Health Psychology Notes

Health Psychology

• Health psychology is the application of psychology to promote physical health and prevent/treat illness.
• Health is a joint product of biological, psychological, and social factors.

Leading Causes of Death (2014)

• Infectious diseases, cancer, and heart disease were leading causes.
• Many of these are preventable through lifestyle, outlook, and behavior changes.
• Key questions:
  • Why do we become ill?
  • How do emotions/personality influence disease risk?
  • How do we respond to illness?
  • How do we maintain health?

Psychology and Medical Problems

• Four ways they are related:
  • Organic malfunctioning/tissue damage may be psychogenic.
  • Problems with no organic basis can be physical symptoms of tension.
  • Psychological factors can weaken or strengthen disease resistance.
  • Psychological factors can cause unhealthy behaviors leading to illness.

Immune System

• It's a network of cells and organs.
• It's the body’s primary defense against infectious diseases or antigens (bacteria/viruses).
• Two types of white blood cells:
  • B-cells: Form in bone marrow, release antibodies to fight bacterial infections.
  • T-cells: Form in thymus, attack cancer cells, viruses, and foreign substances.
• Lymphocytes identify, pursue, and ingest harmful invaders and worn-out cells.
• Macrophages pursue diseased cells.
• Natural killer cells (NK cells) pursue diseased cells.
• Factors like age, nutrition, genetics, body temperature, and stress can cause the immune system to:
  • Attack the body’s own tissues.
  • Allow dormant viruses or cancer cells to multiply.
• Women tend to have immunologically stronger systems than men.
• Self-attacking diseases include lupus and multiple sclerosis.

Stress

• Severe stress can lead to physical, psychological, and behavioral problems.
• Mild stress can be stimulating and motivating.
• Stress is an unpleasant state of arousal when people perceive demands as taxing or exceeding their ability to cope.
• Stress can occur everyday or unexpectedly.

Sources of Stress

• Daily hassles: Annoyances of daily life that impose a stressful burden.
• Chronic stress leads to exhaustion, irritability, and depression.
• Major life events: Significant changes in life circumstances that impose burdens requiring adjustment.
• Frustration: A negative emotional state when efforts to pursue goals are thwarted.
• Catastrophes: Unpredictable, large-scale events considered threatening.

Social Readjustment Rating Scale (SRRS)

• Used to measure stress levels.
• Scores:
  • 150 or below: No problem.
  • 150-199: Mild life crisis, 33% increased risk of illness/accident.
  • 200-299: Moderate life crisis, 50% increased risk of illness/accident.
  • 300 or above: Major life crisis, 80% increased risk of illness/accident.

Hans Selye—General Adaptation System (GAS)

• Body’s response to different stressors is similar.
• Three stages:
  • Alarm stage
  • Resistance stage
  • Exhaustion stage
• Symptoms include muscle weakness, loss of weight/appetite, and lack of ambition.

The Stress Response System: GAS Stages

• Alarm Stage:
  • Activation of the sympathetic nervous system and release of stress hormones.
  • Heart races, digestion slows, blood redirects to muscles, body burns more energy.
• Resistance Stage:
  • Body maintains a moderate arousal level.
  • Introduction of new stressors decreases the ability to resist.
  • Vulnerable to bacterial infection.
• Exhaustion Stage:
  • Demands for adjustment exceed the body’s ability to respond.
  • Resources are depleted.
• Can result in stress-related disorders (diseases of adaptation).
  • Examples: kidney disease, heart disease, allergic conditions, digestive disorders, and depression.
  • The stress response suppresses the body’s immune system.

Revisions to Selye's Model

• Stress responses can be more specific and patterned according to situations and coping behaviors.
• The model ignores situational and psychological factors contributing to stress.
• How potential stressors are appraised or perceived strongly influences their impact.

Richard Lazarus and Susan Folkman (1984): Transactional Model

• Stress is understood by examining environmental events (stimuli) and people’s behaviors (responses) together as a transaction.
• People must continually adjust to daily challenges.

Cognitive Appraisals

• Two aspects of the appraisal process:
  • Primary appraisal: Appraisal of the nature and demands of the situation.
    • Cognitive interpretation of the situation and its implications.
    • "Is this situation going to mean trouble for me?"
    • Events are interpreted as irrelevant, benign-positive, or threatening.
  • Secondary appraisal: Appraisal of the resources available to cope with the situation.
    • Cognitive interpretation of the situation and its implications.
    • "What can I do to cope with this situation?"
• Example: Unexpected pop quiz.
  • Primary appraisal: Is it a source of harm/threat/loss or not?
  • Secondary appraisal: Are there sufficient resources to handle the stressor?
    • If yes, no distress.
    • If no, distress.
• Transactional model emphasizes the ongoing appraisal process as new information becomes available.
• Cognitive reappraisal: Process by which potentially stressful events are constantly reevaluated.
• Gaining confidence can turn a previously stressful appraisal into a benign-positive one.
• Cognitive reappraisal does not always result in less stress; it can increase it if coping responses fail or perceptions change.

Transactional Model Implications

• Situations/events are not inherently stressful or unstressful.
• Cognitive appraisals are susceptible to changes in mood, health, and motivational state.
• The body’s stress response is similar whether a situation is experienced or merely imagined.

Other Relevant Models

• Highlight the interaction of biological and psychological factors.
• Stress response varies with how a particular stressor is perceived.

Depression

• Characterized by:
  • Feelings of sadness
  • Low self-esteem
  • Pessimism
  • Apathy
  • Slowed thought process
  • Sleep disturbances
  • Reduced sexual interest
• Affects 3% of the U.S. population; twice as many women as men.

