Studied by 1 personWhat is health psychology?
One of the most multidisciplinary fields in psychology.
3 broad fields
Health behavior & prevention
Stress and illness
Psychological impact and management of illness
What are the three broad questions of health psychology?
How do people behave when they become ill?
Why do people become ill?
How do people stay healthy?
When was the field of health psychology established and recognized?
Formed in 1978, but physical health was not officially recognized as an outcome until 2001.
How have different historical civilizations viewed illness and health (be able to identify cause of illness and treatments of the stone age, ancient Greeks, Middle Ages, renaissance, and post-renaissance).
Stone Age (Before 200 BC)
Evil spirits cause illness
Mind & Body connected —> mind causing the body to fail.
The cure was releasing the evil spirits
Ritualistic treatments—> Trephination (Small holes in the skull
Upwards 90% of people survived
Ancient Romans & Greeks (200-500 BC)
Hippocrates & Humoral Theory
Illness caused by the body
A body out of balance
Balance of 4 humors/fluids (blood, black bile, yellow bile, and phlegm).
Severity based on how off-balance
Treating imbalances through memetics, bloodletting, laxatives, and special diets.
Mind and body were suggested to be connected
Hippocrates was a pioneer in the field of health psychology.
Middle Ages (476-1500)
Illness was the wrath of God.
The plague was sent to rid the Earth of bad people.
Cure through prayer and being a good Christian.
Renaissance (1300-1600)
Illness caused by the physical body
Explicit separation of the mind and the body.
Vesalius and Descartes
Mind not governed by the laws of nature, but the body is (dualism).
Believed the mind and body could interact through the pineal gland and influence each other.
Post-Renaissance (1600s Onward)
Microscope’s invention (and many other inventions).
Cellular and germ theories of disease.
The mind became ignored in treatment and focused on the body (biomedical model).
Biology was the basis for illness.
Be familiar with the figures that we discussed and their contributions - Hippocrates, Freud, and Flanders Dunbar.
Hippocrates
Humoral Theory
Sigmund Freud
Questioned biology as the sole basis for illness.
Psychoanalysis
Conversion hysteria
Repressed issues manifesting as physical symptoms
Helen Flanders Dunbar
Explored the connection between the mind and the body. (specifically the organic changes such as emotion—> illness).
Based more on the conscious than Freud’s theory.
Compare and contrast the biopsychosocial model and the biomedical model; be able to answer such questions as how do they see health/illness? And how might a researcher operating from these two different perspectives investigate a research question?
While the biomedical model emphasizes physical factors, the biopsychosocial model integrates biological, psychological, and social dimensions. Researchers must choose their approach based on the research question and the complexity of the phenomenon they aim to explore
According to the biomedical model, diseases are disruptions in bodily functions, and treatment aims to restore these functions. Investigated by studying biological mechanisms and processes.
The biopsychosocial model explores multiple dimensions through methods such as surveys, interviews, observational studies, and psychosocial interventions.
How has health psychology expanded the definition of psychology?
Investigates the relationship between physical symptoms and pathologies. Health psychology extends psychology’s reach beyond cognition and behavior, emphasizing the interconnectedness of mind, body, and social context in understanding health and illness.
What is an experiment? Know what random assignment is and why it is used. Know definitions of a dependent variable and independent variable. What is the primary advantage of experiment?
Experiments are the best way to test research questions. They let us determine cause and effect through controlling manipulated variables.
Dependent Variable: Measured
Independent Variable: Manipulated.
Random assignment ensures that incoming differences among participants will be equally distributed. Everyone has equal opportunity to be in either group.
What is a randomized controlled trial? How does this type of experiment differ from a laboratory experiment?
Randomized controlled trial is considered the “Gold Standard”. Differs by prospective measures, extensive baseline assessments, and commonly used for medicine and behavioral treatments.
Test within subjects and/or between-subjects differences. Follow the same subjects closely over time, usually a lengthy period. Random assignment to conditions. All aspects of the participants are identical, except the IV. Blind Study (possibly double-blind).
What is a placebo effect? How do researchers control for this?
Placebo effect—> inconsistent, but believing is seeing; self-fulfilling prophecy.
Control groups allow researchers to control for this.
What is attrition?
Losing participants when you follow up.
Why are experiments sometimes not possible in health psychology?
Unethical, unsafe, or impossible to randomize/control for certain aspects. (Can’t apply participants to anxiety or depression conditions when they don’t have that disorder).
