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Health Psychology Midterm 1.docx

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York University
PSYC 3170
Gerry Goldberg

Health Psychology Midterm #1 - Health is a state of complete physical, mental, and social well being. - The bio-psychosocial model suggests that what health is may vary from culture to culture. - Within a culture “what is health” changes as the status quo is shaken. - Evolution of activism consists of unions, medical research, consumerism, court awards, technology, commercialized medicine, and public and workforce changes. - We have an active role to play in our own health, what we do and think impacts our health. - Health is a complete set of well-being, physical well being (bio), mental well being (psycho), and social well being (social). - Environmental and occupational medicine looked at what people do and its impact on health. - Hippocrates observed the environment of the patient. - Bernardo Ramazzini studied diseases of tradesmen. - Systematic research consists of systematic observation correlation, and controlled experiments. - Correlational studies compare changes in variables (cannot determine causality). - Prospective designs (longitudinal) consist of looking forward. - Retrospective research consists of looking backward. - Attribution Process “Naive Psychology” relates to what you think and its impact on health. Wetry to discern the motives and personality traits psychologists look at how such judgments are made. - Information and self regulatory theory is influenced by culture and schema, amount of info, and social comparison. - A fundamental attribution error is one that causes us harm; it is the idea that as humans we tend to be bias in not giving the environment credit in influencing our behaviour. - Defence attribution is when the victim is blamed. - Information and what we think regulates how our health is influenced. - Attribution therapies involve self defeating vs. self-enhancing: The James- Lange theory is that being in a physiological state of fear, and that we identify this state as fear. The Cannon-Bard theory is that there cannot be a specific biological state for every biological feeling. - Hormone feelings consist of levels of epinephrine, or other hormones affect and influence biological state. - The two-factor theory of emotion Schechter and Singer determines the effect of epinephrine on subjects. When given the epinephrine most interpreted their internal feelings from the situation (the confederates apparent reaction) and not so with the placebo, and not so when informed about the true nature of the drug. - Veridical reattribution involves what is happening within his or her subjective experience. - Veridical reattribution and drug psychosis: the nature of the drug LSD caused psychotic episodes, although the nature of this drug was not to cause these episodes. As time went by admission to hospitals because of drug psychosis dropped with marijuana use, also as time went by the # of people who used marijuana increased as well. This lead to a theory about LSD. - Veridical reattribution and sex problems: are problems with sex research are that it is a private experience, many people are unwilling to discuss their sex life/problems, also people evaluate you as a person by what you are doing. - The myth of the male sexual wisdom: is that men are able to know exactly what or when a women wants something sexually. - The search for aphrodisiacs: there is no guarantee as what may be considered a true aphrodisiac, except the drink the Spanish fly; it makes the urinary tract itch. - Penis size: it was found that it is not important, although 30% of women psychologically believe that this matters. - Masturbation is considered as a part of self awareness but it does not cause mental illness as some used to believe. Chapter 1: What is Health Psychology? - Health psychology is derived to understanding psychological influences on how people stay healthy, why they become ill, and how they respond when they do become ill. - Health is a complete state of physical, mental and social well-being, and not merely the absence of disease or infirmity. - The humoral theory of illness, is when the 4 circulating fluids of the body (blood, black bile, yellow bile, and phlegm) are out of balance, therefore illness is caused (Hippocrates). - Conversion hysteria (Freud) is when specific unconscious conflicts can produce certain physical disturbances that symbolize the repressed psychological conflicts. The patient converts the conflict into a symptom via the voluntary nervous system, he/she then becomes relatively free of the anxiety the conflict would produce. - Psychosomatic medicine helped with bodily disorders caused by emotional conflicts. - The bio-psychosocial model implies that it’s fundamental assumption is that health and illness are consequences of the interplay of biological, psychological, and social factors. - The bio-medical model maintains that all illness can be explained on the basis of aberrant somatic processes, such as biochemical imbalances or neuropsychological abnormalities. - The systems theory maintains that all levels of organization in any entity are linked to each other hierarchically and that change in any level will effect change in all other levels. - Masters and Johnsons’ behavioural therapy for sexual problems involved a focus on socio- cultural deprivation and ignorance of sexual physiology, instead focused on the relationship as a whole, through systematic desensitization (specific sexual exercises), and a focus on pleasure (no pressure). - Seeing parents and others comfortable with sex is the best education, there are 4 concepts: self- awareness, physiological, reproductive, and family. - Puberty is started by the hypothalamus, hormones are chemical messengers, hormones are secreted by the endocrine system and cause the body to grow and change. Attitudes:  An attitude can be defined as a general and enduring positive or negative feeling about some person, object, or issue. There are 8 approaches to attitude formation (PETTY & CACIOPPO): o Conditioning and modelling approaches o The message learning approaches o Judgemental approaches o Motivational approaches o Attribution approaches o Combinatory approaches o Self-persuasion approaches o The elaboration likelihood model  With the elaboration likelihood model there are 2 routes to attitude change (central and peripheral): the central route (persuasive appeal route) is analytical and motivated, it needs a high effort, arguments that evoke an enduring agreement, and a response. The peripheral route is not analytical/involved, it is low effort, events that trigger liking and acceptance are often only temporary, and finally a response.  