HE ED 321 Flashcards
What sort of health problems are related to behaviour?
- Illness and chronic conditions
- Mental health issues
- addictions
- social and interpersonal problems
- financial issues
- environmental
Why don’t people just change their behaviours?
- stress makes it hard to think
- our emotions drive a lot of our behaviour
- we might lack knowledge or information
- we might not have the skills
- we might be motivated by other things
- we might not believe in the positive health behaviour
What are the key steps to behaviour change
- identify the problem
- identify the behaviour that needs to change
- Identify the theory based constructs on how a particular behaviour change technique might work in changing behaviour
- create an intervention to use that technique with a specific target population or individual
- evaluate the efficacy or effectiveness of the intervention
What is efficacy?
Does an intervention work in ideal circumstances ?
- sometimes pilot studies, lab-based, internally valid
What is effectiveness?
does an intervention work in the real world?
- more interested in this throughout the course
- often tested after efficacy has been established
List key health behaviours
- not smoking
- physical activity
- moderate (or no) alcohol consumption
- eating well
- sleep
What are the goals of health psychology?
To promote health and prevent illness
Study psychological aspects of prevention and treatment of illness
- what can we do to prevent illness
What is the focus of health psychology?
To understand etiological and diagnostic correlates of health, illness, and dysfunction
- what is causing them to participate in the behaviour that they participate in?
What is the priorities of health psychology?
Improve health by focusing on delivery systems and policy
- how are we delivering health information
What are individual processes?
perceptions, beliefs and behaviours that influence
- Biological processed, which influence health outcomes
This is a direct effect
- Health behaviours, which influence health outcomes
This is an indirect effect
What do social processes influence
Perceptions, beliefs and behaviours
- that influence health outcomes; indirect effect
Health care delivery
- that influences health outcomes; both direct and indirect
- policies can have an indirect effect on our health
What is epidemiology?
Is the study of the frequency, distribution, and causes of diseases in a population
- this includes both the physical and social environment
How is health psychology different from clinical psychology?
- clinical psychology is concerned with mental health (generally) and requires very specific training, certifications and licenses
- we are restricted to “most of the people most of the time”
- we do not attempt to deal with psychopathology
What are the foundations of health psychology?
- models of physiological function and adaptation clearly show that psychological and social factors influence physiological processes
e.g. stress induction, observations of pathology associated with different social strata - Clear evidence that behavioural factors are also associated with physiological processes
e.g. adherence to medications, lifestyle and health outcomes
What is behavioural psychology?
- That we can change the ‘conditions’ surrounding the performance of a behaviour and the behaviour will change
classical behaviourism: reward/punishment
What is cognitive psychology?
That what we believe (to be ‘true’) influences both our behavioural and our health - representations of ‘reality’ influence our behaviours
What is social psychology?
That how we interact with other influences our physiological processes, our behaviours and our health
What is the combination of behavioural, cognitive, social and health psychology?
The biopsychosocial model
What systems are activated when a stressor presents itself?
- Hypothalamic-pituitary-adrenal axis (HPA)
- Sympathetic Autonomic Nervous system (Sympathetic adrenal medullary system; SAM)
What stress response does SAM have on the body?
- increased CV response
- Increased respiration
- Increased perspiration
- Increased blood flow to muscles
- increased muscle strength
- increased mental activity
What stress response does HPA have on the body?
- stimulated hormone production
- slower response that results in cortisol secretion
- suppressed immune system and increases BP
- provides a steady source of fuel to deal with stressful situations
What is acute stress?
something that is of short duration
- e.g. Car accident, being late, exam
daily hassled
it should not be ignored even if it may pertain to something small
What is chronic stress?
Things that are of long, and probably uncertain duration
- Relationship problems
- work demands
- financial stress
can make you sick
more likely to have other health issues
What is psychoneuroimmunology?
The association between psychological factors and susceptibility to infections
- how we handle our own stress has profound influences on your health
Explain how indirect effects can mediate immune response
the influence of stress on health can work through other factors
Stress -> Physical activity -> reduced illness
not smoking
Quality sleep
good diet
in this example the effects of stress on illness is reduced by engaging in health behaviours
How is pain a learned response?
- tissue damage sends nociceptive signals to the brain
- if the brain senses danger it created more neural pathways to solve the problem
How does the brain judge danger?
- emotions like fear, anger, anxiety, frustration
- unresolved trauma
- personality
- perfectionism
Explain pain modulation in the brain
- when the brain sense danger, it amplifies signals to the body
- if the brain doesn’t sense danger, you will not feel pain
Does pain = tissue damage?
NO, just understand that your pain is controlled by your brain
What is neural conditioning?
