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Week 4 chapters 5&6 psy 498
Terms in this set (54)
is the process by which people try to manage the perceived discrepancy between the demands and resources they appraise in a stressful situation. Manage in the definition demonstrates that effects can vary and may not be successful. Although coping efforts can be aimed at correcting or mastering the situation, they may also simply help the person alter his or her perception of a discrepancy, tolerate or accept the harm or threat, or escape or avoid the situation.
Compare and contrast the two main functions of coping: emotion focused coping vs. problem focused coping. When do people tend to use each of these types of coping?
Emotion-focused coping is aimed at controlling the emotional response to the stressful situation. People can regulate their emotional responses through behavioral and cognitive approaches. behavioral approaches include using alcohol or drugs, seeking emotional social support from friends or relatives, and engaging in activities, such as sports or watching TV, which distract attention from the problem. Cognitive approaches involve how people think about the stressful situation. In one cognitive approach, people redefine the situation to put a good face on it, such as by noting that things could be worse, making comparisons with individuals who are less well off, or seeing something good growing out of the problem. Other emotion-focused cognitive processes include strategies Freud called "defense mechanisms," which involve distorting memory or reality in some way. Defense mechanisms include things like Denial and avoidance strategies. People tend to use emotion-focused approaches when they believe they can do little to change the stressful conditions.
Problem-focused coping is aimed at reducing the demands of a stressful situation or expanding the resources to deal with it. Everyday life provides many examples of problem-focused coping, including quitting a stressful job, negotiating an extension for paying some bills, devising a new schedule for studying (and sticking to it), choosing a different career to pursue, seeking medical or psychological treatment, and learning new skills. People tend to use problem-focused approaches when they believe their resources or the demands of the situation are changeable. Both the husbands and the wives used more problem-focused than emotion-focused methods to cope with the stressful event, but the wives reported using more emotion-focused approaches than the husbands did. People with higher incomes and educational levels reported greater use of problem focused coping than those with lower incomes and educational levels. Last, individuals used much less problem-focused coping when the stress involved a death in the family than when it involved other kinds of problems, such as illness or economic difficulties.
Why might older adults and disadvantaged persons in minority groups use more emotion focused coping than problem focused coping?
Because they view that the stressors are outside of their control. When people feel that something is outside of their control they tend to use more emotional focused stress coping.
Why is it so difficult to measure "coping"?
They were typically developed with the expectation that the scores would predict mental or physical health, but they often don't and they don't seem to be very accurate in measuring people's coping. Most measures of coping are retrospective, asking respondents about the methods used in the past week, month, or more.
Describe four coping methods that may be promising for research (measurable and related to psychological and health outcomes).
partner and then lost that person report both positive and negative emotions occurring together during times of great stress.
2. Finding benefits or meaning. People who are trying to cope with severe stress often search for benefits or meaning in the experience, using beliefs, values, and goals to give it a positive significance.
3. Engaging in emotional approach. In emotional approach, people cope with stress by actively processing and expressing their feelings. To
assess emotional approach, people rate how often they engage emotional processing (in such activities as, "I take time to figure out what I'm really feeling" and "I delve into my feelings to get a thorough understanding of them") and emotional expression ("I take time to express my emotions"). Emotional approach probably includes the method of disclosure of negative experiences and feelings we discussed in Chapter 4 as a way of reducing stress and enhancing health.
4. Accommodating to a stressor. Another way to cope is to adapt or adjust to the presence of the stressor and carry on with life. For instance, people with chronic pain conditions may come to accept that the pain is present and engage in everyday activities as best they can.
Describe four issues to consider related to people's patterns in using different coping methods.
First, people tend to be consistent in the way they cope with a particular type of stressor—that is, when faced with the same problem, they tend to use the same methods they used in the past.
Second, people seldom use just one method to cope with a stressor. Their efforts typically involve a combination of problem- and emotion-focused strategies.
Third, the methods people use in coping with short-term stressors may be different from those they use under long-term stress, such as from a serious chronic illness.
Fourth, although the methods people use to cope with stress develop from the transactions they have in their lives, a genetic influence is suggested by the finding that identical twins are more similar than fraternal twins in the coping styles they use.
