CH 6- Staying Healthy: Primary Prevention and Positive Psychology

Health Behaviors

Actions that people can take to improve/ maintain health

• occurs on a continuum and can have a positive or negative impact

Health habits

Health behaviors that have become firmly established and are performed automatically

Health Belief Model

Maintains that decisions are based on 4 factors:

• Perceived susceptibility → greater= stronger motivation to engage in health-promoting behavior

• Perceived severity of health threat → which factors will result & will it have an impact on friends/ family

• Perceived benefits and barriers to treatment → do benefits of a behavior exceed barriers?

• Cues to action → advice from friends, media, health campaigns, factors like age/ SES/ gender

Protection Motivation Theory

Adds self-efficacy as a separate component

Focuses on an individual’s ability to manage threats by acting more healthfully

Critics argue HBM focuses too heavily on attitudes about perceived risk rather than on emotional responses

Theory of Planed Behavior

Specifies relationship among attitudes and behavior

Maintains that the best way to predict whether health behavior will occur is to measure behavior intention

Behavior intentions are shaped by 3 behaviors

• attitude towards behavior

• subjective norm → reflects motivation to comply with views of other people regarding behavior in question

• perceived behavior control → expectation of success in performing health behavior

Transtheoretical Model

Contends that people progress through 5 stages in altering health-related behaviors

Stages:

Precontemplation → individual is not seriously thinking about changing behavior

• may even refuse to acknowledge behavior needs to be changed

Contemplation → acknowledge existence of a problem and is considering behavior change in the near future

Preparation → engage in actions and throughts

Action → actually change behavior and are trying to sustain efforts

Maintenance → continued success in efforts to reach final goal

People will often move through stages in a nonlinear way

3 Types of prevention

Primary Prevention → refers to health-promoting actions taken to prevent disease/ injury from occuring

• Ex: wearing a seatbelt, good nutrition/ exercise, healthy sleep, etc.

Secondary Prevention → consistent action taken to identify and treat illness early in its course

Tertiary Prevention → action taken to contain damage once the disease has progressed beyond its early stages

• strives to rehabilitate people to the fullest extent possible

Patient Protection/ Affordable Care Act

Cornerstone is stated as strengthening healthcare

Legislation built around emphasizing primary and preventative care linked with community prevention services

Instituted an Individual Mandate → requirement for most Americans to have insurance or pay a tax penalty

Has largely succeeded on delivering main promises

Types of Message Framing

Gain-Framed Messages → focus on positive outcomes from adopting a healthy-promoting behavior, or on avoiding an undesirable outcome

Loss-Framed Messages → emphasizes negative outcomes from failing to take preventative action

• also may emphasize missing a desirable outcome

Cognitive Behavioral Interventions

Focus on the conditions that elicit health behaviors and factors that help to maintain/ reinforce them

Health psychologists will identify target behavior to be modified, measure current status, and examine consequences

Discriminative Stimuli

Habitual behaviors that are triggered by environmental signals which communicate to the brain certain behaviors that are followed by reinforcement

Types of Cognitive Behavioral Interventions

Stimulus Control Interventions → aimed at modifying health behavior

• remove discriminative stimuli for behavior from the environment

• Establish new discriminative stimuli signaling the availability of reinforcement for healthier response choices

Relapse Prevention Programs → deliberately bring a participant into contact with discriminative stimuli that are likely to evoke target behavior

• gives participant opportunity to learn and practice coping skills that increase feelings of self-efficacy & decrease likelihood of lapsing into unhealthy behavior

Contingency Contract → formal agreement with another individual regarding consequences of target behavior

4 Dimensions of healthy work

Stress

Work-family relations

Violence prevention

Relationships at work

Negative Emotion Spillover

When work related frustrations contribute to greater irritability, impatience, or other negative behaviors at home

Social withdrawal

When 1+ working adult parents/ caregivers withdraw behaviorally and emotionally from family life following especially stressful days

Positive Psychology Movement

promotes strength-based, preventative approach to research and interventions versus a traditional approach of attacking problems after they occurred

Thriving

Step beyond resilience

Capacity to withstand stress and catastrophe

Relationship between anabolism and catabolism

Cells of the body are usually occupied with activity that builds up the body → anabolism

Brain perceives an impending threat → anabolic metabolism is converted to catabolism

Catabolism breaks down tissues to be converted to energy

Role of Catabolic Metabolism

Is characterized by the release of catecholamines, cortisol, and other F/F hormones that help the body quickly mobilize energy

Parasympathetic NS triggers the release of anabolic hormones to counteract the neuroendocrine reaction

