PSYC 314 Midterm 1

Health

Health is a state of complete well-being, including:

-physical well-being

-mental/emotional well-being

-social well-being

Health Psychology

The scientific study of how health and psychology intersect:

-promotion and maintenance of health

-prevention and treatment of illness

-identification of etiologic and diagnostic correlates of health,

illness and related dysfunction

-improvement of the health care system.

Criticisms of BPS model

-Unclear boundaries between biology, psychology, and society

-Too inclusive, offering an unscientific, "fluffy," and pluralistic approach to health in which "anything goes"

-Adoption of the model in health care is limited by physicians' knowledge/training (they can't be experts in everything)

Changing patterns of illness and disease

-prevalent causes of death shifted from acute infectious diseases to chronic conditions

-life expectancy increased

-infant mortality decreased

Biomedical model

-diseases or physical disorders can be explained by disturbances in physiological processes, which result from injury, biochemical imbalances, bacterial or viral infection,

Health Psychologists

-provide therapy for emotional and social adjustment problems that being ill or disabled can produce

-help people make difficult changes in behavioural risk factors and manage their health problems

-Their research provides information about lifestyle and personality factors in illness and injury

-They can also educate health professionals toward a fuller understanding of the psychosocial needs of patients

Stress as a stimulus

A stressor or change in environment causes stress

Fight or flight response

-Mobilization, increased energy, and increased focus

-Epinephrine (adrenaline) & norepinephrine (noradrenaline) are released by the adrenal glands

-Cortisol complements the SNS and assists return to homeostasis

Flow

Intense concentration, loss of self-awareness, loss of time awareness (or time 'flying'), loss of environmental awareness, and feeling perfectly challenged (neither bored nor overwhelmed). The activity becomes an end in itself.

Emotion-Focused Coping

-Efforts to manage emotions generated by the stressful situation

-Denial (I told myself it didn't happen.)

-Escape-Avoidance (I avoided thinking about the problem.)

-Distancing (I tried to forget it and put it out of my mind)

-Wishful Thinking (I wished it would go away.)

-Emotional suppression (I tried not to cry.)

-Emotional expression (I told others.)

-Positive reappraisal (I focused on the bright side.)

-Self-Care (I took a break.)

-Social comparison (I reminded myself that I'm still better off.)

-Prayer (I prayed for things to get better.)

-Substance use (I had a drink.)

-Other Defence Mechanisms (e.g., intellectualizing), etc.

Avoidance Coping

-Attempts to distance oneself from the problem and not think about it.

-cognitive (e.g., trying not to think about it) or behavioural (e.g., drinking to reduce tension)

Possible benefits:

-Short-term stress reduction

-Allows for dosing:

(dealing with problem a little bit at a time)

-Increased hope and courage

Possible costs:

-Increased distress

-Interference with action

-Emotional numbness

-Disruptive behaviours

Health Disparities

Inequalities or gaps in health or health care between groups

Can affect:

-how frequently a disease affects a group

-how many people in a group get sick

-how often the disease causes death for a group

Epigenetic Effects

study of changes in organisms caused by changes in gene expression due to environmental influences

IG Effects of Res. Schools

Factors in Resilience for low SES

1. Shifting Oneself: Accepting stress for what it is and adapting through reappraisals.

2. Persisting: Enduring life with strength by maintaining meaning and optimism

Factors in Resilience for Minorities

-subjective social status and perceived social support are correlated with greater resilience to poor health outcomes

-Racial socialization (i.e., learning about race and racism; the place of one's race in society) and racial identity are also correlated with heightened resilience in Black youth

-Cultural resilience has been shown to mitigate the effects of racial discrimination

locus of control

People who believe they have control over their successes and failures

Biopsychosocial model

-More holistic approach

Health is a combination of:

-biological (eg: physical injuries)

-psychological (eg: thoughts and behaviour)

-social perspectives (eg: relationships and social support)

Interplay of Systems in biopsychosocial model

Cartesian Dualism

The mind and body are separate

Types of Stressors

Acute stressor:

-limited

-eg: running late, fight, accident

Chronic Stressor:

-prolonged, repeated

-eg: job strain, poverty

Strain

The psychological and physiological response to a stressor

Stress as a response

a person's physiological or psychological response

Stress as a transaction

a process involving continuous interactions and adjustments between a person and the environment, each affecting and affected by the other

Transactional Model of Stress (Lazarus)

-It is how an event or situation is appraised or evaluated by a person that matters (cognitive appraisal)

-Primary Appraisal: Is this a threat to my physical or mental well-being?

