Health

Discuss two treatments for obesity.

CBT Beck: 10 women who weighed between 90-136 kg a year later the women had lost weight and managed to keep it off. This was due to the fact that the women had targeting their thoughts and beliefs that prevented them from losing weight in the first place. The important thing is to understand why people overeat and deal with the cognitive process behind it. Surgical Treatments Gastric band Putting a band around the stomach to prevent the stomach from receiving food Gastric bypass Cuts off parts of the stomach so that it can no longer absorb food Maggard (2005) performed a meta analysis of effectiveness associated with surgical treatment of obesity. Based on 147 studies. Surgery resulted in loss of 20-30kg which was maintained up to 10 years and was accompanied by general improvement in health. They concluded that gastric bypass was more efficient that banding. Dramatic weight loss, fewer complications

To what extent do biological/cognitive/sociocultural factors influence health-related behaviour?

Cognitive: Jobin et al. (2014) A: To look at the role of optimism on stress and health. P: Participants reported the levels of stress they perceived in their daily lives and took a test to measure optimism/pessimism. Cortisol levels of the participants were then measured over a 6 year period. F: Cortisol levels of pessimists were elevated for longer periods of time than optimists on days of higher than average stress. C: Pessimists tend to be more stressed than optimists. E: Optimism and Pessimism is not black and white, there was no account for variances. The values attributed to optimism and pessimism to measure them were arbitrary. Reductionist. Social: Taylor (2002) A: To investigate whether gender affects social support. P: Meta-analysis research of stress and coping. F: Women had more social support than men. Women drew on socially supportive networks more consistently than men did during times of stress. Women were more benefited by social support. C: There is a gender difference in relation to social support. Biological: Cohen et al. (1991) A: To investigate whether stress affects the immune system in terms of a participants susceptibility to catching a cold. P: Participants infected with a cold virus via nasal drops and then had to undergo different measures of stress. F: Participants who had experienced negative life events in the preceding weeks were more susceptible to developing colds than those who reported lower levels of stress. The longer the duration of the stress, the greater the risk of developing a cold. C: Stress can make an individual more prone to sickness, and therefore shows the extent to which stress can weaken the immune system E: Provides evidence for psychoneuroimmunology, difficult to establish cause and effect due to too many subjective factors.

Discuss two prevention strategies for obesity.

Diets Wadden (1993) Meta-analysis of studies on effectiveness of dieting A: P: The study reviewed randomized control studies on the effectiveness of either moderate or severe calorie restriction on weight loss. F: The results showed that patients stayed in treatment for 20 weeks and that 50% lost around 9 (20 pounds) kg or more. Modern approaches to diet with counseling were more effective in the short term compared to previous methods, which mainly focused on dieting and weight loss. The majority of obese patients in research trials tended to regain their lost weight. C: The conclusion of that study was that weight gain after treatment is the norm. Weight loss is not quick and this fact may result in many negative emotions and giving in to eat more than allowed. Many dieters are guided by all-or-nothing thinking. The belief that one little transgression (e.g. eating an ice cream) ruins the overall attempt to lose weight could make them stop the diet and indulge in food. This is described as the "what the hell effect" and it has been repeatedly demonstrated in chronic dieters. Campaigns: Eat Well Plate Strategy 1 "Eat well plate" British Nutrition Foundation 5 a day encouraged by some UK supermarkets. Educating people/families about food - pictorial summary of the main food groups and their recommended proportions for a healthy diet. It is the method for illustrating dietary advice by the Department of Health, issued officially by the government of the United Kingdom. Limitations: Only focused on food Not focused on lifestyle and cost Holm (2002): Method: survey on the efficiency of health campaigns in relation to food habits in Denmark. Findings: According to Holm, prevention campaigns should address 3 levels 1. what the individual can do 2. what can be done at a community level and 3. what is being done by the government. It can create a general framework for what is considered a healthy diet and good practice in losing weight. Conclusion: They are useful but cannot stand alone. They must been seen as an integral part of health promotion projects. Increased knowledge and motivation is key to campaigns having an effect.

