PSY333 Midterm Lecture QCards

Examples of events that can be experienced as STRESSFUL but not neccessarily NEGATIVE...

-interviewing for a job -asking someone out -planning a wedding -pregnancy (depending on life stage)

Strengths of the HBM

-introduces useful constructs to target in primary prevention -focuses on people's beliefs, and therefore is a subjective model that is individualized

The Lalonde Report's Real Name and Author

'A New Perspective on the Health of Canadians' by the Canadian Government and headed by Lalonde

Perceived (or not) Symptoms' impact on Health Behaviour Practices

'Well I don't feel sick...' attitude makes it hard to get check-ups and engage in preventative behaviours.

Roxy + Rocky have sex via the CMM: Secondary Appraisal

'What are the pros and cons of having sex with Rocky tonight?' -the risks and benefits are based on what the endpoint is likely to be; for example, sex would fulfill goals and be beneficial but STIs and pregnancy are potential risks Then... 'Do I have enough control to affect the outcome?' 'Do I have a condom?' 'Can my goals be realized?' - 'How will Rocky react to using a condom, satisfying me sexually, and being intimate?'

Examples of Health Compromising Behaviours

-lack of condom use and sexual risk-taking -distracted driving -alcohol consumption

The Double ABC-X Model of Stress

*SEE DIAGRAM AND GRAPH ON EXTERNAL QCARD* A longitudinal model with time added as a dimension.

Example of the Transactional Model of Stress

*SEE DIAGRAM ON EXTERNAL QCARD* Cognitive focus is narrowed, and more attuned to what is happening in the moment as all the resources are directed toward dealing with it.

The Theory of Planned Behaviour (TPB)

*SEE DIAGRAM ON EXTERNAL QCARD* Developed by Ajzen to improve the predictive power of the 'theory of recent action' - Ajzen added the element of perceived behavioural control to this model. It holds that three factors influence behaviour change: attitude, norm, and perceived behavioural control

Seyle's General Adaptation Syndrome: 3 Stages of bodily response to stress

*SEE DIAGRAM ON EXTERNAL QCARD* General response for all stressors. -if you are dealing with an acute stressor then this model is great, but the stressor may not be acute and this results in more prominent exhaustion (especially from unresolved stressors)

Minority Stress Model

*SEE DIAGRAM ON EXTERNAL QCARD* Minority stress results in health disparity. Minority groups face higher rates of CVD, suicide, substance abuse, and cancers. Some Canadians have to deal with extra baseline stress (ie. those who are LGBTQ or people of colour). Baseline stress causes stress responses and chronic stress responses - for example, discrimination is an ongoing stressor that underlies other presented stressors. -Distal stressors (external stressors) of discrimination/prejudice against minority groups make them more vulnerable to proximal stressors (happening inside of you, how you are psychologically responding) such as concealing group identity, or negative feelings about a group identity, etc. -double stress = worse health

Information Motivation Behavioural Skills Model

*SEE DIAGRAM ON EXTERNAL QCARD* Specifically designed for understanding HIV risk behaviour. The government wanted to design better interventions to target this risk behaviour.

Layout of the HBM Intervention in the Mammography Use Study

*SEE DIAGRAM ON EXTERNAL QCARD* Targeted the perceived susceptibility and severity belief: gave information on vulnerability to and severity of breast cancer Targeted perceived benefits and barriers belief: talked about the effectiveness of mammograms and the advantages of early detection; increased benefit perception to minimize barriers -provided a slideshow about mammography to minimize fear as a barrier This intervention gave them more information and encouraged their self-efficacy more than the other condition. It specifically targeted each aspect of the HBM.

Health Beliefs Model (HBM)

*SEE DIAGRAM ON EXTERNAL QCARD* The idea that people's beliefs about health problems influence the likelihood of engaging in a behaviour. Interacting factors and beliefs influence health decision making. -the widest known model of behavioural influence in primary prevention, educates us on what kinds of interventions we can run and what should be targeted in these interventions

The Cognitive Mediation Model

*SEE DIAGRAM ON EXTERNAL QCARD* -Sexual decision making is mediated through in-the-moment processing (based on the assumption that decisions are being filtered through this in-the-moment decision making process). -Individuals constantly attempt to adapt to their situation using information from environmental appraisal; this influences decision-making -> note that decision-making is different in the moment than it would be before or after the moment. -The ways information is gathered and processed is influenced by various internal and external factors such as goals and hierarchical situational appraisals (this influences decision-making; we always want to make the decision that benefits us)

Steps of the Transtheoretical Model

*SEE DIAGRAM ON EXTERNAL QCARD* Precontemplation: don't really intend to change behaviour or unaware of the problem. Contemplation: the start of being ready to change your behaviour; are aware that there's a problem but have not committed to action (a long phase where the pros and cons are weighed, and the positive aspects of the behaviour are still being enjoyed) Preparation: intending to change, but haven't done it yet; may have created a plan to change and/or started to change in simple ways (ie. reducing cigarettes/day but not complete quitting) Action: modifying behaviour to improve health outcome Maintenance: not starting the health risk behaviour again

Seyle's General Adaptation Syndrome (what he mapped)

*SEE DIAGRAM ON EXTERNAL QCARD* Prolonged stress makes us more vulnerable to illness in the exhaustion phase - our resistance (how hard the parasympathetic nervous system is working) is exhausted ('This is fine meme' - resisting the pressures of stress) and therefore our resistance continues to fall when we are exposed to a pathogen and we slip into illness as we can no longer maintain homeostasis. -Example: prolonged stress of exams puts us in the exhaustion phase and resistance continues to fall as we get sick after exams even when the initial stressor has disappeared.

Gross' Emotion Regulation Theory

*SEE DIAGRAM ON EXTERNAL QCARD, AND EXAMPLE QCARD* Situation Selection: the situations we put ourselves in; sometimes we feel like we don't have a choice in what situations we are in but we do - the choices we can make about the situations we put ourselves in impact our emotional responses and we want to choose situations that lead to good emotional responses Situation Modification: once we are in a situation we have some degree to control what happens emotionally; we can change the situation to change the emotion before it happens (managing the stress once we are there) - ie. if you are anxious about going to a party alone you can ask a friend to go with you Attention Deployment: can direct attention to non-stressful aspects of the situation Cognitive Change: reframe a situation after it has happened to control emotions (a focus of CBT) -> last chance to change how we really feel about an event Response Modulation: regulation of physical response, and psychological response; you want to modify how your body feels about it after it happens (could use avoidance strategies, relaxation, exercise, talking about it, drugs or alcohol, etc.)

Statistics About Cancer

-1/4 of Canadians will die from cancer; though this death rate has dropped -breast cancer is the most common cancer in Canadian women -prostate cancer is the most common cancer among Canadian men (1/8 men will develop this later in life, especially over age 50) -there are approximately 80,000 new cases of skin cancer diagnosed every year in Canada

Stress is multi-faceted and is associated with change in...

-Cognition (thinking/tunnel vision): 'I'm totally screwed! There is absolutely no way I can pass this test!' -Behaviour: pacing, biting nails -Physiology: heart beating fast, palms sweaty -Emotions: feeling anxious, overwhelmed, angry, frustrated

Statistics on Binge Drinking

-90% of Canadian University Student drink alcohol -32% reported drinking heavily at least once a month (higher in Nova Scotia; not as big of an issue in Canada which has a decreased Greek culture) -drinking rates are on the rise in Canada and in industrialized countries - Canada is drinking less overall but young people are drinking more (their drinking rates are on the rise); this is because people want to forget worries, celebrate, test tolerance, rebel (finding own way of being against their parents ways and norms)

What stage of the TTM does the average smoker sit in?

-Action: 10-15% currently modifying their behaviour -Contemplation: 30-40% -Pre-Contemplation: 50-60% with no intention to quit

Individual dispositional motivations and the message frame that leads to behaviour change

-Approach-oriented: people who want to know the benefits of the behaviour and to engage in it; gain frame is better -Avoidance-oriented: people who want to know what they will lose and not engage in the behaviour; loss frame is better

Two Hypotheses for why stress is reduced by social support...

-Buffering Hypothesis: may mitigate stress indirectly through the use of more effective coping strategies. The health and mental health benefits of social support are chiefly evident during periods of high stress; when there is little stress, social support may have few physical or mental health benefits. We see this hypothesis prominently when we consider support qualitatively - people feel more supported in this hypothesis than in the direct effects hypothesis as the support existing in times of stress has a blunting effect. -Direct Effect Hypothesis: may enhance the body's physical responses to challenging situations, leads to better immune functioning, and encourages healthier lifestyles. May be beneficial in both highly stressful and unstressful times. We see this hypothesis prominently when we consider social support quantitatively - more friends = less stress.

The three sources of stress...

-Cataclysmic Events: such as natural disasters, war, terrorism -Life Events: such as starting college, getting fired, getting married -Daily Hassles: arguing with a partner, overbearing boss, discrimination, overcrowding, pollution

Types of Reappraisal

-Detached: "turn down the volume" - feeling negative about somethings, but letting it simmer -Positive: attempts to evaluate the situation in a more positive life -Arousal: "the tension in my body is helping me gear up for a challenge" - reinterpret the meaning of the arousal state

Biological Risk Factors discussed in class

-biologically, women tend to be at a greater risk for HIV -older people are more prone to chronic disease than acute illness -genetics may cause people to be at higher risk for illness

How Can We Help People Change? What are models of Health Behaviour Change?

-Educational Appeals -Health Belief Model -Theory of Planned Behaviour -Information Motivation Behavioural Skills Model -Cognitive Mediation Model -Diffusion of Innovations Theory -Stages of Change Theory (Transtheoretical Model)

Examples of Indian Ayurveda Medicine Treatments

-Exercise -Yoga -Meditation -3 pronged appraoch: sattvic diet (eating seasonal foods), vomitting, and detoxing -> this is a treatment prescribed to this day (unlike any humourism treatments) but it is a pseudoscience because there is no research proving its efficacy

Taylor's Tend and Befriend Theory

-Fight or flight is a primary physiological response, but there is a more psychological response as well -in addition to fight/flight, humans respond to stress with social affiliation and nurturant behaviour; especially true for women (adaptive in that it release oxytocin which is a good way to cope with stressors) -a response men may engage in as well, though women are more likely to be rewarded for it as kids -adaptive response especially for mothers - to care for and protect young and seek support from others (this ensures genetic material and offspring survive) -the underlying biological mechanism is oxytocin

How much exercise do we need across different age groups? (according to participACTION)

-Infants (less than 1 year old): floor-based play several times/day -Toddlers (1-2 years): 180min/day -Children and Youth (5-17 years): 60min of 'sweat' or vigorous activity that increases heartrate, plus several hours of light physical activity, no more than 2 hours of sedentary activities, and 9-11h sleep (age 5-13) and 8-10h sleep (age 14-17) PER DAY -Adults (18-64 years): 150min/week of moderate - vigorous activity and muscle and bone building activities at least 2x/week (ONLY ACHIEVED BY 15.4% of CANADIANS) -Adults (65+): 150min/week of moderate - vigorous activity

Theories of Stress

-Minority Stress Model -Seyle's General Adaptation Syndrome ('Fight or Flight') -Lazarus and Folkman's Appraisal Theory -Taylor's 'Tend and Befriend' and 'Freeze and Appease' -Hill's ABC-X Model of family stress coping

Other developments in the mid 1700s...