-Secondary Appraisal: Do I have the resources to meet the demands?

Stages of stress transaction

Stress is a transaction leading a person to perceive a discrepancy between demands of a situation and the resources of their biological, psychological, or social systems

Factors affecting appraisal

Personal Factors:

-Personality, self-esteem, motivation, perfectionism, etc.

Situational Factors:

-Degree of demand; imminence; timing; ambiguity; life transitions (e.g., starting school, moving).

-Desirability - some situations are undesirable to most people.

-Controllability - some situations are outside of behavioural or cognitive influences.

How does chronic stress affect health?

-Directly via physiological effects on various bodily systems

-Indirectly via health behaviours

General Adaptation Syndrome (Selye)

1. Alarm: physiological mobilization for action

-Fight or flight response

If the stressor continues...

-Resistance: body tries to adapt to stimulus.

-Exhaustion: breakdown of organs, disease, death; burnout.

Effects of chronic stress

-HPA axis becomes dysregulated, leading to elevated cortisol

-Elevated blood glucose; increased storage of visceral fat

-Higher cholesterol; plaque build-up in arteries over time

-Impaired immune functioning; increased susceptibility to infection

-Inflammation ensues

Cardiovascular Disorders

-Greater cardiovascular reactivity and poorer recovery associated with:

-heightened blood pressure

-diagnosed hypertension

-atherosclerosis - plaque builds up in arteries, restricting blood flow

-Stress increases levels of cholesterol (via cortisol) and inflammatory substances circulating in the blood, contributing to atherosclerosis.

Stress and Cancer

Chronic stress weakens the immune system (via cortisol), which may accelerate cancer or tumour growth

Injected human ovarian carcinoma cells into mice (Thaker)

-more tumour nodules in stressed mice

Psychophysiological Disorders

Physical symptoms or illnesses that result from the interplay of psychosocial and physiological processes

-eg: Digestive system diseases (e.g., ulcers), Asthma, Recurrent headache (inc. migraines), Rheumatoid arthritis

Allostatic Load

-Accumulating effects (wear and tear) that result from the body adapting repeatedly to stressors over time

-impairs the body's ability to adapt to future stressors

Acute Stress Disorder

-Severe anxiety, dissociation, and other symptoms within one month after exposure to an extreme traumatic stressor

-(short term PTSD)

Posttraumatic Stress Disorder (PTSD)

A psychiatric disorder resulting from exposure to a highly stressful or traumatic event, with symptoms lasting for more than one month

Diathesis Stress model

Posttraumatic Growth (PTG)

Positive psychological changes following a highly challenging event or experience:

-Appreciation of life.

-Renewed commitment to goals, new goals/priorities.

-Greater sense of personal strength.

-Greater intimacy in relationships.

-Warmer, more loving personality.

-Higher life satisfaction

What determines PTSD vs. PTG

More likely to develop PTSD:

-Family history; prior/childhood trauma.

-Low openness to experience, low extraversion (personality).

-Peri-traumatic dissociation, perceived threat to life.

-Maladaptive coping responses (e.g., denial).

-Low post-trauma social support.

-Also: being a woman, low income/status, and low education

Fight-Flight-or-Freeze

-Primary predictors of the freeze response are feelings of anxiety and panic during highly stressful events

-dissociation during high-stress events increases likelihood of PTSD

Sources of Stress

1. Within the Individual

-Illness and disease

-Conflicting motivations (approach, avoidance)

-Frustrated goals

2. Within one's family / social network

-New addition to family

-Relationship strain, separation, divorce

-Family illness, disability, death

3. Within the community / society

-Occupational stress

-Environmental stress

Occupational Stress

Stress originating in the workplace or associated with one's employment

Demand-Control-Support Model

Stress Contagion

Stress Spillover:

-Occurs within the individual; Stress experienced at work can be brought home, or stress experienced at home can be brought to work.

