Lecture 4 - 8 Heath Psychology

Page 1: Psychophysiology

Overview

• Psychophysiology refers to the study of links between psychological and physiological processes.

Page 2: Psychological States and Physical States

Key Question

• How are psychological states related to physical states?

• This page hints at exploring the connections and interactions between mind and body in physiological responses.

Page 3: History of Psychophysiology

Ancient Contributions

• Ancient Greece: Hippocrates proposed that bodily functions and health were linked to psychological states.

• Ancient Rome: Galen introduced the concept of four bodily humors:

  1. Blood - sanguine

  2. Black bile - melancholy

  3. Yellow bile - choler

  4. Phlegm - apathy

Page 4: Medieval Perspectives

Influence of the Church

• Middle Ages: The Roman Catholic Church dominated; it held the belief that illnesses were caused by evil spirits and demons.

• This belief led to the church forbidding scientific research on the human body, stunting the growth of medical knowledge.

Page 5: Descartes' Dualism

Mind-Body Dualism

• René Descartes' Influence: Proposed the concept of mind/body dualism, suggesting that the mind/soul is separate from the body, impacting the perception of disease and health.

Page 6: Psychoanalysis

Freud’s Contribution

• Sigmund Freud:

  • Utilized hypnosis to cure hysterical paralysis.

  • Collaborators Alexander & Dunbar suggested that diseases could be a result of unconscious emotional conflicts, like:

    • Ulcers - stemming from oral conflicts.

    • Asthma - linked to separation anxiety.

Page 7: Homeostasis

Concepts of Internal Balance

• Mileur interne (Claude Bernard): All organisms must maintain a constant internal environment.

• Wisdom of the Body (Walter Cannon): Suggests that the body self-corrects to maintain balance.

Page 8: Homeostasis and Allostasis

Definitions and Differences

• Homeostasis: Maintains equilibrium through adjustments in physiological processes.

• Allostasis: Active process of adaptation to maintain homeostasis, anticipating changes.

Comparison:

Page 9: Allostatic Load

Concept of Stress Accumulation

• Allostatic Load (McEwen & Stellar, 1993): Refers to cumulative physiological cost associated with repeated allostasis, leading to:

  • Decreased immunity

  • Results from chronic stressors,

  • Inability to manage continuous or recurrent stressors and to conclude the stress response.

Page 10: Impact of Psychological States on Body's Systems

Query

• How are bodily systems affected by psychological states?

• This page sets the premise to explore these interactions further.

Page 11: Nervous System Overview

Two Major Components

• Peripheral Nervous System: Divided into

  • Autonomic - involuntary actions (internal organs, glands)

  • Somatic - voluntary muscle control.

Central Nervous System

• Comprises the brain and spinal cord.

Page 12: Autonomic Nervous System

Functionality

• Manages internal organs without conscious control.

• Divided into:

  • Sympathetic - mobilizes body to react to stress/activity.

  • Parasympathetic - restores body after arousal.

Page 13: Autonomic Nervous System Responses

Sympathetic vs. Parasympathetic Actions

Page 14: Endocrine System

Hormonal Regulation

• Regulatory system that secretes hormones.

  • Hypothalamus: Controls the pituitary gland.

  • Pituitary Gland: The master gland secreting hormones influencing other endocrine glands (Adrenal glands).

Page 15: Stress Response Pathway

Activation Mechanism

• Stress triggers the Central Nervous System leading to:

  • Hypothalamus activation

  • Activation of Sympathetic-adrenal-medullary (SAM) system results in catecholamine (epinephrine/norepinephrine) release.

  • Additionally activates the HPA system secreting cortisol.

Page 16: Immune System

Function and Relationship to Stress

• Protects bodily tissues from pathogens (bacteria, viruses, cancer cells).

• Stress has been shown to suppress immune functioning.

• The immune system can be classically conditioned (Ader & Cohen, 1975).

Page 17: Cardiovascular System

Response to Stress

• Stress activates the sympathetic nervous system increasing heart rate and blood pressure.

