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Midterm Review

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Richard J.Contrada

Outline of Major Topics and Guide for Review for Mid-Term Exam General Points: 1. Students are responsible for all material covered in lectures and selected material covered in the readings. 2. Lecture and readings sometimes overlap: This is important material. 3. The following is only a guide for review. I do not guarantee that it identifies 100% of the material that will be on the exam. But the guide should help you to focus your review. 4. The guide will likely be revised after the first version is posted. Be alert to announcements of the posting of new versions. Introduction to Health Psychology Main Themes/Points 1. Changes in patterns of health and medicine • There has been a large decline of acute infectious diseases and an increase of chronic diseases over time • Acute Infectious diseases of early 1900s: o Each caused by a single microbe  “one germ one disease”  Thought they could stop it if they found the one germ o No way to:  Avoid exposure  Prevent infection  cure o Infection often fatal without cure o Eventually controlled by:  Public Health advances: • Safer food, waste, waste management, working conditions  Medical advances • Diagnosis, prevention (vaccines), treatment • Chronic Diseases o Develop slowly, persist, recur over long time period, come and go o Often degenerative o Often can be controlled but not cured o Multiple determinants include:  Specific(lifestyle) behavioral/psychosocial factors • Smoking, diet, exercise, stress -> stress  Not caused by a single germ • Greater life expectancy (from 40 to 70 years) o Reduced infant mortality o Greater survival beyond infanthood o The result: aging of the population 2. Models of health and disease 3. What Health Psychology is about • Psychological behavioral influences on: o Staying healthy o Getting sick o Responding to being sick Specific Concepts: 1. Acute vs. Chronic disease 2. Biomedical model • Disease is organic • Single cause • Health is the absence of disease 3. Biopsychosocial model • Involves whole person • Multiple causes • Health is more than the absences of disease • Formed the basis of health psychology From the readings: 1. Schneiderman (2004): Risk factors, Pathways/Mechaniss of Disease, and Interventions What are they? What kinds are there? What are some examples? 2. Ryff & Singer (1998): Core features of “Positive Human Health” What are they? Theory and Methods Main Themes/Points 1. Goals of science • Describe • Predict • Explain – the better your explanation, the better your able to predict • Control 2. The nature of theory 3. How to evaluate theory • Comprehensive • Logical • Parsimonious • Agrees with more basic science • Agrees with previous empirical research • Generates ideas/research • Disconfirmable • Practically useful 4. Pitfalls in interpreting research Specific Concepts 1. Randomized experiments Health Behavior/Seeking Health Care (Lecture 3) Main Themes/Points 1. Health behavior theories as explanations for health effects of demographic and psychosocial factors 2. Health behavior theories and their strengths/limitations • There are many models (from psychology or other fields) • Try to explain health-related behaviors o Used to guide efforts to change behavior • They have many similarities o Most concern:  perceived (beliefs/attitudes) health threats  perceptions of (beliefs/attitudes) threat reduction o Most reflect a rational, value-expectancy approach:  value: people consider utility of behavior (how good/bad it is)  expectancy: people consider probabilities (how likely are good/bad effects) o Some specific constructs appear in multiple models o Even where constructs differ, they are related o Two kinds of models  Variable-focused models  Stage models o Models discussed in assigned reading Specific Concepts 1. Health behaviors and illness behaviors • Health Behaviors: (primary prevention) actions/inactions when healthy • Illness Behaviors: (Secondary Prevention) actions/inactions with symptoms of illness o After diagnosis: Sick Role Behaviors  Societal expectations 2. Health Belief Model • Main Constructs and Paths o Demographic factors: age, sex, race o Psychosocial factors: personality, social support o General Health Values o Disease: perceived seriousness of and susceptibility to o Cues to action: public health warning, advice  Behavior: perceived benefits of and barriers to  Perceived threat of disease • Probability of Health-related Behavior • Key Features o Early and influential o Originated in public health o Basis: a simple conception of relevant beliefs 3. Theories of Reasoned Action/Planned Behavior • Key Features o Considered relevant to all behavior o Originated in social psychology o Basis: distinctive conceptions of attitude and norm; assumption that action is intentional o Attitude toward a behavior, likes and dislikes, positive or negative evaluation o Subjective norm for behavior, what do others expect me to do • Perceived control added to Theory of ReasonedAction o The ease/difficulty in achieving desired outcomes  Reflects past behaviors  Reflects perceived ability to overcome obstacles  Very similar to Bandura’s Self-Efficacy construct • Self-Efficacy: your confidence in your ability to perform a specific behavior to obtain a desired outcome • Outcome expectancy: confidence that if a specific behavior is performed correctly a desired outcome will be attained 4. Transtheoretical/Stages of Change Model • Precontemplation • Contemplation • Preparation • Action • maintenance 5. Precaution-Adoption Model 6. Health Behavior/Illness behavior/Sick Role 7. Self-efficacy 8. System 1 versus System 2 cognition • System 1 o Fast o Heuristic o Parallel o Automatic o Effortless o Associative o Slow-learning o Emotional o No sense of voluntary control • System 2 o Slow o Algorithmic o Serial o Controlled o Effortful o Rule-governed o Flexible o Neutral o Sense of agency From the readings: 1. Brewer and Rimer (2008): Health behavior models Processes models: Common Sense/Self-Regulation Theory (Lecture 5) Main Themes/Points 1. Analysis of factors contributing to delay in health-care seeking 2. The role of fear in behavioral responses to health threats 3. Feedback loops and self-regulation 4. Leventhal’s CS/SR Model and its strengths/limitations • Strengths o Based on psychological process o Stimulated much research/theory o An”open” model • Weaknesses o Difficult to measure constructs o Difficult to disconfirm o Not used much in intervention studies so far Doctor-Patient Interactions/Adhering to Medical Treatment (Lecture 6) Main Themes/Points 1. Socio-demographic and psychological factors in health care use • Socio-demographic factors o Gender: women use health care more than men o Age: young children and elderly use health care more than adolescents and young adults o SES: people with more income/education use health care more than those with less • Psychological factors o Stress  Symptoms of stress and of disease may be confused  Stress may increase or decrease attention to physical symptom o Personality and mood  Neuroticism…  Negative mood, mental health problems o Gender-role expectations: “real men don’t need doctors” o Stigma: guilt/embarrassment and sexual health 2. Gender roles and health care use 3. Doctor-Patient communication • How practitioners make it difficult: o Jargon o Ambiguous questions o Inattentiveness o Interrupting and directing answers o “baby talk” o Depersonalization o Patient stereotypes 4. The CS/SR model and medical adherence/compliance 5. Miller and Mangan study of patients’preferences for information Specific Concepts 1. Technical Jargon, Baby Talk, Depersonalization 2. Adherence/Compliance 3. Monitoring/Blunting 4. “Good” patient versus “Bad” patient From the readings: 1. Springer (2009): How do masculinity beliefs affect use of health care? Whom do they affect the most? Hospitals (Lecture 7) Main Themes/Points 1. Changing patterns in the use of hospitals • Patients are staying in the hospital for shorter periods of time but there are millions more each year 2. Coping with major surgery 3. Anderson study: Psychological preparation for surgery • Providing patients with information improves adaptation to major surgery 4. Psychological preparation for major surgery • Providing subjective information can reduce stress • Providing coping procedures can be helpful if done properly Stress I: PhysiologicApproaches (Lecture 8) Main Themes/Points 1. Stress as a mechanism/pathway influencing health/disease 2. Three general approaches to stress research • Biological: disease mechanisms
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