2990 Lecture# 3: The causes of death
Psychology in health
1. Healthy beliefs
2. Changing unhealthy behaviors
3. Knowing that we are ill
4. Patient-provider communication
- 1900 – acute infectious diseases in America Eg: influenza
- develop quickly; quickly led to death
- today few ppl in America die from these diseases. Why?
- less likely to become infected, b/c…
- better personal hygiene, wash our hands better, bathe more
- better public sanitation (sewage, water)
- vaccines that inoculate us
- effective drugs to treat infections today
- so if you get infected, you can just go to the doc and be treated
Leading causes of death in North America today
- heart disease, cancer and stroke
- aka “chronic diseases, b/c they develop slowly; no effective cure; live with
them for long time.
- Most of them are preventable disease (stem from unhealthy behaviors that
can be changed)
- Quit smoking!! (implicated in all three causes)
- 25% of all deaths from cancer can be prevented if ppl quit smoking
- 30% of all deaths could be prevented if ppl stopped smoking and eat
- 50% of deaths could be prevented if they didn’t drink and drive, wore
seatbelts and didn’t speed.
- Wear condoms consistently (AIDs prevention)
- Regular exercise; limit alcohol, use sunscreen, early testing Eg: breast cancer
- Some of us might engage in some healthy behaviors, but not all
- Many deaths in these days are self-inflicted
Q: how can we encourage ppl to engage in healthy behaviors?
Health psychology offers 2 answers:
1. Encourage healthy beliefs – which will translate into healthy behaviors
2. Directly change unhealthy behaviors
Part 1: Healthy beliefs
A. Basic idea
- unhealthy behaviors stem from unhealthy beliefs - to change behavior, must change beliefs by encouraging :healthy” beliefs.
B. Health – relevant beliefs eg: to quit smoking
- what are the beliefs for the smokers to hold, so they quit smoking?
1. General health values: I am interested and concerned about having
- if they don’t have this health beliefs then it is very likely that they will not
2. Belief in a “health threat” influenced by…
- perceived severity of threat (smoking causes lung cancer, which is deadly)
- though many smokers down play the severity of smoking
- perceived vulnerability to threat (I could die from lung cancer if I smoke)
- understand that they can be PERSONALLY hurt!
- But: “unrealistic optimism” (bad things happen to other ppl, not me)
- Most smokers belief that they are less likely to get lung cancer than the other
3. Response efficacy: the health behavior quitting will reduce the threat (if
I quit now, I wont die from lung cancer)
- how does the person know this?
- But: person might say “its too late for me, I have smoked too long, I’ll get lung
cancer even it I quit, so what is the point to quit”.
4. Self efficacy: person is capable of performing the healthy behavior eg: I
can do it!
5. Outcome beliefs: weigh costs and benefits of healthy behavior (quitting)
- if benefits exceed costs, then the person will try to quit
- if costs exceed benefits, less likely to try to quit
- Important in adolescents: don’t care about long term negative outcomes of
unhealthy behaviors Eg: I might die in 40 years
- Better to emphasize immediate costs (my teeth will be yellow, my
clothes will be smelly, I will have bad breath)
- Teenagers don’t think about the long term costs
6. Subjective norms (2 elements)
- Normative beliefs: what we think other ppl want us to do. Eg:
- family and doc say “yea” (quit)
- smoking friends say “no” (don’t quit)
- teenagers get conflicting normative pressures
Motivation to comply with these other ppl (can be high or low)
Eg: if I am more motivated to comply to my friends who are telling me to
smoke than I will smoke.
- Intervention: want to add normative pressures to quit and increase
motivation to comply (my family wants me to quit… and I really want to
make them happy by quitting) - Adding more normative beliefs = increase motivation to quit.
Part 2: the cognitive-behavioral approach to changing unhealthy behaviors
and beliefs (what they are thinking)
A. Basic idea: unhealthy behaviors and beliefs are learned; so they can be
unlearned eg: reducing unhealthy snacks)
1. Systematically observe the problem behavior (self-monitoring): record
behavior and circumstances of behavior.
- goal is to identify the stimuli that control by bad behavior
a. Stimuli in the environment if so, behavior is under stimulus control; to change
the behavior must change the controlling stimuli
- you might notice that when stimuli is present that is when you carry this behavior.
Eg: TV (if so, remove link btw snacking and TV)
- Eventually the TV looses its power to make you snack during TV time
- availability of snacks that controls your snacking behavior; therefore remove
b. Consequences of behavior (behavioral control) Eg:
- snacking makes you “feel relaxed” = consequence of snaking, rewarding exp, so you
will snack in the future.
- snacks taste good!
- Must introduce new consequences:
- rewards for not snacking (new CD), therefore more likely not snack
- punishments for snacking (loose money).
- we can use this approach to change our beliefs and cognition!!
Interlude 1 : Targeting “self-efficacy” beliefs to enhance “self-control”
- eg: you have failed to change your behavior in the past and this can result ot