• Chronic activation results in hypertension causing damage to heart muscles and vessels.

Page 18: Stress Measurement and Models

Introduction to Stress

• Importance of measurement of stress and understanding models that explain how stress impacts physical health.

Page 19: Stress and Illness

Conceptual Analysis

1. Understanding stress: Conceptualize and measure it through:

• Life changes, daily hassles, perceived stress.

2. Models illustrating stress effects on illness:

• Indirect effects, direct effects, illness behavior, and diathesis-stress model.

Page 20: Conceptualizing Stress

Definition

• Stress is defined as a response to events perceived as challenging.

• Not all stress leads to illness.

Page 21: Measuring Stress

Approaches to Measurement

• Various methods to measure stress include:

  • Life events, minor events, and perceptions of stress.

• Life changes require adaptation and may lead to illness.

• Social Readjustment Rating Scale (SRRS; Holmes & Rahe, 1967) evaluates stress based on life events.

Page 22: Social Readjustment Rating Scale (SRRS)

Life Events and Ratings

• A table indicating the mean values of various life events ranked by their associated stress impact.

Key Life Events:

Page 23: Additional Life Events

Continuation of Life Event Rankings

• Continuation of table with additional life events and their stress values.

Page 24: Assessment of Stress from Events

Examples and Impact

• Showcases various life events and their magnitude of stress impact, particularly focusing on personal situations like death, divorce, and significant changes in health or behavior.

Page 25: Daily Hassles

Negative Health Effects

• Daily hassles consist of minor annoying events requiring some adjustment, which accumulate negatively impacting health.

Page 26: Hassles Scale

Assessment Tool

• Participants check daily hassles and rate their severity. Examples include misplacing items, money concerns, and health family members.

Page 27: Daily Hassles Correlation Study

Findings

• Demonstrates correlations between daily hassles and health, with significant findings noted between the intensity of hassles and health outcomes.

Page 28: Perceived Stress

Definition

• Perceived stress is the appraisal of life situations as unpredictable and overwhelming, often leading to adverse health outcomes.

• Perceived Stress Scale (Cohen et al., 1983) measures this aspect.

Page 29: Correlations with Health Outcomes

Studies on Perceived Stress

• Research indicates that perceived stress negatively correlates with health outcomes, emphasizing the significance of stress appraisal in health.

Page 30: Cognitive Appraisal of Stress

Evaluation Process

• Lazarus & Folkman (1984) define cognitive appraisal as:

  1. Primary Appraisal: Assessment of potential harm from an event.

  2. Secondary Appraisal: Determination of one’s resources and abilities to deal with the event.

Page 31: Illness Behavior Model

Stress Response Relationship

• Focuses on responses to stressful events and the concept of entering the "sick role" as a coping mechanism.

Page 32: Indirect Effect Model

Stress and Unhealthy Behaviors

• Chronic stress can lead to unhealthy coping behaviors, such as overeating or substance abuse, resulting in physiological changes and disease development.

Page 33: Direct Effect Model

Immediate Physiological Effects of Stress

• Focuses on how stress directly leads to physiological changes causing diseases, often summarizing the interplay of environmental stressors and predispositions to illnesses (diathesis-stress model).

Page 34: Physiological Stress Response

Fight-or-Flight Reaction

• Cannon’s theory of fight-or-flight explains how stress mobilizes physiological resources to prepare for confrontation or escape.

Page 35: General Adaptation Syndrome (GAS)

Three Stages of Stress Response

1. Alarm: Initial response with high physiological arousal.

2. Resistance: Continued adaptation under stress, maintaining high arousal.

3. Exhaustion: Resources deplete, potentially leading to health issues.

Page 36: Stress and Immune Functioning

Effects on Immunity

• Chronic physiological responses to stress can impair immune system functioning, correlating with increased illness susceptibility.

Page 37: Stress Research on Colds

Study Findings

• Examines whether stress vulnerability impacts susceptibility to cold viruses through controlled experimental exposure.