-Morton (a dentist) invented anesthetics -X-rays were discovered and we no longer needed to cut into people

Criticisms of General Adaptation Syndrome

-Too simplisitc: conceived of a stress as a non-specific response, but not all stimuli produce the same responses and not all people respond the same way to the same stressors (on a level other than physiology) -Is therefore restrictive to physiological consequences, and does not discuss the role of psychological appraisal *May have occurred as a result of his studies being animal studies - where we aren't inclined to compare thought processes to humans*

Examples of Primary Prevention

-ParticipACTION to increase exercise (to decrease obesity, reduce risk of CVD, among others) -Initiatives to help students quit smoking

Details of Cognitive Mediation Model (Summary - as is applied to the following example)

-Primary appraisal: evaluate the ongoing encounter for goal relevance and evaluate the encounter for potential goal fulfillment -If the primary appraisal passes and indicates that this is what we want, we have the secondary appraisal: evaluate risks and benefits and consider 3 factors including - 'do I have enough control to affect the outcome?', 'do I have the resources to achieve my goal?' (physical and social), and 'what actions can I take to achieve my goals?' *It is a blend of conscious and unconscious processing - running in the background all the time. Things change moment to moment and you may go back to primary and secondary appraisals*

Three Outcomes of the Course

-Study the psychology of wellness and illness -Investigate the biomedical and biopsychosocial approaches -Understand the interplay of the factors that influence our physical well-being, health beliefs, health behaviours, and understanding of health, death and disease

What are the recommended screening behaviours for breast cancer in women?

-Women 50-69 should have a mammogram every 2 years -the amount of women who get screened is high! (~72%)

Weaknesses of the IMBSM

-assumes behaviour is rational -doesn't explicitly address what factors (beyond information and motivation) promote the adoption of behavioural skills

Weaknesses of the HBM

-assumes behaviour is rational according to beliefs - when really there are emotional components to these influences -assumes that people have the skills required to alter their behaviour when hearing about why they should and changing their beliefs -ignores the social context of many health behaviours (ie. the HBM has been evaluated with middle class white women in the US but it may not be as effective in different cultural situations)

Examples of Ancient Greek Medical Treatments

-blood letting (ridding self of blood) -emetics and purges (purging to rid self of yellow bile) -making someone ingest opposite properties (for example, putting hot cups on someone with too much black bile/a cold person OR giving wine to someone with too much phlegm/who is too peaceful (phlegmatic personality of relaxed and peaceful))

How can we help people overcome barriers and engage in screening behaviour?

-change their attitudes towards the barriers -ensure cultural differences are accounted for - aboriginal and Asian women least likely to get screened

The 2 General Ways People Respond to Health Threatening Information

-change their health behaviour -deny the health information (feeling invulnerable, and defensive/personally threatened - may think you are blowing things out of proportion with your message)

Social Risk Factors discussed in class

-culture may lead to riskier behaviours, for example some cultural groups believe condoms are a sign of less trust in a relationship and therefore have less condom use -certain communities have higher rates of disease and lack of health resources (such as indigenous communities) -higher rates of sexual assault in indigenous women -here is less social support as we age -there is higher smoking rates in older individuals (friends smoke, or we are accustomed to it) -being a visible minority increases stress and susceptibility to chronic diseases

Why is it difficult to alter a diet?

-diet habits are formed in childhood -hard to change your diet when you are worried about your appearance rather than improving your overall health

What's more important - exercise or diet?

-diet plays a bigger role in weight loss than physical activity -balance of healthy and unhealthy food is integral, only have unhealthy food as a treat; calorie restriction is not a healthy diet unless nutritional components are still present in appreciable frequencies -complete restriction can lead to binging

Emotion-Focused Coping

-directed inward -attempts to control one's own emotional response to a stressor -develops in adolescence, focuses on how we feel about a stressor and how it impacts us

Problem-Focused Coping

-directed outward -deals directly with a stressor by reducing its demands or increasing one's resources for meeting those demands -leads to better health by getting one the resources they need to ultimately reduce the stressor -more common strategy in children

Problems with the Biomedical Model

-does not account for social or psychological factors; really only allows for treatment of pathogens -dualistic in that it treats the mind and body separately but we now know that our mind can influence our physical body -> when we are nervous, there is physiological effects, AKA the mind is influencing the body -emphasizes illness over health and doesn't capture the full picture of health

Aspects of Persuasive Communications

-does the message appeal to reason or emotion? -does the message appeal to fear (meaning if people fear their health habit will have an adverse effect they will change that health habit so as to reduce the fear)? -is the message framed in terms of losses or gains?

Weaknesses of the TTM

-doesn't really give any new techniques -people may be in the same stage for different reasons and it doesn't evaluate this -does explain how people can get from one stage to the next -doesn't apply techniques for interventions to the stages -the stages may not be mutually exclusive and the sequential order may not be followed

How does chronic drinking affect the brain?

-effects thinking and behaviour -disinhibits things like aggression -> can become fixated on something minorly insulting and get agressive -causes riskier sexual behaviour as compared to a sober person; tunnel vision with focus on having fun and nothing else, including sexual safety

What about modern conveniences makes the increase in obesity almost inevitable?

-healthy food is expensive -unhealthy food is more accessible, especially for those who need to work extra (low income)

Barriers to getting people to exercise...

-inconsistent exercise programs: people who can establish a regular routine are more capable of continuing exercise -stress: having 'too much work to do'; when actually exercise is one of the best ways to deal with stress, and eating comfort foods that results is a health-risk behaviour -self-perception: people who see themselves as 'athletic' are more likely to engage in a health behaviour (more self-efficacy and support from friends) -gender: males get more exercise and older women may feel as though their lifestyle is not cohesive to it - too busy being in the sandwich generation where they need to care for babies and aging parents -resources: accessible exercise such as a neighbourhood run is more likely to be performed than exercise that requires a specific facility, unless there is a social group at the facility; some low SES individuals have less time and physical access to facilities due to lack of time and money, and therefore adding work-out equipment in parks makes exercise more accessible to them

Strengths of the TPB

-links beliefs with behaviour -in-depth look at behavioural intentions

Who is most likely to be obese?

-low SES women -aboriginal women (many of whom are low SES) -high income men

Maladaptive Emotion-Focused Coping

-making/maintaining destructive relationships -wishful thinking -denial -internalizing stress and ruminating: negative recurrent thoughts over and over again which is harmful to our health -drug and alcohol misuse -aggression

Avoidance Coping

-minimizing -"I don't want to think about it." -poor coping with long term stressors -better coping with short term stressors - successful in reducing stress to immediate threats

Methodology of Dr. Sparling's Research

-participants recruited using the UWin Psychology Participant Pool -each participant participated in only one experiment -participated in either the control or experimental condition for their experiment -used deception: didn't tell people the studies were about arousal, this eliminated expectancy effects

Results of Dr. Sparling's Current Work Experiment

-partner familiarity may be an important contextual cue -sexual arousal may draw attention to salient cues -relationship motivation may influence what these cues are -> for thise high in RM arousal is a salient cue for risky-behaviour, but this is not true for those low in RM

Glands of the Endocrine System

-pineal gland -pituitary gland (in the brain, produces ACTH): when exposed to a stressor, the hypothalamus stimulates the pituitary to secrete ACTH which acts on the adrenal cortex to release cortisol or other hormones. -thyroid gland -thymus -adrenal gland

Strengths of the TTM

-practical, doesn't force techniques into one theory (rather flexible) -realistic, acknowledges that people can be at different stages in a health behaviour change

What makes heavy drinking episodes more common among university students?

-reactivity against drinking age, access to alcohol is new and leads to binging -being on your own and making your own rules -stressful life, drinking alcohol to blow off steam and celebrate -university culture has a drinking norm

Coping strategies reach beyond emotion-focused (emotional regulation) and problem-focused strategies to encompass...

-reappraisal -resilience -social support

What successful modification of health behaviours can lead to (in primary prevention)...

-reduce deaths due to preventable diseases (lifestyle-related illness) -increase longevity -expand years of life free from chronic disease -cut the costs of healthcare, less taxpayer money poured into healthcare

What have we learned from Experiment #3?

-sexual arousal does not seem to affect self-efficacy -sexual arousal may affect motivational state - we are more paratelic and less motivated when we are aroused -a reason for sexual risk-taking when aroused is that arousal shifts people into a motivational state that makes us less likely to use precautions such as condoms

Summary of what we know now about Sexual Arousal's Effects

-sexual arousal increases risky sexual behaviour intentions -sexual arousal increases behavioural risk-taking How/Why? -sexual arousal may cause a shift to a more playful, less goal-oriented motivational state -sexual arousal may interfere with self-control and sexual self-restraint, making it harder to adhere to goals

What have we learned for Experiment #4?

-sexual arousal may induce a state that over-consumes the cognitive resources needed for self-control resulting in a self-control dilemma that is easily decided by a lack of sexual self-restraint and the need to gratify short term goals -the relationship between self-control and sexual self-restraint suggests decreased self-control impacts sexual risk-taking via reduced sexual self-restraint

What we have learned from Experiment #1

-sexual arousal seems to encourage risky sexual behaviour intentions in men and women, though men were significantly more risky -this could seriously interfere with condom negotiation and use because risk-taking behaviour increases in moments of passion

Factors that improve educational appeals

-short, clear, and vivid communication -educated, knowledgeable, and likeable communicators (qualities of the communicator is important) -considering primacy and recency effects - meaning that it is easy to remember the beginning and end of a message but not the middle so it is integral to put the most important information at the beginning, end, or both of a message -different tacks developed for different outcomes - depending on what we want the health behaviour to be, we want to change our approach based on new influencing factors

Psychological Risk Factors discussed in class

-stigma of HIV causes stress and makes it harder to get the information required or testing for fear of being HIV+ -stress and opression are risk factors for disease

Measures of Cardiovascular Activity (Blood Pressure, or BP)

-systolic BP: blood pressure when the heart is contracting -diastolic BP: minimum arterial pressure when ventricles are relaxing and the heart is filling with blood *SEE DIAGRAM OF PRESSURE vs. TIME ON EXTERNAL QCARD*

Forms of Social Support

-tangible assistance such as fixing someone's computer, loaning them money, or bringing them food -informational support such as giving someone tips about a course you have taken -emotional support -invisible support is support that we don't even realize is being provided (ie. hanging with a friend can help us recover from a stressful day) -implicit social support is just knowing that you have a support system in place *can be measured with a scale that asks certain yes/no questions about family, lover, and friend supports - how many you answer yes to indicates the amount of support you have

Weaknesses if the TPB

-there are few tests of it's effectiveness -who even cares anymore? - model is out of date

The Goals of the American Psychological Association's 'Health Psychology Division' (1978)

-to study the psychological, behavioural, and social origins of disease (find out why people engage in disease-causing behaviours) -promote health enhancing behaviours -help prevent illness with inventions and help those who are ill manage -work to affect policy and practice

Strengths of the IMBSM

-well-liked, has a lot of empirical evidence supporting it -introduces useful constructs -focuses on the need to build specific skills for more difficult behaviours

Who is missing out on the benefits of exercise and why?

