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HEALTH PSYCHOLOGY EXAM # 1
Terms in this set (103)
Selye discovered the
stress response: A break through that helped to forge an entirely new medical field--stress physiology.
Selye is credited with two important new ides
1. The body has a remarkably similar response to many different stressors
2. Stressors sometimes can make you sick
---Persistent, or chronic, stress influences a person's vulnerability to disorders--and it has become a major theme in health psychology
--Researchers have established links between stress and many physical and psychological disorders, including cancer, heart disease, diabetes, arthritis, headaches, asthma, digestive disorders, depression and anxiety
What is stress?
Stress: the process by which we perceive and respond to events, called stressors, that we appraise as threatening or challenging
Stress is a part of life. Without some stress, our lives would be dull. But when stress overtaxes our coping resources, it can damage our health
--Stress can come from many directions, including school, family, and friends, interactions and strangers, and work
Stress is sometimes used to describe a threatening situation or stimulus, and at other times to describe a response to a situation.
Stress is bad for us because it causes health problems and is good for us because it motivates us.
When you stress less, your performance is better than when you stress more
Stressors: Any event or situation that triggers coping adjustments are demanding events or situations that trigger coping adjustment in a person, and stress is the process by which a person both appraises and responds to events that are judged to be challenging or threatening
--We must judge a challenging event or situation to be threatening or even beyond our ability to cope before we will be stressed by it
What are the bio-psychological approach to understanding stress and its impact on the body
1. Biological processes that occur when wwe experience stress can differ somewhat according to each individual's unique physiology and levels of physiological reactivity, but the same basic processes affect us all
2. Psychological influences affect how we appraise challenging situations--either as manageable ( not stressful) or unmanageable 9 stressful)--based on our personalities and individual life experiences. Gender plays a rp;e in whether we fight or flee or tend- and- befriend
3. Our own unique sociocultural influences affect how we appraise stress from many different sources, including major life events, catastrophes, daily has sles, environmental stress, work, and family
Types of Stressors
1. Significant Life Events
3. Daily hassles
1. The chaning nature of work
4.combing work and family
6. Lack of control
7. Other sources of job reacted stress
5. Social interactions
Significant Life Events
Thomas Holmes and Richard Rahe interviewed 5000 people to identify which events forced people to make the most changes in their lives.
--The assigned each event a value in life change units (LCUs) to reflect the amount of change that was necessary
--EX: divorce disrupts many more aspects of one's life than does taking a vacation, divorce= large number of LCUs
Holmes and Rahe investigated covered a wide range of events, including celebration such as marriage or promotion. Then they ranked these events and devised the social readjustment rating scale
Social readjustment rating scale (SRRS): the first systematic attemot to quantify the impact of life changes on health
--The total number of LCUs per year predicts the likelihood of being sick over the next months
--When life have many changes at once, the stress that result may make us vulnerable to many health problems.
EX: research has found that college students who were perfectionists were more likely than other students to react to stressful live events with symptoms of depression
The critics of SRRS and other scales
1. Many of the items are vague and open to many interpretation.
--Change in personal habits can mean almost anything
2. Assigning specific point values to events fails to take into consideration individual differences in the way events are appraised
--EX: a divorce may mean freedom for one person and not a negative thing
3. The SRRS and other scales lump all events together
4. Self-report inventories may not represent experiences accurately because some people may not report certain life events and some may over port
5.Life event scales tend to underestimate the stress that African Americans and other minorities experience
SRRS studies indicate that there is no simple direct connection between life stress and illness: Subjected to the same stressors, one person will get sick, while another will not.
--The health consequences of stress depend open our appraisal of the stressors
1. After 9/11 and tsunami in New Orleans, 40% had PTSD, panic attacks, depression, generalized anxiety, or alcohol abuse
3. Daily Hassles
Everyday hassles happen all the time and are the most significant cause of stress.
EX: Not having the right answer booklet for an exam, arguing with a professor, losing your wallet, living with a problematic roommate
-The impact of these hassles on stress depends on their frequency, duration, and intensity. Our reaction to minor hassles are influenced by our personality, our individual; style of coping, and the rest of our day has gone
Hassles can cause physical and emotional illness that can lead to health problems
-Hassles are predictor of health problems. Everyday hassels and stressors negatively affect physical and mental health to a degree that exceeds the adverse consequences of major life events. Hassles are associated with worsening of symptoms in people who are already suffering from illness such as lupus
-Some of the hassles are symptoms of stress rather than stresssors
--An overly isolated person may react to the hassels so quickly
Opposite of daily hassels--Mood-lifting experiences such as receiving an approving nod from the boss, hearing your favorite song at just the right moment, or even getting a good night's sleep
see page 113
--In one study, children around the airport had higher systolic and diastolic blood pressure levels and elevated levels of cortisol an other stress hormones compared to members of a control group. The motivation, long-term memory and readings and work skills of the children living near noisy airports were impaired
--Children who lived in noisy apartments had greater difficulty detecting subtle differences in sounds and had more reading problems than did children who lived in quieter apartments.
--Most people attempt to cope with chronic noise by tuning out extraneous sounds and focusing their attention only on relevant cues (such as the voice of the person to whom they are talking)
Noise alone does not cause stress. Loss of sleep increased anxiety. In a study, workers who were more sensitive to noise had higher cortisol levels than workers who found the same noise levels less annoying
A psychological state in which people believe that they do not have enough space to function as they wish
Study: Researcher John Colhoun provided idea living conditions to a group of rats, allowing them to eat, drink, and reproduce freely. When living space was plentiful, the rats behaved normally, forming stable social groups, mating successfully, and rearing their offspring to healthy maturity
--As the population of rats increased, the former cohort started to deteriorate. Infant mortality increased sharply, the sexual receptivity of females declined and some rats become cannibalistic
A measure of crowding based on the total number of people living in an area of limited size
density is needed to produce crowding, but crowding is not a consequence of density
EX: residents of corridor rooms feel more crowded, report lower feelings of control, are more competitive, and react more negatively to minor annoyances.
Environment of poverty= crowding, noise, pollutions, discrimination, unemployment, crime, the threat of violence, and other stressors
Environmental stress is a fact of life. Noise and crowing may cause us to feel anxious and irritable and leave us more vulnerable to physical disorders
Researchers have devoted a great amount of time to study stress.
These studies include:
1. Almost all people at some time experience stress related to their work
2. Work-related stress may be one of the most preventable health hazards
--Job stress is brief in duration and does not pose a serious threat to our health. For some people, job stress maybe chronic, continuing for many years
Factors that can make jobs stressful than others include
1. The changing nature of work
2. social-evaluative threat
4.combing work and family
6. Lack of control
7. Other sources of job reacted stress
The changing Nature if work
Establishing a vocational identity is a key part of bio-psychosocial health for most people
-Emerging adulthood is a critical time for acquiring the education, skills, and experience needed for career success
The nature of work changed from farming to manufacturing to knowledge work
--More work today being outsourced to temporarily employees or being done via telecommuting by people connecting electronically from home and other remote workplaces
--Changing jobs can be stressful. People who change jobs before age 32 have health problems by age 42
This happens because
1. The older the worker is, the more the stressful job changing become
2. A loss of job seniority often means a lower salary, a loss of respects and other disadvantages
3. Older workers lack in newer skills that did not exits when they started working many years ago
4. Older workers cannot find jobs easily
5. Having to relocate for a new job is often disruptive to a worker's social network
--Young people find jobs easily than other workers. For young people, success and failure, hiring and firing are unrelated to their education, skills, and motivation
workers are satisfied with their jobs when
1. They have good income and benefits
2. work in an environment that matches their personality. The interaction between personality and the work environment is crucial to worker well-being
3. Have a best friend at work ( someone they trust)
A stressor in which people fear negative evaluation by others of their appearance or ability
-Is the threat of negative evaluations from others. Is not limited to the workplace and is a central stressor in many models of the stress and health
--evaluations are a frequent, and explicit, experience in many jobs. Feeling accepted, liked, and included by others is a basic social motive, as are the prospects of achievement, protection of status and gaining respect
The experience of stress in a situation where a person's ability. Appearance, or other characteristic has the potential to confirm a negative viewpoint about his or her social group.