Page 38: Stress and Wound Healing

Research Overview

• Investigates the correlation between stress levels and wound healing efficiency, revealing significant differences between high-stress periods and restful conditions.

Page 39: Cardiovascular Activation

Physiological Changes Under Stress

• Demonstrates how acute stress affects cardiovascular responses including heart rate and blood pressure, posing long-term health risks.

Page 40: Stress Moderators: Social Support

Importance of Social Networks

• Exploration of how social support serves as a moderator in stress-related health impacts.

Page 41: Types of Social Support

Classifications

• Emotional Support: Providing care and comfort.

• Informational Support: Offering suggestions and guidance.

• Instrumental Support: Providing tangible assistance.

Page 42: Matching Hypothesis

Effective Social Support

• Suggests that a balance between the needs of the recipient and the type of support received results in the most effective outcomes.

• Mismatched support can elevate psychological distress.

Page 43: Components of Social Support

Elements of Connection

1. Social Connection: Extent of relationships and roles.

2. Structural Connection: Interconnections among social networks.

3. Functional Connection: Perceived availability and quality of support.

4. Quality Connection: Positive and negative aspects of social relationships.

Page 44: Structural Social Support

Impact on Mortality Risk

• The number of social relationships has shown a strong correlation with decreased mortality risk through longitudinal studies.

Page 45: Social Networks and Overall Health

Relationship Insights

• Associations reflecting how the existence of social networks relates positively to better health outcomes and perceptions of support.

Page 46: Functional Support

Dimensions of Support

• Received Support: Amount accessed, typically linked with better health but can also cause dependency risks.

• Perceived Support: Appraisal of available support correlating tightly with lower mortality.

Page 47: Social Isolation and Health Risks

Mortality Implications

• Social isolation and loneliness have demonstrated significant increases in mortality risks, highlighting the need for supportive relationships.

Page 48: Findings on Social Support

Meta-Analytic Results

• Analysis comparing social support aspects and their linked effects on mortality risk reveals vital implications for health.

Page 49: Comparison of Mortality Influences

Relationship Factors

• Meta-analyses show various factors influencing mortality and the strength of their effects in relation to social support.

Page 50: Social Support and Wellbeing

Mechanistic Pathways

• Explores how providing support can generate positive emotions, contributing to decreased morbidity.

Page 51: Relationship Strain

Conflicts in Social Relationships

• Unresolved conflicts and insensitive behaviors can lead to adverse health outcomes, emphasizing the need for supportive interactions.

Page 52: Health Function of Social Support

Hypotheses on Protection

1. Direct Effects Hypothesis: Social ties provide protection during stress.

2. Buffering Hypothesis: Social connections offer buffers against adverse effects of stress.

Page 53: Mechanisms of Social Resources

Pathways to Health

• Highlights how cognitive appraisal, health behaviors, and psychosocial interactions mediate physiological responses to stress.

Page 54: Psychoneuroimmunological Pathways

Immune Responses to Stress

• Studies relate social network diversity with immune responses when exposed to stressors like viruses.

Page 55: Stress and Responses

Impact of Social Support During Stressful Situations

• Examination of blood pressure responses under varying social support conditions during stress-inducing tasks.

Page 56: Hand-Holding Study

Neural Responses to Stress

• fMRI study observing brain activation in stress-processing areas on hand-holding conditions (spouse vs. stranger).

Page 57: Tend-and-Befriend Response

Gender Differences in Stress Responses

• Suggests that females may exhibit nurturing behaviors in response to stress, potentially driven by oxytocin release.

Page 58: Oxytocin's Role

Effects on Stress Responses

• Oxytocin promotes social bonding and mitigates physiological responses to stress, indicating its significance in health.

Page 59: Wound Healing and Oxytocin

Research on Healing Facilitation

• Examines whether social contact and oxytocin facilitate wound healing, presenting experimental results on varying conditions.

Page 60: Hamster Study on Healing

Experimental Results

• Hamsters subjected to stress exhibit varied healing outcomes based on social housing and oxytocin injections, highlighting the hormone's importance.

