Correct Psych 1

Acute disorders

Short-term conditions with rapid onset that often need immediate attention and usually resolve or are cured (e.g., flu, infection, broken bone). Contrast with chronic illness.

Chronic illnesses

Long-lasting conditions (generally 3+ months) that are managed rather than cured (e.g., diabetes, heart disease, asthma, arthritis). Now the leading causes of death in developed countries and strongly tied to lifestyle and behavior, which is why health psychology matters.

Biomedical model

Explains health and illness mainly through biological factors (pathogens, genes, biochemical imbalances, injury). Assumes mind-body dualism, a single biological cause (reductionism), and that health = absence of disease. Worked well for acute infectious disease but ignores psychological and social influences.

Biopsychosocial model

Proposed by Engel (1977). Health and illness result from the interaction of biological (genes, pathogens), psychological (thoughts, emotions, behavior, coping), and social (family, culture, SES, social support) factors. Mind and body interact. Foundation of health psychology.

Health

WHO (1948): a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.

Wellness

A holistic, active, ongoing process of making choices toward a healthy life. Goes beyond "not sick" to include physical, mental, and social well-being (often emotional and spiritual too). Emphasizes prevention and optimizing health.

Health psychology

Field that applies psychological principles to understand how biological, social, and psychological factors influence health and illness. Covers promoting and maintaining health, preventing and treating illness, causes of illness, and improving the health care system and health policy.

Psychosomatic medicine

Early 1900s field (Franz Alexander, Flanders Dunbar) studying how psychological factors such as emotions, unconscious conflict, and personality contribute to physical illness. Psychoanalytic roots; precursor to behavioral medicine and health psychology.

Conversion hysteria

Freud's term for a disorder in which unconscious psychological conflict is "converted" into physical symptoms with no medical cause (e.g., paralysis, blindness, loss of sensation). Now called conversion disorder or functional neurological symptom disorder. Historically key to the idea that the mind affects the body.

Epidemiology

Study of how diseases are distributed in and affect the health and illness of populations (who gets sick, where, when, and why). Key measures are incidence and prevalence.

Incidence vs. prevalence

Incidence = number of NEW cases of a disease in a population during a specific time period. Prevalence = total number of EXISTING cases (new and old) at a given time.

Etiology

The investigation of the cause or origin of a disease.

Morbidity

The presence (rate) of disease or medical conditions in a population.

Mortality

The incidence (rate) of death in a population.

Theory

A system of ideas, grounded in evidence, intended to explain something. Generates testable hypotheses and predictions and can guide interventions.

Evidence-based medicine

Integrating the best available research evidence with clinical expertise and patient values and preferences when making decisions about care.

Correlational research

Studies that determine the relationship (direction and strength) between variables; r ranges from -1 to +1. Cannot show causation because of the directionality problem and third variables.

Experiment

Scientific procedure that tests a hypothesis under controlled conditions by manipulating an independent variable, measuring a dependent variable, and (ideally) randomly assigning participants. The only design that can establish cause and effect.

Longitudinal research

Studies that follow the same participants over a long period to observe changes and development. Strength: shows change over time. Weaknesses: expensive, slow, participant dropout (attrition).

Prospective research

Follows participants forward in time. Risk factors are measured first, then researchers track who develops the outcome later (e.g., Framingham Heart Study). Stronger than retrospective designs, with fewer memory biases.

Retrospective designs

Look backward in time: start with an outcome (e.g., people who already have a disease) and examine prior events or exposures (e.g., case-control studies). Faster and cheaper, but prone to recall bias and unreliable records.

Meta-analysis

Statistical method that combines results (effect sizes) from many studies to reach an overall conclusion with greater statistical power. Limitations: only as good as the studies included, and publication bias.

Randomized clinical trials (RCTs)

Controlled trials that randomly assign participants to treatment or control groups. Random assignment balances out confounding variables so differences can be attributed to the treatment. Considered the gold standard for testing treatments.

