PSY342 Exam 1

why study women's psychology, mortality/morbidity, heart disease, autoimmune disorders, cancer, menstruation/menopause + readings

health psychology

examine the influence and relationship between psychological factors (behavior, emotion, cognition, etc.) and health

what is the #1 major cause of death in men and women?

heart disease

what is a major issue in research?

women are majorly excluded from research

• our understanding of diseases is majorly of male prevalence, presentation, course and treatment

• female presentations are seen as atypical

there’s also less funding for research on diseases that more women are sick with

how do cultural forces impact the lower participation of women in exercise?

• seeing sick/frail/thin/delicate women as attractive

• attractive/modest female clothing sacrificing ease of movement (high heels, tight dresses, lonf skirts etc.)

• safety concerns of women going out to exercise alone

what is the self-fulfilling prophecy seen with women and exercise?

expectations of women being weak → barrier to sports/exercise → women don’t exercise and are weak

title IX

a law passed in 1972 that bars sex discrimination

lead to an increase in women participation in sports/education

why are women excluded from research?

• fear of hormones fucking up drug tests

• researchers fearing that women will get pregnant during clinical trials

women’s health initiative (WHI)

a series of clinical studies done over 15 years by the national institute of health (NIH)

• done to address major health issues in postmenopausal women

• discovered the real impact of hormones (endogenous estrogen protects from heart disease, but exogenous estrogen raises heart disease and cancer rates)

what changes are suggested to change the second-class treatment women receive from the healthcare system?

1. practitioners need to learn to respect all patients

2. women need to be included in research

how do women in pain get treated by doctors?

• doctors attribute their pain to hysterics and psychological causes

• thought to be complaining

• WOC are dismissed even more

gender and racial disparities in life expectancy

the average female life expectancy is longer than male

American Indian/Alaskan Native and Black life expectancy is lower than White expectancy, while Hispanic and Asian life expectancy is higher

racial disparities in maternal mortality

American Indian/Alaskan Native maternal mortality is the highest

Black/Hispanic maternal mortality is higher than White

Asian maternal mortality is the lowest

morbidity

rates of people living with an illness

has been increasing over time, as less people are dying and living to older ages

women have higher morbidity rates than men

sex differences in morbidity

• women perceive their subjective health (perception of one’s own health) as worse than men

• women use healthcare more than men

  • boys use healthcare more than girls, but this reverses in adolescence

• women have higher morbidity rates

biological explanations (gender differences in mortality/morbidity)

• extra X chromosome gives females a chance to become recessive for a genetic disease

• estrogen thought to be a protective factor

• women thought to be more resistant to infections than men

  • however, they’re more vulnerable to autoimmune diseases

artifact explanations (gender differences in mortality/morbidity)

artifacts are factors that might cause a “fake” difference in health

• healthcare providers respond to female patients different than male patients

who is more likely to be prescribed psychological drugs and why?

female patients, due to:

• more psychological distress in females

• doctors attributing women’s complaints to psychology

• women requesting psychological drugs more

• men being under-prescribed psychological drugs

smoking explanations (gender differences in mortality/morbidity)

• men are more likely to smoke

• smoking causes more damage to the lungs for women than men

• women are less likely to quit smoking when they start

what is heavy alcohol use associated with?

• a variety of diseases (heart disease, cancer, cirrhosis, etc.)

• aggressive behavior leading to death

  • drunk driving, suicide, homicide, sexual assault

• economic/social consequences (losing a job, losing a relationship, etc.)

• physiological consequences

  • alcohol usage causes more damage to women’s livers

alcohol use explanations (gender differences in mortality/morbidity)

alcohol use is more diagnosed in men

antidepressant explanations (gender differences in mortality/morbidity)

men use more drugs than women at all ages (except antidepressants, tranquilizers, and sedatives)

women use those 3 drugs more often

obesity/overweight explanations (gender differences in mortality/morbidity)

obesity is a risk factor for heart disease and cancers, and predisposes one to other risk factors

the economic/social consequences of obesity are more damaging for women than men

• e.g. higher risk of poverty

exercise explanations (gender differences in mortality/morbidity)

exercise is important in reducing risk of many diseases

women, especially WOC, are less likely to engage in physical activity than men at all ages

• women are also more prone to gain weight during marriage, after childbirth, and during menopause

why do women survive better than men?

