Lecture week 11 - Physical health

Question 1

WHO 1948 definition of health

Answer 1

“…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

Question 2

how can we describe the link between physical and mental health?

Answer 2

bidirectional

Question 3

study showing bidirectional link between mental and physical health

Answer 3

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

Question 4

risk behaviours driving ill health and premature mortality (Everest et al., 2022)

Answer 4

smoking
poor diet
physical inactivity
harmful alcohol use
lifestyle choices

Question 5

what do health psychologists do?

Answer 5

• 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

Question 6

personological epidemiology

Answer 6

the study of the links between personality traits and health and disease

Question 7

cognitive epidemiology

Answer 7

the study of the links between intellectual abilities and health and disease

Question 8

Murray and Booth 2015 systematic review - personality and physical health link

Answer 8

Personality traits, especially conscientiousness and neuroticism, have small but important effects on health (e.g., cardiovascular diseases, diabetes, high blood pressure, asthma) and longevity

Question 9

casual chain between personality and physical health

Answer 9

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

Question 10

lee et al., 2012 leading risk factor of global mortality

Answer 10

physical inactivity

Question 11

personality and physical activity link

Answer 11

Personality traits associated with sport performance (athletic success) and physical activity (exercise participation) but also unhealthy exercise behaviour (cf. Allen et al., 2014)

Question 12

personality traits as precursors of sport performance (athletic success) and physical activity (exercise participation)

Answer 12

• 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)

Question 13

personality traits as precursors of unhealthy (obsessive and compulsive) exercise behaviour

Answer 13

• 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)

Question 14

link between personality and smoking

Answer 14

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

Question 15

personality and health care use link

Answer 15

• *
  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

Question 16

causal chain between personality and physical health/illness including biological activities

Answer 16

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

Question 17

personality and coronary heart disease

Answer 17

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

Question 18

type A/B coronary heart disease

Answer 18

• 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

Question 19

what explains the effects of type A on coronary heart disease

Answer 19

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

Question 20

correlational link between personality and physical health

Answer 20

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

Question 21

Stephan et al., 2014 - personality traits are shaped by exercise participation - evidence

Answer 21

– physically active adults declined less on conscientiousness,
extraversion, openness, and agreeableness than did less
physically active adults

Question 22

chronic diseases influence personality (Jokela et al., 2014)

Answer 22

Consistent decreases in extraversion, emotional stability, conscientiousness, and openness to experience after onset of chronic disease

Question 23

smith 2006 3 models that delineate the effect off personality considering appraisal and coping in stressful situations

Answer 23

– Health behaviour models
– Interactional stress moderation model
– Transactional stress moderation model

Question 24

4 responses to a stressful situation

Answer 24

1. Experience of negative emotions (e.g., anxiety, fear)
2. Physiological response (e.g., fight or flight, heightening of sympathetic nervous system and suppression of parasympathetic nervous system)
3. Cognitive response (e.g., appraisal, defence mechanisms, rumination, thought suppression)
4. 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

Question 25

Lazarus’ theory of emotion - what is stress viewed as? - process

Answer 25

a transaction between the person and the environment

1. 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?”)
2. Then, the individual appraises their capabilities to cope with the perceived demands, resulting in secondary appraisal (“What can I do about it?”)
3. Finally, the perceived demands are compared to the perceived capabilities
   an - if the perceived demands are greater than the perceived capabilities - stress results.

Question 26

personality influences engagement with health behaviours, what else can it also influence?

Answer 26

an also influence appraisals and our coping strategies when faced with stressful situations

Question 27

interactional stress moderation model

Answer 27

personality moderates both appraisals of potentially stressful circumstances and coping responses, which in turn alter physiological processes involved in disease etiology

Question 28

transactional stress moderation model

Answer 28

it extends the interactional model by including the bidirectional effect of personality on exposure to stressful life circumstances

Question 29

in terms of living, higher intelligence is associated with what?

Answer 29

longer living

Question 30

lower intelligence in youth is associated with what?

Answer 30

– 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

Question 31

Whalley and Deary (2001) 4 non-exclusive possible explanations for the link between intelligence and physical health

Answer 31

1. Health and deprivation affects intelligence scores in childhood & youth; it is the former that predicts future health and mortality
2. The common genetic basis of these constructs supports the notion of “system integrity”
3. Intelligence in childhood and youth might be associated with health literacy & subsequent uptake of health-related behaviours
4. Intelligence is associated with higher educational attainments and, thereby, entry to safer and healthier environment

Question 32

intelligence and vaccination intention (Batty et al., 2021)

Answer 32

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