What is a correlation? Be able to identify + vs - correlations. What is the primary disadvantage of correlation?
A correlation demonstrates a relationship between two variables. Positive correlations indicate a relationship where both measures move in the same direction. Negative correlations indicate a relationship with contradicting patterns of results.
While correlation provides valuable insights, it cannot establish causation or account for all factors influencing the relationship between variables. Researchers must exercise caution and consider additional evidence before drawing causal conclusions
What is cross-sectional, prospective, and retrospective research?
Prospective studies provide strong evidence but require long-term follow-up.
Retrospective studies are more feasible but may suffer from recall bias.
Cross-sectional studies offer quick snapshots but need cautious interpretation.
What is a meta-analysis?
meta-analysis aggregates findings from diverse studies, enhancing our understanding of research questions and shaping evidence-based practices.
What does research comparing mortality rates in the 1900s to 2000 show?
Advancements in healthcare, disease prevention, and public health initiatives have contributed to the remarkable increase in life expectancy and the decline in mortality rates over the past century. Previously, people were more likely to die from illness such as the flu or a sickness. Nowadays, people are more likely to die from chronic illnesses or cancer.
What does Taylor mean when she says health behaviors are independent? Is there evidence for this? (e.g., what did Newsom et al. (2004) do and find?)
Health behaviors are independent
“Health behaviors are, at best, modestly correlated” (Taylor, 2017)
This means that the practice of one health behavior does not relate to the practice of another.
The independence and instability of health behaviors
There is variability among people
There is variability within persons
Natural factors across a person’s lifetime influence health behavior
The factors that control a health behavior may change.
Meta-analyses are the best papers to review for literature in research.
Health behaviors are unstable
The best example of this is relapse
Within the first 6 months of initial behavior change, what are the rates of relapse for addictive behaviors?
The rates are very high: 50-90% of people relapse in the first 6 months of making a change.
What is a health behavior?
Enhancing/Maintaining Health
What is a risk behavior?
Harming Health
What is a habit?
Firmly established behavior performed automatically. Automaticity.
At what age do health behaviors stabilize?
Health habits develop and stabilize around 11-12 years old.
What is a teachable moment?
Teachable moments are opportunities/times in life where one is particularly open to learning (new) health behaviors. Most of these moments occur during childhood. During adulthood, teachable moments often surround major events.
What is a window of vulnerability?
Windows of vulnerability are huge for adolescents. College is an example of a window of vulnerability. In summary, recognizing and addressing the window of vulnerability in adolescence is crucial for promoting healthier behaviors and preventing future health risks
Be familiar with the overall conclusion of the meta-analysis by Newsom et al. (2004)
According to Taylor, what are relapse rates for addictive behaviors within the first year following change?
The rates are very high: 50-90% of people relapse in the first 6 months of making a change.
What are four conditions under which people may be most likely to relapse?
What factors are most important to the likelihood of relapse?
Low self-efficacy
Negative affect/mood - guilt, shame, sadness, anxiety, and boredom
Stress and coping
Lapses
Social support (family and peer relationship - are they supportive or detrimental?)
Anticipation of future outcomes
Define attitude. When will attitudes be most likely to predict behavior?
Attitude
An attitude is a belief or feeling that predisposes a response.
Your attitude towards exercise…
Behavioral processes
Affective processes
Cognitive processes
Be able to answer questions about the following theories, especially what are their main factors influencing behavior: The Health belief model, Theory of planned behavior, Social cognitive theory, Transtheoretical model of change, Prototype willingness model
Theory of Planned Behavior (TPB)
The best way to predict behavior is through behavioral intentions
Intention: What they plan to do.
Behavior intentions are shaped by:
Attitude toward behavior
Subjective norms
Perceived behavioral control- the expectation that one can successfully perform the behavior.
There is much empirical support for TPB
Predicts taking medication, exercise, eating behaviors, condom use, cancer screening, etc.
How does empirical support compare to HBM?
Intention is much more strongly correlated with behavior than perceived risk in meta-analyses
Health belief model (Becker, 1974; Janz & Becker, 1984)
Two factors determine health behavior
Perceived health threat of some negative event
Risk perception
Severity
A belief that doing behavior can effectively reduce the threat
The belief that behavior itself can reduce the threat
The belief that the benefits of doing behavior outweigh the costs
In general, there is good support for this theory, including meta-analyses
Mostly a preventative model meaning predicts preventative behavior decisions; it is less likely to predict whether someone would start smoking
Of all of the different factors studied, perceived risk predicted highest(?)
