EXAM 2 Guideline


Chapter 6

  • Define health behaviors and describe why health behaviors are relevant to morbidity and mortality.

    • Health behavior are actions taken by people to maintain, attain or regain good health and prevent illness

  • For each model of health behavior, be able to name and describe the theory’s constructs, understand contexts in which the theory applies, and explain strengths and limitations of the model.

    • Health Belief Model (susceptibility, severity, benefits, costs, cues to action, self-efficacy)

      • Susceptibility: belief about personal vulnerability to health threat

      • Severity: understanding the potential seriousness of health conditions

      • Benefits: perceived advantages of taking a specific health action

      • Costs: Potential barriers or drawbacks of taking action

      • Cues to Action: Triggers that prompt health-related behavior

      • Self Efficacy- confidence in one’s ability to successfully perform a health

    • Theory of Planned Behavior (attitudes, subjective norms, perceived behavioral control)

      • explains how personal beliefs and perceived control influences an individual’s behavior intentions and actual behavior

        • Attitudes →Intentions→Behavior

        • Subjective Norms→ Intentions→Behavior

        • Perceived behavioral control→iIntentions→behavior

    • Transtheoretical Model (Stages of Change Theory)

      • a behavior change theory that analyzes the stages people go through when attempting to modify their behavior

      • developed to address to addictive disorder

      • Stages of Change

        • 1. Precontemplation: Giving information about the problem

        • 2. Contemplation: Experiencing and assessing feeling about the problem

        • 3. Preparation: Changing the environment

        • 4. Action: Committing to act

        • 5. Maintenance: substituting alternative behavior

        • avoiding risky situations

        • rewarding self for success

        • getting help from trusted friends

  • Be able to define behavior change approaches and provide examples of each 

    • Self-Monitoring

      • Track frequency of target behavior, identify stimuli associated with behavior, use collected data to set goals can lead to short term behavior change

    • Operant Conditioning (positive reinforcement, negative reinforcement, positive punishment, negative punishment)

      • Technique focused on modifying behavior through consequences

    • Contingency contracting

      • Habitual behaviors such as cigarette smoking and overeating are often triggered by environmental signals that communicate to the brain that certain behavior will be followed by reinforcement; these signals are known as discriminative

      • formal agreement with another individual, E.X- therapist regarding the consequences of target behavior the agreement establishes the specific reinforcement or punishment that will be contingent on the participants behavior

    • Stimulus Control

      • aimed at modifying a health behavior involve two strategies:removing discriminative stimuli for the behavior form the environment and establishing new discriminative stimuli signaling the availability of reinforcement for healthier response choices

    • Implementation intentions

      • create specific actionable plans connecting situations to desired behaviors

      • bridges gap between intentions and actual behavior

  • Discuss the importance of the speaker, use of fear, and message framing in the effectiveness of health communications.

    • Speaker Credibility- Health communication message are more effective when the speaker is an expert trustworthy and perceived as having no personal gain

    • use of fear- powerful motivator in health communication particularly for illness detection behavior, highlighting potential risks and losses

    • message framing- different message frame work better for different health behavior

      • loss framed message are more effective for risky illness detection behaviors like mammogram and HIV test, appealing to risk seeking individuals

      • gained framed message works best for health promotion behaviors exercise vaccination, appealing to risk averse individuals

  • Be able to distinguish between gain- and loss-framed messages and describe when each type of message is most effective.

    • Personalized Approach

      • message effectiveness depends on individual’s approach/avoidance orientation

        • approach oriented people prefer gained framed messages

        • avoidance-oriented people prefer loss framed messages

Chapter 7

  • Define and describe physical activity, exercise, and fitness. 

    • physical activity- any bodily movement produced by skeletal muscles, results in energy expenditure includes diverse activities like house work, yard work, childcare, transportation, occupational activities and leisure time activities

    • exercise- planned repetitive and purposeful physical activity, improve or maintain physical fitness.

    • fitness- set of attributes related to ability to perform physical tasks including cardiorespiratory endurance, muscular strength, muscular endurance, flexibility and body composition

  • Describe the guidelines for physical activity in adults.

