PSY 431 Exam 1

What is health psycology

Use of psychological influences

Health

a positive state of physical, mental, ad social well being, not simply the absence of injury or disease that varies over time along a continuum

Experimental research

• independent and dependent variables

• random assignment

• control and experimental groups

Correlational research

• joint relation

• correlation/association

Quasi experimental research

• no random assignment

• correlational, not causal

• naturally occurring over groups no manipulation

Role of biology/genetics

There are individual differences in risk for illness due to biomedical sources such as physiological processes or exposure to microorganisms

DNA

basic substance of genetic material, not determinative

epigenetics

may be in genes but never be shown

4 goals in health psychology

1. promote and maintain health by studying factors involved in unhealthy behaviors

2. prevent illness by reducing risk factors and treating ill

3. identify causes and diagnostic correlates of health, illness, and related dysfunction

4. analyze and improve health care systems and policy

clinical health psychology

• apply psych theories to promote health and well-being, prevent illness

• identify causal factors in the development and maintenance of illness

• Treatment of illness (psycho education, therapy in context of healthcare)

public health psychology

• focused on healthcare/clinical care system as well, but is more concerned with improvement of health of the population (larger system health)

• focuses on health promotion, communication, and epidemiological study of illness prevalence rather than treatment

Community health psychology

• community-level research and action (micro-level community)

• working in partnership with community members with the aim of empowering and facilitating social change to address social and structural obstacles to health

critical health psychology

• concerned with structural factors, analyzing how issues of power, politics, economics, and social processes influence or shape health (critiquing power systems)

• action-oriented approach for social change

what is the biomedical model

fix what is going wrong physically, traditional approach

Challenges to the biomedical model

• mind and body connected

• somatic symptoms (physical symptoms not related to anything specific)

Biopsycholosocial model

the person consists of biological and psychological system, which interrelate

Criticisms of the biopsychosocial model

1. Neither a theory or model, but a useful heuristic

2. new medical model (biology still at the top)

3. lack inclusion of political and social issues

Critiques from sociology from mental illness

• how diagnose and treat to fit the environment

• medicalization for social control

• connects to how we view disability

the medical model of disability: disease or disorder

viewed from a biomedical lens, body as site of disability

the medical model of disability: impairment

any loss or abnormality of psychological, physiological, or anatomical structure or function

the medical model of disability: disability

any restriction or lack of ability to perform an activity in the manner or within the range considered to be normal for a human being

the medical model of disability: handicap

disadvantage experienced as a result of impairment or disability that limits the ability to lead a “normal” life

The social model of disability

• People have impairments, but its society that disables them

• targets structural level as the point of problem

Criticism of the social model of disability

• excludes considerations of lived experiences or impairment

• societies view on normal and abnormal vary from context to context

The social model of disability: impairment

lack of part or all of a limb or having a defective limb, organ, or mechanism of the body

The social model of disability: disability

loss of limitation of opportunities that prevents people who have impairments from taking part in the normal life or a community on an equal level with other due to physical and social barriers

What are lay representations of illness

How everyday people who don’t have medical knowledge talk about and understand illness

Cognitive approaches to illness

• represent cognitive illness

• thoughts and feelings

Leventhal’s self-regulation model

1. stimuli (an event)

2. Perception (thoughts, feelings)

Thoughts

1. illness representations (what do I know about the event)

2. coping behavior for illness control (behavior done for what is thought to be true)

3. appraising of coping outcomes (did it work)

Emotions

1. emotional representations (what you feel about the illness)

2. coping behavior for emotion control (coping for emotion)

3. appraisal (did it work)

common sense illness perception dimensions

go into the illness representation box

• identity (signs, symptoms and the illness label)

• consequence (perceived physical, social and economical consequences of the disease)

• cause (perceived causes of the disease)

• timeline (perceived time frame for the development and duration of the illness threat)

• cure/control (the extent the illness was responsive to treatment)

Cause dimension and attribution theory

• attempt a causal explanation for events, especially if unexpected and have personal relevance

• non-physical, physical

• stable, unstable

• controllable, uncontrollable

Phenomenological approach

• experience is the unit of analysis

• subjective experience of patient int heir own words (every person is different)

What is IPA

• analytic method of interpreting people’s subjective experiences

• phenomena as the unit of analysis

• themes

illness narratives

Representations are not fixed but dynamic, complex, and linked to everyday lives and experiences

restitution illness narrative

minimizes experience of illness, temporary interruption, not a big deal

chaos illness narrative

loses sense of order in life and unable to develop a way of coping

quest illness narrative

illness is a challenge to be met, something to overcome

biological distruption

onset of illness, where it begins

narrative reconstruction

find sense of self

therapeutic writing

short periods of expressive writing, emotional health benefits

illness discourse

• what is the nature of the conversation and the context

• The communicative nature of language is the focus

• language people use to talk about illness and the context of the conversation

• informational conversations are about how society views illness

discursive psychology

• what the discourse is doing

• individuals produce discourse

• how do people talk about illness in different contexts

• conversation produced by individuals

Foucauldian discourse analysis

• focus on particular discursive resources available within a culture and the implications for people

• individuals are products of discourse (we are shaped by words)

• internalization of dominant discourses and deviation from norms

• moving from norm is very harmful for self

What is culture

The inherited lens through which people perceive and understand the world that they inhabit. Lens transmitted between generations within a group of people by means of rituals, symbols, and language

