Summary - Chapters 1-14 PDF

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Chapter 1 What is Health Psychology? Why is the field of health psychology needed? The change in illness patterns has demanded the need for health psychology Until the early 20th century, acute disorders were among the major causes of death and illness in Canada o These tend to be curable Now, chron...

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Chapter 1 – What is Health Psychology? Why is the field of health psychology needed? - The change in illness patterns has demanded the need for health psychology - Until the early 20th century, acute disorders were among the major causes of death and illness in Canada o These tend to be curable - Now, chronic illness are the main contributors o These tend to not be curable o Due to social and psychological factors which can be prevented through proper health psychology education o Health psychologists also help people with chronic illnesses adjust - Epidemiology is the study of the frequency, distribution, and causes of infectious and non-infectious diseases in a population o Morbidity refers to the number of incidents; either the new cases (incidence) or total number of cases (prevalence) o Mortality refers to the number of deaths due to a particular cause o Mortality statistics are essential in reducing the occurrence of diseases that lead to early death  Also, health psychologists are interested in morbidity statistics because they are concerned with improving quality of life Changing Perspectives on Health and Health Care - Health psychology represents an important perspective on health care issues for several reasons: 1. Health psychology’s emphasis on prevention has the potential to reduce the amount of money devoted to management of illness 2. Health psychologists can help in the design of user friendly health care systems as they have done research on what satisfies or dissatisfies people with their health care and whether or not they engage in treatment-related behaviours 3. The health care system employs thousands of people; nearly every individual in the country has direct contact with the health care system - Health clearly has a substantial social and psychological impact on people, an impact addressed by health psychologists - There is an increased acceptance of health psychologists within the medical community Chapter 2 – The Systems of the Body What is the Function of the Nervous System? - The PNS is composed of somatic and autonomic nervous systems o The somatic provides brain with feedback about voluntary movements

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o The autonomic connects CNS with internal organs over which people have no control The Brain o The Hindbrain  The medulla controls the heart rate, blood pressure and breathing  The pons also helps with respiration  The cerebellum coordinates voluntary muscle movement, maintenance and balance of equilibrium and maintenance of muscle tone and posture  Damage makes it hard to coordinate muscle effectively o The Midbrain  Major pathway for sensory and motor impulses moving between hindbrain and forebrain  Coordinates visual and auditory reflexes o The Forebrain  The Diencephalon  Thalamus recognizes sensory stimuli and relays these impulses to the cerebral cortex  Hypothalamus regulates centres in medulla controlling cardiac functioning, blood pressure and respiration o Regulates water balance, hunger and sexual desires o Transition centre for thoughts in the cc and their impact on the internal organs  E.g. embarrassment leads to blushing via hypothalamus o Hypothalamus regulates endocrine system, which releases hormones to affect target organs  The Telecephalon  Composed of two hemispheres of the cerebral cortex  The cerebral cortex is the largest portion of the brain involved in higher order intelligence, memory and personality o Interprets sensory impulses and passes down motor impulses o Composed of frontal, parietal, temporal and occipital lobes o Can relate current sensations to past ones o The Limbic System  Plays a role in stress and emotional responses Neurotransmitters o Stimulation of the SNS prompts secretion of epinephrine and norepinephrine (the catecholamines)  Prompts bodily responses such as increase in heart rate, blood pressure, and respiration; digestion and urination decrease; pupils dilate and sweat glands are stimulated

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Disorders of the Nervous System o Epilepsy  No specific cause  A disease of the CNS marked by seizures o Cerebral palsy  Marked by lack of muscle control  Stems from brain damage caused by interruption in brain’s oxygen o Alzheimer’s Disease  Degenerative disease with serious impairments to thinking and memory o Parkinson’s Disease  Progressive degeneration of the basal ganglia, which controls smooth motor coordination o Multiple Sclerosis  Degenerative disease of certain brain tissues  Autoimmune disorder where the immune system fails to recognize its own tissue and attacks the myelin sheath surrounding the nerves o Huntington’s Disease  Hereditary disorder with chronic physical and mental deterioration  Testing is available to recognize carriers of the disease o Paraplegia and Quadriplegia  Paraplegia is paralysis of lower extremities of the body; results from injury to lower portion of spinal cord  Quadriplegia is paralysis of all four extremities and the trunk of the body; occurs when upper part of spinal cord injured  When there is complete loss of motor and sensory function, spinal cord injury is complete; when there is not complete loss, injury is incomplete