-women (as compared to men) -older adults (*the most important health habit for the elderly, though there are health benefits for every age group) -lower income individuals -lower education individuals -Indigenous Canadians Why? Doctors don't regularly recommend aerobic exercise!

Examples of events that can be experienced as stressful...

-writing exams -being insulted -being fired from a job -breaking up with a partner -feeling alone -losing a parent -being a victim of a crime -struggling to get pregnant -car breaking down -not enough money to pay rent -fighting with a roommate -getting a bad grade -natural disasters -sleeping through an exam -preparing for an exam -being stuck in traffic -experiencing discrimination -and the list goes on...

What factors determine whether or not stress is bad?

-your framing of the stressor -your resources -how long the stressor lasts

Model of Effects of Stress

1. Direct Physiological Effects: elevated lipids, elevated blood pressure, decreased immunity, and increased hormonal activity 2. Health Habit Effects: increased smoking and alcohol use, decreased nutrition (less hungry as blood is directed away from digestions, rather cravings for comfort food may be prominent), decreased sleep, and increased drug use 3. Health Behaviour Effects: harder to execute health behaviours under stress (decreased compliance), increased delay in seeking care, obscured symptom profile, and decreased likelihood of seeking care

The Four Humours

1. Phlegm: north facing, representative of winter, too much of it is characteristic to cold and wet diseases such as tumours and personality traits of apathy, stoicness, and peacefulness 2. Blood: east facing, representative of spring, too much of it is characteristic to hot and wet diseases such as fever and personality traits of socialness and enthusiasm 3. Yellow Bile: south facing, representative of summer, too much of it is characteristic of dry and hot diseases such as insomnia and personality traits of angryness 4. Black Bile: west facing, representative of autumn, too much of it is characteristic of cold and dry diseases such as depression and weakness and personality traits of sombriety, analyticalness, and wiseness

The Transactional Model of Stress (Appraisal Theory) by Lazarus and Folkman

1. Primary appraisal: is this event self-relevant, and a threat (negative/potentially negative)? If yes, is this going to cause *harm* or has it already caused harm? What has already happened because of this? What is the *threat* and what are future harms? What is the *challenge* - how can we face this? 2. Secondary Appraisal: are my *resources* sufficient for dealing with this event? Can we effectively apply *coping strategies* to relieve the stress? 3. Reappraisal: incorporating new information, because the primary and secondary appraisal and change from moment to moment. --> Stress occurs when the demands of a situation are appraised to exceed our capacity to cope effectively (ie. the situation is appraised as harmful or dangerous)

4 Scientific Contributions of Psychology to Science via Health Psychology

1. Promotion and Maintenance of Health 2. Prevention and Treatment of Illness 3. Identification of Causes of Health and Illness 4. Analysis and Improvement of Healthcare System

DSM-5 Criteria for Alcohol Use Disorder

1. Risky drinking (and drinking continues) 2. Impaired control - alcohol drinking leads to more alcohol drinking 3. Social impairment (and drinking continues) 4. Withdrawal symptoms *Not all required, but should see significant social, psychological, and medical problems

Stress Pathways of the Neuroendocrine System

1. Sympathetic-Adrenal-Medullary (SAM) Axis 2. Hypothalamic-Pituitary-Adrenocortical (HPA) Axis

Health-Risk Behaviours

A health-compromising behaviour or habit. -smoking, excessive eating, substance abuse, dangerous driving, risky sexual behaviour

Why did Carrot Rewards target Loyalty Point Programs as reward?

90% of Canadians are members of one or more Loyalty Point Programs. -the value of these points is blown up in people's minds, people do not really know the value of 1 starbucks star for example, and therefore tend to assign it more value than the government needs to pay to purchase it for them

A Health Promoting Behaviour: Exercise Statistics and Benefits

49% of Canadians are at least moderately active during their leisure time. Benefits of aerobic exercise (weight training/yoga not as good): accelerates wound healing, decreases blood pressure, improves heart function, improves sleep, decreases menstrual cycle length, improves mood, and improves cognitive functioning

WHO Definition of Health (1948)

A complete state of physical, mental, and social well-being and not merely the absence of disease or infirmity. *The first definition to do with your overall well being*

Overview of Views on Illness in the Mid 1700s

A focus on the biological causes of disease, development of germ theory and vaccines, and the scientific method yielded much scientific advancement.

Health Behaviours

A health-enhancing behaviour or habit. -exercising regularly, using sunscreen, healthy eating, practicing safe sex, wearing a seatbelt -are often linked to eachother, and many behaviours co-occur (health-risk behaviours also frequently co-occur)

Video: Demonstration of the dangers of appealing to fear and producing stigma; Herpes and HIV

A lot of people attach a stigma to Herpes because fear tactics in advertising make people feel like they can't talk about it - when really many people have it, and you need not show red sores or any symptoms at all to be infected. Same with HIV; the fear tactics have stigmatized it and people don't want to identify themselves (people were even fired from work due to these stigmas attached by fear tactics). *We need to be careful not to attach too much stigma with fear tactics so that it doesn't interfere with people's lives, treatment, support, etc.*

Information

A pre-requisite and guide to change your behaviours. Information can change your 'heuristics', a large determinant of health behaviour.

What is Carrot Rewards?

A public-private team up to encourage healthy living among Canadians. A smartphone app developed by a Toronto-based company. -allows you to earn reward points to reward programs that you already use such as air miles or scene points -you get points if you do good health behaviours such as completing steps for the day -you get points if you take health quizzes that help you learn health information

Social Support

A sense that we are loved, cared for, esteemed, and valued. Helps us cope more successfully with stressors when we do feel stressed, but also helps us feel less stressed in general.

Noradrenaline

A survival mode hormone - beneficially downshifts things that aren't vital so your body can focus on immediate stressors. This is not good if repeatedly stimulated in the long term. -both a hormone and a neurotransmitter (produced in many different places of the body)

Autonomic Nervous System

AKA. Involuntary Nervous System - made up of sympathetic and parasympathetic systems Mostly what we talk about with stress response; critical role in responding to stressors. Not under conscious control, controls heartrate, breathing, etc. -interacts with the neuroendocrine system, secretes hormones into your bloodstream (this is the main way this system exerts effect)

Somatic Nervous System

AKA. Voluntary Nervous System Carries sense information to central nervous system and carries information from CNS to skeletal muscles to do things. -has reflexes as well, some things it does are not voluntary

Tertiary Health Promotions and Examples

Actions taken once damage of disease/disability has progressed. -Examples include radiation, chemo, etc.

Secondary Health Promotion and Examples

Actions taken to identify and treat an illness/disability early in occurrence. -Examples include monitoring symptoms, taking medications, following treatment regimens, etc.

Response-Focused Regulation

An attempt to change one's emotional response to a situation after an emotion-inducing event has occurred. -consists of cognitive change and response modulation

Antecedent-Focused Regulation

An attempt to prevent or encourage the occurrence of an emotion. -before the actual emotion-inducing event occurs, trying to cultivate the emotional experience we want -consists of situation selection, modifying the situation, and selectively employing attention -there is focus on this stage

The Biological Context of the Biopsychosocial Model

Biological aspects of our body that influence health and disease: -Genetics (can be evolutionary as well as specific to individuals; our ancestors need to survive long enough to pass on genes - we act certain ways because it kept our ancestors alive -> Ex/ eating and enjoying fatty foods) -Nervous system -Immune system -Endocrine system -Age (causes of death can differ generationally)

Influences on Health Behaviour Practices (that need to be considered in Primary Prevention)

Biological, Psychological, and Social factors of the biopsychosocial model!

Compare/Contrast HPA and SAM in the stress response

Acute stress activates the SAM Axis which gives us a quick surge of energy as it is activated by NTs, and that chronic stress activates the HPA Axis which conserves our energy over the long term and has longer lasting effects because it is activated by a hormone.

Germ Theory

After the scientific advancement of microscopes, Pasteur used them to see cells and develop his germ theory: there are things that can get into your body and make you sick. -through identifying microorganisms that are making us sick, we can gain control over disease and find treatment -attenuated forms of viruses can prevent disease (Jenner)

Age's impact on Health Behaviour Practices

Age changes across the lifetime and so do our health behaviours. -generally, we have better health behaviours when we are young and they worsen in our teens before improving again in mid-adulthood -the reason for improvement is that we begin to worry about our appearance and recognize our mortality -in our 70s our health behaviours begin to deteriorate again for a variety of reasons including trouble being active and eating healthy *An issue with this evaluation - we are looking at COHORTS which are susceptible to cohort effects - ie. the 70 year-olds we examine are different than we will be at age 70 and hopefully many health promotion activities will have launched since then

Taylor's Freeze and Appease Theory

Another variant on fight or flight. -holds that there are two parts to the stress response; increased sympathetic response is just one part and tend/befriend, freeze/appease, fight/flight responses are the second part -Freeze/Appease: some women can respond to acute stress stimuli differently than some men by freezing (ie. deer in headlights) or appeasing (ie. trying to show subservience to a threat by behaving submissively; hoping that threat will choose to collaborate and protect them rather than harm them)

Acute Stressors

Appear suddenly, demand immediate attention, and don't last long.

Coping Styles

Approach and Avoidance

Arousal Reappraisal Details

Arousal reappraisal is the strategy of situational re-framing of stress-related anxiety or arousal as a tool that facilitates performance rather than an obstacle to be overcome. -seeing you stress as performance-enhancing may be adaptive; people who arousal reappraise feel there are more resources available for them

Measures of Cardiovascular Activity (Impedance Cardiography or ICG)

Assesses changes in resistance due to changes in blood flow.

Parasympathetic Nervous System

Assists in recovery after arousal, need this system as well to regulate stress response. -promotes relaxation, a system that is active under normal conditions -decreases: heartrate, breathing, sweating -increases: gastrointestinal activity

Self-Control Dilemma

Associated with choosing short term over long term goals. -long term goals and values clash with our short term temptations -for example we may have strong sexual cues to seek pleasure, but long term goals of preventing pregnancy and STIs

Maladaptive Problem-Focused Coping

Attempting to escape a stressor in unrealistic ways. -not taking responsibility -seeking inaccurate information an bad advice -developing unrealistic plans -procrastination (maladaptive coping method to reduce stress that actually causes stress) -pessimistic view of the ability to solve the problem

What is BMI? Should we use it to measure obesity?

BMI is a measure of obesity using the weight:height ratio -it doesn't consider what the body is made up of (ie. fit people with heavier muscles as opposed to fat are often ranked 'overweight' in their BMI) -we should not use it as a measure of obesity!

Loss-Frame Message

Bad things will happen if you don't do the behaviour. -works well for detective behaviours/screening behaviours -Ex: a disadvantage of failing to get regular mammograms is that you won't find tumors early, which will leave you with fewer treatment options.

