Chapter 14 Health Psychology. Health Behaviors The major health problems in industrialized nations today are “preventable” diseases that are influenced.

Chapter 14

Health Psychology

Health Behaviors The major health problems in

industrialized nations today are “preventable” diseases that are influenced by lifestyle choices people make.

Health Behaviors Health behaviors are actions

undertaken by healthy people to enhance or maintain their good health.

Eating healthy foods, exercising, avoiding substance abuse, getting enough sleep, controlling weight, using sunscreen, practicing safe sex, getting health screening tests

Health Behaviors The more health behaviors people

practice, the fewer illness and the more energy they have.

College students are some of the worst offenders because the disease consequences seem so remote.

Health Behaviors Five sets of attitudes affect health

behaviors: General Health Values Perceptions of threat posed by diseases Belief in personal vulnerability to disease Self-Efficacy

Belief one can perform a health behavior Response Efficacy

Belief that the health behavior will reduce the threat of disease

For a health behavior to occur, all of these beliefs must fall into place

Health Behaviors Some factors undermine even the

best intentions to practice health behaviors Strong situational influences (e.g., peer

pressure to drink or smoke) Negative mood Alcohol Immediate costs & rewards of behavior

Health Behaviors The health attitude-health behavior

model suggests that people are using systematic processing to make health decisions. This is true when a health issue is

perceived as self-relevant, but when the issue is not seen as self-relevant, heuristic processing is used.

Health Behaviors For people who live at low income

levels, the cost of preventative health care and limitations on access to health care are much more important determinants of health behavior than are attitudes.

Stress and Illness Stress is a negative emotional

experience accompanied by predictable physiological, biochemical, and behavioral changes

Stress and Illness Stress is, to some degree, in the

eye of the beholder.

Money & Time

Social Support

Other life stressors

EXTERNAL RESOURCES OR IMPEDIMENTS

Stressful event

Appraisal of stressor

Coping responses

Coping Outcomes

Usual Coping Style

Other personality factors

INTERNAL RESOURCES OR IMPEDIEMENTS

Stress and Illness Some events are more likely than

others to be appraised as stressful Events that require a person to

change or expend resources Unpleasant or negative events, Uncontrollable or unpredictable

events Ambiguous events Unresolvable events

Stress and Illness In the short term, acute stress

produces emotional distress and physiological strain

In the long term, chronic stress may lay the groundwork for future illness

Stress and Illness Major stressful life events have been

associated with the onset of illness Life events that require one to make

more changes (getting divorced or getting married) are more stressful than those that produce few life changes

The more life events, and the greater their impact, the greater a person’s vulnerability to illness

Stress and Illness Daily Hassles such as getting stuck

in traffic jams or having interpersonal conflicts may have a cumulative negative effect on health.

Stress and Illness Chronic Stressors such as living in

noisy, crowded, crime-filled environments may, over time, have a cumulative negative effect on health.

Coping With Stress Coping is the process of

attempting to manage demands that are viewed as taxing or exceeding our resources (Lazarus & Folkman, 1984)

Coping With Stress Coping is a dynamic process Coping begins with the appraisals

we make of the situations we cope with.

These appraisals influence how people will try to cope.

Coping With Stress Indicators of Successful Coping

Reduced physiological arousal Quick return to previous life activities Reduced psychological distress

Successful coping depends on both internal and external resources Internal resources include coping

styles and personality attributes External resources include money,

time, social support

Coping With Stress Coping Styles

Minimizing or avoiding threats May be effective in the short-term but

may exacerbate long-term stress May be associated with increased

physiological activation & poor health Confronting threats

May deal more effectively with threats in the long-term, but at a short-term cost of greater anxiety

Generally more effective

Coping With Stress Cynical Hostility (characterized by

suspiciousness, resentment, anger, antagonism, and distrust of others) is a risk factor for the development of coronary heart disease.

Coping With Stress Several personality resources may

help people improve adjustment to stressful events Dispositional optimism Hardiness

Commitment, Control, Challenge Conscientiousness Writing or talking about traumatic

events Religion

Coping With Stress Social Support may mute the

effects of stress and enhance health.

Coping With Stress Sources of Social Support

Spouse or Partner Family Members Friends Social & Community Contacts Churches & Synagogues Co-workers or job supervisors

Coping With Stress Ways Social Support Helps

Emotional: liking, love, empathy Instrumental Aid: provision of goods

or services during stressful times Information about the stressor Information that aids self-evaluation

Coping With Stress Effects of Social Support

Lowers likelihood of illness Speeds recovery from illness Encourages good health practices Improves immune function Reduces physiological response to

stress

Coping With Stress Social Support Caveats:

Support only helps when it is supportive. Conflictual relationships can hurt, not help.

Social support may be most effective when it is “invisible.” If it is apparent that others are going out of their way, there are emotional costs.

Coping With Stress Stress Management Programs

Discuss role of appraisal Behavior observation & recording Examine controlling conditions Recognize negative self-talk Set goals and target behaviors Engage in positive self-talk Learn how to reduce physiological

response Meditation, muscle relaxation, guided imagery

Symptoms, Illness, & Treatment

Deciding that one is ill is both a social and a psychological process.

Symptoms, Illness, & Treatment

Labeling symptoms as illness depends on Noticing symptoms

Self-focused, isolated, inactive, boring situation more likely to notice

Expectations that guide the interpretation of information

Vary by individual and cultural beliefs Mood and Life Satisfaction Prior Experience

Symptoms, Illness, & Treatment Patients form illness schemas to

understand their symptoms and how to manage them Illness can be viewed as acute, chronic, or

cyclic Sometimes people adopt inappropriate

models E.g., high blood pressure is chronic but there are

few obvious symptoms, so patients may view it as cyclic; this leads them to abandon medication that they need

Symptoms, Illness, & Treatment

Faulty communication can cause problems between doctors and patients

Symptoms, Illness, & Treatment

Doctors may: Patients may:Use jargon Fail to pay attentionDepersonalize Read too much into a dr.’s comments

Symptoms, Illness, & Treatment

Patients often fail to follow doctor’s advice. Why? Dissatisfaction with care Lack of understanding Non-“Medical”-seeming treatments Long time course of treatment Difficulty of changing habits

Symptoms, Illness, & Treatment

Training doctors to communicate more effectively could help Provide jargon-free information Ask patient to repeat the information

to ensure understanding Use nonverbal signals of friendliness Rely on “legitimate power” and

“referent power”

Symptoms, Illness, & Treatment

Providing patients with a sense of psychological control during medical procedures helps adjustment and leads to improved recovery time Tell them about steps they can take

to control the unpleasantness of the procedure or to control their own reactions

Chronic Illness

Most of us will eventually develop at least one chronic disease that may alter our daily lives for years Self-blame may be maladaptive for

some disorders but not others Blaming other people is associated with

poor adjustment Feeling psychological control is adaptive

Chronic Illness Chronic disease can produce both

negative and positive outcomes

Negative Positive

Physical Changes

Increased self-confidence

Loss of Income Feeling strong

Relationship Changes

Increased Compassion