Describe the developmental changes in coping over the lifespan described by Sarafino.
Some aspects of the changes in coping that occur in the early years are known. Infants and toddlers being examined by their pediatricians are likely to cope by trying to stop the examination .We saw earlier in the case of Molly that young children develop coping skills that enable them to overcome many of their fears, making use of their expanding cognitive abilities. As they grow, children come to rely increasingly on cognitive strategies for coping. The middle aged individuals used more problem-focused coping, whereas the elderly people used more emotion-focused approaches. Because most adults are married or partnered, adults' coping strategies usually operate and develop jointly as a system, with each member's coping processes being shared by and influencing the other's, as in the relationship-focused and dyadic coping described earlier
Women report using more emotion-focused coping and men more problem-focused coping. What exception does Sarafino make to this general finding?
when the men and women are similar in occupation and education, few, if any, gender differences are found.
Describe the relationship between social support and stress. What tends to happen to social support in the presence of long-term chronic stress? How can people enhance their ability to give and receive social support?
The more social support you have, the more it will mitigate your stress, unless it is unproductive. People who experience high levels of chronic stress, such as when their health declines severely, often find that their social support resources deteriorate at the same time. People can enhance their ability to give and receive social support by joining community organizations, such as social, religious, special interest, and self-help groups.
Generally, what do results from experimental studies suggest about the relation between exercise/fitness and stress? Describe two problems with interpreting the findings of correlational studies that suggest exercise and fitness reduce stress potential.
Correlational and retrospective studies of this question have found that people who exercise or are physically fit often report less anxiety, depression, and tension in their lives than do people who do not exercise or are less fit. First, the reduction in self-reported stress and emotion may have resulted partly from a placebo effect—that is, the subjects' expectations that psychological improvements would occur. Second, the results of correlational research do not tell us what causes what. Do exercise and fitness cause people to feel less stress? Or are people more likely to exercise and keep fit if they feel less stress and time pressures in their lives? Fortunately, there is stronger evidence for the beneficial effects of exercise and fitness on stress and health.
What do the most clearly effective methods of preparing people psychologically for surgery have in common?
The most effective methods for preparing people psychologically for the stress of surgery attempt to enhance the patients' feelings of control. To promote behavioral control, for example, patients learn how to reduce discomfort or promote rehabilitation through specific actions they can take, such as by doing leg exercises to improve strength or deep breathing exercises to reduce pain. For cognitive control, patients learn ways to focus their thoughts on pleasant or beneficial aspects of the surgery, rather than the unpleasant aspects. And for informational control, patients receive information about the procedures and/or sensations they will experience.
What do Benzodiazepines and Beta-blockers do? By what physiological processes?
Both are used to manage stress. Benzodiazepines, which include drugs with the trade names Valium and Xanax, activate a neurotransmitter that decreases neural transmission in the central nervous system. Beta-blockers, such as Inderal, are used to reduce anxiety and blood pressure.
Describe systematic desensitization. How is systematic desensitization different from progressive muscle relaxation and biofeedback?
Systematic desensitization, a useful method for reducing fear and anxiety. This method is based on the view that fears are learned by classical conditioning—that is, by associating a situation or object with an unpleasant event. Biofeedback is a technique in which an electromechanical device monitors the status of a person's physiological processes, such as heart rate or muscle tension, and immediately reports that information back to the individual. One way people can learn to control their feelings of tension is called progressive muscle relaxation (or just progressive relaxation), in which they focus their attention on specific muscle groups while alternately tightening and relaxing these muscles.
Systematic Desensitization starts with using relaxation techniques. (the focus of Progressive muscle relaxation is relaxing the muscles to reduce stress by removing tension). Then the steps in a hierarchy are presented individually, while the person is relaxed and comfortable. Stimulus hierarchy—a graded sequence of approximations to the conditioned stimulus, the feared situation. The purpose of these approximations is to bring the person gradually in contact with the source of fear in about 10 or 15 steps. The steps follow a sequence from the least to the most fearful for the individual. Each step may elicit some wariness or fear behavior, but the person is encouraged to relax. Once the wariness at one step has passed and the person is calm, the next step in the hierarchy can be introduced. Completing an entire stimulus hierarchy and reducing a fairly strong fear can be done in a few hours, divided into several separate sessions. Biofeedback is more so focused on the biological responses to the stressor. They pair it with progressive muscle relaxation to ease some sort of physical manifestation of stress like headache. It is not interested in reconditioning of the stressor which is the primary focus of systematic desensitization.