Diffusion of Innovation

Behaviour change is facilitated by opinion leaders (taste makers) which influence other people's decisions.

What influences on health are examined in health psychology?

Behavioural Influences, Psychological Influences, and Social Influences -how do people behave when they are sick? -why are health decisions made and how can we make better health decisions?

The Role of Behavioural Factors in Primary Prevention

Behavioural factors influence poor health behaviours and poor health habits!

Stone Age: Ancient Greeks

Believed health and illness are related to a balance of the humours. If you have too much or not enough of a humour, it will result in disease. -Additionally, personality types are reliant on people's natural balance of humours (if they naturally have more or less of one or multiple humours)

Stone Age: Indian Ayurveda Medicine

Believed that health and illness are related to the balance of the doshas. -similar to humourism in that it categorizes the elements which make up your body

Posture

Better posture helps you perform better and improves the stress response - participants standing upright (taped in their positions), experienced less fear and had a better mood than slouchers in a speech task.

Goals of Dr. Sparling's Research

Better understanding the impact of sexual arousal on: -sexual risk taking -general risk taking -motivational state -self-efficacy -self-control

The Biopsychosocial Model

Biological, psychological, and sociological factors interact to produce health or disease. -Psychology: personality, self-efficacy, personal control, optimistic bias, social support, stress, coping skills, diet, risky behaviours, adherence to medical advice -Biology: genetics, physiology, gender, age, vulnerability to stress, immune system, nutrition, medications -Sociology: poverty, ethnic background, cultural beliefs, racism, living with chronic illness -> all interact to produce outcomes which lead to health or disease (each person's outcomes have specific factors and therefore we are in need of a multidisciplinary treatment for each individual) *Any change in one area can have an effect on other levels and ultimately our health outcomes. Changes on microlevels can have macrolevel effects.*

A comparison of the biomedical and biopsychosocial models

Biomedical Model: reductionistic, single causal factor considered, assumes mind-body dualism, emphasizes illness over health -looking for a physical problem in your body's machinery and how it can be fixed; an incomplete picture of health that ignores people's mental states and how those effect health Biopsychosocial Model: macrolevel as well as microlevel, multiple causal factors considered, mind and body are inseparable, emphasizes both health and illness

Gross studied whether antecedent or response focused was more important in emotional regulation and found that...

Both are important, but they are better for certain things as they have different mechanisms: -antecedent: better at reducing experience of negative emotion in advance -response: better at reducing the physiological changes in result of stress

Exercise vs. Stress

Both can cause the physiological symptoms of arousal, so what's the difference? -Stress: more protein and fatty acids present in sweat which take longer to evaporate and are stinkier; high sympathetic nervous system response, typically negative appraisal, longer cortisol exposure, and repeated exposure weakens stress response in crisis. -Exercise: high parasympathetic nervous system response (directly after, a form of compensation), typically a more positive appraisal with those who appraise it negatively not doing it, acute cortisol exposure, and repeated exposure improves stress response in crisis.

Slowing Down

Can be accomplished using mindfulness meditation

Why do we care about the changing pattern or illness?

Canada has a publicly funded health care system, meaning we all (within a certain tax bracket) chip in some money to provide specific health care services for all. Consider that Canada has an ageing population (more people are aging than are being born, meaning the focus is shifting to chronic, preventable illness), healthcare costs in Canada have increased in the last 50 years , and taxpayers cover these costs. -we want to help people manage chronic illnesses - because we can prevent these diseases and therefore paying these fees *Health psychology aims to modify risky behaviours so people are less likely to become ill and we as a community do not have to absorb the cost* -> see the goals of health psychology!

How Does Alcohol Effect the Brain?

Changes the way you feel - why it is a commonly used and abused substance. -interacts with neurons, glutamate is excitatory and GABA is inhibitory -> alcohol stimulates GABA which increases inhibition and makes you feel less excitatory stimuli (you cannot perceive or think about things properly, alcohol is a depressant) -you are thinking clearly because glutamate is functioning, but you are thinking clearly about one thing without regard to other things beacuse your senses are otherwise inhibited - ie. why drunk people stumble into traffic when focused on getting poutine (cannot perceive traffic stimuli) -behaviour is therefore less inhibited because your inhibition of sensory information has subdued the background noise and you are able to focus on one thing without concern for consequence

Heuristics

Cognitive short cuts which help us make quick decisions. They are general rules we apply to our lives. Ex/ Not using a condom; decision maker could be that you're monogamous

Sexual Arousal

Common element in consensual sexual encounters. Characterized by physiological changes including increase in respiration and heart rate, as well as changes in blood flow resulting in vasocongestion (responsible for erections/exciting genital things).

What companies are targeting Behavioural Economics and Health and what is this principle?

Companies like Carrot Rewards. -this principle states that human decision making is biased in systematic ways and this can make it harder to make good healthy choices (the Present Bias uses economics in application to behaviour and the way this influences health behaviour) -the principle includes using this bias to our advantage - companies like carrot rewards are trying to increase immediate reward for health behaviours

Perfectionism

Compulsively driven by excessively high standards. Different than wanting something to be good (the typical perfection we see in people), the standards here are unrelenting and at a level that interferes with functioning. -results in greater stress responses and poorer coping skills which leads to poor health outcomes -these people are more likely to use maladaptive coping strategies that maintain stress as opposed to reducing it -linked to chronic fatigue syndrome

Human Nervous System

Connects central nervous system and our peripheral organs. For example it connects sensory organs to our brain and spinal chord.

The 3 Stress Hormones

Cortisol, Norepinephrine (noradrenaline), Epinephrine (adrenaline)

Allostatic Load

Created by prolonged activation of the stress response axises. Characterized by wear and tear on the body from prolonged system activation. Results in: -high blood pressure -insulin resistance -strain on organs and tissues -increased waist to hip ratio -high cholesterol

The definition of health promotion differs...

Depending on your field.

The Transtheoretical Model (TTM) Overview

Developed to treat addiction but also has been applied to other health habits. Acknowledges that changing a bad health habit doesn't happen all at once - you can't change as soon as you have the information and motivation all at once. Assesses a person's readiness to change a health behaviour and guides them through the stages/provides support.

Cultural Values' impact on Health Behaviour Practices

Different groups think different things are appropriate and different health practices are encouraged in different cultures. An example is that in some cultures being pale is attractive and in others being tan is attractive.

The Effects of Long-Term Stress

Different than when our body saves us from acute stressors like bear attacks, rather describes what happens to us in weird modern life stresses. We have stress hormones in us that are not serving the purpose for which they were intended. We don't need to have the same stress response to midterms as we do to hurricanes, but we do. -suppressed immune function -increased blood pressure and heartrate -memory problems -increased storage of fat in abdomen -high waist to hip ratio

Pessimism

Dispositionally expect negative outcomes in the future. Describe negative events as due to negative qualities of themselves. -have worse health outcomes over time, experience reduced immune function, interferes with social support (less likely to seek support) -those with lower SES backgrounds have more pessimism as SES effects appraisal of stressors and resources for such; those who are low SES are not used to having resources and this can lead to automatic pessimism as money is a huge and important resource for people

Chronic Stressors

Do not require immediate attention, but last a long time and are a constant source of worry (ie. discrimination).

Behavioural Skills

Do you know how to act on the information given and perform the risk reduction behaviour? -do you have the objective ability and self-efficacy?

Experiment #2: General Risk Taking

Does arousal effect sexual risk-taking decisions or is it a general effector of risk-taking behaviour? Participants: 68 women, 34 men 18-52 years of age (mean: 24, mode: 21) Target Activity: played a rigged blackjack game

Experiment #4: Self-Control and Self-Restraint

Does sexual arousal impact self-control and sexual self-restraint? Will depleted self control lead to choosing short term goals in a self-control dilemma? Participants: 29 women, 26 men (average age: 20) Target Activity: measured general self-control and specific sexual self-restraint after watching the video clips

Why is it important to understand influences on behaviour in primary prevention?

Each person's good or bad health is influenced by all of these interacting factors, and by understanding what influences behaviours we can identify the barriers to becoming healthy. -we can then design more effective interventions targeting individuals and their barriers

What Dr. Sparling's Experiments Entailed

Either a sexually explicit video clip (experimental condition) or a video clip of men and women just talking (control condition) were shown. -participants were then asked to complete a mini mood scale that asked how happy, sad, sexually aroused, and angry they felt. -*participants were then asked to complete a target activity and the results of the mood scale and target activity were measured for each condition* - this is what varies among her experiments

James Gross' thoughts on Emotion Regulation

Emotions are responses to challenge or opportunity, and we can modulate our emotions to these stimuli. Challenge/Opportunity -> positive emotions Stressor -> negative emotions *change negative emotions to positive to change view of stressor -emotional regulation = modulation of emotions to determine how and when we experience stressors; requires the activation of a goal to up or down regulate wither the magnitude or duration of the emotional repsonse

Risk-Based Intervention

Emphasize the immediate threat; this is more effective than talking about the long term risks which are easier to dismiss. -"What has the sun done to you already?!"

Cortisol

Encourages the body to conserve stored sugars, increases inflammation, helps body return to normal after arousal, and settles down the hypothalamus. -can be used as an index of stress -assessed in saliva and urine

Neuroendocrine System

Endocrine glands that are controlled by and interact with the nervous system. -both the endocrine system and the nervous system share, synthesize, and release chemicals. In the nervous system these chemicals are neurotransmitters (a faster chemical response), and in the endocrine system these chemicals are hormones (a slower chemical response in the bloodstream, effects of hormones are also prolonged) -hormones have a key role in mood, sleep, weight, and stress

Exercise

Endorphins released are good and parasympathetic compensation mechanism changes the sympathetic activation characteristic of both exercise and stress.

Adaptive Problem-Focused Coping

Escaping the source of our stress by dealing with the issue/taking it on. -accepting responsibility for whatever the stressor is if it is appropriate to do so -seeking accurate information and gathering resources -seeking advice and help -developing a plan -postponing other activities -maintaining an optimistic view

Overview of Views on Illness in the Stone Age

Evil spirits are what cause infection, pain, etc. Common practice to relieve illness or symptoms was trephination: drilling holes in people's skulls to 'drive out' evil spirits.

