Health & Wellbeing Flashcards
Health Psychologists
These are psychologists who are trained to promote positive behaviours and reduce risk factors for poor health e.g. smoking, inactivity. They are dedicated to understanding and helping modify attitudes, beliefs and behaviours that contribute to poor health outcomes. This can occur in clinical settings or for health promotion through research.
Resilience
Thriving or even surviving despite situations that would be otherwise intolerable.
3 Common Myths About Emotional Resilience
- Resilience is something you either have or don’t. People are born with it. This isn’t a trait that is born into us but a skill that can be developed.
- Resilient people don’t have problems, stress or difficult emotion. The reality is that all people have different struggles however those with resilience will be assisted in challenges that are difficult.
- Resilient people are so tough and self-reliant that they don’t need other people. This isn’t true and a major part of being resilient relies on asking for help and working with others.
Emotional Resilience
The process of showing greater emotional outcome than expected given the adversities faced. Demonstrating more positive emotional outcomes than expected relative to the adversity experienced.
What Impacts Resilience
These can be increased social interaction, a positive attitude and optimism. Research and studies into finding these factors are what will lead to better training of resilience.
Building Resilience
Going through increased amounts of adversity may have the ability to develop more resilience in people.
Differences In Resilience
We are vulnerable to adverse experiences and the more adversity we experience the morel likely we are to develop emotional problems and mental disorder however this varies widely between individuals. Some more resilient individuals are less likely to be stressed, anxious or developing mental illnesses.
Cognitive Processes & Resilience
This is involuntary brain function which is an understudied area in terms of the levels of emotional resilience that occurs. The 2 specific cognitive processes are assessed.
1. whether paying less attention to threats is associated with more resilience or whether greater attentional bias flexibility is associated with more resilience.
2. Whether greater use of strategy (reappraisal) to regulate emotions is associated with more resilience or whether greater emotion regulation flexibility is associated with more resilience.
Stress
This can come from many sources e.g. work/study load, chronic illness/injury, familial relationships etc. This has 3 descriptions which are a stimulus (a deadline for an assignment), a response (can’t sleep or concentrate) or an organism reacting to the environment (a combination of the stimulus and response e.g. I have an assignment and I can’t sleep because of it). It can be defined as a pattern of thoughts, physical responses and behaviours that occur in response to perceived situational demands and the perceived ability to cope with those demands.
The Nature of Stress
This is based on stressor characteristics which are intensity/severity, duration, predictability, controllability and chronicity. Once these stressor characteristics are analysed you then analyse the demands of the stressful object and assess your resources/ability to handle it. This leads to cognitive appraisal which cause worry, racing thoughts, low self-confidence, feeling hopeless etc. It also causes a sympathetic arousal (fight or flight) and the release of stress hormones which cause muscle tension, elevated heart rate, shortness of breath and lesser immune response. The physical responses can lead to coping behaviours e.g. task-irrelevant responses, disorganisation, self-destructive behaviours (alcohol/drug abuse), behavioural rigidity etc.
Acute Stress
When the stress lasts for a short period of time e.g. taking an exam, starting a new job. Individuals typically recover from this quickly however there are some severe instances which lead to significant mental health issues e.g. depression, anxiety, PTSD.
Chronic Stress
Stress that continues for a long period of time such as stress from ongoing difficulties, chronic health problems, unsafe environments, poverty. This can occur when several acute stressors occur at the same time or in close sequence without an opportunity for recovery.
Mental Health
Acute stress can lead to irritability, reduced cognitive capacity but increased accuracy. Chronic stress can lead to poor emotional regulation, development and maintenance of mental health conditions, depression and anhedonia (absence of positive emotions).
Physical Health
Acute stress can lead to increased heart rate, blood pressure, muscle tension, elevated breathing rate and elevated metabolic rate. Chronic stress can lead to high blood pressure, sleep disturbance/insomnia, fatigue, digestive discomfort, frequent headaches, muscular aches/pains and increased susceptibility to illness.
