Health Psychology 2301 Flashcards

Question

Stress - definition

Answer 1

transactions that lead a person to perceive a discrepancy between the physical and psychological demands of a situation and the resources of his biological, psychological or social system (demand, resource or discrepancy can be real OR simply believed to exist)

Answer 2

any environmental demand that creates a state of tension or threat (stress) and requires change or adaptation (adjustment).

Answer 3

**approach/approach** - simultaneous attraction to two appealing possibilities, neither of which has any negative qualities. **avoidance/avoidance** - facing a choice between two undesirable possibilities, neither of which has any positive qualities. **approach/avoidance** - being simultaneously attracted to and repelled by the same goal

Answer 4

Acute: short lived (e.g. writing an exam) Chronic: ongoing conflict, illness e.g. work - stressful job (no control or decision-making, heavy workload) where you live: low SES and health can have a direct relationship (safety concerns, poor housing or hygiene, stress between neighbors)

Answer 5

* Controls the way we initiate behavioiur and respond to events * Stores information, allows us to think, reason and create

Answer 6

* increases speed of nerve impulses * prevents interference from adjacent nerve impulses * degenerates and nerves can become severed * developes top to bottom * poor nutrition can retard myelin growth

Answer 7

(anything covered if wearing a helmet) ## Footnote Cerebrum (sensory / motor) Limbic System (emotion) Thalamus - relay sensory & motor info to cortex Hypothalamus - adjustments (homeostasis - will see what's off and send hormone or NT to fix it) Cerebellum - balance, coordination

Answer 8

Thalamus and Hypothalamus * **Thalamus**: **chief relay station** for directing sensory messages to cortex and commands to skeletal muscles from motor cortex * **Hypothalamus**: emotion / motivation * eating, drinking, sexual activity * maintain homeostasis in body * **feedback system**: receptor (sensory nerve cell that monitors changes in condition)/control centre/effector * directs either NT or Hormone release or both

Answer 9

impulses carried to glands, muscles and organs and target cells to adjust to controlled condition NT communicate needed adjustment Hormones in blood act on target cells Positive feedback can ONLY be stopped from outside (i.e. give birth)

Answer 10

Back brain, below cerebrum cerebrum initiates action, cerebellum coordinates it

Answer 11

1. Midbrain - below Thalamus, gets info and relays to Thalamus 2. Reticular Activating System - attention, arousal, sleep 3. Pons - facial expression, chewing 4. Medulla - vital signs Spinal cord carries messages (efferent, afferent)

Answer 12

Neurons to and from the brain efferent / afferent

Answer 13

Somatic / Autonomic * Somatic - skin, skeletal * Autonomic - organs * Sympathetic - Fight or Flight * Parasympathetic - Rest and Digest

Answer 14

* anything perceived as possble threat & hypothalamus will trigger release epinephrine and norepin (Walter Canon) * also platelets aggregate and adhere to inhibit loss of blood (clotting) in case we get cut * decrease of blood flow from skin * increase blood sugar or energy

Answer 15

* Antagonistically to the sympathetic * (restores body to normal) * slows breathing, decrease HR, lower BP

Answer 16

(part of the Flight or Fight) * Hormone system / Glands * Uses blood stream to transmit hormones * hypothalamus helps out here too * slower than the symp.NS response, catches up * Cortisol (stress hormone) * Glucocorticoids to keep blood sugar up * Mineral corticoids to mobilize the immune response * Endocrine and N.S. connected by link from hypoth.(NT) to pituitary (hormone) then can stimulate other glands (more chemicals) * Long term: can supress and begin to fail

Answer 17

Activates BOTH NS and Endocrine systems ## Footnote **NS** - send nerve impulse to the Adrenal Medulla to release epinephrine and norepinephrine (NT's) - SAM axis **(S**ympath. to **A**drenal **M**edulla) **Endocrine**: signals the Pituitary which then signals the Adrenal Cortex to release cortisols - HPA axis **H**ypothalamus to **P**ituitary to **A**drenal Cortex

Answer 18

3 possibilites 1. Good (benign, positive) - can increase well-being 2. Irrelevant - no implication for well-being 3. Stressful - potentially harmful If Stressful go on to 3 more (secondary) appraisals:

