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Health Psych Midterm 1 Notes.pdf

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Jennifer Heisz

Health Psychology 2G03 Can cold pain tolerance levels be manipulated by self deception?▯ - half were told: increase in cold tolerance is healthy▯ - half were told: decrease in cold tolerance is healthy▯ Results: People select actions that are diagnostic of favorable outcomes▯ ▯ Placebo Effect: beliefs about the treatment have a huge effect on if the treatment will work▯ ▯ Challenged with diagnosing Disease▯ ▯ How do the body and mind communicate?▯ - patient experiences dramatic mood swings, anxiety, hallucinations, racing heart, nausea, joint pain▯ - mental symptoms could be something wrong with her body if she doesn’t respond to anti- depressants▯ - a rare genetic disorder affects her mental function as well as her body function▯ ❖ she suffered for 10 years because the psychiatrists weren’t asking the right questions▯ ▯ diseases of the mind and body are treated separately ▯ - causes a problem in our approach to medicine, because the mind and body do work together▯ ▯ mind-body communication▯ - nervous▯ - endocrine▯ - immune system▯ ▯ Acute Infection Induces a negative Mood▯ - 30 healthy males were injected with placebo or with vaccine▯ - they were testing for mood▯ - those injected with vaccine see a large increase in negative mood▯ ❖ getting injected with a pathogen affects their psychological well being▯ How does the infection alter mood?▯ - receptor cells in cytoplasm detect pathogens ▯ - cytokine receptors come in contact with pathogens and release cytokine - calls out all other immune cells to site of infection to fight▯ - first response is to cause inflammation at site of infection - caused by cytokines, basic innate immune response▯ - MOOD: cytokines activate the brain, they need to shut off inflammation response (neg feedback loop), some cytokines can get into the brain causing symptoms such as fever, lack of appetite, social withdrawal▯ - social withdrawal: cytokines bind with amygdylla and it changes its response - same thing that happens with people with social phobia▯ - the same chemical messengers that protect your body can affect your psychological well being▯ - temporary withdrawal when sick could be said to be adaptive.▯ ▯ Some scientists say chronic inflammation may be the cause of some depression in people with major depressive disorder▯ ❖ maybe people have a heightened immune response rather than lack of serotonin▯ - people who have chronic physical illness report being depressed▯ - when injected with cytokines, many people reported getting depression▯ Health Psychology 2G03 depressed individuals have elevated cytokine levels▯ ▯ how effective are antidepressants?▯ - SRI - frees up amount of serotonin in synapse▯ - most people don’t respond because it doesn’t target origin of depression▯ ▯ Iclicker: ▯ ▯ 1. which of the following is triggered by a heightened amigdala response?▯ a. fever▯ b. inflammation▯ c. social withdrawal▯ ▯ ARE YOU HEALTHY?▯ - most people in north america are unhealthy▯ - BMI (weight/height ) — overall mass▯ ❖ gives generally good idea of health▯ - obesity has become an epidemic▯ - there are more overweight people than underweight in the whole world — driven by the developed world▯ - foods are engineered to be irresistible▯ - a growing sedentary lifestyle leads to less energy expenditure▯ decreased physical activity —> increased consumption of energy dense food▯ ▯ How can we treat the obesity epidemic??▯ - most obese people re-gain the weight lost during successful dieting▯ ▯ Gastric bypass surgery▯ - surgery may lead to weight lost yet not address the root problem in obesity▯ ▯ Obesity is complex - involves the body and the mind▯ Miracle pill?▯ - alli - first drug approved by the FDA - safe for consumption▯ ❖ supposedly allows for maintained weight loss in obese people▯ ❖ reduces the absorption of fat, is excreted instead▯ - treatments of biological basis to reduce calories/maintain weight loss, are ono a quick temporary fix with serious side effects.▯ ▯ obese people are addicted to food▯ - our brains are wired to respond positively to high caloric fatty foods▯ - brain reward (dopamine) binds to dopamine receptors on cells of the brain reward circuit, dopamine transporters re-uptake the dopamine back into the cell - the sensation is temporary… why we can’t just eat one chip▯ - all drugs of abuse release dopamine - cocaine blocks dopamine transporters, so dopamine can be sustained▯ - with chronic drug abuse the brain adapts by getting rid of the number of receptors to cause equilibrium - drug addicts need more drug to get high▯ ❖ people who are obese have fewer dopamine receptors than drug addicts▯ Health Psychology 2G03 1. medical treatment for obesity that targets physical symptoms▯ 2. medical treatment for obesity that target the processes of the mind.