When your brain gets used to a certain thing and may associate a specific situation to an object e.g. a certain smell, foods, physical activity
What is active redirection?
using skills to redirect your attention from your “pain”
- has to be somethin that occupies lots of neurons (focused attention
- is fun, meaningful or creative
- overrides pain
What are some examples of active redirection?
- self talk
- exercise
- calming scents
- visualize the brain cooling down
Explain Danger in me (DIMs)
Refers to experiences associated with danger, DIMs increase pain perceptions
Explain Safety in me (SIMs)
refers to experiences associated to safety. SIMs decrease pain perceptions
What is the Engineering approach to stress?
- Stress is in the environment
- It is any event that produces strain or pressure
- The larger the strain, the larger the stress response
- assumed that stress reactions are ‘autonomic’ and ‘unconscious’
What is the response-based approach to stress?
- considers stress to be the physiological reaction (e.g. increased HR, sweating, etc.)
- Stress has occurred if the person has the response
What are the 3 stages of the General Adaptation Syndrome?
- Alarm
- reaction to a threat (fight or flight) - Resistance
- with prolonged exposure to the threat the response is to try to return to homeostasis - Exhaustion
- if the threat is not overcome, physiological resources are depleted
What is the problem with the General Adaptation Syndrome?
It doesn’t take into account that people may respond differently to the same stressor
Explain the contemporary stress theory
- When we encounter a stressor we have a physiological response; when the stressor is gone, the allostatic response ends
- Allostasis is an adaptive mechanism (fight or flight, cortisol increase) that helps individuals to cope with stressors through physiological and behavioural processes
What is allostatic load?
- Occurs when the allostatic response remains, even after the stressor is gone
- it is a model that tries to quantify the cumulative damage from physiological stress response in the body
What 4 main biological systems is allostatic load commonly characterized by?
- Cardiovascular
- Metabolic
- Immune/Inflammatory
- Neuroendocrine
What are signs of a high allostatic load
- Decreases in cell-mediated immunity
- Inability to ‘shut off’ cortisol response
- Lowered HR variability
- Elevated epinephrine levels
- Memory problems
- high blood pressure
What are 4 situations associated with allostatic load?
Repeated hits from multiple stressors
- causes ‘wear and tear’ on the stress response system
Lack of adaptation
- the stress response fails to fully recover between the ‘hits’ and you never get habituated to stressors; big stress response every time the stressor hits
Prolonged response
- the stress response stays continuously on high, long after the stressor is gone
Inadequate response
- too much stress can result in the inability to respond normally to stress in the future
What is the current stress definition?
- stress is the (negative) emotional experience followed by biomechanical, physiological, cognitive, and behavioural changes that work toward either changing the stressful event or adapting to its effects
What is the transactional approach to stress?
- Relationship between the person and the environment
- includes appraisal by the person that a particular environment is : threatening, exceeds his/her resources, demanding
What are the components to the transactional theory?
- a potential stressor
- a primary appraisal
- a secondary appraisal
- stress
What is a primary appraisal (transactional theory)?
- evaluation of the significance of a stressor or threat; how much is a stake?
- first thing that comes to mind when something may become threatening
What is a secondary appraisal (transactional theory)?
- Evaluation of the controllability of the stressor and a person’s coping resources
- What are one’s perceived coping resources?
How am I going to cope
How can I control this situation
Can I control this situation
What are examples of life events?
- Marital problems
- change in financial state
- death of someone close to you
Examples of daily hassles
- Losing your keys
- Forgetting your purse
- Unpleasant interpersonal interactions
Direct effects of daily hassles
- Increased negative affect (refers to emotions)
- Decreased positive affect
- Agitation
- Raised cortisol levels
Indirect effects of daily hassles
- Poor behaviour choices
- Frequent hassles could lead to chronically poor behavioural choices
- Exacerbates chronic conditions
What is the stress reactivity hypothesis?
- those who have big physiological and emotional stress responses (high stress reactors) are more likely to develop ill health
How is reactivity determined?
- partly genetically determined
- Situational factors can also affect reactivity
Conservation of resources (COR) theory
- less emphasis on appraisal and more on resources people have or may lose
- stress is a reaction to loss, a threat to loss, or failure to gain resources following an investment of resources
- in the face of stress, people try to minimize their losses
- Proactive coping is emphasized
What is perseveration cognition?
- How much do you ruminate and worry? These and repetitive thinking could prolong the stress response or making short-term responses worse
What is the NUTS acronym for?
- characteristics of stressors that make them “more stressful”
What to the letters represent in the NUTS acronym?