He found that muscle tension could be reduced much more if individuals were taught to pay attention to the sensations as they tense and relax individual groups of muscles. Progressive muscle relaxation
an originator of the desensitization method, the reversal comes about through the process of counterconditioning, whereby the "calm" response gradually replaces the "fear" response. Desensitization has been used successfully in reducing a variety of children's and adults' fears, such as fear of dentists, animals, high places, public speaking, and taking tests. Systematic desensitization
What four types of irrational beliefs that increase stress have been described by Albert Ellis and Aaron 'Beck?
The beliefs described by Albert Ellis:
•Can't-stand-itis—as in, "I can't stand not doing well on a test."
•Musterbating—for instance, "People must like me, or I'm worthless."
The beliefs described by Aaron Beck
•Arbitrary inference (drawing a specific conclusion from insufficient, ambiguous, or contrary evidence). For example, a husband might interpret his wife's bad mood as meaning she is unhappy with something he did when she is actually just preoccupied with another matter.
•Magnification (greatly exaggerating the meaning or impact of an event). For instance, a recently retired person diagnosed with arthritis might describe it as a "catastrophe."
sometimes "observational" or "social" learning. People can learn fears and other stress-related behavior by observing fearful behavior in other individuals. The therapeutic use of modeling is similar to the method of desensitization: the person relaxes while watching a model calmly perform a series of activities arranged as a stimulus hierarchy—that is, from least to most stressful. The modeling procedure can be presented symbolically, using films or videotapes, or in vivo, with real-life models and events.
is a process by which stress provoking thoughts or beliefs are replaced with more constructive or realistic ones that reduce the person's appraisal of threat or harm.
approach to change maladaptive thought patterns is called cognitive therapy. Cognitive therapy attempts to help clients see that they are not responsible for all of the problems they encounter, the negative events they experience are usually not catastrophes, and their maladaptive beliefs are not logically valid.
is considered to be an altered state of consciousness that is induced by special techniques of suggestion and leads to varying degrees of responsiveness to directions for changes in perception, memory, and behavior
clients learn a strategy for identifying, discovering, or inventing effective or adaptive ways to address problems in everyday life. They learn to watch for problems that can arise, define a problem clearly and concretely, generate a variety of possible solutions, and decide on the best course of action. Evidence indicates that problem-solving training reduces anxiety and other negative emotions.
is an approach that uses a variety of methods that are designed to teach people skills for alleviating stress. The training involves three phases in which the person (1) learns about the nature of stress and how people react to it; (2) acquires behavioral and cognitive skills, such as relaxation and seeking social support; and (3) practices coping skills with actual or imagined stressors. The methods used in stress-inoculation training are well thought out, include a number of well-established techniques, and are useful for people who anticipate a stressful event, such as surgery.
has several forms that vary in the degree of pressure applied. Some forms of massage use soothing strokes with light pressure, others involve a rubbing motion with moderate force, and others use a kneading or pounding action. Deep tissue massage uses enough pressure to penetrate deeply into muscles and joints. Infants seem to prefer light strokes, but adults tend to prefer more force. It also increases the body's production of a hormone called oxytocin that decreases blood pressure and stress hormone levels reducing stress.
is a method in the practice of yoga that was promoted by Maharishi Mahesh Yogi as a means of improving physical and mental health and reducing stress. Although meditation helps people relax, it has a broader purpose: to develop a clear and mindful awareness, or mindfulness. Practicing mindfulness meditation reduces stress in healthy people and patients with chronic medical conditions.