Rucker and Petty came up with steps in developing risk communications for consumers: o Must consider audience elaboration level o Evaluate message characteristics o Have a message objective type of change o Evaluate the fit from steps 1-3 o Test the message effectiveness o Evaluate the message effectiveness  Classical conditioning can be used in antibioses.  Operant conditioning can be used in behaviour modification.  Modelling is the conformity to a group (parents are models for their offspring)  The message learning approach asks the communicator questions like what and how?  Message factors consist of framing the message, either negative or positive, and performing or not performing the behaviour.  Detection behaviours are negatively framed messages, and are found more effective.  Prevention behaviours, consist of positive messages, it has been found that a combination of positive and negative messages is most effective. - The trans-theoretical model (spiral model of changes) involves: termination, maintenance, contemplation, preparation and action, pre contemplation, and then contemplation preparation and action again. Weinstein developed the precaution adoption process model which involves: o Hearing of a potential hazard o Belief that hazard poses risk for others o Acknowledges a personal susceptibility to the hazard o Has decided not to act or to act o Is acting o And has maintained the behaviour  Judgmental approaches are how judgements are relative to anchors such as past experience, and a personal view of self or attitude.  The sheriffs latitudes is an perspective approach and consists of id a near point of view leads to assimilation, if it is far from a point of view it leads to contrast. The latitude of non-commitment suggests there is some space between acceptance and rejection in which we cannot predict the outcome for. If there is ego involvement then there is narrow latitude of acceptance. One also sees issues in terms of self perception.  Hedonic adaptation occur when the mental scale that people use to judge the pleasantness or unpleasantness of their experiences shifts so that their neutral point or baseline for comparison changes. This helps protect mental and physical health during setbacks such as disease.  The arguments that you generate yourself change your attitudes, the more you think or argue a point of view the more polarized your beliefs become.  Motivational approaches are based on feeling or view that the world is an orderly place so that virtue will be rewarded and evil punished (ex. Cognitive dissonance).  Beliefs may be irrelevant, consonant, or dissonant.  Attribution approaches, are like dissonance but they discard feelings of dissonance, and are based on a need to find order, and seek out causes of what we experience.  Disabilities are comprised of the social and physical limitations which prevent a person from normal functioning, and reaching full potential. -Attitudes have 3 components: thoughts (intellect), feelings (emotions), and actions (behaviours).  The concept of spread is that stereotypes are considered overgeneralizations about people, this concept is the idea that we do not hesitate to make assumptions about a personality trait of a person who is disable.  Thought: devices to overcome stereotyping consist of indexing which is actively remembering differences within a category dating which is the idea that people constantly change, and etcetera that no description is ever complete.  Sources of negative feelings: the need to see a just world, cultural and parental training reinforce this. Isolation, uncertainty and anxiety are reinforced by the reaction to own anxiety.  To improve negative feelings, one must understand feelings, and have exposure to individuals with disabilities. The actions are rejection, social interaction, and finally acceptance. Stage 1- fictional acceptance Stage 2- Breaking through Stage 3- normalization of relationship Chapter 2: Systems of the Body: • The nervous system is a complex network of interconnected nerve fibres that function to regulate many important bodily functions, including the response to and recovery from stress. • Sensory nerve fibres provide input to the brain and the spinal cord by carrying signals from sensory receptors. • Motor nerve fibres provide output from the brain/spinal cord to muscles and other organs resulting in the voluntary or involuntary movement. • The central nervous system consists of brain and spinal cord, the rest consist of the peripheral nervous system. • The peripheral nervous system is made of somatic and autonomic nervous system. The somatic or involuntary nervous system connects, nerve fibres to voluntary muscles and provide the brain with feedback in the form of sensory information. The autonomic nervous system connects the central nervous system with all of the internal organs over which people do not have control (involuntary). • Regulation of the autonomic nervous system occurs via the sympathetic nervous system (it regulates stress, fight or flight, catabolic system), and the parasympathetic nervous system (controls normal circumstances, anabolic system). • The afferent is sensory, and efferent is motor. • The hindbrain: medulla receives information about the rate at which the heart is contracting, it speeds up or slows down the heart rate as required. The pons is the link between hindbrain and midbrain and assists in respiration. The cerebellum coordinates voluntary muscle movement, maintains balance and equilibrium. • The forebrain consists of the thalamus, which involves recognition of sensory stimuli and relay of sensory impulses to the cerebral cortex, and consists of the hypothalamus which regulates centres in the medulla that control cardiac functioning, blood pressure, and respiration. • The epencephalon is