Primary prevention

Efforts to prevent a disease or injury BEFORE it occurs, aimed at healthy people (vaccination, healthy diet, exercise, not smoking, sunscreen, seat belts, safe sex, health education).

Secondary and tertiary prevention

Secondary = early detection and treatment in early stages or at-risk people (screenings like mammograms, blood pressure checks). Tertiary = managing an existing disease to limit complications and disability (rehab, medication adherence, diabetes management).

Health-enhancing vs. health-compromising behaviors

Health-enhancing (health-promoting) behaviors improve or protect health (exercise, healthy diet, adequate sleep, vaccination, screening). Health-compromising behaviors increase risk of illness or injury (smoking, heavy drinking, drug use, poor diet, sedentary lifestyle, unsafe sex, risky driving, sleep deprivation, excessive sun exposure).

Demographic factors in health behavior

Characteristics like age, gender, race/ethnicity, socioeconomic status, education, income, and geography. They predict health behaviors and outcomes. Examples: higher SES is linked to better health (SES gradient), health habits often worsen from adolescence into adulthood, men have higher mortality while women have higher morbidity (more reported illness).

Factors related to health behaviors

(1) Individual: knowledge, attitudes, beliefs, self-efficacy, personality, habits. (2) Social: family, peers, culture, social norms, social support. (3) Environmental and structural: access, cost, neighborhood, laws and policy, media. (4) Demographic and biological: age, gender, SES, genetics.

Socialization

The process of learning the norms, values, and behaviors of one's society or group, through family, peers, school, culture, and media. Early socialization shapes lifelong health habits (diet, smoking, exercise), partly through modeling and observational learning.

What makes vaping ads more impactful?

Ads are more persuasive for adolescents when they feature appealing flavors, young attractive models or influencers, social and lifestyle themes (fitting in, fun, independence), bright and youthful imagery, and exposure on social media. Repeated exposure and framing vaping as a safer or cooler alternative to smoking increases positive attitudes and intentions to vape.

Role of peer influence on adolescent health choices

Peers influence behavior through modeling, direct pressure, and perceived norms. Teens also choose friends who are similar (selection) and become more similar over time (socialization). Peer presence increases risk taking. Teens often overestimate how much their peers smoke, drink, or vape, which pushes them to match the perceived norm.

Theory of planned behavior (TPB)

Ajzen. Behavior is predicted by intention, which is determined by (1) attitude toward the behavior, (2) subjective norms (perceived social pressure), and (3) perceived behavioral control (confidence you can do it, similar to self-efficacy). Perceived behavioral control also directly predicts behavior. Extends the theory of reasoned action by adding perceived behavioral control.

Criticisms of the theory of planned behavior

(1) Intention-behavior gap: intentions often do not become action. (2) Assumes people are rational and ignores emotion, habit, and unconscious influences. (3) Ignores environmental and structural barriers. (4) Leaves out past behavior and moral or identity factors. (5) Mostly correlational evidence. (6) Does not explain how or when intentions change.

Implementation intentions

Gollwitzer. Specific if-then plans ("IF situation X occurs, THEN I will do Y") that specify when, where, and how you will act. They link a cue to a response, making action more automatic and bridging the intention-behavior gap, which leads to better goal attainment.

Determinants of regular exercise

Self-efficacy, intention and motivation, enjoyment, perceived benefits vs. barriers, past exercise habits, social support (friends, family, exercise partner), and convenience and access (facilities, safe neighborhoods, time, cost). Demographics: exercise declines with age, is higher in men, and is higher with higher SES and education.

Exercise-promoting interventions

Education and mass media campaigns, goal setting and self-monitoring (trackers), social support or exercise buddies, implementation intentions and planning prompts, reminders, incentives and rewards, commitment contracts, worksite and school programs, and environmental changes (stairwell prompts, safe trails, access to facilities).

Exercise megastudy (Milkman et al., 2020/2021): purpose and conclusions

Purpose: test many interventions in the SAME large population (61,000+ gym members, 54 interventions by multiple scientific teams) to directly compare what increases gym attendance, and to showcase the "megastudy" design. Findings: about 45% of interventions significantly boosted visits (roughly 9-27%); rewarding people for returning after a missed workout worked among the best; effects mostly faded after the 4-week program ended; experts were poor at predicting which would work.