Stress Crossover:

-Occurs between people; Stress experienced at work can be brought home and transmitted to the spouse, child(ren), etc.

Environmental Stress

Aversive and primarily uncontrollable environmental stimuli; sometimes unpredictable, variable in duration and frequency

-eg: noise, crowding, air pollution

-eg: natural or human caused disasters

Coping

-things that people do to reduce their stress

-Includes efforts to manage internal and external demands, whether successful or not

Transactional Model of Stress and Coping

Problem-Focused Coping

-Direct efforts to solve the problem

Changing the situation:

-Thinking of options / Weighing pros & cons

-Making a plan of action / Formulating a list

-Increasing efforts to make things work

Changing ourselves:

-Seeking information from other sources

-Learning new skills / Practicing / Rehearsing

-Taking a course / Reading a book

Relationship-Focused Coping

-Efforts to maintain and manage social relationships during stressful periods

-Empathic responding (I tried to understand how other person felt.)

-Perspective taking (I tried to see things from person's perspective.)

-Support seeking (I called a friend for help.)

-Support provision (I tried to help the other person involved).

-Compromise (I tried to find a solution that was fair to all involved.)

-Interpersonal withdrawal (I spent time alone.)

-Confrontation (I expressed anger to the other person.)

Meaning-Focused Coping

Efforts to manage the meaning of an event or situation

Approach Coping

-Attempts to actively deal with the problem or manage the tension

-cognitive (e.g., trying to see the positive) or behavioural (e.g., talking to a friend)

Possible benefits:

-Appropriate action

-Release of emotions

-Assimilation of trauma

-Stress reduction

Possible costs:

-Increased distress

-Non-productive worry

-Rumination

Psychological Resilience

Positive adaptation or successful coping after a stressful or adverse situation

3 aspects of personality affect resilience

self‐esteem, personal control, and optimism

Hardiness

1. Control

-people's belief that they can influence events in their lives

2. Commitment:

-people's sense of purpose or involvement in the events, activities, and with the people in their lives

3. Challenge:

-tendency to view changes as incentives or opportunities for growth rather than threats to security

How to effectively manage stress

-Deal with things, problem-solve. (problem-solving / denial/avoidance X)

-Process and express your feelings. (disclosure / rumination X)

-Engage positive emotions; find benefits/meaning. (positive reappraisal)

-Accommodate to the stressor as needed. (acceptance)

-Find support and collaborate. (support-seeking / empathy / withdrawal X)

Positive Reappraisal

Involves deriving personally relevant positive meaning from an experience in the face of its negative qualities

Disclosure

An adaptive strategy in which a person describes their feelings about a stressful or traumatic experience

Tend-and-Befriend (Taylor)

-People also respond to stress with social behaviours

Oxytocin:

-lowers HR, BP, etc.; modulates HPA activity; increases social behaviours.

-released during/after childbirth, during breastfeeding, and in response to low- intensity stimulation (e.g., touch), mutual smiling, and sexual activity.

-plays a role in attachment, pair-bonding, trust, social recognition, and stress reduction; also out-group aggression

Stress Buffering Hypothesis

Social support is a protective factor; it buffers the impact of stress and environmental demands on the individual

Stress Buffering hypothesis (study)

eg: in couples coping with early-stage dementia

-Examined whether the negative relationship between perceived stress and quality of life can be buffered by perceived social support in patients with dementia and in their caregivers

Types of Social Support

-Emotional/Esteem: feeling loved and cared for by others; valued and respected by others; empathy, concern, positive regard.

-Tangible/Instrumental: receiving material aid, assistance from others.

-Informational Support: getting advice & information from others.

-Companionship Support: availability of others to spend time with

-Invisible Support: Person isn't aware of the support they're receiving

Negative social support

-Protective Buffering: keeping information from someone in order to protect them; avoiding potential for negative interaction.

-Solicitousness: expressing concern; helping without request

Quality vs Quantity

Social Support:

-Functional content and quality of social relationships

-Quality

Social Networks:

-Number of social relationships; degree of social integration

-Quantity

social media effects on health

-Loneliness, frustration, anger

-Lower well-being and life satisfaction

-Increasing depression

-Negative body image

-Narcissism

-Depression, anxiety, psych. distress

-Some people interact less with family and friends.

