Lecture week 11 - Physical health Flashcards
WHO 1948 definition of health
“…a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (p. 100)
- as for mental health, health is a state of well-being in addition to the absence of illness
how can we describe the link between physical and mental health?
bidirectional
study showing bidirectional link between mental and physical health
English Longitudinal Study of Ageing (ELSA, Ohrnberger et al., 2017)
* ongoing since 2002
* N=10,693
* past mental and physical health have strong direct and indirect effects on current mental and physical health
risk behaviours driving ill health and premature mortality (Everest et al., 2022)
smoking
poor diet
physical inactivity
harmful alcohol use
lifestyle choices
what do health psychologists do?
- use their knowledge of psychology and health to promote
general well-being and understand physical illness. - are specially trained to help people deal with the
psychological and emotional aspects of health and illness as
well as supporting people who are chronically ill. - promote healthier lifestyles and try to find ways to encourage
people to improve their health. - use their skills to try to improve the healthcare system (e.g.,
doctor-patient communication) and health policy
personological epidemiology
the study of the links between personality traits and health and disease
cognitive epidemiology
the study of the links between intellectual abilities and health and disease
Murray and Booth 2015 systematic review - personality and physical health link
Personality traits, especially conscientiousness and neuroticism, have small but important effects on health (e.g., cardiovascular diseases, diabetes, high blood pressure, asthma) and longevity
casual chain between personality and physical health
Having certain personality traits causes individuals to engage in (health) behaviours that influence their health/increase the risk of illness
– risky behaviours, e.g., smoking, substance abuse, unprotected sex
– protective behaviours, e.g., proper nutrition, weight control, physical activity, sleep, immunizations, safe driving Health outcomes are mediated by behaviour
personality –> behaviours –> illness
Causal link: Illness produces changes in personality
Illness –> Personality
lee et al., 2012 leading risk factor of global mortality
physical inactivity
personality and physical activity link
Personality traits associated with sport performance (athletic success) and physical activity (exercise participation) but also unhealthy exercise behaviour (cf. Allen et al., 2014)
personality traits as precursors of sport performance (athletic success) and physical activity (exercise participation)
- athletes competing in national/international competitions report higher conscientiousness and lower neuroticism than do those competing in regional competitions (Allen et al., 2011)
- high extraversion and conscientiousness and low neuroticism relate to high levels of physical activity (e.g., Rhodes & Smith, 2006)
- older adults with high extraversion have greater muscular strength (Tolea et al., 2012)
personality traits as precursors of unhealthy (obsessive and compulsive) exercise behaviour
- Exercise addiction: excessive exercise patterns with potential negative consequences such as overuse injuries; often associated with eating disorder
- Excitement seeking (extraversion), achievement striving (conscientiousness), and straightforwardness/compliance (agreeableness) have strongest associations with exercise addiction (Lichtenstein et al., 2014)
link between personality and smoking
Hakulinen et al. (2015); meta-analysis of 9 cohort studies
– current smoking associated with higher extraversion, higher
neuroticism and lower conscientiousness
– non-smokers: smoking initiation predicted by higher
extraversion and lower conscientiousness
– ex-smokers: higher neuroticism predicted smoking relapse
personality –> smoking –> (lung) cancer, coronary heart disease
personality and health care use link
- *
Hajek et al. (2020); meta-analysis of 15 studies
E.g., higher neuroticism linked to
– increased use of general
practice/physician visits
– dental care use
– use of medication
– use of any emergency department
Personality –> health care use –> health/illness
causal chain between personality and physical health/illness including biological activities
Personality may directly influence biological activities that influence the development of a physical disease
Health outcomes are mediated by biological activities
Personality –> Biological activities –> Illness
personality and coronary heart disease
Friedman and Rosenman (1959) identified a coronary-prone behaviour pattern which they labelled Type A personality
- Type A personality individuals are:
– achievement-oriented and competitive
– hardworking and at high levels of alertness
– unhappy with time-wasting and serious about deadlines
– easily roused to anger when goals are obstructed - In contrast, individuals with Type B personality are:
– less interested in achievement, competition, and power
– relaxed and unhurried
– rarely driven in a compulsive manner, though may work hard
– more likely to take life as it comes
Hypothesis:
Individuals with scores towards the Type A end are more likely to develop coronary heart disease than those towards the Type B end of the Type A/B continuum
type A/B coronary heart disease
- Inconsistent evidence: some findings are supportive of the role of Type A personality on coronary heart disease , others are not
- Booth-Kewley & Friedman (1987); meta-analysis
