Health Psychology - Exam #1 - PSY 2601 - Temple University

WHO's definition of health

"a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity

response where the body is readying to either attack or escape

"flight or fight response"

Nonadherence

#1 reason for readmission into hospital is from non-medication adherence *people think they don't need medication anymore - not everyone adheres - approximately 125,000 people die each year because they are nonadherent - most people also cannot afford it

ethnicity and mortality

- #1 cause of death for europeans + african americans is heart disease - #1 cause of death for asian and hispanic americans is cancer

Self-Efficacy Theory

- Bandura - people will adhere to behaviors if they 1. Believe they can initiate and carry out this behavior (self-efficacy) 2. Believe they the behavior will produce valuable outcomes (outcome expectations)

Most Adherence Diseases

- HIV/AIDS - Arthristisis - Cancer - GI

Implementing Intentions

- Planning is an important factor for translating intention into behavior - education strategies - increasing people's knowledge - behavioral strategies - mor directly involved in changing behaviors

Transtheoretical Model

- Prochaska - suggests that people progress and regress through five stages - precontemplation, contemplation, preparation, action, maintenance

Health Action Process Approach

- Schwarzer, incorporates aspects of both continuum theories and stage theories - Motivational Phase - included outcome expectations, risk perceptions, self efficacy, and intention

Continuum Theories

- Use a single set of factors to explain adherence for everyone - "one size fits all" - health belief model - self-efficacy theory - theory of planned behavior - behavioral theory

Adherence

- ability and willingness to follow recommended health practices - following a medical regimen - maintaining healthy lifestyle practices -going to the doctor regularly

factors related to mortality

- age - ethnicity - income - education level

Measures of physiological stress

- blood pressure, heart rate, galvanic skin response, respiration rate advantage - reliable and direct disadvantage - process may produce stress itself; expensive; biofeedback

Sources stress can come from

- cataclysmic events = tragic events, war, terrible news, bad situations - changes in a person's life history = moving from childhood home - hassles from everyday life = work, homelife, small little things add up and make us view them as more of bigger problem than it actually is

How coping is applied with a stressful situation

- coping is a process, and constantly changes and adapts to the situation - coping is not automatic; it is a learned pattern of responses to stressful situations - coping requires effort - coping is an effort to manage the situation

Barriers to adherence

- cost - patients see the regimen as being too difficult or time-consuming - patients treat regimen as advice rather than "orders" patients stop taking medication when symptoms disappear, "optimistic bias" patients reduce thoughts of negative outcomes with their illness

Less Adherence Diseases

- diabetes - pulmonirary (diseases) - less adherence for diet + exercise

What jobs can health psychologists do?

- health research, in university, or government, agency settings - hospitals or clinics - Health Maintenance Organizations (HMOs) - private practice

ACH - Acetylcholine

- is pumped out from the endocrine system - is a neurotransmitter that plays a part in memory and attention - people with Alzheimer's have a reduction of this

Self-report measures of stress

- life event scale = checklist of life events, such as marriage death, traffic violations - everyday hassles scale - measures daily hassles, traffic concerns of weight, household chores advantage - can predict occurrence of stress-related symptoms disadvantage - people may overreport or underreport events

poverty and mortality

- limited access to health insurance and medical care - poor mothers more likely to have low-birth weight babies - 2002 = 5.547 deaths per 1,000 financially disabled

living longer additional causes

- marriage helps couples live longer - pets can also help people live longer - strong social support

sympathetic nervous system

- mobilizes body for action; active under stressful conditions - increases: heart rate, breathing, sweating - decreases: gastrointestinal activity

low birth weight in infants

- mom has an eating disorder - mom does not have food - mom smokes or has another addiction *poverty plays a drastic role if a baby can live or not around the world

Biomedical Model

- negative viewpoint - views health as the absence of disease - a disease results from exposure to a pathogen

how age relates to mortality

- older people are more likely to die than younger people - differential causes of death based on age - unintentional injuries for those 44 years and under - chronic diseases are leading cause for those 45-64 years old - cardiovascular disease + cancer ----> 60% of deaths - health + lifestyle related

Sheldon Cohen's Research on colds

- participants receive a cold virus and then are quarantined - not all participants develop a cold - those who develop are more likely to have a stressful experience

stress can be measured in two broad ways

- physiological measures - self-report measures

parasympathetic nervous system

- promotes relaxation; active under normal conditions - decreases: heart rate, breathing, sweating - increases: gastrointestinal activity

techniques psychologists have developed to cope with stress

- relaxation training - cognitive-behavior therapy (CBT) - emotional disclosure

What factors predict adherence?