Answer 19

**Assesses the resources available to cope (transactional)** - change as you move through it Coping: cognitive, emotional and behavioral efforts to manage the stress / event a) Harm / loss - damage already occured b) Threat - expectation of future harm c) Challenge - opportunity to grow, master or profit Cope: no stress OR Coping not good = stress

Answer 20

* SAM: alarm stage (says: MOBILIZE) * epinephrine and norepinephrine * HPA trigger for cortisol * Resistance - HPA predominates (body will then replenish hormones adrenals release) * Exhaustion - severe, long term or repeated stress * disease, damage organs, death * Criticisms: some stressors elicit stronger emotional response than others; cognitive appraisal plays role; we mediate stress response using our brains and find ways to cope (mice can't)

Answer 21

Allostatic load is "**the wear and tear on the body**" that accumulates as an individual is exposed to **repeated or chronic stress.** 1. Frequency of exposure 2. Duration exposed for 3. Magnitude of the stress 4. Magnitude of the reactivity - response to stressor 5. Rate of recovery - ruminating will delay recovery; sleep will help

Answer 22

Physiological Habituation: * magnitude of stress response decreased with repeated exposure to the stimulus

Answer 23

* can be stressed even without exposure to stressor (**imagine what could go wrong**) * anticipation can be as stressful as the event * planning, inventing and reason - lead to stress * worry / **rumination** - stressor * negative impact on decision making (cuz stressed)

Answer 24

1. **Personal Factors:** * **self esteem / self efficacy** * whether webelieve we have resources * see as threat? challenge? * **motivation** * if an important goal is threatened (need A+) * **Irrational Belief?** * can be an irrational belief that increases stress (I must be perfect)

Answer 25

* **Physiological Arousa**l: * BP, respiration, HR, persperation * biochem analysis (blood, urine, saliva) * + quantifiable, objective * neg: expensive and measurement stressful * **Life Events (rate how you adjust)** * can be ambiguous depending on question * e.g. change in $ situation (more $? less $?) * **Daily Hassles** - **minor annoyances** - if cumulative or continual can lead to poor health (depends on your appraisal) + might put X over edge or cope with unhealthy behaviors (poor diet, no gym, etc.)

Answer 26

* Need some stress to function at an **optimal level of arousal** (energized, some adrenalin), focused * also builds resilience and coping skills

Answer 27

* **Social Support** * **Emotional** * empathy, understanding, caring, ecouragem. * feel validated, valued * **Tangible / Instrumental** * money, stuff, help, * **Informational** * information, insight, advice (doc, nurse) * **Perceived Social Support** - know you have a social network you can rely on whether you use it or not

Answer 28

* **Phobia:** intense and irrational fear directly associated with **specific events and situations** * **Anxiety**: uneasiness or apprehension of impending doom (**uncertain/unspecified threat**) * If severe depression/sadness lasts MORE than 2 weeks: Disorder

Answer 29

* **Women:** more reactivity when **freindship or love challenged**; more "tend and befriend" * **Men**: more reactivity if **comptence challenged**; more fight or flight

Answer 30

* Can be source of tension and conflict * addition to family * divorce * family illness/disability/death * child with chronic illness * sick parent

Answer 31

* demands of the task (workload) * responsible for peoples' lives (medical personnel) * environment - noise, temperature,lighting * perceived insufficient control: can't make decisions * poor interpersonal relationships * perceived inadequte recognition or advancement * job loss or insecurity Can all spill over into family (stress spillover) and if effects another person (stress crossover)

Answer 32

* constant threat of violence or harm * hazardous chemical seepage into water supply * natural disasters * wealth vs poverty in neighborhood (low SES has reduced life expectancy and higher risk disease) * stressful social relationships - less supportive * Rural areas - more stress if no accessible health services * low SES can be discriminated against - more stress

Answer 33

* **How well we adjust per life event** * Look at past 24 months and sum up for total score * **used to relate stress to illness** (but not strong as stress not always reason ppl get sick) * items can be very vague/ambiguous * no distinction between desireable and undesireable events * measures only acute and not chronic stress * depends on accurate recall

