Lecture notes, course - - Notes introduction health psychology PDF

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Introduction Be able to define health and health psychology. o Health: health is not just the absence of disease and infirmity, but is recognized to be an achievement involving balance among the physical, mental, and social well-being; optimum health is known as “wellness” o Health Psychology: healt...

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Introduction 1. Be able to define health and health psychology. o Health: health is not just the absence of disease and infirmity, but is recognized to be an achievement involving balance among the physical, mental, and social well-being; optimum health is known as “wellness” o Health Psychology: health psychology is devoted to understanding the psychological influences on how people stay healthy, why people become ill, and how they respond when they become ill 2. Know the different historical perspectives on the mind-body relationship. o Ancient Greeks  Note the role of the body in health and wellness  Humeral Theory  Disease resulted when the four circulating fluids (blood, black bile, yellow bile, and phlegm) were out of balance o Middle Ages  Thought disease was a punishment from God  To cure disease, evil had to be tortured out of the body  Healing was within the realm of the priest o Renaissance  Mind and body are two separate systems  Attempts to break away from superstitions of the previous centuries  Theologians, priests, and philosophers treat the mind  Physicians heal the body  Physical evidence is the sole basis for diagnosis 3. Understand the difference between the biomedical and biopsychosocial models. o Biomedical Model  Focuses on the illness  Dominant model for the last 300 years  Illness is explained on the basis of aberrant somatic processes  …such as biochemical imbalances or neurophysiological abnormalities  Psychological/Social processes are independent (irrelevant) to the disease  Liabilities:  Reduces illness to low-level processes, such as disordered cells and chemical imbalances, rather than recognizing the role of social/psychological processes  Explains illness in terms of a biological malfunction rather than recognizing that a variety of factors may be responsible for illness and only some are biological o Biopsychosocial Model  Focuses on the system  Fundamental assumption is that health & illness are consequences of interplay btw. biological, psychological, and social systems  Advantages:  Macrolevel processes  Psychological/social factors are health determinants  Multiple factors involved in health & illness, produce multiple effects  How do biological, sociological, and psychological variables interact, esp. if biological factors are microlevel processes and psych/social factors are macrolevel?  Adopted the “systems theory”  Maintained that all levels of organizations in any entity are linked to each other hierarchically and that change in any one level will effect change in all other levels

4. Be familiar with the different definitions from epidemiology (e.g., morbidity/mortality) and the different

types of research methodologies. o Morbidity: number of cases of a disease that exist at some given point in time; i.e. how many people are suffering from what kinds of illnesses at any given time o Incidence: number of new cases at a given time o Prevalence: total number of existing cases at a given time o Mortality: number of deaths due to a particular cause 5. Understand the different roles of health psychologists. o Role in technology & research  Ability to identify genes that contribute to particular disorders o Role in decision making  Making informed decisions is a psychological task  Conduct research to identify risk factors for disease o Health care services  Conduct research on people’s satisfaction with care  Design user friendly systems  Main emphasis on prevention & reducing health care costs

Systems of the Body 1. Know the different components of the nervous system. Figure 2.1 can serve as a guide.

2. What are the different parts of the brain, and what roles do neurotransmitters play? o Hindbrain  Medulla: responsible for regulation of HR, BP, and respiration  Pons: link btw. hindbrain and midbrain; also helps control respiration  Cerebellum: voluntary muscle movement, maintenance of balance and equilibrium, muscle tone and posture o Midbrain  Major pathway for sensory/motor impulses moving btw. forebrain/hindbrain  Responsible for coordination of visual and auditory reflexes o Forebrain  2 sections  Diencephalon o Thalamus: recognition of sensory stimuli/relay of sensory impulses to the cerebral cortex o Hypothalamus: regulates centers in medulla that control cardiac functioning, BP, and respiration  Telencephalon o Cerebral cortex: largest portion of the brain, involved in highest order of intelligence, memory, and personality; sensory impulses coming from peripheral areas go up the spinal cord and are interpreted in the c.c. o Neurotransmitters: regulate nervous system functioning 3. What are some disorders of the nervous system? o Epilepsy Huntingtons