in the forebrain and incorporates the cerebral cortex which is the largest portion of the brain and is involved in higher order intelligence, memory, and personality. • The cerebral cortex contains the frontal lobe (motor cortex), parietal lobe (somato-sensory cortex), temporal lobe (auditory and olfactory impulses), and the occipital lobe (visual cortex). • The basal ganglia help make muscle contradicting be orderly, smooth, and purposeful. • The limbic system plays an important role in stress and emotional responses. • Neurotransmitters regulate nervous system functioning. Epinephrine and Norpinephrine together are termed the catecholamine’s these substances enter the bloodstream and are carried throughout the body to promote activity of sympathetic stimulation. • The endocrine system complements the nervous system in controlling bodily activities. • Autoimmunity is a condition characterized by a specific humoral or cell mediated immune response that attacks the body’s own tissues. • Diabetes is a chronic endocrine disorder in which the body is not to manufacture or properly use insulin. • The cardiovascular system is composed of the heart, blood vessels, and blood and acts as the transport system of the body. • Atherosclerosis is caused by deposits of cholesterol and other substances on the arterial walls, which form plaque that narrow the arteries. • Angina pectoris is chest pain, which occurs because the muscle tissue of the heart must continue its activity without a sufficient supply of oxygen or adequate removal of carbon dioxide and other waste products. • A myocardial infarction is most likely to occur when a clot has formed in a coronary vessel and blocks the flow of blood to the heart. • Blood pressure is the force that blood exerts against the blood vessel walls. • Platelets serve to clump together to block small holes that develop in blood vessels and play an important role in blood clotting. • The respiratory system involves a number of organs, air is inhaled through the nose and mouth and the passes through the pharynx and larynx to the trachea. • Immunity is that body’s resistance to injury from invading organisms. • Nonspecific immune mechanisms are a general set of responses to any kind of infection or disorder. • Specific immune mechanisms are always acquired after birth, fight particular micro-organisms and their toxins. • Phagocytosis is the process by which certain white blood cells ingest microbes, phagocytes are usually overproduced where there is a bodily infection so that the site of infection if ingest foreign particles. • Humoral immunity is mediated by B lymphocytes, these protect against bacteria and preventing a viral infection. • Cell-mediated immunity involves T-lymphocytes from the thymus gland, and kills the infection. • The lymphatic system is a drainage system of the body it is involved in important ways in immune functioning. Health Behaviours:  Health promotion means being aware both of health habits that pose risks for future disease and of already existing risks, such as the vulnerability of breast cancer. It is a general philosophy that has at its core the idea that good health, or wellness, is a personal and collective achievement.  Health behaviours are behaviours undertaken by people to enhance or maintain their health.  A health habit is a health related behaviour that is firmly established and often preformed automatically without awareness.  Instilling good health habits and changing poor ones is the task of primary prevention.  The health locus of control is the perception that one’s health is under personal control, and is controlled by powerful others such as physicians or is determined by external factors including chance.  Socialization is the process, by which people learn the norms, rules, and beliefs associated with their family and society, parents and social institutions are usually the major agents of socializations.  A teachable moment refers to the fact that certain times are better than others for teaching a particular health practice.  A window of vulnerability is the fact that at certain times people are more vulnerable to particular health problems.  Fear appeals are efforts to change attitudes by arousing fear to induce the motivation to change behaviours; fear appeals are used to try to get people to change poor health habits.  The health belief model states that whether person practices particular health behaviour can be understood by knowing 2 factors, whether the person perceives a personal health threat and whether the person believes that a particular health practice will be effective in reducing that threat.  The prospect theory is the theory that different presentations of risk information will change people’s perspectives and actions.  Self-efficacy is the belief that one is able to control one’s practice of a particular behaviour.  The theory of planned behaviour is derived from the theory of reasoned action, this theoretical viewpoint maintains that a person’s behavioural intentions and behaviours can be understood by knowing the persons attitudes about the behaviour, subjective norms regarding the behaviour and the perceived behavioural control over that action.  Cognitive behavioural theory approaches to health habit modification change the focus to the target behaviour itself, the conditions that elicit and maintain it and the factors that reinforce it.  Self-observation/self-monitoring is accessing the frequency, antecedents and consequences of target behaviour to be modified.  Classical conditioning is the pairing of a stimulus with an unconditioned reflex, such that over time the new stimulus acquires a conditioned response, evoking the same behaviour, the process by which an automatic response is conditioned to a new stimulus.  Operant conditioning is the pairing of a voluntary, non-automatic behaviour to a new stimulus through reinforcement or punishment.  Modelling is a learning that occurs by virtue of witnessing another person performing behaviour.  Observation and subsequent modelling can be effective approaches to changing health habits.  A discriminative stimulus is an environmental stimulus that is capable of eliciting a particular behaviour.  