HBM views perceived health threat/perceived risk as central, however…
What do interventions to increase perceived risk show?
In addition, studies (including meta-analyses) show only moderate associations between perceived risk and intentions
This has been a problem for the model
Researchers have argued that the HBM has focused too much on cognitive measures of perceived risk and not enough on the affective measures of risk
The over-emphasis on cognition may lead to a seemingly low correlation.
Acknowledging risk allows better predictions of behavior
Social Cognitive Theory (SCT; Bandura, 1988, 2006)
Behavior is an interaction between personal qualities and the environment
Vicarious Learning: We can learn (behaviors) through watching others (it doesn’t have to be a physical presence, it could be through media).
When is this learning more likely to occur?
When the behavior is new
When we perceive the person we’re observing as similar to us.
Self-efficacy is essential: How might vicarious learning increase self-efficacy?
Watching the behavior makes you more confident that you can perform it (too)
Making information more apparent
Shows ways people can get over/through setbacks
Other ways of increasing self-efficacy
Through verbal persuasion
What well-known program is based heavily on SCT?
Alcoholics Anonymous
Transtheoretical Model
TTM also known as the Stages of Change
Originally developed to treat addiction-based behaviors
People go through distinct stages or degrees of readiness to change
Recognizes change as a process that unfolds over time.
Individuals may go through stages several times
Linear but when relapse occurs, they may skip some stages.
Stages of change assessed based on a set of responses to categorical and continuous measures
Five stages: precontemplation, contemplation, preparation, action, and maintenance.
Precontemplation
Consciousness-raising
“Are you seriously intending to change the problem in the near future, within the next 6 months?”
No
Contemplation
Decisional Balance
Self-efficacy
“Are you seriously intending to change the problem behavior in the near future within the next 6 months?”
Yes, but have made no actions
Preparation
Forming specific plans (Ex: Setting a quit date)
“Are you seriously intending to change in the next month?”
Yes
Action
“I am really working hard to change.”
Not permanent change; why?
Only has been 6 months at most
High relapse rates
Maintenance
“I may need a boost right now to help me maintain the challenges I have already made.”
Being free of the behavior for 6 months or longer
The possibility of relapse is still present.
Termination
Zero urge to do a behavior
Most people are not successful on their first try/cycle; They will relapse and recycle
Be familiar with the following techniques of cognitive-behavior therapy: monitoring, cognitive restructuring, reinforcement strategies, role playing
Cognitive Behavior Therapy (CBT)
It is a popular treatment that has been successful for people with depression, anxiety, and other conditions as well.
Based on the idea that:
People have learned behaviors that can be bad for them (risky behaviors) there are conditions of these behaviors that reinforce and maintain these behaviors. These behaviors are associated with automatic thoughts. The thinking is often negative and reactionary. If you can change the pattern of thinking, you can change the behavior.
Self-Monitoring
Identify a target behavior; then monitor for quantity (how often the behavior is performed/desired) and quality (experience surrounding the behavior).
For example, an individual who wants to change unhealthy eating habits keeps a journal for 2 weeks and records thoughts and experiences surrounding this behavior.
Cognitive Restructuring
Modify or change thoughts relating to the behavior; many techniques; distraction, thought suppression, counterarguing.
Role Modeling
Reinforcement; Operant conditioning principles (B. F. Skinner)
The distinction between positive and negative
Positive reinforcement: Giving yourself something pleasurable so the behavior occurs again (tangible or intangible)
Negative reinforcement: Removing something aversive to make the behavior likely to occur again.
The distinction from Punishment.
Punishment is giving something aversive or negative (or taking something reinforcing away) to reduce behavior.
Punishment rarely works by itself (add reinforcement).
Learned associations; Classical Conditioning principles (Isaac Pavlov)
The earliest health behavior interventions were based on this learning
E.g. Antabuse (medicine to make people sick when they have alcohol).
You are pairing something you love with a new behavior (e.g., “temptation building”).
What is a stressor?
Stressor - A demanding event or situation that triggers coping or adjustment.
What is a stress moderator?
What are the physiological effects associated with sympathetic arousal?
Sympathetic arousal stimulates the adrenal medulla to release hormones
Catecholamines —> fight or flight hormones
What is the SAM system? HPA system? What are distinctions between them?