▯ ▯ ______________________________________________▯ ▯ How do we determine if something is a health risk?▯ - is someone more likely to be Type A personality as a kinesiologist??▯ Personality▯ ❖ a type A personality is a hypothetical construct▯ ❖ does not have a biological basis - allows simply for characterization▯ ❖ personality is difficult to study, so psychologists have developed tools such as surveys Myers Briggs - characterizes people based on pairs of preferences▯ ❖ E - extroversion or I - introversion▯ ❖ creative - N (intuition) or pragmatic etc…▯ ▯ — Can our personality affect our Biology?▯ ❖ can it put us at risk for CHD?▯ STUDY▯ Type A: competitive, senior partners, male, 83 (69 actually had Type A)▯ Type B: not competitive, happy, mostly accountants, men, 83 (58)▯ Type C: not competitive, unhappy, unemployed blind men, 46▯ — they performed an ECG, analysed abnormalities to determine heart disease▯ — collected lifestyle factors: smoking, alcohol etc…▯ — genetic risks ▯ Results: Type A had a higher disease prevalence than Type B or Cs▯ ❖ Type A also smoked more, consumed more alcohol▯ ▯ Recently There has been a spike in the prevalence of autism in the last 35 years▯ Why?▯ - the vaccine for MMR that supposedly caused autism.. so it was wiped out▯ - then they found that the evidence linking MMR vaccine to autism was weak - self reported paren❖ simply asked about an event that occurred 4 years ago…▯ ❖ in 8 children the onset of behavioural problems and been linked by the parents or by the child’s physician, the parent’s memory was unclear about other events so how could we say that they could accurately depict behavioural problems?▯ - data was retracted - wakefield (author) was being funded by anti vaccine lobbyists - he had financial gain from biased results…▯ ▯ - a later study found no evidence between MMR vaccine and autism▯ ▯ ____________________________________________________________________▯ ▯ Health Psychologists must distinguish between causal and correlational findings▯ - sometimes we make associations that are not causally related to each other▯ ▯ Heart Disease and Type D Personality▯ Health Psychology 2G03 - researchers created a new personality type for Type A that were also socially withdrawn and negative affect.▯ ❖ BUT, remember that this withdrawal may be due to the immune response▯ ❖ people with Type D personality have heightened cytokine levels, suggesting a heightened immune response▯ ❖ the question is… do we really need a Type D personality?▯ Principle of Parsimony: the simplest explanation is usually the correct one.▯ Keep It Simple Stupid▯ - we could make up a hypothetical construct, but sometimes its easier to choose what makes sense▯ ▯ Evaluating Health Risks▯ 1. not all research findings are created equally▯ 2. we need well designed and controlled studies to evaluate health risks.▯ 3. understanding complex issues in health is often benefitted with parsimony▯ 4. the public deserves evidence-based information to make decisions on health practice.▯ ▯ Are we More likely to get sick before, after, or during exams?▯ ▯ Necessary components of any research study:▯ Who (subjects) , How (method) , Input (IV), output (DV)▯ 1. A research question (what)▯ 2. Subjects (who? how many?)▯ 3. Method (how?)▯ ❖ IV and DV▯ 4. Hypotheses▯ ❖ alternative hypothesis (what you expect)▯ ❖ null hypothesis (opposite to what you expect)▯ ▯ - humans are experts at detecting patterns in the natural world▯ ▯ Why would couples who adopt find it easier to conceive??▯ - what is the outcome for couples who adopt?▯ ❖ there’s actually no data to support this idea▯ ❖ people who adopted actually had a worse rate of conception▯ - we can be blinded by the availability heuristic▯ which is more common?▯ ❖ words that start with k▯ ❖ words that have k as the third letter▯ - its easier to think of words that begin with k, however words with k as the third letter are twice as common - it’s more salient in our mind to think of the k at the start, sometimes we can confuse this with accurate results▯ ❖ things that come to mind easily, we perceive as common▯ ▯ The Shooting Streak in Basketball - The “hot hand”▯ - the misperception of random sequences… people think the shot is dependant on whether you just made your last shot▯ Is the probability of getting a hit dependant on recent histories of hits or misses??