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Chapter 8

PSYC 328 Chapter 8: Chapter 8 Using Health Services


Department
Psychology
Course Code
PSYC 328
Professor
Barbel Knauper
Chapter
8

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Chapter 8 Using Health Services
LO1 How do We Recognize and Interpret Symptoms?
Recognition of a Symptom
o Individual Differences and Personality
Some individual differences are stable.
Some are consistently more likely to notice a symptom
Hypochondriacs people who are preoccupied and worried that normal bodily
symptoms are indicators of illness.
o 4-5%
o Extensive use of medical care services
The most frequent symptoms that show up among patients who convert their
distress into physical symptoms: back pain, joint pain, pain in the extremities,
headache, abdominal symptoms such as bloating, “allergies” to particular foods,
and cardiovascular symptoms such as palpitations
o Women are NOT more likely than men to report.
o Pronounced age effects -older people reporting more symptoms
Neuroticism: pervasive dimension of personality marked by negative emotions, self-
consciousness, and a concern with bodily processes.
Symptom perception hypothesis: high in neuroticism/negative affectivity
recognize symptoms more quickly, report more quickly, or both
o Neurotic, anxious people exaggerate their symptoms or more attentive to
real symptoms
o Anxiety and depression - distinct roles in the experience of physical
Depression: increased physical symptom reporting but only when
symptoms were recalled retrospectively
Anxiety: increased reports of physical symptoms only for
concurrent or momentary physical
o Encoding and retrieval processes are: depression - better retrieval of past
symptoms, anxiety - encoding of current symptoms
o Cultural Differences
How quickly and what kind of symptoms are recognized
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Possible explanation: cultural variations in the emotional responses
Symptoms arising from the same problem can be experienced differently
Menopause study: Canadian, American, and Japanese women
Symptom reporting were significantly lower among the Japanese women (more
likely to report no menopause symptoms, esp. hot flushes)
Konenki (menopause) different meaning
Cultural differences in symptom reporting may be accounted for not only by
socio-cultural differences in language and meaning but also perhaps by biological
variations in the experience of symptoms associated with different lifestyles
o Situational Factors
Influence whether a person will recognize a symptom
A boring situation more attentive to symptoms
E.g. more likely to notice itching or tickling in their throats cough in response to the
sensations during boring parts of movies than during interesting parts
Any situational factor that makes illness or symptoms especially salient promotes their
recognition.
Medical students’ disease: as they study each illness, many members of the class
imagine that they have it.
Studying the symptoms leads students to focus on their own fatigue and other
internal states symptoms consistent with the illness under study seem to
emerge
As students learn more about the different diseases, the distress from, but not the
perceptions of, apparent symptoms tends to decrease.
Normal process
o Stress
Can precipitate or aggravate the experience of symptoms.
Under stress believe they are more vulnerable attend more closely to their bodies.
Financial strain, disruptions in personal relationships, and other experience stress-
related physiological changes
Sometimes, symptoms are real but perception and interpretation may be exaggerated
Chronic illness, stress can change perceptions of the symptoms use of coping
strategies that are not always adaptive
Arthritis and inflammatory bowel disease: stress may trigger or flare-ups existing health
problems.
o Mood
Influences self-appraised health
Positive mood as more healthy, report fewer illness-related memories, report fewer
symptoms.
Negative mood report more symptoms, more pessimistic, perceive tas more
vulnerable to future illness
Even people with diagnosed illnesses report fewer or less serious symptoms when they
are in a positive mood
o Summary
Symptom recognition is determined both by individual differences in attention to one’s
body and by transitory situational factors that influence the direction of one’s attention.
Interpretation of Symptoms
o Understanding the contextual factors - how symptoms may be interpreted
o Prior Experience
Experience with a medical condition estimate the prevalence of their symptoms to be
greater and often regard the condition as less serious
Meaning of the symptom how common it is within a person’s range of acquaintances
or culture
Highly prevalent risk factors and disorders - less serious than rare or distinctive risk
factors and disorders
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o Expectations
Role in the experience and interpretation of symptoms
Simply expecting symptoms activates brain areas associated with the experience of
symptoms
o Seriousness of the Symptoms
Symptoms that affect highly valued parts of the body more serious, more likely to
require attention
Limits mobility, valued organ more serious, more likely to prompt the seeking of
treatment
Believing that a symptom has a profound impact on one’s life seeking medical care
and/or taking medication
Pain seek treatment more promptly
Cognitive Representations of Illness
o Illness Schemas
Illness representations (or schemas): concepts of health and illness that people have,
influence how they react to symptoms
Acquired through the media, through personal experience, from family and friends who
have had experience with particular disorders
For certain life-threatening illnesses, recognizing certain symptoms is critical for
survival need accurate illness schema public awareness campaigns
o E.g. Stroke: Vision problems, Headache, Weakness, Trouble speaking,
Dizziness”
o Do campaigns work?
Significant increase in public’s awareness, but decrease slightly
after
Number of ER visits for stroke increased significantly during the
campaign increased awareness about the warning signs for
stroke
Awareness alarmingly low among women, esp. Chinese and South
Asian
Lend coherence to a person’s comprehension of the illness experience
Influence people’s preventive health behaviours, reactions when they experience
symptoms or are diagnosed with illness, their adherence to treatment recommendations,
and their expectations for their health in the
Self-regulatory model of illness cognitions: Illness schemas have five distinct
components that include basic information about an illness guide decisions about the
types of actions that may need to be taken to help cope with the perceived illness.
Identity or label: illness’ name;
Consequences: symptoms and treatments that result, extent to which the person
believes the illness has ramifications for his or her life
Causes: factors that the person believes gave rise to the illness, such as
environmental or behavioural factors;
Duration expected length of time the illness is expected to last;
Cure: whether the person believes the illness can be cured through appropriate
treatment.
Conceptions develop quite early in life
Acute illness: caused by specific viral or bacterial agents, short in duration with
no long-term consequences.
o E.g. flu
Chronic illness: caused by several factors (health habits), long in duration, often
with severe consequences
o E.g. heart disease
Cyclic illness: alternating periods during which there are either no symptoms or
many symptoms
o E.g. heart disease
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