• onset of disease: men tend to have earlier onset of diseases

• women’s immune systems are better built and are more intense

• women don’t die from sickness/illness as easily

medical gaslighting

term used by patients who felt their symptoms were inappropriately dismissed as minor or primarily psychological by doctors

• experienced more by women, especially WOC

mediators

kind of middle “middle ground” factors that help explain the effect of one variable on an outcome

• e.g. the mediators between psychological factors and cardiovascular disease are physiology and health behaviors

how does age affect heart disease?

the incidence of heart disease increases with age

• this increase is greater for women in menopause

factors that affect cardiovascular health

• family history

• obesity (stronger impact on women than men)

• smoking (stronger impact on women than men)

• estrogen (cardio-protective factor)

estrogen impacts on women

estrogen is a protective factor of heart disease, but a risk factor for breast cancer

due to women in menopause getting heart disease more, women were prescribed estrogen pills

• not until a study revealed that exogenous estrogen does nothing for heart disease and increases the risk for breast cancer did the pills get pulled off the shelves

psychosocial risks of heart disease

• stress

  • high-damnd jobs, and especially if there’s work waiting for them at home, is the riskiest schedule to have

• hostility

• social isolation

• depression

• lower SES

  • has an inverse correlation with cardiovascular disease cross-culturally

men physiologically react higher to stress than women, which might explain the higher prevalence of heart disease in men

hostility

a stable tendency to become angry

• raises risk of cardiovascular disease by the following:

  • health behaviors: more caffeine, tobacco, substance, and calorie consumption

  • physiology: high levels of stress hormones + higher reactivity to stressors

racial disparities in hypertension

in the US, black populations have more prevalence of hypertension

• this isn’t seen in African populations, so it’s just the US being it’s racist thing

gender disparities in symptom/diagnosis of heart disease

symptoms

• women have different symptoms of a heart attack than men

  • most common symptoms are extreme/unexplained fatigue, shortness of breath

• results in:

  • women delaying seeking help during a heart attack

  • doctors delaying in examining women + less likely to refer them to the hospital

diagnosis:

• a lot of tools used to diagnose CVD were originally designed for men and are not as effective in women

gender disparities in treatment of heart disease

men: most commonly treated surgically

• due to:

  • women’s hearts being smaller in size and harder to operate on

  • depression is common in women following a heart attack, which makes surgery recovery harder

women: most commonly treated pharmacologically

cardiac rehabilitation

programs focused on promoting positive health behaviors following CVD

• women are less likely to be referred to and stay in these programs

there are cardiac rehab programs specific to women

• women are 3x less likely to die in these programs

autoimmune disorders

disorders where the immune system acannot differeniate between the self and non-self and attacks body’s own cells

• e.g. multiple csclerosis, lupas, rheumatoid arthritis, etc.

why are autoimmune disorders challenging?

• difficult to diagnose properly

• unpredictable and unique symptoms

• autoimmune disorders are progressive + not curable

• the treatment side-effects are hard to cope with

• many people are unfamiliar/uninformed about them

etiology

study of the cause of the disease

epidemiology

study of the spread of the disease

gender disparity in autoimmune disorders

a lot of women have these disorders

• they are thought to be caused by hormones or the menstrual cycle (women who have less pregnancies are more at risk for autoimmune disorders)

age of autoimune disorders

autoimmune disorders tend to strike in mid-life (30s-50s)

• can lead to harmful stigmas about people with autoimmune disorders in their midlife not being able to perform

are autoimmune disorders genetic or environmental?

thought to have a genetic contribution that is triggered by environmental factors

stress can exacerbate autoimmune symptoms, as we know that stress suppresses the immune system

issues in patient/physician interaactions in autoimmune disorders

• studies show providers often don’t cooperate with/believe/trust female patients and their complaints

• the assumption that the provider is more knowledgeable is ineffective for getting a diagnosis

  • women who ask a lot of questions/complain a lot seen as uncooperative

how do autoimmune disorders impact work/family roles?

men:

• more likely to return to the workforce

women:

• experience higher divorce rates than men

how to autoimmune disorders affect body image/sexuality?

