Health Psychology- Psych 101

What is health psychology?

• the empirical study of how psychology contributes to our psychological and physical well-being

What is the biopsychosocial model?

• the causes and effects of physical and psychological well-being are a combination of biological, psychological, and social factors

What is burnout?

• long-term exhaustion and loss motivation caused by chronic stress

What is PTSD?

• a clinically diagnosable disorder characterized by flashbacks, nightmares, social withdrawal, anxiety, and insomnia weeks after a traumatic event

What is stress?

• a physiological response to an event that is appraised as taxing or exceeding one’s ability to adapt and is magnified by the social context

What is the stress appraisal theory?

• the cause of the stress reaction is one’s interpretation of an event

What is primary appraisal?

• evaluation of the situational demands and whether they are challenging or threatening

What is secondary appraisal?

• evaluation of our available resources and whether they have enough of them to deal with the challenge or threat

What are common situations that lead to stress response?

Psychological Uncertainty: inability to predict what will happen next or what outcome an action will have

Time Pressure: having to make complex decisions under time pressure or with insufficient information

Goal Conflict: being stuck between two goals

What are the types of goal conflict?

• approach-approach: wanting two opposing desirable things

• avoidance-avoidance: choosing between two bad things

• approach-avoidance: wanting a single goal that has both good and bad consequences

What is stress response?

• a set of physiological response to stress; has two pathways- the “SAM axis” and the HPA “axis

What is the hypothalamic-pituitary-adrenal (HPA) axis?

• a slow reaction, beginning in the hypothalamus, that- through ACTH-stimulates the adrenal gland and releases glucocorticoids

What is the sympathetic-adreno-medullary (SAM) axis?

• a fast reaction, beginning in the hypothalamus, that activates the sympathetic system and, through the adrenal gland, releases catecholamines

What catecholamines does the SAM axis release?

• epinephrine/adrenaline: the hormone secreted by the adrenal gland involved in activating the sympathetic system; main effects are on body

• norepinephrine: the hormone secreted by the adrenal gland involving in activating the sympathetic system; has psychoactive effects in the brain

What do catecholamines do?

• they suppress digestion, increase focus, and increase respiration and heart rate (“fight-or-flight” reaction)

What is cortisol?

• a stress-specific hormone, released through the HPA axis, secreted by the adrenal gland

• it’s primary function is to regulate energy use by the body by increasing the amount of sugar (glucose) in your blood, which improves brain function and speeds up the healing of tissues

• it also suppresses the immune system, digestion, and reproduction systems

• the effects of it are slower, build up over time, and stick around longer compared to catecholamines

What is general adaptation syndrome (GAS)?

• a three-stage response to stress

What is happens in the alarm phase of GAS?

• catecholamines and cortisol activate sympathetic system and get the body ready to cope with stressor

What is happens in the resistance phase of GAS?

• in response to prolonged threat, ongoing effects of cortisol are felt, including modification of normal biological functions

What is happens in the exhaustion phase of GAS?

• the body can no longer properly deal with the stress, and physical, emotional, and psychological resources are drained, increasing susceptibility for long-term consequences

How can social context help both enhance or slow down the stress response?

• amplification: other people are reliable stress trigger

• coping: cooperation can help us cope with a stressor better than we could alone

How do cortisol and catecholamines help with stress coping in the short term?

• increased attention on the stressful event

• increased encoding of memories for the current event

• conservation of energy so we expend it on the threat/challenge

What is good stress?

• in the short-term the stress response is critical for survival, as it allows our bodies to act rapidly and with more energy

• short-term stress in moderate amounts is something we enjoy

  • horror movies

  • cliff jumping

What is bad stress?

• when stress is chronic/prolonged it leads beyond the alarm phase and into full-blow exhaustion

What is the biological model of disease?

• health is a consequence of biological factors

What does the biopsychosocial model of disease mean?

