MIDTERM 1 (Chapter 1,2,4) Flashcards
What is health
Positive and desired state of being
Involves bio-psychosocial processes
Occurs along a continuum
What is health psychology
Understanding the biopsychosocial influences on health and illness
4 missions
Promote and maintain health
Prevent and treat illness
Identify the causes of health and illness
Analyze and improve the health care system
Preventive medicine
Efforts to maintain well-being and offset of disease
Chronic disorder
Persist or worsen over time
Over 3 months
Acute disorder
Abrupt onset and short duration
Identifying the causes
Identifying the biopsychosocial factors that put people at risk
Etiology
Causes of disease
Epidemiology
Factors occurring most often with a disease
Improve the health care system
Analyze how changes in the delivery of health could improve the lives of patients
Components of the biopsychosocial model
Biology
Psychology
Social context
Biopsychosocial model
Consider the interactions between these processes for health and illness
Risk genes
May increase the likelihood that we will develop the disease but they don’t cause directly the disease
APOE-e4 gene (25% more likely if we have this gene)
Deterministic gene
Genes that actually cause the disease to develop
HTT gene mutation
Systems theory
Concept of the body as a system governed by many different factors
Input - Processing - Output
Objective
Assessment of health from observable measures
Subjective
How individuals evaluate their own health status
Health is BOTH a subjective and objective experience because of interindividual differences
Health around the world
BPS model encourages a global health approach
Improve health and achieve more equal outcomes, and highlights areas to improve
Examine the differences in the experience of health
Helps overcome the ethnocentric views (discrimination)
Countries
Developed countries are wealthy
Underdeveloped countries are less wealthy (lower level of material well-being)
Health disparities
Differences in overall health, access to the quality health care system
Social determinants of health
Social and community context Economic stability Education Neighborhood and built environment Health and health care
2267-2648 BC
Imhotep
Physician of a pharaoh
Healing god
1550-1536 BC
Ebers Papyrus attributes illness to supernatural causes
460-370 BC
Hippocrates argued that disease is not divine punishment
129 BC-200 AD
Galen connected spinal cord damage and paralysis
In force for the next 14 centuries
Humoral theory: body fluids are very important to regulate emotions (blood, yellow bile, black bile, phlegm)
14th century
Bubonic plague
Poor sanitation
Beliefs that health is focused on superstition
Illness results from the sins of the soul
Relief through meditation, prayers, trepaning, exorcism
14-15th century
Renaissance with renewed interest for science (da Vinci, Paré, Versalius)
The germ theory of disease attributed the disease to microorganisms (van Leeuwenhoek)
17th century
Descartes set apart mind and body
Discovery of antibiotics and vaccines
Penicillin by Flemming
Polio vaccine by Salk
Late 19th century
Dualism of mind and body created a division in healing
Freud unites mind and body in a belief in holism (everything works as a whole)
19th-20th century
Freud: discovered therapeutic influence of talk therapy, the basis of psychoanalysis
Psychosomatic medicine: the relationship between mind and body in disease
1930
American Psychosomatic Society
Lessons
HP follows the history of medicine
HP is based on belief in the mind-body link
Beliefs tied to HP can only be understood in the context of time and place
Why are we living longer
Current life expectancy of 29 y.o. Treating acute and infectious diseases Managing chronic illness to preserve a quality of life Medical advancements Riskier lifestyle choices
Evidence-based practice
Evidence-based science
Conscientious use the best current scientific evidence
Applied to health-related decisions making
What is included in evidence-based practice
Best research evidence
Clinical expertise
Patient values and preferences
Theory
Set of ideas that explain the world in which we live
Hypotheses
Statements that can best be tested to determine if the theory is supported
Epidemiology
Field concerned with gathering data on health-related issues
First developed to discover causes of contagious diseases
Now also includes chronic conditions
Mortality rate
Number of deaths
Risk factors
Variable associated with an increased risk of disease
Try to reduce the risks
Morbidity
State of being unhealthy
Incidence
Number of new cases at a given time
Prevalence
Total number of cases at a given time
Lifetime prevalence
The proportion of the population that has, at some point in their lives, had the condition
Surveillance
Gathers detailed information about health by assessing the magnitude of a problem
Descriptive and Analytic studies
Research methodology
Quantitative data are gathered through carefully designed examination
Discrete and continuous data
Quantitative research
Gathered through designed examination
Qualitative research
Gathered through observations and open questions
Correlational research
Aims to find linkages between variables Correlation coefficient (r) to quantify that link Statistical relationship
Correlation and causation
Only when
- Predictor variable and outcome variable are related (covariation)
- Predictor variable precedes the outcome in time (temporal precedence)
- No plausible alternative explanation (nonspurious relationship)
Independent variable
Factors that researchers manipulate across different groups of conditions within the experiment
Predictor variables
Dependent variable
Observed outcomes that researchers measure
Outcome variables
Experimental research
Direct manipulation of the variables within a carefully controlled experimental condition
Experimental and control group
Random assignment
Measure outcomes for both groups
Quasi-experimental research
Less complete control
No random assignement
Comparaison group
Experimental protocol