workers who volunteer for their own work hours are more happy than those who are required to go to work at a certain time
Combining work and family
Stress occurs when people attempt to balance several different jobs at the same time and experience role overload
Studies support two hypothesis:
1. Scarcity hypothesis: Maintains that because they have only so much time and energy, women with competing demands suffer from role overload and conflict
2. Enhancement hypothesis: argues that the benefits of meaningful work in enhancing a worker's self-esteem out-weight the costs
--Role overload: The task of managing multiple roles affects both men and women, but the increase in employment of women has triggered more research on role overload and job-related stress in women. Some research findings regarding the stress of role overload have been contradictory; however the overall conclusion seems to be that what matters most is the quality of a working mother's experiences in her various roles
-Women stress is determined by the interaction of conditions at home and work. Whereas men's stress is determined ore by situations at work
Psychologically, women are more stressed by their greater unpaid workload and by a greater responsibility for duties related to home and family
--Physiologically, women had higher norepinephrine levels than men did, both during and after work, which reflected their greater workload
--For many working mothers, employment is an important source of self-esteem and life satisfaction. Single mothers are very stressed
--Partners often adjust to each other's work, which helps them function as a unit. EX: Husbands spend more hours at work after marriage while moms stay at home to take care of the family
A job-related state of physical and psychological exhaustion
-occur when you work with extremely needy people, and in jobs that involve taking the responsibility of other people. First responders, such as police officer and physicians are exposed to burnout because they take car of other people
--According to bio-psychosocial model: health problems overlap from every domain of health ( biology, psychology, and social factors)
Lack of Control
Workers feel more stress when they have little or no control over the procedures, pace, and other aspects of their jobs
--Workers who have more say over their aspects of jobs are more likely to not be stressed
--workers who do not have say over their jobs, are more likely to be stressed
Other sources of Job-related stress
--Aspects that increase job stress among workers
1. Role ambiguity or conflict: Ambiguity occurs when workers are unsure of their jobs or the standards used to evaluate their performance. Role conflicts occurs when a worker receives mixed messages about these issues from different supervisors or coworkers
2. Shiftwork: continuous staffing of a workplace by groups of employee who work at different times. Most human functions have a rhythm with peaks and valleys that occur over a regular 24 to 25 hours cycle
3. Job loss: Losing jobs can have a serious impact on the worker's well-being
4. Lack of fairness and inadequate career advancement: People who feel that they have been promoted too slowly or that they are not getting the recognition they deserve on the job experiences more stress and have higher rates of illness
Social relationships are an important factor in how we deal with stress often serving as a buffer against low control and other work stress
1. Enhance immune functioning
2. Loneliness and relationship stress= affects immune functioning adversity
3. Immunosuppression has been linked to interpersonal conflict among married couples
The process by which a member of one ethnic or racial group adopts the values, customs, and behaviors of another
--Immigrant stress: immigrants are expected to intergrade into the society in which they are living
Poverty: causes stress
Gender: Men and women experience stress differently. Women have chronic stress and minor daily stressors. Women's daily experience are more negative and less comfortable than men. Women age 65 or older are more likely than men to report a lot of stress in their lives
Caregivers with lower % of cells and other measures of immunosuppression and overproduction of proinflammatoy cytokines
--Cytokines: Is associated with a broad array of adverse conditions, including vascular tissues, asthma, cardiovascular disease, Type 2 diabetes and certain cancers
The Physiology of Stress
1. The role of the brain and nervous system
2. The role of the endocrine system: The SAM and HPA systems
3. Measuring Stress
4. How Does Stress Make you sick?
The physiology of stress
1. Walter cannon introduced the term stress to medicine and believed that it caused medical problems. Cannon said extremes of temperatures, lack of oxygen, and emotion-arousing incidents all had a similar arousing effect on the body.
Fight or fight reaction: the response to stressful events
--1. Outpouring of epinephrine, cortisol and other hormones that prepare an organism to defend its self against a threat, either by attacking or by running away.
---2. Adaptive for our ancestors and us in acute stressor situations ( Fight or flight was important to our ancestors' survival in a time when human beings faces numerous physical threats and had to either fight or run away). This is why humans and other primit
--3. Chronicity: we have turned it into a pass time, much beyond just survival response
The physiology of stress continues
--Outpouring of epinephrine, cortisol and other hormones that prepare an organism to defend
--Adaptive for our ancestors and us in acute stressor situations
--Chronicity: We've turned it into a pass time, much beyond just survival response.
The role of the Brain and Nervous System
The body;s overall reaction to stress is regulated by the central nervous system
Nervous system consists of two parts:
--The central nervous system ( the brain and the spinal cord) and the peripheral nervous system. The peripheral nervous system is divided into two branches: The autonomic nervous system ( ANS) and the somatic nervous system. The ANS is divided into two branches: The sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS).
--when an external event is perceived by your sense organs, sensory neurons in the somatic nervous system transmit nerve impulses to lower-level brain regions announcing the impending threat.
The reticular formation= plays a role in alerting the brain to an impending threat or challenge
--It coordinates two neural pathways of brain--body communication= Through the first, it routes information about the existence of a potential stressor to the thalamus, which sorts this sensory information and relays it to the hypothalamus, the limbic system, and higher brain regions in the cerebral cortex that interpret the meaning of the potential stressor
--Under the instructions from the SNS, the adrenal glands release hormones that cause the fight-or flight response, in which heart rate increases, the pupils dilate, stress hormones are secreted, and digestion slows.
SNS activation increases blood flow to the muscles and causes stored energy to be converted to a form that is directly usable by the muscles. Hypothalamus controls the stress response
coordinates the activity of the endocrine system, and the endocrine system's hormones play a key role in how we respond to stress
The role of the endocrine system: The SAM and HPA systems
The endocrine system is the body's relatively slow-acting communication system consisting of a network of glands that secrete hormones directly into the bloodstream.
--The communication system is involved in our body in two ways:
1. Under stress, the hypothalamus orders the pituitary gland to secrete adrenocorticotropic hormone (ACTH), which is taken up by receptors in the adrenal glands, a pair of small endocrine glands lying just above the kidney. Each of the structures consists of two nearly independent glands: a central region called the adrenal medulla and an outer covering called the adrenal cortex.
The adrenal medulla secretes epinephrine ( aka adrenaline) and norepinephrine (noradrenaline) into the blood. These endocrine system help, which help trigger the fight or flight response, last much lon
Two Neural Pathways of Brain-body communication:
1. Reticular formation to thalamus to hypothalamus to limbic system to cerebral cortex
---Reason: ROUTE FOR INFORMATION ABOUT A Potential STRESSOR
2. higher brain regions to reticular formation to target organs, muscles and glands controlled by sympathetic nervous system
--Body mobilized for defensive action
The sympatho-adreno-medullary (SAM) system or adrenomedullary system
Stress: A Closer Look at the Endocrine System
The interaction of the SNS and adrenal medulla by the SNS. The body's initial, rapid-acting response to epinephrine and norepinephrine form the adrenal medulla under the direction of the sympathetic nervous system
--Sympatho-adreno-medullary (SAM) system
- Release of epinephrine and norepinephrine from adrenal medualla
--see page 131
The body's response to stress:
-During a moment of stress, the hypothalamus secrets releasing factors that coordinate the endocrine responses of the pituitary and adrenal glands. As part of the sympatho-adreno-medullary system ( SAM), the adrenal medulla releases the stress hormones epinephrine an epinephrine as the stress hormones epinephrine and norepinephrine as the body's intial, rapid-acting response to stress. Epinephrine and norepineprine increase heart rate, breathing, and bloood pressure, slow digestion; and dilate the pupils. A second, delayed response involves the hypothalamic-pituiatry-adrenocortical (HPA) system, which triggers secretion of corticosteroids from the adrenal cortex. These steriod hormones flight inflammmation, promote, and trigger the release of stored reverses of energy
SAM and HPA: Hypothalamus secretes cortiicotropin-releasing hormone (CRH)
-SAM and HPA: CRH causes the pituitary gland to secrete adrenocorticotropic hormone (ACTH).