• biological effects can be inhibited or magnified by social and psychological factors

• psychosocial factors are a major (but not only) predictive factor the susceptibility, severity, and course of health problems

• the patient-clinician relationship influences medical outcomes

• patients should be treated as individuals with empathy in addition to biological core

What does the biopsychosocial model not claim?

• the failing to get better is the fault of your own thinking

• that disease are caused by the mind or by negative thoughts

• the positive thinking can prevent or cure diseases, such as cancer

What studies support the biopsychosocial model?

• poison ivy study: participants who has their skin touched with poison ivy but were told it was a harmless plant showed significantly reduced swelling

• marrow transplant study: patients who has better stress coping skills experienced less post-operational pain than those with poor stress coping skills (biological factors were still the best predictors of the overall amount of pain)

What is increased resilience?

• students with a moderate level of lifetime adversity find it easier to withstand a mild experience of physical pain

What negative outcomes does chronic stress have on our health?

• changes in brain structure

• increased risk of cardiovascular disease

• problems in regulating immune function

• gastrointestinal issues

• aging

What is the prefrontal cortex (PFC)?

• brain region largely involved in control of goal-directed behaviour and inhibition of impulses

• reduced PFC function leads to low impulse control, problems in emotional regulation, and inflexible behaviour

• long-term stress is associated with PFC volume

What is inflammation?

• the release of cytokines by the immune system in a effort to fight off potential diseases

• chronic stress leads to dysregulation of cytokine production, leading to higher inflammation

• this makes make conditions worse, including rheumatoid arthritis, inflammatory bowel disease, asthma, and inflammatory skin conditions

What is coronary heart disease (CHD)?

• a condition in which the heart’s blood supply is blocked or interrupted by built-up substance in arteries, leading to a heart attack

Why is stress a major predictor of CHD?

• prolonged increased blood pressure can damage heart arteries

• cortisol reduces liver function, making cholesterol breakdown less efficient

• chronic inflammation can affect the arteries themselves, leading to reduced ability to carry blood

How is psychological stress involved in heart attacks?

• acute stress increases heart rate, which can be a trigger for a heart attack

• stress can mask the symptoms of an incoming heart attack, making it less likely to be caught in time

What is the baboon TB finding?

• a troop of baboons were exposed to tuberculous (TB), but deaths were overwhelmingly amongst the highly aggressive alpha-males, rather than the rest of the troop

What is a type-a-personality?

• ambitious and driven, but also controlling and aggressive

What is inflammatory bowel disease (IBD)?

• a disorder of the gastrointestinal tract that causes severe pain, damage to intestines, chronic fatigue, and more

• IBD both causes stress which, in turn, increases inflammation and aggravates IBD

• modulation of immune system from chronic stress affects gastrointestinal biomes

What is a peptic ulcer?

• the lesion in the stomach lining that causes significant pain and discomfort, primarily caused by a bacteria

• the bacteria normally have little effect because stomach linings regenerate; but with prolonged stress that regeneration is slowed down

What is a telomere?

• chemical “caps” that prevent chromosomes from fraying and sticking to each other

• with age, they wear away

What is telomerase?

• an enzyme that rebuilds telomeres and slows down the process of aging

• chronic stress slows down the creation of telomerase

What is defensive/avoidance/repressive coping?

• minimizing stress by distancing ourselves from the stimuli triggering it

• a person attempting to defensively/avoidantly cope avoids or withdraws from the stressor, hoping the stressor will later be gone or their coping will be better latter

What are the ways avoidance can backfire if a stressor doesn’t go away on its own?

• substance use: a common strategy to mask physiological and psychological effects of stress, which can lead to addictive behaviours

• stress eating: high-calorie food intake can activate high-reward brain areas, leading to feelings of satisfaction during high stress situations

• lack of positive coping practice: avoidance coping doesn’t allow us to discover and practice more enduring coping strategies

What is learned helplessness?