Which stress management techniques have been found to be effective in reducing each of the following: Type A Behavior; hypertension
Use of stress-inoculation training and relaxation in helping people control their anger. Many studies have confirmed the success of interventions using cognitive and behavioral methods in decreasing anger and research has shown that such interventions reduce both hostility and diastolic (resting) blood pressure in patients with CHD and mild hypertension.
is any activity people perform to maintain or improve their health, regardless of their perceived health status or whether the behavior actually achieves that goal.
is any activity people undertake to maintain or improve current good health and avoid illness. These activities can include healthy people's exercising, eating healthful diets, having regular dental checkups, and getting vaccinations against diseases.
is any activity people who are ill undertake to determine the problem and find a remedy. These activities usually include complaining about symptoms, such as stomach pains, and seeking help or advice from relatives, friends, and medical practitioners.
refers to any activity people undertake to treat or adjust to a health problem after deciding that they are ill and what the illness is. This behavior is based on the idea that sick people take on a special "role," making them exempt from their normal obligations and life tasks, such as going to work or school. You'd be showing sick-role behaviors if you got a prescription filled, used it as the physician directed, stayed home from work to recover, and had someone else do your household chores.
State three research based conclusions about the consistency of people's health behavior over time. Explain why people's health behaviors are not more stable and strongly linked to each other.
First, various factors at any given time in people's lives may differentially affect different behaviors. For instance, a person may have lots of social encouragement to eat too much ("You don't like my cooking?"), and, at the same time, to limit drinking and smoking. Second, people change as a result of experience. For example, many people did not avoid smoking until they learned that it is harmful. Third, people's life circumstances change. Thus, factors, such as peer pressure, that may have been important in initiating and maintaining exercising or smoking at one time may no longer be present, thereby increasing the likelihood that the habit will change.
consists of actions taken to avoid disease or injury.
actions are taken to identify and treat an illness or injury early with the aim of stopping or reversing the problem. In the case of someone who has developed an ulcer, for example, secondary prevention activities include the person's symptom-based behavior of seeking medical care for abdominal pain, the physician's prescribing medication and dietary changes, and the patient's sick-role behavior of following the doctor's prescriptions
involves actions to contain or retard this damage, prevent disability or recurrence, and rehabilitate the patient.
Compare and contrast these terms: primary prevention; secondary prevention; tertiary prevention.
Primary Prevention is about preventing illness or harm to your person by participating in well behaviors. Secondary Prevention is about identifying an illness early on and aim to stop or reverse the problem. People participate in more symptom based behavior or giving into a Sick-role behavior. Tertiary prevention is trying to stop or reverse damage that has already been done in the late stages of an illness and about rehabilitation. People here are going to participate in Well behavior to improve their health and sick -role behavior.
Apply systems thinking to the process of preventing illness and injury, giving examples of factors within the individual, interpersonal factors and factors in the community. Combine ideas in the von Bertalanffy reading and your text.
The process of preventing illness and injury can be thought of as operating as a system, in which the individual, his or her family, health professionals, and the community play a role. This plays into Von Bertalanffy reading in that he believed that every human is a individual system of their psychological and biological processes. All of these processes interact amongst themselves and with the environment. Each of our human systems are a part of other systems (i.e our family, schools, work). Also that our human system is open and interacts freely with our environment as we develop and receive feedback. All of our human lives have context and there for we cannot be a closed system. On our individual system scale, there are four factors that are important for the well-being of the individual person : First, adopting wellness lifestyles may require individuals to change longstanding behaviors that have become habitual and may involve addictions, as in cigarette smoking. Habitual and addictive behaviors are very difficult to modify. Second, people need to have certain cognitive resources, such as the knowledge and skills, to know what health behaviors to adopt, to make plans for changing existing behavior, and to overcome obstacles to change, such as having little time or no place to exercise. Third, individuals need sufficient self-efficacy regarding their ability to carry out the change. Without self-efficacy, their motivation to change will be impaired. Last, being sick or taking certain drugs can affect people's moods and energy levels, which may affect their cognitive resources and motivation. Another system influence is Many social factors influence people's likelihood to adopt health-related behaviors. For instance, one partner's exercising or eating unhealthfully before marriage can lead his or her partner to adopt the same behavior over time. People are more likely to adopt healthful behaviors if these behaviors are promoted or encouraged by community organizations, such as governmental agencies and the health care system. Each of these things interact to influence the collective health.