How Does the Endocrine System Operate? - Complements the nervous system in controlling the body - Secretes hormones into blood, stimulates changes in target organs - Nervous system is responsible for fast-acting responses to changes in body, whereas endocrine system is responsible for slow-acting ones - Regulated by hypothalamus and pituitary gland - The Adrenal Glands o Involved in reactions to stress - Disorders of the Endocrine System o Diabetes  Type I is partly genetic whereas Type II is largely due to lifestyle choices What is the Cardiovascular System? - Diseases of the Cardiovascular System o Atherosclerosis

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Associated with two clinical manifestations  Angina pectoris (chest pain) which occurs when there is lack of oxygen supply to the heart or inadequate removal of CO2  Myocardial infarction which occurs when a clot in the coronary vessel blocks blood flow to the heart

The Blood o White blood cells play an important role in healing o Lymphocytes play an important role in combating foreign substances; they produce antibodies o Red blood cells carry oxygen o Platelets block small holes in blood vessels and play a role in blood clotting Disorders related to white cell production o Leukemia is a common form of cancer; disease of the bone marrow where there is too many white blood cells and not enough red blood cells o Leukopenia is a deficiency of white blood cells o Leukocytosis is an excessive number of white blood cells Disorders related to red cell production o Anemia is when the number of red blood cells or amount of hemoglobin is below normal o Sickle-cell anemia is the inability to produce normal red blood cells Clotting disorders o Hemophilia is when your blood cannot clot properly in response to injury

What is the function of the immune system? - Implicated in infections, allergies, cancer and autoimmune diseases - Primary function is to distinguish between what is self and what is foreign - Disease by infection is the invasion of microbes and their growth in the body - Four ways infections are transmitted o Direct transmission involves bodily contact o Indirect transmission occurs via airborne particles o Biological transmission occurs when a transmitting agent picks up the microbe, changes it into a form conducive to growth in the human body, and passes it on o Mechanical transmission is the passage of a microbe to an individual by means of a carrier not directly involved in the disease process - The course of infection o Incubation period until symptoms appear o Nonspecific symptoms o Acute phase where symptoms are at a height  Unless fatal disease, followed by a period of decline - Infections come in three forms o Localized stay where they are o Focal stay where they are but send toxins to other parts of the body

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o Systemic affect a number of areas of the body Primary infections may lead to secondary infections, which usually pose greater risks than the first infection Immunity o Nonspecific immunity is mediated in four ways:  Anatomical barriers, e.g. the skin  Phagocytosis, the process by which certain white blood cells ingest microbes  Antimicrobial substances kill invading microorganisms  Inflammatory response is a local reaction to infection o Specific immunity is acquired through contracting a disease or artificial means  Operates through antigen-antibody reaction o Humoral immunity  Release antibodies into the blood  Two types of B cells:  Mature, antibody secreting plasma cells  Resting, nondividing memory cells which turn into antigenspecific cells when re-exposed to the same antigen  Humoral immunity defends the body against bacterial infections and viral infections that have not yet invaded the cells o Cell-mediated immunity  Operates at the cellular level; T cells kill invading organisms and infected cells  Two types of T cells  Cytotoxic T cells respond to specific antigens and destroy virally infected cells  Helper T cells enhance the function of Cytotoxic T cells, B cells and macrophages o The Lymphatic system  Drainage system of the body involved in immune functioning  The spleen produces B and T cells  Tonsils filter out microorganisms that enter the respiratory tract  Thymus gland helps T cells mature o Disorders of the immune system  AIDS, a progressive impairment of immunity  Cancer  Splenomegaly is an enlargement of the spleen resulting from various infections  Hinders spleens ability  Tonsillitis is an inflammation of the tonsils  Infectious mononucleosis is a viral disorder marked by an unusually large number of monocytes  Lymphoma is a tumour of the lymphatic tissue