What is race?

not biological system of categorization of people into groups based on phenotypic features, for the purpose of assigning differential status, power, and resources

What is scientific racism

race based medicine

What is ethnicity

group of people who may share a common ancestry and have similar cultural and physical attributes such as language, religion, social rituals and norms

High collectivism society

• fit in, care about society as a whole

• more in tine with larger spirit and body

• spiritual beliefs

High individualism society

• you should stand and make your mark

• individual action, fight and charge

• suppression of emotional energy

What is the cultural system according to kleinman

1. each country has a system of health care informed by the countri’s social and cultural context

2. which is integrated into that society to become a socially organized response to disease

3. system of interconnected relationships include people experiencing, people treating, institutions related to disease and illness

The professional sector

• organized medical professionals

• In the US very biomedical

• could be herbal medicine in China

• formal aspects of health care

• give legitimacy

The popular sector

• informal, non specialist

• early identification and definition of illness

• self and home based treatment unpaid

• family, friend, and community

The folk sector

• semi-specalized, limited focus

• holistic treatment

• shared worldview

• paid or gifted

What is stress

circumstances in which person-enviornment transactions lead to a perceived discrepancy between the physical/psychological demands and the resources of the individual’s biological, psychological or social systems

When is there no stress

when the demand of the environment and the resources you have to complete the demand are balanced

Primary cognitive appraisal

• how does it affect me

• irrelevant

• good

• stressful

secondary cognitive appraisal

what resources do i have

Harm loss

amount of damage already done

threat

expectation of future harm

challenge

opportunity for positive outcomes

Life transitions

passing from one life condition or phase to another, developmental transitions

difficult timing

events that happen earlier or later in life than usual or expected, about societal expectations

ambiguity

lack of clarity in a situation

low desirability

some circumstances are undesirable to most people in virtually all aspects

low controllability

circumstances that seem to be outside the persons behavioral or cognitive influence

general adaptation syndrome

1. perceived stressor

2. alarm reaction

3. stage or resistance

4. stage of exhaustion

approach/approach conflicts

2 desirable things that can’t happen together

avoidance/avoidance

2 undesirable things that dont happen together

approach/avoidance

attractive and unattractive features of a single goal

measuring stress physiological arousal

quantitative, experiments

measuring stress life events

higher score for more stressful events

measuring stress daily hassles

small events in life

Diathesis-stress model

• vulnerability depends on the interplay of predisposition and the amount of stress experienced

• vulnerable individual: naturally more vulnerable and risk of worse health in high stress

• resilient individual: stays constant

• only negative

differential susceptibility model

• fixed individual: environment doesn’t matter

• plastic/malleable individual: more susceptible to the environment, for better or worse

• more negative and positive

social support

• comfort, caring, esteem, or help available to a person from other people or groups

• both received and perceived support

Buffering hypothesis

• during or after appraisal

• protects from having a greater impact on health

direct effects

• hypothesis - positive outlook healthy lifestyle

• regardless of environment you are protected

stress prevention model

• prevention rather than processes after stressor occurs

• avoid or minimize exposure

• before you appraise something as stressful

• having high social support allows you to avoid stressful situations

Personal control

• the feeling that people can make decisions and take effective action to produce desirable outcomes and avoid undesirable ones

• we feel like we have autonomy

Behavioral personal control

how you behave

cognitive personal control

how you think

outcome expectancy

lead to favorable outcome

self-efficacy expectancy

perform behavior properly

attributions and personal control

• internal and external (who is responsible)

• stable and unstable (consistency over time)

• global and specific (applies to everyone)

what is coping

process by which people try to manage the perceived discrepancy between the demands and resources they appraise in a stressful situation

two main functions of coping

1. altering the problem

2. Regulating the emotional response to the problem

problem focuses coping

tend to use when perception is that believe resources or demands of situation are changeable, alter the problem its self

emotion focused coping

tend to use when perception is that little can do to change the stressful situation, how you feel about the problem and things you cant control

what are healthiest coping

• more active coping strategies

• engaging positive emotions

• finding benefits or meaning

• engaging in emotional approach

• accommodating to a stressor

issue in coping

• tend to be consistent in coping method for a particular stressor

• seldom just use one type of method

• coping for short term stressor tend to be different than for long term stressor

• individual differences in coping styles

managing interpersonal problems

• assertiveness not aggressive or indirect

• not being mean, but being clear with communication

improving ones personal control

• learned helplessness

• locus of control is important for self-image and health

• have more controls make us feel better

organizing the world

• set goals

• to do lists

• daily schedule

exercising

• overall finding: less anxiety, depression, tension, but potential placebo effect

• can be preventative for stress-related illness

preparing for stressful events

• preparatory information may be beneficial

• too much information can be stressful

stress management

any program of behavioral and cognitive techniques that is designed to reduce psychological and physical reactions to stress

progressive muscle relaxation

• guided mediation

• training on alternately tightening and relaxing muscles

• over long term

Systematic desensitization

• classical conditioning

• systematically going more and more intense

• counterconditioning: calm replaces the fear response

• stressors that evoke a strong physiological reaction

Biofeedback

• receiving feedback via devices about what the body is doing

• coupled with training to increase awareness of bodily stress processes and disrupt them

cognitive restructuring

is a technique to replace thoughts and beliefs with those that are more constructive and realistic, reducing the apprasial of threat or harm, replaces thoughts