A1 – Psychological Definition of Health and Ill Health, Addiction, and Stress Health and Ill Health

A1 – Psychological Definition of Hyealth and Ill Health, Addiction, and Stress

Health and Ill Health

Definitions and Characteristics:

  • Biomedical model:
    Views health as the absence of disease or physical malfunction.

    • Example: A doctor diagnoses hypertension — treatment focuses solely on lowering blood pressure through medication.

    • Evaluation:

      • Strengths: Scientifically testable, objective, effective for acute illnesses.

      • Limitations: Ignores psychological and social factors, e.g. stress or lifestyle choices.

  • Biopsychosocial model (Engel, 1977):
    Health results from the interaction between biological (genes, hormones), psychological (beliefs, coping strategies), and social (support networks, culture) factors.

    • Example: A person’s recovery from surgery depends on genetic resilience (bio), optimism (psych), and family support (social).

    • Evaluation:

      • Holistic – considers multiple influences.

      • Harder to test empirically due to complexity.

  • Health as a continuum:
    Health and illness exist on a scale rather than a binary (healthy vs unhealthy).

    • Example: A smoker with no disease yet may be mid-continuum; someone with cancer may be at the illness end.

    • Evaluation:

      • Recognises fluctuation and subjective perception of health.

      • Difficult to measure where individuals lie on the continuum.

Addiction

Definitions and Characteristics:

  • Behavioural addiction: Compulsive engagement in rewarding non-substance-related behaviour (e.g., gambling, gaming).

  • Physiological addiction: Physical dependence on a substance (e.g., nicotine, alcohol) leading to withdrawal when stopped.

Griffiths’ Six Components of Addiction (2005):

  1. Salience: Activity dominates thinking/behaviour.

    • Example: A gambler constantly thinking about betting odds.

  2. Tolerance: Needing increasing amounts for same effect.

    • Example: Smoker needing more cigarettes to feel relaxed.

  3. Withdrawal: Unpleasant symptoms when stopped.

    • Example: Anxiety and irritability when quitting alcohol.

  4. Conflict: With self or others.

    • Example: Ignoring family to play online games.

  5. Relapse: Returning to behaviour after abstinence.

  6. Mood alteration: Emotional changes such as euphoria or escape from reality.

Evaluation:

  • Useful for identifying behavioural vs substance addictions.

  • Ignores social/cultural influences on addictive behaviour.

Stress

Definitions and Characteristics:

  • Stressor: Any event perceived as threatening or demanding.

    • Example: Exams, financial problems.

  • Psychological stress: Emotional strain from perceived inability to cope.

  • Coping and Perception: Stress depends on the person’s appraisal (Lazarus, 1993).

    • Example: One student sees an exam as a challenge; another as a threat.

    • Evaluation:

      • Explains individual differences in stress response.

      • Difficult to quantify “perceived” stress objectively.

A2 – Psychological Approaches to Health

Biological Influences

  • Genetic predisposition: Some individuals inherit vulnerability to addiction or illness.

    • Example: DRD2 gene linked to dopamine receptor sensitivity and addiction risk.

  • Neurotransmitter imbalances:

    • Example: Low serotonin → depression; dopamine surges → addiction.

  • Evaluation:

    • Supported by twin studies.

    • Reductionist – ignores environmental triggers.

Behaviourist Approach

  • Healthy/unhealthy behaviour explained by learning:

    • Positive reinforcement: Reward encourages repetition.

      • Example: Praise for going to the gym.

    • Negative reinforcement: Removal of unpleasant feeling encourages behaviour.

      • Example: Smoking to reduce stress.

    • Operant conditioning applications:

      • Health campaigns using incentives for quitting smoking.

    • Evaluation:

      • Explains habit formation.

      • Ignores internal cognitive processes.

Social Learning Approach (Bandura, 1977)

  • Observation and imitation of role models (parents, peers, media).

    • Example: Teen copies parents’ drinking habits; or influencer promotes healthy eating.

  • Vicarious reinforcement: Seeing others rewarded encourages imitation.

  • Evaluation:

    • Explains social transmission of health behaviours.

    • Fails to explain individual differences if same model observed.

Cognitive Approach

  • Behaviour influenced by thoughts, beliefs, and interpretations.

    • Example: Person drinks alcohol to “relieve stress” (self-medicating belief).

  • Cognitive dissonance: Discomfort from conflicting beliefs and actions (e.g., “I know smoking kills but I enjoy it”).

  • Professional biases: Doctors’ expectations affect diagnosis and treatment.

  • Evaluation:

    • Useful in therapies like CBT for addiction.

    • Overemphasises rational decision-making; emotions play a role too.

A3 – Theories of Stress, Behavioural and Physiological Addiction

Health Belief Model (Becker, 1974)

  • Behaviour depends on:

    • Perceived seriousness: How severe illness is believed to be.

    • Perceived susceptibility: Risk of experiencing illness.

    • Cost-benefit analysis: Pros and cons of changing behaviour.

    • Cues to action: Internal (symptoms) and external (adverts).

    • Example: A smoker quits after TV ad on lung cancer.

  • Evaluation:

    • Useful for predicting preventive health actions.

    • Does not consider habits or social influences.

Locus of Control (Rotter, 1966)

  • Internal locus: Belief that personal actions determine outcomes.

  • External locus: Belief that fate or others control outcomes.

