Midterm Flashcards
What is the premise of the biomedical model?
Malfunctioning of the body As a site of illness Biological explanations A need to fix the body Separation of mind spirit, emotion and the body
What are the four assumptions of the biomedical model?
Biological reductionism
Mind body dualism
Body is a machine
Doctrine of specific ethology
Describe biological reductionism
Aims to explain all social and cultural phenomena in biological terms
Creates profound misunderstanding when unwisely applied
Describe body mind dualism
A view that the mind and the body are essentially separate entities
Born out of need to escape religious restrictions in studying human anatomy
No space for psychological and spiritual aspects of human experience
Describe doctrine of specific etiology
A single agent causes a single type of disease and a specific therapy can be used to treat that disease
Ignore the concept of illness as well as the possibility that psychological, social, and even political factors can impact health
Describe the biopsychosocial model
Provides a more holistic approach to health
Considers social factors
Interactions between peoples genetic composition, mental health, personality, and sociocultural environment contribute to their experience of health and illness
What are the issues with the biopsychosocial model?
Issues with degree of influence each factor has
Issues with degree of interaction between factors
Unknown variation across individuals and life course
Describe social cures
Health care system focuses on symptoms, sickness, illness, and treatment mostly with pharmacological implications
Define stress
Arises when an individual percieve that they cannot adequately cope with the demands being made in them or with threats to their well being
Can have good stress of bad stess
Define stressor
A stimulus or event that is appraised or perceived as being aversive and causes a stress response that compromises a series of behavioural, emotional, and biological changes aimed at maintaining an organisms well being
What are the different types of stressors?
Environmental: heat, noise, crowding
Physiological: drugs, caffeine, tobacco, exertion
Psychosocial: pressures, life events, life in general
What are some characteristics of stressful events?
Negative: harder to accept than positive
Uncontrollable: take control of what you can
Ambiguous: accompanies poorly defined expectations
What is psychological stress?
Degree to which people have to change and readjust their lives in response to an external event
What is physiological stress?
Stress on the body caused by physical or psychological stressors
Define allostasis
Body’s ability to adapt to constantly changing environments to maintain homeostasis
A tight allosteric system is one that moves from high to low levels of arousal flexibly and fluidly depending on demands
What is allostatic load?
A chronically elevated state of arousal which damages the body and makes it less able to flexibly adapt to environment
Result of chronic stressor
Give an overview of the stress process
- Potentially stressful objective events (ex. Exam)
- Subjective cognitive appraisal (personalized perception of threat)
3a. Emotional response
3b. Physiological response
3c. Behavioural response
What are some emotional responses to stress?
Annoyance, anger, rage
Apprehension, anxiety, fear
Dejection, sadness, grief
Positive emotions
What are some physiological responses to stress?
Cannons fight or flight response
Selyes general adaptation syndrome
What are some behavioural responses to stress?
Appraisals: controllable, threat, challenge, central to well being
Coping: problem-focused, emotion-focused (engagement), emotion-focused (avoidant)
What are some problem focused coping strategies?
Taking direct action Planning Suppression of competing activities Cognitive restructuring Seeking social support
What are some emotion focused coping strategies?
Rumination Behavioural disengagement Mental disengagement Denial Turning to religion Seeking social support
What are some behavioural and psychological effects of stress?
Impaired task performance
Burnout
Psychosocial problems and disorders
Positive effects
What are some physical effects of stress?
Heart disease in type A behaviour
Stress and immune functioning: reduced immune activity
What are some factors moderating the impact of stress?
Social support: increased immune functioning
Optimism: more adaptive coping, pessimistic explanatory style
Conscientiousness: fostering better health habits
Autonomic reactivity: cardiovascular reactivity to stress
Describe the effect of stress on performance
Can inhibit or improve your performance
Challenge = improve
Threat = inhibit
Describe the inverted U-hypothesis
As anxiety increases so does performance to a certain point then performance decreases with anxiety
When do we receive something as a challenge or a threat?
Challenge: personal resource > situational demands
Threat: personal resources < situational demands
Describe the effect of stress on memory
In response to extreme stressors, body releases hormone cortisol
Cortisol reduces memory and linguistic functioning
How does stress effect the immunity?
Psychological stress decreases immune function making you more susceptible to disease
How is long term health and stress related?