Discuss how reinforcement, extinction, and punishment affect health-related behavior.
1. Reinforcement. When we do something that brings a pleasant, wanted, or satisfying consequence, the tendency to repeat that behavior is increased or reinforced. A child who receives something she wants, such as a nickel, for brushing her teeth at bedtime is more likely to brush again the following night. The nickel in this example is a positive reinforcer because it was added to the situation (the word "positive" refers to the arithmetic term for addition). But reinforcement can also occur in another way. Suppose you have a headache, you take aspirin, and the headache goes away. In this case, your headache was unpleasant and your behavior of taking aspirin removed it from the situation. The headache is called a "negative" reinforcer because it was taken away (subtracted) from the situation. In both cases of reinforcement, the end result is a desirable state of affairs from the person's point of view.
2. Extinction. If the consequences that maintain a behavior are eliminated, the response tendency gradually weakens. The process or procedure of extinction exists only if no alternative maintaining stimuli (reinforcers) for the behavior have supplemented or taken the place of the original consequences. In the above example of toothbrushing behavior, if the money is no longer given, the child may continue brushing if another reinforce exists, such as praise from her parents or her own satisfaction with the appearance of her teeth.
3. Punishment. When we do something that brings an unwanted consequence, the behavior tends to be suppressed. A child who gets a scolding from his parents for playing with matches is less likely to repeat that behavior, especially if his parents might see him. The influence of punishment on future behavior depends on whether the person expects the behavior will lead to punishment again. Take, for example, people who injure themselves (punishment) jogging—those who think they could be injured again are less likely to resume jogging than those who do not.
Define habitual behavior. Explain why habitual behaviors are so hard to change.
Habitual behavior- that is, the person often performs it automatically and without awareness, such as when a smoker catches a glimpse of a pack of cigarettes and absent-mindedly reaches, takes a cigarette from the pack, and lights up. Antecedents are internal or external stimuli that precede and set the occasion for a behavior. A smoker who says, "I must have a cigarette with my coffee after breakfast," is pointing out an antecedent. That internal/external triggers creates that automatic response thus making it harder to change.
According to the health belief model what two types of assessments determine whether a person will take preventive action?
1) perceived threat
2) perceived benefits and barriers: the pros and cons
List the shortcomings of the health belief model.
One shortcoming is that it does not account for health-related behaviors people perform habitually, such as tooth brushing—behaviors that probably originated and have continued without the person's considering health threats, benefits, and costs.
That there is no standard way of measuring its components, such as perceived susceptibility and seriousness.
According to the theory of planned behavior, what determines people's intentions to perform a behavior?
Theory of planned behavior- an expanded version of the theory of reasoned action people decide their intention in advance of most voluntary behaviors, and intentions are the best predictors of what people will do.
The theory indicates that three judgments determine a person's intention to perform a behavior, which we'll illustrate with a girl named Ellie who has decided to start exercising:
1. Attitude regarding the behavior, which is basically a judgment of whether or not the behavior is a good thing to do. Ellie has decided that exercising "would be a good thing for me to do." This judgment is based on two expectations: the likely outcome of the behavior (such as, "If I exercise, I will be healthier and more attractive") and whether the outcome would be rewarding (for example, "Being healthy and good looking will be satisfying and pleasant").
2. Subjective norm. This judgment reflects the impact of social pressure or influence on the behavior's acceptability or appropriateness. Ellie has decided that exercising "is a socially appropriate thing for me to do." This decision is based on her beliefs aboutothers' opinions of the behavior (such as, "My family and friends think I should exercise") and her motivation to comply with those opinions (as in, "I want to do what they want").
3. Perceived behavioral control, or the person's expectation of success in performing the contemplated behavior (which is very similar to the concept of self-efficacy). Ellie thinks she can do the exercises and stick to the program.
What are the shortcomings of the theory of planned behavior?
One problem is that intentions and behavior are not strongly related—people do not always do what they decide (or claim they decide) to do. The theory is incomplete; it does not include, for example, the important role of people's prior experience with the behavior.
State a general weakness shared by the health belief model and the theory of planned behavior. Give an example.