Diathesis-Stress Model

• Certain people have a vulnerability or predisposition (diathesis) to developing a particular disorder.
• Diathesis + Environmental Stressors = Development of the Disorder.
• A stronger diathesis requires less stress to produce the disorder.
• Examples:
  • Inherited predisposition
  • Prenatal trauma
  • Childhood abuse
  • Family conflict
  • Life changes
  • Leads to Psychological disorders

Cognitive Appraisals: Attributions and Learned Helplessness

• Attributions are the explanations people make for positive and negative life events.
  • Attributions influence the cause of depression.
• Learned helplessness is:
  • Experience with an uncontrollable event creates passive behavior toward a subsequent threat.
  • Prolonged exposure may cause apathy, inactivity, loss of motivation, and pessimism.

Cognitive Appraisals: Explanatory Styles

• Depression is a state of hopelessness brought on by negative self-attributions for failure.
• Depressive explanatory style is:
  • A tendency to attribute negative events to causes that are stable, global, and internal.
  • Successful Coping: Attribute temporary, specific, external causes.
• Undergraduate students with a negative explanatory style are more likely to suffer from depressive disorders.
• Examples:
  • Stable vs. Temporary: "I’ll never get over this" vs. "I'll get through this."
  • Global vs. Specific: "I can’t do anything right" vs. "I miss my partner, but thankfully I have family and other friends."
  • Internal vs. External: "Our breakup was all my fault" vs. "It takes two to make a relationship work and it wasn’t meant to be."

Cognitive Appraisals: Perceptions of Control and Hardiness

• Stress affects people differently.
  • Why are some more resilient?
• Hardiness:
  • Attitudes toward themselves, their jobs, and the people in their lives.
  • Perception of control: most important element of hardiness.
  • Commitment: A sense of purpose regarding work, family, and other domains.
  • Challenge: Openness to new experiences and a desire to embrace change.
  • Control: Belief that one has the power to influence important future outcomes.

Cognitive Appraisals: Optimism and Hope

• Optimism is a generalized tendency to expect positive outcomes.
  • Attributions about past outcomes and perceptions of control in present situations influence outlook on the future.
  • Characterized by a nondepressive explanatory style.
    • Blame failures on external, temporary, and specific factors.
    • Credit successes to internal, permanent, and global factors.
• Optimists:
  • Report fewer illness symptoms.
  • Take a problem-focused approach to coping with stress.
  • Are more likely to complete rehab programs.
  • Make a quicker recovery from bypass surgery.
  • Are less likely to have coronary heart disease.
  • Are overall more healthier.

Explaining Optimism's Effects

• Two possible explanations:
  • Biological: Stronger immune system response to stress.
    • Shown in blood sample analyses.
  • Behavioral: Make global rather than specific attributions for good events.

Placebo Effect

• The tendency for an ineffectual drug or treatment to improve a patient’s condition because they believe in its effectiveness.
• Early medical practices (e.g., frog sperm, shock treatments).
• Gives patients faith and hope, an important part of the healing process.

Cognitive Appraisals: Optimism and Hope (Finland Study)

• Finland study with 2,428 middle-aged men assessing feelings of hopelessness.
• Findings: "Where there’s hope, there’s life."

Coping with Stress

• Stress is inevitable.
• People cope differently depending on the person and stressor.
• Two general types of coping:
  • Problem-focused coping
  • Emotion-focused coping

Types of Coping

• Problem-focused coping:
  • Cognitive and behavioral efforts to alter a stressful situation.
  • Goal is to attack the source of stress.
• Emotion-focused coping:
  • Cognitive and behavioral efforts to reduce the distress produced by a stressful situation.
• If we think we can overcome a stressor, we take a problem-focused approach.
• If we perceive the problem to be out of control, we fall back on an emotion-focused approach.

Coping with Stress: Problem-Focused Coping

• Our most active and assertive efforts are associated with better health.
• We benefit from confronting a stressor head-on rather than avoiding it.
• Procrastinators are relatively stress-free until the deadline nears, then under greater stress and report more symptoms of illness.
  • In dealing with essential tasks, it's better to confront and control than to avoid.
• Problem-focused coping isn't always better, because an over controlling orientation can cause problems and not all events are within our control.

Coping with Stress: Emotion-Focused Coping

• Stress is an unpleasant experience that fills us with negative and unhealthy emotions.
• Positive and negative emotions can coexist.
  • People may find consolation in loss.
  • Positive emotions help people cope with adversity, provide distraction from negative states that increase blood pressure, and narrow focusing attention.
• Resilient people tend to experience positive emotions in the face of stress.
• Two ways to cope with the emotional aspects of stress:
  • Shutting down
  • Opening up

Emotion-Focused Coping: Shutting Down

• We react by shutting down, trying to deny or suppress unpleasant thoughts/feelings.
• A specific form of avoidance coping is distraction.
• Suppression of unwanted thoughts can produce a rebound effect.
• Focused distraction (rather than mere suppression) is the solution.
• When people try to block stressful thoughts, the problem may worsen.
• Participants who coped through suppression were slower to recover from pain, while those using focused self-distraction recovered faster.
• To manage stress, distraction is a better coping strategy than suppression.
• Keeping secrets and holding strong emotions is physically taxing.
  • Greater cardiovascular response was exhibited when trying to inhibit feelings while watching a film.

Emotion-Focused Coping: Opening Up

• Two aspects to this emotional coping:
  • Acknowledge and understand our emotional reactions to important events.
  • Express these inner feelings to ourselves and others.
• Psychotherapy, religious rituals, self-help groups, and talking to friends offer a chance to confide in someone and talk freely about our troubles.
• Provides catharsis/discharge of tension.
• Talking about a problem can help sort out thoughts, understand the problem better, and gain insight.
• The listener must be trusted.
• Opening up can cause distress if those we confide in react with rejection, unwanted advice, or betray what was said.