314 - MT1 Flashcards
WHO definition of Health
- definition
- aspects of wellness (3)
- complete state of physical well-being; not merely absence of disease/infirmity
- physical, mental and social aspects
health psychology
- definition
- goals (4)
- psychological influences on how ppl stay healthy, why ppl become ill, and how ppl behave when ill
- promote and maintain health
- prevent and treat illness
- identify causes and diagnostic correlates of health, illness and related dysfunction
- analyze and improve healthcare systems and health policy
psychology contributions
- health promotion and maintenance (2)
- illness prevention and treatment (3)
- identification of etiologic (causes) and diagnostic correlates of health, illness and dysfunction (3)
- improvement of healthcare systems/policy (2)
scientific, educational and professional contributions
- health promotion and maintenance
- encourage healthy eating habits in children
- promote physical activity - illness prevention and treatment
- prevent common diseases (CVD, cancer, diabetes
- effective ways to cope w chronic disease and influence illness trajectories
eg. prevent COVID-19 transmission: wash hands, distancing, face mask, etc - identification of etiologic (causes) and diagnostic correlates of health, illness and dysfunction
- does social isolation inc risk of disease
- does stress alter susceptibility to infections - improvement of healthcare systems/policy
- what impact do health institutions have on people’s behaviours
- how can we improve the communication between patients and providers
Patient-provider communication importance: airplane story
- Atlanta man had rare tuberculosis (very contagious) and travelled on 2 commercial air flights which could have possibly exposed passengers to infection
- CDC told him to wait in isolation but he decided to take early flight because he didn’t want to miss his wedding, then he thought he was in trouble so he ran away on another flight
- CDC worked with the airlines to contact him and test the passengers near him
- luckily, his tuberculosis was not at the stage where it would spread
Bonnie Henry
public health messaging for COVID
- she answers the public’s questions for an hour every single day so people will understand what is at stake and do the right thing
leading causes of death in canada
- susceptibility
- life expectancy
- gender gap
- inuit
- cancer (29.9), CVD (19.7%), accidents (4.4%), etc
- susceptibility to disease/life expectancy are not evenly distributed»_space; psychosocial aspects matter!
- life expectancy: growing due to medical discoveries, hygiene, etc. and differs depending on socioeconomic status (less well off ppl have a shorter life expectancy)
- gender gap: women tend to outlive men (gap is narrowing)»_space; bigger gap in socioeconomic status (low vs high) for men (5yrs) than women (2yrs)»_space; stress hormones take a toll
- 15% diff between inuit (male) life expectancy and total expectancy »_space; stress and resources play a huge roll»_space; NOT just some biological difference
health behaviours
- promoting behaviours
- compromising behaviours
promoting: physical activity, fruit/veg consumption (at least 5 times daily»_space; women eat more than men, but still not even 50% meet guidelines)
compromising: smoking, alc consumption, poor eating habits, obesity
smoking ads (1960s)
- promotions
- health intervention
- age groups
- distribution
- doctors recommended smoking, athlete-endorsed
- successful health intervention!»_space; found out smoking is an issue to health and ti decreased significantly in the last 15 yrs (but ~20% of popn still smokes)
- w/in each age group there are differences»_space; ppl my age represented a lot :(
- smoking not evenly distributed w/in Canada
(15. 8% BC, 59.7% Nunavut)
physical activity
- benefits
- intervention
- guidelines
- physical activity has great health benefits»_space; extends lifespan
- unsuccessful intervention»_space; no change in phys activity»_space; ~50% meet activity guidelines (150 mins per week, 10 min duration)
sugar-rich diets
- 60s
- struggle to limit
- obesity rate, Canada’s rank
- differences (3)
- in the 60s ppl would give toddlers soda
- even though there is very solid evidence that sugar consumption is bad, it’s still a struggle to limit consumption (like tobacco/smoking) since outcomes don’t impact others like second-hand smoking does
- obesity has a clear upward trend (inc changes of CVD and diabetes)
- Canada is in the middle in terms of obesity rates
- different food culture, public healthcare, and transportation (eg. more walking = lower obesity rates)
alcohol consumption
- inc?
