19 Introduction to Health Psychology

Question 1

What is WHO (1948) definition of health?

Answer 1

“state of complete physical, mental and social well-being.. Not merely the absence of disease or infirmity”

Question 2

What does Bircher (2005) define health as?

Answer 2

Dynamic state of well-being characterised by a physical and mental potential satisfying the demands of life according to their age, culture and personal responsibility. No single definition, complex concept extending beyond biological aspects of individual functioning

Question 3

What do Indigenous Australian people define health as?

Answer 3

“not just the physical well-being of the individual but refers to the social, emotional, spiritual and cultural well-being of the whole community. This is a whole of life view and includes the cyclical concept of the life-death-life”

Question 4

What are the models of health and illness?

Answer 4

Biomedical model of illness Biopsychosocial model of illness

Question 5

Describe the Biomedical Model of Illness

Answer 5

Symptoms of illness considered to have underlying pathology, therefore removal of pathology -> restored health Criticism: Too simple, reductionist- ignore the fact that individuals might respond differently to different illnesses because of personality, social support, development, cultural beliefs etc.

Question 6

Describe the biopsychosocial model of illness

Answer 6

• Psychological and social factors can add to biological or biomedical explanations and understanding of health and illness -> diseases and symptoms can be explained by physical, social, cultural or psychological factors - Employed in health psychology

Question 7

Which model is the more current view of health

Answer 7

Bio-psychosocial model of illness

Question 8

What is health psychology?

Answer 8

Health psychology is an interdisciplinary field concerned with the application of psychological knowledge and techniques to health, illness, and health care.

Question 9

List what health psychology is devoted to

Answer 9

Devoted to understanding psychological influences on how people - Stay healthy - Why they become ill - How they respond if they do become ill

Question 10

Explain the usefulness of models of health behaviour

Answer 10

• Theoretical models seek to explain and predict why people engage in health-enhancing or risk behaviours - Models have identified modifiable influences upon health behaviour that offer potential targets for health intervention (promotion and education).

Question 11

Why are we looking at models of health behaviour

Answer 11

Health enhancing - Healthy eating - Exercise - Safe Sex - Screening - Vaccination Health Risks - Sedentary lfiestyle - Smoking - Alcohol - Risky sexual behaviour - Nutrient poor diet

Question 12

What do we want to focus on in terms of the models?

Answer 12

We want to focus on enhancing health and reducing health risk

Question 13

List the different models of health behaviour

Answer 13

• Transtheoretical model - Health belief model - Theory of planned behaviour - Health action process approach - Temporal self-regulation theory

Question 14

Describe the transtheoretical model

Answer 14

Provides a framework for explaining how behaviour change occurs -> can design an intervention approach based on what stage someone is at (flexibility)

This model has 5/7 stages of change

(1) Precontemplation (2) Contemplation (3) Preparation (4) Action (5) Maintenance
(6) Termination (7) Relapse

This model is not linear - can enter and exit at any point and people may repeat a stage several times

Question 15

What do the first 5 stages of the Transtheoretical model entail?

Answer 15

1. Precontemplation

• No intention of taking action within next 6 months
• Individuals more likely to be in denial -> report lower self-efficacy and more barriers to change

1. Contemplation

• Intends to take action in the next 6 months
• May seek information although may still underestimate the potential for relapse

1. Preparation

• Intends to take action within the next 30 days, has taken some steps in this direction
• People start to set their goals and some will make concrete plans. Motivation and self-efficacy are crucial if action is to be elicited

1. Action

• Has changed overt behaviour for less than 6 months
• Realistic goal setting crucial if action to be maintained. Use of social support is important to receive reinforcement of change

1. Maintenance

• Has changed overt behaviour for more than 6 months
• Can be enhanced by self-monitoring and reinforcement

Question 16

What do the added 2 stages of the Transtheoretical model entail?

Answer 16

1. Termination

• Overt behaviour will never return, and there is complete confidence without fear of relapse
• e.g. they quit smoking 20 years ago

1. Relapse
   * Where a person lapses into their former behavioural pattern and returns to a previous stage (common, can occur at any stage)

Question 17

What are the strengths of the Transtheoretical Model?