Social influence and perceived norms in medical screening

People are more likely to get screened when friends and family do (descriptive norms) and approve (injunctive norms), when a doctor recommends it, and when they receive social support. Believing that "people like me get screened" raises screening, while misperceiving screening as uncommon or embarrassing lowers it.

Diet interventions

Nutrition education, self-monitoring (food logs), goal setting, CBT techniques (stimulus control, cognitive restructuring), social support and group programs, family-based approaches for kids, and environmental and policy changes (menu calorie labels, school lunch standards, portion sizes, food taxes and subsidies).

Adequate sleep

Roughly 7-9 hours for adults (8-10 for teens). Supports immune function, memory consolidation, attention, mood regulation, metabolic and hormone balance (appetite regulation), cardiovascular health, and lower risk of accidents.

Sleep deprivation

Impairs attention, memory, decision making, and mood. Raises risk of accidents, weight gain and obesity (higher ghrelin, lower leptin), type 2 diabetes, hypertension, heart disease, depression, and infection (weakened immunity). Increases cortisol and stress reactivity.

Psychological and social impact of obesity

Weight stigma and discrimination (work, school, health care), bullying, low self-esteem, body dissatisfaction, depression and anxiety, social isolation, and disordered eating. Bias in health care can lead people to avoid care. (Obesity is generally defined as BMI of 30 or higher.)

Interventions for obesity

Behavioral and CBT-based weight programs (self-monitoring, goal setting, stimulus control), diet and exercise changes, family-based treatment for children, medication (e.g., GLP-1 drugs), bariatric surgery for severe cases, and public health and policy changes plus efforts to reduce weight stigma.

Treatment for smoking

Nicotine replacement therapy (patch, gum), medications (bupropion, varenicline), behavioral counseling, CBT, motivational interviewing, quitlines, and relapse prevention. Combining medication with counseling works best. Policy: taxes, smoking bans, warning labels, age limits.

Treatment for alcohol use

Brief interventions and screening, motivational interviewing, CBT and relapse prevention, support groups (AA and 12-step programs), medications (naltrexone, acamprosate, disulfiram), and inpatient or outpatient treatment. Prevention: social norms campaigns, college feedback programs, minimum drinking age, taxes, DUI laws.

Cognitive-behavioral therapy (CBT)

Treatment approach that changes unhealthy behaviors by changing the thoughts and habits that maintain them. Key components in health behavior change: self-monitoring, stimulus control, cognitive restructuring, and self-reinforcement.

CBT: self-monitoring

Tracking your own behavior (e.g., food, cigarettes, exercise) along with triggers, moods, and situations to build awareness of patterns and measure progress.

CBT: stimulus control

Changing the environment to remove cues that trigger the unhealthy behavior and add cues for healthy behavior (e.g., no junk food in the house, keeping workout clothes visible, avoiding places where you smoke).

CBT: cognitive restructuring

Identifying and challenging maladaptive or irrational thoughts ("I blew my diet, so I might as well give up") and replacing them with more realistic, helpful thoughts.

CBT: self-reinforcement

Rewarding yourself for reaching goals or performing the healthy behavior (non-food rewards for dieters, for example) to strengthen the new habit.

Transtheoretical model (TTM) stages of change

Prochaska and DiClemente. In order: (1) Precontemplation, (2) Contemplation, (3) Preparation, (4) Action, (5) Maintenance, (6) Termination (in some versions). People move through stages in a cycle or spiral, and relapse is common. Interventions should match the person's stage.

TTM: precontemplation

Not intending to change in the next 6 months. Often unaware of the problem or demoralized or defensive. Goal: raise awareness.

TTM: contemplation

Intends to change within the next 6 months. Aware of pros and cons and often ambivalent. Goal: tip the decisional balance toward change.