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Multiple sclerosis Parkinson’s Alzheimer’s

Cerebral Palsy Polio Para/Quadriplegia

4. Know the components of the endocrine system. o Pituitary gland, adrenal glands 5. What is a disorder of the endocrine system? o Diabetes 6. Know the cardiovascular system. o Heart, blood vessels, & blood o Acts as the transport system of the body o Blood carries nutrients to cells, waste products away from cells to kidneys 7. What are the components of the heart? o Right atrium: receives oxygen-depleted blood from the body and pumps it into the right ventricle o Right ventricle: pumps oxygen-depleted blood into the lungs o Left atrium: receives oxygen-rich blood from the lungs and pumps it into the left ventricle o Left ventricle: receives oxygen-rich blood through the aortic valve to the entire body, including the heart (through coronary arteries) 8. What are some disorders of the cardiovascular system? o Atherosclerosis Angina o Rheumatic fever Myocardial Infarction (Heart Attack) o Arteriosclerosis 9. What factors influence blood pressure? o Cardiac output Viscosity o Blood volume Temperature o Peripheral resistance Activity o Elasticity Emotional Experience 10. What are the components of the blood? o Plasma (55%) o Blood Cells (45%) 11. Know the respiratory system. o 3 main functions  Take in oxygen  Excrete carbon dioxide  Regulate composition of blood o Nose  Mouth  Pharynx  Trachea  Diaphragm  Abdominal Muscles  Lungs 12. What are some disorders of the respiratory system? o Asthma Cystic Fibrosis Whooping Cough o COPD Bronchitis Viral Infections o Bronchitis Tuberculosis Hay Fever o Hyperventilation Lung Cancer Pleurisy o Pneumonia Strep Throat Asphyxia 13. Know the digestive system and how digestion occurs (e.g., how food is absorbed). o Bolus (food lubricated by saliva) passes through esophagus  stomach  gastric juices break down bolus  pancreas secretes juices into duodenum (breaks down into proteins, carbs, fats)  pancreas produces insulin  liver produces bile  absorption of food in small intestine  food

residue passes into large intestine  rectum 14. What are some disorders of the digestive system? o Gastroenteritis Gallstones o Diarrhea Appendicitis o Dysentery Hepatitis o Ulcers 15. Know the renal system. o Kidneys, ureters, urinary bladder, urethra o Important in metabolism o Kidney’s regulate bodiy fluids, maintain sodium/potassium ions 16. What are some disorders of the renal system? o Urinary tract infection Kidney Failure o Tubular necrosis Acute Glomerular Necrosis 17. Know the basics of the reproductive system. o Female  Fallopian tubes, uterus, ovary, cervix, vagina  Ovaries produce estrogen/progestrerone o Male  Penis, testes, scrotum, vas deferens  Testes produce testosterone 18. What are some disorders of the reproductive system? What is not a disorder of the reproductive system? o STD’s Amenorrhea o Pelvic Inflammatory Disease Endometriosis o Cysts Menopause – NOT A DISORDER o Fibroids 19. Know the immune system components. o Non-specific immune mechanism: general set of responses to any kind of infection or disorder o Specific immune mechanisms: acquired after birth; fight particular microorganisms and their toxins 20. How does infection occur? o Direct Transmission: involves bodily contact o Indirect Transmission: occurs when microbes are passed via airborne particles o Biological Transmission: occurs when a transmitting agent picks up microbes, changes them into a form conducive to growth in the body, and then passes it on to the human o Mechanical Transmission: passage of a microbe to an individual by means of a carrier that is not directly involved in the disease process o Course of infection  Incubation period: period btw. when the infection is contracted and the time the symptoms appear  Non-specific systems: fatigue, headaches, etc.  Acute phase: disease at its height; experiences fever, nausea, fatigue 21. What are some disorders of the immune system? o AIDS Hodgkin’s disease o Cancer Lymphoma o Smallpox 22. Why is autoimmunity a problem?

