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Chapter 6

Chapter 6 Emotional Health and Well.docx

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Psychology 2036A/B
Sarah Khan

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Chapter 6 Emotional Health and Well­Being Curanderismo – a form of practiced medicine found in many Latin American countries; performed by a curandero Psychosomatic illness – an illness believed to have underlying emotional or psychological causes Section I Four Models of Well­Being Biomedical Model - A model supported by scientific inquiry and empirical study - Proposes that health is the absence of disease or dysfunction - Disease is defined as an abnormality, dysfunction or deviation in a body organ or other body structure - This wholly physiologically based concept of health is consistent with some earlier beliefs - The biomedical model defines dysfuntionality as an illness and interprets physiological symptoms as signs of the illness Limitations of the Biomedical Model - By focusing on the physical causes of illness, the biomedical model overlooks emotional or psychological determinants that also influence well-being - The second limitation is the problem-oriented focus of the biomedical model – proposes that a change in normal bodily functions that results in a deviation from or dysfunction of the body signals a problem to be rectified - Some illnesses can occur independent of symptoms o i.e. hypertension (aka “the silent killer”) – often develops with no observable symptoms o i.e. HIV – no external symptoms - In some cases, external symptoms of an illness can appear without evidence of an underlying disease or diseases may be present but no identifiable symptoms are present Biopsychosocial Model - Engel - AKA holistic health model - Supports the belief that well-being is determined by biological, psychological and sociological factors - Psychological influences: emotions, social support systems, health behaviours, personal traits - Sociological factors: familial, cultural, and community factors - Appends the psychological and sociological determinants of health to the biomedical model – biology is still at the center of the definition Psychological Factor #1: Emotions - Hippocrates: relationship between health and emotions o Believed that an imbalance in any one of four body fluids (humors) could lead to illness  Black bile  sadness/melancholy  Yellow bile  anger - Emotions and the Immune System o Rabin: One way that emotions affect our immune system is through the nerve fibers in our bodies o Fibers connect with the CNS – brain + brain stem o The nerve fibers act like cables carrying information from our receptors to our CNS o The messages are carried by neurochemicals – neurotransmitters – that travel within the neuron cables o When sending messaged from a receptor site to the brain, a NT is triggered at the receptor site and passed along from neuron to neuron via the dendrites until the message reaches the processing center of the brain  Dendrites are branchlike structures that extend from the cell body and receive the neurochemical message from other cells o Once the message is received, the axon carries the message to neighbouring cells o The nerve cables that carry messaged can be categorized as afferent or efferent nerve fibers  Afferent = carry info TO the CNS from the receptor sites  Efferent = carry info FROM the CNS to the periphery of the body to coordinate the response - Impact of Emotions on Health o Research on stress helps to demonstrate the effect of emotions on health outcomes o Immune system – body’s defense system against illness-producing microorganisms o Cohen: stress may influence the production of hormones that turn affect the immune system o Epinephrine – a stress hormones that helps to suppress the immune system  Suppressing the body’s immune system decreases the body’s ability to fight foreign or disease-carrying microorganisms and increases the risk of contracting a disease o If an individual experiences high levels or extended periods of stress, the body may increase production EPI and signal the brain the immune system o Schulz: link between depression and mortality  Individuals with depressive symptoms were 25% more likely to die within 6 years  Emotional factor (depression) negatively influences the physiological health of individuals, resulting in an early onset of death o Depression cannot be defined as the definitive cause for early death  Depression can affect hormone production  immune suppression  Depression can lead to self-destructive behaviours - Negative Emotions, Positive Effects o Sympathetic nervous system (SNS) is part of the autonomic nervous system (ANS) o The SNS is responsible for mobilizing the body in response to danger  i.e. stimulating immune system o Negative emotions can lead to behaviours negatively affecting health yet, can also lead to health-enhancing behaviours in some causes o Studies suggest that negative emotions can increase the likelihood that individuals will seek timely medical help o Salovey: when experiencing health problems, negative affect such as anxiety or depression may cause a person to perceive his or her physical condition more accurately and therefor increase the probability that the person will seek medical help - Positive Emotions and Health o Cohen: exposed participants to a common cold virus to determine whether a person’s affect influences disease progression  Study revealed that participants with a positive affect (positive emotions or feelings) at the time of exposure to the virus developed a less severe form of illness than did participants with a negative affect o Research suggests that positive affect can also decrease mortality rates among people with diabetes o Affect is just one of a number of factors that influence health – emotions are just one of several factors that influence physical health Psychological Factor #2: Health Behaviours - Emotions can and do influence health behaviours – i.e. alcohol use and negative emotions - Depression and anxiety are cited by some individuals as factors that contribute to their abuse