Health Psychology - Exam #1 - PSY 2601 - Temple University
WHO's definition of health
"a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity
response where the body is readying to either attack or escape
"flight or fight response"
Nonadherence
#1 reason for readmission into hospital is from non-medication adherence *people think they don't need medication anymore - not everyone adheres - approximately 125,000 people die each year because they are nonadherent - most people also cannot afford it
ethnicity and mortality
- #1 cause of death for europeans + african americans is heart disease - #1 cause of death for asian and hispanic americans is cancer
Self-Efficacy Theory
- Bandura - people will adhere to behaviors if they 1. Believe they can initiate and carry out this behavior (self-efficacy) 2. Believe they the behavior will produce valuable outcomes (outcome expectations)
Most Adherence Diseases
- HIV/AIDS - Arthristisis - Cancer - GI
Implementing Intentions
- Planning is an important factor for translating intention into behavior - education strategies - increasing people's knowledge - behavioral strategies - mor directly involved in changing behaviors
Transtheoretical Model
- Prochaska - suggests that people progress and regress through five stages - precontemplation, contemplation, preparation, action, maintenance
Health Action Process Approach
- Schwarzer, incorporates aspects of both continuum theories and stage theories - Motivational Phase - included outcome expectations, risk perceptions, self efficacy, and intention
Continuum Theories
- Use a single set of factors to explain adherence for everyone - "one size fits all" - health belief model - self-efficacy theory - theory of planned behavior - behavioral theory
Adherence
- ability and willingness to follow recommended health practices - following a medical regimen - maintaining healthy lifestyle practices -going to the doctor regularly
factors related to mortality
- age - ethnicity - income - education level
Measures of physiological stress
- blood pressure, heart rate, galvanic skin response, respiration rate advantage - reliable and direct disadvantage - process may produce stress itself; expensive; biofeedback
Sources stress can come from
- cataclysmic events = tragic events, war, terrible news, bad situations - changes in a person's life history = moving from childhood home - hassles from everyday life = work, homelife, small little things add up and make us view them as more of bigger problem than it actually is
How coping is applied with a stressful situation
- coping is a process, and constantly changes and adapts to the situation - coping is not automatic; it is a learned pattern of responses to stressful situations - coping requires effort - coping is an effort to manage the situation
Barriers to adherence
- cost - patients see the regimen as being too difficult or time-consuming - patients treat regimen as advice rather than "orders" patients stop taking medication when symptoms disappear, "optimistic bias" patients reduce thoughts of negative outcomes with their illness
Less Adherence Diseases
- diabetes - pulmonirary (diseases) - less adherence for diet + exercise
What jobs can health psychologists do?
- health research, in university, or government, agency settings - hospitals or clinics - Health Maintenance Organizations (HMOs) - private practice
ACH - Acetylcholine
- is pumped out from the endocrine system - is a neurotransmitter that plays a part in memory and attention - people with Alzheimer's have a reduction of this
Self-report measures of stress
- life event scale = checklist of life events, such as marriage death, traffic violations - everyday hassles scale - measures daily hassles, traffic concerns of weight, household chores advantage - can predict occurrence of stress-related symptoms disadvantage - people may overreport or underreport events
poverty and mortality
- limited access to health insurance and medical care - poor mothers more likely to have low-birth weight babies - 2002 = 5.547 deaths per 1,000 financially disabled
living longer additional causes
- marriage helps couples live longer - pets can also help people live longer - strong social support
sympathetic nervous system
- mobilizes body for action; active under stressful conditions - increases: heart rate, breathing, sweating - decreases: gastrointestinal activity
low birth weight in infants
- mom has an eating disorder - mom does not have food - mom smokes or has another addiction *poverty plays a drastic role if a baby can live or not around the world
Biomedical Model
- negative viewpoint - views health as the absence of disease - a disease results from exposure to a pathogen
how age relates to mortality
- older people are more likely to die than younger people - differential causes of death based on age - unintentional injuries for those 44 years and under - chronic diseases are leading cause for those 45-64 years old - cardiovascular disease + cancer ----> 60% of deaths - health + lifestyle related
Sheldon Cohen's Research on colds
- participants receive a cold virus and then are quarantined - not all participants develop a cold - those who develop are more likely to have a stressful experience
stress can be measured in two broad ways
- physiological measures - self-report measures
parasympathetic nervous system
- promotes relaxation; active under normal conditions - decreases: heart rate, breathing, sweating - increases: gastrointestinal activity
techniques psychologists have developed to cope with stress
- relaxation training - cognitive-behavior therapy (CBT) - emotional disclosure
What factors predict adherence?