-SAM: ACTH causes the sympathetic ganglia to stimulate the adrenal medulla to release a mixture of epineprine and norepineprine that triggers the physiologial fight-0r-flight responses: increased heart rate, breathing, blood pressure etc..
HPA: ACTH causes the adrenal cortex to secrete corticosterids, including cortisol, that combat inflammation. promote healing, and mobilize the body's energy resources.
-All of these endocrine system actions help the organism deal with stress. Faced with a threat, the brain needs energy in the form of glucose, which cortisol helps provide. Too much cortisol can have negative consequences, leading to hypertension, a decrease in the body's ability to fight infection, and perhaps psychological problems
-The condition of hypercortisolism and prolonged activtaion of the HPA systemm has been linked to the rate of cognitive decine in individuals with Alzheimer's disease
-HPA axis may become underactive in some indiivudals on the face of chronic stress, creating a state of adrenal exhaustion and chronically low levels of cortisol ( hypocortisolism)
2 categories for measuring stress
1. Self-reports such as life evvents inventories and dailu hassle scales are the most common, but have many limitations in their reliability and validity
-The major disadvantage of self-report is that information that is recalled long after significant event have occurred is often inaccurate. To fix this, health psychologists increasingly rely on self-reports made closer in time to the events they are investigating
2. Ecological momentary assessment (EMA): A method of measuring stress that involves repeated sampling of people's behaviors and experiences in real time, and in their natural environment
--This approach asks research participants to look back , at the end of the day, and report about mood, stressors, social interactions =, and other variables. To reduce the reliance on memory even further, EMA may require the reporting of information several times a day.
--One example is the signal-contingent recoding= in which reports are requested in response to a signal form a personal digital assistant (PDA), smart phone, or other reminder device that occurs a fixed number of times per day on a random schedule
Include changes in heart rate, blood pressure, respiration rate, and the electrical conductance of the skin ( a measure of sweating). changes occur in response to stress- or emotion -induced activation of the sympathetic division of the autonomic nervous system
EX: ambulatory blood pressure (ABP) aka signal-contigent recording is recorded via a cluff worn under the participants' clothing and a small control box attached to their belt
--Stress is measured via its association with hormones such as Coriol, epinephrine, and epinephrine
--Epineprine and norepineprine levels are measured via blood or urine samples, and cortisol levels are measured via saliva. Blood levels of hormones decrease quickly ( within minutes) after a stressful experience, so researchers must be very quickly to obatin accurate measurement
How does Stress Make You Sick?
Study: The rats were given a drink of the artifically sweetened water ( a neutral stimulus), they received an injection of a drug ( unconditioned stimulus), which made them nauseous ( unconsitioned response)--sick enough so that a single pairing of the two stimuli should have been sufficient to establish a conditioned aversion to the water.
--Over the course of several weeks of training and testing, a number of the rats became very sick and died
result: When the rats were given saccharin-flavored water alone, without the drug, their immune systems responded as if the drug were actually circulating in their bloodstream. Classical conditioning had created a learned associattion between the taste of the water as conditioned stimulus and the suppression of T cells as a conditioned response. Over time, conditioned responding made the animals increasingly susceptible to disease as their immune reserves were weakened with each drink of sweetened water
After Robert Ader and Nicholas Cohen pared saccharin-flao=vored water with an immune-suprresiing drug, the taste of the sweetened water alone elicited a conditioned response ( immune suppression) in laboratory rats
see page 134
are protein molecules produced by immune cells that have a multitude of biological effects, including serving as a means of inter-cellular communicationThese chemicals are similar to neurostransmitters ( the chemical messgenders in the process of neural communication)
-Cytokines are like nt and the bind to receptor sites on brain cells and trigger nerve impulses
The field of research that emphasizes the interaction of physiological, neural, and immunological processes in stress and illness. Is a link among emotions, immunity, an ddisease
Psycho= psychological processes
neuro= neuroendocrine system ( the nervous and hormonal systems)
Immunology: The immune sysytem
PNI researchers investigate interactions between the nervous and immune sysstems, and the relationship between behavior and health
--The goal of PNI is to condict basic research that can be applied to health care
--OVERALL FINDINGS: studies demonstrates that Short-term stressors, such as loud noise and eletric shocks in the laboratory ( being called by a professor in class) can have a positive effect or up-regulation in natural immunity
--Reduced immune functioning (immunosuppression has been demonstrated following a divorce, bereavement, unemployment, and stressful bouts of exercise or military training, during exam period and when experiencing occupational stress.
Stress is also linked to lowered immune resistance to viral infections. In a study, 47% of participants lving stress-filled lives developed colds after being inoculated with a rhinovirus, compared to only 27% of those inoculated who reported relatively stress-free lives.
Psychological stress has been linked with autoimmune disorders such as coronary artery disease with accelerated progress. This connection occurs as the immune system reacts to stressful events by releasing cytokiness that promote inflammation
--Researchers found that lower rate of wound healing reflected activation of the HPA system. This was done in two ways: By assessing serum corticosteroid levels and by blocking the activity of naturally circulating stress hormones in restraint-stressed animals with a chemical that binds to corticosteroid receptor sites
--Long-term/chronci stress tends to suppress immune response
The goal of PNI is to reveal the many ways that behaviors and health are interrelated, with a focus on the immunological mechanisms that unerlie these interactions
Taken together, these studies demonstrate
Two Pathways from stress to disease
1. Direct effect hypothesis
2. Indirect effect hypothesis
Direct effect Hypothesis
1. immunosuppression is part of the body's natural response to stress
2. HPA and SAM neuroendocrine response to stress reduce the body's defenses
According to this hypothesis, stress directly influences the nervous, endocrine, and immune systems, each of which can lead to disease.
3. Stress may directly affect immune efficiency through the activiation of the HPA and SAM systems. T cells and B cells have receptors for corticosteroid stress horones ( which produce immunosuppression) and lymphosytes have ccatecholamine ( epineprine and norepineprine) receptors
--Preschooler's everyday conflict at Home and Diurnal Cortisol Patterns slide 10
-Study: researchers areported the direct cardiovascular effects of social stress in daily experience in 94% married, working couples. ( page 135)
result: In both women and men, momemntary reports of social-evaluative threat were associated with higher systolic blood pressure (SBP). This effect was mediated by negative affect. SBP increased when participants were worrried about how their appearance or abilities were being perceived, but only if they also were frustrated or upset.
--Social-evaluative threat was also associated with higher diastolic blood pressure, but only in women, suggesting that gender help role in how evaluative threats have physiological effect
Greater conflict at home was associted wih children having a lower awakening response and flatter cortisol responses throughout the day, both of which have been linked to negativee health consequences in adulthood, inclduing earlier mortality
1. Suggests that immunosuppression is an aftereffect of the stress response
2. Stress may encourage maladaptive behaviors that disrupt immune functioning
eX: sleep, smoking, nutrition, physical activity ect..