• due to prolonged stress and trauma, an agent becomes convinced that they have no control over the situation, failing to change the situation even when given an opportunity too

What is the animal shock study?

• animals tethered in a cage and repeatedly shocked will subsequently fail to jump to the safe side even when the tether is removed

What is the evidence of learned helplessness in humans?

• school tests and exams: when students are given a test on which all of the hardest questions are presented first, they do more poorly on later easy questions

• nursing home study: seniors in low-quality nursing homes rarely engage with novel activities, but increase exploration if they are introduced under the frame of “you have influence over your lives here”

• depression: many models of depression suggest that some depressive symptoms are tied to learned helplessness in response to persistent trauma

What are three stages of remembering?

• acquisition/encoding: the first step during which attention plays a large role in what we remember

• consolidation: the second step during which the memory becomes more fixed in long-term storage in the brain

• recall: the process of retrieving the memory

What are flashbulb memories?

• vivid and specific memories tied to specific, intense, often negative events that we experience

How does stress affect memory?

• acute stress can sometimes boost encoding and consolidation, but selectively for the stressful event itself

• acute and long stress reduces the ability to successfully recall information, especially when it is not directly related to the stressor itself

• acute and long-term stress significantly reduces short-term memory, especially under time pressure

What is executive function (EF)?

• skills involved in goal-directed problem solving, including working memory, inhibitory control, and set shifting/flexibility; highly related to PFC function

Why do stress and EF have a bidirectional relationship?

• higher EF function associated with more adaptive stress-coping strategies, reduced negative health outcomes, and reduced aggression in type A personalities

• long-term stress impairs ability to multitask and inhibit impulses

• these effects most likely occur through effects of norepinephrine modulating PFC

What is burnout?

• a state of exhaustion, cynicism, and detachment from work/school

What are the three elements of burnout?

• exhaustion: feelings of energy depletion (emotional and physical)

• cynicism: loss of belief in the value of the work

• reduced efficacy: reduced ability to work and increases beliefs of inadequacy in one’s performance

What makes burnout more likely to occur?

• recurrent stressors: ill-defined tasks or role ambiguity

• avoidance coping: we become more cynical as a method of defensively reducing stress of our work

• emotional and physical stress, especially moving past the alarm phase into the resistance phase

• cycle: if nothing gets us out of this loop, we move to exhaustion phase

Besides amount of workload, what are the highest predictors of burnout?

• lack of control: the less we can control our tasks, the more we burn out

• lack of reward: the fewer positive rewards we get, the more we burnout

• lack of social support: the fewer people around us who can support us, the more we burn out

What negative consequences is burnout associated with?

• job dissatisfaction, low organizational commitment, absenteeism, intention to leave the job turnover

• burnout can also have a negative “spillover” effect on home life

• exhaustion is typically correlated with health symptoms such as headaches, chronic fatigue, gastrointestinal disorders, etc

• burnout correlates with depression and other emotional symptoms, such as anxiety and irritability

What has research on high-stress occupations shown?

• law enforcement: strong relationship between occupational stress and defensive coping, especially alcohol use; social support in discussing workplace stress and strain especially effective at reducing defensive coping

• nursing: main predictors of burnout are role ambiguity and role conflict; levels of supervisor support has protective effects on well-being

• teaching: exposure to high numbers of students strongly predicts the experience of burnout in university professors; young professors experience much higher emotional exhaustion

What is post-traumatic stress disorder?

• a clinically diagnosable disorder characterized by:

  • recurrent and intrusive memories, dreams, flashbacks, nightmares

  • social withdrawal, anxiety, and insomnia

  • lingers for at least one month after a traumatic event

  • the event in question can either be experienced, witnessed, or learned about, and can be one-time or recurrent (e.g., first responders)

How does PTSD change brain function?