This is the first part of the stress response, known as the SAM: sympatho-adreno-medullary pathway
HPA axis: The hypothalamic-pituitary-adrenocortical axis is the second part; it involves the hypothalamus, pituitary gland, and adrenal cortex.
Described as a negative feedback loop
It doesn’t really shut off (read about it in the book *)
Helps the body cope with stress by releasing glucocorticoids
I.e., cortisol (the most studied hormone on stress; elevated cortisol indicates chronic stress)
Some distinctions…
First part (SAM) vs second part (HPA)
One is instantaneous (SAM) and the other is not (HPA)
We can relate to this in a physical bodily sense
SAM is the gas pedal —> gives you a burst of energy
HPA is cruise control —> allows you to be on high alert while keeping energy
After stress passes the parasympathetic nervous system (the brake) then dampens the stress response
What is appraisal? How does it not fit with Hans Selye’s model? When did researchers discover the importance of appraisal?
Appraisal
The process by which a person both perceives and responds to events that are judged to be stressful.
Appraisal will influence one’s response to stress or their stress experience.
Explains why two people react differently to the same stressor.
Be familiar with different stages of general adaptation syndrome.
Hans Selye’s (1974, 1976, 1987) General Adaptation Syndrome
Known as the father of modern stress theory
Stress was “the non-specific response of the body to any demand upon it”
What did he mean by non-specific?
It didn’t matter what type of stressor it was, if it was a stressor, the body would react.
Argued that over time stressors lead to “wear-and-tear”
Alarm reaction
Shock and counter-shock
Shock —> huge surge in epinephrine
Counter-shock—> rise in cortisol to resolve the stressor
Recovery from shock if they overcome it
Resistance
Where other processes are affected
I.e., digestion, reproduction
When the stressor is more long-term
The symptoms of the alarm reaction disappear and it almost looks as if the organism has adapted to the stress. In reality, the organism is still actively fighting the stressor.
Exhaustion
Cannot fight the stressor any longer
Where tissue and cell death can occur
Impossible for the organism to have a stress response
Physical consequences of stress
I.e., stomach ulcers, shrinking of lymph glands
Selye was one of the first to suggest that stress and illness may be related via psychology
He found that prolonged and repeated exposure to stressors led to physical damage; stress response became depleted
What big idea was being suggested?
Speculation of appraisal
But both Cannon and Selye…
Define the transactional model (Lazarus & Folkman, 1984); Describe each of the three steps.
Transactional model (Lazarus & Folkman, 1984).
When an event creates a challenge, we…
We interact with the environment and we make adjustments (transactions)
Appraisal is a necessary component of stressful experiences.
Lazarus & Folkman’s (1984) transactional theory of stress and coping is remarkable and remains the cornerstone of psychological stress and coping research across multiple fields.
Three step process
Primary appraisal: Does this mean trouble? Interpreted as one of three things: irrelevant, benign/positive, potentially negative (leads to secondary appraisal only when potentially negative)
Secondary appraisal: Can I cope with this? Controllability is a big factor here. (Also can be influenced by mood and resources)
(Third step) Responses to stress: physiological, behavioral, cognitive, and emotional responses.
What is cognitive reappraisal?
Cognitive Reappraisal
Transaction model’s important messages
Events themselves are not inherently stressful
Appraisal is vulnerable to the characteristics of the person
Appraisal can be powerful just by itself
Characteristics that increase the likelihood
Significant Resources- if an event takes a lot of our energy, time, and money, it will lean into being more stressful
Negative vs positive events
Controllability
What are three examples of acute stress paradigms? What outcomes do researchers measure in response to these stressors?
Acute stress paradigm
The Trier social stress test
What is it
People are asked to give a speech on their weaknesses while people give negative feedback with body language
Then move to a numbers task where an experimenter yells at them
Within 30 mins your cortisol levels double
Examples
Cold pressor task
Shocks/Threat of a shock
Why might it be important to look at how people respond to stress in the lab?
Better than self-reports
Measures reactivity
Two primary outcomes assessed
Psychological distress
Reactivity
Change in the autonomic or endocrine system
I.e., a rise in blood pressure
What is chronic stress? Provide examples of ways researchers have studied chronic stress.
What is caregiver burden? Under what conditions will caregiving be especially likely to lead to burden?