- risk
- inc significantly during COIVD»_space; not evenly distributed
- alc consump can put people at risk (drunk driving)
demographic changes
- projections
- demographic
- senior homes
- projections show drastic inc in age demographic (eg. in 2050)»_space; worry about how to distribute healthcare resources (most spent on older ppl 80+) and promote health/wellbeing (will reduce amt of money spent on chronic illnesses
- demographic used to look like a population pyramid (baby boomers at the bottom) but in 2050 it will look like a vase kind of thing (bigger at the top, skinny at the bottom)
- senior home care support in BC is at breaking point
successful aging (3)
psychosocial factors
- maximize number of years spent in good health
- promote active engagement w/life
- foster independence
mind body relationship
- holism (priests)
- dualism
- current views
holism: mind and body are same system
- priests = physicians»_space; treat mind
dualism: mind and body are 2 separate systems
current views: psychology and medicine initially embraced dualism, but we now know that psychological variables contribute to physical health
Ancient Greeks
- they recognized lifestyle factors shape wellbeing»_space; if sick, go for a walk, eat well, etc.
- Plato first suggested that the mind and body are separate
Humoral Theory
- polished by?
- 4 humors (what are humors, what are the diff types, unbalance?)
- Hippocrates proposed the humoral theory which was later expanded by Galen»_space; what happens in the mind affects the body
4 humors (circulating fluids in the body)»_space; if one dominated problems arose, but if all harmonious you would be healthy
- yellow bile: choleric (bad tempered), chronically irritable and angry (Type A personality)
- black bile: sad, melancholic, depressive
- blood: sanguine (optimistic), cheerful, positive
- phlegm: calm, listless
Middle Ages
- disease = punishment (dogma) from God (for ill-doing)
- cure = torture evil out and do penance later
- healing = priests realm»_space; influence of church slowed medical knowledge
Renaissance
- dualistic concept of mind and body (14th -15th centuries)
- breaking away from superstitions of the past centuries (catholic thinking)
- theologians, priests, philosophers would deal with the mind, and physicians would heal the body
Cartesian Dualism
Descartes believed that the mind and the body are separate entities, but can communicate via the pineal gland»_space; body is like a machine that must obey laws of physics
Technological strides
- Anton van Leeuwenhoek
- Giovanni Morgagni
- Medicine
- rejected humoral theory for new theories
- Anton van Leeuwenhoek: microscopy»_space; bacteria, blood cells, identified infectious diseases
- Giovanni Morgagni: autopsies»_space; atlas of anatomy
- Medicine: looked more to lab/scientific discoveries and less to mind
Germ Theory
- cause of disease
- magic bullet
- in the 19th century, microorganisms (pneumonia, food poisoning) were discovered as cause of disease
- emphasis on biology as a sole cause of disease
» searched for “magic bullet” (antibiotic to get rid of all illnesses»_space; penicillin!»_space; found from a mold by Alexander Fleming
The biomedical model
- focused on illness»_space; dominant model for past 300 years
- all illness can be explained by biological malfunction or physiological disturbance (eg. injury, biochemical imbalance, infections, etc)
- said that psychological/social processes are independent of disease (disease = affliction of the body)
biopsychosocial model
- fundamental assumption
- discovery»_space; caused what?
- prevalent causes of death
- implications (2)
- fundamental assumption: health or disease is the consequence of the interplay between biological, psychological, and social factors
- discovery of microorganisms and the resultant development of antibiotics (as well as clean water and nutrition) led to a decrease in causes of death due to infectious agents
- the most prevalent causes of death are no longer infectious or acute conditions (eg. respiratory diseases, tuberculosis, gastroenteritis aka diarrhea)
Implications:
- diagnosis and treatment must consider interactions
- relationship between patient and healthcare practitioner is important for the delivery of care (full circle»_space; back to Greek way of thinking)
acute disorders (examples = 2)
chronic disorders (examples = 3)
- stat?