Hyperactive Amygdala: the amygdala becomes hyperactive, leading to regular heightened emotional arousal that activates the HpA axis (“hyper vigilance”)

Prefrontal Cortex: frequent flow of norepinephrine impairs function of PFC, leading to issues in inhibiting memories and behaviours that trigger them

Hippocampal Volume: the hippocampus - a key brain region for long-term memory - can change in volume, leading to problems with forming new memories and sudden recall of old ones

What cycle are people with PTSD in?

• memories and flashbacks trigger the stress response in resurface, sending catecholamines and cortisol back through the system without any recognizable external triggers

• this impairs everyday function, allowing them to ruminate and re-experience the events, sending further stress hormones through the body

According to the stress appraisal theory how can we cope with stress?

• distancing ourselves from the stressor (defensive/avoidant//repressive coping)

• changing primary appraisal (ie. situation change or re-interpretation)

• changing secondary appraisal (ie. adding resources)

What is constructive/active/rational coping?

• directly deal with the stressor, either by finding a solution to the problem, or changing how we react to it

What are the two types of constructive coping?

• problem-focused coping: coping by finding a solution to the problem, often by acquiring more resources for finding novel solution

• emotion-focused coping/reframing: coping by a changing our perception of the stressful event as something not threatening or challenging

Why is no way of coping strictly better than the other?

• sometimes no amount of resources/effort will deal with the stressor (i.e, problem-focused = bad)

• sometimes an event will be inherently stressful no matter how much we try to think about it differently (i.e., appraisal-focused=bad)

• sometimes stressors will just go away on their own (avoidant = good)

When does constructive coping occur?

• only if you believe that you have control over your resources or over your reaction to the event

What is the executive rat study?

• if a rat has control over when it gets shocked, it will be less stressed compared to a rat shocked as often but with no control

What is the relationship between stress and perceived control in human?

• internal locus of control: an internal locus of control is associated with higher functioning, lower neuroticism, and lower stress and anxiety

• medical procedures: children given a signalling device experience significantly less stress and physiological arousal during complex operations

• it helps when it’s false: participants told that they can shorten a loud noise by pushing a button experience less stress, even when the button has no effect at all

What trait-like predictors are associated with higher constructive coping?

• optimism: a personality trait associated with having a positive outlook on events (as opposed to pessimism)

• grit: a personality trait associated with commitment in the face of failure, a strong sense of internal control, and willingness to accept challenges

• high self-esteem: a positive sense of identity, capability, and efficacy

What is positive psychology?

• a subdiscipline a psychology that focused on improving our well-being, including coping with stress and finding meaning in life (“meaning-based coping”)

What are the two notions of well-being that positive psychologists differentiate between?

hedonic well-being: a sense of well-being associated with positive emotions and feeling good, and avoiding suffering and pain

eudamonic well-being: a sense of well-being associated with having a sense of purpose meaning in life (e.g, self-actualization)

What skills increase positive emotion?

• attending to positivity: participants who has their stress level raised would return to baseline faster if watching media with positive emotions compared to fearful, angry, or sad

• goal flexibility: not remaining fixated on the same goal, especially when one cannot control it

• positive reappraisal: taking a negative event and interpreting it as a positive challenge; strongly related to

What techniques increase the skills related to positive emotions?

• keeping a journal of goals and try you r best to read and review it once a moth; at the end of each day, try and write some things you are thankful for

• disreputation: actively coming up with reasons why some evidence against our self-esteem or efficacy is not indicative and should be ignored

• counselling therapy: techniques such as motivational interviewing and unconditional positive regard significantly increases positive emotions

What is PERMA?

• a popular model of subjective well-being within positive psychology

What does PERMA stand for?

• positive emotions: general tendency towards contentment and joy

• engagement: frequent feeling of being absorbed in activities

• relationships: feeling loved, supported, and cared for by others

• meaning: feeling a sense of direction and purpose in life

• accomplishment: feeling of mastery and achievement in some domain

Why have people criticized PERMA?

• for the absence of any physical well-being, for not focusing on resiliency, and for being overly broad

What is aerobic exercise?