Page 61: Further Study on Oxytocin

Mechanistic Investigation

• Study procedures evaluate oxytocin's interaction with stress hormones on wound healing in socially isolated vs. paired conditions.

Page 62: Summary of Key Findings

Comparative Results on Healing

• Summarizes significant findings of wound healing and hormonal interactions, unveiling the profound effects of social conditions.

Page 63: Stress Moderators: Personality

Concept of Control

• Perceived control and predictability in stress situations are linked to lesser physiological reactivity in studies involving rats.

Page 64: Control in Nursing Homes

Effects of Choice

• Resident studies demonstrate improved health outcomes with increased resident choices and control over their environments.

Page 65: Perceived Control Overview

Beliefs and Health

• Individuals' beliefs regarding their ability to influence outcomes significantly correlate with overall health, with physical activity being a mediator.

Page 66: Personality Models and Health

Health-Related Behaviors

• Connections between personality traits and health behaviors demonstrate ongoing influence from childhood traits to adult behaviors associated with health outcomes.

Page 67: Big Five Personality Traits

Overview of Traits

• The Big Five traits include:

  • Extraversion

  • Agreeableness

  • Conscientiousness

  • Neuroticism

  • Openness

Page 68: Health Behaviors and Personality

Patterns

• Personality traits significantly influence health-related behaviors: e.g., conscientious individuals exhibit lower alcohol and smoking habits.

Page 69: Disease-Caused Personality Changes

Bidirectional Relationships

• Investigating how disease can induce psychological changes and consequently impact personality traits and health.

Page 70: Stress Moderation by Personality

Coping Mechanisms

• Understanding how personality can moderate the effects of stress and influence health outcomes.

Page 71: Hardiness and Health

Characteristics of Hardiness

• Includes elements such as commitment, control, and challenge. Hardiness is associated with resilience against illness.

Page 72: Hardiness Study Findings

Research on Hardiness Impacts

• Studies indicated that individuals with higher levels of hardiness reported fewer illness symptoms post-stressful life events.

Page 73: Explanatory Style

Cognitive Variables

• Internal vs. external, stable vs. unstable attributions impact resilience and psychological health, affecting mortality risk.

Page 74: Optimism and Health

Outcomes of Positive Outlook

• A propensity to believe in positive outcomes correlates with better health outcomes, including faster recovery from surgeries.

Page 75: Conscientiousness

Nuances of Personality Effects

• Mixed evidence regarding how conscientiousness impacts health, while neuroticism showcases varied links to mortality risk.

Page 76: Type A vs. Type B Personality

Character Traits Studies

• Type A personalities (competitive and hurried) are linked with higher risks of coronary heart disease compared to Type B (relaxed) personalities.

Page 77: Research on Type A Behavior

Epidemiological Studies

• Landmark studies revealing the link between Type A behavior patterns and increased heart disease risk over substantial periods.

Page 78: Hostility and Its Effects

Impact on Health

• Analyzes the correlation between hostility, cardiovascular disease, and overall mortality risk across various studies.

Page 79: Interventions for Type A Behavior

Programs to Reduce Risks

• Training programs for Type A individuals focusing on reducing myocardial infarction (MI) incidences and improving health outcomes through behavior modification.

Page 80: Coping with Stress

Overview of Strategies

• Coping with stress involves efforts to mitigate threats, with:

  • Problem-focused coping: Addressing the source of stress.

  • Emotion-focused coping: Managing emotional reactions.

Page 81: Emotion-Focused Coping

Strategies for Emotional Management

• Approach Coping: Adjusting cognitions/expressing emotions to manage stress effectively.

• Avoidance Coping: Denying or ignoring issues, sometimes resulting in maladaptive behaviors (like substance abuse).

Page 82: Role of Religiosity

Health Benefits

• Engagement in religious practices is linked to lower mortality risk and overall better health outcomes, analyzed through various studies (McCullough et al.).

Page 83: Attendance Effects

Impact on Longevity

• Regular attendance at religious services contributes to reduced mortality risk; social bonds contribute additionally to health outcomes.

