Health Psychology Midterm 2

Average life span, upper limit?

85, 122

#1 Enemy for Obesity

Portion size

Well-Behavior

Behavior that promotes health and well being

Symptom based behavior

Behavior that is a manifestation of internal distress/symptoms (sleeping more)

Sick-role Behavior

Social expectations of a person with an illness (rest, health advice adherence)

Health habits linked to each other?

No

3 Interdisciplinary Perspectives on Preventing Illness

1. Behavioral

2. Environmental

3. Preventative Medical Efforts

Primary Prevention

Actions to AVOID to begin with

Secondary Prevention

Actions to IDENTIFY and TREAT

Tertiary Prevention

Actions to SLOW or REVERSE

Individual Factors To Wellness

1. Changing long-standing habits

2. Cognitive resources

3. Self-efficacy beliefs

4. Illness/Drugs

Community Factors to Wellness

• Insufficient Funding

• Effective messaging to diverse populations

• NIMBYism

• Approach/Avoidance conflicts

Variable Reinforcement

Slot Machine

Modeling

Similar to us, Credible in their high status

Personality Linked to Health

Conscientiousness, Unrealistic optimism

Health Belief Model

Perceived seriousness, susceptibility, cues to actions, benefits vs. barriers

Theory of Planned Behavior

Intentions best predictors of deliberate behavior

Theory of Behavior Determined by What?

1. Attitudes toward specific behaviors

2. Subjective norms

3. Perceived behavioral control

Stages of Change Model

1. Precontemplation - Im fine

2. Contemplation - Aware

3. Preparation - for action

4. Action

5. Maintenance

Motivated Reasoning

• Direct cognitive processing to weigh the preferred outcome

• Confirmation bias

Weakness in Health Models Theories Don’t Account for

1. False hope

2. willingness (not intention to engage in risky behaviors)

Learning Theories of Health

• Reinforcement

• Punishment

• Extinction

• Learning Theory

Infant Health Dependent On

• Antibodies and white blood cells from Mom

• Natures Vaccine/Natural immunity

How many neonates have birth defect

3%

Teratogens

Harmful agents

ex. Maternal infections, radiation, chemical and drugs

Fetal Alcohol Syndrome

1/750 infants

Spectrum disorder

Possible low intelligence, facial deformities

Preterm

Born prior to 38 weeks gestation, less than 30 weeks in womb

Low Birth Weight

Less than 5 ½ pounds

Small for Gestational Age Infants

babies that weigh less than 90% of average

Age of Viability

Age at which pre term infant can survive (22 weeks)

Very Low Birth Weight

2 ¼ pound

Gestation and Survival

Increase with time, 27th week

Health Risk in Childhood/Adolescence

• Accidents

• stablishing identity increases health risk

• Brain changes in prefrontal cortex

• Peer pressure

• Dopamine

Adulthood changes from Adolescence

• Become less likely to adopt new behavioral risks

• Most likely to practice health behaviors

• Perceive themselves as more vulnerable to illness

Aging Demographics

• More old people alive than ever (65+)

• Fastest growing segment of pop is older than 85

• By 2050, more older than 60 than younger than 15

Why Women Live Longer

1. greater physiological reactivity

2. Estrogen delays heart disease/reduce cholesterol

3. Unhealthful behaviors

4. More likely to see a doctor

5. Work environments safer for women

Women have less health problems?

No, more acute illness

Use more medical and drug services

British vs. America

They smoke and drink more, we have more health issues

Low Social Class Health

• Very low birth weight

• Infancy death high

• Earlier signs of heart disease

• Worse overall health

• HIV and Tuberculosis

• More unhealthy behaviors

Race and Health Risks

Health ratings ranking: NA, Black, Hispanice

• Black/Hispanic vulnerable to stress from discrimination, substance abused, AIDS, and injury/death from violence

• Black and Hispanic several times more likely to die from homicide

Health Promotion: Informational

• One approach is through tailored content

Gain Frame

• Focus on attaining positive outcomes or avoiding negative ones

• Focus on prevention

• You’ll feel better and look better by eating a healthy diet

Loss Frame

• Focus on avoiding undesirable consequences

• Detection tests such as mammograms

• Not getting vaccinated puts you and others at risk for serious illness

Fear Appeals

• Too much fear is often not effective

• Moderate fear can influence when people believe they can influence their outcome (provide info on how to reduce fear

