraternities drink more than those that do not. Can't randomly assign.]

Benefits of Social Support- The value of diverse types of support (5) and the value of giving social support (6)

Neighborhood connectiveness, pets Research shown tremendous support in terms of support provided by pets (having this sort of connection is important) Friedman & Thomas, 1995 - Older adults (no pet, dogs, cats.) One year survival. A cat does not do anything for your health but a dog is beneficial for your health. (dog much more about unconditional love - always happy to see you.) Also, if you have a dog you walk more → healthier. [Also, a dog is a very good conversation starter - dogs are like a proxy to people] -- It's difficult to disentangle which of these effects are driving it. The value of giving social support - Could be sustained volunteerism in community, holding door for someone, giving homeless a dollar. → also leads to better help outcomes. [Feel better about yourself, make people think highly of you/want to connect with you] * Could distract us from our problems or also help us emotionally.

Physical Effects of Stress

Nervous system - Controls peoples overall reaction to stress (sympathetic vs. parasympathetic. One leads to heightened arousal and the other one you're seeing the opposite.) Endocrine System - Works by releasing hormones * Increases in epinephrine (adrenaline), cortisol * Decreases in hormones linked with growth and reproduction Cardiovascular System - consists of heart, veins, arteries * Increases in blood pressure and heart rate (what lie detection systems look at) Immune System - Defends against infections and diseases * Decrease immune response during times of stress Rheinschmidt-Same et al., 2017 (DISCUSS) - Looks at physical effects of different housing situations overtime. Having cultural based housing offsets burden of expected discrimination? Yes Psychoneuroimmunology- Can't distinguish between these body systems. Psychosocial factors interact in complex ways with all body systems, including the nervous, cardiovascular, endocrine, and immune systems (all these things interrelate; they do not operate in isolation.) * How do you disentangle the events in terms of what's driving the benefits? * Might there be a tipping point. Are they differentially effective for different people?

Negative States

Neuroticism/negative affect- always in bad mood, anxious. Opposite of positive affect. They assume bad things will happen and always feel negative about themselves. (associated w/ negative health outcomes?) Type A behavior - These types of people are always multi-tasking (experience more coronary heart disease) ; can never play a friendly game. Everything is win/lose. They assume everyone is out to get them. o Time urgent - I get impatient when I have to wait o Competitive - I want to be the best at everything o Angry/hostile - I easily get angry [people angry/hostile experience negative health outcomes- this is the driver of that] Hostility/disagreeableness - Mad at other drivers for tailgating, mad at friends/spouses/strangers. Believe people are bad and out to get them. Seems to be the kicker in terms of negative health outcomes.

The downside of Social Support

Not all social support is good. * Can be emotionally taxing/stressful. * Can be used to it and depend on it so being alone can be difficult * People can try to be helpful and have good intentions but other person might not get it and support they are offering can not be useful and actually be disruptive. --> People can encourage something that isn't useful such as drinking, smoking King & Reis, 2012- Married people are 2.5 times more likely to be alive 15 years later after heart surgery than single people. But happily married people are 3.2 times more likely to be alive 5 years later than unhappily married people. * Having an unhappy marriage is a constant stressor. * Social support of some kinds is good, and other kinds may not be.

Types of Epidemiological Research Methods (1)

Observational methods: 1) Prospective: Researchers compare people with a given characteristic to those without it to see whether these groups differ in their development of a disease. (looking ahead) -Stress can inhibit conception. -High stress vs. low stress: what are rates of pregnancy years later. 2) Retrospective: Researchers examine differences in a group after a disease has occurred and attempt to look back over time and examine what previous factors might have led to the development of the disease. (what distinguishes people in these groups)

Precaution Adoption Process Model

People go through a series of 7 stages when attempting to change a behavior. Stage 1 - not even aware of the disease or problem (similar to pre-contemplation) Stage 2 - are aware, but do not believe that they personally are at risk (I know some people who smoke get addicted, but that won't happen to me b/c I just smoke with friends) Stage 3 - believe they are at risk but have not decided to take protective action (very similar to contemplation) Stage 4 - decide that action is unnecessary (smoking helps me relax and also prevents me from overeating) [Thought about it and decided I'm not doing anything.] Stage 5 - decide to take action Stage 6 - begin changing behavior Stage 7 - maintain the behavior over time Both these models describe the process you go through in trying to change behavior. You come to the decision over time. EX: Some people might not understand sleep deprivation is a problem, some know it's a problem and aren't willing to do anything about it. Go through process of trying to go to the next step.