- reasons for chronic illness increase (3)
acute: short term medical illnesses eg. diarrhea, pneumonia
chronic: slow-developing, persistent diseases, often cannot be cured, only managed, psychosocial factors often involved»_space; cause of 60% of deaths today
eg. degenerative illnesses (heart disease, cancer, stroke)
- people are living longer and chronic illnesses are more likely to affect older people
- increased exposure to harmful chemicals (industrialization)
- more rapid inc in low income/developing nations
Sigmund Freud
- what causes bodily illness?
- conversion?
- physicians opinion
- psychoanalysis + example (hypertension)
- unconscious conflicts lead to physical disturbance
- the person is freed from anx bec the conflict has been converted into a phys symptom
- for illnesses couldn’t be fixed quickly, physicians were willing to listen to Freud
- psychoanalysis: psychiatric treatment focus
eg. hypertension is connected to an inability to express feelings of anger in an appropriate manner (unresolved conflicts)
psychosomatic medicine
- psychosomatic illness
- examples
- asthma causes
- psychosomatic illness (physical symptoms w no detectable organic disorder) is the result of underlying emotional chronic conflicts that surface in the form of physical symptoms
- anything that couldn’t be explained reasonably by medical knowledge was categorized as psychosomatic
eg. ulcers, IBS, HBP, asthma, migraines and arthritis»_space; result from impaired immune function
asthma: caused by allergies, respiratory infections, or biopsychosocial arousal (stress/exercise)
peptic ulcer
- open sores on the stomach/intestine lining
ulcer»_space; stress (mind)»_space; bacterial disorder (body) - bacterial disorders are not unique, but when stressed he immune system is weakened which increases the proliferation of the bacteria, and the chronic excess gastric juices erode the stomach lining
- you need both the bacterial disorder AND the high stress levels to get a peptic ulcer (both mind and body involved)»_space; high stress increases amount of gastric juices
past illnesses (2 types) - causes
dietary diseases: malnutrition
infectious diseases: acute illnesses caused by harmful matter/microorganisms such as bacteria/viruses, pneumonia, tuberculosis, diarrhea, HIV/AIDS, etc»_space; leading causes of death in low income/developing countries
early settlers
- periodic pandemics
- indigenous ppls (2)
- periodic pandemics: smallpox, measles, flu, etc.»_space; thousands could die from a single pandemic
- settlers brought disease with them»_space; rapid inc in death toll of indigenous ppls because
a) they had no immunity (lacked exposure)
b) immune functions were lower due to low genetic variation
decline of infectious disease
- causes (4)
- smallpox eradicated due to preventative measures such as improved physical hygiene, greater disease resistance because of nutrition improvement, and public health innovations (water purification and sewage treatment facilities)
risk factors for disease
- do risk factors cause disease?
