test 2 Flashcards
re-explain the traditional view of health
- biopsychosocial model
- focuses on biological, psychological, and social reasons for illness
- criticized because it still focuses too much on bio
- all three elements influence one another
how can hormones influence health
they can influence immune response
explain how emotions can influence physical health
- may increase likelihood of engaging in certain unhealthy behaviors
- increase in eating and eating of unhealthy foods
what is the wellness model
builds on biopsychosocial model
- includes biological, psychological, and social
- also includes spirituality and quality of life
what is quality of life?
- life satisfaction
- money, education, ability to receive health care, and population density in your area
what is the world happiness report
- landmark survey of the state of global happiness
- ranks countries by happiness levels
- ask to rank happiness on ladder
what are the global results of the world happiness report
- no countries at highest or lowest levels of happiness
- US ranked 18th (GDP, social support, life expectancy, freedom, generosity and corruption plays role)
- Finland, Norway, Denmark, Ireland are happiest
- US happiness has declined over the years (statistically significant, declined more than researchers predicted)
what are the misperceptions people have about how happy other people are
- we underestimate self-reported happiness
- South Korea predicted 24% are happy, but 90% are actually happy
- highest guesses are Canada and Norway
can money buy happiness?
- research shows that this is true
- people in richer countries tend to be happier and within all countries richer people tend to be happier
what is the definition of the five virtues
the factors that are most strongly associated with life satisfaction
what are the five virtues
1) hope: optimism and future mindedness
2) curiosity: interest and openness to experience
3) zest: vitality, energy and enthusiasm
4) love: valuing close relationships
5) gratitude: appreciation for the good
explain the “reliability” of the satisfaction with good life scale
has good reliability when doing test-retest
what does the holistic model of health do
stresses the importance of the mind and spirituality
-important for psychological treatment
what is considered mainstream or conventional medicine or treatments
western medicine given by doctors with pHd
what does CAMs stand for
complementary and alternative medicine
what is alternative medicine
using an unconventional approach to treatment as your only form of treatment
what is complementary medicine
blending of treatments combining both mainstream and alternative approaches
what are some categories of alternative methods
- natural products
- mind-body practices
people use them for wellness or treating a health condition
explain the natural products in US
- fish oil is most common
- essential oils also common
explain essential oils
- mixture of findings right now
- effectiveness differed between oils and disorders
useful for treating: sleep disturbance, anxiety in nonclinical populations, certain bacteria and fungal infections
-this could be the placebo effect but it doesn’t matter because it still works
not useful in treating: stress, hypertension
explain some detail from the 10 most common complementary health approaches
- natural products most common
- deep breathing and mediation
- homeopathy is separate category
what are homeopathic treatments
- distinct from herbal supplements and remedies
- small doses of natural substances intended to mimic your body’s symptoms to specific illnesses (“like cures like” and “law of minimum dose”)
- regulated by FDA, but does not evaluate safety or effectiveness
treatments don’t actually work, no evidence
what are mind body practices and their trends
-focuses on physical manipulation of practices
trends:
- no change for guided imagery, acupuncture or progressive relaxation
- decrease in massage therapy
- increase in yoga and meditation
is there examples / evidence of pseudoscience?
-there have been several studies within the last few years that support spinal manipulation as an effective option for back conditions/ pain
what % of people claim that mind-body practices actually work
- 85% of yoga doers report better health and feeling better
- 65% of natural products users and of spinal manipulation users report the same
if perceived results are placebo effect, it doesn’t matter
what are the types of meditation
transcendental, mindfulness, hypnotic
what is transcendental meditation
- usually practiced 15-20 minutes a day with eyes closed and an accompanying sound
- pures tate of consciousness
- used for pain, blood pressure, PTSD
what is mindfulness meditation
-being mindful of sensations and external stimuli in a nonjudgmental way
what is hypnotic treatment
a mind and body practice designed to facilitate a hypnotic state, coolness, and control of symptoms
-used for weight loss, pain management, quitting smoking, and IBS (gut-related hypnotherapy)
does hypnosis/meditation work?
study shows it may reduce blood pressure, IBS, anxiety, depression and insomnia
are certain people more likely to use complementary forms of treatment?