Answer 34

* some people don't get the kind support they need * trouble getting the support or asking for it * can be a difficult person to support * might worry you are a burden on others * provider might be tapped out (can't provide support) So: if have big social circle with intimate connections it's better and more likely to get support

Answer 35

**Socio:** native born Canadians more support than immigrents (smaller network, less family here, might use them less); smaller communities have better support (know everyone)

Answer 36

**Positives:** * can get it quicker (texting) * can get informational support online * having "close others" to text daily may reduce impact of stress **Negatives:** * can waver according to social media ("likes") * if "too available" can be distracting * can become dependent - don't do things on own * found correlational but not causal link that allostatic load decreases

Answer 37

Acute stressful situation study: * measured the SAM and HPA responses to stress * **lower response when supportive companion present** * **can keep HR, BP and stress-related hormones low** * (dogs therapy dogs great)

Answer 38

4700 person study of social support; 9 year follow-up, all ages found: lower mortality rate, lower cancer incidences, and heart disease (measured SS before then health outcome later) found: low SS and death link; risk factor was on par with smoking and sedentary lifestyle Loneliness: public health issue (screen ppl for social connectedness?)

Answer 39

**Social support** affects health: **protects person against the negative affects of stress** Why? * may be less likely to appraise event as stressor * may modify after initial appraisal (secondary appraisal)

Answer 40

Social support benefits health and well being regardless of the amount of stress people experience i.e.: belongingness / self esteem are good all the time

Answer 41

1. wrong kind of support - get adivce, need validation 2. insufficient 3. might not want help 4. personal cost - feel guilty that needed $ or physical help and could not handle it 5. impact self-esteem - makes us feel stupid, can be controlling or overly directive 6. "dense" - family in your business, want privacy 7. overprotective - too much, create helplessness

Answer 42

can make decisions and take effective action to produce desirable outcomes and avoid undesirable ones (**experiment in seniors homes re plants and furniture of level of independent choice and caring for things)** * High PC - happier, more alert, more active * prolonged stress can lead to learned helplessness when have Los PC

Answer 43

**can succeed at an activity if we want to** * decide activiy based on * **outcome expectancy** - behaviour properly carried out would lead to favorable outcome * **self-efficacy expectancy** - can perform behaviour properly * Ppl with strong self-efficacy may have less stress (physiological, mental) as know can meet demands * make judgement based on prior successes and failures

Answer 44

* more likely to say that can't fix it * think thing will be forever like that * will affect whole life, not just part

Answer 45

Type A * Competitive / Achievement oriented * even when no competition * Time urgency - never enough time/ "running" all day * Impatient - anthing that gets in way is problematic * Vigorous vocal style - rapid, emphatic, gestures, dominant * Anger / Hostility - quick to anger, more likely to perceive situations as threatening * Measured in interview setting (manipulated)

Answer 46

* physiological changes in heart, blood vessels, blood * vascular changes, platelets, cholestorol, high inflammatory substances - artherosclerosis * link to CHD, hypertension and stroke * different than exercise when heart is asking to receive more oxygen * increase in HR and BP are excessive - well beyond what need (goes to F or Fl levels)

Answer 47

* wear and tear * if always releasing glucose into bloodstream to give body eneregy for F or Fl can develop **diabetes** * impair immune system (**always in resistence state**) * cortisol study: amt. of **cortisol** in urine predicted risk of dying of CHD or stroke or heart attack

Answer 48

* Top Kidneys * **release hormones in response to emergency/stress** * epin. and norepin. (adrenalin) * cortisol - reduce swelling * works with Sympath. N.S. to speed up HR, respiration and liver's sugar output

Answer 49

* release of epinephrine, norepinephrine during arousal and looking for pathogens to destroy * emotions (pessimism, depression, stress impair immune) * **brief stressor: activate immune system** * **chronic stress: suppresses immune system** and inflammation - body less sensitive to anti-inflammatory effects of cortisol * Study: a) how well antibodies replenish themselves b) how well T cells working to kill antigens c) how well respond to flu vaccine

Answer 50

substance that **triggers an immune response** ## Footnote **(bacteria, virus)**

Answer 51

Develop and deploy lymphocytes (white blood cell soldiers of defense)