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Immune system attacks itself Disorders  Arthritis Multiple Sclerosis  Lupus Inflammatory Bowel Disease

Health Behaviors 1. Know the difference between health behaviors, health habits, health promotion, and prevention. o Health behaviors: behaviors undertaken by people to enhance or maintain their health (healthy diet, exercise, sleep) o Health habits: a health-related behavior that is firmly established and often performed automatically o Health promotion: general philosophy that says that good health (wellness) is a personal and collective achievement o Prevention: Instilling good health habits and changing poor ones  2 strategies  Alter problematic behaviors  Prevent poor habits from developing (preferred method) 2. What are some factors associated with predicting and changing health behaviors? o Demographics Symptoms o Age Social Influence o Values Cognitive Factors o Personal control Access to health care o Goals 3. What's the difference between teachable moment and window of vulnerability? o Teachable Moment: refers to the fact that certain times are better than others for teaching particular health practices o Window of Vulnerability: certain periods of time when children/adolescents learn important healthrelated habits 4. What are some at-risk groups? Why should we intervene with particular groups? o Children, adolescents, elderly… o Early identification of at-risk people may prevent or eliminate the poor health habits that can exacerbate vulnerability 5. Be familiar with each of the health behavior models and how they are used. It is best to be familiar with the variables in each: a. Educational efforts fear appeals and message framing. o E.E.  People will change if they have the correct information  Communication should be colorful and vivid  Strong arguments should be presented  Message should be clear and concise o F.A.  People will change if they are fearful that a particular habit is hurting their health o M.F.  Messages that emphasize potential problems work better for behaviors that have uncertain outcomes, whereas messages that stress benefits seems to be more persuasive for behaviors with certain outcomes b. Health Belief Model o Whether a person practices a particular behavior depends on two factors:

whether the person perceives a personal health threat and whether the person believes that a particular health practice will be effective in reducing that threat 

c. Social Cognitve Theory o d. Theory of Planned Behavior e. Stages of Change/Transtheoretical Model f. Self-Regulation Model 6. Be familiar with the Cognitive-Behavioral Approaches to health behavior change: a. self-monitoring: assessing the frequency, antecedents, and consequences of a target behavior to be modified (i.e. self-observation) b. classical conditioning: the pairing of a stimulus with an unconditioned reflex, such that over time the new stimulus acquires a conditioned response, evoking the same behavior; the process by which an automatic response is conditioned to a new stimulus c. operant conditioning: the pairing of a voluntary, non-automatic behavior with a new stimulus through reinforcement or punishment d. modeling: learning gained from observing another person forming the target behavior e. stimulus control: interventions designed to modify behavior that involve the removal of discriminative stimuli that evoke a behavior targeted for change and the substitution of a new discriminative stimuli that will evoke a desired behavior f. self-reinforcement: systematically rewarding or punishing ones-self to increase or decrease the occurrence of a target behavior g. contingency contracting: a procedure in which an individual forms a contract with another person detailing what rewards or punishment are contingent on the performance or nonperformance of a target behavior h. cognitive restructuring: a method of modifying internal monologues in stress-producing situations; i. behavioral assignments: home practice activities that people perform on their own as part of an integrated therapeutic intervention for behavior modification j. social skills training: techniques that teach people how to relax and interact comfortably in social situations k. motivational interviewing: engaging intrinsic motivation to change behavior by developing discrepancy and exploring and resolving ambivalence within the client l. relaxation training: procedures that help people relax; includes progressive muscle relaxation and deep breathing, guided imagery, and forms of mediation or hypnosis 7. Understand relapse and the factors associated with relapse.