Discuss two models and/or theories related to health promotion

Health Promotion: The process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions. Health Belief Model: Predict whether a person will choose to engage in healthy behavior to reduce or prevent chance of disease / premature death Predicts that individuals take a health-related action if they think a negative health problem can be avoided by taking the recommended action; and that they will be successful in doing so Becker et al. (1978) A: Correlational study to test the health belief model on asthma prevention medication. P: 111 mothers aged 17 to 54, with asthmatic children aged between 9 months and 17 years, took part in 45 minutes interviews, in which the mothers were asked about compliance, perceptions of susceptibility, seriousness of conditions, interference with education, embarrassment, interference with mother, effectiveness of medication and faith in doctors. Compliance was checked by blood tests of children, taken under the precedent that it was for medical rather than research reasons. F: Positive correlations were found between compliance and the following factors: susceptibility to attacks, seriousness of condition, interference with own activities, education and marital status. Negative correlations were found between compliance and disruption, inaccessibility to chemists, and complaints. C: It was concluded that the HBM was accurate in compliance with the medical regimen for asthma. E: Fails to account for underlying causes and the role of 'denial' and the way in which addictions for example affect the reward circuits in the brain thus reinforcing such things as substance abuse, addictive behaviour and obesity Focus on individual cognition, ignores emotional and social as well as socioeconomic factors Difficult to make standard measurement of many of the concepts (perceived vulnerability) Assumes people are rational which is not always the case (some people are unrealistically optimistic about their health) e.g self diagnosis, doctor google, many people looking up symptoms or self consult rather than seeing their external doctor about issues Research suggest that awareness of health risks does not always inhibit people from engaging in risky behaviour Stages of Change Model: 1. Pre-contemplation Individual has no intention to change behaviour nor perceive that they have a problem e.g. problem might be observable by individuals family and friends. 2. Contemplation Individual is aware of their problem and contemplating asking for help- HAS no commitment to take action. People can stay in this stage indefinitely (Prochaska et al. ,1992). 3. Preparation - "Get set" In this stage the individual has started taking action or considering taking action. 4. Action "Go" In this stage environmental, experience and behavioural changes are implemented to deal with the problem. 5. Maintenance New changes are not implemented as frequently as in the Action stage, the changes are just maintained to minimise the risk of relapse. Maintenance typically lasts from 6 months to 5 years. E: - Model may be more applicable to addictive behaviour for those who are morbidly obese who will be more aware of health related issues due to its effects on mobility - No account for psychological effects of labelling and discrimination that can be associate with some health disorders e.g. obesity and drug addiction Contemplation stages doesn't account for help being offered/advised e.g. in the UK heroin addicts can seek help and the free NHS in UK offers care plans in order to be given drug substitute and thus alleviate withdrawal symptoms. This is not the case globally where citizens have to pay for health care - Accounts for social and cognitive factors. Cultural differences not considered

Discuss the effectiveness of one or more health promotion strategy.

Health promotion: process of enabling people to increase control over, and to improve their health Changing the wider determinants of health - changing environment, physically by adding more stairs and public exercising facilities World Health Organisation: M: Monitor tobacco use and prevention policies P: Protect people from tobacco smoke - smoke free areas O: Offer help to quit smoking tobacco W: Warn about the dangers of tobacco use E: Enforce bans on tobacco advertising R: Raise taxes on tobacco Public health campaigns - changing belief, attitudes, and motivations; letting them know the dangers of smoking Campaigns: Eat Well Plate "Eat well plate" British Nutrition Foundation 5 a day encouraged by some UK supermarkets. Educating people/families about food - pictorial summary of the main food groups and their recommended proportions for a healthy diet. It is the method for illustrating dietary advice by the Department of Health, issued officially by the government of the United Kingdom. Limitations: Only focused on food Not focused on lifestyle and cost Fear Appeals: Induce fear in an individual in order to alter behaviour to avoid the threat of the danger if behaviour is not changed. Eshrati et al. (2008): A: To determine the association between the beliefs of a group of adult, male prisoners in Iran about the transmission of HIV and high-risk practices while in prison. P: A cross-sectional study was conducted. The study population was a random selection of 100 men serving time at Rajaei-Shahr prison. The data was collected through a self-administered questionnaire. Focus group discussions were held at the prison to guide the design of the questionnaire. F: The use of fear appeals and education resulted in prisoners not engaging in HIV high-risk behaviours. C: Increased education that would make prisoners aware of the risks would be beneficial.