▯ ❖ Hypothesis: if there is a positive correlation between successive shots.▯ Health Psychology 2G03 evidence shows the opposite▯ - you are more likely to get a basket after you have MISSED▯ - this suggests that the hot hand is just a myth▯ ▯ Confirmation Biases: “what we see depends mainly on what we look for”▯ ❖ ie for the basketball example we are looking for the hot hand▯ ❖ we discard the data that does not support our hypothesis▯ ❖ we see the world in a way that confirms what we already think▯ ❖ EX: a researcher reports data that are predicted by a testable hypothesis from his model which competes with an established model▯ ** this is different from the availability heuristic but that is the ease of remembering (the frequency of occurrence) - confirmation is believing something about the world and then you will see it▯ ▯ Summary:▯ ❖ we need a scientific method to carefully analyse data so its free from human bias▯ ▯ __________________________________________________________▯ ▯ Natural Experiment - categories naturally exist, groups of different people▯ Randomized control trial - different people in each group (between subject)▯ Randomized waiting list study - everyone is put on the wait list of a study. they measure before and after as a control. then once you enter treatment you have experienced control and treatment▯ patient preference trials - patients decide what group they want to be in.▯ ▯ The Case of Clever Hans:▯ - a clever horse named Hans. he could answer very complex math questions and tell you what today’s date is, and he could differentiate numbers of days in months by counting with his hooves.▯ ❖ 89% accuracy▯ ❖ his teacher had a Human Intelligence Training Protocol▯ ❖ the owner believed that these years of training made this horse highly intelligent▯ - at first people just thought the owner was cueing the horse to do things▯ - they removed the owner and Hans would still answer questions with high accuracy▯ - BUT they started noticing that the horse was only good at answering the question if the person asking the question knew the answer▯ ❖ the questioner unconsciously cued the horse and nodded their head when he was doing well, it wasn't the intelligence training it was about what the questioner was doing with their bodies….▯ ❖ POINT: what the owner thought was the mechanism for the intelligence was not actually the case, it was just a matter of cueing the horse. the HITP was not as legit as they once thought.▯ ▯ Alzheimer’s Disease▯ - a guy portrayed his experience with Alzheimer’s through self-portraits▯ - his cognitive ability significantly declined as depicted by his portraits▯ - AD is a neurodegenerative disease that impairs motor and cognitive function▯ ❖ increases the ventricles▯ Health Psychology 2G03 ❖ shrinks: the hippocampus - without it we have no memory▯ ❖ shrinkage of cerebral cortex▯ - plaque (protein deposits) accumulate in the brain, when the neuron is dying, it gets surrounded by this plaque. people once believed if you can treat the plaque then you’re all good. but it turns out that this doesn’t actually stop it.▯ ❖ currently no cure for AD▯ ❖ over the next 30 years the # of Canadians with Dementia is projected to DOUBLE▯ ❖ Will cost upwards of 150billion dollars.▯ - EXERCISE AND AD▯ ❖ exercising earlier in life reduces the risk of AD later in life▯ ❖ we don’t currently understand the mechanism▯ Q: should we really prescribe exercise for AD without a mechanism?▯ ❖ what are the risks? falling, deception of a cure▯ ❖ what are the benefits? ▯ Q: if we choose to prescribe, should we continue searching for a mechanism?▯ ❖ depending how effective on whether or not its worth it▯ ▯ Lessons from Peptic Ulcer Disease▯ ❖ believed that stress and poor diet cause ulcers…▯ ❖ therefore a treatment would be bed rest and bland food such as bread and rice▯ Hypothesis: antacids hastens the healing of duodenal ulcers▯ ❖ antacid was not more effective at relieving symptoms than placebo▯ ❖ the people who were healed later had a reoccurrence of the ulcer, the antacid was not healing the ulcer, was just temporarily getting rid of it.▯ ❖ people believed once they had an ulcer they would have it forever,▯ in 1982, warren and marshall identified a link b/w peptic ulcers and H. pylori bacteria▯ - high proportion of people with ulcers had this same bacteria.▯ - huge results - not stress or diet, it’s simply a bacterial infection▯ - if we treat the infection… it will go away FOREVER… yay▯ - HOWEVER, the medical community was very skeptical at first, so W&M replicated it over and over and over▯ ❖ for years people believed the treatment was antacids for a lifelong disease▯ ❖ people had invested their lifetime researching antacids▯ ❖ it wasn’t until Marshal drank H. pylori, infected himself, developed an ulcer, and then treated himself with antibiotics to cure the ulcer…▯ ❖ almost a decade later they decided he was right…▯ ❖ took very long for this to actually be practiced, still today a lot of people believe stress causes ulcers▯ MORAL OF THE STORY….