• exercise that increases heart rate and oxygen intake (e.g, running, rowing, swimming, biking)

• on average, 20 minutes of aerobic exercise a day (around 140/week) extends your life by 2-4 years and significantly reduces the risk of cardiovascular and other health problems

• aerorbic exercise also significantly reduces stress: when individuals are randomly placed into an aerobic condition their measured level of stress are almost half of the control group

What is guided relaxation therapy?

• a progressive series of instructions to consciously focus and then relax different body parts; most often guided by another person and it begins from the top of the head down

• guided relaxation has also been shown to be an effective short-term treatment for anxiety disorders, including panic attacks

What is mindfulness meditation?

• a meditation technique in which the mediator places their attention onto one aspect of their present (e.g., their breath) and the accepts any and every sensation, thought, or emotion that emerges in the present moment without an interpretation or judgement

What does the research of meditation show?

• Reduced stress and anxiety: regular practice (~10-20 minutes/day) leads to increases in
  relaxation and feelings of control.

• Higher concentration and self-control: mindfulness slowly trains us to better pay attention to
  some parts of our experience and not get distracted by others.

• Better emotional management: especially anger and fear.

• Focus on short-term pleasures: focusing on what is good in the moment, rather than what is
  stressful in the future.
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What is primary aging?

• changes in physical and psychological functioning that are attributable to biological changes that occur with age (e.g., telomeres)

  • e.g., loss of visual acuity, hearing sensitivity

What is secondary aging?

• changes in physical and psychological functioning that are attributable to long-term behaviours or exposure to environmental effects

  • e.g., osteoarthritis, type-2 diabetes, posture

  • explain may level differences in aging and mortality

What psychological factors are implicated in secondary aging?

• higher levels of neuroticism and emotional volatility

• lower levels of conscientiousness

• quality of one’s social networks

• perception of control with age and declining health

What cognitive abilities naturally decrease with age?

• Cognitive Speed: speed of processing (i.e., fluid IQ) is slower after age 50.

• Working Memory: short-term memory somewhat decreases with age.

• Episodic Memory: the long-term memory for specific events that happened in one’s past
  slightly decreases with age.

• But many other forms of memory - procedural and semantic - do not naturally change
  with age.
  TH 5 5

What is dementia?

• a broad category of diseases that reduce the ability to think, remember, speak, and control one’s emotions with age (e.g., Alzheimer’s, Parkinson’s, and Huntington’s)

What is mild cognitive impairment (MCI)?

• the first subtle stage of dementia during which patients first start experiencing problems with attention and memory but can still live independently

• 50-60% of those diagnosed with MCI will go on to develop dementia

• MCI is diagnosable with standardized clinical assessments

• MCI is not “natural part of aging”, but evidence of a potential disorder

• MCI is not well predicted by subjective concerns: many individuals with strong memory
  concerns do not have MCI, and many without concerns do

• The biggest risk factors for progression to dementia include symptom severity, autobiographical and procedural memory loss, brain white matter changes, and the presence of the APOE4 allele.
  

What is Alzheimer’s disease?

• the most common form of dementia; includes significant loss of working and episodic memory, problems with finding words, reasoning, spatial navigation, an issues with controlling emotions.

• Alzheimer's affects the entire brain, but especially the hippocampus, the area related to long-term memory formation and spatial navigation.
  

What are some potential causes of alzheimers?

• Genes: Alzheimer’s is somewhat heritable, but the localization of which genes are responsibleremains debated (APOE4 allele exists in 25% of patients).

• Protein build-up: certain proteins and peptides are associated with a build-up that prevents neurons from functioning properly or signals that the brain’s neural connections should be removed.

• Environmental effects: repeated concussions, exposure to toxins, pesticides, and air pollution all increase the probability of Alzheimer’s.

• none of these are impactful enough to diagnose or start doing early intervention
  

How does higher loneliness cause negative secondary aging effects?

