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Chapter 8

PSYC 328 Chapter Notes - Chapter 8: Irving Janis, Gynaecology, Pap Test

Course Code
PSYC 328
Blaine Ditto

of 5
PSYC328 Chapter 8 Notes
Using Health Services:
Not everyone who feels sick or is sick seeks medical care from a professional, and not everyone who seeks medical care is
sick with a physical illness
Psychological, social, and cultural factors are involved in whether one chooses to seek medical care
How Do We Recognize and Interpret Symptoms?
People’s awareness of their body is limited, allowing for many psychological and social factors to influence the recognition of
symptoms and interpretation of illness
Recognizing and then interpreting symptoms as reflecting an illness are the necessary first steps before decisions to seek
medical care can be made
Recognition of a Symptom:
In the face of seemingly severe symptoms, some people continue normal activities, while others go to bed when they detect
any minor bodily disturbance
Individual Differences and Personality:
Some people are consistently more likely to notice a symptom than others
Hypochondriacs (4-5% of population) worry that normal bodily functions are signs of illness
Most frequent symptoms among patients converting distress to physical pain are: back pain, joint pain, pain in the extremi-
ties, headache, abdominal symptoms such as bloating, food “allergies”, cardiovascular symptoms such as palpitations
Women are not more likely than men to report symptoms, but older people are
Neuroticism (personality dimension marked by negative emotions, self-consciousness, and concerns with bodily processes)
affects perception of symptoms
Symptom perception hypothesis: people high in neuroticism or negative affectivity trait recognize and/or report symptoms
more quickly
Neurotic people may exaggerate their symptoms or simply be more attentive to real ones
Depression linked to increased physical symptoms but only when recalled retrospectively
Anxiety increased reports only for concurrent or momentary physical symptoms
These differential association are consistent with the notion that encoding and retrieval processes are distinct for anxious and
depressed individuals, with depression linked to better retrieval of past symptoms, whereas anxiety heightens encoding
current symptoms
Cultural Differences:
Reliable cultural differences in how quickly and what kind of symptoms are recognized
Reasons for these differences not fully understood
Cultural differences in emotional responses may be at the root of observed differences
Even symptoms from the same problem can be experienced differently
Japanese women less likely than American women to report menopause symptoms – differences may be due to socio-cultur-
al differences in language/meaning and biological variations in experiencing symptom associated with different lifestyles
Situational Factors:
Situational factors influence whether a person will recognize a symptom
Boring situations makes people more attentive to symptoms than an interesting situation
Medical student’s disease: students imagine they have the illnesses they study and symptoms consistent with the illness
under study seem to emerge, but as they learn more about different diseases, their distress (not perception) from appar-
ent symptoms tends to decrease – likely a normal process, not hypochondriasis
Stress can precipitate or aggravate experience of symptoms
People who are under stress may believe that they are more vulnerable to illness and so attend more closely to their bodies
Stress-related physiological symptoms can include accelerated heartbeat or breathing and people can interpret these as
symptoms of illness
Symptoms people experience are real but their perception and interpretation of the meaning of the symptoms may be exag-
gerated if they are under stress
Stress can trigger symptoms or flare-ups of existing health problems
Mood influences self-appraised health
People who are in a positive mood rates themselves as more healthy, report fewer illness-related memories, and report fewer
symptoms (opposite for negative mood)
Even people who have diagnosed illnesses report fewer or less serious symptoms when they are in a positive mood
Interpretation of Symptoms:
Interpretation of symptoms is heavily a psychological process
Understanding the contextual factors surrounding the symptom can often provide valuable clues about how it may be inter-
Individual, historical, cultural, and social factors all conspire to produce interpretations of the symptom experience
Prior Experience:
Interpretation of symptoms is heavily influenced by prior experience
People with experience of medical condition estimate the prevalence of symptoms to be greater, and regard condition as less
A symptom’s meaning is also influenced by how common it is within a person’s range of acquaintances or culture
High prevalent risk factors and disorders are generally seen as less serious than rare or distinctive ones
Expectations play a role in experience and interpretation of symptoms
Simply expecting symptoms activates brain areas associated with the experience of them, and distracting yourself reduces
Seriousness of the Symptoms:
Symptoms affecting highly valued body parts are seen as more serious and requiring more attention (ex. eyes, face)
A symptom will be regarded as more serious and will be more likely to prompt seeking of treatment if it limits mobility or if it
affects a highly valued organ
Believing a symptom has a profound impact on one’s life can prompt seeking medical and/or taking medication
If a symptom causes pain, a person will seek treatment faster
Cognitive Representations of Illness:
Illness Schemas:
Illness representations (schemas): organized conceptions of illness influencing how people react to symptoms
Illness schemas are acquired through the media, personal experience, and family/friends who have had experience with par-
ticular disorders