Stimulus-control interventions are interventions designed to modify behaviour that involves the removal of discriminative stimuli that evoke a behaviour targeted for change and the substitution of a new discriminative stimuli that will evoke a desired behaviour.  Self-control is a state in which an individual desiring to change behaviour learns how to modify the antecedents and the consequences of that target behaviour.  Self- reinforcement is systematically rewarding or punishing one’s self to increase or decrease the occurrence of the target behaviour.  Contingency contracting is when an individual forms a contract with another person, such as a therapist detailing what rewards/punishments are contingent on non- performance/performance of behaviour.  Covert self-control trains individuals to recognize and modify these internal monologues to promote health behaviour change.  Cognitive restructuring is a method for modifying internal monologues that has been widely used in the treatment of stress disorders.  Self-talk are internal monologues, people tell themselves things that may undermine/help them implement appropriate health habits.  Behavioural assignments are home practice activities that support the goals of a therapeutic intervention, they are designed to provide continuity in the treatment of a behaviour problem, and typically, these assignments follow up points in the therapeutic session.  Social skills training/assertiveness training is part of the intervention package and is used to alter health habits; they are techniques that train people how to be appropriately assertive in social situations.  Relaxation training; are procedures that help people relax, they include progressive muscle relaxation and deep breathing, they may also include guided imagery and forms of mediation or hypnosis.  The broad-spectrum cognitive behaviour therapy is the use of a broad array of cognitive behavioural intervention techniques to modify the individual’s health behaviour.  Abstinence violation effect is a feeling of loss of control that results when a person has violated self-imposed rules.  Relapse prevention is a set of techniques designed to keep people from relapsing to prior health habits after initial successful behaviour modification, includes training in coping skills for high risk for relapse situations, and lifestyle rebalancing.  Lifestyle rebalancing is the long term maintenance of behaviour change that can be promoted by leading the person to make other health orientated changes in lifestyle.  The trans-theoretical model of behaviour change accounts for and analyses the stages of change that people go through as they attempt to change the health behaviour and suggests treatment goals and interventions for each stage.  Social engineering involves modifying the social environment in ways that affect people’s ability to practise the particular health behaviour. Health-Enhancing Behaviours  Aerobic exercise is a high intensity, long duration, and high endurance exercise, believed to contribute to cardiovascular fitness and other positive health outcomes.  Anorexia nervosa is a condition produced by excessive dieting and exercise that yields body weight grossly below optimal level, most common among adolescent girls.  Bulimia is an eating syndrome characterized by alternating cycles of binge eating and purging through such techniques as vomiting or extreme dieting.  A clinical breast exam is a thorough physical examination of the breast by a health care professional to detect changes or abnormalities that could indicate the early signs of breast cancer.  Obesity is an excessive accumulation of body fat, believed to contribute to a variety of health disorders including cardiovascular disease.  The set point theory of weight is the concept that each individual has an ideal biological weight that cannot be greatly modified.  Sleep apnoea is an air pipe blockage that disrupts sleep and can compromise health. When apnoea occurs, a sleeping person stops breathing sometimes for as long as 3 minutes, until he/she suddenly wakes up gasping for air.  Stress eating is eating in response to stress, approximately half the population increases eating in response to stress. Changing Behaviour – The modern multifaceted approach:  Traditional approaches are laws and organizational rules (they do work) and educational motivational appeals (can result in new awareness and new skills).  Both traditional approaches “tell” what to do, therefore get reactance.  Law based strategies need to reflect community consensus, they require surveillance and control, and do not allow freedom of choice.  Educational/motivational appeals yield only short term results if any compete with other factors in life and requires other competence to have a strong effect.  Social marketing links target behaviour to existing needs, interests, etc.  Personal participation links onto what the target group is willing to do.  Local group/community participation consists of: the workplace, community groups, organizations used to deliver and institutionalize programs, need to design programs to help the organizations achieve their goals.  Social marketing takes commercial/product marketing techniques and attempts to sell us health (proper eating, exercise, etc).  Social marketing needs to segment and define the target group, develop programs which link groups, and present programs to target groups to be effective.  Plans:  Step 1- get social demographic data  Step 2 - conduct focus groups  Step 3 – develop a survey  Step 4 – select, develop, and tailor programs  Step 5 – regular evaluations  Step 6 – the institutionalization of programs  Behaviour modification in the workplace consists of a peer evaluation program, or a continuous improvement program.  Operant conditioning is the foundation of behaviour modification: antecedent (prompts), behaviour (actions), consequences (rewards/punishments).  Behaviour modification is how environment and situational factors already influence behaviour.  Behaviour modification began with B.F. Skinner.  4 environments: physical, task, organizational, and social-cultural.  Behaviour modification and achieving self control: specify your target behaviour, gather baseline data, design a program, execute and evaluate your program, and finally end your program. Health Compromising Behaviours:  Physical dependence is the state that occurs when the body has adjusted to the substance and incorporates the use of that substance into the normal functioning of the body’s tissues.  