TTM: preparation

Intends to take action soon (within about 30 days) and may have taken small steps. Goal: make a concrete plan.

TTM: action

Has recently changed the behavior (within the past 6 months). Requires the most effort. Goal: avoid relapse, use support and coping skills.

TTM: maintenance

Has sustained the change for 6+ months. Goal: prevent relapse and consolidate gains.

TTM: termination

Behavior fully ingrained: no temptation to relapse and complete self-efficacy. (Not included in all versions of the model.)

Motivational interviewing (MI)

Client-centered, collaborative counseling style (Miller and Rollnick) that strengthens a person's own motivation to change by resolving ambivalence. Principles: express empathy, develop discrepancy, roll with resistance, support self-efficacy. Core skills (OARS): Open questions, Affirmations, Reflective listening, Summaries. Not confrontational or lecturing.

Acute vs. chronic stressors

Acute stressors are short-term and time-limited (exam, argument, public speaking, accident). Chronic stressors are ongoing and persistent (poverty, caregiving, a bad job, chronic illness, discrimination). Chronic stress is more damaging because the stress response stays activated.

Primary appraisal

First step of Lazarus and Folkman's model: evaluating what an event means for you: irrelevant, benign-positive, or stressful (harm/loss, threat, or challenge). Asks "Is this a problem for me?"

Secondary appraisal

Evaluating your resources and options for dealing with the event: "Can I cope with this? What can I do?" Stress is highest when the perceived demands exceed perceived coping resources.

Person-environment fit

Stress occurs when there is a mismatch between a person's abilities, needs, and resources and the demands of the environment (e.g., job). Good fit means less stress; poor fit means more stress and worse health.

Nervous system responses to stress

Sympathetic nervous system (SNS) = fight-or-flight arousal: increased heart rate and blood pressure, faster breathing, energy mobilized, digestion slowed. Parasympathetic nervous system (PNS) = "rest and digest": calms the body and restores homeostasis once the threat passes.

Sympathetic-adrenomedullary (SAM) system

Fast stress response: the sympathetic nervous system signals the adrenal medulla to release epinephrine and norepinephrine. Rapidly raises heart rate, blood pressure, breathing, and alertness (fight-or-flight).

Hypothalamic-pituitary-adrenocortical (HPA) axis

Slower, longer-lasting stress system: hypothalamus releases CRH, pituitary releases ACTH, adrenal cortex releases cortisol. Cortisol mobilizes energy (raises blood sugar) and suppresses immune function; negative feedback shuts the system off. Chronic activation is damaging.

General adaptation syndrome (GAS)

Selye's three stages of the stress response: (1) Alarm: fight-or-flight activation (SAM). (2) Resistance: body adapts and fights the stressor, with cortisol elevated. (3) Exhaustion: resources depleted, leading to illness ("diseases of adaptation") and breakdown.

Tend-and-befriend stress response

Taylor et al. (2000). Especially in women, stress leads to nurturing offspring and protecting others (tend) and seeking social contact and support (befriend), linked to oxytocin and endogenous opioids. An alternative to the male-centered fight-or-flight model.

Allostatic load

McEwen. The cumulative "wear and tear" on the body from chronic or repeated activation of stress response systems (allostasis = achieving stability through change). High load raises risk of cardiovascular disease, immune problems, and other illness.

Effects of long-term stress

Cardiovascular disease and hypertension, weakened immune function and slower wound healing, more colds and infections, digestive problems, increased risk of diabetes, weight gain, depression and anxiety, sleep problems, memory problems, burnout, faster cellular aging, and more unhealthy behaviors (smoking, drinking, poor diet).

Problem-focused coping

Acting directly on the stressor to change or remove it (planning, problem solving, gathering information, taking action). Works best when the stressor is controllable.

Emotion-focused coping

Managing the emotional response to the stressor (venting, seeking emotional support, reappraisal, relaxation, acceptance, distraction). Works best when the stressor is uncontrollable. Overuse of avoidance-type versions can backfire.