- european americans more likely than african americans or hispanic americans
- women more likely than men
- well-educated and higher income more likely
- 50-70 year olds more likely to use (most common for back pain, neck pain, joint pain and arthritis; maybe this is because this is ages when people experience the most pain)
explain how the definition of stress has changed
stress: state of mental tension and worry caused by problems in your life
problem: good situations can cause stress (not just bad ones) ex. getting married or getting a job
stress: any event that provokes an internal, physical or emotional response can be viewed as stressful
can stress be good
stress in moderation could actually improve out ability to perform certain tasks
what is the inverted-U hypothesis
predicts that task performance should improve with increase emotional arousal- up to a point
- past that point may deteriorate performance
- task specific: a simple task requires high level of arousal, a medium complexity task requires a medium level of arousal, and a high complexity task requires a low level of arousal
what are the three types of stressors
acute stressors, chronic stressors, anticipatory stressors
what is an acute stressor
threatening evens with short durations and clear endpoints
what is a chronic stressor
threatening events with long durations and no apparent endpoint
what is an anticipatory stressor
upcoming or future events that are perceived to be threatening, despite the fact they have not occurred
examples of three stressors
acute: taking test, giving speech, driving in bad weather
chronic: chronic illness, sick loved one, work frustrations
anticipatory: is my boyfriend going to break up with me? (waste of time)
what should stress surveys include
1) major life events: infrequent occurrences, so how much stress can they actually cause?
2) minor life events: experience these more often, but if they are minor how much impact do they actually have?
what are the three theories of stress
talk about how the body and mind handle stress
1) fight or flight
2) General Adaptation Syndrome (GAS)
3) transactional model
what is the difference between the three theories of stress
Fight or flight and GAS: centered on the body’s physiological response to stressful stimuli
Transactional: centered on the cognitive appraisal process in response to stress
explain fight or flight
- when faced with a stressful event, certain body systems work to help you respond to that event (heart, muscles, lungs, stomach, etc)
- the endocrine system consists of glands that secrete chemicals called hormones into the blood stream
what are the two brain-body pathways in the fight or flight response
control physiological responses to stress
1) catecholamine pathway
2) corticosteroid pathway
what is the general adaptation syndrome (GAS)
- homeostasis: body maintains balanced state
- stressor occurs
1) alarm: body initially responds to a stressor with changes that lower resistance
2) resistance: if the stressor continues, the body mobilizes to withstand the stress and return to normal
3) exhaustion: ongoing, extreme stressors eventually deplete the body’s resources so we function at less than normal
return to homeostasis or not, if body cant handle the exhaustion it results in illness or death
what is the transactional model
- need to consider the individuals ability to cope with a stressful stimulus, the body only reacts if the encountered stress exceeds the individuals personal and social resources
- relies on cognition to appraise the situation
what are the three steps of appraisal in the transitional model
1) primary appraisal: initial evaluation of relevance, level of threat, and degree of stress event brings (determines if event is stressful)
2) secondary appraisal: your ability to cope (determines how stressful an event is)
3) cognitive reappraisal: re-evaluation of the event as it develops
ex. seeing something scary in room and realizing it’s just a shadow
the appraisal process is unique to the individual and based upon his/her previous exposure to stimuli, coping resources (both physical and mental) and situational factors (health, mood, etc)
what can people control in regards to stress
cannot control if you experience stressful situations, but you do have control over your appraisal of situations to some degree
when there are stressors you can anticipate, you can: prepare yourself mentally and physically and/or choose to reinterpret the situation
what are the biggest stressors in the US
1) money
2) work
3) family responsibilities
4) health concerns
what are demographic differences in stress
- women report higher levels of stress than men, but the gap is closing
- both men and women report similar stressors
- higher amounts of stress in LGBT
- Hispanic adults report most stress
- those with disabilities more likely to experience extreme stress
what are differences in stress based on SES
-it does not seem as though income used to have such of an impact, but now lower income is associated with higher stress
what are generational differences with stress
generation Z (15-21), millennials (22-39), generation X (40-53), baby boomers (54-72), traditionalists (73+)
-millennials report highest stress levels, the Gen Z, then Gen X, baby boomers lowest
what are additional stressors that younger generations experience?