Physical dependence often involves tolerance, which is the process by which the body increasingly adapts to the use of the substance.  Craving is a strong desire to engage in behaviour or consume a substance.  Addiction occur when a person has become physically or psychology dependant on a substance following use overtime.  Withdrawal refers to the unpleasant symptoms that people experience when they stop using a substance they are dependent on.  Harm reduction is an “approach that focuses on the risks and consequences of substance use rather than on the use itself”.  Alcohol is responsible for more than 8000 deaths per year, making it one of the leading causes of preventable death after tobacco and improper diet and exercise.  The term alcoholic is reserved for someone who is physically addicted to alcohol. Problem drinkers may have substantial social, psychological, and medical problems resulting from alcohol.  For hard-core alcoholics, the 1st phase of treatment is detoxification, because this can produce severe symptoms and health problems, detoxification is typically conducted in a carefully supervised and medically monitored setting. Once the alcoholic is partly dried out therapy is initiated, the typical program begins with a short-term, intensive inpatient treatment followed by a period of continuing treatment on an outpatient basis.  Placebo drinking involves the consumption of non-alcoholic beverages while others are drinking or the alternation of an alcoholic with a non alcoholic beverage to reduce the total volume of alcohol consumed.  Self-help aids are programs developed to quit an addiction on their own like with smoking. Smoking prevention programs are aimed to catch potential smokers early and attack the underlying motivations that lead people to smoke.  Evans social influence intervention consists of 2 central perspectives: first the modelling of others, by observing models that are apparently enjoying a risky behaviour, a successful intervention program with adolescents must include the potential for modelling high-status, non-smokers.  The 2nd behavioural inoculation is that if one can expose individuals to a weak, version of a persuasive message, they may develop counterarguments against that message, so that they can successfully resist if the encounter is in a stronger form.  The life skills training approach is that if adolescents are trained in self esteem and coping enhancements as well as social skills, they will not feel the need to smoke per say to bolster their self image, the skills will enhance the adolescent’s sense of being an efficacious person. Chapter 1 Health Psychology · Health psychology: o understanding psychological influences and how ppl stay healthy. o Why they become ill o How they react to getting ill · Health definition o “complete state of physical, mental and social well-being not merely the absence of infirmity o Some use ‘’wellness’’ instead · Health psychologists focus on: o Health promotion and maintenance o Prevention and treatment o Etiology, correlates of health, illness, dysfunction. § Etiology -is origins that cause illness: tend to look at social factors, and states of mind to determine illness’ cause. Also habits and learned activities. o Develop recommendations to improve health care and promotion · Early Philosophers: evil spirits cause of disease. · Greeks: bodily functions to attribute health. o Hippocrates/Galen: disease caused by bodily factors, which also impact on mind. · Middle ages: evils and punishment · Morgannis 1682- autopsy and rejection of humoral theory of illness · Psychoanalytic: o Freud: conversion hysteria § Unconscious conflicts produce psychological disturbances Psychosomatic Medicine § Dunbar/Alexander: linked patterns of personality to specific conflicts and illness · Conflicts produce anxiety; takes physiological toll on body via autonomic nervous system. § Medicine: profiles of particular disorders caused by psychological disorders · Current view of Body-Mind Relationship o Good habits, under ones control, culture, social factors, socio-economic factors, stress all attribute to health. · BioPsychological Model:  Body n mind together determine health/illness; study both. Health and illness are consequence of interplay between biological, psychological and social factors  Biomedical model: Biomedical model is the basis that all illness can be explained by biochemical imbalances or neuropsychological abnormalities Is a reductionist modelo  Reduces illness to low level processes(disordered cells/chemical)  Rather than to habits and social/psychological processes  Single cause model of illness  Assumes a mind-body dualism.  BioPsychological bases on many factors at all levels and uses system theory:  system theory: hierarchy of linked systems affecting each and every levels Biomedical BioPsycholgical Single cause factor Multiple cause and factors Mind-body dualism Inseparable mind/body Emphasizes illness over health Both health/illness emphasized Reductionist Macro/micro levels considered  Clinical implications of BioPsycho-model o Interdisciplinary approach o Recommendations for treatment must examine all three sets of factors o Explicit significance relationship b/w patient and practitioner Changing Patterns of Illness o Until 20th century Acute illnesses such as TB, pneumonia, infections, were leading illnesses in Canada  Chronic Illnesses(slowly developing, stay for long time) such as heart disease, cancer, diabetes, disabilities Therefore Health Psychology has come about to investigate the cause/effect relationship and habits which cause or prevent these illnesses  Help them adjust psychologically/socially to the changing illnesses  Technology o Identifying genes to attribute a disorder or to inspect early in life o Identify carriers of life threatening diseases...  