• Living alone or with strongly reduced social support is associated with an over 50% higher risk of developing clinical disorders.

• Loneliness positively correlates with changes in mental abilities, including reduced IQ scores(especially fluid).

• Persistent loneliness also approximately doubles the risk of developing dementia.
  

What are the best factors that protect against atypical aging?

• Physical factors: regular physical activity, stretching, mild exercise, improvements in diet.

• Cognitive factors: high self-esteem, positive outlook and optimism, future-oriented behaviours and sense of purpose, lifelong learning.

• Social factors: social support, positive and ongoing relationship with family and friends, financial stability, regular community engagement.

• Independence: ability to live without assistance, financial independence.

What is personal mastery?

• one’s confidence and ability to focus on their values, personal and professional goals, and the extent to which people feel that these are in their control.

• Higher personal mastery has been positively associated with better cardiovascular health in aging, physical functioning like motor control, and increased lifespan.

• Older adults with arthritis experience less pain, fatigue, and lower blood pressure if they are high in personal mastery.
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How are aging effects tied to long-term partners?

• Partners often engage is similar healthy or unhealthy behaviours together.

• Partners can provide emotional support.

• Partners help form new routines, especially post-retirement, that can help social relationships become stronger.

• A person with high personal mastery tends to increase the mastery for their partner, as well.
  

What is sexual health?

• physical and psychological well-being related to sexuality, including preventing disease but also experiencing consensual pleasure.

  • Western cultural norms around sexual health are largely preventative in nature.

  • Health psychologists, on the other hand, have documented extensive benefits of sexual
    activity for both physical and psychological health.

What are sexual scripts?

• a set of expectations of typical sexual experiences, including roles,typical desires, sequence of events in sexual interactions, etc.

  • Sexual scripts vary dramatically across cultures, age, and gender roles.

  • e.g., heterosexual women in Western cultures, on average, express equal interest in frequency
    of sexual activity but differences in type of activity (e.g., desiring more foreplay)

  • Access to pornography early in life has been influential in creating sexual scripts,carrying both positive and negative long-term effects.

What is asexuality?

• an enduring absence of sexual attraction or interest in sex with other people (though not necessarily an entire absence of sexual activity)

  • Sexual attraction is not the same as sexual desire/libido (i.e., urge for sexual stimulation),
    which stays typical for many asexuals

  • People vary on a spectrum of asexuality, with some experiencing sexual attraction only rarely, and some never at all.

  • Asexuality is not viewed as a disorder

What are the risks associated with sexual health?

• Around 30% of healthcare costs are related to sexual activity and STIs

• HIV remains a top 10 risk for mortality, especially in the Global South

• Most adolescents underestimate the risk of STIs and unwanted pregnancy

• Amongst undergraduates, the frequency of casual sex with new partners is associated with higher rates of short-term depression, STIs, and anxiety

• In university especially, negative sexual outcomes are strongly associated with alcohol
  and drug consumption

How does changes in sexual activity affect later well-being?

• In several samples across multiple cultures, higher rates of sexual activity are associated with longer lifespans, even when controlling for other variables.

• These effects hold even for individuals with existing health issues, such as cardiovascular problems, even though sexual activity increases the chance of some negative health effects

What is the relationship between perceived quality of sex life and overall relationship quality?

• Sexual activity is associated with higher degrees of communication, trust, positive emotion, reciprocal support, all of which predict better stress management

• Sexual activity tends to decrease with increased length of relationship

What are stressors?

specific events or chronic pressures that place demands on a person or threaten a person’s well-being

What is a type A behaviour pattern?

• the tendency towards easily aroused hostility, impatient, a sense of time urgency, and comparative achievement strivings

What are the 3 steps of rational coping?

• acceptance, coming to realize that the stressor exists and cannot be wished away

• exposure, attending to the stressor, thinking about it and even seeking it out

• understanding, working to find the meaning of the stressor in your life