Novelty
- something new you have not experienced before
Unpredictability
- Something you had no way of knowing it would occur
Threat to the ego
- Your competence as a person is called into question
Sense of control
- You feel you have little or no control over the situation
What are some outcomes of coping?
- Emotional well-being
- worry, positive or negative affect - Functional status
- Physical outcomes (e.g. cortisol levels) - Health behaviours
- Seeking care, communicating with health providers, adherence to medications
What are the 4 categories of active coping?
Instrumental/Problem-focused- confrontative
- Doing things directly related to the problem
Emotional focused
- Ruminating about emotions
Emotional-approach
- Doing things to “work through” the emotions
Palliative
- Doing things to make yourself better
What are the 2 categories of passive coping?
Avoidance
- Daydreaming
Procrastination
- Engaging in irrelevant tasks
What are repressors? (Coping)
- unconsciously direct attention away from threatening information
- tend not to be aware of physiological activation because they rapidly avoid or distract themselves, sometimes without even being aware
What are monitors? (Coping)
- High monitors seek information
- visit physicians more and demand more tests
probably as a way of managing uncertainty
What are blunters? (Coping)
- Actively avoid the threat or the problem
- Want minimal information
What is message matching? (Coping)
- seems to be more critical to blunters - giving them too much information increases their distress more than giving too little information to monitors
What is resilience?
- it’s not a personality trait, but rather the ability to have healthy functioning after a specific event
- defined by outcomes
What things could contribute to resilience?
- coping
- social networks
- income and education
Explain variety in coping
Everyone has their own ways of coping
Explain flexibility in coping
if you find that you are always reacting the same way but it is not working for you then find a different method to cope
What is the pessimistic style of coping?
- pessimists are always explainig a stress response= “it’s my fault it happened”
What are moderators in coping?
perceptions of control
- belief that one can influence one’s own behaviour and environment
- higher emotional well bein g
- focus on tasks
- better health
- better performance on cognitive tasks
What is structural social support?
Simple existence of networks and friends
What is functional social support?
What do these people do in terms of support?
Explain direct effects of social support
- an approach that hypothesizes that social support has beneficial effects during times of high and low stress
Explain buffering of social support
- a hypothesis proposed that social support is beneficial only when highly stressed
- allows a person to cope more effectively
What is loneliness in regards to social support?
- social isolation, a lack of social networks
- is the perception of social isolation
- lonely people can have higher stress, worse sleep, worse cardiovascular health
What are the 4 types of health behaviours?
- Health enhancing behaviours
- Health protective behaviours
- Health harming behaviours
- Sick role behaviours
What are some examples of health enhancing behaviours?
- Exercise
- Health eating
What are some examples of health protective behaviours?
- health screening
- vaccinations
What are some examples of health harming behaviours?
- smoking
- excessive alcohol consumption
- risk taking
- substance abuse
What are some examples of sick role behaviours?
- Following prescriptions
- Following proscriptions (Things you should be doing)
What are some things that influence health behaviours?
- SES
- Gender
- Personality to some degree
- Cognitions and emotions
Why do people engage in any behaviour?
- They have to think engaging in the behaviour is a ‘good’ thing
- They have to think that they are capable of doing the behaviour
- They have to think that their social influences will also think it is a good thing
- They have to have access to any required facilities or support
What is self-regulation?
Process through which people are able to achieve their goals?
What are the 3 aspects to self-regulation?
- Re-evaluation of beliefs
- Self-monitoring
- Goal-setting
What are the key social cognition models (focus on the motivational phase)?
- Health belief model
- Protection motivation theory
- Theory of planned behaviour
- Social cognitive theory
What are the aspects of The Health belief model?
- Demographics (e.g. age, gender, SES)
- Threat - Perceived susceptibility, Perceived severity
- Health motivation
- Response Effectiveness- Barriers/costs, benefits
- Behaviour
- cues to action
What is susceptibility in the Health belief model?
- opinion of chance of getting the disease
- can be applied by defining which populations might be at risk or by increasing perceived susceptibility in those who don’t think they are at risk
e.g. “I feel that my chance of developing heart disease at some point in my life is…”
What is severity in the health belief model?
- opinion of how serious a disease and its consequences are
- can be applied by specifying consequences
e.g. “ I feel heart disease would be a very serious illness for me to develop”
What are cues to action when talking about the health belief model?
- social and environmental influences on whether the behaviour gets undertaken
Why is the health belief model useful?
- for getting an idea of thoughts about a disease but not if you want to try to actually change the behaviour
What is stigma?
Is experiences with an attribute or trait that is SOCIALLY devalued and has macro- and micro- level implications on people who may resonate or have that trait
What is health stigma?
