1. Chapter 14 Health Psychology

2. Health Behaviors The major health problems in industrialized nations today are “preventable” diseases that are influenced by lifestyle choices people make.

3. Health Behaviors Health behaviors are actions undertaken by healthy people to enhance or maintain their good health. Eating healthy foods, exercising, avoiding substance abuse, getting enough sleep, controlling weight, using sunscreen, practicing safe sex, getting health screening tests

4. Health Behaviors The more health behaviors people practice, the fewer illness and the more energy they have. College students are some of the worst offenders because the disease consequences seem so remote.

5. Health Behaviors Five sets of attitudes affect health behaviors: General Health Values Perceptions of threat posed by diseases Belief in personal vulnerability to disease Self-Efficacy Belief one can perform a health behavior Response Efficacy Belief that the health behavior will reduce the threat of disease For a health behavior to occur, all of these beliefs must fall into place

6. Health Behaviors Some factors undermine even the best intentions to practice health behaviors Strong situational influences (e.g., peer pressure to drink or smoke) Negative mood Alcohol Immediate costs & rewards of behavior

7. Health Behaviors The health attitude-health behavior model suggests that people are using systematic processing to make health decisions. This is true when a health issue is perceived as self-relevant, but when the issue is not seen as self-relevant, heuristic processing is used.

8. Health Behaviors For people who live at low income levels, the cost of preventative health care and limitations on access to health care are much more important determinants of health behavior than are attitudes.

9. Stress and Illness Stress is a negative emotional experience accompanied by predictable physiological, biochemical, and behavioral changes

10. Stress and Illness Stress is, to some degree, in the eye of the beholder.

11. Stress and Illness Some events are more likely than others to be appraised as stressful Events that require a person to change or expend resources Unpleasant or negative events, Uncontrollable or unpredictable events Ambiguous events Unresolvable events

12. Stress and Illness In the short term, acute stress produces emotional distress and physiological strain In the long term, chronic stress may lay the groundwork for future illness

13. Stress and Illness Major stressful life events have been associated with the onset of illness Life events that require one to make more changes (getting divorced or getting married) are more stressful than those that produce few life changes The more life events, and the greater their impact, the greater a person’s vulnerability to illness

14. Stress and Illness Daily Hassles such as getting stuck in traffic jams or having interpersonal conflicts may have a cumulative negative effect on health.

15. Stress and Illness Chronic Stressors such as living in noisy, crowded, crime-filled environments may, over time, have a cumulative negative effect on health.

16. Coping With Stress Coping is the process of attempting to manage demands that are viewed as taxing or exceeding our resources (Lazarus & Folkman, 1984)

17. Coping With Stress Coping is a dynamic process Coping begins with the appraisals we make of the situations we cope with. These appraisals influence how people will try to cope.

18. Coping With Stress Indicators of Successful Coping Reduced physiological arousal Quick return to previous life activities Reduced psychological distress Successful coping depends on both internal and external resources Internal resources include coping styles and personality attributes External resources include money, time, social support

19. Coping With Stress Coping Styles Minimizing or avoiding threats May be effective in the short-term but may exacerbate long-term stress May be associated with increased physiological activation & poor health Confronting threats May deal more effectively with threats in the long-term, but at a short-term cost of greater anxiety Generally more effective

20. Coping With Stress Cynical Hostility (characterized by suspiciousness, resentment, anger, antagonism, and distrust of others) is a risk factor for the development of coronary heart disease.

21. Coping With Stress Several personality resources may help people improve adjustment to stressful events Dispositional optimism Hardiness Commitment, Control, Challenge Conscientiousness Writing or talking about traumatic events Religion

22. Coping With Stress Social Support may mute the effects of stress and enhance health.

23. Coping With Stress Sources of Social Support Spouse or Partner Family Members Friends Social & Community Contacts Churches & Synagogues Co-workers or job supervisors

24. Coping With Stress Ways Social Support Helps Emotional: liking, love, empathy Instrumental Aid: provision of goods or services during stressful times Information about the stressor Information that aids self-evaluation

25. Coping With Stress Effects of Social Support Lowers likelihood of illness Speeds recovery from illness Encourages good health practices Improves immune function Reduces physiological response to stress

26. Coping With Stress Social Support Caveats: Support only helps when it is supportive. Conflictual relationships can hurt, not help. Social support may be most effective when it is “invisible.” If it is apparent that others are going out of their way, there are emotional costs.

27. Coping With Stress Stress Management Programs Discuss role of appraisal Behavior observation & recording Examine controlling conditions Recognize negative self-talk Set goals and target behaviors Engage in positive self-talk Learn how to reduce physiological response Meditation, muscle relaxation, guided imagery

28. Symptoms, Illness, & Treatment Deciding that one is ill is both a social and a psychological process.

29. Symptoms, Illness, & Treatment Labeling symptoms as illness depends on Noticing symptoms Self-focused, isolated, inactive, boring situation  more likely to notice Expectations that guide the interpretation of information Vary by individual and cultural beliefs Mood and Life Satisfaction Prior Experience

30. Symptoms, Illness, & Treatment Patients form illness schemas to understand their symptoms and how to manage them Illness can be viewed as acute, chronic, or cyclic Sometimes people adopt inappropriate models E.g., high blood pressure is chronic but there are few obvious symptoms, so patients may view it as cyclic; this leads them to abandon medication that they need

31. Symptoms, Illness, & Treatment Faulty communication can cause problems between doctors and patients

32. Symptoms, Illness, & Treatment Doctors may:Patients may: Use jargonFail to pay attention DepersonalizeRead too much into a dr.’s comments

33. Symptoms, Illness, & Treatment Patients often fail to follow doctor’s advice. Why? Dissatisfaction with care Lack of understanding Non-“Medical”-seeming treatments Long time course of treatment Difficulty of changing habits

34. Symptoms, Illness, & Treatment Training doctors to communicate more effectively could help Provide jargon-free information Ask patient to repeat the information to ensure understanding Use nonverbal signals of friendliness Rely on “legitimate power” and “referent power”

35. Symptoms, Illness, & Treatment Providing patients with a sense of psychological control during medical procedures helps adjustment and leads to improved recovery time Tell them about steps they can take to control the unpleasantness of the procedure or to control their own reactions

36. Chronic Illness Most of us will eventually develop at least one chronic disease that may alter our daily lives for years Self-blame may be maladaptive for some disorders but not others Blaming other people is associated with poor adjustment Feeling psychological control is adaptive

37. Chronic Illness Chronic disease can produce both negative and positive outcomes NegativePositive Physical ChangesIncreased self- confidence Loss of IncomeFeeling strong Relationship Changes Increased Compassion