Impacts of Chronic Stress
This is associated with a range of negative health outcomes and increased risk of chronic diseases and reduced immunity. A study showed that increased emergency admissions for peptic ulcers on Sundays and holidays. This provides evidence that at a normal baseline stress the body doesn’t notice some complications however once you relax these begin to become more prevalent. This phenomena is called the let-down effect. Another study found that once there was a reduction of stress the number of headaches that people would experience would increase.
Adaptive Strategies
These are used to better cope with stress. Problem focused coping is involved with attempts and strategies to confront and directly deal with the situation, or change the situation to reduce threat. Emotion focused coping uses positive reappraisal/framing to manage the emotional responses to reduce the perceived threat. Seeking social support from others without shifting responsibility involves engaging in supportive behaviours for mental health e.g. seeing friends.
Maladaptive Strategies
Unproductive worry is the excessive worrying without doing anything to reduce the source. Repression/avoidance is the inhibition or avoiding the task at hand in order to have a feeling of disconnect e.g. going out and not doing an assignment. Aggression/blame seeks to transfer responsibility and blame to others.
Cognitive Behavioural Therapy (CBT)
A scientifically informed ‘talk-based’ therapy used for stress which occurs in 4 steps.
1. Assist individuals in determining specific situations that create a stress response (not always obvious).
2. Identifying patterns of thinking and behaviour that promote distress or prevent reduction in distress.
3. Determine and implement new ways of thinking and behaving to reduce stress or enable adaptive coping with unavoidable situations.
4. Develop skills and confidence to deal with stressful situations in the future.
Acute Pain
1 of the 2 kinds of pain which is provoked or maintianed by a specific disease or injury. This will disappear when the injury or disease resolves and serves a useful biological purpose.
Chronic Pain
1 of the 2 kinds of pain which outlasts the expected time of healing when associated with an acute disease or injury. There is no clear relationship between pathology and pain intensity. There is no recognisable endpoint, meaning this is persistent or recurrent. It is not otherwise medically explains e.g. side effect of a drug and doesn’t seem to serve a useful biological purpose.
Biopsychosocial Model of Chronic Pain
The widely accepted best approach for understanding chronic pain. The biological factors can be changes to the nervous system arising from a period of continuous pain. This can involve heightened pain reactivity to discomfort leading to the amplification of pain (hyperalgesia) or the feeling or pain from stimulation that isn’t typically painful (allodynia). Psychological factors can be the fear of pain and unhelpful beliefs about self-efficacy or ability to control or deal with pain. Social factors can be lack of social support or a lack of pain experience validation.
Psychological Factors in Chronic Pain
Fear of pain can lead to catastrophising and avoidance of activities that may result in pain which leads to expectation about pain e.g. going to the gym increases the pain therefore I won’t go to the gym. Personal beliefs regarding pain is that pain will signals that the injury/illness is getting worse. These will effect the coping skills and perceived control over pain along with factors such as pre-existing mental health challenges e.g. depression, anxiety, personality disorder.
Psychological Treatment of Chronic Pain
The coping skills, perceived control and self-efficacy. Avoidant coping strategies can result in greater fear/anxiety and catastrophising, leading to fear-avoidance cycle. Previous failed attempts to control pain or the belief that pain can’t be controlled can lead to elevated avoidance or failure to engage in therapy. Self-efficacy is associated with and predicts the levels of disability and pain.
Psychological Factors in Pain
The perceived control is important in pain management. One study evaluated self-reported pain of 2 groups randomly assigned after a bone-marrow transplant. The patients who controlled their own medicine (Patient Controlled Analgesia) reported less pain that control (Non-patient controlled analgesia).
CBT for Chronic Pain
Providing psychoeducation about pain, behaviour and mood. Identifying maladaptive responses to pain e.g. fear and avoidance. Implementing strategies to alleviate the maladaptive responses. Developing coping skills in order to manage pain and improve psychological functioning. Treat the associated mental health issues e.g. depression, anxiety, personality disorders.
Belongingness
A sense of inclusion and acceptance.