- severity of the disease - treatment characteristics - personal characteristics - environmental factors -age

Health Belief Model

- suggests four beliefs that should predict health-related behaviors 1. Perceived susceptibility 2. Perceived severity of the disease 3. Perceived benefits of health-enhancing behaviors 4. Perceived barriers to health-enhancing behaviors - All 4 are combined to predict if one will make a change

education and mortality

- those who have been to college have lower death rates than those who have not - higher education = better jobs, more money, more access to healthcare, less stressed, healthier habits

Behavioral Theory

- uses principles of operant conditioning to explain what behaviors will be strengthened or decreased - reinforcement strengthens behavior positive (+) reinforcement = add something, negative (-) reinforcement = take away something - punishment decreases behavior

health psychology

-branch of psych that concerns individual behaviors and lifestyles affecting a person's physical health -recognized by the APA as a subfield of psychology in 1978 -includes psychology's contributions to the enhancement of health, the prevention and treatment of disease, the identification of health risk factors, the improvement of the healthcare system, and the shaping of public opinion with regard to health

Social Support in adherence

-tangible and intangible help a person receives from friends and/or family - those will low social support are likely to be nonadherent - practical support is a stronger predictor of adherence than emotion support

4 major trends that changed the field of health care

1. Changing pattern of disease; i.e chronic replacing infectious 2. Escalating cost of medical care 3.Changing definition of health 4.Emergence of biopsychosocial model

4 categories of behavioral strategies

1. Using prompts 2. Tailoring the treatment regimen 3. Using positive reinforcement to shape behavior 4. Using a contingency contract

6 basic methods of measuring patient adherence

1. ask the practitioner 2. ask the patient 3. ask other people 4. monitor medication usage 5. examine biochemical evidence 6. use a combination of those procedures

Amount of years, pregnant women's stress cells were

10 year old cells

1900 life expectancy and today's life expectancy?

1900 - 47.3 years 2000 - 79 years

Diseases for deaths in 1900s and 2000s

1900s: pneumonia 2000s: heart disease

Nonadherence to medication regimens percentage?

24.8%

Theories of Planned Behavior

3 factors shape intention: 1. Attitude toward the behavior 2. Subjective norms 3. Perceived behavioral control - Intention then predicts behavior

"the wedge"

3-5 mins to reflect, and ask yourself what do i normally do? then think, what is the opposite, flip it around, even if it's a failure *requires wanting to break a habit

Albert Ellis - ABC Mode;

A = activating event, what is stressing you out? B = behavior, add wedge and ask what would i do? C. = consequence, the outcome

Bacterial Illnesses

A major change in American health is that 100 years ago, death was caused most often by

Behavioral Willingness

A person's motivation at a given moment to engage in a risky behavior

Perceived Discrimination - between race and health care workers

African Americans - 14.1% Asian Americans - 20.2% Hispanic Americans - 19.4% Race + Adherence Statistics

difference between health psychology and behavioral medicine

Health psychology and behavioral medicine overlap, having many common goals. However, behavioral medicine is an interdisciplinary field, whereas health psychology is a specialty within the discipline of psychology.

The single cause of life expectancy increasing?

Lower infant mortality

Ph.D? PsyD? Psychologist?

Ph.D ~ Research based PsyD - Clinical Psychology Psychologist - licensed in their state for psychology

Theories of Adherence

Psychologists have developed theories to identify, and then target modifiable, factors that can increase adherence - Continuum theories: spectrum, process, long - Stage theories: steps, ups and down, and more

changes in increases life expectancy

Reasons why people are living longer: 1. vaccinations 2. safe drinking water 3. better nutrition 4. healthy lifestyle 5. disposal of sewage

Health Process Approach Model

Self efficacy———>>>> intention -> planning -> action Outcome expectancies ^ and risk perception ^

Intention-Behavior Gap

Some health behavior theories suggest that people's intentions are predictive of people's behaviors

US rank in life expectancy and the number one country with the highest life expectancy?