Page 84: Expressive Writing's Benefits

Therapeutic Effects

• Expressive writing activities linked to significant improvements in physical health, such as lower doctor visits and enhanced immune functioning.

Page 85: Emotional Disclosure Studies

Empirical Findings

• Empirical evaluations indicate that expressing traumatic experiences positively affects health, with meta-analysis supporting its benefits across various populations.

Page 86: Exercise and Mental Health

Physical Activity Advantages

• Exercise proven to reduce stress and anxiety, with specific studies demonstrating substantial recovery improvements in clinically depressed participants.

Page 87: Mechanisms Behind Exercise Benefits

Health Outcomes

• Potential mechanisms explaining exercise benefits on health include increased endorphin levels, improved self-esteem, and distraction from stressors.

Page 88: Mindfulness Practices

Concepts and Benefits

• Mindfulness practices illustrated through awareness and acceptance of present thoughts lead to better health, including stronger immune functioning and lower stress levels.

Page 89: Self-Affirmation Techniques

Stress Mitigation

• Self-affirmation practices, affirming personal values, significantly buffer against physiological stress responses during challenging situations.

Page 90: Relaxation Techniques

Approaches to Stress Reduction

• Various techniques such as deep breathing, progressive muscle relaxation, and guided imagery aid in emotional and physiological stress management.

Page 91: Nature Exposure and Health

Influence of Natural Environments

• Interaction with nature correlates with lower stress levels and improved overall health outcomes, linking nature exposure to enhanced well-being.

Page 92: Positive Emotions

Longevity and Health

• Positive emotional states directly associate with better mental and physical health, impacting longevity and immune functioning.

Page 93: Humor as a Health Factor

Mechanisms Behind Benefits

• Humor is suggested to have various mechanisms contributing to health improvement, including physiological changes and enhanced social support.

Stress Moderators (Social Support)

• What are the direct effects and buffering hypotheses?

  • Direct Effects Hypothesis: When social support is provided, it leads to improvements in health outcomes, irrespective of the stress levels.

  • Buffering Hypothesis: Social support serves as a protective shield against the negative effects of stress on health.

• What are the potential mechanisms in the relation between social support and health?

  • One significant mechanism is cognitive appraisal, where social support influences how individuals perceive and handle stressors.

• What is the evidence for psychoneuroimmunological pathways between social support and health?

  • Studies by Cohen et al. (1997), Coan et al. (2006), and Lepore et al. (1993) established that social support affects neuroendocrine and immune responses, revealing biological links to health outcomes.

• What is the tend-and-befriend hypothesis?

  • This hypothesis suggests that females often seek social connections and support as a response to stress, potentially driven by oxytocin release in the body.

• What is the evidence for the roles of social contact, oxytocin, and cortisol in physiological stress responses?

  • A study by Detillion et al. (2004) indicates that social interactions can help lower cortisol levels and improve wound healing through the action of oxytocin.

Stress Moderators (Personality)

• What is the relation between control and health?

  • Research by Visintainer et al. (1982) shows that greater control over stressful situations correlates with better health outcomes, as seen in studies involving rats.

• What were Langer and Rodin’s studies?

  • In studies conducted in 1976 and 1977, these researchers found that increased perceived control over daily activities improved overall well-being among nursing home residents.

• How is perceived control related to health?

  • Infurna & Gersdorf (2014) demonstrated that individuals who perceive they have control over their life events generally experience better health outcomes.

• What are the 5 models of personality and disease?

  • They include the stress moderation model, health behaviors model, disease-caused personality changes model, and additional frameworks that connect personality traits to health outcomes.

• What is the evidence for the health behaviors model?

  • Evidence provided by Friedman et al. (1995) shows that personality traits significantly influence health-related behaviors and corresponding health outcomes.

• In the disease-caused personality changes model, how can personality change result from disease?

  • Illness can lead to changes in personality traits, which may, in turn, impact health behaviors and coping mechanisms.

• What is hardiness and what are its 3 components?

  • Hardiness refers to a personal resilience characterized by commitment, control, and challenge, contributing positively to stress management and health.