These schemes can range from sketchy and inaccurate to extensive, technical and complete
Their importance stems from the fact that they lend coherence to a person’s comprehension of the illness experience
Schemas influence preventative health behaviours, reactions to diagnoses and experience of symptoms, adherence to treat-
ment, and expectations for future health
Five distinct components (info. about illness): identity (name of illness), consequences (symptoms, treatment, extent person
believes illness will affect life), causes (factors believed to give rise to the illness), duration (expected length of time illness
is expected to last), cure (belief of whether illness can be cured)
Characteristics of illness cognitions guide decisions about the types of actions needed to cope with illness
3 models of illness:
Acute illness: caused by specific viral/bacterial agents, short duration; no long-term consequences (ex. Flu)
Chronic Illness: caused by several factors, long duration; severe consequences (ex. Heart disease)
Cyclic illness: alternating periods of many symptoms/no symptoms (ex. Herpes)
Disease model a person has can greatly influence behavior related to disease (ex. Diabetes can be seen acute or chronic de-
pending on the person and thus people will treat their disorders differently)
The conception of disease an individual holds determines health behaviors in important ways
The Lay Referral Network:
Lay referral network (LFN): informal network of family/friends who offer their own interpretations of symptoms well before
medical treatment is sought
LFN preferred mode of treatment in many communities
70% of people talk with people in LFN about whether to seek treatment for symptoms
LFNs often recommend home remedies and alternative forms of treatments
Alternative medication is so on the rise, the World Health Organization has taken steps to evaluate their efficacy
Natural health products (NPH): include vitamins, herbal remedies and teas, minerals, plants
71% of Canadians have tried NPH and 31% use them daily
Only a fifth of Canadians consult alternative therapy providers (ex. chiropractor) in a year
Therapies mainly used to complement rather than replace traditional medicine, but health care providers are usually unaware
of the supplemental treatments and this can cause risk of conflicting treatments
The Internet:
Internet could be a LFN on its own
4million Canadians seek health information online per day
6/10 internet users have used the net to seek health information
Women 2x more likely than men use internet for health info, and households with children are much more likely to. Men 15-24
are least likely
Most common info searched is for specific diseases/conditions - Lifestyle information is 2nd
96% of surveyed physicians say internet will positively affect health
What Predicts the Use of Health Services?
Wait times main reason for not getting care when needed in Canada, and cost in main barrier in USA
Presence of atypical or numerous symptoms, serious illness, or disability are common reasons people seek help, but individ-
ual and social factors also play a role
Age influences use of healthcare serves- very young, and elderly most frequent users
Young children develop many infectious diseases and more likely to experience unintentional injuries such as falls- children
under 5 accounted for more ER visits than any other group
In late adulthood, chronic conditions and diseases start to develop
Advancing age (as isolated factor) associated with increased physician consultations
Women use healthcare system more than men
Pregnancy and childbirth account for much of gender difference but not all
Women have better homeostatic mechanisms- report pain earlier, experience temperature changes more rapidly, and detect
new smells faster
As women age, use becomes closer to men
It is more socially acceptable for women to express feelings of pain
Economic factors- more women work PT/not at all so don’t have to skip work for treatment- however less work also means
more money woes which can lead to poorer health
Medical care for women is also more fragmented- physician, gynecologist, breast cancer specialist, etc- medical care not well
structured to meet their needs
Socio-economic Status:
Income, education; and culture associated with how and when health services are used
Lowest-income households and people without high school education are less likely to have visited family doctor in a year,
but those in the same group that do consult a physician are more likely to make 4x visits to physicians than higher SES
people, and more ER visits/hospital admissions
People in rural areas have less access to healthcare, especially specialists
Cultural factors influence types of medical and health services people use
Use of health services vary considerably by ethnicity in Canada
Ethnic minorities (except Aboriginals and Black people) more likely to see physician, but less likely to see specialist (including
cancer screening, Pap test, prostate screening, etc.)
Linguistic barriers may influence use of health care services- important to provide linguistic minorities with language appropri-
ate health care services
Misconceptions about availability of services can contribute to low use among minorities
Social Psychological Factors:
An individual’s attitudes and beliefs about symptoms and health services influence whether they use health services
Health belief model - 2 factors predict if a person seeks treatment: extent to which person perceives a threat to health, and
degree to which they believe a health measure will be effective in reducing the threat
Health belief model explains people’s treatment-seeking behavior well
Use of healthcare services influenced by socialization - actions of parents
How Are Health Services Misused?
People misuse services by seeking treatment for insignificant medical problems
People also misuse services by not getting treatment when they should