• Drunk driving

• Cigarette smoking

Motivational Interviewing

• Developed to help people overcome addictions

• Leads the client to voice arguments for behavioral change

• Attempts to get patients to recognize their unhealthful behavior

• Personalized feedback, decisional balance (pros and cons)

Health Promotion Rewards

• Must be matched to individuals

• Concrete Awards: young people

• Social rewards: As people age (monetary rewards can be encouraging)

Health promotion: Cognitive Methods

• increasing self-efficacy

• Change the way people think

• Combined with behavioral and cognitive method

Hebb’s Axiom

“neurons that fire together, wire together”

• How learning and memory happens

• behavior increase when done repeatedly

Abstinence Violation Effect

• when one slip up causes immense guilt, low self-efficacy, feeling like you failed so you might as well give up completely

School Health Programs

• best when involve community and parents long term

• Can cultivate healthy behaviors from an early age

HIV Risk Factors

1. Promiscuity

2. Intoxication

3. Youth (esp when sex orientation rejected)

4. Gay/Lesbian

5. Unmarried

6. Sexual decisions making deficiencies

7. *Mostly affects Black, White and Hispanic

HIV Prevention

• Education

• Reduce other risky behavior

• Interpersonal skills

• Training for specific skills

• Increase self-efficacy

Physical Dependence

When body has incorporated substance into normal functioning

Psychological dependence

Dependent on effect, and substances that are primarily psychologically but not physically addictive

Withdrawal

Physical and psychological symptoms that occur when substance stops or decreases

Tolerance

Occurs as body adapts to substances

Psychological Dependence Drugs

Cannabis, Cocaine (withdrawal physical is relatively mild)

Substance Use Disorder

1. Increasing tolerance

2. Wanting to cut down on use

3. Failing to meet obligations

4. Putting yourself or others at risk

5. Substance related legal difficulties

6. Withdrawal symptoms

Substance Use Disorder Diagnosis

Mild: 2-3

Moderate: 4-5

Severe: 6+

Dependence of Drugs Maintained By Reinforcement

Operant Conditioning

• Positive: rewarded

• Negative: removing averse feeling

Substance-Related Cues

Classing conditioning

1. Increases cavings

2. Activates neural pathways associated with behavior

3. Expectancies

Dopamine: Incentive Sensitization

Increases when person comes into contact with salient reminders of substance and compels them to use more

Genetics and Addiction

• MZ more likely to share addiction compared to DZ

• Different genes influence different addictions

Tobacco Advertisement

• First use Indingeous

• Tobacco advertised as healthy

• Men used to mostly buy in 1900s

• Advertisers targeted women (weight): improved the ratio in 1955

• By 2012, about half women half men (20%)

Tobacco Deaths

#1 controllable cause of death

• not because tobacco companies spend money advertising

Tobacco Who Smokes and How Much

• less than 15%

• Develop during teens

• Non-college more likely

• gender gap not huge

• socioeconomic lower more smoke

• White people smoke

• Smoke more in developing countries

Why people Smoke

• Impossible to not know effects but perceived as low risk

• Also benefits about weight gain

• Low self-esteem

• High prestige models

• Peers or family

Factors to become Regular Smoker

1. At least one parent smokes

2. Perceived parental indifference

3. Friends/Siblings who smoke

4. Thrill seeking personality

5. Positive attitudes towards smoking

6. belief that they can quit

Nicotine

Quickly to brain, central and sympathetic nervous system, carbon monoxide reduces ability of blood to carry oxygen

• Smaller half life so must smoke to maintain

• Smoke more low nicotine cigarettes than high ones to maintain affect

Smoking and Health

• Decreases life expectancy and quality of life

• Worst single health behavior

• Impairs immune function, damage lungs

• Much damage is reversible

Smoking and Cancer

• Bronchial tubes exposed to carinogens

• Annual death rat for lung cancer rose

• Nistrosamines

• PAHs

• Also increases risk of Chronic heart Disease 2-4x

• COPD: reduced airflow

Alcohol Origins

China, Middle East

Frugivory By-Product Hypothesis

Alcohol consumption is a by-product of adaptive fondness for ripe fruit (contains sugar and ethanol) Heritability for alcoholism