Examples, Advantages, and Disadvantages of measuring stress using Physiological Measures

Examples: blood pressure, heart rate, galvanic skin response, respiration rate, cortisol, epinephrine, norepinephrine, and more Advantages: direct, not under conscious control and therefore not subject to reporting biases (you cannot control these physiological responses) Disadvantages: expensive, procedures themselves may causes stress (why saliva/pee tests are preferred as blood tests may themselve cause stress), and most are not specific only to stress (ie. HR also increases in response to anger, sexual arousal, and exercise)

Examples, Advantages, and Disadvantages of measuring stress using Self-Report Measures

Examples: life events scale, everyday hassles scale, 'how stressed are you feeling?' - rates stress people are feeling in the moment Advantages: quick and inexpensive, with good predictive validity Disadvantages: subject to reporting biases (lying)

Optimism

Expectancy that good things will happen in the future. -more effective copers, can deal with illness, have a reduced rate of stress-related illness -can be measured using a scale of true/false questions that measure pessimism, optimism, or filler questions - you add the number of true answers to optimistic questions and reverse coded answers of true to the pessimistic questions and the numerical result is your optimism score

Social Support and Cortisol Study (Collins, Jaremka, Kane)

Experimental manipulation of support to examine cortisol reactivity in response to a lab stressor. -Participants: 64 couples, relationship duration 6-123 months -Lab Stress: speech about job qualifications -Support Manipulation: one partner wrote supportive notes to their partner for before and after the speech or no notes were written Results: when the individual had low baseline speech anxiety, the notes did not have a significant effect on cortisol levels; but when the individual had high baseline speech anxiety, the notes had a huge effect on reducing cortisol levels

Psychological Control

Feeling that you have control over stressful events. More narrow than self-efficacy; a sense of handling specific situations rather than more general self-efficacy. -associated with better immune response, health behaviour change success, less stress/physiological response because of a better immune response and stress control system

Definition of Binge Drinking

Females: 4 drinks in less than 2 hours Males: 5 drinks in less than 2 hours *Males tend to drink more than females, but the gap is closing - this is an issue because there are physiological differences between men and women in their body's alcohol processing so this is concerning for females.

Summary of Taylor's Theories: 4 possible fear reactions

Fight, Flight, Freeze, Appease (tend & befriend) -can be activated in any gender, but women seem to preferentially exhibit appease because they have lower physiological fear responses.

Overview of Views of Illness in the 1900s

Following of the biomedical model with rapid advancement in investigation of the body's machinery. -believed the causes of disease are physical -was a reductionist view not leaving room for other influential factors of disease -stated that health was simply absence of disease but we now know that it is more than that

Environment's impact on Health Behaviour Practices

For example, it is easier to exercise in a place with a lot of greenspace.

Motivational Orientation and Message Framing Study Results

For reading the loss-framed article, those with avoid motivation flossed more than those with approach motivation, and this group flossed more overall. In reading the gain-framed article, those with avoidance motivation flossed less than those with approach motivation. -therefore the congruency effect is confirmed -the idea that certain behaviours align with message frames (ie. detective with loss-frame and protective with gain-frame) is contradicted here as flossing is a protective behaviour, and generally gain-framed messages are better for those behaviours but those in the loss-framed condition flossed more overall

Results of Experiment #3

For the Exp Condition: only significant change between pre and post test liekert scores was the pre-test motivation (telic/paratelic) measure and post-test motivation (telic/paratelic) measure; a telic state shift was observed... -post-test the experimental and control groups scored lower on telic state measures - representing a shift into the paratelic state -this effect was more prominent in the experimental group and was significant from the reduction in the control group -shows that individuals are more enjoyment oriented after watching sexual clips

Freud's 'Talking Cure'

Freud formed this for Conversion Disorders: -patients would talk with him and their symptoms would ease and go away -he thought that the mind must be linked to the body and is doing physical things (contrary to Mind-Body Dualism)

The Essence of Primary Prevention

Getting people to alter their poor health behaviours so they don't develop into poor health habits which are more difficult to change. Keeping people from developing poor habits is integral so they do not become ill.

Example of biopsychosocial effects of bad health

Getting really sick can effect your psychological well-being, and can make you stay at home and become disconnected from your social network.

Adrenaline

Gives you a shot of energy, produced in the adrenal medulla, used as an index of stress, and measured in time.

Obestiy Rates on the Global Scale & in Canada

Global Scale: obesity has skyrocketed and is at a crisis point - more people are obese than not! National Scale: obesity has increased in Canada and our weight problem has an age effect - the aging boomer population is more overweight! High stress lifestyles and relying on fast food are a big issue

HBM Example: Mammography Use Study

Goal: to increase the number/rate of women getting mammograms for early breast cancer detection Design: 1/2 of a group of white middle class women were given an intervention based on the HBM and 1/2 of the group were given information not following the HBM

Gain-Frame Message

Good things that can happen if you do engage in a behaviour. -works well if you want someone to engage in a protective behaviour -Ex: an advantage of getting regular mammograms is that you will find tumours early, which will increase treatment options.

Examples of Psychological Stressors

Grades, job security, money, relationships, traffic. -not having a sense of control enhances these stressors considerably (ie. traffic is extremely stressful when you don't know how long you'll be stuck there, but apps like WAZE can reduce stress by telling you the average amount of time spent in traffic that day in that area)

The BC pilot test of Carrot Rewards

Had a good uptake, was the most downloaded app the week it came out and has had regular sustained engagement. -Health Quiz Completion rate in the app was much higher than expected (78%) *Launched in Ontario in February, currently has 200,000 users*

What prompted Freud to develop psychosomatic medicine?

He wanted to figure out what to do with a patient in pain who has no physical cause for pain.

What are health promoting and preventative behaviours?

Health Preventative Behaviours: preventable injuries, caner-related health behaviours such as screening, sun safety Health Promotion Behaviours: exercise, maintaining a healthy diet, sleep behaviour

Video on making stress your friend

Health psychologist read a study that made her rethink her approach to stress: -study examined how much stress participants experienced in the last year, and whether they thought it was adverse to their health - then looked at which of them died -people with a lot of stress died but only if they also believed stress was harmful to health, those with much stress that didn't believe it was harmful to health survived more often than those with low stress -when you change your mind about stress you can change your body's response to stress - if participants are told their physiological responses are helpful to performance, their blood vessels do not constrict as much and CVD is prevented -stress releases oxytocin which makes you more social and compassionate, and protects the CV system from stress and helps heart cells regenerate/be stronger -oxytocin's effects are strengthened through social support and therefore resilience is built through social support in times of stress -study found that those who spent time helping others in the community experienced no more mortality from high stress experiences Conclusion: how you think about stress and how you act in times of stress reframe your relationship with stress and improve you physical and emotional well-being

Primary Health Promotion and Examples

Health-enhancing efforts to prevent disease/injury from occurring. Instilling good health habits and changing risk factors before they become bad health habits and eventually illness. -Examples include wearing seatbelts, nutrition, exercising, not smoking, health screening, etc.

Examples of Physical Stressors

Heat, cold, pain, fatigue, injury, hunger, predators, being sick. -add an extra layer of stress making other tasks difficult

Hill's Thoughts and Development of the ABC-X Model of Stress and the Family

How a family handles a problem will depend on their outlook, their resources, individual factors, and normative life stresses (standard stresses such as being busy, having a new baby, and other life stressors that may be individualized and not related to the family). -Coping strategies and outlook can change over time as stressors change over time ; for example now we are worried about school and assignments, but in grad school we will have different worries and when we are parents we will have different worries, etc.

Health Promotion for Health Psychologists

How can we help people practice healthy behaviours and change poor ones? -look at interventions to help health behaviour change and research whether or not these things make people change their behaviours -we care about this because of the transition into chronic illness such as accidents, cancers, etc. (we are no longer dying of acute illness which is caused by sickness of microorganisms due to lack of cleanliness or vaccination)

Dr. Sparling's Current Work

How do sexual arousal, partner familiarity, and relationship goals (the want to be in a relationship) impact sexual risk-taking and condom negotiation?

Video: Can Stress Actually Kill You?

Humans cannot turn off their hormones, and psychological stressors continue bathing our system in stress hormones. This leads to... -decreased immune function, decreased inflammation, etc. and can lead to increased incidence of disease (especially stroke) - *Karoshi in Japan = death from overwork -decreased telomere length which speeds up aging and increases the chance of getting sick *Oxytocin helps blood vessels relax, etc. to improve the bad effects of the stress response and this is released through social interaction*

Statistics on Alcohol

If we all followed the low-risk alcohol guidelines we would prevent nearly 4600 alcohol-related deaths each year, including ~1000 annual road fatalities due to drunk driving. -one of the leading causes of preventable death (third after smoking and poor diet/exercise) -linked with stroke, ciarrhosis of the liver, cancers, and FASD (200 different nervous system abnormalities in babies) -many drinkers keep their problems hidden and this makes it difficult to help them -alcohol abuse costs Canada billions per year

Roxy + Rocky have sex via the CMM: The Secondary Appraisal Directly Impacts...

In a secondary appraisal she is judging what he is like and the situation. -how strongly she insists on using a condom -what tactics she will use to persuade Rocky -whether or not she'll agree to unprotected sex if he refuses to use a condom

The Carrot Reward/Provincial Government Team-up isn't the only organization trying this, there's also...

In the US: the Patient Protection and Affordable Care Act -Gives employees money for reaching health targets -This is actually a lower cost for the government as insurance companies then don't have to pay out as much for healthcare costs

Results of Intervention using DI

In the intervention community: the proportion of men who engaged in unprotected sex decreased from 37% to 28%, there was a 16% increase in condom use, and an 18% decrease in men with multiple sex partners In the comparison city: there was no significant change

The Pattern of Motivated Behaviour associated with Condom Use

Inconsistent condom use - the more sexual arousal experienced, the lower the condom use intentions are. -arousal is impacting our condom use behaviours: a strong experience of sexual arousal = less likely to have used a condom and more sexual arousal = lower condom use intentions

The Social Context of the Biopsychosocial Model

Influencers of health: -gender (comes with socially prescribed roles, and these roles may not align with what one feels the role of their gender is -> there are also health disparities between men and women that are not physiological including the fact that there are more overweight and binge drinking men as this is part of the masculine gender identity) -race/ethnicity -cultural identity -SES -birth cohort

The Psychological Context of the Biopsychosocial Model

Influences on health behaviour and influences on body's physiological responses: -beliefs -attitudes -motivations -these three things really influence health, and therefore constitute a major treatment index *Interpretation of situations can modify stress emotionally and physiologically*

The Assumptions of most Public Health Campaigns

Information -> Attitude Change -> Behaviour Change The first step of simply making people aware of health risks (such as dangers of not wearing a seatbelt) may cause them to employ a health behaviour in and of itself; other times an attitude change is required as well.

The 3 fundamental determinants of reducing HIV risk behaviour

Information, Motivation, and Behavioural Skills

When is reason more persuasive and when is emotion more persuasive?

Involved audiences prefer appeals to reason because they are processing the information more deeply. Uninvovled audiences prefer appeals to emotions because they are not even paying attention. -we always assume we have an uninvolved audience because people are busy and don't really care -emotional target is usually fear because it is easy to appeal to in health situations - situations that impact your quality of life

Experiment #3: Motivational State and Self-Efficacy

Is arousal modifying our motivational state and self-efficacy (self perception of capability - general and sexual)? Participants: 84 women, 32 men 18-26 years of age (mean: 20) Design: slightly altered, a pre-post design; people were measured before and after watching the video clip on a liekert scale that evaluated the telic and paratelic state, a liekert scale that evaluated general self-efficacy, and a liekert scale that evaluated sexual self-efficacy

Experiment #1: Sexual Risk-Taking Intentions

Is increased sexual arousal linked to decreased condom use? Participants: 80 women and 30 men 18-32 years of age with a mean of 23 Target Activity: asked a questions about sexual risk-taking intentions and had participants respond to a Liekert Scale of how likely they were to take a risk (the risks was either distracter - not related to sexual risk taking, or target scenarios - related to sexual risk taking -> combination of the two to make up a worksheet of responses)

The Present Bias

It can be harder to make good health choices when you are focused on what's happening right now and not in the future. This is especially true when you are focused on present cost and discount possible benefits of the future. -Ex/ when you are focused on the cost of going to the gym (physical money, not getting to do other things) and discount the future implications/benefits (not thinking about improved quality of life) it is easy to not perform a health behaviour

Which Type of Message Frame Works Better?