- Gen Z stressors: work, money, health economy (higher stress levels in all of these compared to adults except for economy)
- social media can be used to cope with stress but is also a source of stress
explain stress and technology
- constant checkers of social media experience greater stress than non-constant checkers
- millennials have the greatest # of social media worries (think it has negative effect on health, think they’re attached to phone)
what is the differences in perception of impact of stress on health in gender
more women think stress has a strong impact on their health than men
men more likely to indicate that stress has little to no impact on their physical and mental health
does stress make you more susceptible to mental and physical health problems?
it depends
-stress and vulnerability to stress related influence can affect this
what is the Diathesis-stress (D-S) Model
- a model that attempts to explain why stress will impact the health of some and not others
- predisposition (diathesis) to the diseases
1) genetic weakness or biochemical imbalance
2) childhood abuse or maltreatment
what happens to the body in response to acute stressors
- body releases cortisol (more energy, less pain); this is good in short tun but can be harmful in long run
- can lead to memory problems, fatigue, weight gain, reduced serotonin levels, and inhibited sex drive (result of too much cortisol)
what are stress related health issues
1) coronary heart disease
- social isolation and workplace stress increase relative risk of getting it
2) gastro intestinal issues
- microbiome-brain-gut axis indicates stress can lead to gastrointestinal issues (relationship between brain and gut)
3) development of ulcers
- shown to be related to the following pre-existing mental disorders: depression, phobias, PTSD and alcohol and drug abuse
4) obesity and addiction
explain sex difference in stress illness
- males report higher prevalence in alcohol abuse and drug abuse
- psychiatric disorders that occur more often in women than men are related to stress
- sex differences in stress response systems contribute to this sex bias in disease
explain stress leading to negative emotions
- irritable/angry
- nervous/anxious
- tired
- sad
- lack of interest/motivation
explain the kindling hypothesis
major life stress provides a “kindling” experience that prompts the development of depression
-greater risk for depression specifically associated with health related stress and work related stress
depression ailment of entire body?
- has mental and physical effects (heart disease, hypertension, stroke, dementia, diabetes)
- scientists are finding that the same changes to chromosomes that happen as people age can also be found in people experiencing major stress and depression (telomere end of DNA longer =longer life)
explain chronic illness
- has the most widespread effect on the immune system
- most common stressors related to chronic illness
1) unpredictable disease outcomes
2) inability to control disease progression
3) rate of deterioration - the level of stress experience by individuals with chronic illness can vary greatly, even when we are looking at individuals suffering from the same illness
what is positive reappraisal
trying to see a situation in a more positive light
explain how americans are optimistic about the future
they are stressed about the present, but hopeful for the future
explain some coping techniques (especially in millennials)
- physical activity (running, kickboxing, yoga)
- watching TV
- surfing internet, napping, eating, drinking and smoking
explain millennials coping with stress that have money problems
millennials who say their stress about money is extreme are more likely than millennials who report low stress about money to say they engage in unhealthy behaviors to cope with stress
how do people cope with food
- eating more
- eating more unhealthy foods (usually involves certain types of foods with high fat or high cholesterol)
define catharsis
does an aggressive, physical release of energy lead to stress reduction?