Temperance Movement

18th amendment, moral evil, reapplied 1933, drinking is big business

Alcohol and Age/Gender

• begins in adolescence

• HS seniors 71%

• Males generally consume more

• Greek Life: higher rates, binge drinking (70, 50% vs 42, 29)

Alcohol Use Status

51% regular drinkers

Lifetime abusers 21%

Former 14%

Infrequent %14

Binge Drinking

5 or more drinks (women =4)

Over 40% 18-25

Alcohol Abuse

• Adolescent drinkers more likely to become heavy drinkers

• 17% abusers

• Modeling

• Normative social influence

• Adolescent depression

• Positive reinforcement

• Negative reinforcement

Alcohol Moderate vs Heavy Drinkers

1. Perceive fewer negative consequences

2. Experience higher levels of stress

3. Live in environments that encourage

4. Heredity and family history

5. Specific gene pattern

Alcohol Long Term Damage

1. Decreased liver function

2. Cirrhosis

3. body and Brain damage

Drug Use by Sociocultural Factors

Same as smoking dinking

• Except: Tranquilizers, barbiturates and painkillers

• Weed: ½ HS

• Cocaine: 6% HS

Stimulatnts

• Caffeine, meth, cocaine

Depressants

• Benzodiazepines, barbiturates

Hallucinogens

• LSD, Mushrooms

Narcotics

• Opiates, morphine, fentanyl

Drug Variation Use

• more men

• Varies little by race/ethnicity

• varies by college intention

Why Kids Use Drugs

• High sensation seeing

• Prestige cues

• Normative social influence

• Positive experience increase likelihood of use

• Rebelliousness and acceptance of illegal behaviors

Drug Use Research

• Limited due to difficulties in acquiring patients

• Can say for sure: harms fetus, effect on decision making increase accident and injuries

Reducing Drug Use

• prevent first exposure

• When: adolsecne

• Why: peer usage, depression, other social/psych factors

Legal and Public Policy Approach to Drugs

• Create barrier to acess

• Limit avdertising

• High taxes

• Dui checkpoints

Family Involvement Drug Prevention

• Children in low supervision households 4x more likely to try

• Parents who assertively disapprove of drugs have kids who use less

• Parental awareness of drug and alcohol

• Teach parenting skills

Quitting Smoking w/o Therapy

Smoking viewed as deviant behavior

• Most people who quit do it on their own

• 1/2+ are successful

• Much harder for heavy smokers

• If you start when adolescence, you dont quit for another 20 years

Successful Quitters:

• Want to and are ready

• Confident about sucess

• Were light smokers

• Not experiencing high strrss

• Intrinsically motivated

• Do not see failure as permanent

• Cold turkey

Successfully Quitters of Alcohol

• Higher self-esteem

• Fewer past experiences

• Social network support

• Network members who drink less

• Around 20% successful

Treatment Methods for Drug and Alcohol

• Lowers treatment success bc both physically and psychologically dependent

• Move from contemplate to action

• Removing barrier to change

• Offering support

• External consequences

Early Interventions

• Tries to identify those at high risk

• Provide information/support

• Employee assistance programs

Drug and Alcohol Treatment Methods

• Positive reinforcement

• Coupled with other methods - reinforcement can increase success rates

• Token economy: behavior modification using operant conditions where desired behavior earns tokens (secondary reinforcers) which can be exchanged for meaningful rewards (backup reinforces)

Multidimensional Programs

Most approaches for abuse are not successful on their own

• Smoking cessation: combining cognitive behaviroal therapy with a nicotine patch

• Methadone for heroine addiction along with positive reinforcement more successful

Factors Associated With Relapse

1. Low self-efficacy beliefs

2. NEgative emotions and poor coping

3. High cravings

4. Reinforcement

5. Low motivation

6. Low social support

7. Cognitive distortions - especially in smokers

8. Weight gain - for smokers

Preventing Relapse

• identify high risk situations

• Stress training

• Practice coping skills in high risk situations

• Social support