Transtheoretical (Stages of Change) Model

People go through distinct stages as they attempt to change a behavior. 1) Precontemplation- Lack awareness that their behavior is problematic, unmotivated to change 2) Contemplation - Growing awareness of behavior costs and susceptibility, seek information and strategies about changing. 3) Preparation - Small changes as steps towards the ultimate change (Ex: I'm going to join a gym that I found. Preparing to engage in regular exercise.) 4) Action- Engaging in new behavior, risk of relapse is strongest here. 5) Maintenance - Change is sustained (usually 6+ months)

Benefits of Social Support- Preventing Illness (1)

People that have more social support are more susceptible to minor and major illnesses. [Has some role] Cohen et al., 1997 (DISCUSS) - Everyone got cold inserted into nostril. More diverse social support networks less likely to get a cold. Are all social networks the same (social media connections?) Challenge: All relationships are not equal. What's the relationship of the support provided? Could pre-existing differences such as dependence on social network help explain these relationships?

Social Cognitive Theory

People's behavior is influenced by observing other people engage in such behavior (and seeing the outcomes these people experience from such behavior) as well as their own confidence that they could engage in that behavior. Self-efficacy: A person's confidence that he or she can effectively engage in a behavior. (can you do it) [Confidence across all the different permutations- Ex: can you stand up to ridicule from people if you don't drink? Can you do this consistently?] Outcome Expectancies: Beliefs about the consequences of engaging in a particular behavior. [Will people be supportive/think well of me or will they be dismissive.] [Have a game next day, job interview next day] - If I resist/stop drinking then it will help me with these things.

Risk Factors for Unintentional Injury

Personality traits- Impulsivity, hostility increase likelihood. Some increase peoples risk. "Wear seatbelt", "Slow down" - people might say no you're trying to control me. Anger/hostility/impulsiveness Conscientiousness- Conscientiousness decreases likelihood (but not always) - they'll get a designated driver for example. Parr et al., 2016 - People who are conscientiousness may be more likely to text/drive- they understand risk in general but don't feel personally vulnerable. They may not want to keep somebody waiting. "I'm so conscientiousness i'll even respond to them when driving." Substance abuse - Using drugs/drinking makes someone more at risk for experiencing all of these. I wouldn't normally fall walking down a flight of stairs unless i'm drunk. You also make bad decisions (i know i shouldn't do this but i'm not thinking clearly so I make bad decisions. This is true for lots of things we've talked about.) Up to 70% of water recreation deaths of teens and adults involve use of alcohol. Lots of other example shows substance abuse leads to bad decisions.... [11:17] Social influence- Especially during adolescence --> Fear of rejection, really care about what other people think of them Simons-Morton et al., 2005- Looked at risky driving behavior (male and female drivers.) Look at how driving changes if alone with male/female passenger. Male drivers drive horribly with other men (during adolescents are especially bad- look I don't speed) Men driving with women are better (probably trying to impress them) Little effect with women driving with women being a little more risky but in general they're safer drivers. Poverty- Physical environment? - Unsafe building, lack of smoke detectors, car seats. Less supervision? (so children more likely to experience fall/burn?) Less education? More stress? (reaction to feeling life is out of control/greater stress) More drug use? Poverty is linked with unintentional injury but we don't exactly know how.

Factors Contributing to Smoking (2)

Personality- People of certain personalities are at-risk of smoking * High risk-takers * People low in self control (difficulty resisting peer pressure, become addicted easier) * Concern with weight (assumption smoke helps reduce appetite. If smoke, easier to be thin which is seen as popular) --> Virginia slims- specifically marketed to appeal to women. If smoke it'll help you be thin. If you try to stop smoking, might overeat to compensate which is another problem.

Explaining the Personality- Physiological Mechanisms (2) and Coping Strategies (3) [LISTEN]

Physiological mechanisms- Their heart is beating faster, muscles tense (fight or flight all the time.) People who are hostile go through life feeling like people out to get them will lead to higher beating hearts. Coping strategies- Heart surgeries, measured health outcomes. Scheier et al., 1989- People who are optimistic were likely to get information on the surgery (can I have info to read about this so i can cope with it better.) They were not just blindly optimistic- they made a plan, sought out information, got strategies to speed up recovery. People optimistic were more likely to do this.