One weakness in these theories is that they assume people think about risks in a detailed fashion, knowing what diseases are associated with different behaviors and estimating the likelihood of becoming seriously ill. In reality, people may modify their lifestyles, such as reducing coffee consumption, for very vague reasons, such as, "My doctor says coffee is bad for you." People appear to be especially inaccurate in estimating the degree of increased risk when the risks of illness, such as cancer, increase beyond moderate levels—for example, for individuals who smoke more than 15 cigarettes a day
Describe the five stages in the stages of change model. Give examples of behavior that might occur in each stage.
Maintenance. People in this stage work to maintain the successful behavioral changes they achieved. Although this stage can last indefinitely, researchers often define its length as, say, 6 months, for follow-up assessment.
Action. This stage spans a period of time, usually 6 months, from the start of people's successful and active efforts to change a behavior.
Preparation. At this stage, individuals are ready to try to change and plan to pursue a behavioral goal, such as stopping smoking, in the next month. They may have tried to reach that goal in the past year without being fully successful. For instance, these people might have reduced their smoking by half, but did not yet quit completely.
Contemplation. During this stage people are aware a problem exists and are seriously considering changing to a healthier behavior within the next several months. But they are not yet ready to make a commitment to take action.
Precontemplation. People in this stage are not considering changing, at least during the next several months or so. These people may have decided against changing or just never thought about it.
Define motivated reasoning. How does the process of motivated reasoning affect decisions about health behavior?
People's desires and preferences influence the judgments they make of the validity and utility of new information through a process called motivated reasoning. People can use convoluted reasoning to support a unhealthy habit, like eating fatty foods or smoking. They are selective in their supporting evidence because it supports their ideals. People will use defense mechanisms to cope with their stressful information's and are more likely to deny risks. People will use Deinal. The reason may be that they develop false hopes, believing without rational basis that they will succeed.
Describe conflict theory. According to conflict theory how do perceptions of risks, hope and adequate time affect decision making.
Conflict theory - presents a model to account for both rational and irrational decision-making, and stress is an important factor in this model. According to conflict theory, the cognitive sequence people use in making important decisions starts when an event challenges their current course of action or lifestyle. The challenge can be either a threat, such as a symptom of illness or a news story on the dangers of smoking, or an opportunity, such as the chance to join a free program at work to quit smoking. This produces an appraisal of risk: if the person sees no risk in the status quo, the behavior stays the same and the decision-making process ends; but if a risk is seen, the process continues—for instance, with a survey of alternatives for dealing with the challenge.
Contrast the coping patterns of vigilance and hypervigilance in conflict theory. Which seems to be most adaptive? Why?
•Hypervigilance. People sometimes see serious risks in their current behavior and those alternatives they have considered. If they believe they may still find a better solution but think they are fast running out of time, they experience high stress. These people tend to search frantically for a solution—and may choose an alternative hastily, especially if it promises immediate relief.
•Vigilance. When people perceive serious risks in all possibilities they have considered but believe they may find a better alternative and have time to search, they experience only moderate levels of stress. Under these conditions, people tend to search carefully and make rational choices.
Vigilance seems most adaptive because rather than seeking immediate relief, they are careful in what they do and make rational choices eliminating possible further harm.
Describe the biological and behavioral factors that may explain the shorter life expectancy of males than females.
•Physiological reactivity, such as blood pressure and stress hormones, when under stress is greater in men than in women, which may make men more likely to develop cardiovascular disease.
•The female sex hormone estrogen appears to delay heart disease by reducing blood cholesterol levels and platelet clotting.
•Men smoke more and drink more than women do, thereby making men more susceptible to cardiovascular and respiratory diseases, some forms of cancer, and cirrhosis of the liver.
•Males are more likely than females to use drugs, eat unhealthy diets, become overweight, and engage in risky driving and sexual activity.
•Males are less likely than females to consult a physician when they feel ill.
•Work environments of males are more hazardous than those of females; men account for the large majority of fatalities on the job.
Explain why health correlates with social class.
For example, individuals from lower classes are more likely than those from higher classes to
•Be born with very low birth weight.