Answer 17

• Focused consideration on what is the best type of intervention to conduct at each stage
• Implications for interventions à little focus on how to achieve change if in pre-contemplation

Question 18

Describe the weaknesses/limitations of this model

Answer 18

• Someone can be at more than one stage at a time
• Might have too much focus on motivation and intention à past behaviour is a more powerful predictor of future behaviour
• Participants that change stage might not be predictive of the success of intervention
• Doesn’t consider social aspects of health behaviour, severity of illness/disease/outcome, characteristics of
  the individual

Question 19

Describe the nature of the Health-Belief Model

Answer 19

The HBM is a social cognitive model that attempts to explain and predict health behaviours

• This is done by focusing on the attitudes and beliefs of individuals

A person’s readiness or likelihood of behaviour change is determined by their beliefs, which are in turn determined by their demographics and situation -> there are four main factors:

1. Perceived severity or seriousness of the disease
2. Perceived susceptibility of the disease
3. Perceived benefits of health action
4. perceived barriers to performing the action

Question 20

Elaborate on the four main factors in the Health-belief model

Answer 20

• Severity or seriousness: thinking you will get a certain disease
• Susceptibility: thinking a disease is serious because of a specific reason
• Benefits: thinking certain behaviours would reduce/increase the chances of getting the disease
• Barriers: thinking it will be hard to perform certain health behaviours

Question 21

What are the strengths and criticisms of Health-belief model?

Answer 21

Strengths

• it has been adapted to explore a variety of long- and short-term health behaviours

Criticisms

• Limited model -> does not allow for a dynamic process of change in beliefs
• Assumes that individuals are rational information processers and decision-makers, does not take environment, social influences or uncommon stimuli into consideration
• Does not account for habitual behaviours e.g. eating behaviours

Question 22

What is the nature of the theory of planned behaviour (TPB) and its aim?

Answer 22

Aims to incorporate wider social influences and the necessity of intention formation

Behaviour determined by intention, which can be influenced by an attitude towards the behaviour (outcome expectancy, outcome value) and their perception of social pressure regarding the behaviour (subjective norm)

Question 23

Describe what is meant by the attitude in Theory of planned behaviour (TPB)

Answer 23

• Outcome expectancies: expected consequences of behaviour e.g. quit smoking
• Outcome evaluation: evaluation of the favourableness of expected consequences of a behaviour e.g. if I could not have yellow teeth that would be great

Question 24

What is the subjective norm in the theory of planned behaviour (TPB)?

Answer 24

• Normative beliefs: your perception of how other people regard your performance on a behaviour e.g. I will look lame if I put on sun cream
• Motivation to comply: desire to comply with wishes of others e.g. I want to be cool so I wont put cream on

Question 25

What is the perceived behavioural control in the theory of planned behaviour (TPB)?

Answer 25

Similar to self-efficacy – beliefs about the extent of your control over your behaviour e.g. I think it will be hard for me to control my diet because I am a university student (poor)

Question 26

Describe the intention in the theory of planned behaviour (TPB)?

Answer 26

Intention is thought to be the most proximal predictor of behaviour - with attitude and subjective norm (and most of perceived behaviour control) influencing behaviour through their effect on intention

Question 27

What are the strengths and criticisms of the theory of planned behaviour (TPB)?

Answer 27

Strengths:

• It addresses many of the criticisms of the health belief model
• The relationship between variables is well-defined
• Includes consideration of the social influences on behaviour
• Considers whether the individual feels able to perform the behaviour

Criticisms:

• Prediction of behaviour from TPB variables is significantly lower than the prediction of intention

Question 28

What is a stage-based model and what models follow this?

Answer 28

Individuals can be at ‘discrete ordered stages’ each on denoting a greater inclination to change

e.g. Transtheoretical model

Question 29

What are social cognitive models?

Answer 29

Health belief model & theory of planned behaviour

Question 30

What are models focusing on post intentional behaviour and which models follow this?