  • Research by Kobasa et al. (1982) found that greater levels of hardiness corresponded with fewer health issues during stressful situations.

• What is explanatory style, and what are its dimensions?

  • Explanatory style refers to how individuals explain life events, with three dimensions being internal vs. external, stable vs. unstable attributions. This style relates to resilience and health outcomes, according to Peterson et al. (1998).

• What is optimism, and how is it linked to health?

  • Optimism refers to a tendency to expect positive outcomes and is connected with healthier outcomes, as demonstrated by Scheier et al. (1989).

  • Concepts such as unrealistic optimism and defensive pessimism also shape how stress impacts health.

• How is conscientiousness related to health?

  • Research by Friedman et al. (1993) and Turiano et al. (2013) indicates that individuals high in conscientiousness are more likely to engage in healthier lifestyle choices.

• How is neuroticism related to health?

  • Studies by Chapman et al. (2010) and Turiano et al. (2015) found that high levels of neuroticism are associated with negative health outcomes and unhealthy coping strategies.

• What is the Type A behavior pattern?

  • Type A personalities are characterized by competitiveness and urgency, correlating with a higher risk for health problems, particularly linked to hostility.

• Can interventions lower Type A personality traits/hostility?

  • Interventions aimed at modifying behavior have been shown to reduce Type A traits and resulting health risks (Friedman et al., 1984; Davidson et al., 2007).

Coping With and Reducing Stress

• What are problem-focused and emotion-focused coping?

  • Problem-focused coping involves taking direct steps to address the source of stress, while emotion-focused coping aims to manage one’s emotional response to stress.

• What are approach and avoidance coping?

  • Approach coping entails actively dealing with the stressor, whereas avoidance coping involves behaviors like denial to distract from problems.

• What is the relation between religiosity and health?

  • Studies by McCullough et al. (2000) indicate that higher levels of religiosity are often associated with better health outcomes and enhanced well-being.

• What were the results of McCullough et al.’s study on religiosity and mortality risk?

  • Their research conducted in 2009 showed that regular attendance at religious services correlates with reduced mortality risk.

• What were the results of Li et al.’s study on attendance at religious services?

  • Findings from the 2016 study highlighted that increased attendance at religious gatherings is linked to better health outcomes.

• What is the relation between expressive writing and health outcomes?

  • Engaging in expressive writing about emotional experiences has been shown to result in improved health metrics.

• What were the results of Pennebaker’s studies on expressive writing?

  • His research indicated significant health benefits from expressive writing, which were also discussed in a meta-analysis (Frattaroli, 2006), revealing moderators influencing these outcomes.

• What is the relation between gratitude and health?

  • Emmons and McCullough (2003) found that practicing gratitude can lead to enhanced mental and physical health.

• What is the relation between exercise and psychological health?

  • Blumenthal et al. (1999) and Babyak et al. (2000) highlighted that regular exercise positively affects psychological well-being and mental health.

• What are the potential mechanisms of exercise on psychological health?

  • Exercise may lead to increased endorphin levels, improved self-esteem, and provide distraction from stressors, contributing to better mental health.

• What is mindfulness, and what are its health outcomes?

  • Mindfulness involves being present and aware of one’s thoughts and emotions, associated with decreased stress and improved health outcomes.

• What is self-affirmation?

  • Self-affirmation allows individuals to affirm their values, and studies by Sherman et al. (2009) showed it can lower physiological stress responses, like reducing epinephrine levels during stressful situations.

• How is relaxation beneficial?

  • Relaxation techniques aid in managing stress and promoting overall health improvements.

• How are positive emotional states related to health outcomes?

  • There is a direct correlation between positive emotions and better mental and physical health outcomes, including enhanced longevity.

• How is spending time in nature beneficial?

  • Research (Li, 2010) indicates that time spent in natural settings can lower stress levels and improve health outcomes.

• What are the potential mechanisms regarding humor and health?

  • Humor appears to contribute to health through various physiological changes in the body, enhancing psychological and social well-being.