Health Psychology (Exam 1)

Health Psychology

The scientific study of psychological processes related to health and healthcare.

What does health psychology study?

-physiological reactions to stress

-experience of stress

-promotion and maintenance of health

-coping with pain and disease

-effects of pain and disease on physical functioning

-How sociocultural factors affect health behaviors and outcomes (race, ethnicity, SES)

Health Psychologist

study how biology, environment and behavior impact health and illness.

Health

a state of complete physical, mental and social well being.

What led to the birth of health psychology?

1) the changing pattern of disease

2) rising costs of healthcare

3) social inequities

4) inadequacy of biomedical model

How has the pattern of disease changed over time?

- decrease in acute and infectious disease

-increase in chronic illnesses, related to health habits and behaviors. ex: cardiovascular disease, cancer, AIDS

-people are living longer with diseases -> psychological issues

The focus is now shifting towards prevention

Why have health care costs risen?

-increase in life expectancy --> chronic conditions

-technological advancements

Social inequities in health

-health disparities

-gender, race/ethnicity, SES, age, education

Biomedical Model

-health = absence of disease

-focuses on physical treatment for diseases

-dualism (mind and body not connected)

Germ theory

get rid of germs, restore health

Why is the biomedical model ineffective now?

-didn't explain how some people got sick and others remained healthy

-infectious diseases were replaced by chronic diseases

-fails to take into account how psychological factors can influence development of and recovery from illness and disease

Biopsychosocial model

views health and illness as the consequences of the complex interplay between biological factors (genetics, physiology), psychological factors (personality, cognition) and social factors (culture, community, family, media).

What made the Biopsychosocial model effective?

-multi-cause, multi-effect approach to health and illness

-facilitates interdisciplinary research and effective theories

-accounts for why some people get sick and others don't and resilence.

The Scientific Method

1. Specify a problem or hypothesis

2. Form an operational definition

3. collect data

4. analyze the data

5. draw conclusions/ form a theory

Types of research designs/studies:

-correlational designs

-experimental

-quasi-experimental

Correlational Studies

-identify factors related to disease

-degree of relationship between two variables

-descriptive research design

Limitation: doesn't determine causality

Experimental Designs:

-to determine causality-compare at least 2 groups, an experimental and control group

-involves MANIPULATION of the independent variable to see the effect on the dependent variable

-random assignment

independent variable

the factor being studied

dependent variable

the measured outcome of the experiment

Weaknesses of experiments

-artificial settings (can influence behavior)

-ethics

Quasi-experimental designs

used because it is not ethical to manipulate certain variables in an experiment (ex: sunscreen)

-no iv and no random assignment

-subject variables- factors in naturally occuring conditions

Cross-sectional research

different participants of various ages are compared at ONE point in time to determine age related differences

Longitudinal research

Same participants are studied at various ages to detemine age-related changes

retrospective study

GO BACK IN TIME

begin with a group of people already suffering from a particular disease or disorder and then look backward for characteristics or conditions that marked them as being different from people who did not have that problem

Prospective studies

Look to future

-follow a group of people over a period of time to determine whether a given condition (e.g: cigarette smoking) is related to a later condition (e.g: heart disease)

Ways to collect data

-observations (obtrusive or unobtrusive)

-surveys or questionnaires

-interviews

-archival data

-physiologic measures

Archival research (data)

-observational approach to collect data

-researchers use already-recorded behavior, e.g: divorce rates, disease rates and death rates.

What is good scientific research?

-a scientific theory must be tested before it is accepted

How to be savvy consumer of research?

-where are u getting your info?

-what kind of study is it?

-what is the IV or subject variable? What is the DV?

-what do u know about the people in the study?

-what did they do in the study?

-third variable or confounding factors?

Randomized Clinical Trials

An experimental design which exclusively tests the effect of a new drug, treatment or intervention. More expensive than experiments.

1. experimental and placebo/comparison condition

2. double blind

3. random assignment

How can we evaluate research studies?

-internal validity

-external validity

External Validity

-the experiment is repeatable

Internal Validity

a high internal validity means that it is highly likely that the effects on the dependent variable were caused by the independent variable.

How do you increase internal validity

-participants expectations cannot influence the dependent variable

- blind study

- double blind study

Placebo

-inactive substances that should cause no psychological effects inherently

-help control for participants expectations

Experimenter Expectancy Effects

produced when an experimenter's expectations about the results of the experiment influence his or her behavior toward the subjects

-controlled with double blind studies

Ways to increase external validity?

-use a representative sample

What was the Tuskagee experiment?

A well-known unethical experimental study conducted in Tuskegee, Alabama from 1934-1974, examining the effects of syphilis on 412 African American men.

-Deception--> didn't tell men they had syphillis

-didn't give men treatment for syphillis (penicillin) in order to study the long term effects of the disease.

-caused lasting effects on the perception of the healthcare system for many African Americans.

What ethical procedures to researchers have to go through when conducting scientific research?

-institutional review

-require informed consent

-patient confidentiality

-debriefing

Institutional Review

This review by a panel is required for all organizations in the US (i.e: schools, hospitals, community organizations, etc)

-review whether the potential benefits of the research are justifiable in light of possible risks or harms

Experimental Deception

false info is given to subjects in order to measure their responses to certain stimuli.