-stress induce delays in healing and other adverse health outcomes may occur because stress alters immune processes indirectly by encouraging maladaptive behaviors
-Risks factors that could slow healing this are:
Smoking, alcohol and drug abuse, fragmented sleep, not enough exercise, and poor nutrition, each of which has been associated with increased stress
Smoking could slow healing by weakening the normal proliferation of macrophases at wound sites and by reducing the flow of blood through vasoconstriction
The role of duration
1. Acute = last half an hour or less ( ex: in laboratory studies stress) produced transient immune changes, which most immune cell parameters returning to pres tress levels within an hour or so
EX: Stresses associated with upcoming exams also produce temporary changes in cellular immune response
Allostatic load--The cumulative long-term effects of the body's physiological responses to stress
-The ability to recover after a stressful experience strongly influences the total burden that the expeirnce has on an individual. The neuroendocrine system plays an important role in the concept of allostatic load (allostatis).
EX: Stressors that are unpredictable, uncontrollable, which manifests in many ways, including decreased immunity, elevated load epinephrine levels, increased abdominal fat, decreased hippocampal size and functioning (leading to problems with thinking and memory) and the overproduction of interleukin 6 and other proinflamantory cytokines
-many of these changes occur wth aging, leading some researchers to characterize a high allostatic load as a form of accelerated aging in response to stress
alloastatic overload exist in people with low social economic background.
Stress, inflammation, and disease
1. Immunosuppression model ( a combo of indirect and direct)
Investigations of direct and indirect effect hypothesis have given rise to an Immunosuppression model of the relationships among atress, immunity, and disease, which nicely summarizes what we' ve discussed thus far.
Accoring to this model, stress suppresses the immune ssytem, which leaves the invidual vulnerable to opportunistic infaction and disease
The immunosuppression model offers a plausible exlanation for how stress influences wound healing infectious dieases, and some forms of cancer. But it does not explain how stress might influence diseases whose central features is excessive inflammation. These include many allergic, autoimmune, rheumatologiv, neurologic, and cardiovasuclar diseases--all of which are exacerbated by stress involves a loss of brain neurons that produce dopamine and serotonin.
Stress does not improve the course of such diseases by supressing inflammation. Stress has been implicated as a major risk factor for Parkinson's diases
Summary of the physiology of stress: immunosuppression Model
These conditions compromise the immune system's capacity to mount an efffective response to infection or injury
1. activating autonomic nervous system fibers that descend from the brain to immune tissues
2. Triggering the secretion of hormones that bind to white blood cells and alter their functioning
3. Including immunosuppressive coping behaviors, such as poor diet and substance abuse
Glucorticoid receptor (GCR) resisttance model
The idea that chronic stress promotes the development and progression of disease by reducing the sensitivity of immune system receptors to glucorticoid hormones such as cortisol, thereby interfering with the body's ability to regulate the inflmmantory response.
--Was proposed to explain the impact of stress on inflammantory disease
--glucorcoticoid hormones function as anti-inflammantory signals by suppressing the production of proinflammantory cytokines by immune cells. Patients of cancer show less suppression of cytokine production in response to an administred glucocorticoid compared with parents of healthy children. These findings are significant because overproduction of cytokines has been linked with a spectrum of chronic inflammantory diseases and adverse conditions, including cardiovascular disease
--result of the study indicated that people who recently experienced a prolonged stressful event were more likely to have immune cells that were unable to respond to hormonal signals that normally regulate inflammation. They were alos more likely to develop colds when exposed to the virus
Other major Models of Stress and Illness
The immune supprssion and glucocorticoid resistance model of stress and illness developed from many years of research and from other important models including:
1. Selye's General Adpation Syndrome
2. Cognitive Appraisal and Stress
3.The Diathesis- stress Model
4. Post-Traumatic Stress disorder (PTSD)
5. Trend- and-Befriend Theory
General Adpation Syndrome
Seleye's Term for the body's reaction to stress, which consists of three stages;
1. Alarm= same as Cannon's fight-or-flight responses. The strength of the alarm reaction depends on the degree to which the event is perceived as a threat.
When stressful situations continue, the body's reaction progresses to stage 2
2. Resistance: Physiological arousal remains high ( BUT NOT AS HIGH AS DURING THE ALARM REACTION)
-as the body tries to adapt to the emergency of replenishing adrenal hormones. There is a decrease in the individual's ability to coupe with every day events and hassles. At this stage, people often become irritable, impatient, and increasingly vulnerable to health problems
If the stressful situation persists and resistance is no longer possible, the body enters the final stage of the GAS--
3. Exhaustion: At this point the body's energy reserves are depleted. If stress persists, disease and physical deterioration or even death may occur
--eX: one disease of exhaustion is the disease of adaptation. Among these are allergic reactions, hypertension, and common colds, as well as more serious illness caused by immune deficiencies
EX: People who have endured the prolonged stress of combat, child abuse or chronic disease may suffer enlarged adrenal glands bleeding ulcers, damage to the brain's hippocampus, and abnormalities in several other cerebral areas.
Stress disrupts neurogenesis, the brain's production of new neurons and the process by which cells divide. Women who are chronically stressed, prematurely agee because they have shorter DNA segments called telomeres at the end of chromosomes
Telomere shortening causes cells o die because they can no longer reproduce, is assciated with a wide range of age related disease
Selye's belief that all stressors produce the same physiological reactions bas been revised in the face of more recent evidence
-Some stressors led to increases in epineprine, norepineprine, and cortisol, whereas others increased only one or two of these stress hormones. Not all stressors produce the same endocrineresponses
Cognitive Appraisal and Stress
--The transactional model
What describes the importance of conscious appraisal to stress is the transactional model
transactional model: Lazarus's theory that the experience of stress depends as much on the indivudal's cognitive appraisal of a potential stressor's impact as it does on the event or situation itself
--The fundamental idea behind this model is that we cannot fully understand stress by examing environmental events ( stimuli) and people's behaviors (responses) as seprate entities; rather, we need to consider them together as a transaction, which each person must continuously adjuts to daily challenges
--The process of stress is triggered whenever stressors exceed the personal and social resources that a person is able to mobilize in order to cope.
Appriaing an event as stressful means seeing it as a challenge, a source of harm, or a threat to one' s future well being overome, and the person can profit from the situation.
-Appraisals of harmloss or threat refer to less positive outcomes.
Harm-loss is the assessment that some form of damage has occured already as a result of a situation. An event may be appraised as a threat when the person anticipates that a a situation may bring about loss or harm at some point in the future
When the demands of an event or situation to create stress, our response is not static but instead involves continous interactions and adjustments called
Transactions--between the envionment and our attempts to cope. Each of us is an active agent who can dramatically alter the impact of a potential stressor through our own personal resources
see page 144
Lazarus believes that the transactions between people and their envionment is driven by
cognitive appraisal of potential stressors
--which involves assessing
1. whther a situation or event threatens our well-being
2. whther there are sufficient personal resources available for coping with the demand
3. Whether our strategy for dealing with the situation or vent is working
When we confront a potentially stressful event, which as unexpected pop quiz we engage in a
1. Primary Appraisal: A person's intial determination of an event's meaning, whether irrelevant, benign-positive, or threatening. Which helps us determine the event's meaning
In priary appraisal, we interpret the event in one of the three ways:
3. Challenging or harmful ( which is considered to be threating)
_ If events is appraised as irreleveant or begign-positive, no physiological arousal-and no stress-occurs
A person's determination of whether his or her own resources and abilities are sifficient to meet the demands of an event that is appraised as potentially threateing or challening
Addresses the question.. " what can I do to cope with this situation?