Answer 52

**Lymphocytes and Phagocytes** **Phagocyte** will respond to **ANY antigen** **Lymphocytes** attack **SPECIFIC antigens**

Answer 53

Immune response directed at body part it should protect Rheumatoid arthritis, MS, Lupus

Answer 54

* reported social ties, SS system * **Those with larger social groups were less likely to develop a severe cold** * immune system less likely to be suppressed

Answer 55

* 2 groups to write about traumatic or trivial even * Trauma group - more upset right away but 6 months later had fewer visits to clinics for health issues * So: **more we express better for immune system**

Answer 56

**Changing your mind about stress can change your body's reaction to the stressor** * one group told to view their stress response to stressor as helpful for challenge - those who did were les stressed and anxious; blood vessels did not constrict * **What you think about stress matters** * need to get "better" at stress

Answer 57

The process by which people try to **manage the perceived discrepancy between the demands and resources they appraise** in a stressful situation * in response to the secondary appraisal * We cope to: manage how we think, calm our emotional reaction or do things to change the stressor itself * not a personality trait as not stable over time

Answer 58

* Emotional focused coping - **not much we can do about it so we manage our emotions about it** * distract ourselves * get our SS to manage it * change way we think about it - redefine * deny / avoid * can interfere with getting medical treatment * low SES use this more **Relationship or Dyadic coping**: bolster each other's emotional needs

Answer 59

1. **Engage positive emotions:** not all stressors are bad, _infuse good into situation_ (AIDS caretaker case) 2. **Find benefit or meaning** - e.g. _everything happens for reason_, tested by God, etc., positive significance 3. **Accommodate to it** - _carry on_, take personal control 4. **Engage in an emotional approach -** actively _process it and express it_ (Breast cancer case - those who vocalized 3 mos after procedure had better perception of health; those who overprocessed or ruminated had more distress)

Answer 60

**Reduce the demands of the stuation or expand resources** * not available to everyone (need time, sometimes $, good health, education, etc.) * if low SES or disadvanted might not apply * simultaneous stressors lead to fewer resources (tapped out)

Answer 61

1. Psychological distress decreases (depression, anxiety) 2. Physiological arousal decreased (sleeping good, breathing relaxed, lower BP) 3. Return to pre-stress activities - getting on with it 4. Stress reaction is gone or less

Answer 62

* can be a placebo effect - think you are less stressed * people with less stress more likely to exercise * **exercise causes people to feel less stress (there is evidence!** showed reduced BP and HR for those who exercised People who exercise still have stress but it impacts them less

Answer 63

program of **behavioural and cognitive techniques** that is designed to reduce psychological and physical reactions to stress * Pharmacological - benzodiazepines (xanax, valium) * Relaxation - progressive relaxation * Mindfulness * Meditation * Massage * Hypnosis

Answer 64

1. **Attention: more present**, less going on to be stressed about, not worrying about past regrets or future worries - in the present 2. **Awareness:** experience events from a place of **curiosity, openness**, and acceptance regardless of desireability Reduces BP, enhances immune system

Answer 65

* release of oxytocin * say kind things to ourselves * have to learn to be good to yourself

Answer 66

* electromechanical device monitors physiological prcesses (HR, muscle tension) * info feeds back to participant * **person can learn to control the processes**

Answer 67

* Event is a stimulus - leads to **negative thought** * **Catastrophize** or cognitively **distort** the event * **need to reframe the even as neutral or positive** CBT can help to think of things in a more helpful way to experience less stress **cognitive** - change thoughts / feelings **behavior** - help ppl interact in world in better way through operant and classical conditioning

Answer 68

* **good for reducing fear / anxiety** * calm resonse to replace fear response * use **graded sequence** to fear stimulus * use some real life stimulus and some imagined (work up to the real things)

Answer 69

**measures negative traits** Angry, hostile ppl experience more conflictwith others at home and work, likely have less SS and: * don't respond to SS with reduced physiological reactivity * sleep more likely to suffer during stress * often related to obesity and drinking and smoking * social dominance as risk factor

