Health Psychology Final RS

Biomedical model

Illnesses can be explained by abnormal somatic processes

Biopsychosocial

Health is influenced by biological, psychological, and social factors

How many deaths are attributable to health related behaviors?

50%

What is correlation design?

Investigates association between two things without manipulation.

What is experimental design?

Investigates a relationship between two things WITH manipulation

How do you interpret correlation coefficients?

The closer to 1, the stronger. Positive means they both increase, while negative means one goes down as the other goes up.

Quasi-experimental design

Experimental design without random assignment

Moderator

Something affecting the relationship between the independent and dependent variable

Mediator

Something that occurs after the independent variable leading to the dependent variable outcome

Confound

An unseen third variable that may affect the outcome of an experiment

Retrospective design

Predictor variables measured AFTER outcome

Prospective design

Predictable variables assessed BEFORE outcome

Cross-sectional design

Collecting data from one point in time

Longitudinal design

Collecting data from multiple points in time (like checking up periodically)

Internal validity

Likelihood that outcome happened because of independent variable

External validity

Generalizability, ability to apply results out in the real world

Meta-analysis

Statistical combination of previous study results

Allostasis

The body’s response in anticipation of stressors

Allostatic load

The physiological toll on the body after repeated allostasis

Autonomic nervous system

Involuntarily manages internal organs

Sympathetic Nervous System

Mobilizes body to react to stress

Parasympathetic Nervous System

Restores body to normal after stress state

Endocrine system

Secretes hormones (Hypothalamus, pituitary gland, adrenal gland)

Hypothalamus

Controls pituitary gland

Pituitary gland

Master gland that secretes hormones and directly influences other endocrine glands

Adrenal gland

Adrenal medulla and cortex, releases hormones when stress

How does stress affect endocrine system

Stress → CNS → Hypothalamus → SAM or HPA system activation

What hormones are released by the SAM system?

The catecholamines, epinephrine and norepinephrine (fast but short-lived stress response)

What hormones are released by the HPA system?

Cortisol, which has a slow-starting but longer-lived stress response

What is Holmes and Rahe’s Social Readjustment Rating Scale and how does it conceptualize stress?

Conceptualizes stress by ranking stress events

Daily hassles

Minor annoying events that demand a little adjustment but slowly accumulate

Perceived stress

Appraisals of life situations as unpredictable and overwhelming

Indirect effect model

Stress → Unhealthy coping behaviors → Disease

Direct effect model

Stress → Unhealthy physiological changes → Disease

Diathesis stress model

Stress + Predisposition to disease → Disease

Cannon’s fight or flight response

Stress → Physiological Stress Response → Preparation for mobilization

Selye’s Generalized Adaptation Syndrome

Body’s generalized attempt to defend from stressors with 3 phases

1. Alarm - Immediate impact, highest physical arousal

2. Resistance - Body keeps responding to stressor

3. Exhaustion - Physical resources depleted (hormones too)

Cardiovascular Reactivity

Everyone has different responses to stress, variation in cardiovascular response

Relationship between social support and health (Holt-Lunstad & Smith, 2012)

Very strong relation

Direct effect hypotheses for stress

Social support provides protection during times of stress

• Social support is helpful whenever

Indirect effect hypotheses for stress

Social support provides protection against effects of stress

• Social support is ONLY helpful during times of stress

Potential mechanisms in the relation between social support and help

• Cognitive appraisal - People help us during times of stress

• Health behaviors - Exercise, etc

• Adherence

• Psychoneuroimmunological pathways - Social relations moderate physiological response to stress

Tend-and-befriend hypothesis

• Tend - Protecting offspring in the face of stress

• Befriend - Depending on others for support for stress

Relationship of control and health (Langer and Rodin)

Greater choices to nursing home residents → Improved health

Hardiness

• Commitment, control, challenge

• Affects cognitive appraisal 

• Leads to less illness

Explanatory style

How we think about negative events in our lives

1. Internality vs. externality

• Internal is like self-blame

2. Stability vs. Instability

• Catastrophizing

3. Globality vs. Specific

• This ruins everything

Health behaviors model

Personality → Health-related behaviors → Health

Stress moderation model

Personality → Moderates effect of stress → Health

Big Five Personality Traits

1. Openness

2. Conscientiousness

• Most consistently related to positive health outcomes

3. Extraversion

4. Agreeableness

5. Neuroticism

Type A Behavior Pattern

• Competitive, hostile, hurried, tense

• Linked with heart disease

Problem-focused coping

Addressing the problem that causes stress

Emotion-focused coping

Addresses the emotions arising from stress

Approach coping

Confronting the emotions from stress

Avoidance coping

Ignoring the emotions from stress

Relationship between religiosity and help

Positive health outcomes for a number of reasons like community and social support

Relationship between expressive writing and health

Helpful when confronting emotions and trauma

How are gratitude, mindfulness, spending time in nature, and humor related to health?