▯ ❖ it’s important to do research▯ ❖ discovery in health psychology is an ongoing process▯ ❖ humans can complicate the objectivity of the research process▯ ❖ we invest years of time searching for answers, it’s hard to get out of it▯ ❖ its important to understand the mechanisms to effectively treat the disease.▯ ▯ Back to Alzheimers Disease…▯ - a study was done with people Dementia-free at 65, based on self-reported PA levels of at least 15 minutes a day▯ ❖ people more than 3x a week and less than 3x a week▯ Health Psychology 2G03 ❖ naturally with age, risk will go up▯ ❖ RESULTS: this study showed an increase of dementia-free with those who exercised more than 3x a week▯ ❖ PROBLEM: we can’t give someone alzheimers just to see what happens…▯ ❖ this is why people choose to study mice/other animals▯ - exercising mice had less amyloid accumulation in the brain then sedentary mice..▯ ❖ didn’t get rid of it completely, just reduced the amount▯ ❖ complications: we can’t test animal cognition the same way that humans operate▯ ❖ they try to do this by seeing how long it takes mice to find a platform in a pool, exercised mice still found it faster, yet we cannot fully understand the mechanism because we can’t study humans in the same way.▯ ▯ _______________________________________________________________▯ ▯ TUBERCULOSIS▯ - an infection caused by micro bacteria▯ Symptoms▯ - chronic cough▯ - fever, night sweats▯ - blood in the mucous▯ Highly Contagious▯ - spread through the air▯ ▯ - used to be huge campaigns to help stop this disease, and people were placed in special places, primarily poor people. everyone with tuberculosis would be in the same place.▯ ❖ if you went into the sanatorium you were more likely to die within 5 years▯ - not everybody infected actually gets the disease - only 1 in 10 will actually develop the disease▯ - most commonly infected were the poor▯ - Thomas Holmes began researching this disease▯ ❖ looked at healthy people exposed to tuberculosis to see who developed/didn’t develop it▯ ❖ he examined the sanatorium employees. 40 who worked there, 20 who were infected and developed TB, and 20 who didn’t develop it▯ ❖ is stress a factor in determining if people develop the disease?▯ ❖ Method: stress level, retrospective self-reports (they didn’t induce stress). ▯ ❖ Stress provoking activities:social evaluation and uncontrollable variables, public speaking…▯ ❖ these all tap into the same stress system▯ STRESS ** check textbook▯ - activation of endocrine system.▯ - locus coeruleus - first responder to stress. releases norepinephrine which activates the hypothalamus. ▯ ❖ Fast stress response: “fight or flight” sympathetic adrenal medulla (SAM axis). speeded nervous impulse innervation causes the adrenaline rush. activates adrenal gland to release epinephrine. activates a system of physiological responses (sweaty palms etc..). activates in order to heighten arousal and to help us be vigilant.▯ ❖ slow and sustained stress response: activation of HPA axis stimulates pituitary gland to release. not working with nervous system, it’s working with endocrine system. hypothalamus releases corticotrophin hormone to activate pituitary gland. Health Psychology 2G03 adrenocorticotrophic hormone is released and activates adrenal cortex, releases glutocorticoltrophic hormones which include cortisol. Cortisol increases blood glucose to allow sustained energy to respond to the threat in pressure.▯ ❖ the immune cells have receptors for these hormones - they can change the function of the immune cells▯ ❖ the sympathetic nervous innervates the lymph nodes which have receptors for epinephrine (this is how epinephrine can change the properties of the lymph node)▯ but how exactly do these two stress systems affect the immune response??▯ - stress system suppresses the immune system▯ - Holmes didn’t examine the immune system (bc they didn’t know about this affect)▯ ▯ Psychological stress and susceptibility to the common cold▯ - 420 healthy adults▯ - given nasal drops with respiratory virus▯ - IV: psychological stress level▯ - DV: infected or not by the virus, and total WBC count▯ ▯ Hypothesis; more stress = more infection bc immune cells are suppressed.▯ ▯ Results: s. the more stressed people were, the more suscep
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