Performances
Belongingness doesn’t see any statistically significant correlation with achievement. It was also found however that there are indirect factors which improve achievement which in themselves are positively correlated with belongingness. This was measured through belongingness and students’ self-efficacy. These strategies are used to identify things that improve confidence and the ability to belong in order to improve the grades and performance of students at universities.
University Engagement
In isolation conditions who are more engaged with the university typically do better in terms of grades (academic success). It is theorised that the belongingness of people increases the university engagement which in turn also increases academic achievement.
Obesity
Excess body weight which is based on the body mass index (BMI). BMI = weight (kg) / height (m). 25-29.9 = overweight while 30+ = obese. The trends of obesity are increasing over time in Australia. The proportion of adults ages 18 and over living with overweight or obesity increased from 57% in 1995 to 67% in 2017-18. Over this time the proportion of the population living with obesity almost doubled, from 19% in 1995 to 31% in 2017-18. The proportion living with overweight but not obesity declined from 38% to 36%.
Criticisms of BMI
It was developed by Lambert Adolphe Jacques Quetelet who was a mathematician not a medical researcher. It was designed for population measurements of body fat not at an individual level. Most of the data was based exclusively on a white, male population. It isn’t made for extreme individual circumstances e.g. Arnold Schwarzenegger was considered obese. This is insensitive to the location of body fat, muscle and bone density, health risks etc.
Complex Heath Condition
Obesity is very complex health condition and is linked with other chronic health conditions e.g. diabetes, hypertension. A range of genetic, physiological, behavioural and environmental factors which vary across individuals contribute to obesity. Genetic risk factors estimate that heritability accounts for 40-70% of obesity and there are 20 types of gene expression associated with susceptibility to obesity. Environmental risk factors are limited access to places of physical activity, limited access to healthy food, exposure to high-calorie food.
Obesity & Mental Health
Obesity isn’t a mental disorder and isn’t present in diagnostic manuals for psychological disorders however is associated with mental disorder e.g. depression, anxiety, eating disorders etc. Obesity has a negative impact of self-perceptions and self-efficacy. Obese children 2-4 times more likely than normal weight children to report low self-esteem. Obese adults are more likely to experience mental health disorders e.g. depression, anxiety and food consumption disorders etc. The impacts and associations upon mental health are critical for psychologists to understand.
Diet
This is a health challenge with yo-yo and crash diets being common which are effective in the short-term however there is negative consequences in the long-term. This is a process of extreme caloric restriction. Many people undertaking these diets will gain the weight back and potentially more than before. Food restriction leads to food fixation which leads to binge eating adding on more weight.
Weight Stigma
People with obesity experience considerable discrimination e.g. weight-based teasing, poor employment prospects, discriminatory medical care (biased beliefs, denial of medical procedures). One study of people with a gastric band reported they would rather have serious heart disease than return to previous weight. 91% said they would rather have a leg amputated or be legally blind than return to previous weight. There is a widespread belief that negative labels will lead to weight loss but exposure to stigma has negative psychological consequences (poor emotional health, avoid healthcare, developing eating disorders).
Internalised Weight Stigma
External, social stigma from family, peers and the medical establishment can lead to Internalised stigma (self-directed blame, contributes to poor emotional health). Stigma and shame aren’t associated with greater success with weight loss and contributes to adverse physical and psychological health consequences. People with Internalised stigma are less confident in their ability to lose weight, engage in more binge eating/less activity, are at greater risk of depression, suicide and low-self esteem.
Psychological Factor that Influence Obseity
Maladaptive beliefs, self-efficacy and decisional balance.
Maladaptive Beliefs
Thin ideal beliefs is a fearful dieting that can lead to maladaptive behaviours and beliefs around food. Catastrophising beliefs regarding food e.g.
Self-Efficacy and Decisional Balance
reduced self-efficacy (the confidence that one can successfully engage in healthy behaviour). Decisional balance is the relative balance between the perceived gains and perceived losses of engaging in a health-related behaviour, such as reducing consumption and increasing physical activity.
Coping Styles
As the severity of depression or stress increase so does the odds of being obese. Emotional eating is considered on behavioural mechanisms that links the presence of depression and stress with the later development of obesity. Increased depression, anxiety, anger or stress increased the likelihood of binge eating. Typically there is a cycle caused by stress which leads to abuse of a substance (food in this case) which may cause more guilt and negative emotions leading to more abuse.