It depends on the person and we see a congruency effect... -we can reach an individual most effectively by matching their dispositions with the appropriate frame -health messages framed to be concordant with individuals' dispositional motivations will be most effective at leading to behaviour change

Why did the biomedical arise despite its problems?

It was developed during a time where people were mainly dying due to infectious diseases.

Overview of Views on Illness in the 1800s

It was recognized that the focus on pathogens didn't explain all disorders, and sometimes pain didn't have any physical causes. -Things that are wrong without physical cause were common and noticed by Freud.

Personal Control's impact on Health Behaviour Practices

It's harder to change what we think we cannot control. For example, before using a condom for the reason of STI protection we need to ensure we feel control over the use of a condom - otherwise being told it is integral in STI protection will have no meaning as the behaviour is not perceived as possible.

The Origin of Vaccines

Jenner noticed that milkmaids were immune to smallpox and got blisters on their hands from milking cows with coxpox. To see if the cowpox was providing immunity to smallpox he infected a child with cowpox first, and then with smallpox - the smallpox did not develop. -from this he inferred that cowpox were like an attenuated form of the smallpox virus and acted as a vaccine

Statistics on Diet & The Importance of Eating a Healthy Diet

Less than half of Canadians consume the recommended daily servings of fruits and vegetables. World-wide obesity has more than doubled since 1980. -eating a complete and healthy diet prevents heart disease and lowers risk for colorectal cancer, as well as lowering risk for many other chronic illness; and therefore decreases money spent on healthcare costs

Lazarus's Theories

Lazarus (1984) conceptualized stress as being determined by a person (all about the psychological response). -held that it's not the environmental event nor the person's response, but rather the person's perception of the situation that determines what is stressful -stated that appraisal moderates the relationship between perception and response to an event

Hill's ABC-X Model

Looks at the family (this can be a family you have procreated, your family, or people that you see as family such as roommates) as a unit rather than looking at one person's stress. It emphasizes systems and the importance of family development across the life course over just looking at the individual level. Recognizes that families are unique, cultural, and react to stressors in different ways. A- Provoking event or stressor (ie. parent loses a job) B- Family's resources or strengths at the time of the event (ie. other parent can support family the family for a bit or there are savings, or not!) C- Meaning/perception attached to the event by the family (ie. viewing the job loss as a chance for a new career rather than as a failure) X - represents the stressor and crisis (ie. what happens and how it plays out)

Gain Framed vs. Loss Framed Messages and what behaviours they are useful in reinforcing

Loss-Frame Message: lists the negative impacts not doing a behaviour will have; useful to promote illness detection behaviours Gain-Frame Message: lists the benefits you will get from doing a behaviour; useful to promote protective behaviours

Two forms of message framing

Loss-Frame, Gain-Frame

Physiological Measures of Stress

Main type is cardiovascular measures which indicate how your heart is functioning: EKG, blood pressure, and impedance cardiography. -The results of these tests include modification of heartrate (HR) , ventricular contractility (how hard the heart is beating), cardiac output (how much blood the heart is pumping), and systolic and diastolic BP due to stress.

Overview of Views on Illness in the Renaissance

Mind-Body Dualism was the prominent view. -Descartes: believed the mind is non-physical and the body is physical. The pineal gland is where the mind and body interact. The body can influence the mind through the pineal gland, but the mind cannot influence the body. -Therefore, physicians only worried about the physical body as a machine and not the mind/soul. This allowed medical science to leap forward through studying cadavers as the body was no longer a sacred vessel or keeper of the soul, only the mind was.

Results of Experiment #1

Mood Scale for the Exp/Control: people were aroused by sexually explicit clips, not by other clips. Sometimes men were more aroused and sometimes there was no difference between genders for the sexually explicit clips. There was not a significant difference in other moods between the two conditions. Target Activity for the Exp/Control: female erotica compared to female control and male erotica compared to male control both resulted in higher average sexual risk-taking intentions scores; average sexual risk-taking intentions scores were higher for the control and erotica group in men as compared to women.

Alcoholism

More chronic binge drinking - these people are considered 'alcoholics'. If you binge drink and are predisposed to alcoholism, there may be a link between binge drinking and alcoholism. -characterized by physical addiction to alcohol, withdrawal symptoms when abstaining from alcohol, and high tolerance for alcohol

Approach Coping

More prepared to take on cognitive and emotional challenges associated with a stressor. -confrontative/vigilant -"What can I do to deal with this stressor?" -more success with long term stressors -more stress with short term stressors

Fear Appeals in HIV Education

Motivational components of HIV educational interventions include videos depicting sexually active young people with the disease (ie. 'People Like Us'). -these types of HIV educational videos have been shown to prompt defensive risk assessments: some people see the video and feel 'Yes, condoms always!' and others say 'forget this! You're blowing it out of proportion!' -those who are defensive are scared by the health message and don't change their health behaviour

The Negative Personality Styles

Negative Affectivity, Pessimism, Perfectionism

Negative Affectivity

Negative mood with high anxiety, depression, and hostility. A way of being that is more predisposed to experience negative events more negatively, and to be more unhappy in a wider variety of contexts. -these people are more likely to have genetic markers for alcohol abuse which is an issue because they are more likely to be stressed, have a higher risk of suicide, and have more cortisol in their bodies which is decreasing immune function

What types of personality are associated with stress?

Negative personality styles; which are persistent feelings over time that many agree are established in childhood and develop or change over time. Those with negative personality styles have more trouble with stressors while other personality styles may have an easier time with stressors.

Is stress always bad?

No! Our body's reaction to acute stressors can help us, it's chronic stress to psychological stressors that is the most threatening. -this is because your body responds the same way to taking midterms as it does to a bear attack, which is okay in the short term but in the long time this produces a lot of wear and tear (allostatic load)

Seyle's Definition of Stress

Non-specific response (response is the same no matter what the stressor is), can cause long-lasting physiological changes and have a negative impact on health.

Hill did not see stressors as either positive or negative, but rather as...

Normative. The positive or negative appraisal of the situation depends on resources you have and how you frame the situation. Stressors happen and this is normal (and in some cases stress can even be positive). -has the potential to initiate change in the system (change your life - anything that initiates change can cause stress)

Pile-Up

Occurs when we have concurrent stressors. Multiple crises may be happening at the same time (ie. birth of a child at the same time as a major housing relocation for work), and minor stressors may become a huge issue. -pile-up is one of the phenomena that leads people to a midlife crisis. There are extra stressors that pile up at midlife such as work, kids, elderly parents, etc. which accounts for this.

Reappraisal

One of the response-focused strategies in the emotion regulation theory - trying to prevent a full-blown emotional response. -includes re-constructing a potentially emotional situation in a way that decreases its emotional relevance; re-framing after the emotion-inducing event has occurred -can be effective but uses more energy and ideally we want to diffuse an emotional situation before the response occurs (antecedent-focused strategies) and we can be trained to do this

Educational Appeals

Operate based on the idea that people need the correct information to change their behaviour - they do not currently know the correct information. They believe that should people receive the correct information, they will then engage in the behaviour change!

Positive Personality Styles

Optimism, Self-Compassion, Psychological Control

The California Study

Participants asked to name which health behaviours they engage in from a list and people who practiced more of them got sick less often, lived longer lives, and had a higher quality of life later in their life.

Motivational Orientation and Message Framing Study Set-Up

Participants: 63 undergraduates Procedure: measure approach and avoidance orientation, read gain or loss framed message, measure flossing behaviour one week later *Loss Frame - 'floss now or forever hold your breath!'; if you don't floss you will get terrible breath and gum disease, showed gross photo of gums *Gain Frame - 'sweet breath, healthy gums, only a floss away!'; everyone will love your mouth if you floss, showed a good photo of gums

Issues with the Patient Protection and Affordable Care Act

Pay-out to employees may be yearly, and therefore doesn't really hack the present bias. Employees may not include pay in evaluation of cost to performing a health behaviour. -the closer to the behaviour the reward is, the stronger the effect

The Influence of Pokemon Go on Physical Activity (a paper by Althoff, White, and Horvitz)

People go for walks much more regularly because the game is more fun if you do. -researchers compared physical activity between those who played the game and those who didn't (using a 'fitbit' like thing) and found that using PG increased physical activity across all groups and there was a bigger increase in those who were initially more inactive before starting to play

Opinion Leaders or Taste Makers

People who influence other people's decisions. -are sought out for information and advice -exert influence informally which gives them power because you may not realize you are being influenced -they are good role models for community -they bridge innovators and everyone else because they introduce ideas from the innovators to the public Ex/ people who get free products on social media and talk about them - the industry has decided they are opinion leaders and that they will influence people to buy their product

SES's impact on Health Behaviour Practices

People with more resources fare better. -people with higher SES experience less stress, have better access to healthcare, and can take more time off to go to clinics -they also have the ability to eat healthier and exercise more as they have more leisure time and a higher income

Reversal Theory

Personality and motivation are fluid. There are various domains, and states within those domains that determine motivation and therefore behaviour. -The Means-End Domain: Telic vs. Paratelic States; the telic state is goal-oriented, serious, and arousal avoidant whereas paratelic state is enjoyment-oriented, playful and arousal seeking -you must satiate a paratelic state before you can move into a telic state

Difference between negative affectivity and pessimism

Pessimists expect negative outcomes, but may not be unhappy all the time (dispositional negative affect), whereas those with negative affectivity are unhappy all the time.

The four types of stressors...

Physical, Psychological, Acute, Chronic

What is the most effective preventative behaviour against cancer risk?

Screening! Early detection really improves survival rates.

Motivation

The factor that forces individuals to take the knowledge they have and act on it. There are two types of motivation: -personal motivation (one's own attitudes towards behaviours) -social motivation (perception of social support and norms)

What types of personality are associated with the reduction of stress?

Positive personality styles; approaching stressors and having a more positive mood (and therefore less likelihood of being sick as per Cohen's study), quicker cortisol recovery, and better stress regulation systems. -appraise stressors as less threatening/harmful and rather appraise them as challenging or surmountable

Smoking Example of the TTM

Precontemplation: 'I have no plan to quit smoking' Contemplation: 'I need to quit smoking' Preparation: 'I have seen my doctor and told her I'm going to quit smoking. She wrote a prescription to help reduce my cravings for nicotine' Action: 'I'm actively cold turkey and it's week two. So far, so good' Maintenance: 'I've been tobacco free now for six months'

Together the SAM and HPA Axises...