Common Causes of Unintentional Injury (1)

Poisoning - poisoning (opiod addiction) - rates of overdose deaths have increased substantially (Ex: rates of heroin have increased a lot.) * A rise in terms of subscription. When have surgery for example can write yourself one , continue using it, and get addicted. If have trouble breaking addiction may get addicted to heroine. Nobody intends to be/get addicted (just to be relaxed, feel better, etc) All sort of modeling might play a role. Challenge of opiod addiction: We've gotten good at making drugs that can help manage pain. Better technology has led to better drugs but also means people can abuse them off-counter. Oxycotton- sustained pain relief over long period of time. Then people figured out you can crush them (using it in unintended ways, off label. Amount of addiction was underestimated.)

Understanding Smoking

Prevalence- * More men than women smoke * Whites and Blacks more likely to smoke then latinos, who are more likely to smoke with asian americans. Rates highest among native americans * Highly correlated with education level (those with graduate degree rarely smoke) Highly correlated with poverty (26% who live below poverty line) * Smoking is a function of sub-culture you live in. Those with lower income/education are less likely to smoke than those with high income/education. * Variation in terms of how much states have legalized smoking; age you can buy cigarettes; amount of tax on cigarettes; religious beliefs (Mormonism) * States where tobacco is made are less likely to enforce laws * Poverty is concentrated in particular states.

Descriptive Research Method Type (1)

Qualitative research- Understanding and interpreting behavior in a natural setting (behavior not numbers) Case study: Studying one or more individuals in great depth to determine the causes of the person's behavior and to predict the behavior in others who are similar. Naturalistic (participant) observation: Researchers observe and record people's behavior in everyday situations and interactions, then somehow systematically measure that behavior.

Epidemiological Research Methods (3)

Randomized controlled trials (ECTS): Tests the effectiveness of different drugs or treatments; uses random assignment to condition. [?] Double-blind

Managing Relapse

Relapse to a behavior even when someone is trying to stop a behavior happens all the time. Relapse curve: Addictions are different (between heroin, smoking, alcohol) but the relapse curves look virtually identical People have trouble maintaining behavior change. * If you can do 3 months of abstaining, you have a good chance of maintaining that behavior. * Therefore, what we care about is getting someone to the 3 month mark (amount of attrition is slower)

The Influence of Religion and Spirituality

Religiosity - A formal link to religious organizations Spirituality - A personal orientation towards religious beliefs * Linked with positive health outcomes

Descriptive Research Methods

Research in which behavior and/or thoughts are systematically observed and recorded. -Rate of suicide attempts for athletes experiencing head injuries -Go into cabinets - % of healthy foods?

Explaining the Personality- Social Support (4), Health Habits (5), and Self-Report (6)

Social support- People positive/optimistic/extraverted get more levels of social support (this could reduce the amount of stress they experience) People who are hostile are likely to have less. Health habits- People who are conscientious may have better sleep strategies, may get flu shot. Can go through stressful experiences with healthy habits → lead to better health outcomes. Self-report - Someone high in neuroticism/negative affect always finds complaints. Not better or worse * Maybe not actually being driven by health outcomes.

Explaining the Personality- Stress (1)

Stress - (type A people) - If every situation is win/loss, you go through life experiencing stress consistently Broaden-and-build theory- Positive emotions broaden people's attention and cognition. McCanlies et al., 2014- Police officers following Hurricane Katrina. Outcome: Symptoms of PTSD. People who were high in positive traits showed lower levels of PTSD and were able to manage stress. People low in these traits experienced more stress and more negative health outcomes.

Descriptive Research Method Type (3)

Surveys: Asking people questions about their thoughts, feelings, desires, actions Problem: People could lie if they don't want to reveal information -Survey data can be useful but have to be careful getting accurate responses

Health Belief Model

The likelihood of a person engaging in a behavior is a function of 5 factors. Susceptible- Belief about risks of a behavior (what are the risks? Am I susceptible? Some that engage in unprotected sex get an STD but am I susceptible to this?) Severe- Evaluation of how severe consequences would be for yourself or others Benefits- Factors that work against barriers (the cons) --Lots of times cues remind us of a potential health problem (kids, warning labels on packages, etc) Barriers- Factors that work against benefits (the pros) cues to action - Any reminder about a potential health problem that could motivate behavior change (cue you to act in a particular way) To change behavior, have to measure where they are with these things and move them along. [Specific EX's in google doc]

Theories of Reasoned Action/Planned Behavior (general)

Theories of Reasoned Action/Planned Behavior- Attitudes and subjective norms lead to intentions, which in turn lead to behavior. Theory of planned behavior: An updated version of the theory of reasoned action that accounts for perceived behavioral control in determining intentions. **People's attitudes, subjective norms, and perceived behavior control feeds into intention which feeds into behavior. [Perceived behavioral control also directly feeds into behavior]**