  • Example: Internals more likely to diet successfully.

  • Evaluation:

    • Predicts motivation for health behaviour.

    • Cultural bias – Western emphasis on personal control.

Theory of Planned Behaviour (Ajzen, 1985)

  • Components:

    • Personal attitude

    • Subjective norms

    • Perceived behavioural control

  • Example: Teen decides to exercise because friends value fitness and they feel capable.

  • Evaluation:

    • Strong predictor of intention.

    • Intention ≠ behaviour (gap between planning and doing).

Self-Efficacy Theory (Bandura, 1977)

  • Belief in one’s ability to succeed in specific situations.

    • Sources:

      • Mastery experiences (past success)

      • Vicarious experiences (seeing others succeed)

      • Social persuasion (encouragement)

      • Emotional states (low anxiety → higher self-efficacy)

    • Example: Someone who successfully quits once is more likely to do so again.

  • Evaluation:

    • Central in behaviour change programs.

    • Doesn’t account for external barriers (e.g., cost of gym).

Transtheoretical Model (Prochaska & DiClemente, 1983)

  • Stages:

    1. Precontemplation

    2. Contemplation

    3. Preparation

    4. Action

    5. Maintenance

  • Example: Smoker progresses through stages when quitting.

  • Evaluation:

    • Recognises change as gradual.

    • Oversimplifies relapse and individual variation.

B1 – Stress

Causes of Stress

  • Life events: Big changes like divorce, bereavement (Holmes & Rahe, 1967).

  • Daily hassles: Minor irritations accumulate (Lazarus, 1984).

  • Workplace stress: Role conflict, low control, poor environment.

    • Example: Air traffic controller with high responsibility but low control.

  • Personality:

    • Type A (competitive, hostile) – higher stress risk.

    • Type B (relaxed) – lower risk.

Physiological Responses to Stress

  • GAS (Selye, 1936): Alarm → Resistance → Exhaustion.

  • SAM System (acute): Adrenaline from adrenal medulla – fight/flight.

  • HPA System (chronic): Cortisol release – prolonged stress.

Evaluation:

  • Explains biological mechanisms.

  • Gender bias – women may “tend and befriend” (Taylor, 2000).

  • Fight or flight maladaptive in modern contexts.

Link to Physical Ill Health:

  • Short-term: Headaches, nausea.

  • Long-term: Heart disease, hypertension, stroke.

B2 – Physiological Addiction

Smoking

  • Biological approach:

    • Initiation: Genetic predisposition (dopamine reward pathways).

    • Maintenance: Nicotine regulates dopamine; tolerance develops.

    • Relapse: Withdrawal symptoms drive relapse.

  • Learning approach:

    • Initiation: Parental role models.

    • Maintenance: Negative reinforcement (stress relief).

    • Relapse: Conditioned cues (smell of smoke).

  • Evaluation:

    • Biological + learning models complement each other.

    • Ignores cognitive motivations (e.g., self-image).

Alcohol

  • Cognitive approach (Self-medication):

    • Initiation: Coping with stress.

    • Maintenance: Belief that alcohol manages anxiety.

    • Relapse: Increased stress when abstaining.

  • Learning approach (Operant conditioning):

    • Positive reinforcement: Relaxation, social acceptance.

    • Negative reinforcement: Relief from withdrawal.

  • Evaluation:

    • Explains social and emotional aspects.

    • Neglects genetic influences.

B3 – Non-Substance-Related Addiction

Gambling

  • Cognitive approach (Expectancy Theory):

    • Initiation: Cost-benefit analysis (“I might win big”).

    • Maintenance: Cognitive biases – illusion of control.

    • Relapse: Recall bias (remember wins, forget losses).

  • Learning approach:

    • Variable reinforcement – wins unpredictable but powerful.

    • Cue reactivity: Seeing betting adverts triggers relapse.

  • Evaluation:

    • Explains persistence despite losses.

    • Ignores emotional regulation motives.

Shopping

  • Learning approach:

    • Initiation: Role models and advertisements.

    • Maintenance: Positive reinforcement (pleasure, dopamine rush).

    • Relapse: Exposure to cues (sales, ads).

  • Cognitive approach (Self-medication):

    • Initiation: Coping with boredom or distress.

    • Maintenance: Anxiety reduction.

    • Relapse: Withdrawal boredom, guilt, or anxiety.

  • Evaluation:

    • Explains emotional cycle of spending.

    • Difficult to measure objectively; overlaps with OCD behaviour.

Approach

Strengths

Weaknesses

Best Explains

Biological

Scientific, objective, effective treatments

Reductionist, deterministic

Smoking, alcohol

Behaviourist

Explains habit and relapse, testable

Ignores thoughts/emotions

Smoking, gambling

Social Learning

Explains initiation, media influence

Doesn’t explain persistence, ignores biology

All initial addiction onset

Cognitive

Focus on beliefs, supports CBT

Hard to prove causation, ignores withdrawal

Gambling, shopping, alcohol relapse

  • Smoking: Best explained by biological (nicotine, dopamine) and behaviourist (conditioning to cues) approaches.

  • Alcohol: Best explained by cognitive (self-medication) and biological (genetic vulnerability) models.

  • Gambling: Strongly explained by cognitive (biases) and behaviourist (variable reinforcement) theories.

  • Shopping: Explained by cognitive (coping with emotions) and social learning (role models, advertising).