Prepare the body to respond to a variety of stressful situations.

The three types of Health Promotion

Primary, secondary, and tertiary

Coping Strategies; which is better?

Problem-Focused Coping, and Emotion-Focused Coping Important to use both strategies; both types can be useful for stressful events but the nature of the stress can define which may be more useful. -emotion focused coping is more useful for health problems -problem-focused coping is more useful for daily hassles

Condom Use Intervention using the Information Motivation Behavioural Skills Model

Problem: relatively few interventions have had a significant impact on HIV risk behaviour Participants: undergrads assigned by residence floors to intervention vs. control condition... -Intervention Condition: information (gain-framed message for protective behaviours delivered through a HIV101 prevention slideshow), motivation (improved attitude towards condom use, instilled social norms for condom use, and change perception of personal risk for AIDS), and behavioural skills (improved objective skills for performing preventative acts and self-efficacy for behaviour change)

What can we apply our knowledge of how health behaviour can be modeled too?

Public Health Campaigns. -we can create more effective campaigns by assessing how they are effecting our audience based on the models that are predicting their behaviour changes

Measures of Cardiovascular Activity (Electrocardiography or ECG)

Records electrical activity of the heart. Gives us information about heart rate as well as the timing of various components of the cardiac cycle.

Study of Risk-Based Intervention for Encouraging Sun Safety

Researchers went to the beach with two special cameras: one UV light camera that showed damage spots on skin from UV exposure and one that aged people depending on what damage had already happened. -Group One: UV light -Group Two: Photo Aging -Group Three: Both -Group Four: None *Group three was most effective in changing health behaviour, but group one was better than group two, reinforcing the validity of risk-based strategies.*

Roxy + Rocky have sex via the CMM: Roxy's Goals

Roxy enters a relationship with Rocky with the goals of intimacy, sexual satiation, personal validation and sexual safety. Her goals are influenced by the past, attitudes, and beliefs about what's normative. The number of goals and hierarchy of the goals are unique to each individual, Ideally she meets all her goals, but she knows which ones are the most important so when she judges the situation show knows how to act so she can meet her most important goals.

Subjective Well-Being Index (major evaluation of overall health)

Score each statement from 0 (at no time) -> 5 (all of the time), and add points up to get a score between 0 and 25. A score lower than 13 is indicative of bad subjective well-being and can be treated with mindfulness meditation. Example statements: 'I have felt cheerful and in good spirits', 'I have felt calm and relaxed', 'I have felt active and vigorous', 'I woke up feeling fresh and rested', and 'My daily life has been filled with things that interest me'

Self-Compassion vs. Self Esteem

Self Esteem is a sense of worth and ability. Self-compassion is not about ability necessarily, it is about accepting yourself for who you are and your ability. There is less risk of illness and better coping strategies associated with self-compassion. -self-compassion may be more important than self-esteem

Two Measurement Methods in Stress Research

Self Report Measures and Physiological Measures

Results of Experiment #4

Self-Control in Exp/Control Conditions: those in the experimental group showed significantly lowered self-control (no effect of gender) Sexual Self-Restraint in Exp/Control Conditions: those in the experimental group showed significantly lowered sexual self-restraint (no effect of gender) The correlation between self-control and sexual self-restraint: positive; as self control increases, so does sexual self-restraint (but arousal lowers our self control and therefore also lowers our sexual self-restraint)

Self Control and Self Restraint

Self-control and self-restraint prevent us from engaging in contextually inappropriate behaviours; allows us to resist our impulses and conform to appropriate social rules. If sexual arousal taxes our ability to tap into our self-control and engage in sexual self-restraint, this could explain sexual risk taking (self-control is general and self-restraint is specific to sexual risk-taking).

Combined Knowledge from Experiments #1 and #2

Sexual arousal impacts decision making for sexual situations and for general situations.

Sexual Arousal and Sexual Decision Making: The Problem and Solution

Sexually transmitted infections (STIs) like human immunodeficiency virus (HIV) remain a significant health concern for men and women all over the world. Unprotected sexual contact accounts for the majority of new STI/HIV infections. -Understanding factors that can affect condom use decision "in the heat of the moment" will be instrumental for reducing the number of new STI and HIV infections

Demonstration of the insufficiency of the biomedical model: Does a virus always lead to a cold?

Sheldon Cohen's research on colds: participants receive an inoculation of a cold virus and are then quarantined. -Results: people who had a positive emotional style and more diverse social network were less likely to get sick -> the biomedical model cannot account for this as it assumes that they would all have an equally likely chance of getting sick

Overview of Views on Illness in the Middle Ages

Sick people are bad in some way. They are sick for a reason, God's punishment - torture is reprimand. -being sick is the patient's fault and a sign of doing something worthy of punishment

Smile

Smiling, even fake smiling, can reduce physiological responses to stress. -participants who had their mouths arranged into a smile with chopsticks had lower resting heartrates than those who had chopsitcks making a neutral expression. Some participants were told to smile and these had the lowest heartrates overall.

Definition of Habit

Something so automatic that you don't even have to think about doing it before you do it.

Stressor

Something we have appraised as being harmful, threatening, or challenging. -what a stressor is depends on individual appraisal of event and the individual responses, as well as resources had to meet the challenges of the event

Intervention using DI

Stage 1: Identified Opinion Leaders -bartenders, which were chosen from popular opinion (these bartenders where deemed the best ones in the community) Stage 2: Trained Opinion Leaders -gave the bartenders info about safe sex strategies and trained them how to effectively share this information Stage 3: Opinion Leaders Spread the Word -personally endorsed values for safe sex and started a conversation with people in the bar about it

What is the cost of appealing to fear?

Stigma

Sympathetic-Adrenal-Medullary (SAM) Axis

Stimulates release of epinephrine and norepinehprine from the adrenal medulla via NTs in an efferent neuron: mobilizes energy for 'fight or flight' response, including increased heartrate, respiration, blood flow and muscle strength. A surge of energy and alertness as blood flow is directed to the muscles and away from gastrointestinal activity and extremities. -acts immediately -quick recovery (NT are reabsorbed quickly)

Hypothalamic-Pituitary-Adrenocortical (HPA) Axis

Stimulates the release of cortisol from the adrenal gland via a hormone (ACTH) being released from the pituitary which conserves energy (rather than giving us a surge of it) and decreases immune function. And this system is only activated for chronic stressors as opposed to acute stressors. -maintains vigilance; increases availability of glucose and surpresses (metabolically costly) immune system, increases energy, decreases inflammation -slower recovery -long term activation leads to negative health effects via the cortisol and immunological changes; long term activation interferes with how effective this system is at doing its job and causes problems in health

Overview of Illness through History (Historical Perspective)

Stone Age = Evil spirits Middle Ages = God's Punishment Renaissance = Mind-Body Dualism Mid 1700s = Germ Theory 1800s = Comfort 1900s = Biomedical Model 1960s+ = Biopsychosocial Model

The GRE Study of Arousal Reappraisal (Jamieson et al.)

Students taking the GRE were in one of two conditions: -reappraisal condition: educated to treat their stress about the exam as performance-enhancing rather than an obstacle that needs to be overcome -control condition: not educated Results: measured sAA (salivary alpha amylase reactivity from spit samples) - a measure of sympathetic nervous system activation/STRESS; found that those in the reappraisal condition were having an enhanced stress response but that is was a much healthier and functional stress response -also measured GRE scores on math and verbal components; those in the reappraisal condition had better math exam performance (no significant difference between the groups on the verbal component) and this effect persisted when they retook the exam months later

Experiment in using self-affirmation to support health messages

Study: in the self-affirmation condition you were asked to write about your best values and how it effects your everyday life and in the control condition you were asked to write about something not good about yourself and how it could be useful to another person. These two conditions were then educated about how they were at risk and drinking excessive alcohol could lead to breast cancer. Results: self affirmation condition rated themselves as more at risk, were more inclined to change their behaviour, were more receptive of the behaviour, and experienced less negative affect - we replaced their self-worth so they could be less threatened and more receptive to the health information

Dr. Sparling's Experiment on Relationship Motivation and Condom Negotiation

Study: think about someone you know vs. someone you don't know (2 conditions - each containing those with higher and lower relationship motivation) and were asked questions... -if partner seemed more familiar the participants were more interested in taking sexual risks than if the partner seemed less familiar -men take greater risks than women with less familiar partner types -those interested in relationships (high relationship motivation) took greater risks -men who have higher relationship motivation were more likely to engage in sexual risk-taking -women who are high in RM were more willing to engage in risky behaviour if aroused, but not if they weren't -women who were low in RM were more likely to engage in risky behaviour if not aroused

Conclusion on Carrot Rewards

Successful, it is working. It is one of the real ways to influence health behaviours.

Physical Reactions to Stress

Sweaty, cold and clammy hands as body directs blood to central body parts, stomach issues.

Demonstration of the insufficiency of the biomedical model: Telomeres

Telomeres are the protective caps at the end of your DNA that keeps it from shortening. -People with low SES as children have been found to have shorter telomeres and are more likely to have a cold than people who had high SES as children -> this also cannot be explained by purely biological explanations

Resilience

The ability to bounce back from negative emotional experiences rather than letting failure overcome you. Good emotional regulation, seeing failure as helpful feedback for how we can do things better. -the ability to flexibly adapt to the demands of stressful experiences -most likely and quicker in those who have had resources historically

Sympathetic Nervous System

The 'fight or flight response' - preps body for automatic stress responses (increases heartrate, breathing, blood flow to skeletal muscles, decreases digestive activity and immune function). -mobilizes body for action, a system that is active under stressful conditions -increases: heartrate, breathing, sweating -decreases: gastrointestinal activity (sucks blood away from extremities resulting in the cold and clammy hands often experienced)

Seyle

The Father of Stress: stressed rats when running a study to test ovarian extracts on rats; he was really bad with them and chased them around and dropped them. He found that rats in all of his conditions had enlarged adrenal glands, ulcers, and decreased lymphnode size. He found that stress had had an impact on their bodies/health!

Problems with the HBM, IMBSM, TPB, and how the CMM is different

The HBM, IMBSM, TPB are designed to predict health behaviour from a static perspective. They assume you collect information, and attitudes beforehand and the execute a behaviour in a situation. The CMM attempts to encompass the in-the-moment variability inherent in a live sexual encounter - acknowledges that you have to make a decision in the moment, and the attitudes and info cannot be pre-planned.

What should we use to measure obesity instead of BMI?

The Hip-to-Waist Ratio. -weight in the abdominal area is the highest indicator of chronic illness (as measured by the hip-to-waist ratio), which was confirmed in a longitudinal study -> in the study, high BMI was the worst predictor of chronic illness

Specific Barriers to modifying health behaviour...