– Type A reliably but modestly associated with coronary
heart disease
– studies using interviews to assess Type A/B produced
more reliable results than studies using self-report questionnaires
what explains the effects of type A on coronary heart disease
Hostility & negative affect seem to be the toxic components – the behaviour causally linked to the development of coronary heart disease – of Type A personality
Chida & Steptoe, 2009, meta-analysis
* hostility/anger was associated with a 20% increased risk of coronary heart disease and led to poorer outcomes in patients with coronary heart disease
hostility –> coronary heart disease
Studies reporting correlations between hostility and coronary heart disease assume a causal chain: hostile behaviour causes biological processes resulting in increased cardiovascular disease e.g., Suarez et al., 2002:
* very hostile men produce higher levels of C-reactive proteins in their immune system
* C-reactive proteins are associated with an increased risk of coronary heart disease
Personality –> C-reactive proteins –> coronary heart disease
correlational link between personality and physical health
Correlational link – the same biological process might underpin personality traits and illness outcomes
Example:
– A specific kind of coronary heart disease was found to be
linked to a gene, which also causes a predisposition
towards being a hostile person
Biological causes –> Personality
Biological causes –> Illness
Stephan et al., 2014 - personality traits are shaped by exercise participation - evidence
– physically active adults declined less on conscientiousness,
extraversion, openness, and agreeableness than did less
physically active adults
chronic diseases influence personality (Jokela et al., 2014)
Consistent decreases in extraversion, emotional stability, conscientiousness, and openness to experience after onset of chronic disease
smith 2006 3 models that delineate the effect off personality considering appraisal and coping in stressful situations
– Health behaviour models
– Interactional stress moderation model
– Transactional stress moderation model
4 responses to a stressful situation
- Experience of negative emotions (e.g., anxiety, fear)
- Physiological response (e.g., fight or flight, heightening of sympathetic nervous system and suppression of parasympathetic nervous system)
- Cognitive response (e.g., appraisal, defence mechanisms, rumination, thought suppression)
- Behavioural response; healthy (e.g., exercise, seeking social support) or unhealthy (e.g., drugs) coping behaviours
- Ineffective coping can prolong or even intensify the stress
Lazarus’ theory of emotion - what is stress viewed as? - process
a transaction between the person and the environment
- When a demand occurs in the environment, the individual undertake primary appraisal to assess the perceived demands (“Am I fine or am I in trouble?”)
- Then, the individual appraises their capabilities to cope with the perceived demands, resulting in secondary appraisal (“What can I do about it?”)
- Finally, the perceived demands are compared to the perceived capabilities
an - if the perceived demands are greater than the perceived capabilities - stress results.
personality influences engagement with health behaviours, what else can it also influence?
an also influence appraisals and our coping strategies when faced with stressful situations
interactional stress moderation model
personality moderates both appraisals of potentially stressful circumstances and coping responses, which in turn alter physiological processes involved in disease etiology
transactional stress moderation model
it extends the interactional model by including the bidirectional effect of personality on exposure to stressful life circumstances
in terms of living, higher intelligence is associated with what?
longer living
lower intelligence in youth is associated with what?
– various diseases (e.g., cardiovascular disease, hypertension, respiratory disease, diabetes)
– all-cause mortality (death from cardiovascular disease, external causes including accidents, suicide and homicide)
– health-care use, treatment compliance
Whalley and Deary (2001) 4 non-exclusive possible explanations for the link between intelligence and physical health
- Health and deprivation affects intelligence scores in childhood & youth; it is the former that predicts future health and mortality
- The common genetic basis of these constructs supports the notion of “system integrity”
- Intelligence in childhood and youth might be associated with health literacy & subsequent uptake of health-related behaviours
- Intelligence is associated with higher educational attainments and, thereby, entry to safer and healthier environment
intelligence and vaccination intention (Batty et al., 2021)
N=12,035 (UK)
* Variables assessed:
– Vaccination intention (24 November 2020 (efficacy of the AstraZeneca vaccine was announced)
“Imagine that a vaccine against COVID-19 was available for anyone who wanted it. How likely or unlikely would you be to take the vaccine?”
– Intelligence (2011/2012)
– Control variables: age, sex, ethnicity, highest education level, physical health status, shielding status of any household member, current psychological distress
- After controlling for age, sex, and ethnicity, participants with a lower intelligence were markedly more likely to be vaccine hesitant
- Controlling for mental and physical health and household shielding status had no impact
- Controlling for educational attainment led to partial attenuation of the effect