(ex: thinking you are receiving a drug but you receive the placebo.)

Debriefing

During this disclosure to subjects after research procedures are completed, the researcher explains the purpose of the study, answers any questions, attempts to resolve any negative feelings, and emphasize the contributions to science of the research.

What is the golden standard of research design?

experimental design

Summarize the Suffoletto RCT on binge drinking

After discharge from an emergency department, a group of subjects recieved SMS and feedback, a group of subjects received SMS with no feedback and another group didn't receive anything. Conclusion: a text message intervention can produce small reductions in self-reported binge drinking and the number of drinks consumed per day in hazardous drinking young adults after ED discharge.

General idea/evidence for the NYT article: Brody- A cold hard fact: high stress can make you sick

the higher a person's stress score on a standardized test, the more likely the person was to develop a cold when exposed to a cold virus.

-Stress was an important risk factor even when smoking, lack of exercise, poor diet, disturbed sleep and alcohol consumption

were taken into account

Stress

-represents anything that poses a threat or a challenge to our wellbeing

-stress is typically a negative emotional experience

Stressors (sources of stress):

-daily hassles

- major life events

- traumatic events

Types of stress:

-acute

-chronic

ptsd

chronic state os physiological arousal

Walter B. Cannon

-experimental physiologist in 1900s

-fight or flight (SNS)

2 core systems activated

1. sympathetic adrenomedullary system (SAM)

2. hypothalamic pituitary adrenal (HPA)

During times of stress, what two core systems in the SNS are activated?

1. SAM (sympathetic adrenomedullary system)

-responsible for immediate fight or flight response to stress

2. HPA axis (hypothalamic pituitary adrenal axis)

-slower neuroendocrine response to stress

What happens when SAM is activated

-immediate fight or flight response

-hormones: epinephrine + norepinephrine released

-physiological changes

What physiological changes occur in the fight or flight response?

-dry mouth

-pupils dilate

-skin- chills & sweats

- increased heart rate and bp

-digestion slows

-adrenal glands release epinephrine, norepinephrin and Cortisol

-breathing rate increases

-liver- glucose is released

-intestinal muscles relax

What happens when the HPA axis activates?

Slower system -> releases corticotropin-releasing hormone (CRH) -> Adrenocorticotropic hormone (ACTH) -> stress hormones like cortisol

What does cortisol do?

1. inhibits swelling around injuries and infections -so the body has more energy to respond to threats and is protected from injuries

2. rising levels of cortisol indicate to the brain to shut off the fight or flight response.

Hans Selye

-General Adaptation Syndrome (GAS)

-extended Cannon's work by describing the stages that the body goes through when reacting to stressors.

-triad of responses

General Adaptation Syndrome (GAS)

Three Stages

1) Alarm

2) Resistance

3) Exhaustion

How did Hans Selye define stress?

non-specific response of the body to any demand made upon it.

Criticisms of Hans Selye's GAS

-different types of stressors produce different physiological responses

-duration of the stressor influences the physiological response(acute vs chronic)

-doesn't take into account psychological or cognitive responses that humans may have to certain situations

Acute stressors

Short lived stressors

ex: going on a blind date, passing a driving test, job interview

-daily hassles

-assessed through daily hassles scale

Chronic stressors

continue over a long period of time.

-leads the body to try to maintain a certain set point of equilibrium

ex: living in a dangerous neighborhood, trying to work full-time while attending school, or experiencing continuing discrimination based on your race

-assessed through life event inventories

Transactional Model (description AND steps)

The meaning of a particular event has for a person is a more important predictor of the experience of stress than the actual event.

-due to difference cognitive interpretations of stress influence their reaction

1) Primary Appraisal- assess situation

2) Secondary appraisal- assess resources available for coping with the event

Lazarus

Transactional Model

What are the 4 models of stress response from oldest to newest?

-Fight or Flight- Cannon

-GAS- Hans Selye

-Transactional Model- Lazarus

-Allostasis + Allostatic overload- McEwen

Examples of stress-related illnesses

headaches,ulcers, coronary artery disease

Eustress

beneficial stress, small amounts of stress that cause arousal and extra energy

Allostatic response

turns on when a person faces a challenge and turns off as soon as the challenge ends.

- on too long --> allostatic load builds up --> physiological responses affecting nearly every body system.

Central nervous system

brain and spinal cord

peripheral nervous system

neural pathways that bring info to and from the brain

-somatic nervous system (transmits messages based on sensation)

-autonomic nervous system (survival)

Autonomic nervous system

carries info directly related to survival (for organs not under voluntary control)

-Sympathetic

-Parasympathetic

Immune systems 3 levels of protection

1. external barriers

2. non specific responses

3. specific responses

Allostasis

-the ability of the body to achieve physiological or psychological stability through behavioral or physiological change.

-takes environmental stimuli and history into account

Psychoneuroimmunology

multidisciplinary field that focuses on the interactions among psychosocial, the nervous system, the endocrine system and the immune system.