The INSTABILITY of health behaviours themselves is a barrier. -factors related to behaviours can be *different for each individual* and can *change across time* (over time health habits change in the population and throughout our lifetime health habits change) -for example, different health habits are controlled by different factors and different individuals may have different factors causing their health habits (for example the health habit of not getting enough sleep is often caused by stressed and the habit of not getting enough physical activity is often caused by not valuing physical activity, THOUGH different individuals may not get enough physical activity due to stress for example) -health beahviours are unstable over time, and especially if they are not yet habits. One factor may be responsible for causing engagement in a health behaviour (ie. smoking to make friends) and another factor can maintain it (ie. addiction)

Results of Experiment #2

The average percentage of 'hits' on ambiguous hands of blackjack was significantly higher (risk-taking behaviour) in the experimental, sexually aroused, group - this was true for men and women with no significant differences between their results.

Another Preventative Behaviour: Sun Safety Statistics

The biggest risk for skin cancer is the sun - excessive exposure to UV radiation achieved from being in southern latitudes, tanning beds, and/or engaging in many outdoor activities. -1/2 of Canadian adults report sunburns each year -protective practices lowest among 15-24 year olds because we think tans are sexy and are worried about our physical appearance; therefore, this group is most likely to expose themselves to UV radiation

Overview of Views on Illness in 1960+

The biopsychosocial model!

Allostasis

The body's maintenance of an appropriate level of activation under changing circumstances. Good allostasis results in appropriate responses to threats of different magnitudes.

The Lalonde Report

The first government document in the western world to acknowledge that the biomedical perspective is wrong and called for change such as more green space, more produce in stores, healthy community standards, etc. It outlined the two objectives of the health field: -the Health Care System -Preventing health problems and promoting good health (NEW); indicated that determinants of health exist in our biology, our environments, and our lifestyles and just attending the doctors office will not determine our sickness or wellness (ie. can still contract AIDS even if you get tested regularly) *Also said that it's important to target interventions specifically at those who are at a higher risk - this is integral because a lot of fatal illnesses can be prevented because they are caused by modifiable behaviour*

Roxy + Rocky have sex via the CMM: Primary Appraisal

The first step for Roxy, first appraisal in the encounter. -'Is this relevant to my goals?' -'Can my goals be met?' If yes, Roxy proceeds.

Who isn't getting screened for breast cancer?

The highest income women and the lowest income women. -women who are immigrants, smoke, and don't have regular doctors are less likely to get screened -women who are embarassed, worried about pain, anxious about having cancer, or feel invulnerable to cancer/want to live in blissful ignorance are less likely to get screened -the healthcare system is circulatory meaning you need referrals, lots of appointments, etc, and if your job doesn't allow for this kind of time off it can be a big barrier

When self-control is depleted (we have used it up)...

The negative consequences of engaging in situationally inappropriate sexual behaviours (sexaul self-restraint) are less obvious to us. This results in a self-control dilemma, and more chance of choosing short term goals over long term goals.

Appraisal

The process of perceiving and interpreting the event. This is interactional between a person and their environment - appraisal is key to determining what is stressful for an individual.

Exercise Intervention Strategy

The theory of planned behaviour is applied and perceived control is manipulated to enforce behaviour change. -a study of whether or not people continued attending the gym, found it was dependent on how much people felt they had control over their gym-going behaviour; if they felt like they had control they were more likely to go and in turn a regular gym routine increased their perceived behavioural control -gamifying health beahviours for example can increase perceived control (as in the pokemon Go! example up next) you trick them into participating in a health intervention with a free smartphone app that is accessible to many different people (unfortunately not in rural areas)

Changing Patterns of Illness

There are now less deaths due to infectious disease, and more focus on long-term chronic illnesses that are fatal. -these are illnesses that build over time or are caused by a dangerous behaviour -there are not direct medical treatments per say for these illness, a lot of health treatment needs to be behavioural change *From 1900 -> 2010 the No. of Deaths/100,00 has switched from things like TB, GI infections, senility and diptheria to things like suicide, diabetes, alzheimer's disease, etc. and the prevalence of things like heart disease, and cancer has risen*

What kind of alcohol drinkers cause the most issues in our system?

Those who have lighter alcohol problems (moderate alcohol abuse) - which is 4 to every 1 heavy alcohol abuser - because they are less likely to get help!

Conclusions from the GRE Study

Those who use arousal re-framing experience more sympathetic arousal (stress), but in a functional way that enhances performance on the math component of the GRE.

Exercise and the Elderly (65+)

Those with poor mobility should be doing additional exercises to their 150min/week to improve balance. -this age group has the lowest rate of physical activity -even a small amount of activity can make a big difference (and it's really important to get older adults moving) -we are focusing most of our exercise interventions on people over 65

What is a best way to reach people in our society?

Through smartphones - 76% of Canadians own one.

Functional Emotion-Focused Coping

Trying to clarify emotions, figure out what we are feeling; can be beneficial in many situations such as dealing with chronic conditions, pregnancy, breast cancer, and daily hassles. It is linked with self-compassion; you are identifying what you are feeling and being kind to yourself about it. -making/maintaining supportive and empathetic ties -seeking spiritual support -emotional processing -reframing and cognitive restructuring -finding humour in the situation -relaxation and exercise

Self-Compassion

Treating yourself with kindness and being mindful. -reduces likelihood of negative self-evaluation and self-blame

Freud's 'Conversion Disorders'

Unresolved conflicts in the mind taking a physical form. -these are not common today but have still been observed

How Carrot Rewards uses Behavioural Economics to Increase Health Behaviour

Uses incentives to increase health behaviour. -offsets the present bias by making the cost of taking time to go to the gym for example LESS (you get a reward!); this in turn increases the likelihood of the health behaviour.

How do we subdue the dangers of using fear appeals in health messages? (ie. stigmatization and defensive responses of denial)

Using self-affirmation to support health messages!

The Doshas

Vata (Air and Ether): the element of movement, may have flatulence or joint pain if imbalanced Kapha (Earth and Water): a nourishing element, may feel weak if imbalanced Pitta (Fire and Water): element of sharpness and burning, may have a fever or redness if imbalanced *The 3 Doshas need to be balanced, therefore you must not surpress natural urges - for example, supressing a sneeze (air element release) may lead to shoulder pain.*

Get outside

Walking on green spaces reduces anxiety - students stressed about a bad math test performance showed faster cardiovascular recovery from stress when viewing photos of nature as opposed to urban city landscapes.

Methods for Assessing Endocrine Levels

We are looking for cortisol, adrenaline, and noradrenaline in the results of a blood test or urine sample. -Spit and urine tests for these things are good because they are low stress

A few effective coping tools for stress...

We are not built for chronic stressors or many stressors at the same time; we are made to deal with stressors one at a time and with recovery time. Stress is a part of life but effective coping tools can reduce your stress and help you recover more quickly: -slow down -exercise -get outside -smile -posture -re-framing

Why are smartphones effective tools in health interventions?

We can use it to track a wide variety of behaviours (Ex/ phone records things like number of steps someone takes - removes aspect of self-report and falsifying results) and to reward these behaviours quickly.

SPF - how strong do we need?

We need strong SPF and frequent re-application of sunscreen for proper sun safety behaviour: -it's hard to get people to do this, even if they have been persuaded about the importance of good sun habits -we generally need at least 30, preferrably 50

Results of the Condom Use Intervention via the IMBSM

We saw improvement in reduction of HIV risk behaviours - after one month the intervention group had significantly improved their condom use compared to the control group. They were using condoms more frequently and discussing HIV risk with their partners.

Patterns of Cortisol and the adverse effects of prolonged stress on cortisol rhythms...

We usually start the day with the most cortisol - surges after lunch, but is low in the afternoon and then drops off until bedtime. -in chronic stress we see elevated levels all day, the system is on all the time -interferes with the body's natural rhythms/way of dealing with things -may have too big or too long stress in acute responses, or nor response at all as a result of chronic activation

Why are apps like Carrot Rewards developed?

We want to target modifiable behaviours that cause illness because they are expensive to treat. -things like smoking, physical inactivity, etc. are preventable behaviours that if modified will reduce healthcare cost - this means less money put in by the government and less tax payer dollars (a good investment for everyone!)

Do Fear Appeals Lead to Attitude Change?

When fear is plotted on the X-axis with attitude change on the Y-axis, we see an upside down U. Attitude change increases with fear to a point - then attitude change drops of as fear increases - this indicates that too much arousal (fear or other) makes it difficult to think about things and change your attitude.

Re-framing

When shown a video about the negative effects of stress on the body versus one about viewing stress in a positive light - those who learned about the positive effects of stress were less stressed overall.

Conclusions on using Self-Affirmation to Support Health Messages

When threatened, people process information differently. Those most at-risk are typically least persuaded. People are motivated to protect themselves from threats (by not engaging in HBC and protecting ego instead); as they challenge their self worth by making them think they are vulnerable. -we can help avoid this issue by bolstering self-worth and self-affirmation -replacing their self-worth can make them more objective to health information

Why may the Greeks have thought this?

When you sediment blood in a testtube it separates into 4 layers: clotted cells, blood plasma, white blood cells, etc. The four layers will fluctuate depending on people's health - thus representing the 'imbalances' they may have observed.

What we have learned from Experiment #2

Women and men are influenced to engage in more general risk-taking when sexually aroused. -sexual arousal may work a little bit like alcohol myopia (being drunk) - people who are aroused are not in the position to make judgments

What else needs to be considered in breast cancer screening behaviour?

Women aren't the only people who get breast cancer. -breast cancer also occurs in men -it also occurs in trans men who have or haven't had top surgery (some breast tissue may be left) *Problem: our interventions for breast cancer are very cis-gendered woman centered and boobie centred - you can only get screened if you are identified as a woman on your health card, which can be a barrier for trans men who have identified to the government. Treatment rooms and aspects of the healthcare system are feminized and this is a problem.

Results of the Mammography Use Study

Women given an intervention based on the HBM: 30% had mammograms in the next 3 months, and 50% in the next 6 months indicating that it had a lasting effect Women in control group not given information according to the HBM: 10% had mammograms in the next 3 months and 20% in the next 6 months

Why is 'appease' apparently unique to women?

Women respond with less adrenaline and testosterone to stressors. -they have less of a physiological fear response than men - which seems weird as women are generally more fearful in our culture Because of this fight or flight may not be applicable to them and freeze/appease may be (tend and befriend can also be incorporated into appease). -they are less afraid and want to de-escalate situations and this may put them in harms way; therefore they are more likely to be submissive and get in harms way

Canada's low-risk alcohol guidelines: you are a low risk drinker if...

Women: no more than 10 drinks/week and no more than 2/day most days Men: no more than 15 drinks/week and no more than 3/day most days

Noradrenaline and Adrenaline

Work together to make you alert, awake, and focused. -blood is shifted away from the skin/non-essential areas and redirected to the muscles -effect experienced right away because they act as NTs -don't want these hormones hanging around all the time

Can Stress be Good for You?

Yes! -Resilience is harnessing your stress response constructively -You can build up your resilience with 'stress inoculations': athletes build up physical endurance, you build up to adulthood though highschool, uni, etc. By taking on mildly stressful challenges that are manageable you can reduce your stress in stages (ie. taking on some small public speaking tasks to build up to a full speech) -make stress your friend: there is an optimal, positive, amount of stress and we need to use cognitive re-framing to harness this. Oxytocin is part of the stress response, and this hormone is good.