-research shows that aggressive, physical activity only fuels the fire
define coping
any behavioral or cognitive action used to manage when situational demands exceed our expectations
what are the two broad categories for types of cognitive coping
1) problem focused v. emotion focused
2) engagement focused v. disengagement focused
explain problem focused v. emotion focused
problem- objective: find a workable solution, trying to solve the problem
emotion- objective: seek emotional support, not necessarily trying to solve problem, looking to deal with emotions of problem
explain engagement focused v. disengagement focused
engagement: either problem focused or emotion focused, finding solutions or dealing with emotions (engaged with the problem)
disengagement: not engaged with the problem, ignoring it, least effective method, but could work for minor stressors
explain strategies for coping in men v women
- men indicate that they do not use any coping strategies at all moreso than women (could be disengagement focused)
- men less likely than women to report that psychologists can help with making lifestyle/behavioral changes
- men more likely to report they have been diagnosed with chronic illness
why is HIV unique
- has behavior of normal viruses like the flu
- flu makes copies of its genes and proteins, HIV inserts itself into host DNA
how is HIV transmitted
sex, sharing needles, mother to baby transmission
not transmitted by water/air, saliva, tears, insects, pets or sharing food
explain HIV & AIDS
Human Immunodeficiency Virus (HIV): retrovirus that causes Acquired Immunodeficiency Syndrome (AIDs): final stage of HIV
when does the diagnosis of AIDs occur
when you have low levels of CD4 cells or if you have certain other diseases due to your weakened immune system
what are CD4 cells
send signals to activate your body’s immune response when they detect “intruders”
- CD4 count less than 350 cells/mm3= consider treatment
- CD4 count less than 200 cells/mm3= AIDs
“opportunistic” infections
suppressed immune system leaves the body vulnerable
-take advantage of a weakened immune system
- most common cause of death for people with AIDs
- HIV and 1 of the top 20 OI’s = AIDs
- HIV = distal cause of death, OI = proximal cause of death
where did HIV origniate
Africa
-hunters came in contact with chimpanzee (just a theory)
explain AIDs in US
- originated in 1981
- 1982: term AIDs used for first time
- 1985: one HIV case reported in each world region, boy with AIDs unable to attend school and he spoke publicly against this
- *learned HIV is not a disease limited to homosexual men or intravenous drug use**
explain AIDs in the beginning
- understanding of HIV/AIDs was very limited
- we needed an explanation and Gaetan Dugas (patient 0) became that
- *had a lot of sex with a lot of men, so he was a factor in how fast it spread**
- *he would still have sex with men even when he knew he was getting them sick-he didnt care**
what groups have a higher prevalence of AIDs
- sex workers and clients
- gay men
- transgender women
- those who inject drugs
what is the rate of diagnosis of AIDs
- higher in men than women
- more common in Black/ African American races (43%)
- lowest in white and Asian races (25%)
what are the trends of AIDs
-rates have decreased for all races except for Asian and American Indian
what is the most common transmission of AIDs
- male to male sexual contact
- followed by heterosexual contact and injecting drugs
explain the incidence in homosexual men of AIDs
- blacks have highest risk
- then Hispanic then white (these incidences just changed rank, Hispanic went up 30% and white went down 16%)
explain age prevalence of AIDs
- 25-34 most common (has gone up 30%)
- > 55 lowest numbers
- decrease in incidence in 13-24 year olds (-32%)
** could be because people are not getting tested**
where is AIDs most common currently
- in Africa, still has 2/3 of people with AIDs
- 15 countries account for 75% of people living with HIV
explain the unknowingness of AIDs
1 in 7 people with HIV don’t know they have it
- the disease is asymptomatic especially in early stages
- only way to know is to get tested
what are the AIDs test recommendations and requirements
- if you injected drugs
- had sex with men who have had multiple partners
- exchanged sex for money
- been diagnosed with STDs
CDC recommends screening be voluntary and opt-out, instead of opt-in
is there mandatory testing for AIDs (different levels PA, various states, and federal regulations)
-WHO supports testing for blood and organ donors
PA:
- testing for individuals 13-64 in all health care settings
- separate written consent not necessary
Various states:
-require testing for prisoners, health professionals, people applying for life and health insurance, pregnant women and newborns