Answer 70

Well Behaviour Symptom-based Behaviour Sick-role Behaviour

Answer 71

* activity or behaviour undertaken to **maintain or improve** current health and avoid illness * nutrition, exercise, brush and floss, seatbelt * Don't often do them when you are well because you don't have a "threat" to motivate you

Answer 72

* do this to **find out the problem and find a remedy** * find way to reduce or eliminate symptoms * **seek help or advice** * **complain** * may not do it if you are either not concerned (think it will pass) or scared of what you might find out OR have no money for care

Answer 73

* **treat or adjust to a health problem after deciding that you are ill** * **Learned behaviour**: how you display the behaviour will depend on what you observed when you were young (i.e. if babied by parents) vs (suck it up) * can use it to get out of obligations and life tasks * example: going to doctor * getting prescription and filling it * differernt cultures respond differently

Answer 74

1. more HB practised the fewer the illnesses and disabilities 2. 9-12 years later, regardless of age, #HB directly related to mortality 3. Health Behaviours especially important for men

Answer 75

* people fluctuate wrt behaviours * **if engage in one HB not necessarily engaging in all HB and each person is different** Why * reasons we do them are different for each type of HB * Reasons change over time (teen vs adult) * Changes can reflect learning about harms

Answer 76

* used to **avoid illness or injury** * ****getting kids immunized * eating well, exercising, not smoking * yearly physical * docs giving health promotion material * many illnesses are preventable (cancer, CHD, accidents - can do things to prevent these * CHD: High BP or cholest, diabetes, obesity, alcohol abuse, inactivity, smoking, stress

Answer 77

* **actions taken to identify and treat an illness or injury with the aim of stopping or reversing the problem** * symptom-based behav of complaining * get prescription and take meds

Answer 78

* **Can't reverse or stop illness so try and cope with it or slow the progression** * arthritis: manage symptoms to reduce amount of disability * Lease cost effective of the 3 approaches * $$ for meds, treatments

Answer 79

* **People who think they are healthy will not have the incentive to change behaviours** * may have to **change longstanding behaviours** and even possibly addictions * need **cognitive resources** to know what to do or will create obstacles * need **self-efficacy or motivation** will be impaired "I can do it" * being sick can affect **mood and energy leve**l and can slide back (stress, low energy, work) * some people will try to set limits (middle ground) but some go with what feels good at time

Answer 80

* can be affected by **partner's habits** (if you are trying to eat well and they eat poorly) * in **family**, one person's unhelathy behaviour in house can affect others - might not have control over food cooked, or others don't care about your goal * **workplace:** someone brings in donuts every day * **Community**: may not be enough money to fund promotional programs (e.g. to fund a smoking cessation program)

Answer 81

Learning * reinforcement -likely to repeat * extinction-without reinf. response weakens * punishment * modelling - see behaviour (ie parents made salad every night, exercised) Anything you give after the behaviour (reinforcement) will increase the likelihood they will do it again (even if take reward away)

Answer 82

* do mind tricks to justify a behaviour * unrealistic about the risk of developing illnesses * (less optimistic if alreay sick) * Note: **if unrealistically optimistic less likely to take preventative action**

Answer 83

Likelihood that a person will take preventive action depends directly on the ourcome of two assessments: 1. **Perceived threat**: a) perceived **seriousness** of the problem - more severe, will engage in HB b) perceived **susceptibility** (more susceptible, more likely to engage - mad cow example) c) **cues to action** - things around will help (sign: free flu shot) 2. **Pros and Cons** 1. **benefits** - reduced risk of being healthier - time off to go to doc, office far, etc. 2. **barriers** - cost in taking action

Answer 84

**Perceived Susceptibility**: Youth believe can get STIs or HIV or create a pregnancy. **Perceived Severity****:**Youth believe consequences of getting STIs or HIV or creating a pregnancy are significant enough to try to avoid. **Cues to Action**:Youth receive reminder cues for action in the form of incentives (reminder messages (such as messages in the school newsletter). **Perceived Benefits**:Youth believe recommended action of using condoms would protect them from getting STIs or HIV or creating a pregnancy. **Perceived Barriers**:Youth identify their personal barriers to using condoms (limit the feeling, too embarrassed to talk to partner about it) and explore ways to eliminate or reduce barriers (i.e., practice condom communication skills to decrease their embarrassment level).