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Reasons for relapse  Likely when people are depressed, anxious, or under stress  Have a greater need for addictive behaviors when going through rough situations  Less likely to occur if the person has social support from friends/family, but is more likely if the person lacks social support or is involved in a conflictual, interpersonal situation

8. How can we prevent relapse? o Must be integrated into treatment programs from the beginning o Screening techniques – weeds out people who are not truly committed to behavior change, thus vulnerable to relapse o Identification of situations that are likely to promote a relapse and then develop coping skills that will enable people to deal with those stressful events o Restructuring of environment to eliminate situations that will trigger a relapse 9. How can we modify the environment to change health behaviors? o Social Engineering  Passive methods: don’t require the individual to take personal action 10. What are some different venues to modify health behaviors? o Therapist’s Office Schools o Health Practitioner’s Office Workplace Interventions o The Family Community-Based Interventions o Managed Care Facilities Mass Media o Self-Help Groups Internet o Schools Workplace Interventions

Health Promoting Behaviors 1. Understand the importance of exercise in promoting health. o Decrease risks for chronic diseases o Increase in CV fitness o Improved mental feelings 2. What are some benefits of exercise? How does it affect psychological health? o Decrease BP Increase longevity o Increase strength of the heart Decrease CVD o Decrease obesity Decrease negative moods o Exercise benefits physical and mental health; it improves mood, feelings of well-being, sense of selfefficacy 3. What are the determinants of regular exercise? o Sustained exercise that stimulates/strengthens the heart and lungs and improves the body’s utilization of oxygen o Marked by high intensity, long duration, and high endurance 4. How can we promote exercise? o Individualized exercise programs o Cognitive behavioral strategies o Relapse prevention 5. Be familiar with the different types of accidents that negatively impact health. o Accidental poisonings & falls o Motorcycle/automobile accidents

6. Why are motorcycle and automobile accidents such an important problem? o #1 cause of accidental death 7. How can we decrease accidents? o Prevention:  Home accidents  Parenting classes  Dietary/medical interventions to help reduce bone loss and prevent falls in the elderly  Motorcycle/Automobile accidents  Speed limits  Seat belts/car seats  Helmets  Visibility 8. Understand the different types of cancer screening (e.g., ACS guidelines). o Breast cancer  Yearly mammograms starting at age 40, every 3 years for women age 20-30 o Colon & Rectal Cancer  Men and women with average risk should start getting checked at age 50  Colonoscopy – 10 years  DCBE – 5 years  Virtual colonoscopy – 5 years  FOBT – every year  FIT – every year  sDNA – interval uncertain o Cervical Cancer  Screenings should begin 3 years after sex  Age 30, 3 normal pap tests – get tested every 2, 3 years  Age 70+, can stop having screenings o Endometrial Cancer  Women with high risk of developing cancer – annual biopsies stating at age 35 o Prostate Cancer  PSA & DRE annually to men 50+ with at least a 10 year life expectancy  Men at high risk should begin at age 45 9. Be familiar with the importance of healthy diet in promoting health. o Good diet helps prevent weigh problems, CVD… 10. What are some interventions? o Cognitive-behavioral  Self-monitoring  Relapse prevention  Support o Family interventions  Meet with dietary counselor to change family diet o Social engineering  Banning snack foods from schools  Make snack foods more expensive/health foods less expensive 11. What is obesity, and why is it a health risk? 12. When is a good time to intervene to change diet? 13. What are some factors associated with obesity? 14. How can we treat (intervene) obesity? 15. Be familiar with anorexia and bulimia.

16. How are anorexia and bulimia treated? 17. Be familiar with the concept of and th importance of sleep. 18. What are some disorders associated with sleep? 19. What is savoring? Health Compromising Behaviors 1. Understand the common characteristics of health-compromising behaviors. 2. Be able to define the difference between alcoholism and problem drinking. 3. What are tolerance, craving, addiction, and withdrawal? 4. Understand the importance of alcoholism and problem drinking. 5. What is the etiology of alcoholism and problem drinking? 6. How can we treat alcohol abuse and prevent relapse? 7. What is AA, and why is drinking a problem in college? 8. Understand the threat of drinking and driving. 9. Can alcohol ever be beneficial? 10. Understand the importance of smoking. 11. What types of factors synergize/interact with smoking? 12. How have smoking rates changed over time? Why did they change? 13. What factors are associated with smoking? What is nicotine addiction? 14. What are 'chippers'? 15. What types of interventions are available to smokers? 16. How can we prevent people from starting to smoke? 17. What are health effects of smoking?...