Federal regulations:
- military testing (high risk group, especially during conflict)
- HIV positive people cannot join military
- test every two years and when you test positive it does not lead to automatic discharge, but leads to restrictions
what % of people actually get tested for AIDs
- around half of adults report being tested (16% in the last year)
- more whites say they have never been tested (blacks get tested more often)
why do people not get tested
- think they are not at risk or ignorance is bliss
- stigma: afraid of what people will say or think
- money reasons
what is stigma protect
intended to reduce stigma (by no longer saying HIV positive)
what are some of the insurance policies with AIDs
- there is insurance coverage for testing (medically necessary)
- initiative was taken to cover all adults for testing (US Preventative Services Task Force)
explain AIDs in Atlanta
- one half of Atlanta’s HIV patients have AIDs (didnt get tested in time / knew they had it)
- Atlanta is #5 in new HIV diagnosis
- focus HIV testing program
- 1% of HIV testing program test positive
what are the AIDs testing options
-in 1990s ELISA (enzyme linked immunosorbent assay) test (results take 2 weeks, individuals may not return to obtain results)
- *Now you can get results in a matter of minutes**
- mouth swab
- urine
- blood sample
how do at home AIDs testing work
detecting antibodies produced by body to fight HIV
-takes 2-8 weeks after infection before the disease is detectable
what are the two types of at home tests
1) traditional mouth swab
- results take a few days to a couple of weeks
- only FDA approved test
2) rapid test
- takes 20 minutes
- if positive, must confirm with FDA approved test
what are the two FDA approved at home tests
1) oral- results at home
- swab gums and place in a tube, takes 20-40 minutes
2) blood- results at lab
- anonymous:you are identified by #
- help line: toll free phone line
- timely: results available in 7 days
what happens when you are HIV positive
- all positives reported to state health department for tracking (no personal info given)
- post test counseling (info about test, info about transmission and protection, info about confidentiality, and explanation of results)
what are HIV treatment options and how have they changed
1987: AZT first approved treatment, but it is actually harmful
- now there are more than 2 dozen drugs approved by FDA to treat HIV
- usually take a cocktail, a Highly Active Antiretroviral Therapy (HAART), but drugs must be taken daily at consistent times
- the same thing doesn’t work for everyone: most effective method is using different drugs from different classes
explain the HIV treatment gap
most people who should be receiving treatment are not
-treatment can add years onto your life
how can you protect a baby from HIV
- moms take meds during pregnancy and birth
- C-section reduces risk of HIV transmission
- HIV can spread through breast milk, so give formula
these things in conjunction can reduce transmission to <1%
what is also very important for people with HIV to do outside of taking meds
-good diet, exercise, avoid alcohol and drugs, lots of rest, regular check ups, take care of mental wellbeing
some spiritual practices may help (complementary approaches may help)
explain the HIV trends of classification, deaths, prevalence, race, cause. and age
classification: increase due to expansion of HIV surveillance cases
deaths: decrease due to the success of highly active antiretroviral therapies
prevalence: maybe due to increase in testing
race: went from white to black showing highest numbers ( but all races show decrease)
cause: male to male sexual contact is leading cause
age: median age of death increased from 36 to 53 due to improved treatments
is aids a leading cause of death in US?
used to be, but has declined rapidly
tuberculosis is leading cause of death with those with HIV
-hasn’t improved, we need to offer antiretroviral therapy to people long before CD4 counts fall
explain criminalization of HIV
- laws/ prosecutions for HIV non-disclosure or transmission
- many states have laws
in PA
- assault by prisoner if they expel bodily fluid (10 years) purposefully
- prostitution: is a misdemeanor, but if HIV+ it is a felony
explain risk by type of exposure
- blood transfusion is greatest risk
- anal sex risk > vaginal sex risk
- antiretrovirals reduce risk by 96%, condoms reduce risk by 80%, both combined reduce risk by 99%
what are psychologists role in the HIV epidemic
primary prevention
-changing behavior to decrease transmission of HIV (informing about risks and sexual safety)
secondary prevention
-helping people live with infection (coping with diagnosis, tailoring interventions to situations, finding meaning, adhering to complex medical regime)