-Limiting social media use is associated with decreased loneliness

Human-Animal Interaction (HAI)

Physiological: reduced blood pressure; improved cardiovascular health; enhanced immune system functioning; improved pain management; lower cortisol output.

Psychosocial: improved mood; reduced aggression; increased trustworthiness and trust of others; reduced impact of stress

-Activation of oxytocin system plays key role in the health benefits of HAI

-oxytocin is released in both humans and animals in response to touch/petting and mutual gaze

Health benefits of Nature

-The visual presence of wood in a room lowers sympathetic nervous system (SNS) activation in occupants

-Indoor plants help too

Health Benefits of Greenspace

Significant reductions in:

-heart rate

-diastolic blood pressure

-salivary cortisol

Decreases in incidence of:

-Type 2 diabetes

-all-cause mortality

-cardiovascular mortality

"Old friends" hypothesis: Increased exposure to range of micro-organisms which may be important for development of immune system and regulation of inflammatory response

Tree cover and stress

Found a positive, linear association (dose-response) between density of urban street trees and self-reported stress recovery, controlling for gender, age, and baseline stress

Blue space impact on health

Exposure to blue spaces (aquatic environments) has been associated with psychological well-being and physical activity in a number of studies

Nature Deprivation

Biophilia Hypothesis:

-Humans have innate desire to seek out connections with other life and living systems

-Humans systems (including brain) evolved in nature. Desire to connect is rooted in our genes and evolution

Meditation

various practices and behaviours that induce a calm, peaceful, or relaxed state

Mindfulness

-intentionally focused awareness of one's immediate inner and outer experiences; commonly integrated into meditation

1. Set aside some time: to observe the moment as it is; let your judgements roll by.

2. Body Scan: Observe the sensations throughout your body. 3. Mindfulness-Based Meditation: Pay attention to

breathing, relaxation; observe your thoughts and feelings

Shinrin-Yoku (Forest Bathing)

A traditional Japanese practice of immersing oneself in nature

Indigenous people Health disparities

-Lower life expectancies; higher infant mortality rates.

-Lower self-reported health; higher rates of obesity, cancer, heart disease, hypertension, diabetes, asthma, etc.

-Higher rates of depression, substance abuse, and other mental illnesses.

-more likely to experience stress and trauma of all varieties.

-Youth are more likely to die by suicide

Indigenous health trends

-Lower life expectancy at birth

-Higher prevalence of select health conditions

-Higher prevalence of diabetes

Diabetes in First Nations

-Less healthy diet, lower consumption of traditional foods, less physical activity due to historical changes to way of life

Is poverty a factor?

-Lower income and education are believed to play a role in the increased stress and poorer health of Indigenous peoples

Trauma of Colonization

European colonization involved a series of highly traumatic stressors, including new disease, loss of land, criminalization/loss of culture, genocide, and forced assimilation

evidence of:

-higher prevalence of PTSD

-higher psychological distress

Intergenerational Trauma

trauma passed down to subsequent generations

-Direct experience of trauma

-vicarious trauma (via stories)

-Lack of culture and cultural identity

-Marginalization and discrimination

-compromised parental funcitoning

-modelling of poor coping

-genetic/biological vulnerabilities

Intergenerational Epigenetic Effects (study)

Epigenetic changes can be heritable via various processes; can affect multiple generations

-PTSD-like symptoms of isolation and jumpiness observed in male mice exposed to early stress/trauma; also alterations in genes associated with stress-related hormones and behaviours.

-These mice fathered young, but played no role in rearing

-Pups showed same symptoms of trauma: anxious behaviour, same signature gene changes

Cultural identity

-Historical and ongoing attacks on Indigenous culture have compromised cultural identity clarity

-Cultivating a stronger cultural identity may be an important way to reduce the impact of stress and trauma on the health of Indigenous communities

Factors in Resilience for Indigenous

-Indigenous communities that engage in more efforts to reclaim their culture tend to experience decreases in youth suicide, improved education, and fewer children being placed in foster care

-sense of connection to the land and nature and engagement with nature have been associated with better health and resilience

SES and Health trends

Higher income:

-Higher life expectancy at birth

-Lower mortality rates for select illnesses

-Higher cancer survival rate

Socioeconomic Gradient in Health

At each rung up the income ladder, Canadians have less sickness, longer life expectancies and improved health

Inequalities in COVID-19 Deaths

significant inequalities in death rates for:

-lower income neighbourhoods

neighbourhoods with more people who:

-are a visible minority

-recently immigrated to Canada

-were born outside of Canada, or

-speak neither English nor French

Whitehall Studies

higher employment grade (ranking) was associated with higher life expectancy and lower incidence of many diseases and risk factors

Baboons & Stress

-Lower-ranking males experience ongoing, uncontrollable social stress which affects health.

-displacement aggression is common: top baboon kicks the one below him, and so on

Biological Embedding Model (Miller)

Childhood adversity gets programmed into the immune system through multiple mechanisms, including epigenetics

Income & Health

-Social status: Social hierarchies result in chronic stress and poor health for people at the bottom.

-Individual income: Less money to invest in health

-Reverse association: Poor health interferes with an individual's ability to secure and maintain employment.

-Social cohesion: Income inequality leads to a decrease in the social bonds that exist in society, aggravating problems (e.g., crime).

-Social disinvestment: In lower-income neighbourhoods, fewer health promoting resources are invested in the social and physical environment.

Minority Stress Model (Meyer)

Stigma, prejudice, and discrimination create a hostile social environment → leads to increased stress for minorities and increased incidence of disease & illness

sources of minority stress

-direct experiences of discrimination, prejudice, harassment

-social stigma; internalized bias and stigma

-rejection and expectations of rejection

-hiding or concealing identity

Factors in Resilience for Trans people

-personal mastery (control)

-support-seeking and social support

-emotional coping (esp. positive reappraisal)

The Status-Health Relationship

Types of control

-personal control: the feeling that you can make decisions and take effective action to produce desirable outcomes and avoid undesirable ones

-Behavioural control: ability to take concrete action to reduce the impact of a stressor

-Cognitive control: ability to use thought processes or strategies to modify the impact of a stressor, such as by thinking about the event differently or focusing on a pleasant or neutral thought

self-efficacy

-belief that we can succeed at a specific activity or goal that we want to accomplish

-Decision to attempt activity based on if:

1. Outcome expectancy: behaviour will lead to a favourable outcome

2. Self-efficacy expectancy: they can perform the behaviour properly

learned helplessness

people can learn to be helpless by being in uncontrollable situations that lead to repeated failure

attribution

1. Internal-external: People consider whether the situation results from their own personal inability to control outcomes or from external causes that are beyond anyone's control

2. Stable-unstable: People assess whether the situation results from a cause that is long-lasting (stable) or temporary (unstable). If they judge that it is long-lasting, they are more likely to feel helpless and depressed than if they think their condition is temporary.

3. Global-specific: People consider whether the situation results from factors that have global and wide-ranging effects or specific and narrow effects. Individuals who fail at stopping smoking cigarettes and make a global judgment—for ex- ample, "I'm totally no good and weak-willed"—may feel helpless and depressed, but others who fail and make a specific judgment, such as "I'm not good at controlling this part of my life," are less likely to feel helpless.

Type A behaviour pattern

1. Competitive achievement orientation: strive toward goals with a sense of being in competition with others, and not feeling a sense of joy in their efforts or accomplishments.

2. Time urgency: seem to be in a constant struggle against the clock. Often, they quickly become impatient with delays and unproductive time, schedule commitments too tightly, and try to do more than one thing at a time, such as reading while eating or watching TV.

3. Anger/hostility: tend to be easily aroused to anger or hostility, which they may or may not express overtly.

4. Vigorous vocal style: speak loudly, rapidly, and emphatically, often "taking over" and generally controlling the conversation.

Type B behaviour pattern

-easy going and "philosophical" about life

-more likely to "stop and smell the roses."

-In conversations, speech is slower, softer, and reflects a more relaxed "give and take

Behaviour Patterns and Stress

-Type A respond more quickly and strongly to stressors, often interpreting them as threats to their personal control

-Type A also often choose more demanding or pressured activities at work and in their leisure times, and they often evoke angry and competitive behaviour from others

-have greater exposure to stressors