US ~ 24th #1 —-> Japan

Biopsychosocial Model

a disease results from a combination biological, psychological, and social influences - views health has a positive condition

3 stages represent response to stressors

alarm stage - initial response to stressor resistance - body mobilizes to defend against stressor exhaustion - ongoing response to stressor can lead to depleted resources for the body

Cultural Norms

are implicated in adherence - individuals less acculturated to western medicine have poorer adherence - income is more important to affecting adherence than education

short gesiation in infants

baby is born too soon causes baby to not survive - nowadays - 25 weeks - needs extensive care

norepinephrine

both a hormone and a neurotransmitter (produced in many places in the body)

cortisol

can be used as an index of stress; assess in saliva and urine

problem-focused coping

changing the source of the stress, such as making a plan to help you solve a problem

Leading causes of death in the 2000s

chronic diseases

Lazarus's View of Stress

conceptualized stress as being determined by a person - stress is interactional between a person and the environment - person's appraisal is key in determining what is stressful - stress arises when the situation is threatening, challenging, or harmful

behavioral medicine

concerned with the integration of biomedical science with behavioral sciences -similar discipline to health psychology; clinical work - working with people in a hospital, lab, or clinic

endocrine system

consists of ductless glands throughout the body

pathogen

disease causing organism

neuroendocrine system

endocrine glands that are controlled by and interact with the nervous system

In the endocrine system, these chemicals are called?

hormones

personal control

individuals who are confident have some control over their lives are better able to cope with stress

social support

individuals with a strong social network are better able to cope with stress - helps adopt healthy habits and increase confidence

Leading cause of death in the 1900s

infectious diseases

autogenics training

learning how to control breathing, heart rate; has helped olympic athletes; offers control over our psychological aspects of the body

emotion-focused coping

managing emotions that come from stress, such as venting about a problem

mental illness and chronic disease

mental illness is chronic for *most* people that have it

In the nervous system, these chemical are called?

neurotransmitters

longenital malfunctions

not genetic but happens between conception and birth and causes disorder in a baby

MAMAs study

offers program for pregnant women to decrease stress, and overall health for their pregnancy mainly low income women who are overweight or obese

3 types of appraisals

primary appraisal: person determines whether the event is irrelevant, good, or stressful secondary appraisal: person determines whether they can successfully apply coping strategies to alleviate stress reappraisal: person incorporates any new information

epinephrine

produced in the adrenal medulla, used as an index of stress, measured in urine

Stage Theories

propose that people pass through a series of stages as they attempt to change their behavior (think steps for stages)

cognitive behavioral therapy (CBT)

simplest and easiest to use of all psychological interventions; useful in managing stress type of therapy that aims to develop beliefs, attitudes, thoughts, and skills to make positive changes in behaviors

stress-buffering hypothesis

social support lessens harmful effects of stress and protects against disease

cartharsis

someone with anger issues, throwing things in therapy does not actually help

coping

strategies that individuals use to manage the distressing problems and emotions in their life - determined by their personal resources and the specific personal coping strategies chosen

strengths and weaknesses of the theory of planned behavior

strengths: identifies beliefs that shape behavior- useful in guiding internet based interventions weaknesses: not successful at predicting risk taking behavior - tasking the first step is hard

SEEDs study

study of the infant impact from overweight/stressed moms babies are preprogrammed for future issues or outcomes women who respond less and are less stressed have healthier babies mom needs to be healthy mentally and physically

automatic nervous system

sympathetic and parasympathetic nervous system

general adaptation syndrome

the body's generalized attempt to defend against a stressor; helps to explain how stress relates to physical illness

emotional disclosure

therapeutic technique in which people express their strong emotions by talking or writing about negative events that precipitated those events

What was the prevalent attitude of Americans a century ago if they caught infectious diseases?

they felt little responsibility because those diseases could not be controlled

women and men in stressful situations

think hunters and gatherers: men - hunters women - gatherers - each sex responds differently in stressful situations - females animal are dull colors to protect themselves from predators because they carry the babies - women release the hormone oxytocin - bonding and affiliation - women "tend and befriend"

Selye's view of stress

view of stress led to much research on how people experience stress - view is too simplistic - view ignores situational and psychological factors

Freud Drive Theory

we all have a drive for something, so still doing the action for anger for example, does not actually solve the problem for that person's anger issues

maladaptive coping mechanism

worrying and overthinking makes us hyperfix on our stresses

Infant Deaths

~ US Still has bad rates of infant deaths ~ infant deaths also relate to race + ethnicities ~ vermont has the lowest infant mortality rate in the US ~ states highest rates are southern states (less access to healthcare or economically challenged) ~ racism - black women in America have highest infant mortality races

Chronic Diseases

~ long lasting, recurrent disease ~ hear disease, cancer, stroke ~ leading cause of mortality in the US, and 50% of all deaths in the US

Research + Race

~ people of color feel they are not taken as seriously by doctors ~ white men are researched the most ~ harder to get people of color I'm research, due to finances, over white people who can afford it and are financially supported ~ racism affects infant mortality