Chronic stress predicts hypertension, type II diabetes, weakened immune system
What is percieved control?
The belief that we can influence our environment in ways that determine whether we experience positive or negative outcomes
Define self efficacy
The belief that you can competently complete the actions necessary to deal with a demanding situation
Describe learned helplessness and the perceived negative events associated with it
The acquired sense that one can no longer control the environment, with the result that one gives up trying
Stable: caused by factors that don’t change over time
Internal: caused by you
Global: causes of one negative event apply to other events
What are the two aspects of positive stress?
Acute stressors
Complete relaxation in between stressors
Why are intermittent stressors better?
More efficient coping with subsequent stressors
Healthier immune system
Longer cell life
Responding positively to past stressors leads to perception of benefiting from stressors
Viewing stressors as a challenge improves responses to subsequent stressors
Describe what occurred is roseto
Town with unusually low rate of heart attacks
Italian immigrants maintain they social norms but were actually worse that many communities around them
When men in the area lost their jobs due to closure of quarry, social ties were lost and the number of heart attacks increased
Termed the roseto effect
Describe social support
Characteristics of social interaction that are potentially helpful to the individual, such as emotional, instrumental, and informational support
What are the three types of social support?
Emotional support: empathy and caring
Instrumental support: tangible support, childcare, housekeeping, transportation, money
Informational support: guidance
What are some probably health-relèvent effects of social support?
Lowering stress Raising self esteem Improving cognitive development Encouraging better health behaviours Decreasing anxiety
What are social networks?
The qualitative nature of social interaction
An individuals number of contacts and frequency of interaction with them
Contacts can be mapped by showing the relationship among the members of groups, deriving measures of extent and frequency of contact
What affects social networks?
Number of contacts
Frequency of contacts
Density of network
What is the six degrees of separation theory?
Everyone and everything is six or fewer steps away, by way of introduction, from any other person in the world so that a chain of a friend of a friend statements can be made to connect any two people in a maximum of six steps
What are connectors?
People with extraordinary social networks
What is social capital?
Collective benefits arising from cooperative attitudes and practices, grounded in trust and reciprocity
Define bonding and bridging
Bonding: resources potentially available in strong ties
(Strong ties = Homogenous and close knit groups)
Bridging: resources potentially available in weak ties
(Weak ties = usually acquaintances, more diverse and heterogeneous)
How is social capital theorized to be a key determinant of population health?
Higher levels of social capital is associated with great equality and social engagement
What is social cohesion and what is it measured through?
The extent to which bonds form among members of a group or between groups Measured through: - participation in community affairs - number of community organizations - level of interpersonal trust - crime statistics
Define social identity
The individuals self concept derived from percieved membership of social groups
What is multiple identities?
A person has not one personal self but rather several selves that corresponds to widening circles of group membership
What does social identity include?
Ingroup affect (positive or negative) Ingroup centrality (importance) Ingroup ties (a sense of belonging)
What are the 3 fundamental psychological mechanisms underlying SIT?
Social categorization
Social comparison
Positive distinctiveness
Describe social categorization
The cognitive process where objects, events and people are classified into categories
Tend to exaggerate similarities of our group and differences of others
Describe social comparison
We tend to compare our own social groups to other groups
Distance ourselves from groups that do not share the same beliefs and ideas
Describe positive distinction
The motivation to show that our ingroup is preferable to an outgroup
Often done by:
- ethnocentrism (the ingroup serving bias)
- ingroup favouritism
- stereotypical thinking
- conformity to ingroup norms
What can social identity be used for?
Determinant of symptom appraisals and responses
Determinant of health-related norms and behaviour
Basis for social support
Coping resources
Determinant of clinical outcomes
What is social exclusion?
A process of excluding members of a group from normal interaction and sharing of benefits
An expression of unequal relations of power among groups in society, which then determine unequal access to economic, social, political, and cultural resources
Define descrimination
The unjust or prejudicial treatment of individuals or groups of people based on their actual or percieved membership in a certain group or social category
What is the social cure?
Social identities constitute a social cure
Capable of promoting adjustment, coping, health and wellbeing for individuals dealing with a range of illnesses, injuries, trauma, and stressors
Define race
A socially meaningful category of people who share biologically transmitted traits that are obvious and considered important
Ex. Caucasian, Latino
Define ethnicity
Shared cultural heritage
Ex. Swedish, Jewish
Define culture
Language, norms, values, beliefs, and more, that togeter form a persons way of life
Central to the way we view, experience, and engage with all aspects of our lives and the world around us
What is a social majority?