Cognitive-Behavioural Therapy for Obesity
Identifying and modifying maladaptive thinking styles and behaviours to change body image, dietary expectations, maladaptive beliefs. Developing coping skill to handle stress and emotion to develop skills for stress management and reducing emotional or binge eating. Identifying safe and achievable weight loss targets. Identifying thoughts and actions that occur during setbacks to build adaptive responses for these setbacks.
Societal Factors in Obesity
While self-efficacy, coping styles and beliefs about weight are important these are all impacted by our treatment by others and the social and medical systems around us. Stigma and discriminatory treatment reduces self-efficacy, exacerbates stress and frames overweight and obesity as a defining personal characteristic rather than a bodily state.
Substance Use vs Abuse
Substance use is the taking of substances that have a negative impact of health. These can be legal or illegal e.g. alcohol, nicotine, illicit drugs. Substance abuse is a pattern of repeated or compulsive substances use that negatively interferes with health, work or social relationships. Also called substance dependence or addiction and when it becomes severe substance use disorder. This can include legal and illegal substances e.g. alcohol, nicotine, illicit drugs.
Substance Use Disorder
Regularly using substance more than intended. Spending excessive effort getting, using, or recovering from a substance. Failing to meet responsibilities at work, home, school or in relationships due to the substance. Continuing to use a substance even when it is causing distress. Withdrawal symptoms such as feeling of physical illness when not using the substance which is only relieved by taking more of it.
Psychological Factors of Substance Abuse
Coping styles involving tendencies to avoid negative emotions e.g. alcohol to cope with stress. These styles avoid rather than confront sources of distress. Coping styles that are emotion reduction focused rather than problem focused and over time these coping styles become entrenched.
Smoking
Australia has the lowest level of tobacco used for OECD countries 16.1% in 2021. There is a downward trend in smoking between 1991-2019. There is an increase in people who haven’t tried smoking and a decline in the number of smokers with an increase in the number of ex-smokers. These trends however seem to be changing with an increase in smoking from 2020-2023 in people ages 14-17. This change in trends are associated with vapes with 31% of smokers only use vapes and only 16% of current cigarette smokers are under 25 whereas 34% of current vapers and 25.
Smoking Cessation
It often takes several attempts to quit,. Environmental barriers may be supportive (tax). It is important to consider harm minimisation. Behavioural change is required.
Alcohol
In 2017-18 16% of adults consumed more than 2 standard drinks per day on average which exceeds the risk guidelines. In 2021-22 alcohol was the most common principal drug of concern for which clients sought drug treatment services (42% of treatments). Alcohol was the only drug where approval of regular use by an adult was higher than disapproval (45% approved and 21% disapproved).
Contributing Factors for Alcohol Abuse
The genetic risk factors show a 40-60% of the variance of risk of developing alcohol use disorder is hereditary. The rate of alcohol use disorder is 3-4x higher in close relative of individuals with alcohol use disorder. Environmental risk factors include societal attitudes towards drinking and intoxication (think its ok), availability and accessibility of alcohol e.g. price and familial exposure to alcohol consumption.
Cognitive-Behavioural Therapy for Alcohol Abuse
To identify sources of emotion that give rise to substance use. Develop adaptive/eliminate maladaptive coping skills. Behavioural strategies for reducing craving (identifying and removing triggers). Modifying maladaptive beliefs and expectancies. Relapse prevention skills. You can also aim to reduce the negative affect or other mental health issues.
Harm Minimisation for Alcohol Use
Punitive approaches toward substance use are ineffective. Harm minimisation is policies, programs and practices that aim to reduce the harms associated with the use of psychoactive drugs in people unable or unwilling to stop. This focuses on the prevention of harm, rather than on the prevention of drug use itself and focusses on people who continue to use drugs. An example is a sobering up center planned for Melbourne where people who are publicly intoxicated can go for medical treatment and rest rather than being criminalized and charged.