Examine factors related to overeating and the development of obesity

Obesity: An excess of body fat that frequently results in a significant impairment of health. Overeating: The consumption of excess food in relation to the energy that an organism expends, leading to weight gaining and often obesity. Biological Factors: Genetic Predisposition/Influence Stunkard et al. (1990) A: investigate the relationship between genes and vulnerability to P +F: Studied the BMIs of 93 monozygotic twins and found that 66-70% of the variance in their body weight was accounted for by genetic factors. C: Concluded that genetics play a large role in the development of obesity, and that genetics played a greater role in those twins who were slim. - The genetic factor isn't clear; it might be number of fat cells or metabolism which can be genetically determined. Sociocultural Factors: SIT Nylander & Soerensen (2004) - meta-analysis of 20 of obesity related studies. Identified common themes in prevalence of obesity. Found that culture and social ideals played a large role in inducing obesity related behaviour. 70% of participants identified self-esteem caused by idealisation of thin bodies to be a significant factor in overeating due to oppressive social expectations. Prentice and Jebb (1995) Studied changes in correlation to obesity and car ownership and watching TV. Positive correlation was found between the variables but no cause and effect relationship was established. E: Correlation is not equal to causation, they could all be unrelated factors that positively correlate with each other, no evidence to suggest any causation. Reductionist, biopsychosocial approach needed.

Evaluate two strategies for coping with stress.

Stress Inoculation Training (SIT) - Meichenbaum (1996): - Aims to change thought processes to combat the effects of stress Conceptualization phase: individual to identify their stressors and how they respond to these and how successful these responses have been. Patterns of self-defeating internal dialogue are identified. Skills acquisition and rehearsal phase: individual to develop and practice positive coping statements to be used in stressful situations. Other techniques such as relaxation and making a realistic appraisal of situations are also practised. Application and following through phase: individual begins to apply the newly acquired skills to progressively more difficult situations in the real world. Evaluation: Meichenbaum (1997) reports that SIT and 'the power-of-positive-thinking' can be successful in bringing about appropriate behaviour change, particularly in relation to the anxiety associated with exams and pain. However, individuals vary in how easy they find it to use positive coping statements and the technique requires commitment and time before benefits can be experienced. MBSR ( mindfulness based stress reduction) Davis et al 2007 Aim: investigate if MBSR could reduce stress related behaviours MBSR is a stress reduction programme based on meditation principles from Buddhism. Method: 18 participants in the study. Had an average stress related smoking history of 19.9 cigarettes per day for 26.4 year MBSR instructors trained the group in mindfulness in 8 weekly sessions. Results: showed 56% of the participants had stopped smoking (breath test) and reported it to be due to a lower level of stress. There was a positive correlation between compliance with meditation, smoking cessation and low levels of stress. Conclusion: MBSR could be useful for smoking cessation but this needs to be tested in a larger sample.

Discuss physiological, psychological and social aspects of stress.