This counters arousal & promotes relaxation, energy storage, and healing processes such as protein synthesis

Prolonged elevation of catabolic hormones → damaged body/ chronic illness

• repeated stress can strongly impact the hippocampus

• Allostatic Overload: indicated by predominance of catabolic activity at rest

Neurobiology of Resilience

Thought of as the capacity of the brain and body to withstand challenges to homeostasis

DHEA → normally released from the adrenal cortex along with cortisol in response to stress

• has antioxidant/ anti-inflammatory effects

Hormones= agents of adaption and change in the brain’s response to environmental events

• alter the complexity of dendrites and turnover of synapses in PFC, amygdala, and hippocampus

Types of Psychosocial Factors that impact Psychological Thriving

Self-enhancement → tendency to recall positive information over negative, see oneself more positively, and feel personally responsible for good outcomes

• is associated with lower resting HPA axis levels

• indicated chronically healthier neuroendocrine state

Social integration → number of social roles one participates in

• people who maintain strong social ties are more likely to retain better mental/ physical health and live longer

Relaxation → associated with decreases in negative emotions and alterations of neuroendocrine function

• most consistent finding = increase in anabolic hormones

Spirituality → sense of connection to something bigger than the outcomes

• Benefits include: elevated mood, protection against stress by promoting problem-focused coping, reducing unhealthy lifestyle behaviors, promoting better health practices

Curiosity → person’s orientation towards novel stimuli

• may enhance healthy aging because it enables older adults to successfully meet daily physical/ environmental challenges

• allows individuals to use active coping strategies to approach potential problems

• those with greater curiosity tend to be more responsive to healthy opportunities for growth and cognitive stimulation

Perceived Control and Self-Efficacy → those with a greater sense of control are more likely to take action/ engage in health-promoting behavior

• individuals with a sense of control believe that what they do makes a difference

• those with higher sense of control have lower cortisol levels and return more quickly to baseline levels after stress

Broaden and Build Theory of Positive Emotion

Want to share positive emotion

Broaden cognitive experiences

Positive emotions expand awareness and make us engage, while negative emotions have the opposite effect

Cultivating positive emotions= way to build resilience

Characteristics/ Qualities of a fragile system

Characteristics:

• Highly efficient

• Easily damaged

• Usually on the edge of capability but collapses when something new enters

• Difficult with volatility,

• Negative view of change/ uncertainty

• Mistakes are usually rare, but detrimental

Qualities:

• Procrustean/ conformist

• knowledge is narrow/ over specialized

• fail to balance physical and mental development

• avoid uncertain situations

• pronounced negative reaction to stress

• lack coping mechanisms

Characteristics/ Qualities of a resilient system

Characteristics:

• performance may halt momentarily when faced with a stressor

• efficient but with some redundancies

• resistent to most damage

• tolerates mild volatility

• indifferent to change/ uncertainty

• the effect of a mistake is relative to its severity

  • still somewhat buffered

Qualities:

• resourceful

• knowledgable

• mentally and physically healthy

• cool under pressure

• adaptive to stress

• process coping skills to match needs

Anti-Fragile system characteristics/ qualities

Characteristics:

• grow in response to change

• have lots of built-in redundancy

• grow stronger in response to damage

• thrives on volatility

• actively seeks uncertainty

• trial and error learning from mistakes

Qualities:

• creative, inventive, innovative

• purposefully challenging of mind and body

• capitalize on chaos

• approach oriented mindset

• regularly try new things

• grow in response to stress, stockpile coping resoruces

Scientific Precedent for Fragile/ Resilient Models

Hormesis: low doses of toxins/ damage results in strengthening at the cellular level

Evolution: environmental perturbation results in death of some, allowing for genetic dominance of favorable characteristics

Ways to become anti-fragile

Seek out small challenges → short-term low-risk stressors

Create redundancy → get rid of bad habits; develop multi-modal skills/ strategies

Adopt a growth mindset

Diversify

Ambivalence

Unresolved conflict between pros/ cons that leads to a continued engagement of behavior

Persistent ambivalence is the principal impediment of change

Goals of Motivational Interviewing

Find out what stage the client is at and address concerns to a specific stage

Have the client articulate pros/ cons so the can better process and resolve conflict

Empathize and empower the client to take steps towards change by affirming strategies

General Principles of Motivational Interviewing

Express empathy

Develop discrepancy

Roll with resistance

Support/ facilitate self-efficacy

Two theories of Behavioral Change

Health Beliefs Model:

• perform a cost-benefit analysis

  • ask about the belief in the threat and the belief in the effectiveness of behavior

Theory of Planned Behavior

• think about behaviors as a result of intention