Answer 30

Some researchers have developed new models to explain what happens after you form an intention to perform a behaviour

E.g. Health Action Process Approach (HAPA) & Temporal Self-Regulation Theory

Question 31

What is the Health Action Process Approach (HAPA)?

Answer 31

Fills the intention-gap by highlighting self-efficacy, and action plans.

• A pre-intentional motivation phase
• A post-intentional volition phase

First, an intention to change is developed (motivation phase) and then the change must be planned, initiated and maintained (volition phase) and the relapse be managed

Question 32

What does HAPA suggest?

Answer 32

• Adoption, initiation and maintenance of health behaviours must be explicitly viewed as a process that consists of at least a pre-intentional motivation phase, and a post-intentional volition phase
• Different factors are used to explain behaviour at a qualitatively different stage à importance of self-efficacy

Question 33

What does the motivation phase of HAPA involve?

Answer 33

Self-efficacy and outcome expectancies are important predictors of goal intention -> perceptions of threat severity and personal susceptibility (perceived risk) are considered a distal influence on actual behaviour, playing a role only in the motivation phase.

Question 34

What does the volition phase of HAPA?

Answer 34

HAPA proposes that in order to turn intention into action, planning has to take place

• Self-efficacy (action cycle)
  
  • Initiative: a person believes they are able to take initiative when planned circumstances arise
  • Maintenance: belief in your ability to overcome temptations
  • Recovery: getting back on track when they suffer a relapse in behaviour

Question 35

What is the first step of HAPA?

Answer 35

First, an intention to change is developed, in part on the basis of self-beliefs

Question 36

What is the second step in HAPA?

Answer 36

The change must be planned, initiated, and maintained, and relapses must be managed

Question 37

What are the criticisms of HAPA?

Answer 37

Literature is limited -> too rational? emotion might be neglected -> social and environmental influences are not considered as directly affecting behaviour, but rather as cognitions

Question 38

What is Temporal Self-Regulation Theory (TST)?

Answer 38

Adds variables to explain the intention-behaviour gap -> Incorporates behavioural pre-potency (habits) and individual differences in self-regulatory capacity

• It posits that health behaviour is proximally determined by there factors:

1. Intention strength
2. Behavioural pre-potency
3. Self-regulatory capacity

Question 39

What are behavioural pre-potency and self-regulatory capacity theorised to have:

Answer 39

They are theorised to have direct influences on behaviour and also to moderate the intention-behaviour link

Question 40

What is intention strength a function of in TST?

Answer 40

Combo of self-regulation and behaviour pre-potency determines the likelihood that intentions will be translated into behaviour, which also has their own direct influences on behaviour regardless of intention

• Connectedness belief: anticipated connections between behaviour and important/relevant outcomes (the value of outcomes can range from negative/costs to positive/benefits
• Temporal proximity - beliefs are weighted by temporal valuations
  
  • time as a barrier, short-term vs. long term

Question 41

What are Temporal Valuations in TST?

Answer 41

TPB and other social cognitive models (HBM, PMT) may not predict adequate intention-behaviour consistency because they have no temporal (immediate vs distal) weighting of anticipated outcomes

• Differing relationship between proximity and valence characteristics

Question 42

What is self-regulation in TST?

Answer 42

Impulse control/management of short term desires (executive functioning – the ability of an individual to exert control over cognition, emotion, behaviour and physiology)

Question 43

What is behavioural pre-potency in TST?

Answer 43

• Examines the strength of the past performance and presence of similar cues to action in the environment
• The combination of self-regulation and behavioural pre-potency determines the likelihood that intentions will be translated into behaviour, and each also has direct influences on behaviour itself regardless of intention

Question 44

What are criticisms in TST?

Answer 44

Trying to find good ways to measure self-regulation and behavioural pre-potency. Unclear whether the model is better than the TPB

Question 45

Models of behaviour provide what?

Answer 45

A useful way of understanding (and hopefully changing) health behaviours

Question 46

What does new research suggest?

Answer 46

That new models like HAPA and the temporal self-regulation theory might help explain post-intentional processes