Psychological Influences on Health

Question 1

What are the leading causes of disease in order?

Answer 1

Behaviour, biology, environment and access.

Question 2

Define behaviour.

Answer 2

The actions or reactions of an individual to a situation - can be conscious or unconscious, voluntary or involuntary.

Question 3

What are the different behaviours?

Answer 3

Health vs illness;

Adaptive vs maladaptive;

Prevention vs detection;

Public vs private;

Service-use vs self-care

Question 4

List some daily behavioural health issues.

Answer 4

Tobacco use - smoking.

Alcohol consumption.

Poor diet and physical activity.

Question 5

What are the key behavioural risk factors for chronic diseases?

Answer 5

Smoking

Obesity/overweight

Poor diet

Lack of physical activity/sedentary behaviour

Excessive alcohol consumption

Question 6

Give an example of a poor diet.

Answer 6

High saturated fats;

Low fibre/fruit and veg (<5 portions/day);

High salt;

High red meat, low fish.

Question 7

Which factors make up the framework for determinants of health behaviour?

Answer 7

Background, stable, social and situational.

Question 8

What are stable factors?

Answer 8

Individual differences, dispositions and personality.

Question 9

How do stable factors influence appraisal?

Answer 9

Determine if and to what extent an event is salient - sensitivity towards particular types of event;

Provide generalised framework for understanding and evaluating the event (threat or challenge);

Make available or suggest potential response - initiate response options.

Question 10

What are the 3 broad types of individual differences?

Answer 10

Emotional dispositions (experience and expression); generalised expectancies (formulating expectations in relation to future outcomes); explanatory styles (causes of negative events)

Question 11

Describe the emotional dispositions.

Answer 11

Negative affect:
Tendency towards the experience of negative affective states e.g. hostility, depression, anxiety, etc.
Risk factor for development of physical disease.

Emotional expression:
The (low) expression of (negative) emotional experience, both unconscious repression and conscious suppression.
Risk factor for recovery post MI and cancer progression.

Question 12

Explain generalised expectancies.

Answer 12

Locus of control:
Expectations that future outcomes will be determined by factors that are either internal (more favourable outcomes) or external.

Self-efficacy:
Belief if one’s own ability to organise and execute a course of action and the expectation that the action will result in or lead to a desired outcome.

Question 13

What is self-efficacy? And what does it underpin?

Answer 13

Belief in the ability to change.

Underpins:
Goal setting, effort investment, persistence in face of barriers and recovery from setbacks.

Question 14

How is self-efficacy measured?

Answer 14

The general self-efficacy scale by Schwarzer and Jerusalem 1995.

Consists of 10 different factors of self-efficacy
e.g. “I can usually handle whatever comes my way”
These 10 things are scored 1-4
1 = not at all true
2 = hardly true
3 = moderately true
4 = exactly true

Question 15

Describe the explanatory styles

Answer 15

Optimism:
Expectation of positive future outcomes despite current negative events. Associated with better physical health, illness recovery, etc.

Attributional style:
Causal explanations of negative events as internal (self), stable (time), and global (situation).
Better - external, unstable and specific attributions.

Question 16

What are the NICE interventions and programmes aimed at populations?

Answer 16

• Fiscal (taxes) and legislative interventions
• National and local advertising and mass media campaigns
• Campaigns, promotion of positive role models and general promotion of health enhancing behaviours
• Point of sale promotions and interventions (partnership vs private)
• Sector organisations to offer information (price reductions, etc.)

Question 17

What are the NICE interventions and programmes aimed at communities used for?

Answer 17

These are used to identify and build on the strengths of individuals and communities and the relationships within communities

Question 18

Give examples of interventions aimed at communities.

Answer 18

• Support organisations and institutions that offer opportunities for local people to take part in
• Planning and delivery of services
• Support organisations and institutions that promote
  participation in leisure and voluntary activities
• Promote resilience and build skills, by promoting positive social networks and helping got develop relationships

Question 19

What are the NICE interventions and programmes aimed at individuals?

Answer 19

• Feel positive about benefits of health-enhancing behaviours and changing their behaviour
• Plan their changes in terms of easy steps over time
• Recognise how their social contexts and relationships may affect their behaviour
• Plan explicit ‘if-then’ coping strategies to prevent relapse

Question 20

Who is responsible for using these interventions aimed at individuals?

Answer 20

Commissioners, service providers and practitioners working with individuals should select interventions that motivate and support people.

Question 21

What are SMART goals?

Answer 21

S - specific
M - measurable 
A - achievable 
R - realistic 
T - timely

Question 22

What are the determinants of health behaviours and beliefs?

Answer 22

Background factors - cultural normals, gender, ethnicity, chronic health status.

Stable factors - emotional disposition, generalised expectancies, explanatory styles.

Social factors - perceived support, subjective norm, helping relationships.

Situational factors - situation-specific self-efficacy, perceived risk, emotional response, intention (motivation), outcome evaluation.

Question 23

What are social cognition theories?

Answer 23

They attempt to explain the relationship between social cognitions (such as beliefs, attitudes, goals, etc.) and behaviour.

Question 24

Give examples of social cognition theories.

Answer 24

Health Belief Model
Theory of Planned Behaviour
Transtheoretical Model

Theory of reasoned action
Protection motivation theory