Answer 85

**Need behavioural intention** (i.e. to be able to predict whether person actually intends to engage in behaviour 1. **Attitude** re action: if they **see the action** (ie quitting smoking) **as negative or positive** (if positive, so of value, more likely to have intention 2. **Social Norm**: if social **group** agrees with behaviour and **supports it** more likely to have intention 3. **Know what to do** / have a plan / capable of it (high **self-efficacy**) Good predictive Model

Answer 86

* good for addicion counselling * move people along based on how ready they are to engage in the health behaviour * **5 stages of readiness** * approach depends on the stage they are at

Answer 87

1. **pre-contemplation**: not usually there of your own accord (mandated or family intervention) 2. **Contemplation**: starting to think about it so best to focus on benefits re treatment 3. **Preparation:** will do it (ready), plan to do the change soon, might have (eg) quit smoking by half but not for good yet 4. **Action** (change made) - usually over 6 month span 5. **Maintenance** - work to maintain the specific behavioural change

Answer 88

Not true that people will always weigh pros and cons and look at things rationally: * e.g.: use biased cognitive processes to justify making decisions / mind trickery * sexual intimcy no condom: think if someone is good looking they are less likely to have an STI * Grandma lived till 90's and smoked so no need quit * Vaccines can lead to Autism - don't vaccinate kids

Answer 89

* WHO: enabling people or supporting then to increase their control over improving their health * theory: if give general public info they will do the behaviours (not necess. the case) * **NOT great at making people change unless massive blitz/constant exposure (smoking/seatbelt)** * colorful better / vivid / trustworthy communicator * short / clear / direct - too much small print bad * fear messaging: yes, but if too scared will distance themselves * **a) emphasize consequences of not engaging in HB b) personal testimonials c) provide specific instructions d) bolster confidene "You can do it!"**

Answer 90

* Great when used with Stages of Change model because at each stage have to motivate person to get them to next stage of readiness * **helps people resove ambivelence** * **Decisional Balance: help people understand their level of risk and associated consequences (perceived susceptibility)** * walk them through barriers to identify them and brainstorm them to overcome them plus can then help them plan - esp. addictions

Answer 91

* **triggers:** manage antecedents (former experiences that trigger us) - what comes BEFORE behaviour * **self-observation**- how feel afternoon re energy * **monitoring** - what happen right before you eat donut? (bad sleep so tired, no gym, bad mood) * Stimulus control: get better sleep, go to gym, etc. * linked pairs: cig/coffee, mood/carb loading * remove the stimulus for while or replace it * **will get clues as to what you need to change** (triggers)

Answer 92

* **Combine different techniques to be able to tailor the treatmeny to the person's spcific problem**

Answer 93

* biggest problem in health habit modification * biopsychosocial factors: * **bio:** family history, genetic vulnerability/withdrawl symptoms from addiction * **psych:** negative emotion - common re relapse * **social:** conflict - common re relapse

Answer 94

* override something that is naturally happening in the body e.g. body hungry but deny it food * do not listen when body hungry, try to **cognitively control** when to eat, structured, rules * lots of work, vigilence * if bad mood or fight or alcohol (reduces vigilence) and lapse? **may engage in extreme behaviour (binge eat)** * okay now to talk about relapse in counselling - help ppl identify high risk situations re relapse and plan how to avoid them (can mentally rehearse situations, responses for difficult encounters)

Answer 95

* **Family:** can help ppl restructure positive health change, help with reward, etc.) * **Worksite:** can offer programs that are convenient, cheap, have incentives, can remove junk food bldg., promote self management * **Community**: campaigns re risks and services, limited funding but cost-effective (Naloxone Kits) * **Social Engineering:** law comes down and decides for us, (e.g. with legislation) - more impact and success (seatbelts, texting &driving, weed / driving ?)

Answer 96

* Internal - external - is it within my control or not * Stable/Unstable - long-lasting (stable) or temporary (unstable) - Unstable or chronic, more likely to feel helpless * Global - specific - wide ranging or narrow effects; if helpless more likely global judgement (I'm no good at anything) vs I'm no good at "this"