When a threat or challenge is high and coping resources are low, stress is likely to occur
The process by which potentially stressful events are constantly reevaluated
--We constantly update our perception of sucess or failure in meeting a challenge or threat. New information may allow us to turn a previously stressful appraisal into a begign-sopitive one's as when gain confidence in our ability to do well an unexpected pop quiz successfully answering the first few questions
3 implications of Lazarus' transactional model
1. Situations or events are not inherently stressful or unstressful
--Any situation can be stressful for one person but not the other.
2. Cognitive appraisals are extremely susceptible to changes in mood, health, and motivational state. You may interpret the same event or situation in very different ways on serrate occasions
3. Some evidence suggests that the body's stress response is nearly the same whether a situation is actually experienced or merely imagined. This means, even recalled or imagined appraisals, may elicit a stressful response. Similar physical responses to imagined or real events
How does this work?
The HPA axis and homesostasis are central players in the stress response. When the hypothalamus receives signals from its various inputs ( inclduing the cerebral cortex) about conditions that deviate from an ideal homeostatic state
See page 145 (buttm)
The model that proposes that two interacting factors determine an individual's susptibility to stress and illness: predispositing factors in the person ( such as genetic vulnerability) and precipating factors from the envionment ( such as traumatic experience)
The predispostion can result ffrom genetic factors or from prior envionmental factors, such as chronic exposure to secondhand tobacco smoke. In most cases, the precipitating enevionmental factors (stress) are not believed to be specific for a given health condition whereas predisposing genetic facors ( diathesis) are
Some inviduals are more vulnerable to illness becasue their biological systems show greater reactivity
reactivitity: They react more strongly to specific envionmental triggers. and vary by persons and affects our vulnerability to ilnness
EX: page 146
Post-Traumatic Stress Disorder (PTSD)
A psychological disorder triggered by exposure to an extreme traumatic stressor, wucg as combat or a natural disaster. Symptoms of PTSD include haunting memories and nightmares of the traumatic event, extreme mental distress, and unwanted flashbacks
PTSD has been associated with poor health and chronic illnesses such as cardiovascular disease (CVD), ovelry sensitive limbic system
sensitive limbic system causes disruptions in the HPA axis, leading to dysregulation of cortisol levels and atrophy of the hippocampus as the traumatic event is relieved time and time again
A behavioral response to stress that is focused on protecting offspring ( tending) and seeking others for mutual defense ( befriending)
-fight or flight characterizes the primary physiological response to stress in both females and males.
Females are more likely than males to respond to the same stressors with tend-and-befriend behaviors that
1. quiet, nurture, and care for offsrping in order to protect them from harm
2. establish and maintains osicla netwroks that faciliate this process
see page 148 bottom
Women live longer than men in general. The health of women is inextricably linked to their status in society. It benefits from equality and suffers from discrimination. Although men are twice as likely as women to die of any cause, women have higher disease and disability rates
The application of psychological principles and research to the enhancement of health and the prevention and treatment of illness.
Health psychology concerns include:
1 Social conditions (availability of health care and support from family and friends)
2. Biological factors (such as family longevity and inherited vulnerabilities to certain diseases)
3. Personality traits (such as optimism)
Heath: State of complete psychical, mental, and social well-being. The absence of disease rather than as the absence of a debilitating battlefield injury. Healthy people are free of disease.
The goal of health psychology are
1.to promote health
2.prevent, and treat illness;
3. investigate the role of biological, behavioral, and social factors in disease; and
4. evaluate and improve the formulation of health policy and the delivery of health care to all people
--Although many of the world's citizens have the promise of a longer and better life than their ancestors, these health benefits are not universally enjoyed.
Health disparities such as ethnic and socio-economic group differences in the rates of disease occur in every nation
What are health? Illness, and disease?
The illness/ wellness continuum (Wellness paradigm):
Pre-mature death is caused by:
High Level wellness:
World Health organization: A complete state of physical, metal, and social well-being and not merely the absence of disease and infirmity
Health benefits are not universally enjoyed:
1. The number of healthy years of life that can be expected by a child born today differs substantially from country to country ranging from 37.1 to 71.7 for women. Infections continue to have a profound impact in populations deprived of social and economic resources
2. The number of new cases of cancer among minority populations in the United States is projected to double in upcoming decades
3. Violence, drug-and alcohol-related deaths and injuries, accidents, and sexual perils such as abuse and sexuality transmitted infections often mark the transition from adolescence to adulthood.
4. Health disparities: Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal heath that are experienced by socially disadvantaged populations. Death rates vary by ethic group. African-Americans do not have a long life expectancy than white-American.
Preventable injury and death:
1. Control o underage and excess of alcohol
2. Eliminate public possession of firearms
3. Eliminate all forms of tobacco
4. Better nutrition and exercise
5. Reduction in risky sexual behaviors
6. Full access to immunizations for infectious diseases
United States has a lower life expectancy than other countries and was ranked by the World Health Organization 37th out of 191 countries in terms of overall performance of its health care system
--In US, The Department of Health and Human Services focused on improving access to health services, eliminating health disparities between women and men and various ages and sociocultural groups. Improve the health and quality of life and well-being for all Americans.
The Overarching goals are:
1. Promote health
2. Prevent and treat illness
3. Investigate biological, social, and behavioral factor contributions to health
4. Improve the health care policies and deliver health care to all people.
To help the nation meet these goals, Barack Obama signed the Patient Protection and Affordable Care Act (PPACA): A new federal law aimed at reducing the number of people in the United States who do not have health insurance, as well as lowering the costs of health care. The most significant overhaul of the U.S health care system in nearly 50 years. The primary goal of PPACA are:
1. O decrease the number of people who do not have health insurance and to lower the costs of health care
2. Aimed at improving health care outcomes and streaming the delivery of health care.
3. Insurers are required to cover certain types of preventive care to no cost to the consumer, including blood pressure and cholesterol tests, mammograms, colonoscopies, and screenings for osteoporosis
Select Topic Area Goals and Targets of Healthy people 2020:
Adolescent Health: Increase the proportion of adolescents who have had a wellness checup in the past 12 months. Reduce the proportion of adolescents who have been offered, sold, or given an illegal drug on school property
Physical Activity: Increase the proportion of adults who engage in aerobic physical activity of at least moderate intensity. Increase the proportion of the nation's public and private schools that require dily physical education for all students
Nutrition and Weight Status: Increase the proportion of schools that do not sell or offer calorically sweetened beverages to students. Increase the proportion of adults who are at a healthy weight
Injury and violence prevention: reduce unintentional injury deaths. Reduce motor vehicle crash-related deaths
Sleep Health: Increase the proportion of adults who get sufficient sleep. Reduce the rate of vehicular crashes
Health and Illness: Lessons from the Past
2.Greek and Roman Medicine
3. Non-Western Medicine
4. The Middle Ages and the Renaissance
5. Post-renaissance Rationality
6. Discoveries of the Nineteeth century
Health in the earliest-known cultures, illness was believed to result from mystical forces and evil spirits that invaded the body.
----During this time, Mariana's symptoms might have been treated with rituals of sorcery, exorcism, or even a primitive form of surgery called Trephination
-Trephination: An ancient medical intervention in which a hole was drilled into the human skull, presumably to allow "evil spirits" to escape. ( See page 8)
Ancient Greek and Roman medicine:
Illness is caused by an imbalanced of bodily humors, good diet and moderation in living would cure it.
Hippocrates= father of modern medicine, argued that disease is a natural phenomenon and that the causes of disease (prevention and treatment) are knowable and worthy of serious study. Build the foundation for a scientific approach to healing. Hippocratic Oath= the oath physicians took to practice medicine ethically. He proposed the humoral theory
-Humoral theory: a concept of health proposed by Hippocrates that considered wellness a state of perfect equilibrium among four basic body fluids called humors. Sickness was believed to be the result of disturbances in the balanced of humors. Humors: blood, yellow, bile, black, and phlegm. To maintain a balance, a person had to follow a healthy lifestyle including exercise, sufficient rest, a good diet, and the avoidance of excesses. When the humors were out of balance our body and mind affected in predictable ways, depending on which of the four humors was sin excess. Hippocrates was interested din patients' emotions and thoughts regarding their health and treatment.