alcohol or other substances Sociological Factor #1: Socioeconomic Class and Income - Socioeconomic class greatly affects his or her access to care - SES is a term that categorizes individuals according to their positions in society as determined by their parents’ level of education and occupation, their family’s social status and their family’s income and wealth o Poor - $500,000 - SES is a sociological factor that affects health by regulating access to medical care o The ability to pay for health insurance or to pay a medical provider’s fee will influence a person’s likelihood of seeking health care in a timely manner - Studies also suggest that people in lower SE classes may express negative affect more frequently than people in higher SE classes due largely to environmental factors Sociological Factor #2: Family and Culture - Familial and cultural pattern of behaviour, including diet and orientation to exercise and sports, also contribute to overall well-being - Maintaining a regular exercise regimen is dependent on a number of factors, including past patterns and practices which are often influence by family or cultural practices Wellness Model - Includes the same psychological, social and emotional factors included in the biopsychosocial model, but it adds quality of life and spirituality Quality of Life - Defines health according to an individual’s assessment of his or her own state of physical, mental, emotional, and spiritual well-being - Mr. B Case Study o Mr. B unwillingly undergoes an emergency amputation of two fingers to protect him from a likely infection o Medically, the operation restores him to a state of good physical health o According to Mr. B, removal of his two fingers took part of his life force o For Mr. B, the procedure diminished his quality of life and negatively impacted his spiritual well-being - Example: knee replacement surgery o Often necessary in the case of knee osteoarthritis o The decision to have knee surgery often is based on the patient’s feelings of vulnerability because of the unreliable knee, the desire not to depend on others for mobility, and the fatigue associated with an increased effort when performing daily tasks  quality of life issues Spirituality - Scientists often consider spirituality a pseudoscience or a primitive superstition and therefore not something to be included in rigorous studies that explain individual health outcomes - Spirituality does not necessarily refer to religious dogma – rather it refers to an individual’s philosophy, values and meaning of life - Scientists suggest that the health-enhancing role of spirituality may afford individuals peace and tranquility in the face of stressful events and a sense of meaningfulness that provides them with direction and fulfillment o i.e. Christian denomination often include abstinence from alcohol - Studies examining the relationship between spirituality and well-being among migraine- sufferers o Migraines are believed to be associated with depression and anxiety  suggests an emotional basis for the illness - Research on the effects of spirituality on well-being suggests that spirituality offers some individuals tranquility in troubles times, guidance on healthy lifestyles and behaviours, and emotional wellness Social Ecological Model - Determinants unique to the social ecological model: physical and psychological environments, health systems, and health policy Environmental Determinants - 1. Social environment o Interpersonal, familial, and cultural factors that affect an individual’s emotional state of well-being - 2. Physical space and perceived quality of that space as a determinant of health - Physical Environmental Determinants o i.e. contaminated environments can be severely detrimental on health o Hazards like toxic waste sites contribute to high incidences of disease and high infant mortality rates; many cancers and severe respiratory illnesses have also been linked o Lower SE classes are more likely to be exposed to health-compromising environmental conditions - Health Systems and Health Policy o The inclusion of health systems and health policy are unique to the social ecological model o Regulatory agencies and regulations that define the structures of health care and that regulate its services are considered distinct determinants of health outcomes o Smith: found that the absence of sewers and drainage systems was correlated with the frequency of high fever among residents o Health policy initiatives can influence health status and can either enhance or impair the health outcomes of citizens - Psychological Environment and Health o Environment can also be defined as the quality of an individual’s physical space as determined by psychosocial variables o i.e. overcrowded neighbourhoods or high crime rates are psychosocial variables that influence the quality of life and overall well-being o High crime  1. Less likely to go outside and exercise 2. More anxiety involved with living in such an environment  Increased anxiety about their safety may have long-term consequences for well-being - Workplace Environments as Determinants of Emotional Health o Kawano: study among nurses in Japan to determine whether working in specific medical services units (i.e. operating rooms, ICU, surgical unit) cause higher levels of emotional distress or physical fatigue  Results: nurses in each of the three special units experience higher levels of emotional distress than their colleagues in nonspeciality units  Operating room nurses – reported higher levels of fatigue  ICU nurses – reported higher levels of anxiety  Surgical or internal medicine nurses – reported higher levels of depression o Work performed by nurses is vital to returning a patient to overall well-being o In settings like the operating room or in ICUs, unintentional mistakes can seriously impair a patient’s health or even contribute to death  Higher levels of anxiety or depression reflects nurses’ concern about the consequences of an error – the potential loss of life Section II Positive Psychology Positive Psychology – involves a systematic study
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