    • moderate intensity aerobic activity: 150 minutes per week

    • vigorous activities: 75 minutes per week

    • equivalent mix: combination of moderate and vigorous activities

  • Summarize the physical and psychological benefits of regular exercise. 

    • Physical health benefits- Protection against 25 chronic diseases, improved health metric, reduced resting heart rate, improved blood pressure (systolic and diastolic), reduced waist circumference and enhanced cardio-respiratory fitness

    • Psychological health benefits- Mental well-being, lower levels of anger and perceived stress, higher health related quality of life and reduced rates of major depression and anxiety disorder

  • Describe factors that may contribute to inadequate physical activity, including forecasting myopia and self-efficacy.

    • personal barriers- no time, limited money and low energy level

    • psychological factors: individual belief about health benefits and personal ability to exercise (self efficacy)

    • cognitive limitations:affective forecasting- people underestimate how much they’ll enjoy exercising, forecasting myopia-focusing on the unpleasant initial moments of exercise which discourages participation

    • environmental challenges- built environmental barriers- physical surrounding, community infrastructure limitations lack of accessible exercise space

  • Describe the characteristics of effective physical activity interventions.

    • self control principles, incorporate self monitoring set goal and plan activities

    • motivation and personalization: increase intrinsic motivation, match individual readiness for change, promote personal values, focus on individualized approaches

    • implementation strategy- create specific strategy, create specific implementation intentions, plan the how, when and where of health behavior, bridge the gap intentions and actual behavior

  • Describe the factors that control sleep timing, and components of sleep continuity. You should be familiar with terms including circadian rhythm, sleep efficiency, and sleep latency.

    • circadian rhythm: the body’s natural 24 hours cycle of sleep and wakefulness, roughly matched to the day/night cycle of light and dark

    • sleep efficiency- percentage of time actually spent asleep in bed

    • sleep latency- time going to bed to falling asleep

  • Identify the consequences of poor sleep for physical and psychological well-being.

    • sleep latency impact- higher rate of mortality risk for those falling asleep in less than 30 minutes after going to bed

    • cardiovascular- heart disease risk- greatest risk of cardiovascular disease observed in individuals with both short and long sleep durations (Ayas et al)

    • potential long-term effects, chronic sleep restrictions can lead to reduced cognitive function increased health risks, potential long term physiological consequences


Chapter 8

  • Describe obesity trends among U.S. adults over the past 40 years.

  • Describe the roles of insulin and leptin in long-term weight regulation.

    • insulin function- signals the body to store glucose, acts on brain pathway when intake exceeds expenditure, helps regulate metabolism appetite

    • leptin function- protein secreted by fat cells, signals the hypothalamus about fat stores, inhibits appetite stimulating neurons that suppress appetite

    • metabolic balance mechanism- when intake> expenditure, high insulin and leptin level, inhibits appetite, stimulates energy expenditure and increased basal metabolic rate

    • when expenditure >intake, low insulin and leptin levels, increases appetite, decreases appetite and decreases energy expenditure and reduces BMR

  • Understand factors that influence weight determination including set points and basal metabolic rate.

    • Basal Metabolic Rate (BMR)- calories needed to maintain bodily functioning

  • Do diets work in the long term? Why do diets fail? 

    • diets failure- basal metabolic rate slows down, making it harder to spend energy, being hungry for prolonged periods can increase obsession with food

    • long term diet study insights, shows significant weight regain, initial weight loss 39 pounds and the ultimate weight loss 32 pounds, 31 to 64 percent of dieters regained more than they lost

  • What is weight cycling? What is metabolic syndrome?

    • weight cycling- yo-yo dieting a pattern of repeated weight gain and loss often associated with crash diets and binge eating (Steven and others, 2012)

    • metabolic syndrome- a cluster of conditions that occur together increased blood pressure, elevated blood-sugar, excess body fat around the waist,(abdominal obesity, low HDL cholesterol level and high triglyceride level (a type of fat found in the blood, increased risk of diabetes heart disease and stroke

  • Understand the results of the starvation study by Ancel Keys and the milkshake studies, especially the differences in the behavior of dieters and non-dieters.