Hippocrates, Galen, and other Greek scholars developed the first rational approach to the study of health and disease. Non-Western forms of healing, including traditional orientatal medicine (TOM) and Ayurveda, developed simultaneously. Today we know that many diseases are caused by imbalance among the brain's neurotransmitters.
TOM: Is found on the principle that internal harmony is essential for good health. Fundamental to this harmony is the concept of qi, a vital energy or life force that ebbs and flows with changes in each person' mental, physical, and emotional well-being
Ayurveda: Human body represents the entire universe in a microcosm and that the key to health is maintained a balnce between the microsmic body and the macrocosmic world. The key is balance is held in three bodily humors: doshas, vats, pitta, and kapha
Galen wrote about anatomy, hygiene, and diet, building on the Hippocratic foundation of rational explanation and the careful description of each patient's physical symptoms. Disease caused by an excess of a hot and moist humor could be cured only with drugs that were cold and dry.
Chinese developed a traditional oriental medicine (TOM). TOM is founded on the principle that intenral harmony is essential for good health.
Fundamental to this harmony is the concept of qi
qi= a vital energy or life force that ebbs and flows with changes in each person's mental, physical, and emotional well-being.
Ayurveda is the oldest-known medical system in the world from India. Is based on the belief that the human body represents the entire universe in a microscosm and that the key to health is maintaining a balance between the microcosmic body and the macrocosmic world. The key to this relationship is held in the balance of three humors
1. doshas, vata, pitta, and kapha
The middle Ages and the Renaissance:
The middle Ages and the Renaissance:
--Illness was viewed as God's punishment for evildoing, and epidemic diseases such as the two great outbursts of plague that occurred during the middle Ages, were believed to be a sign of God's wrath. Vesalius said Galen made erros because he never dissected a human body. Vesalius's volumes became the cornerstones of a new scientific medicine based on anatomy.
-In Europe during the Middle Ages, scientific studies of the body (especially dissection) were forbidden, and ideas about health and disease took on religious overtones. Illness was viewed as punishment for evildoing, and treatment frequently involved what amounted to physical torture.
--French philosopher Rene Descartes advanced his theory of mind-body dualism—the belief that Human have two natures, mental and physical. The mind and the body are autonomous processes, each subject to different laws of causality. During the Renaissance, Descartes influenced ushered in an era of medical based on the scientific study of the body. This research gave rise to the anatomical, cellular, and germ theories of disease.
• Descartes believed that disease occurred when the machine broke down, and the physician's task was to repair the machine. The mind and the body are autonomous processes that interact minimally, and that each subject to different laws of causality. He rejected the notion that the mind influenced the body
Mind-body dualism: The phisophical viewpiint that mind and body are seprate entities that do not interact
The middle ages bgan with an outbreak of plague that orginate spread throughout the Roman empire, killing as many as 10,000 people a day. SO great in number were the Corpses that gravedigers could not keep up.
--Epidemic: diseases such as the two great outbursts of plagues ( a bacterial disease carried by rats and other rodents) that occurred during the Middle Ages, were believed to be a sign of God's Wrath. Treatment in this era attempted to force evil spirits out of the body
Anatomical theory: The theory that the origins of specific diseases are found in the internal organs, musculature, and skeletal system of the human body.
Discoveries of the 19th Century: ee*9
Discoveries of the Nineteenth century
Cellular Theory: Formulated in the 19th century, the theory that disease is the result of abnormalities in body cells. Disease results when body cells malfunction or die. Life can only come from existing life.
--spontaneous generation: The idea that living organisms can be formed from nonliving matter. EX: flies come from dead meat. EX: Pasteur experiment with the flies ( page 13): Pasteur's meticulous work in isolating bacteria in the laboratory, then showing that life can come only from existing life, paved the way for germ-free surgical procedures.
--Germ theory: The theory that disease is caused by viruses, bacteria, and other microorganisms that invade body cells cause them to malfunction. The germ theory form the modern medicine
The Twenties Century and the Dawn of a New Era
The early 20th century brings us the biomedical model
----The dominant view in modern medicine is the biomedical model: which assumes that disease is the result of a virus, bacterium, or some other pathogen invading the body. Because it makes no provision for psychological, social, or behavioral factors in illness, the model embraces both reductionism and mind-body dualism Illness always has a physical cause. The model represents the modern view of medicine.
The Biomedical Model assumes that disease is the result of a pathogen. Disease of the body is separate from the mind (mind-body dualism).
• Helped us understand many diseases and developed cures and vaccines
Three features of the biomedical model
1. Pathogen: a virus, bacterium, or some other microorganism that invades the body and cause disease. The model makes no provision for psychological, social, or behavioral variables in illness to embrace reductionism: The view that complex phenomena such as health and disease derive on the Cartesian doctribe of mind-body dualism (the mind and the body are separate and autonous entities that interact minimally). Health is nothing more than the absence
--Sigmund Freud and Franz Alexander promoted the idea that specific disease could be caused by unconscious conflicts. These views were expanded into the field of psychosomatic medicine, which is concerned with the treatment and diagnosis of disorders caused by faulty processes within the mind. Psychosomatic medicine fell out of favor because it was grounded caused by faulty processes within the mind. Psychosomatic medicine fell out of favor because it was grounded in psychoanalytic theory and predicated on the outmoded idea that a single problem is sufficient to trigger diseases.
--Freud patients exhibited symptoms such as loss of speech, deafness, and even paralysis. Freud believed that these diseases were caused by unconscious emotional conflicts that had been converted into a physical form. He called his conversion disorder.
Alexander nuclear conflict model: Each physical disease is the outcome of a fundamental, or nuclear, psychological conflict. EX; people with reheumatoid personality who tended to repress anger and were unable to express emotion, were believed to be prone to developing arthritis.
o Alexander established psychosomatic medicine.
o Psychosomatic Medicine: An outdated branch of medicine that focused on the diagnosis and treatment of physical diseases caused by faulty psychological processes. Was based on reductionism. Psychosomatic medicine is the start of multifactorial= diseases are caused by the interaction of several factors, rather than by a single, invading bacterial or viral agent. These include, biological factors such as genetic, environmental factors ( pollutants and hazardous chemicals), behavioral factors (diet, exercise, and smoking), and psychological factors ( optimism and overall hardiness)
1. Behavioral medicine (1970s): An interdisciplinary field that integrates behavioral and biomedical science in preventing, diagnosing and treating illness
o Was based on behaviorism movement in psychology.
o It role of learning behaviors in health and disease by using conditioning (operant conditioning) and other learning principles to change health statuses. Was an outgrowth of the behaviorist movement in American psychology. An interdisciplinary field that integrates behavioral and biomedical science in preventing, diagnosing, and treating illness. Today, the field is an interdisciplinary subspecialty of medicine concerned with the integration of behavioral and biomedical information to the prevention, diagnosis, and treatment of physical and psychological disorders
• Behaviorist define psychology as the scientific study of observable behavior, they emphasized the role of learning in the acquisition of most human behavior.
• Biofeedback: Becoming aware of physiological states and altering behaviorsPeople could gain some control over their blood pressure and resting heart rate when they were made aware of these physiological states.