- is experiences in relation to a physical, mental or socio health condition that is SOCIALLY devalued and has macro- and micro-level implications on people who may resonate or have that trait
- making judgement based on diseases
What is the root cause of stigma?
Blame
What is weight stigma?
Negative social stereotypes and misconceptions associated with weight
Where would people experience weight stigma?
- In healthcare
- In social spaces
- In the media
What are some impacts of weight stigma on behaviours?
- Negative attitudes and views we hold towards weight
- Maladaptive coping behaviours
- reduces access to care
How does weight stigma inform weight bias?
- Negative attitudes and views we hold towards weight
- Our biases may be informed by weight stigma
- can be implicit bias
- can lead to weight-based discrimination
What is fear appeal? (Protection Motivation Theory
- persuasive messaging designed to scare people by describing the terrible things that will happen to them if they do not do what the message recommends
What is the goal of fear appeal?
- to create high threat, high efficacy message
What are the aspects of the Protection Motivation Theory?
- Threat appraisal
- Coping appraisal
- cope with threat
- protection motivation
- threat protective behaviour
Explain the threat appraisal aspect of PMT
- perceived susceptibility
- perceived severity
- fear
Explain the coping appraisal aspect of PMT
- Mental representation of the recommended behaviour to response to the threat
- Perceived response efficacy
- Perceived response-cost
- Perceived self-efficacy
Explain the protection motivation of PMT
- intention to act to manage the threat
What are adaptive responses?
- Engages in behaviour likely to reduce the risk
- sometimes is avoiding the ill health behaviours
What are maladaptive responses
- does not tackle the threat
- sometimes maladaptive is taking up an ill-health behaviour
- Sometimes it is failing to address the ill-health behaviour
When do fear appeals work?
- threats only work when response or self-efficacy is high
What is the theory of planned behaviour used for?
to understand and predict behaviours of an individual
Explain the attitude aspect of TPB
- Belief about the outcomes
- Evaluations of outcomes
e.g. If I am physically active, I will be healthier
Explain subjective norms in terms of TPB
- normative beliefs
- motivation to comply
Explain perceived behavioural control in terms of TPB
- perceived likelihood of occurrence
- Perceived facilitating/inhibiting power
Explain why TBP is a 2 factor model
Attitudes, subjective norms and perceived behavioural control all have 2 branches to them e.g. attitudes - Instrumental and experiential
What are the 2 branches of attitudes? (TPB)
Intstrumental
Experiential
What are instrumental attitudes?
-The behaviour will lead to a certain outcome like better health or illness prevention (e.g. vaccine)
What are experiential attitudes?
The behaviour will result in a certain experience like fun (e.g. physical activity is fun)
What are the 2 branches of subjective norms (TPB)
Injunctive
Descriptive
What are injunctive subjective norms?
someone (spouses, friends, physicians,etc.) approved or disapproved of the behaviour
What are descriptive subjective norms?
Do people I know or people who are like me do the behaviour?
What are the 2 branches of perceived behavioural controls?
- control beliefs
- perceived confidence
What are self-regulatory skills?
- behaviour is goal directed
- consequences of current action (re-evaluate beliefs- what do I actually believe), evaluate current behaviour (self-monitoring)
What are social skills?
- To manage behaviour and seek others’ support for change
- To provide support for others
What is action planning (approaches to planning)?
- forming a set of procedures to help enact behaviour
What is preparatory planning (approaches to planning)?
- forming plans that enable accessibility to resources needed to obtain a goal
- planning in advance
What is coping planning (approaches to planning)?
- Forming plans to overcome important barriers when starting or maintaining a behaviour is challenging
What is implementation intentions (approaches to planning)?
- if-then action plans that creates a link between a cue and a behavioural response
How do goal work to improve performance?
- Goals help the direct attention to goal-relevant activities
- Once attention is directed to these activities, people will exert effort to complete them
- Goals motivate people to stick with the effort for longer
- Goals lead to self-regulation strategies like action plans
What are the 4 categories of strategies to achieve goals
- Task specific strategies
- new strategies
- Search and information processing strategies
- Self-regulatory strategies
What does action planning specify?
The when (what time, what day)
The where (The place the behaviour will happen)
The how (specific sub-actions needed to achieve the goal)
What are the coping planning steps?
- Deliver a message about coping planning and its utility;
- Provide an example of a coping plan
- Consider potential barriers that may impede their performance of a target behaviour
- Develop a coping plan to overcome each anticipated barrier or difficulty
What is self-control?
the process of giving precedence to distal, long-term motives over proximal, short-term motives when these motives conflict