- severity of the disease - treatment characteristics - personal characteristics - environmental factors -age
Health Belief Model
- suggests four beliefs that should predict health-related behaviors 1. Perceived susceptibility 2. Perceived severity of the disease 3. Perceived benefits of health-enhancing behaviors 4. Perceived barriers to health-enhancing behaviors - All 4 are combined to predict if one will make a change
education and mortality
- those who have been to college have lower death rates than those who have not - higher education = better jobs, more money, more access to healthcare, less stressed, healthier habits
Behavioral Theory
- uses principles of operant conditioning to explain what behaviors will be strengthened or decreased - reinforcement strengthens behavior positive (+) reinforcement = add something, negative (-) reinforcement = take away something - punishment decreases behavior
health psychology
-branch of psych that concerns individual behaviors and lifestyles affecting a person's physical health -recognized by the APA as a subfield of psychology in 1978 -includes psychology's contributions to the enhancement of health, the prevention and treatment of disease, the identification of health risk factors, the improvement of the healthcare system, and the shaping of public opinion with regard to health
Social Support in adherence
-tangible and intangible help a person receives from friends and/or family - those will low social support are likely to be nonadherent - practical support is a stronger predictor of adherence than emotion support
4 major trends that changed the field of health care
1. Changing pattern of disease; i.e chronic replacing infectious 2. Escalating cost of medical care 3.Changing definition of health 4.Emergence of biopsychosocial model
4 categories of behavioral strategies
1. Using prompts 2. Tailoring the treatment regimen 3. Using positive reinforcement to shape behavior 4. Using a contingency contract
6 basic methods of measuring patient adherence
1. ask the practitioner 2. ask the patient 3. ask other people 4. monitor medication usage 5. examine biochemical evidence 6. use a combination of those procedures
Amount of years, pregnant women's stress cells were
10 year old cells
1900 life expectancy and today's life expectancy?
1900 - 47.3 years 2000 - 79 years
Diseases for deaths in 1900s and 2000s
1900s: pneumonia 2000s: heart disease
Nonadherence to medication regimens percentage?
24.8%
Theories of Planned Behavior
3 factors shape intention: 1. Attitude toward the behavior 2. Subjective norms 3. Perceived behavioral control - Intention then predicts behavior
"the wedge"
3-5 mins to reflect, and ask yourself what do i normally do? then think, what is the opposite, flip it around, even if it's a failure *requires wanting to break a habit
Albert Ellis - ABC Mode;
A = activating event, what is stressing you out? B = behavior, add wedge and ask what would i do? C. = consequence, the outcome
Bacterial Illnesses
A major change in American health is that 100 years ago, death was caused most often by
Behavioral Willingness
A person's motivation at a given moment to engage in a risky behavior
Perceived Discrimination - between race and health care workers
African Americans - 14.1% Asian Americans - 20.2% Hispanic Americans - 19.4% Race + Adherence Statistics
difference between health psychology and behavioral medicine
Health psychology and behavioral medicine overlap, having many common goals. However, behavioral medicine is an interdisciplinary field, whereas health psychology is a specialty within the discipline of psychology.
The single cause of life expectancy increasing?
Lower infant mortality
Ph.D? PsyD? Psychologist?
Ph.D ~ Research based PsyD - Clinical Psychology Psychologist - licensed in their state for psychology
Theories of Adherence
Psychologists have developed theories to identify, and then target modifiable, factors that can increase adherence - Continuum theories: spectrum, process, long - Stage theories: steps, ups and down, and more
changes in increases life expectancy
Reasons why people are living longer: 1. vaccinations 2. safe drinking water 3. better nutrition 4. healthy lifestyle 5. disposal of sewage
Health Process Approach Model
Self efficacy———>>>> intention -> planning -> action Outcome expectancies ^ and risk perception ^
Intention-Behavior Gap
Some health behavior theories suggest that people's intentions are predictive of people's behaviors
US rank in life expectancy and the number one country with the highest life expectancy?