1978: APA establishes the division of health psychology (DIVIsion 38) and lays down four goals for the new field
The goal of health psychology:
1. To study scientifically the causes or origins of specific diseases= etiology
2. To promote health—get people o engage in health-enhancing behaviors
3. To prevent and treat illness—create programs to help people stop smoking
4. To promote public health policy and the improvement of health care systems. (page 17)
Biopsychosocial (Mind-Body) Perspective:
The viewpoint that health and other behaviors are determined by the interaction of biological mechanisms, psychological process, and social influences. All health behaviors are explained in terms of biological , psychological, and sociocultural forces act together to determine an individual's health and vulnerability to disease—health and diseases must be explained in terms of multiple contexts. The biopsychosocial perspective in effect combines these perspectives, recognizing that biological, psychological, and social forces act together to determine an individual's health and vulnerability to disease.
The biopsychosocial Model of Mariana's Anxiety
The biological context:
1. Every behavior, thought, mood, and urge is a biological event
2. Biological contributions to health include enetics and the interaction your body's systems
3. Biological and psychological/behavior constantly interacting
4. Life-course perspective
The Psychological context
1. Stress and ability to cope or have resources to do so ( go to school)
2. Attitude and treatment effectiveness
3. Psychological interventions
--- Treaching effective management strategies, promoting health behaviors, and supporting change
1. Ways that we think about, influence, and relate to one anothr
2. Your gender, family role, social connections, race/ethnicity, socioeconomic ststus, nirth cohort, etc (context)
3. Sociocultural perspective: Theoretical perspective that focuses on how social and cultural factors contribute to health and disease
4. Gender perspective
5. EX: A study was done with physicians where they were presented these supposed heart patients, identical in occupation and symptoms, and other aspects expect age, race, and gender. Result, The physicians recommended catheterization treatment to younger, white patients than for the older female or black patients (page 17)
The Biological Context
All behaviors occur in a biological context. Health psychology draws attention to aspects of our bodies that influence health and disease: Our genetic makeup and our nervous, immune and endocrine systems. Genes provide a guideline for our biology and predispose our behaviors—health and unhealthy, normal and abnormal. EX: The tendency to abuse alcohol has been known to run in some families.
Health is best understood in a hierarchy of systems 9 our bosy systems, our immediate envionments, school, health care system, societal health care issues and values 0
Genome: set of genetic instructions that make a living organism.
Genomics: The study of the structure, function, and mapping of the genetic material of organisms.
Evolutionary perspective: Our characteristic human traits and behaviors exists as they do because they helped our distant ancestors survive long enough to reproduce and send their genes into the future. EX: People's mouth water when they see food because eating is important for them to survive.
---Genes may influence all traits—both psychological and physical, even identical twins who share identical genes, do ot have identical traits. The most important traits are epigenetic:
---Epigenetic: The effects of environmental forces o how genes are expressed some epi influences impede our chances of optimal health ( child abuse) and some improve them ( nourishing food).
EX: Research on MAOA show that boys who inherit one variation of the gene, and girls who inhrit a different variation of the same gene are more likely to engage in high-risk delingquent behavior as adolescents.
Gene-envionment effects—some genes are expressed and affect our health, while some genes are silences and remain unnoticed from one generation to the next unless circumstances such as childhood circumstances change.
The sociocultural perspective calls attention to how social and cultural factors such as ethnic variations in dietary practice and beliefs about the causes of illness affect health.
: In health psychology focuses on important age-related aspects of health and illness. EX: How a pregnant woman's malnutrition, smoking, or use of psychoactive drugs would affect her child's lifelong development.
Five major causes of death:
3. Chronic lower respiratory diseases
Most older people die because of diseases caused by internal conditions (chronic diseases such as heart diseases and cancer). People age 1 to 24 years old die because of accidents, homicide, and suicide, followed by heart diseases and cancer I external causes)
Positive psychology gave rise to subjective well being: Our feelings of happiness and sense of satisfaction with life. The cognitive and emotional evaluations of a person's life. Patients who are relaxed are usually between able, and more motivated to follow their doctors' instructions. Psychological interventions assist patients in managing the everyday stresses of life that affect the immune system.
The social context:
---Gender= entails a particular, socially prescribed role that represents your sense of being a woman or a man.
Birth Cohort: A group of people born within a few years of each other.
Feeling supported by others may serve as a buffer that mitigates the output of stress hormones and keeps the body's immune defense strong during traumatic situations. It may promote better health habits, regular checks, and early screening of worrisome symptoms
Infant mortality in the United States: Les than a century, 15 percent of babies born in the United States died before their first birthday. Today 90 percent of new born babies survive to at least 1 year of age
Sociocultural Perceive: Considers how social and cultural factors contribute to health and disease. The viewpoint that it is important to understand the person fully without understanding his or her culture and ethnic identity.
Culture; enduring behaviors, values, and customs that a group of people have developed over the years and transmitted from one generation to the next.
Ethnic groups: Large groups of people who tend to have similar values and experiences because they share certain characteristics. In multiethnic culture such as US, wide disparities exist between the life expectancy and health status of ethnic minority groups and the majority population.
Socioeconomic status (SES), which is a measure of several variables, including income, education, and occupation, highest rates of chronic diseases occur in people who have lower SES levels. Sociocultural perspectives play role in the variation in health related beliefs and behaviors.
EX: Christian scientist rejected the use of medicine in their belief that sick people can be cured only through prayer.
Immigrant paradox: The finding that, although low socioeconomic status usually predicts poor health, this is not true for Hispanics and other ethnic groups in the United States.
epigenetic_ The effect of envionmental forces on how genes are expressed
Life-course perspective: Theoretical perspective that focuses on age-related aspects of health and illness
he gender perspective
The gender perspective calls attention to male-female differences in the risk of specific diseases and conditions, as well as in various health-enhancing and health compromising behaviors. Focuses on the study of gender-specific health behaviors, problems, and barriers to health care.
Compare to women, men are more likely to:
1. Make unhealthy food choices
2. Be overweight
3. Exceed guidelines for alcohol consumption and engage in binge drinking
4. Ignore illness symptoms and avoid seeing doctors
5. Engage in risky competitive sports where there is a higher rate of injury and
6. Be at greater risk for nearly all the major disease that affect both sexes.
The medical profession has a long history of treating men and women differently. Research studies have shown that women treated for heart diseases are more likely to be misdiagnosed, are less likely to receive counseling about the heart healthy benefits of exercise, nutrition, and weight reduction or to receive and use prescription drugs for the treatment of their heart disease. White women are treated better than black women. Health behavior is not an automatic consequence of a given social, cultural, or gender context. Patients who are married tend to survive longer than patients who are unmarried. Unhappy marriage lead to poor health.
is the cognitive and emotional evaluations of a person;'s life
see page 20
Ecological systems approach: Is based on the idea that our well-being- and all of nature—is best understood as a hierarchy of systems in which each system is simultaneously composed of smaller subsystems and art of larger, more encompassing systems.
EX: he individual is at the center. We are a system made up of interacting systems such as the endocrine system, the cardiovascular system, the nervous system, and the immune system. Within each of our biological systems, there are smaller subsystems made up of tissues, nerve fibers, fluid, cells, and genetic material. Other stud interact with us—families, school, job, cultures, societies, communities etc.
A system at any given level is affected by systems at other levels.
EX: weakened immune system affects specific organs in a person's body, which affect the person's overall biological health, which in turn might affect the person's relationships with his or her family and friends.
see page 28
Applying the Biopsychosocial Model:
Alcohol abuse is best understood as occurring in three contexts: biological, psychological, and social. People drink alcohol to cope with difficult situations. Students stop drinking alcohol than non-studnets.