The social group considered to have the most power and something the most group members
Describe social minority
Any category of people distinguished either by a physical or cultural difference that society has subordinate
What are health inequities/disparities?
Disproportionate burden of disease or presence or absence of well-being between different social groups
What is stigma?
Negative, disrespectful, and untrue judgements
Stigmatized attitudes, stereotyping, beliefs and labelling
Occurs across multiple identities and statuses
Define racism and discrimination
Negative and disrespectful actions
Beliefs, attitudes, institutional arrangements, and acts that tend to denigrate individuals/groups because of phenotypic characteristics (racism) or ethnic group affiliation (discrimination)
What is interpersonal racism?
Blatant personally-mediated racism
Micro-aggressions: more common in society today and most people are unaware they are doing it
What is systemic and institutionnalized discrimination?
Patterns of behaviour, policies, or practices that are part of the structure of an organization that disadvantage less empowered groups while serving the advantages group
What is internalized racism/discrimination?
When those who are stigmatized accept these messages about their own abilities and lack of worth
How is discrimination a stressor?
May function like other psychosocial stressors
It’s negative effects may be dependent upon appraisals regarding discriminatory events and the availability of coping resources to deal with them
What are some pathways to health inequities related to racism?
Inequitable access to education and other social resources Unequal economic opportunities Internalized racism Psychosocial stressors Health service use Exposure to unhealthy environments Engagement in risky health behaviour
What is white privilege?
Power, advantage, benefits (material, social, psychological)
Whiteness as a culturally normative space (invisibility, a racial category, normativity of whiteness)
How is religiosity as an identity helpful?
Group membership central to self concept
Personal and/or collective self esteem
Common bind = belongingness
Shared belief system
How is social identity of religion beneficial? Harmful?
Beneficial: religious ID may be unique, social belonging and unfalsifiable belief system
Harmful: religious ID threat = percieved eternal consequences
What is intrinsic and extrinsic religiosity?
Intrinsic: looking to religion for spiritual development, guidance, and meaning (ex prayer)
Extrinsic: drawing in religion primarily for social benefits (ex worship attendance)
Why is religious discrimination a two fold threat?
Salient social identity
System of sacred beliefs
What was found about atheism?
Conincides with an irreligious belief system through which to understand the world
Have worse psychological health, social support relationships, and health behaviours
What are the three types of newcomers?
Immigrants: choose to settle in new country
Refugee: forced to flee their countries because of well-founded fear of persecution and unable to return home
Asylum seekers: seeking refugee protection from within Canada
What are the myths about newcomers?
Immigrants steal jobs from Canadians
Newcomers are unskilled and uneducated
Canadas immigration system is very generous, there are too many newcomers here
Newcomers are a drain on society and tend to live on social assistance
Newcomers do not know how to speak English and do not want to learn p
Why is the statement immigrants steal jobs from Canadians a myth?
Canada needs skilled workers in certain industries
Despite better education unemployment rate double that or non-immigrants
Many end up in entry level jobs
Why is the statement newcomers are unskilled and uneducated a myth?
Recent immigrants often come to Canada with more education than many Canadian born citizens
More likely to be overqualified for their jobs and stay overqualified in their positions (often due to discrimination)
Why is the statement canadas immigration system is very generous; there are too many newcomers here a myth?
Canadas population is increasing but there is actually a decrease in annual growth - migratory increase is the main driver of population growth at the national level
If Canada closed its doors over the next two decades the labour force would be reduced to less that 18 million by 2031
Canada takes in less refugees than Pakistan, South Africa, and USA
Why is the statement newcomers are a drain on society and tend to live on social assistance a myth?
Recent immigrants living in poverty depend less on social assistance and family support than other impoverished Canadians
Immigrants are required to pay the same taxes and declare all income
Why is the statement newcomers do not know how to speak English and do not want to learn a myth?
92% of immigrants arriving between 2001-06 knew English or French
58% of those who did not know English could speak well after being here for 6 months
What are the three main migratory experiences impacting health and mental health of immigrants?
Pre migration
Settlement
Post migration
What is pre migration health?