Caregiver burden refers to the high level of distress experienced by those caring for close others who have a chronic illness
What physical outcomes have caregiver burden been linked to
High blood pressure
High levels of cortisol
Faster heart rate
Most consistently linked with depression
Many medical personnel ignore the caregiver
Janice Kiecolt-Glaser has long studied caregivers and caregiver burden
She pioneered the wound healing paradigm tested in caregivers.
Conditions
Emotional impact: affected emotionally by the patient’s illness, with worry and frustration being most common emotions reported•
Daily activities: involved aspects of caring, including helping with dressing, personal hygiene needs, assisting with mobility, and providing food.
Many reported feeling a burden from caring for the patient, and feeling they had no freedom or time to enjoy their interests.•
Family relationships: affected relationships among family members; felt that they had to be with the patient all the time to care for them and notable to spend time with other members•
Sleep and health: Sleep loss was caused by worry and by having to wake to help the patient for personal hygiene needs or medication. Several developed depression.•
Holiday- not being able to go on vacation.•
Involvement in medical care and support given to family members: described lack of support from friends and other family members; felt others did not understand what they were going through and many found it difficult to talk about the patient’s illness
How have researchers linked caregiver burden to reduced immunity? For example, what did Kiecolt-Glaser (1995) do and find?
Caregivers healed the wound much slower than control conditons and people under less stress.
What is the outcome that caregiver burden has been most consistently linked to?
Depression
What characteristics have been identified as increasing chronic stress at work? Be able to define and provide examples of control and demand.
The worst combination in terms of job strain is low control and high demand.
This combination is linked with elevated levels of stress hormones, poorer psychological health, and physical health symptoms, some stress-related diseases like cardiovascular disease, and risky behaviors.
What is the main idea of the Allostatic load (AL) model? Be familiar with the four patterns of AL and examples of each.
The Allostatic Load model - a contemporary framework that helps us understand how chronic stress increases our likelihood of illness
Explains the paradox of the stress response; what paradox?
The inconsistency or incompatibility
How is the model related to Selye’s
Allostasis
Literal meaning and extension of the concept of homeostasis
Refers to the body’s reaction
Allostasis is “reliably flexible”; Why is this important?
Can deal with stressors big and small.
Can deal with all sizes/forms of stress.
Allostatic Load
The cumulative physiological wear and tear that results from repeated efforts to adapt to stressors
Refers to the normal allostasis process being dysregulated
Selye did not account for the appraisal
The Allostatic load model gives much attention to moderators
Cognitive and behavior can moderate the allostatic load-disease relationship
Also… genetics.
Stress response turned on/off frequently, lack of habituation, stress response does not shut off, and insufficient response.
Define chronic illness.
Chronic Illness
Illnesses that are prolonged, do not resolve spontaneously and are rarely cured completely.
Prolonged: lasting 12 months or longer or being expected to last 12 months or longer
Approximately, how many adults in U.S. have a chronic illness? Why might the number be an underestimate?
How many Americans (adults) have a chronic illness?
50-60% of people
1 in 2 or 6 in 10
Have also gone up in children
30% of kids
This could be an underestimation
Comorbidity: two or more illnesses (about 20% of people)
Who is disproportionately affected?
Women and minorities
Part of that is related to SES. More likely to have less money to go to the doctor’s office.
Women also have more misdiagnoses (despite women living longer)
Women are more likely than men to have chronic illnesses
Which chronic illness is responsible for most early mortality today? Which chronic illness is responsible for most disability?
Consequences of Chronic Illness
Mortality - responsible for 7 of the top 10 causes of death in the United States each year. (Cancer and heart disease are the most prevalent)
Disability - limitations in one or more major life activities; major life activities are considered work, self-care, and taking care of dependents
Arthritis is the most disabling.
How do psychologists define adjustment to chronic illness?
Adjustment to chronic illness
For psychologists, adjustment is key in response to a chronic illness.
How do they define adjustment?
Presence or absence of a psychological disorder, psychological symptoms, or negative mood.
Note about subclinical symptoms and timing
Some symptoms may affect how one copes with the disease but be just short of being a clinical symptom.
Adjustment will influence the quality and quantity of life.
There is a trajectory, and timing has to be evaluated case by case and dependent on the person/illness.
Three emotions are primary
Denial, anxiety, depression
Be able to describe the stages of adjustment to a chronic illness diagnosis.