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 E.g. Hodgkin’s disease is a malignant lymphoma Infectious disorders  May have been increased through hygiene used to control infectious disorders  Contribute to chronic diseases  Are increasingly resistant to treatment

What are the physiological systems involved in stress? - Sympathetic arousal results in the cranked up feeling we experience in response to stress - HPA activation acts to conserve stores of carbs and reduce inflammation in case of an injury; helps the body return to its steady state following stress by inhibiting release of CRF o Repeated activation of the HPA axis in response to chronic stress can compromise its functioning - Effects of long-term stress o Suppression of immune functions o Increased blood pressure and heart rate o Provoke variations in normal heart rhythms o Produce neurochemical imbalances that can contribute to the development of psychiatric disorders o Prolonged cortisol secretion can lead to problems in verbal functioning, memory, and concentration o Pronounced HPA activation is common in depression; not sure the direction of this relationship o Health consequences of HPA activation seem to be more detrimental than those of sympathetic activation; sympathetic adrenal activation may also require HPA activation to lead to disease o Stress may also impair immune system’s ability to respond to hormonal signals that terminate inflammation; can lead to coronary artery disease Chapter 3 – Health Behaviour and Primary Prevention -

The media can contribute to health behaviours through health promotion and education Legislation can contribute by mandating certain activities that reduce risk

Why are Health Behaviours Important? - Health behaviours include positive, negative, and treatment-related behaviours - One study emphasizes seven important good health habits: o Sleeping 7 to 8 hours a night o Not smoking o Eating breakfast o No more than one to two drinks of alcohol a day

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o Getting regular exercise o Not eating between meals o Being no more than 10 percent overweight This study found that the more good health habits people had, the fewer illnesses, the better they felt and the less disabled they had been o Also lower mortality rates In Canada, the prevalence of acute infectious disorders has declined, while there has been an increase in preventable disorders o Estimated that half of the deaths in Canada are caused by modifiable behaviours, such as smoking, poor diet and physical inactivity o Cancer deaths alone could be reduced by 50 percent by changing health behaviours o Successful modification of health behaviours will have several benefits:  Reduce deaths due to lifestyle-related diseases  May delay time of death, increasing life expectancy of the population  May expand the number of years during which a person may enjoy life free from complications  May begin to make a dent in the amount of money spent on health services Factors that influence the practice of health o Socio-economic factors  Younger, better educated people under lower levels of stress with better social support more likely to practice health behaviours o Age  Good in childhood, deteriorate among adolescents, improve among retired adults and then go downhill again among adults 73 and older o Gender  Among school age children, girls eat healthier but engage in more dieting, as well as less sports activities o Values  Exercise for women may be very desirable in one culture but not another o Personal control o Social influence  E.g. peer pressure may lead adolescents to smoke  The media can also contribute o Personal goals o Perceived symptoms  E.g. a smoker may cut back if they believe they are vulnerable to health problems at that time o Access to health care services  Direct influence such as ability to get Pap smear  Indirect such as advice from health care providers about losing weight o Place

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 People living in rural areas generally have poorer health behaviours o Supportive Environments  E.g. Walking and bike pathways in the community o Cognitive factors  Being health conscious and thinking about the future Barriers to changing health behaviours o Not sure when and how to intervene o People are not really concerned about what their health will be like when they are 40 or 50, and thus engage in behaviours now that have long-term impacts down the road o Unhealthy behaviours can be pleasurable, automatic, addictive and resistant to change o Health behaviours are independent of each other and one must be tackled at a time