Biology and behavior do not occur in a vacuum. The new field of epigenetics focuses environmental factors near and around genes that affect their expression
A key element of biological context is our species' evolutionary history, and an evolutionary perspective guides the work of many health psychologists
According to the ecological-system's model, health is best understood as a hierarchy of systems in which each system is simultaneously composed of smaller subsystems and part of larger, more encompassing systems
A biopsychosocial Model of alcohol abuse
--Alcohol abuse is best understood to occur in three contexts: biological, psychological, and social
What Do Health Psychologists Do?
Health psychologists are engaged in three primary activities: Teaching, research, and clinical intervention. Health psychologists work in a variety of settings, including hospitals, universities, and medical schools, health maintenance organizations, rehabilitation clinics, private practice, and increasingly, the workplace.
A growth body of research centers in health psychology focus on positive health, scientific study of health assists that produce longer life and optimal human functioning
Preparing for a career in health psychology usually requires a doctoral degree. Some students enter health psychology from the fields of medicine, nursing, or one of the allied health professions. An increasing number enroll ungraduated programs in health psychology
Positive health: the scientific study of health assets, which are factors that produce longer life, reduce illness, and increase overall well-being
Health literacy: the ability to understand health information and use it to make good decisions about one's health
Massification: The transformation of a product or service that was once only available to the weathy such that it becomes accessible to everyone. Applied to education and health, it is the idea that College can benefit everyone.
Causes of death in 1900:
3. Gastrilis, enteritis, colitis
4. Heart disease
6. Vascular lesions
Causes of death in 2011:
1, Heart disease
3. Chronic lower respiratory disease
5. Accidents (unintentional injuries)
6. Alzheimer's disease
10. Intentional harm/suicide
Major Modifiable Risk factors for Chronic Diseases:
3. Physical activity
4. High Cholesterol
5. High Blood pressure
7. Low socioeconomic status
Estimated contributions of different factors to health status
1. 20% genetic factors
2. 10% medical care
3. 40% behavior
4. 30% other factors
History of Medicine (page 8)
Shaping up Health psychology
1. Historical/political/societal forces
2. The moe you know! ( role of research and understanding)
3. Health Trends/epidemics emerge (chronic diseases and lifestyle disorders. Childhood obesity. HIV/AIDS, etc.
Where do Health Psychologists Work?
How do I become a health Psychologists?
Critical Thinking and The evidence Based
Many research have found results
In 1996, pregnant women who drank drank three or more cups of coffee or tea dialy were at increased risk of spontaneous abortion, while caffeine drinkers who were trying to conceive were twice as likely as non.
--Women who drink more than half a cup of caffeine each day might increase their fertility
--Caffeine offer protection against parkinson's disease by reducing the destruction of nerve cells in the brain
-areduces the risk of dying early from heart attack or stroke and oofers some protection against type 2 diabetets, gallstones, and parkinson's disease
The ganders of Unscientific Thinking
1. to understand healthy behaviors, focus more on cause and effect relationships about our own and other people's behaviors
--It is dangerous to be our information on anecdotal evidence, or unverified sources of information
Leaping to unwarranted (untested) conclusions is an examle of belief bias
belief bias: A from of faulty reasoning in which our expectations prevent us from seeing alternative explanations for our observations
All culturess develop incorrect beliefs about human behavior. SOme people believe the myths that couples who adpt a child are later more likely to conceive a child of their own, and that more babies are born when the Moon is full. Be on guard for examples of unscientific psychology in yoour own thinking
Types of research methods in health psychology
A research method in which researchers obsrve and record participants' behaviors, often forming hypotheses that are later tested more systematically.
Research setting: Field or laboratory
Data collection method: Case studies, surveys, and interviews, naturalistic observation
1. In depth information about one person ( by using case studies)
2. often leads to new hypotheses
3. Detects naturally occurring relationships among variables
1. No direct control over variable
2. Subject to bias of observer
3. Single cases may be misleading, cannot determine causality
4. correlation may mask extraneous variables (confound)
Types of descriptive method
1. Case studies:
4. observational studies
A descriptive study in which one person is studied in depth in the hope of revealing general principles
--The person is studied over a long period of time in order to uncover principles that are true of people in general
Advantage: It permits a researcher to gather a much more complete analysis of the individual than ordinary can be obtained in studies involving larger groups. They suggest hypothesis for future studies
In a study about psychologists.
-The psychologists who used positive in their autobiography such as lively, vigorous, and humorous lived longer than those who did not. Use of positive or negative words might be associated with gender, health, native language, or year of birth of the psyhcologists
The use of active, positive-emotion words is associated with three to six additional years of life
Disadvantage: The results cannot be generalized
A questionnaire used to ascertain the self-reported attitudes or behaviors of a group of people.
-In the self-report measures, research participants are asked to rate or describe some aspect of their own behavior, attitudes, or beliefs such as what they think of a new health product or how often they exercise
--Surveys are widely used tools in healthh psychology because they easy to administer, require only a small investment of time from participants, and quizly generate a great deal of useful data
Surveys are used by clinicians for diagnostic assessment step in developing intervention programs
EX: chronic-pain patients may be asked to complete a questionnaire related to their problem that sheds light on the effectiveness of previous treatments and the impact of their condition on their dily functioning
-surveys are easy to conduct but not always accurate because survey answers may change with sequence and wording ofthe questions
EX: global warming and climate change
This is one reason why surveys that seem to focus on the same issue may reac opposite conclusions
2. respondents sometimes answer questions in ways that they would like to be perceived or that they believe the investigator expects
EX: see page 42
a non experimental research method in which a researcher observes andd records the behavior of a research partcipant.
-The researcher oberves participant's behavior and records relevant data
obervational studies may be structured or unstrctured
1. Strctured obervations: Take place in the laboratory and involve tasks usuch as role-playing or respondig to a very cold stimulus
2. Unstructured obervations: referred to as naturalistic obervation, the researcher attempts to be unobstrusive as possible in oberving and recording the participants' behaviors.
EX: Health psychologists might oberve family memebrs visiting a parnt in a nursing home to gain insight into how people cope with watching a parent decline
Determines the relationship bteween two variables
-correlation coeffiecient: a stastistical measure of strength and direction of the relationship between two variables, and thus of how well one prdicts the other
-r value ( + 1.00 to -1.00) indicates the direction of the correlation ( positive or negative)
Positive correlation: Increases in one variable is accompaied by increases in another variable
Negative correlation: one goes up and one goes down. Negative corelation says nothing about the strength or weakeness of the relationship between the variables. It simply means the variables are inversely related
The abosulte value of the correlation coefficeint indicates the strength of the correlation -- the closer to 1.00, the stronger the relationship, and the more accurately a researcher can predict one vairable from a known value to another
EX: relationship between body weight and blood pressure
EX: The relationship between Body mass index and hypertension in people of African Descent
-Scatterplot: A graphed clluster of data piints, each of which represents the values of two variables in a descriptive study
The strength of a correlation is revealed by how closely the points in a scaterplot are clustered together along an imaginary line.
Perfect corrrelation= strength line
Correlation does not mean causation. Even when two variables are correlated, it does not mean that they are related to each other
The ability to read and interpret statistics and to think critically about arguments that use statistics a evidence. The abilty to read and interpret satstictics in graphs, tables, surveys, and research studies, and to think critically about arguments that use stastics as evidence. It focues on the skills of understanding hwhatis being asserted in a research report, asking good questions, and evaluating evidence
A common error reasoning about the results of research is mistaking statements of association for statements of causation
To be statistically literate, one must undertsnad thatthe difference between the two statements is the difference between association and causation
see page 45
exists between two variables if, when you depict ther values in a scatterplot, the result is a straight line. Many variables in health are related, but in ways in which the relatioship does not follow a straight line
-curvilinear relationship is that between age and the use of care. Many variables in health reserch are relatedd, but in ways does not follow a straight line
correlations identiy relationships often among several variables that are later studied more closely with experiments
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