• autoimmune symptoms affect pateint’s appearance and mobility

• treatments often lead to weight gain

• sexual dysfunction as a result of the disorder

how do poverty and stress affect autoimmune disorders?

conditions from being in poverty can exacerbate symptoms, such as:

• stress from limited finances

• uncontrollable events + daily hassles

• unsanitary living/working conditions

• less access to good healthcare

how does social support affect autoimmune disorders?

social support is good for:

• mental health

• practical help (taking care of responsibilities, transportation to appointments, etc.)

some social support groups exist for autoimmune disorders, but they are predominantly white and middle/upper class

• excludes minorities

posiitve reappraisal

focusing on finding something positive within a bad situation

a strategy uadherence in autoimmune disorderssed by autoimmune disorder patients

adherence in autoimmune disorders

adherence is difficult in autoimmune disorders because of:

• complex ass instructions

• multiple prescribed medicines

• many appointments/referraks

• need to change to lifestyle

belief systems like fatalism can also make adherence harder

fatalism

a belief system that everything that happens to a person, good or bad, was meant to be

can made adherence to treatment of various diseases hard

cancer

the rapid and uncontrolled multiplication and spread of abnormal cells

theres many types of cancers and a lot of variability in how they interact/are caused

what is the most common type of cnacer among women?

breast cancer

which cancer is responsible for the most deaths?

lung cancer

which health behaviors would cause a reduction in 50% of cancer deaths?

• stopping the use of tobacco

• limiting exposure to second-hand smoke

• limiting heavy alcohol use

nutrition-related health behaviors related to cancer

• obesity increases risk

• unhealthy/poor diet includes ovarian hormones, which could be a mediator to getting cancer

• staurated/animal fat is a risk factor

  • meanwhile., omega 3 fats/fiber are protective of cancer

natural killer cells

cells in the body that control tumor growth

high stress + insufficient social support = lower levels of these cells

greater emotional support = higher levels of these cells

what is the hormone theory of cancer?

this theory states that the total number of ovulatory cycles a woman has determines her risk for breast cancer

• because every cycle, the breast tissue is flooded by ovarian hormones

evidence for this theory is the following women have higher incidences of breast cancer:

• women whos tart menstruating earlier

• women who enter menopause later

• women who have few/no children

what are the 2 genes that contribute to breast cancer?

BRCA1 and BRCA2

these 2 genes contribute to the genetic factor of cancer, but only 10% of people with these genes actually develop breast cancer

• suggests that the environment plays a big role

human papillomavirus (HPV)

a virus that causes cervical cancer

gender disparity in cancer incidence

women were always at a lower risk of getting and dying of cancer

gender differences in lifestyle/behavior contributing to cancer

• work and stress (women have second shift at home

• discrimination (ssexism for women)

• risky behavior (men more likely to engage in this)

• sunscreen (more women use)

• eating patterns (men eat more high fat, women eat more vegetables/fruits)

culture

shared understandings of food, activities, values, attitudes, etc.

• culture impacts health behaviors and risk factors

gender disparities in poverty

women are more likely to live below the poverty line than men

• affects their access to medical care and other high-cost things

racial differences in health behaviors health behaviors affecting cancer

• white women tend to use more alcohol

• Native American + white women smoke more

• African-American and white women consume more fat

  • white women c

how does immigration affect cancer risk?

immigrants who come to America adopt American diets which is hella unhealthy and bad

• e.g. latin-american/Asian women have healthier diets before adopting America’s

how does poverty affect cancer rates?

• lower paying jobs associated with exposure to carcinogens

• lower access to good medical care

• less education associated with more obesity, less exercise, and more smoking

some reasons why heart disease is different for women?

1. heart attack symptoms more subtle (women less likely to experience straight up chest pain)

2. women have many different types of heart disease

3. women patients take longer to get to the hospital

4. everyday stress affect women’s hearts more

5. doctors are less likely to dicuss women’s heart risks

6. tools don’t work as well in women (e.g. implanted defibrillators)

why do women delay seeking shelp for their heart attack symptoms?

• obscure symptoms (not straight up chest pain)

• belief that women aren’t as vulnerable to heart attacks as men

• women having heart attacks later in life

social gradient

the trend of mortality/morbidity increasing as social status decreases

what were 3 health strategies valued by women in that one reading we did about how women are treated with heart disease?

• supporting give and take in relational connections

  • being listened to = good

• identifying/acknowledging unique health-promoting behaviors

  • providers dismissed how maintaining housework could be beneficial for patients

• focusing on empowerment

  • being dismissed in the health care system reinforced sex discrimination women face

  • zon’t zo it

according to the readings, what were some of the theories for the sex discrepancy in autoimmune disorders?

• X chromosome has more genes related to autoimmune functioning

• women have smart af immune systems to fight antigens without killing a fetus

  • placenta makes powerful anti-inflammatory hormones

• sedentary lifestyles cause this

• complex interactions of all of these combined

what is the relationship between age and cancer?

as one gets older, the risk fo contracting most cancers increases

• health behaviors performed early in life can increase or decrease this risk

what is the relationship between depression and cancer?

depression + symptoms are common in people with cancer

• a lot of MDD criteria and cancer treatment side-effects overlap, making diagnosing hard in patients with cancer

• depression can lower adherence to treatment

in what 3 parts of life is anxiety common for people with cancer?