•Die in infancy or in childhood.
•Develop early signs of cardiovascular disease, such as atherosclerosis.
•Have poorer overall health and develop a long-standing illness in adulthood.
•Have higher incidence rates of infectious diseases, such as HIV and tuberculosis.
They are exposed to worse living conditions, do not always have available preventive care, have poor nutrition due to low resources.
Compare African American infant mortality in the United States with infant mortality in Cuba and white infant mortality the United States.
Three ethnic minority groups in the United States have high levels of health problems: in a national survey of adults, self-ratings of fair or poor health were given by 22.9% of Native Americans, 19.7% of Blacks, and 16.6% of Hispanics, compared with 11.2% of Whites. Today a baby born in Cuba stands a better chance of reaching the age of one than the average African American newborn in the United States. The rate of infant mortality in America is over twice as high for Blacks as it is for Whites. Among babies who survive the first year, the life expectancy for an African American baby is about 4 years shorter than that for a White baby in America.
In which populations of Americans does research on social class, ethnicity, and health show a higher incidence of disease?
African Americans and Hispanics also share a vulnerability to four health-related problems: stress from discrimination, substance abuse, AIDS, and injury or death from violence
Describe motivational interviewing, including decisional balance and personalized feedback.
motivational interviewing—a counseling style designed to help individuals explore and resolve their ambivalence in changing a behavior—was originally developed to help people overcome addictions, such as to alcohol and drugs. Two important features of the process are decisional balance and personalized feedback. In decisional balance, clients list their reasons for and against changing their behavior so that these can be discussed and weighed. In personalized feedback, clients receive information on their pattern of the problem behavior, comparisons to national norms for the behavior, and risk factors and other consequences of the behavior.
Define these terms and give an example of each: lapse; relapse; abstinence-violation effect.
A lapse is an instance of backsliding—for instance, a person who quits smoking might have an occasional cigarette. Lapses should be expected; they do not indicate failure. A more serious setback is a relapse, or falling back to one's original pattern of the undesirable behavior. Relapses are very common when people try to change long-term habits, such as their eating and smoking behaviors. Psychologists G. Alan Marlatt and Judith Gordon have proposed that for many individuals who quit a behavior, such as smoking, experiencing a lapse can destroy their confidence in remaining abstinent and precipitate a full relapse. This is called the abstinence violation effect. Because these people are committed to total abstinence, they tend to see a lapse as a sign of a personal failure
Although ignorance and a lack of availability of protection appear to be the main reasons that people in many developing countries continue to engage in unsafe sex but other factors are more influential in other cultures. Describe the 8 factors discussed by Sarafino that influence people's decisions to have unsafe sex "developed" countries.
•People are much more likely to have unsafe sex if they are promiscuous or have sex while under the influence of alcohol or drugs In men, intoxication seems to increase negative attitudes and decrease self-efficacy about using condoms and to increase the willingness to have unsafe sex when they are sexually aroused . Women are less likely to request condom use when they've been drinking
•Young adults are much more likely to engage in risky sex if their parents reject them for their sexual orientation or abused/neglected them in childhood
•Lesbian, gay, and bisexual teens are more likely to abuse alcohol and engage in risky sex if they live in a community that is religiously intolerant rather than accepting of their sexual orientation
•Unmarried partners are less likely to use condoms if they perceive their relationship to be close or serious
•Decision-making in sexual situations is often subject to non-rational processes, such as denial or wishful thinking . Sexual arousal and having an attractive partner decrease rationality in sexual decisions.
•Many individuals have maladaptive beliefs about their own low self-efficacy to use condoms and the effect that doing so would have on sexual pleasure and spontaneity.
•Many people, especially young women, are embarrassed to buy condoms and make errors putting them on a penis, for example not leaving a space at the tip and squeezing air out
•The advent of medical treatments that lower viral load and prolong life has led to over-optimism in many individuals, leading them to think that protection is not as necessary anymore.
How can programs designed to reduce HIV transmission be made more effective?
Providing information about HIV has been more effective in reducing risky behaviors of intravenous drug users and gay men. Drug users have learned that sharing needles can transmit HIV and that there are ways to protect themselves
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