- behavioural
- biological
risk factors are ASSOCIATED, not CAUSING the development of disease
- behavioural: smoking inc chance of cancer; unhealthy eating
- biological: inherited genes, family history
risk factors for leading causes of death
- cancer, heart disease, stroke, COPD, accidents
- cancer: smoking, high alc consumption, obesity
- heart disease: smoking, HBP, high cholesterol, lack of exercise
- stroke: smoking, HBP, high chol, lack of ex
- chronic obstructive pulmonary disease (COPD): smoking
- accidents: alc/drug use, not wearing seatbelts
personality and illness
- definition of personality
- low conscientiousness
- high positive emotions
- high anxiety, depn, hostility, pessimism
personality = cognitive, affective or behavioural tendencies
- low levels of conscientiousness (being thorough and organized) = more likely to die of CVD than other diseases
- high levels of positive emotions (happiness, enthusiasm) = tend to live longer
- high levels of anxiety, depn, hostility, pessimism = at risk of dying early and developing a variety of illnesses (esp. heart diseases)
behavioural medicine
- conditioning
- interdisciplinary»_space; not just behaviourism (classical/operant conditioning)
- operant is good for modifying behaviours using behavioural methods, and emotions using cognitive methods which alter thought process
psychological factors (3)
- cognition: perceiving, learning, remembering, thinking, interpreting, etc
- emotion: subjective feelings»_space; affects thoughts, behaviour and physiology
- motivation: start, choose direction, and persist
role of social factors
- social relationships
- types of social factors
social relationships (family, friends, acquaintances) affect behaviour, susceptibility and long term health >> social support is important! - culture, mass media, community, and env characteristics are also social factors
holistic approach (holism)
wide range of “alternative” approaches to promote health eg. aroma, healing herbs
- many indigenous people (First Nations, Metis, Inuit) rely on holistic healthcare
Systems: the world vs the person (2)
the world:
- social systems»_space; society, community, family
the person:
- psychological systems»_space; experience/behav»_space; cognition, emotion, motivation
- biological systems»_space; genetics/physiological»_space; organs, tissues, cells
sociocultural
- types of factors»_space; disease variation
- culture vs ethnicity vs race
social/cultural factors»_space; ethnicity, culture, nationality, sex/gender»_space; diseases vary by ethnicity due to health disparities/genetics
- culture = characteristics/knowledge of group in similar context
- ethnicity = ppl identify w e/o due to shared nation/ancestry
- race = social construct based on physical characteristics
Epidemiologist terms
- mortality, morbidity, incidence, prevalence, epidemic, pandemic
- mortality: occurrence of death (large scale)
- morbidity: illness, injury or disability
- incidence: new cases in a period of time
- prevalence: number of cases (both past and present)
- epidemic: incidence increases rapidly
- pandemic: epidemic on a worldwide scale
Theories are useful if… (4)
- they are clearly stated
- bring together/organize known facts
- relates info that previously seemed unrelated
- enables predictions
retrospective vs prospective approaches
retrospective: looking at histories of subjects and find commonalities between ppl w same disease
prospective: study if the diff in a variable will relate to the diff in another variable at a later time»_space; eventual devel of disease
inter-related fields w psychology
medicine, bio, social work, epidemiology, public health, soci, arthro, health ec, health policy
acute stress vs chronic stress
- resilience
- chronic stressor long term outcomes
acute: we are hardwired to respond well (won’t impact long term)
- high resilience (recover back to base hormone level)
chronic: less opportunity for recovery
- results in loss of resiliency, cognitive decline, physical/mental health problems, and mortality
Caregiving
- caregiving is prototypical chronic stressor
- role typically falls on women (wife, daughter)
- caregivers have elevated disease risk
factors affecting caregiving stressor
- eg. dementia (3)
- what makes it stressful?
- any positive experiences?
eg. dementia caregiving
- long duration (3-15yrs): not getting better, no breaks
- high demands (physical and emotional): unable to do things they used to do themselves »_space; need help with daily necessities like feeding and bathing
little control: can’t change or plan things
stressful: economic stress, worry/anxiety
positives: emotional support, education for kids, spend more time with person
cortisol response
- acute (examples)
- chronic (original purpose of response, associated with?)