1. when waiting for test results/to receive a diagnosis

2. when in active cancer treatment

3. when a person with cancer is in remission

how do women adjust to life after finishing cancer treatment?

after around 2 years, women who completed treatment have similar quality of life as to people who didn’t experience cancer

yippie

common physical symptoms of cancer/treatment?

• fatigue (recall the coined term “cancer fatigue”")

• insomnia

• physical pain (especially after surgery)

sexual-reproductive concerns of cancer

• cancer treatments can cause women to enter menopause early/become infertile

  • poses concerns about having children, especially since cancer in younger women has been on the rise

social effect/influences on cancer

• cancer declines the amount of social relationships women have

• women get good social support during the beginning stages of cancer, but that support deteriorates over time

  • and we know social loneliness is a risk factor and not good

• a cancer diagnosis affects not only the patient but everyone in her close circle

benefit finding (post-traumatic growth)

phenomenon of people who experience cancer to find positive things during their diagnosis/treatment

• e.g. being more grateful, finding relationships to be more meaningful/pleasurable, etc.

what are the most adaptive ways of coping with cancer?

• problem-focused coping: focusing on the problem itself

• accepting the reality of one’s situation (not avoiding/denying diagnosis)

• expressing cancer-related emotions

pap smear

a preventative screening tool for cervical cancer

mammogram

a preventative screening x-ray of the breasts for breast cancer

what are the 3 stages of prevention as described by Dr. Iris Granek?

• primary prevention

  • health behaviors, vaccinations, preventative meds like folic acid supplements for pregnant women

• secondary presentation

  • early detection via screening

• tertiary prevention

  • preventing further negative effects of the disease

arrythmias

irregular heartbeats

• stroke is a risk factor for this

• a type of heart disease

stroke

a type of heart disease where there’s a blood clog in the brain, preventing circulation in the brain

2 types:

1. embolic stroke: which is a clog

2. hemorrhagic stroke: a weakness in the blood vessel

coronary heart disease (CHD)

type of heart disease where there’s a buildup of plaque in the coronary arteries, leading to shitty circulation of stuff to the cardiac muscle and surrounding tissue

what are the risk factors in the female body of heart disease?

• smaller blood vessels

• caregiver responsibilities delaying prevention/treatment for heart disease

what is the #1 cancer killer in men and women?

lung cancer

what is the most prevalent form of cancer among women?

breast cancer

gender disparities in heart attack diagnoses and deaths

men:

• have higher prevalence of heart attacks (diagnosed)

women:

• have lower prevalence of heart attacks (diagnosed)

• more likely to die from a heart attack

  • due to being diagnosed older

what does the reading Psychology, men, and cancer suggest to reduce population-level differences?

population-level differences call for population-level interventions

• also, making sure these interventions are gender non-specific

• e.g. societal ban on smoking indoors to reduce lung cancer

menarche

the onset of menstruation in female bodies

usually around 12-13 years of age on average

what is a recent trend we’ve been seeing around the world regarding menstruation?

the age of menarche, amount of people with irregular cycles, and development of secondary sex characteristics (e.g. breasts) is decreasing

• a substantial # of girl bodies are starting to menstruate before 11

• especially for WOC and girls of lower SES

what are some of the reasons for the trend of earlier menarche happening around the world?

• exposure to hormonal disruptors (from poor diet, BPA/chemicals in plastic, etc.)

• rising obesity rates

• exposure to sexualized stimuli

• stress (chronic, discrimination, trauma, abuse, etc.)

how does early menarche impact attitudes of the person menstruating?

insufficient preparation for starting their period + having an earlier menarche → girls having more negative attitudes towards their periods → leads to more physical symptoms during menstruation

PMS (premenstrual syndrome)

there is no consensus on how to define PMS, what its causes are, what the treatments are, or whether it really exists

the idea of “PMS” is separate from physical symptoms of abnormal menstruation, such as dysmenorrhea and endometriosis

dysmenorrhea

painful menstruation; NOT PMS!

endometriosis

chronic disease where endometrium (uterus tissue) is found outside the womb

• associated with very painful menstruation

• no definitive etiology (cause)

how do studies define PMS?

negative emotions, behaviors, and sometimes physical symptoms happening only during the luteal phase