Epidemiology o Study of frequency, distribution, cause for infectious diseases  Based on investigations of Physical and Social environments  Search why some places have more prevalent than others  Morbidity: number of cases of diseases at any point in time.Mortality: number of deaths attributed to a particular cause  Both statistics are essential to creating safer environments  (Car accidents a good example)(along with the precautions instituted) Concerned not only with biological outcomes, but also health related quality outcomes Not only prevention, but also improving quality of life to symptomatic complaints from chronic illnesses  Changing Perspectives on Health/Health Care o WHO: health is a positive state rather than a mere absence of disease  Lalonde Report: § 4 main cornerstones to health : Human biology, environment, lifestyle, health-care organization o Health is the ‘’capacity of ppl to adapt, respond, and control one life’s challenges o Health psychs need to understand these determinants and to inform policy makers, safety boards ,schools boards, news, and the like o Health Psych represents an important perspective on these issues for several reasons:  Containing health-care costs and targets is important in modifying illness through PREVENTION : · Changing ppl’s risky behaviour/habits before they become ill  Design user-friendly healthcare systems to better ones care and quality of care  Its impact on ppl is enormous, employees, patients, practitioners, tax money etc...  Increased Medical Acceptance  oCaregivers are recognizing that psychological/social factors are always important for health n illness  Techniques which take minutes to teach, will have life-lasting effects of benefit  Experiments  oRandomized clinical trials also act as experiments in treatment and their effectiveness  oHow ppl adjust to cancer in groups or not by comparison  oBy manipulating variables they can judge cause-effects relationships  Correlation Studies  oMeasures whether a change in a variable corresponds with changes in another variable  I.e.: ppl higher in hostility have heightened chances of heart disease o Disadvantage being the pinpoint accuracy at attributing one on the other, and not looking at all factors involved  I.e.: ppl might be hostile when they get heart disease instead!  Prospective designs  oResearch: looks FORWARD in time to see how a group of individuals change or how therelationship of 2 variables change over time (i.e.: hostility and heart disease)  oLongitudinal research: observe same ppl over long period of time  Retrospective  oResearch: Looks BACKWARD in time and attempts to reconstruct the conditions that led to a current situation  Careers in Practice  No amount of education in a self-care plan for a chronically ill person will be successful unless the family members are also brought in and educated in the regimen. Key Terms  biomedical model :The viewpoint that illness can be explained on the basis of aberrant somatic processes and that psychological and social processes are largely independent of the disease process; the dominant model in medical practice until recently.  acute disorders: Illnesses or other medical problems that occur over a short period of time, that are usually the result of an infectious process, and that are reversible. (See page(s) 9)  biopsychosocial model The view that biological, psychological, and social factors are all involved in any given state of health or illness. (See page(s) 7)  chronic illnesses Illnesses that are long lasting, are the main contributors to disability and death, and are usually irreversible. (See page(s) 10)  conversion hysteria The viewpoint, originally advanced by Freud, that specific unconscious conflicts can produce physical disturbances symbolic of the repressed conflict; no longer a dominant viewpoint in health psychology. (See page(s) 5)  correlational research Measuring two variables and determining whether they are associated with each other. Studies relating smoking to lung cancer are correlational, for example. (See page(s) 14)  epidemiology The study of the frequency, distribution, and causes of infectious and noninfectious disease in a population, based on an investigation of the physical and social environment. Thus, for example, epidemiologists not only study who has what kind of cancer but also address questions such as why certain cancers are more prevalent in particular geographic areas.(See page(s) 11)  etiology The origins and causes of illness. (See page(s) 4)  experiment varies the treatments that people in each condition are given, and then measures the effect on some response. (See page(s) 14)  health:A type of research in which a researcher randomly assigns people to two or more conditions,  health psychology The absence of disease or infirmity, coupled with a complete state of physical, mental, and social well-being; health psychologists recognize health to be a state that is actively achieved rather than the mere absence of illness. (See page(s) 4)  mind-body relationship:T he subarea within psychology devoted to understanding psychological influences on health, illness, and responses to those states, as well as the psychological origins and impacts of health policy and health interventions. (See page(s) 4) The philosophical position regarding whether the mind and body operate indistinguishably as a single system or whether they act as two separate systems; the view guiding health psychology is that the mind and body are indistinguishable. (See page(s) 4)  longitudinal research: The repeated observation and measurement of the same individuals over a period of time. (See page(s) 15)  morbidity:The number of cases of a disease that exist at a given point in time; it may be expressed as the number of new cases (incidence) or as the total number of existing cases (prevalence). (See page(s) 11  mortality: The number of deaths due to particular causes. (See page(s) 11)  prospective research A research strategy in which people are followed forward in time to examine the relationship between one set of variables and later occurrences. For example, prospective research can enable researchers to identify risk factors for diseases that develop at a later point in time. (See page(s) 15)  psychosomatic medicine A field within psychiatry, related to health psychology, that developed in the early 1900s to study and treat particular diseases believed to be caused by emotional conflicts, such as ulcers, hypertension, and asthma. The term is now used more broadly to mean an approach to health-related problems and diseases that examines