acute: after stressor is over, cortisol levels return to normal levels (eg. experiment = social stressor, naturalistic = ballroom dancing competition)
chronic: physiological changes occur in response to stress, but the original purpose was for short term mobilization of resources to fight or flee»_space; long term stressor = dysregulation of cortisol patterns which is associated w elevated disease risk
allostatic load
- Definition (2)
- Damage (2)
- Depends on (4)
Definition:
- allostatic load = accumulated effects of one’s body adapting repeatedly to stressors over time (hormone fluctuations)»_space; impairs ability to adapt to future stressors
- physiological regulatory system that accommodates environmental demands»_space; key to adaptive functioning»_space; help adapt to internal/external challenges
Damage:
- repeated activation of physiological systems leads to wear and tear»_space; results in cumulative dysregulation of physiological systems
- price body pays to meet life’s challenges
Depends on:
- amount of exposure
- magnitude of reactivity
- rate of recovery
- resource restoration (eg. sleep»_space; depends on quality and amount)
chronic stress and cognition
- damage (where? how? (2))
- consequence
damage to hippocampus
- systematic loss of dendrites
- reduction in hippocampal volume
consequence: memory problems
McGill research
correlational link between cortisol levels and detectable memory problems which aligns with the idea that there is a link between chronic stress and cognition
chronic stress and CVD risk
- damage
- consequences
- wear and tear on blood vessels
- consequences: hypertension, risk for heart disease/stroke
chronic stress and glucose regulation
- damage
- consequences
- association
- repeated inc in blood sugar
- consequences: development of insulin resistance, type 2 diabetes
- associated with having a lower sEc status
Heart Diseases
- atherosclerosis and arteriosclerosis
- myocardial infarction (heart attack)
- angina pectoris
- aneurism
- stroke
atherosclerosis: accumulation and hardening of fatty plaques in artery wall»_space; causes arteriosclerosis: diameter/elasticity of artery is reduced
myocardial infarction: death of heart muscle (myocardium tissue) caused by arterial blockage (clot caused by atherosclerosis)
angina pectoris: pain caused by temporary obstruction
aneurism: bulge in weakened section of artery/vein which ruptures»_space; can cause death
stroke: blood supply going to portion of brain is disrupted by artery rupture»_space; causes hemorrhage in brain/blockage from blood clot
Trier Social Stress Test (TSST)
- 2 parts
- testing conditions
- cause and effect
- criticisms (4)
- used to study moderators of stress
1. free speech 5 min
2. mental arithmetic 2 min - unresponsive audience and being recorded = very potent stressor
- cause and effect are clear (emotional support reduces stress response to social stressor)
criticisms:
- can have low ecological validity»_space; is the experimental manipulation relevant to real life?»_space; want to test things that are useful to patients
- practical issues »_space; we can’t always manipulate/produce IV of interest in health psychology (eg. disease status)
- not all responses are uniform (gender diff)»_space; TSST does not capture differences»_space; go undetected
- it’s easier to do this test on males because you wouldn’t want to stress out a pregnant woman
time sampling research
- assessment
- advantages (4)
- disadvantages (3)
- focus on everyday life»_space; captures the moment
- assessment via diaries, phone calls, computer-based assessments, etc daily
Advantages:
- captures natural behav without changing them
- high ecological validity (generalize findings)»_space; real world relevance of positive interactions
- daily life processes may accumulate
- neither work stressors nor intimacy are easy to recreate in the lab, so time sampling is useful
Disadvantages:
- third variable problem
- labour intensive
- lots of info on few people
Time sampling - couples study
- number of participants
- measurements (3)
- association
- asked couples about everyday experiences
- 51 dual-earner couples with young kids
- chronic problems at work
Measured 6x a day for a week:
- time spent in intimacy
- current affect quality
- saliva samples for cortisol whenever they completed questions
association: between intimacy and lowered cortisol level is mediated by positive effect (inc intimacy = dec cortisol levels)
ways to do time sampling (3)
- pros and cons
Paper:
- PROS: cheap and easy, familiar to participants
- CONS: low compliance, back-filing, time-intensive
Plastic: aka electronics
- PROS: high compliance, better data management
- CONS: time and resource intensive, may not work with all populations (eg. elderly)
Phone:
- PROS: high compliance, familiar, builds rapport
- CONS: time and resource intensive, intrusive
Cross-sectional self-reports
- studies what? when? what do subjects do?
- studies naturally existing phenomena
- single time point (limit)
- subjects look back in time and report their experiences/ feelings over a specific time interval