Process of coping with stress

Stressor, then primary appraisal (is it a threat?), then secondary appraisal (can I cope?), then choose coping strategies (problem- or emotion-focused) using coping resources (social support, money, health, personality), then outcomes, then reappraisal in a feedback loop (Lazarus and Folkman's transactional model).

Negative affectivity

Stable tendency to experience negative emotions (anxiety, anger, depression, hostility) across time and situations; overlaps with neuroticism. Linked to reporting more stress and symptoms and to some poorer health outcomes.

How negativity, stress, and illness are linked

Negative emotions and chronic stress activate the SAM and HPA systems, raising inflammation and suppressing immunity (e.g., Cohen's cold-virus studies: higher stress, more infection). They also promote unhealthy behaviors (smoking, poor sleep) and poor treatment adherence. Depression and hostility are linked to heart disease risk.

Positivity and illness

Positive emotions are linked to lower illness rates, better immune function, lower cardiovascular risk, faster recovery, and longer life (e.g., nun study; Cohen's findings that positive emotional style lowers cold risk). Mechanisms: lower stress hormones, healthier behaviors, more social support, and broaden-and-build effects.

Optimism and health

Optimists expect good outcomes. They use more problem-focused and approach coping, seek support, practice healthier behaviors, recover better from surgery, and have better immune and cardiovascular outcomes. Caution: unrealistic optimism can cause underestimating risk.

Control-enhancing interventions

Programs that give people a greater sense of control over their health or environment, improving well-being and health (e.g., Langer and Rodin's nursing home study: residents given choices and responsibility were healthier and lived longer). Examples: patient choices, information, self-management training. Too much responsibility can backfire.

Conscientiousness

Big Five trait: organized, responsible, self-disciplined, goal-directed. Linked to healthier behaviors (exercise, not smoking), better treatment adherence, fewer risky behaviors, better coping, and longer life.

Avoidant vs. approach coping

Approach coping engages the stressor directly (confronting, planning, seeking information and support) and generally leads to better outcomes. Avoidant coping disengages (denial, withdrawal, wishful thinking, substance use). It can help briefly with uncontrollable stressors but is linked to worse long-term outcomes.

What constitutes effective coping?

Coping that fits the situation (problem-focused for controllable stressors, emotion-focused for uncontrollable ones), is flexible and uses multiple strategies, relies on approach rather than avoidance, includes social support, reduces distress and arousal, restores functioning, and does not create new problems.

Outcomes of coping

Emotional well-being, physiological functioning (stress arousal and recovery, hormones), social functioning, return to normal activities and health status, and resolution of the stressor. Good coping reduces distress and illness risk; poor coping prolongs them.

Social support

Perceived or actual assistance and comfort from others. Forms: emotional (caring, empathy, reassurance), tangible/instrumental (money, services, goods), and informational (advice, guidance). Some models add esteem support and network (belonging) support. Perceived support often matters more than received support.

Why social support matters and how it works

Linked to lower mortality (Berkman and Syme; Holt-Lunstad meta-analysis), better recovery, and better mental health. Buffering hypothesis: support protects against the effects of stress. Main effect hypothesis: support helps regardless of stress. Biological pathways: lower cardiovascular reactivity and blood pressure, lower cortisol, stronger immune function, less inflammation, oxytocin release. Also encourages healthy behaviors and adherence.

When does social support help most?

When stress is high (buffering effect), when the type of support matches the need (e.g., informational for uncertainty, emotional for loss), when it comes from close relationships and is perceived as available, and when it is "invisible" (given without making the recipient feel indebted or weak). Unwanted or overprotective support can backfire.

Four changes to make care more patient-centered (Bergeson and Dean, 2006)

[VERIFY WITH YOUR SLIDES/TEXT, exact four not confirmed.] General themes of patient-centered care: (1) shift focus from provider to patient needs, preferences, and values, (2) shared decision making and partnership with patients and families, (3) coordinated team-based care and shared information, (4) patient education and support for self-management and prevention.