Denial
Avoiding the implications of an illness
Can be both conscious and unconscious
There are affective, cognitive, and behavioral indicators.
Unrealistic optimism, relentless optimism, getting multiple opinions, carrying on with business as usual.
Both early and later research has revealed that Denial may be protective in the short term and harmful in the long term.
Denial may protect from anxiety initially, right after diagnosis; but can impede treatment or further preventative action in coming months
Denial surrounding cardiovascular disease
Researchers examined associations between denial and psychological and physical health variables
45 male participants hospitalized for MI or surgery or bypass surgery.
Levine Denial of Illness scale
A semi-structured interview
Findings: correlations between denial and outcomes
Denial was negatively correlated with anxiety and depression
Days in intensive care
Spent fewer days in intensive care
Cardiac function
Presence of arterial arrhythmias
Sinus tachycardia
Higher in denial meant less rehabilitation (attendance)
Those higher in denial were more likely to be back in the hospital a year later.
Anxiety
An emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure
People with anxiety disorders usually have intrusive thoughts, physical symptomology (chest tightness, etc.), and a lot of avoidance.
A diagnosis of anxiety may occur when:
Anxiety is out of proportion to the level of threat
Anxiety persists or deteriorates without intervention
Anxiety includes a level of symptoms which are unacceptable regardless of the level of threat
There is a disruption of usual or desirable functioning.
What might these criteria be difficult to evaluate in chronic illness?
The nature of chronic illness presents disruption of usual functioning and it is hard to determine what is out of proportion anxiety and whether it is generalized or directed at the threat.
About 25% of cancer patients have high or subclinical anxiety. About 10% reach diagnostic thresholds.
Patients are likely to have anxiety disorders if they have:
Few family members or friends
Pain that is not controlled well
Not getting better with treatment
Trouble taking care of their personal needs. (Disability)
Depression: According to the APA, one of the most “common complications” of chronic illness
A diagnosis of depression may occur when an individual has five or more of these symptoms for at least two weeks:
Depressed mood most of the day, nearly every day
Diminished interest in pleasurable activities
Significant weight loss or gain (5% of body weight)
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feelings of worthlessness or inappropriate guilt
Diminished ability to think
It is sometimes difficult to diagnose depressive disorders in those diagnosed with a chronic illness
Clarification may be aided by assessing factors such as:
Is the chronic illness severe?
Do they have a history of mental illness (such as depression)?
What amount of social support do they have?
Depression in chronic illness
25% of those who have cancer
40-50% of those with Parkinson’s disease
40-65% of those who have a heart attack
18-20% of those with CVD without a heart attack
40% of those who have multiple sclerosis
10-27% of those who have a stroke
25% of those with diabetes
30-54% of those with chronic pain syndrome
Overall estimate?
What characteristics of individuals put them at risk of depression, according to Beck’s theory and research on depression?
Cognitive Theory of Depression (Beck, 1976, 2009)
Depression is characterized by:
Negative thoughts and negative moods (thoughts causing depression)
Negative thoughts surround the self (worthless), world (unfair), and future (hopeless)
Negative explanatory style - negative events are viewed as stable (permanent), global (pervasive; affecting everything), and internal (all my fault).
Define problem focused coping. Provide 3-4 examples.
Problem-focused and emotion-focused
The two types of coping are not mutually exclusive
Generally, problem-focused coping will not have negative effects, but emotion-focused coping can have them (can be clearly good or clearly bad)
Rumination:
Repetitive, excessive thinking about a stressor
Linked to self-destructive behaviors
Clear negative strategy
Emotion-approach coping:
Thinking about their emotions (processing and expressing them).
Clear positive strategy
Active coping, planning, suppression of competing activities, restraint coping, and seeking social support for instrumental reasons.
Define emotion focused coping. Provide 3-4 examples.
Seeking social support for emotional reasons, positive reinterpretation and growth, acceptance.
When are people likely to use emotion-focused coping?
When are people likely to use problem-focused coping?
Define personality.
A characteristic pattern of thinking, feeling, and acting.
What is the contemporary approach to personality?
The contemporary approach is the five-factor model or the “Big 5”
The interaction among the five factors produces personality.
The Big 5 (OCEAN)
Openness: a tendency toward a variety of experience
Conscientiousness: a tendency toward self-discipline
Extraversion: a tendency toward sociability (also called sociability)
Agreeableness: a tendency to be compassionate, cooperative
Neuroticism: a tendency to experience unpleasant emotions.