Treating Substance Abuse (1)

There are 5 distinct approaches. For people addicted, might use 2 or 3 of them together. These difference strategies are rooted in assumed differences about what's driving the behavior. 1) Pharmacological Approaches - Manage symptoms caused by withdrawal. Trying to ease you over the withdrawal symptoms to change the behavior so that it can be less bad. Stop + reduce symptoms * About replacing the symptoms caused by withdrawal A) Nicotine-Replacement Therapy- Were going to let you keep the nicotine. All the beneficial effects nicotine leads to, were going to let you keep it but take away cigarettes, chewing tobacco, etc. * This could be nicotine patch, nicotine gum * Reducing withdrawal symptoms that make you want to engage in behavior again. 2) Aversion Strategies - Create new (unpleasant) associations * People use alcohol/cigarettes/drugs because they feel positive. These drugs feel good and feel they need to do this to feel good, less stressed. * Try to create new, unpleasant associations --> Antabuse is a constant aversion strategy- take antabuse then when you have alcohol you vomit. (develop new association with alcohol) * Study: Put in small room and smoke for 20 minutes. They show horrible pictures on a screen right in front of you (big, ugly horrific pictures.) Idea is now that smoking associated with these negative things. * Vodka tonic and get electric shock. * Problem with these is people think about this. Even if you have these negative things there's still withdrawal. When addicted, you have years of positive associations. A few minutes in this room is not going to be sufficient.

Stage Models of Health Behavior Change

These models say behavior change happens over time. Other models say they happen in these certain circumstances

Updates to these Models

Types of stressors - Different stressors are associated with different physiological responses. Not everything leads us to respond in same way. (ex: can't fight or flight your way out of poverty) Duration of stressors- Short-term stressors have less of an impact on health than long-term stressors. [This is why things like poverty are a very long term stressor] Role of individual differences - Personality and gender influence physiological stress responses. (men tend to show faster physiological responses compared to women) --> Tend-and-befriend : Women prefer to affiliate with others during times of stress. Role of Appraisal (transactional model) - the meaning of an event matters more than the actual event * Primary appraisal - assess the situation (I just got fired from the job.) * Secondary appraisal - assess resources available (have lots of connections- will be able to bounce back. Maybe you hated the job.) Benefits of Stress- Experienced work at athletics, school and this has led you to produce your best work. Some people are clutch players- rise to occasion when stakes are highest.

Creating Health Behavior Change (1)

What are ways that we motivate people to do that. Fear-based appeals: Messages that use negative stimuli to create the threat of impending danger or harm caused by either engaging in particular types of behavior or failing to engage in other types of behaviors. [If you do this, this thing will happen] * Thought to be good because they increase perceived vulnerability * Activate parts of the brain that process emotion, memory, and decision-making. * People change what they buy as a result (doing this will result in obesity, diabetes, etc.) Critiques: * Not clear how effective they are because They may create high levels of anxiety, but may not change behavior (anxiety may make you want to put it out of your mind/not think about it. ) * Anxiety may interfere with cognitive processing (meaning less comprehension and less attitude change.) * People may protect themselves from anxiety by denying or downplaying information * People may respond defensively actually increasing risky behavior. [Additional notes- May be bad if it happens to someone else but they believe they're not personally at risk.] * These ads don't tell you what to do. Strategies for improving: * Create moderate levels of fear (most effective/more effective then low levels of fear) * Provide specific strategies to handle anxiety (tell people not to call you in car. Don't just say you'll die in car crash.) * Focus on short-term consequences (people don't care as much about what might happen in 40 years) * Enhance vulnerability * Provide self-affirmation to increase receptivity (makes it easier for people to accept it: you're a really responsible driver/student and that's why it's a shame you're also doing "X")

Explaining the Personality-Health Link - Important!

Why are these personality traits associated with better/worse health outcomes? We don't know- it's possible that all of these play a role.

Consequences of tobacco use

[Many harmful consequences] - * Smoking is leading cause of preventable mortality in the US, causing estimated 480,000 deaths per year. * More people die as a result of cigarette smoking than from car accidence, HIV, illegal drug use, alcohol combined * Linked with other types of cancer (cancer of bladder, colon, liver, etc) * Smoking can lead to other major illnesses (stroke, coronary heart disease, etc) **Even light smokers experience health consequences:** compared to never smokers, people who smoke b/w 1 and 0 cigarettes a day are more than 6 times as likely to die from respiratory diseases and about one and a half times as likely to die from cardiovascular disease.