psychological as well as somatic origins. (See page(s) 6)  retrospective research A research strategy whereby people are studied for the relationship of past variables or conditions to current ones. Interviewing people with a particular disease and asking them about their childhood health behaviours or exposure to risks can identify conditions leading to an adult disease, for example. (See page(s) 15)  systems theory: The viewpoint that all levels of an organization in any entity are linked to each other hierarchically and that change in any level will bring about change in other levels. (See page(s) 8) Chapter 2 Health Psychology - Nervous system: Complex network of interconnected nerve fibres that functions to regulate many important bodily functions - Response to stress/ recovery from stress o Motor vehicle fibres provide output from the brain or spinal cord to muscles and other organs, resulting in voluntary and involuntary movement - Made of central nervous system/ peripheral nervous system - Central: consist of brain and spinal cord - Peripheral: consist of all other nerves connecting to the brain/spinal cord somatic nervous system and autonomic nervous system - somatic: voluntary; connects nerve to voluntary muscles and provides brain with feedback in form of sensory info abt the voluntary movements o - autonomic: Involuntary; connects central nervous sys. - With all internal organs ppl don’t have control over - occurs in sympathetic and parasympathetic: - o sympathetic: plays role in reaction to stress - Prepares body to respond § Anger/fear § Mobilization/exertion of energy - Catabolic system o Parasympathetic: Controls organs under normal circumstances - Acts antagonistically to sympathetic - Restores body to normal - Conserves body § Anabolic system Brain: Hindbrain/ midbrain: 3 mains in hindbrain : 1. Medulla  Receives info about rate heart contraction Speeds or slows down as needed Blood pressure regulation Blood vessels  Rates of breathing 2.Pons:  Serve as link b.w. hind/midbrains  Controls respiration 3.Cerebellum:  Coordinates voluntary muscle movements  Balance equilibrium  Muscle tone/ posture o Midbrain: Major pathway for sensory and motor impulses § B.w. forebrain and hindbrain · Forebrain: 2 main section: the diencephalon and telecephalon  Diencephalon: Consists of Thalamus and hypothalamus  Thalamus: Recognizes sensory stimuli and relay of sensory impulses §  Hypothalamus: Regulates the centres in medulla , Control cardiac functioning , Blood pressure, Respiration, Water balance , Appetite, Sexual desire  Anxiety: Secretion of hydrochloric acid in stomach via hypothalamus signals Two hemispheres: o Cerebral cortex L and R  Largest portion of brain  Intelligence  Memory  Personality  Left part of motor cortex is for voluntary muscles on right side of body  Right side is for motor cortex controlling voluntary on left side Four lobes: 1.Frontal 2. Parietal  Somatosensory cortex  Touch, pain, temp, pressure 3. Temporal  Cortical areas responsible for auditory and olfactory(smell) · 4. Occipital :Visual cortex Basal ganglia : 4 round masses embedded deep in cerebrum.  Make muscle contractions smooth n orderly Limbic System: o Amygdale: are involved in the detection of threat o Hippocampus; and in emotionally charged memories o Cingulated gyrus, septum, areas in hypothalamus. Emotional functioning o Anterior portion of thalamus: Important for social relevant behaviours · Neurotransmitters:  Regulate nervous system functioning  Secretion of 2 neurotransmitters called catecholamines, Epinephrine n nonepinephrine  Promoting activity of sympathetic stimulation  Release can increase rates, blood pressure etc...Respiration...,Digestion/urine lowered, More sweat  Arousal of sympathetic and release of catechlomines important to stress  Have implications on coronary artery disease and hypertension Disorders in Nervous systems o Epilepsy: § Idiopathic; no specific cause  Injury during birth, head, disease, meningitis, metabolic/nutritional disorders  Seizures of ranging movements o Cerebral Palsy:  Chronic, nonprogressive disorder  Lack of muscle control o Parkinson’s:  Basal ganglia ruined,  Less smooth motor activation  Slow/rigid movements o Multiple Sclerosis:  Blindness, deafness, mental deterioration  Disintegration of myelin: the fatty membrane surrounding nerve fibres and facilitates conduction of nerve impulses o Huntington’s:  Chronic physical and mental deterioration  Muscle spasms § Loss of motor abilities  Personality changes  Mental disintegration o Paraplegia and Quadriplegia:  Para: paralysis of lower extremities of spinal cord  Quad: paralysis of all 4 extremities and trunk of body; upper spinal cord severed Endocrine System: o Made of ductless glands  Secrete hormones into blood  Stimulate changes in target organs o Depends on nervous systems and affect one another o Regulated by hypothalamus and pituitary gland: o 2 lobes in pit gland:  Anterior pit lobe of pit gland secretes hormones responsible for growth:  Somatotropic hormone STH o Bone, muscle, other organ development  Gonadropic hormone o Control growth development and secretion of the gonads  Thyrotrophic hormone TSH o Thyroid gland  Andrenocorticotropic hormone ACTH o Cortex regions of adrenal glands § Posterior lobe of pit gland:  Controls contractions during labour and vasopressin, and antidiuretic hormone ADH which controls water absorbing of kidneys Adrenal glands: o 2 small groups of glands, one on top of each kidney o Each consists of an adrenal medulla and adrenal cortex o Adrenal medulla:  Epinephrine and non-epinephrine o Adrenal cortex:”  Stimulated by ACTH ^ from anterior  Releases steroids  Mineralcortcos, glucocorticoids, androgens, estrogens o Both involved in stress o Both catechlomines secreted along with sympathetic arousal are implicated in biological responses to stress Disorders in Endocrine: o Diabetes:  Not able to manufacture or properly use insulin  Over 2 million Canadians §  Type I is insulin dependant  Late in childhood  Autoimmune disorder by early viral infection  Eliminating ability to produce insulin  Type II after 40 yrs old, more common  Disturbance in glucose metabolism and delicate balance between insulin production/responsiveness to it  Tied to obesity/stress among others CVS System: o Comprised of heart, blood vessels, blood o Transport system for body o Blood carried oxygen around to lungs and tissues, o And CO2 is excreted as expired from lungs o The heart:  Pumping blood to circulate body  Left side(left atrium)/left ventricle takes and pumps into aorta(major artery leaving heart)then the blood passes to smaller vessels(arteries/capillaries)to reach cell tissues.  