Stress: Refers to the failure to respond appropriately to emotional or physical threats that are either real or imagined. Physiological: Changes of the sympathetic nervous system - Canon's Fight or Flight Theory Cohen et al. (1991) A: To investigate whether stress affects the immune system in terms of a participants susceptibility to catching a cold. P: Participants infected with a cold virus via nasal drops and then had to undergo different measures of stress. F: Participants who had experienced negative life events in the preceding weeks were more susceptible to developing colds than those who reported lower levels of stress. The longer the duration of the stress, the greater the risk of developing a cold. C: Stress can make an individual more prone to sickness, and therefore shows the extent to which stress can weaken the immune system E: Provides evidence for psychoneuroimmunology, difficult to establish cause and effect due to too many subjective factors. Psychological: Jobin et al. (2014) A: To look at the role of optimism on stress and health. P: Participants reported the levels of stress they perceived in their daily lives and took a test to measure optimism/pessimism. Cortisol levels of the participants were then measured over a 6 year period. F: Cortisol levels of pessimists were elevated for longer periods of time than optimists on days of higher than average stress. C: Pessimists tend to be more stressed than optimists. E: Optimism and Pessimism is not black and white, there was no account for variances. The values attributed to optimism and pessimism to measure them were arbitrary. Reductionist. Social: Taylor (2002) A: To investigate whether gender affects social support. P: Meta-analysis research of stress and coping. F: Women had more social support than men. Women drew on socially supportive networks more consistently than men did during times of stress. Women were more benefited by social support. C: There is a gender difference in relation to social support.

Outline two stressors.

Stressor: Any event, real or imagined, cognitive, environmental, or biological, that leads to stress Jobin et al. (2014) A: To look at the role of optimism on stress and health. P: Participants reported the levels of stress they perceived in their daily lives and took a test to measure optimism/pessimism. Cortisol levels of the participants were then measured over a 6 year period. F: Cortisol levels of pessimists were elevated for longer periods of time than optimists on days of higher than average stress. C: Pessimists tend to be more stressed than optimists. E: Optimism and Pessimism is not black and white, there was no account for variances. The values attributed to optimism and pessimism to measure them were arbitrary. Reductionist.

Explain factors related to the development of substance abuse or addictive behaviour.

Substance: anything ingested that alters mood / cognition / behaviour; e.g. alcohol, drugs, nicotine Substance abuse: continued use of a substance despite knowing problems associated with it / unsuccessful efforts to control use Addictive behaviour: being physically dependent on a substance because of repeated use over time Psychological addiction: craving, strong desire to smoke / drink / take drugs Situations associated with smoking / smoker's mood and psychological state triggers craving Physiological addiction: display symptoms such as tolerance Person needs more of the substance to achieve the same effect Withdrawal symptoms if substance not taken - nausea, irritability, anxiety Biological factors - The psychoactive drug in tobacco is nicotine. Nicotine is also associated with relaxation and changes in mood. Nicotine is a highly addictive substance. A habitual smoker will experience withdrawal symptoms if the level of nicotine is not constant in the body. This could explain why up to 80% of smokers in the USA who would like to quit are not able to do it (Benowitz, 2009). Social Factors SLT (Bandura) Vicarious learning - Bauman et al. (1990) found that 80% of a sample of American adolescents aged 12-14 whose parents did not smoke had never tried to smoke themselves. If the parents smoked, half of the children had tried smoking. Murray et al. (1984) found that in families where the parents were strongly against smoking, the children were up to seven times less likely to smoke. Charlton (COGNITIVE): Young smokers associate it with fun and pleasure Social Identity Theory - some do it to fit in Advertisements manipulate beliefs, self-image (if you believe smoking is cool then you are more likely to smoke)

Evaluate two examples of psychological research (theories and/or studies) relevant to health psychology.