    • starvation study by Ancel Keys

      • dieters and non-dieters responded differently to milkshake preloads,

      • non-dieters- milkshake preload caused them to eat less ice cream

      • dieters-milkshake preload caused them to eat more ice cream

      • showing an interaction effect showing eating is not solely controlled by hunger

  • Describe the causes and consequences of weight stigma.

    • causes of weight stigma- societal sector, like media, social platforms and other institutional sources like political systems, food industry

    • consequences of weight stigma- mental health impacts higher rates of depression, increased anxiety social isolation and poorer psychological adjustment

    • associated with increased mortality risk

  • Describe evidence linking diet to mental health and understand the potential mechanisms underlying this association (e.g., inflammation, oxidative stress). 

  • Understand the rationale, methods, results, and strengths/limitations of the article by Francis and colleagues (2019) assigned for class.

    • Methods- study was 3 week parallel group, single blind RCT of an intervention to improve depressed mood participants were recruited from an undergraduate psychology course

    • participants in the diet change group received the diet intervention instruction from our registered dietician via a 13 minute video, available for re-watching online, participants were instructed to intake of vegetable, were provided a sample meal plan and recipes, a handout answering

    • results- 262 were excluded, The DC group showed a significant increase in consumption of the recommended foods, DC group showed a significant reduction in consumption of foods high in saturated fat and refiend sugar

    • limitation of the current study is the lack of an active control group as a comparison.The sample was undergraduate university student


Chapter 9

  • Describe the features of substance use disorders as characterized in the DSM-5.

  • Describe the physical and psychosocial consequences of alcohol use.

    • physical consequences of alcohol- long term term physical consequences, dementia , stroke and neuropathy, cardiovascular- heart disease, gastrointestinal- pancreatitis gastritis, liver- cirrhosis, pregnancy fetal alcohol syndrome, short term consequences- violence 2/3 of intimate partner violence cases, child maltreatment: leading factor in child neglect, risky sexual behavior, alcohol poisoning

    • psychosocial- mental health, depression anxiety suicide risk and social problem- unemployment family issues t

  • What is binge drinking? How does college attendance relate to risk of binge drinking? What factors contribute to risk of binge drinking in college students?

    • binge drinking- male 5 or more drinks, female 4 or more drink consumed within about 2 hours

    • college attendance relate to risk of binge drinking- 49 of college students report drinking alcohol in the past month, 28.9 engaged in binge drinking, 14 meet criteria for past year alcohol use disorder

    • risk factor for binge drinking in college personality traits, behavioral under-control: sensation seeking, thrill-seeking, less consideration of long term consequences, easily bored

  • Describe the role of genes, personality, and psychosocial factors in alcohol dependence.

  • Describe the interventions that have been used to treat and prevent alcohol dependence.

  • Describe why adolescents and young people are particularly vulnerable to engaging in substance use as well as negative effects of substance use.

  • Describe patterns of cannabis use, smoking and e-cigarette use in the U.S. over the past century.

  • Outline the physical and psychological effects of THC and discuss the health benefits and risks associated with cannabis use.

  • Describe features of Cannabis Use Disorder and effective therapies for CUD. 

  • Outline the physical effects of nicotine and discuss the health hazards associated with tobacco use and e-cigarette use.

  • Discuss the biological, psychological, and social factors that may explain why people start smoking, why they continue, and why they find it difficult to quit.

  • Describe the difference between positive reinforcement and negative reinforcement, and how both concepts are related to nicotine dependence.

    • positive reinforcement- adding a stimulus to strengthen a response and increase its likelihood,

    • negative reinforcement- removing an unpleasant stimulus to strengthen a response

    • related to nicotine dependence- both reinforcement type contribute to persistent substance use, motivation include experiencing pleasurable nicotine effects, relieving negative emotions, avoiding uncomfortable withdrawal symptoms

  • Describe reasons that young people initiate and continue e-cigarette use.