Blood exchanges its oxygen and nutrients for the waste materials of cells and is returned them to right side of heart(atrium/ventricle)who pumps back to the lungs via the pulmonary artery.  Performs is rhythmic form; Cardiac cycle  During systole: blood pumped out of the heart; blood pressure increases  During diastole: blood pressure drop; muscle relax; blood taken to heart  Heart valves ensures one direction of flow § Most speedup (stress/workout) comes out of diastolic period Disorders in CVS: o Atherosclerosis:  Caused by deposits of cholesterol and others in arterial walls.  Plaques and narrows these arteries.  Reduces flow of blood through arteries and interferes with nutrients passing  blood clots; cut of blood flow § associated with 2 conditions: · 1. Angina pectoris: chest pain o Less oxygen flow supply · 2. Myocardial infarction (MI) o Clot develops in coronary vessel o Blocks flow  Results when calcium, salts, scar tissue react with elastic tissues of arteries  Decrease elasticity of arteries; making rigid n hard  Then causes hypertension  Then aneurysm is a bulge in section of wall of artery or vein; reaction to weak region of pressure § Phlebitis is an inflammation of vein wall, often accompanied by water retention/pain; chief in causing clots Blood pressure: o Force that blood exerts against the blood vessel walls o Systole: greatest force on blood vessel walls o Diastole: falls to lowest force on walls o Influenced by:  Cardiac output § Pressure against artery walls is greater as volume of blood increases § Peripheral resistance of blood flow in small arteries(arterioles)  Influenced by thickness of blood .  Highly viscous blood produces higher blood pressure o Hypertension is consequence of too high a cardiac output or too high a resistance Blood o Consists of plasma and cells § Plasma 55% of blood vol; 45% cells o Blood suspended in plasma which has proteins and electrolytes and nutrients of the blood oxygen being transferred by the blood o Bone marrow has 5 types of blood forming cells:  Myeloblast/monoblasts: produce white blood cells(absorb foreign substances and granules that secrete digestive enzymes)  Lymphoblasts: produce lymphocytes(combat foreign substances; produce antibodies)  Erythroblasts: produce red blood cells (haemoglobin which carry oxygen/c02 around)  Megakaryocytes: platelets ( clump and cause good clots) o Flow of blood is responsible for temperature  When temp too low, skin blood vessels constrict § Non-epinephrine generally constricts blood vessels( vasoconstriction)  Epinephrine constricts skin blood vessels while dilating muscle blood vessels Blood disorders: o White cells: Bad production can cause:  Leukemia: bone marrow; common form of cancer  excessive white blood cells  reduces red blood cells(anaemia results)  leucopenia · deficient white blood cells  accompanied with TB, measles, viral pneumonia  can’t stop infections(antibodies)  leukocytosis: Excessive white cells  Leukemia, appendicitis, mononucleosis Disorders to Red cells: Anaemia: Haemoglobin below normal  Many women b.c of menstruation  Can cause permanent damage to nervous system.  Chronic weakness Erthrocyytosis:  Increases viscosity of blood  Reduces rate of blood flow Sickle cell anaemia:  Genetic  Inability to make red  Common among blacks  Genetic adaptation promoting resistance to malaria Clotting disorders: Haemophilia  Unable to produce thromboplastin and fibrin  Cannot clot naturally Repertory System: o Taking in oxygen, out C02, regulate composition of blood o Needs oxygen to metabolize food o Organs: nose, mouth, pharynx, trachea, diapraghm, abdominal muscles, lungs § Alveoli and capillaries responsible for exchange of O2/C02 o Inspiration: lungs expand in thorax o Expiration: passive; reduces lung volume o Controlled by respiratory centre in medulla o Mucus removed by coughing · Disorders: o Asphyxia:  Oxygen lack and C02 excess o Anoxia:  Shortage of just O2  More serious o Hyperventilation:  Emotional excitement  Reducing CO2 content  Constricts blood vessels; flow to brain hindered o Hay fever:  Allergic reaction to foreign bodies  Pollens dusts  Cause inflamed capillaries o Asthma:  Dust, dander, fungi, pollens  Emotional stress/exercise  May produce hyperventilation/bronchial spasm o Viral infections:  Common cold § Influenza  Attacking lining of respitory track, killing healthy cells  Bronchitis:  Inflammation of mucosal membrane in lungs o Bacterial infections:  Strep, whooping cough, diphtheria o Chronic obstructive pulmonary disease(copd)  Fourth leading killer in Canada § Common/deadly  Chronic bronchitis/emphysema common compromise of copd  Pulmonary emphysema involves persistent obstruction of air flow  When alveoli become dilated, atrophied, and thin so they lose elasticity and then cannot constrict during exhalation  Then exhalation becomes difficult and CO2 is not eliminated § Lobar is primary; entire lobe of lung o Pneumonia  Bronchial is confined to bronchi; secondary infection to flu o Tuberculosis:  Bacteria invade lung tissue  oLung cancer:  Obvious tie to smoking  Air pollution  Lungs cells divide rapidly and produce tumour Digestive System: o Food is lubricated by saliva, round lump called a bolus, through esophogus by peristalsis, o Then to stomach which produces various gastric secretion of pepsin and HCL o Pancreatic juices add in containing enzymes which break down carbs, fats n proteins o Liver metabolizes fats using bile o Hyperlipedemia:  Excess of lipids including fats cholesterols and lecithin o Absorption of food in small intestine  Breaks down to amino acids o Parasympathetic activity speeds up metabolism; sympathetic reduces it o The large intestine... Disorders in digestion: o Gastroenteritis:  Inflamed lining of stomach  2-4 hrs after ingestion  Vomiting, diahrhea, cramps, nausea o Dysentery: § Similar to diarrhea except that mucus, pus, an
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