Wadden (1993) Meta-analysis of studies on effectiveness of dieting A: To investigate the effectiveness of dieting through a meta-analysis. P: The study reviewed randomized control studies on the effectiveness of either moderate or severe calorie restriction on weight loss. F: The results showed that patients stayed in treatment for 20 weeks and that 50% lost around 9 (20 pounds) kg or more. Modern approaches to diet with counseling were more effective in the short term compared to previous methods, which mainly focused on dieting and weight loss. The majority of obese patients in research trials tended to regain their lost weight. C: The conclusion of that study was that weight gain after treatment is the norm. Weight loss is not quick and this fact may result in many negative emotions and giving in to eat more than allowed. Many dieters are guided by all-or-nothing thinking. The belief that one little transgression (e.g. eating an ice cream) ruins the overall attempt to lose weight could make them stop the diet and indulge in food. This is described as the "what the hell effect" and it has been repeatedly demonstrated in chronic dieters. Beck: 10 women who weighed between 90-136 kg a year later the women had lost weight and managed to keep it off. This was due to the fact that the women had targeting their thoughts and beliefs that prevented them from losing weight in the first place. The important thing is to understand why people overeat and deal with the cognitive process behind it. Maggard (2005) performed a meta analysis of effectiveness associated with surgical treatment of obesity. Based on 147 studies. Surgery resulted in loss of 20-30kg which was maintained up to 10 years and was accompanied by general improvement in health. They concluded that gastric bypass was more efficient that banding. Dramatic weight loss, fewer complications Cohen et al. (1991) A: To investigate whether stress affects the immune system in terms of a participants susceptibility to catching a cold. P: Participants infected with a cold virus via nasal drops and then had to undergo different measures of stress. F: Participants who had experienced negative life events in the preceding weeks were more susceptible to developing colds than those who reported lower levels of stress. The longer the duration of the stress, the greater the risk of developing a cold. C: Stress can make an individual more prone to sickness, and therefore shows the extent to which stress can weaken the immune system E: Provides evidence for psychoneuroimmunology, difficult to establish cause and effect due to too many subjective factors. Becker et al. (1978) A: Correlational study to test the health belief model on asthma prevention medication. P: 111 mothers aged 17 to 54, with asthmatic children aged between 9 months and 17 years, took part in 45 minutes interviews, in which the mothers were asked about compliance, perceptions of susceptibility, seriousness of conditions, interference with education, embarrassment, interference with mother, effectiveness of medication and faith in doctors. Compliance was checked by blood tests of children, taken under the precedent that it was for medical rather than research reasons. F: Positive correlations were found between compliance and the following factors: susceptibility to attacks, seriousness of condition, interference with own activities, education and marital status. Negative correlations were found between compliance and disruption, inaccessibility to chemists, and complaints. C: It was concluded that the HBM was accurate in compliance with the medical regimen for asthma. E: Fails to account for underlying causes and the role of 'denial' and the way in which addictions for example affect the reward circuits in the brain thus reinforcing such things as substance abuse, addictive behaviour and obesity Focus on individual cognition, ignores emotional and social as well as socioeconomic factors Difficult to make standard measurement of many of the concepts (perceived vulnerability) Assumes people are rational which is not always the case (some people are unrealistically optimistic about their health) e.g self diagnosis, doctor google, many people looking up symptoms or self consult rather than seeing their external doctor about issues Research suggest that awareness of health risks does not always inhibit people from engaging in risky behaviour

Evaluate treatments for substance abuse and or addictive behaviour

World Health Organisation: M: Monitor tobacco use and prevention policies P: Protect people from tobacco smoke - smoke free areas O: Offer help to quit smoking tobacco W: Warn about the dangers of tobacco use E: Enforce bans on tobacco advertising R: Raise taxes on tobacco Bullen et al (2010) Experimental research on electronic cigarettes on withdrawal AIM: To examine the short-term effectiveness of e-cigarettes on desire to smoke and withdrawal symptoms vs. a nicotine inhaler PROCEDURE: - Single-blinded (they did not know which they were being given) controlled experiment - Participants were 40 smokers who had not smoked overnight - Given either cigarettes, e-cigarettes or a nicotine inhaler FINDINGS: - E-cigarette had fewer side-effects than inhaler - Both produced a low desirability to smoke - The electronic cigarette produced the same significant decline in the desire to smoke as the nicotine inhaler and had fewer side effects. Even the 0 mg cigarette suppressed the desire to smoke. - This is interesting because it shows that simulation of smoking behavior was enough to reduce craving. CONCLUSION: - The e-cigarette stimulated the smoking behaviour - Positive associations achieved without the addiction EVALUATION: - Bias of self-report - Reductionist - Ethnocentric - New on market thus research is lacking in replicating their effectiveness