US ~ 24th #1 —-> Japan
Biopsychosocial Model
a disease results from a combination biological, psychological, and social influences - views health has a positive condition
3 stages represent response to stressors
alarm stage - initial response to stressor resistance - body mobilizes to defend against stressor exhaustion - ongoing response to stressor can lead to depleted resources for the body
Cultural Norms
are implicated in adherence - individuals less acculturated to western medicine have poorer adherence - income is more important to affecting adherence than education
short gesiation in infants
baby is born too soon causes baby to not survive - nowadays - 25 weeks - needs extensive care
norepinephrine
both a hormone and a neurotransmitter (produced in many places in the body)
cortisol
can be used as an index of stress; assess in saliva and urine
problem-focused coping
changing the source of the stress, such as making a plan to help you solve a problem
Leading causes of death in the 2000s
chronic diseases
Lazarus's View of Stress
conceptualized stress as being determined by a person - stress is interactional between a person and the environment - person's appraisal is key in determining what is stressful - stress arises when the situation is threatening, challenging, or harmful
behavioral medicine
concerned with the integration of biomedical science with behavioral sciences -similar discipline to health psychology; clinical work - working with people in a hospital, lab, or clinic
endocrine system
consists of ductless glands throughout the body
pathogen
disease causing organism
neuroendocrine system
endocrine glands that are controlled by and interact with the nervous system
In the endocrine system, these chemicals are called?
hormones
personal control
individuals who are confident have some control over their lives are better able to cope with stress
social support
individuals with a strong social network are better able to cope with stress - helps adopt healthy habits and increase confidence
Leading cause of death in the 1900s
infectious diseases
autogenics training
learning how to control breathing, heart rate; has helped olympic athletes; offers control over our psychological aspects of the body
emotion-focused coping
managing emotions that come from stress, such as venting about a problem
mental illness and chronic disease
mental illness is chronic for *most* people that have it
In the nervous system, these chemical are called?
neurotransmitters
longenital malfunctions
not genetic but happens between conception and birth and causes disorder in a baby
MAMAs study
offers program for pregnant women to decrease stress, and overall health for their pregnancy mainly low income women who are overweight or obese
3 types of appraisals
primary appraisal: person determines whether the event is irrelevant, good, or stressful secondary appraisal: person determines whether they can successfully apply coping strategies to alleviate stress reappraisal: person incorporates any new information
epinephrine
produced in the adrenal medulla, used as an index of stress, measured in urine
Stage Theories
propose that people pass through a series of stages as they attempt to change their behavior (think steps for stages)
cognitive behavioral therapy (CBT)
simplest and easiest to use of all psychological interventions; useful in managing stress type of therapy that aims to develop beliefs, attitudes, thoughts, and skills to make positive changes in behaviors
stress-buffering hypothesis
social support lessens harmful effects of stress and protects against disease
cartharsis
someone with anger issues, throwing things in therapy does not actually help
coping
strategies that individuals use to manage the distressing problems and emotions in their life - determined by their personal resources and the specific personal coping strategies chosen
strengths and weaknesses of the theory of planned behavior
strengths: identifies beliefs that shape behavior- useful in guiding internet based interventions weaknesses: not successful at predicting risk taking behavior - tasking the first step is hard
SEEDs study
study of the infant impact from overweight/stressed moms babies are preprogrammed for future issues or outcomes women who respond less and are less stressed have healthier babies mom needs to be healthy mentally and physically
automatic nervous system
sympathetic and parasympathetic nervous system
general adaptation syndrome
the body's generalized attempt to defend against a stressor; helps to explain how stress relates to physical illness
emotional disclosure
therapeutic technique in which people express their strong emotions by talking or writing about negative events that precipitated those events
What was the prevalent attitude of Americans a century ago if they caught infectious diseases?
they felt little responsibility because those diseases could not be controlled
women and men in stressful situations
think hunters and gatherers: men - hunters women - gatherers - each sex responds differently in stressful situations - females animal are dull colors to protect themselves from predators because they carry the babies - women release the hormone oxytocin - bonding and affiliation - women "tend and befriend"
Selye's view of stress
view of stress led to much research on how people experience stress - view is too simplistic - view ignores situational and psychological factors
Freud Drive Theory
we all have a drive for something, so still doing the action for anger for example, does not actually solve the problem for that person's anger issues
maladaptive coping mechanism
worrying and overthinking makes us hyperfix on our stresses
Infant Deaths
~ US Still has bad rates of infant deaths ~ infant deaths also relate to race + ethnicities ~ vermont has the lowest infant mortality rate in the US ~ states highest rates are southern states (less access to healthcare or economically challenged) ~ racism - black women in America have highest infant mortality races
Chronic Diseases
~ long lasting, recurrent disease ~ hear disease, cancer, stroke ~ leading cause of mortality in the US, and 50% of all deaths in the US
Research + Race
~ people of color feel they are not taken as seriously by doctors ~ white men are researched the most ~ harder to get people of color I'm research, due to finances, over white people who can afford it and are financially supported ~ racism affects infant mortality