All lead to lowered stress

Relationship between self-affirmation and stress

Reduces physiological response to stress

Temptation bundling

Pairing a temptation with a health behavior (like watching a show on the treadmill)

Health Belief Model

4 factors that affect participation in preventative health behaviors

1. Perceived susceptibility

2. Perceived severity

3. Perceived benefits

4. Perceived barriers

Theory of Planned Health Behavior

Behaviors determined by behavioral intentions (commitment to a behavior)

1. Behavioral intentions - Commitment to a behavior

2. Attitudes - Feelings about a  behavior

3. Subjective norms - Will people support me

4. Perceived behavioral control - Self-efficacy

Implementation intentions

Specific plans for when, how, and where one will engage in a behavior

Transtheoretical model

Representation of how change is not a linear model

1. Precontemplation

2. Contemplation

3. Preparation

4. Action

5. Maintenance

6. Termination

Most important component of models of health behavior

Self-efficacy

Primary prevention

Preventing the disease in the first place

Secondary prevention

Detection of the disease

Tertiary prevention

Treatment to prevent the disease from doing more damage

For what types of health behaviors are loss- and gain-framed messages most effective?

Loss-framed more effective for detection

Gain-framed messages better for prevention

When are fear-based messages most effective?

Moderate amount of fear with a strategy

Behavioral nudges

Small and subtle pushes to make a health behavior cheap and easier

Nicotine regulation model

Someone has to reach a certain amount of nicotine

Affect-regulation model

Smoking to feel good or less bad

What makes social influence programs for smoking prevention effective?

• Focus on short-term effects

• Role models

• Emphasize peer attitudes

• Target high-risk groups

Stimulus control

Managing the things that remind you of or make you want to smoke

Response substitution

Doing something besides smoking

Contingency contracting

Getting a trusted person and making a deal with them that ultimately pushes you away from smoking

alcohol myopia

When you can only focus on the most immediate thought & what's in front of you while being drunk

Tension-reduction theory

-drink to cope w/ (-) emotions
-mixed support--> only explains some drinking,
- focuses on (-) emotions

Pluralistic ignorance

--> assumption that our own attitudes & beliefs differ from others' (behaviors r the same)
--> Prentice & Miller
-drunk on weekend normal for college ppl
-person things its not good (individual) but publicly is good (not rlly)

Intervention Programs

Providing information about the consequences of alcohol use
--> Not too effective
Providing strategies for decreasing alcohol use
--> Skills training EFFECTIVE
--> practiced mod. Blood alcohol levels learned
Challenging expectations about alcohol
--> EFFECTIVE
--> gave placebo—> "your just goofy no matter what"
Challenging perceptions about others' alcohol use
--> EFFECTIVE
--> Shown actual data, same pattern of Perceived behavior

Antabuse

-take every day, drink alcohol—> get violently ill
-won't drink then

BMI Problem

- Only measures weight & height, barley tells anyone about fat cells compared to muscle
- more accurate- % of body fat

Tomiyama (2016)
Measured BMI & real predictors of health outcomes
large majority was healthy—> labeled as obese from BMI
ppl who were "health" weren't

apples vs. pears

--> Waist-to-hip ratio
-different distribution
-Apple: abdominal fat—> health risk b/c increased rate of fat --> around organs
-Pear: gluteal fat—> no risk

Set-point theory

body seeks to maintain certain weight
- consume fewer calories—> metabolism slows
- consume more calories —> metabolism increases

internal-external

-Use of external cues rather than internal(physical) cues for eating
--> External Cues: foot taste good, smells good, variety at a buffet + portions

mood regulation

Food used to manage mood(stress, anxiety, depression)

restraint theory

Ppl restrict calories intake & food they eat to attempt to lose weight
-->backfires b/c will end up breaking diet

Diets often fail

- dieters regain more weight than they lost
- weight cycling

delay behavior

1) Perceiving symptoms
-May not perceive as serious symptoms"it's fine"
-->Commonsense illness representation
-->Lay referral network
2) Social situation
-Distraction
-->Rates of coughing (Pennebaker 1980)
-->Medical students' disease
3) Culture
-Language barrier, use of herbs & natural remedies, discrimination
4) Income,time,access
5) Stress/mood
6) Self-presentation
-->False alarm (embarrassment)
-->Social desirability of condition (broken ankle vs. STD)

Coughing

Pennebaker (1980) (distraction in social situation)
-Movies & classes (coughed at boring parts)
-Classes ( worse evaluation→ more coughs)

commonsense illness

Some knowledge on illness
Ex. flu → you know you got it

lay referral network

Going to friend or family for medical advice

View from Hospital Bed

Ulrich (1984) patients recovering from gallbladder surgery
- Tree→ stayed for less time, quicker recovery
- Wall→ longer time, slow recovery, cried

Sunlit vs. Dark Rooms

Beauchemin & Hay's (1998) heart attack patients
- Sun→ shorter stay, lower mortality
- Women only → stayed less longer in sunny room

Plants

Park & Mattson's (2009) thyroidectomy patients & plants
- Plants→ shorter hospital stay, less pain, lower anxiety

Info from Video

Doering et al. (2000) hip replacement surgery video
- Video→ less pain medication, less cortisol, less anxiety

non-adhering

-Failure to keep scheduled appointments
-Failure to take full does
-Taking other medications
-Failure to take medication at correct intervals
-Taking expired medications
-Intentionally not listening (creative/intelligent/rational non adherence)

25-50%

average rate of nonadherence

outcomes of nonadherence

-Over-prescription of drug
-Drug-resistant germs
-Recurrence or lack of improvement of symptoms
-Physician-patient relationship jeopardized

Physician Communication & Training

Haskard-Zolnierek & DiMatteo (2009) association w/ communication and training
-Physician communication → better patient adherence
-Physician training → better patient adherence