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Health Studies
Course Code
Anna Walsh

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HLTB01H3Y: Health, Aging and the Life Cycle
Department of Health Studies
University of Toronto at Scarborough
Summer 2010
Instructor: Anna Walsh.
Term: Summer 2010 Mondays 10 a.m.-12 p.m.
Lecture Room: SW 319.
July 5/2010.
A&G: Ch 9 - The Interface Between
Physical and Mental Health.
Stress and Mental Health.
A&G: Ch 10 - Stress, Coping, and Health.
Chapter 9
The Interface between Physical and Mental Health
Personality Processes and Disease
x The idea that personality characteristics are related to health and illness is not new, by
any means.
x Hippocrates:
o Substances called humors influenced personality and health
Blood: ruddy, sanguine personality
Melancholy (black bile): excess > prone to depression and degenerative
Choler (yellow bile): too much > angry and bitter
Phlegm: cause apathy
x Descartes: mind and body were separate and only connected through the pineal gland
x Sigmund Freud is credited with developing the first Western scientific theory of mind,
and he believed that eventually psychological phenomena would be traced back to
neurophysiological events.
o Many of the studies done in the past had no controls or compared people with
pre-existing illnesses to healthy controls
x Many people also blamed the psychosomatic illnesses on the victim and said it was all in
their heads
o However, health psychology and behavioural medicine state that the mind and
the body are connected in a transactional manner
Bidirectional: reciprocal relationship between physical and psychological
x More recent research has reinstated the relationship between personality and disease
Psychological Risk Factors and Health
x Type A personality/Type A Behaviour Pattern (TABP)
o Friedman and Rosenman > noted that chairs of patients worn at the ends because
they sat at the edges

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Dinctinctive characteristics include: extreme and eaily aroused hostility,
achievement motivation, time urgency, explosive speech patterns
o Two ways of assessing this personality type:
Structured interview: express hostility in standardized ways, get annoyed
by slow people and finish their sentences, angry when challenged
Self report questionnaires (ex. Jenkins activity survey): did not predict
heart disease well and they found that the hostility component was the
best predictor of CHD
o Relation to Coronary heart disease (CHD)
Higher in hostility = more likely to develop it and have higher rates of
overall mortality
Structured interview provides more consistent results of having this
Relationship between hostility and CHD is stronger for men, young
After age 56, Type Bs were higher in it probably due to survivor effects
High in hostility tend to be low in social support = higher risk for CHD
o More likely to have poor healthy behaviour: likely to smoke, drink excessively,
weigh more, be less active
x Hostility levels are highest in adolescence
x May be protective in late life because negative behaviour produces more attention from
nurses and dismisses feelings of helplessness
x Relatively consistent effects of anxiety on heart disease and overall mortality have been
x High in anxiety = 4.5 times the risk for sudden cardiac death, phobics = 6 times the risk
for sudden cardiac death
x Releases catecholamines which stimulates the heart rate
x Heart disease = loss of control of normal autonomic nervous system = decrease in
parasympathetic control = heart vulnerable to stimulation via catecholamines
x Heart rate variability decreases with age but marked among those with diabetic
neuropathy and vascular disease
x Perhaps the strongest association between negative affect and health in late life is found
with depression.
x Widowed men more likely to die of CHD after first year of bereavement > risk
decreasing after 1 year
x Relationship between bereavement and mortality stronger among middle aged than older
x Depressive symptoms were unstable > those found depressed at one point not necessarily
depressed when assessed later
x High levels of depression = 1.5 2 times more at risk to develop CHD
x Depressed individuals were 4 times as likely to die than those with a myocardial
infarction because depression was a stronger predictor of mortality
x More likely to be smokers, have poor diet, less likely to exercise
x Loss of appetite = classic symptom of depression
x Linked to atherogenesis, arrhythmias, sudden death

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x Type C personality: women with passive personalities that suppressed emotional
expression = more likely to develop cancer
o Older women most likely to exhibit this personality and develop breast cancer
Psychological Protective Factors and Health
Control and Self-Efficacy
x Many early studies showed the protective effects of internal locus of control
o Ex. nursing home: group that chose movies and watered plants = better self rated
health, lower mortality
x In occupational settings:
o High responsibility + fair amt of control = lower levels of work related stress
o Responsibility + little control = greatest amount of stress > more likely to
develop cardiovascular disease
o More control + little responsibility = low amounts of stress
x External locus of control = higher overall mortality
x Langer:
o Took older adults to camp for a week
o Took responsibility in different ways > carried luggage
o Self reported mental and physical health imporved
Optimism (Positive Outlook)
x The construction of optimism is one of the primary foci in the current emphasis on
positive psychology.
x Two different ways of defining this contruct
o Explanatory style
Internality: whether attributes cause of events to internal or external
Stability: temporal dimension of attribute (bad economy is temporary)
Globality: specificity of the cause (one one part of economy is bad, not
all parts)
o Personality disposition
Generalized expectancies concerning future outcomes
x Have lower risk for premature mortality, fewer illnesses over lifespan, fewer contact with
x Not always protective: after 18 months of unemployment, optimists were more depressed
than pessimists > have a hard time coping with chronic stress = adverse immune
consequences for persistent stress
Emotional Stability
x Clearly, part of the negative effect of anxiety, hostility, and depression is related to
emotional labiality.
x Is protective of health in midlife and later
Alcohol and Aging
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