Patient-provider communication

The exchange of information, concerns, and emotions between patients and health care providers. Strongly affects patient satisfaction, understanding, adherence, and health outcomes.

Effective patient-provider interactions and influencing factors

Effective interactions involve warmth, empathy, listening, clear non-jargon language, eye contact, shared decision making, and adequate time. Influencing factors: provider (communication skills, bias, stress), patient (health literacy, anxiety, culture, language, age, gender), and system (time pressure, continuity of care, setting).

Why use nonperson treatment?

Providers sometimes treat patients as objects or cases (talking about them as if absent, using jargon) to create emotional distance. It helps providers cope with stress and anxiety, perform painful or intimate procedures, manage heavy workloads, and avoid burnout. But it harms communication and patient satisfaction.

Results of poor patient-provider communication

Patient dissatisfaction, misunderstanding of diagnosis and treatment, poor adherence, delayed or avoided care, increased anxiety, worse health outcomes, medical errors and misdiagnosis, more malpractice complaints, and weakened trust.

5 steps of good patient-provider communication

[VERIFY WITH YOUR SLIDES for your course's exact five.] Common version: (1) establish rapport and a welcoming opening, (2) elicit the patient's concerns with open-ended questions and active listening, (3) show empathy, (4) give clear information in plain language, (5) check understanding and agree on a plan together (shared decision making).

Best training style for communication skills in medical and nursing students

Active, experiential, skills-based training: practice with role plays or standardized patients, with feedback and observation, over time. More effective than lectures or purely didactic instruction alone.

Placebo

An inert treatment (such as a sugar pill or sham procedure) with no active ingredient. The placebo effect is improvement caused by expectation and belief that a treatment works rather than by its active ingredient.

Placebo effect: how it works and the provider's role

Mechanisms: patient expectations, classical conditioning, reduced anxiety, and brain changes (endogenous opioids and dopamine release; naloxone can block placebo pain relief). Provider's belief matters: providers who are confident and enthusiastic about a treatment communicate it verbally and nonverbally and boost patient improvement. Placebo effects are stronger for injections, larger or brand-name pills, and more elaborate rituals.

Nocebo effect

Negative expectations cause negative effects or side effects from an inert treatment (e.g., headaches or nausea from a sugar pill after being warned of side effects).

Why placebo-controlled RTCs are the "gold standard"

Random assignment balances confounds, the placebo control group accounts for expectation and placebo effects, and blinding (single- or double-blind) reduces participant and experimenter bias. Differences between groups can then be attributed to the active treatment.

Mindfulness

Intentionally paying attention to the present moment, nonjudgmentally (Kabat-Zinn). Practiced through meditation, body scans, breathing, and programs like MBSR. Works by improving attention and emotion regulation, reducing rumination, and increasing awareness and acceptance of thoughts and feelings without reacting to them.

Potential benefits of mindfulness

Lower stress, anxiety, and depression; reduced chronic pain and blood pressure; better sleep, attention, and emotion regulation; improved immune function and well-being; reduced relapse in depression and addiction.

Why is a wandering mind an unhappy mind?

Killingsworth and Gilbert (2010): people mind-wander about 47% of the time and are less happy when their minds wander, regardless of activity, and mind wandering predicted later unhappiness more than the reverse. Wandering often involves rumination, worry, and negative thoughts, so staying in the present boosts well-being.

Mindfulness in psychotherapy and addiction recovery

Therapy uses mindfulness (MBCT, DBT, ACT) to help people observe thoughts and feelings without judgment, reducing rumination and reactivity (MBCT cuts depression relapse). In addiction recovery (e.g., mindfulness-based relapse prevention), people notice cravings and triggers and "ride out" urges without acting, which reduces relapse.

Healthcare disparities

Differences in access to care, quality of care, and health outcomes between groups based on race/ethnicity, SES, gender, geography, and other factors that persist even when insurance and income are accounted for. Causes: lack of insurance and access, provider bias and stereotyping, language and communication barriers, mistrust (e.g., Tuskegee), low health literacy, and structural inequalities.