Detailed plan of study
Baseline, random assignment to conditions, experimental or control condition, outcome measured, differences due to treatment
Blind experiments
Patients are unaware of which treatment they are receiving
Double-blind experiment
No one involved knows of the assigned experimental conditions
Developmental studies
How age or developmental stage relates to some outcomes
Cross-sectional studies
Compare groups of people at one point of time
Cross-cultural
Longitudinal studies
Follow individuals through their lifespan
Prospective (through time) and retrospective (backward through time) studies
A lot of data, expensive, hard to follow individual through time
Sequential
Mix of both
Social genomics
Aims to understand genetic, chemical, hormonal, and neural mechanisms
Uses complex technologies and methodologies to examine the reciprocal interactions between biological and social-cognitive characteristics
Epigenetics
Only a small portion of a gene is expressed
Influence of body and mind
Microbiome
We all have a unique microbiome and the microbiota within are constantly in flux
Within the gut live microorganisms that contain genetic information referred to as the microbiome
Microbiota
Contained within the microbiome and form part of the microbiota-gut-brain axis
Ethics of experiments
Must receive approval from Institutional Review Board
The review process was instituted due to past harm and endangerment of participants (Tuskegee Syphilis experiment)
Current issues of experiments
Replicability crisis: scientific fraud, falsified data, failure to replicate studies
Need to facilitate full disclosure of and access to methods, data, and findings
Health-enhancing behaviors
Behaviors that maintain and promote good health, well-being, and longevity
Self-efficacy focuses on what one can do, not one cannot
Healthy eating
Maintains or improves your health
Protects against malnutrition
May decrease risks for chronic diseases
Some consensus about healthy eating, but no one size fits all
Good eating habits
- Try to burn as much energy as you eat, eat as much energy you burn
- Increase consumption of plant foods
- Limit intake of fats, avoid saturated fats, prefer unsaturated fats, eliminate trans fats
- Limit intake of granulated sugar
- Limit salt consumption, prefer iodized salt
- Limit alcohol consumption
Carbs
Complex: not processed, harder to digest, healthy foods, more nutrients
Simple: processed, easier to digest, unhealthy foods
Food recommendation
Balanced and varied Increase in fruit and veggies Increase in complex carbs Decrease in fats Decrease in sugar Decrease in sodium
Malnutrition
Food scarcity
Limited food security
Causes more than a third of deaths in childhood developing countries
Fast-food over-consumption in developing countries
Obesity
Genetic factor: heritability estimated at 40-70%
Environmental contribution: consumption of high caloric foods, sugar-rich foods and drinks
Linked to health problems: cardiovascular diseases, diabetes, cancer
Body mass index
Measure of body fat based on weight and height
Weight x 703 divided by height 2
Not a good indicator because differences in body shape and doesn’t distinguish fat distribution
Waits-hip ration
Factors of influence for weight
Thrifty gene hypothesis Genetic component Age-related changes in metabolism Eating habits Big-five personality traits
Thrifty gene hypothesis
Evolutionary perspective
Store fat more easily for survival (cytokines) with sex differences
Women: hips, thighs, buttocks
Men: abdomen, upper body
Genetic component
Heritability 40-70% Gene polymorphisms (involved in the regulation of appetite, satiety, energy expenditure, weight)
Eating habits
Intuitive eaters (most optimal type of eating, better health outcomes)
Restrained eaters restrain their eating
External eaters eat in response to food cues
Emotional eaters tend to eat in response to negative emotions
Big-five Personality traits
Neophobia
Emotionality
Self-control
Ability to control one’s desire, emotions and behaviors
Self-efficacy
Belief in one’s ability to succeed
Eating biology
Preference for sweet and salty foods is a genetic predisposition that is shaped by experiences
Sweet comes first as a newborn (breast milk is sweet)
Salty comes with solid eating
Heritability component (twin studies and sugar)
Needs vary depending on an individual’s basal metabolic rate
Hypothalamus
Neural appetite center
GI tract, adipose tissue, stomach
Ghrelin: hunger hormone (signal that we are hungry, excitatory)
Insulin: help breaks down sugar (inhibitory)
Leptin: suppressant (inhibitory)
Physical exercise
Physical inactivity costs a lot in health care and lost productivity
Important to maintain a certain level of aerobic and resistance training
Benefits of exercise
Decreases depression and stress
Increases chances of living longer
Increases energy and self-esteem
Promotes better sleep
Improves cardiovascular, respiratory, and immune functioning
Reduces body fat, overweight, and obesity
Builds endurance and strong bones, muscles, and joints
Conditions heart and lungs
Lack of physical exercise
2 hours per day sitting around can increase the chance of having heart problems
Lifestyle choices are key
Various barriers to exercise reported
Sleep
About 7-8 hours per night
Sleep debt: potential deleterious consequences of suboptimal sleep
Circadian rhythm
Biological cycles that carry us from night to day, and day to night
Cortisol and melatonin
Sleep stages
Light transitional sleep: voluntary muscles relax
More stable sleep: body temperature drops, heart rate slows, sleep spindle occurs
Deep sleep: tissue repair occurs
REM sleep: memory is revitalized, dreams occur
Sleep hygiene
Maintain a consistent bedtime schedule Avoid screens Limit alcohol Avoid eating before bed Comfortable room temperature Exercise during the day Limit decision making Unwind
Other healthy behaviors
Reduce tobacco use Screening for breast cancer or colorectal cancer at 40-50 y.o. Preventive health practices Increase sun protection Increase seat-belt use Safe(r) sex