Interventions with At-Risk People - Ethics o Risk-prevention may be ineffective for genetically based risk factors o May not know what an effective intervention will be Health Promotion and the Elderly - Exercise is the most important o Reduces risk of mortality o Increases the likelihood the elderly can maintain the activities of daily living o Can reverse age-related cognitive defects o Can also be beneficial for the frail elderly - Alcohol consumption o Becomes more risky in old age o If on medications, will interact with alcohol o Increases the risk of gastrointestinal disorders and accidents o Elderly are at risk for depression, leading to an accelerated physical decline - Vaccinations o Influenza a major cause of death among elderly o Influenza increases the risk of heart disease and stroke - Current evidence suggests health habit changes are working Ethnic and Gender Differences in Health Risks and Habits - Alcohol consumption a greater problem among men than women - Smoking a greater problem for non-minority men o Smoking among Aboriginal are triple the rate for Canadians - Aboriginals less likely to exercise regularly - South Asians and Chinese have more dangerous abdominal fat than Europeans, with greater risk for cardiovascular disease, hypertension, diabetes and other complications

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Current guidelines for healthy weight may need to change to include ethnic differences

What Theories and Models are used in Health Behaviour Change? Attitude Change and Health Behaviour - Message Framing o Prospect theory states that different presentations of risk information will change people’s perspectives and actions o Messages that emphasize potential problems (loss-framed) work better for behaviours with uncertain outcomes (high risk) and messages that emphasize benefits (gain-framed) work better for behaviours with certain outcomes (low risk) o Messages emphasizing exercise may work better when framed from a promotion than prevention perspective o Effectiveness of the message may depend on individual’s own motivation; known as congruency framed messages  People who are approach-oriented or want to maximize rewards respond better to gain-framed  People who are avoidance-oriented or seek to minimize losses are influenced better by loss-framed  Congruency framed messages increase feelings of self-efficacy for engaging in behaviour  May also depend on matching the message to the emotional state of the recipient Social Cognition Models of Health Behaviour Change - Suggests beliefs people hold motivate their decisions to change behaviour - Based on the expectancy-value theory, stating that people engage in behaviour they expect to succeed in and that have outcomes they value - Self-efficacy and health behaviours o Self-efficacy is an important determinant of the practice of health behaviours o Bandura’s social cognitive theory  Outcome expectancies  Efficacy expectancies o Strong relationship between self-efficacy and initial health change as well as longterm maintenance - The Health Belief Model o Perceived threat reduction influenced by:  Perceived efficacy  Perceived barriers o Cues to action  Include people, events or things that activate readiness and stimulate behaviour

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 Can be internal or external o Self-efficacy  Explains why some people will not perform a health behaviour even if they believe it is effective o The health belief model is supported fairly well o Some problems:  Focuses mainly on beliefs regarding health behaviour change rather than emotional responses to perceived risk, which drive behaviour  Also, does not account for the perception that one will be able to engage in the health behaviour Implementation intentions and health behaviour change o Having good intentions is often not enough to ensure changes are successful o An approach that can help with the intention-behaviour gap is forming implementation intentions o An implementation intention is a specific behaviour that highlights the how, when, and where of a behaviour, and includes “if-then” contingency plans to deal with anticipated barriers o Has a clear plan of how the behaviour can be carried out under any circumstances and thus has a stronger influence on behaviour o Making more specific intentions is a greater predictor than simply making a greater number of intentions o Good way to shield from interfering states

Attitudes, Social Cognition, and Changing Health Behaviours: Some Caveats - Not very successful in explaining spontaneous behaviour change or long-term behaviour - Communications designed to change beliefs may evoke defensive or irrational processes o E.g. May think a threat is less relevant than it is - Thinking about the disease can lead to a negative mood which may lead people to ignore or defensively interpret their risk - Social cognitive models view health behaviour as a rational process and ignore other important factors o One study found feeling positive about physical activity was a better predictor of physical activity than attitudes, etc. - Because health habits are difficult to modify, attitude changes may not go far enough in providing the informational base for altering health habits o Instill motivation but do not provide steps and skills necessary to alter behaviour Transtheoretical Model of Behaviour Change - Addresses the stages of behaviour change o Goals and interventions for each stage - Self-efficacy important to prevent relapse o Increases as temptations decrease

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Important because: o Captures the stages people go through o Illustrates successful change may not occur on the first try or all at once o Also shows why many people are unsuccess...