What does research on personality suggest regarding heritability, stability, and maturation?
Heritability
What is this?
The extent to which variation among people is due to genetics. (Nature vs Nurture).
Types of twin and adoption
Fraternal vs identical twin studies
Identical twins are always more similar than fraternal and score similar (correlation r= 0.90+)
Adopted children are more strongly correlated with their biological parents than their adoptive parents.
Stability
When researchers look at personality across time, what do they find?
Scores remain stable
What happens when people experience major life events?
Your personality doesn’t change
Evidence of a maturation effect whereby…
As we all grow older, we become a little less neurotic.
We also become more conscientious and agreeable.
These trends are stable, but not fixed. (You’re not going to stay exactly the same but you will stay in that ballpark).
Historically, personality research has focused on one or two traits and outcomes.
Have to consider the situation as well.
How does neuroticism relate to psychological and physical health? How does it relate to health behaviors?
4 traits associated with psychological disorders
High neuroticism (strongest correlation)
Low Agreeableness
Low conscientiousness
Low extraversion
Findings
Extraversion and neuroticism were most strongly correlated with scores on happiness measures
Neuroticism and conscientiousness were most strongly correlated with scores on Life Satisfaction
What is the most consistent and predictable association between personality and health?
People high in neuroticism will experience more negative physical health (the relationship between neuroticism and reporting physical symptoms/poor health).
What is the symptom perception hypothesis? What did Cohen et al. (2003) do and find?
The symptom perception hypothesis states that neuroticism is a lens through which some individuals interpret their health. This lens leads them to exaggerate mild symptoms or, in some cases, believe there is poor health when there is not.
People high in neuroticism are more likely to misattribute benign sensations to illness, think they have symptoms or an illness after being exposed to information about it, and experience the nocebo effect.
They injected people with a virus and monitored their physical symptoms in relation to the virus. They also did blood tests, tested perceptions of symptoms, and tested personality traits. People high in neuroticism (a significant moderator) reported more negative physical symptoms despite not experiencing more negative physical symptoms.
What is “Type D” personality?
A Type D personality is a disease-prone personality. Linked to social inhibition. Also linked to early mortality and increased risk of heart disease. “Extra bad” in the presence of social inhibition. Up to 20% or 1/5 of healthy Americans may be categorized as Type D, in people treated for heart problems, the number is raised to 50%.
What is conscientiousness? How does it relate to longevity? Health behaviors?
People who are conscientious are more likely to perform healthy behaviors and less likely to engage in risky behaviors.
Define trait optimism. How does this optimism relate to coping?
What is unrealistic optimism? How does it differ from trait optimism?
What is resilience? What individuals did the early research on resilience focus on? What do highly resilient people have in common?
What is social support? What are the three main categories?
What have researchers concluded regarding the benefits of perceived social support vs. received social support?
Describe costs that receiving social support may have according to empirical research.
What is the direct effects hypothesis? What is the buffering hypothesis?
Who gets the most health benefit from marriage and why?
What is socioeconomic status? Why is it a complex construct?
What did the Whitehall study do and find: Whitehall I? Whitehall II?
They linked with cardiovascular disease, controlling for risk factors!!
First to look at the “Health-Wealth” gradient
Whitehall1 related SES to cardiovascular disease
Whitehall2 focused on stress related disease and gastrointestinal problems/cancers/disease and depression.
Conclusions were the same. Less likely to have these diseases when higher on SES ladder.
Measured SES by level of job. Administrative were highest level (i.e., Bosses; best health)à Professional (i.e., lawyers), Clerical (i.e., secretary)à Other (i.e., butlers/custodians). All worked for the government and had similar working hours. No one in the study was in poverty.
What is the “health-wealth gradient”? What is meant by the term ‘gradient’?
What are high stress neighborhoods? Be able to describe characteristics of these neighborhoods.
Tend to over-represent racial minorities.
How do African-Americans and Whites differ in terms of health? How has this difference often been explained?
What is perceived discrimination? Who tends to report the most and least perceived discrimination?
What were the findings of Williams and Mohammed (2009)? How did they measure perceived discrimination?
High and low SES and use of health services- where is the biggest gap?
Be familiar with examples of how high and low SES differ in awareness and knowledge of health; literacy and numeracy issues,
Mistrust as a factor in use of health services? Who is likely to mistrust and why?
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