Variation among different immigrant groups
History of stress and trauma, survivors of torture, war torn countries
What is settlement health?
Acculturation stress, language discrimination, un/underemployment, accession health care, legal and policy barriers
Additional stressors: arrive on short notice, housing barriers, barriers to education, financial, lost material possessions, separated from family, great physical, mental and cognitive health problems
What is post migration health?
Work to overcome systemic barriers and to participate in Canadian society as equals to the Canadian born population
What are some social determinants affecting immigrant and refugee health?
Culture shock Previous shock/trauma Language barriers Marginalization/social exclusion/discrimination Poverty and low income Unemployment Lack of social support networks Uncertainty
What is the healthy immigrant effect?
An observed time path in which the health of immigrants just after migration is substantially better than that of comparable native-born people but worsens with additional years in the new country
What causes the healthy immigrant effect?
Upone arrival are more health:
- self selection, screening process, age confounding factor, chosen based on social attributes, cultural values emphasize healthier lifestyles
Health advantage erodes over time:
- adoption of North American lifestyle
- stress: poverty, discrimination, acculturation
Compare multiculturalism and assimilation
Multiculturalism: cultural mosaic
Assimilation: melting pot
How can culture effect illness and adaptation?
Interpretations of and reaction of symptoms
Explanations of illness
Patterns of coping, of seeking help and response
Adherence to treatment
Styles of emotional expression and communication
Relationship between patients, their families, and health care providers
What are some cross-cultural assessment considerations?
Cognitive practice differences
Place of origin can effect exposure, childhood immunization, and previous health care
Patients with limited language skills may be encouraged to use medical interpreter
May consult traditional forms of healing
Tendency to focus on patient in primary care must be supplemented by close attention to the family system and social network
Referral to community resources can be helpful
Define gender
Society-determined roles, personality traits, attitudes, behaviours, values, relative power and influence that society ascribes to the two sexed on a differential basis
What are men more likely to suffer from?
Homelessness Substance abuse Suicide Imprisonment Earlier mortality, despite social and economic advantages
Describe LGBT health
Lesbian women are less likely to report being in good health compared to straight counterparts
Bisexual adults more likely to experience psychological distress compared to straight counterparts
Adults who identify as gay, lesbian, or bisexual are more likely to be heavy drinkers
What sociocultural factors prevent women and girls from attaining quality health services and the best possible level of health?
Unequal power relationships between men and women
Social norms that decrease education and paid employment opportunity
An exclusive focus on women’s reproductive roles
Potential or actual experience of physical, sexual, and emotional violence
Define maternal health
The health of women during pregnancy, child birth, and postpartum period
Define maternal death
Death of a women while pregnant or within 42 days of termination of pregnancy from any cause related to or aggravated by the pregnancy and its management
What are the major complications that account for 80% of all maternal deaths?
Severe bleeding Infections High blood pressure during pregnancy Obstructed labour Unsafe abortion
What is the leading killer of women? Why is this unnoticed?
Cardiovascular disease
Women often show different symptoms and are underdiagnosed
Tend to develop later in life
How does violence affect women’s health?
Women who have been physically or sexually abused have higher rates of mental I’ll-health, unintended pregnancies, abortions and miscarriages
What are women more likely to suffer from?
Depression
Stress overload
Chronic conditions such as arthritis and allergies
Injuries and death resulting from family violence
What is the imposter syndrome?
Women who feel like phobies despite high levels of intelligence and success
What is the glass ceiling?
An unofficial acknowledged barrier to professional advancement, especially among women and minority group members
What is the glass cliff?
Women are more likely to be found in leadership positions that are associated with a greater risk of failure and criticism
Why is multitasking a problem?
Brain can’t handle it and will process it the same way as a result threat
Why is talk therapy not useful?
Can be great in some people but not in other who just relive their trauma over and over again
Only tried to fix brain which doesn’t fix the bodily trauma and make people unaware of what is going on in their body or aware of their stress response
Why is meditation useful?
Can reduce chronic pain
Just as effective for depression/anxiety and medication
Ideal for trauma, concussions, and other brain trauma
What is mindfulness?
Paying attention, on purpose, in the present, and non-judgementally to the unfolding of experience moment by moment
People with a terminal illness and positive outlook survive better than those who believe they are going to die
