Chapter 3 Pyschology applied to health
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Prologue : The causes of death
1900 : acute (aiguë) infectious diseases (e.g. influenza, pneumonia) :
Why called them acute? Because they develop quickly, and quickly lead to death.
Today few people in North America die from these diseases.
Why? Less likely to become infected due to:
- better personal hygiene,
- better public sanitation (sewage, water)
- vaccines that inoculate us
Effective drugs can also treat infections.
Leading causes of death in North America today:
=> heart disease, cancer and stroke (=attack) :
- chronic diseases (develop slowly; no effective cure; live with them for long time)
- preventable (steam from unhealthy behaviors that can be changed).
E.g. quit smoking (implicated in all three causes) 25% of death will be prevented if people quit
cigarette. / don’t drink and drive (and don’t speed, wear seatbelts). / wear condoms (AIDS
prevention). / regular exercise; limit alcohol; use sun screen; get early testing (like for breast cancer
and heart disease)
Most of us are engaged in a behavior could perhaps will kill us => we talked about influenced death.
How can we encourage people to engage in healthy behaviors?
Health psychologist offers two answers:
1. Encourage health beliefs (which will translate into healthy behaviors)
2. Directly change unhealthy behaviors
1. Healthy beliefs
A. Basic idea:
- Unhealthy behaviors stem from unhealthy beliefs
- To change behavior, must change beliefs (by encouraging “healthy” beliefs)
But what are healthy beliefs?
B. Health-relevant beliefs (e.g. to quit smoking)
What beliefs will stem smoker to quit smoking for example?
This is the 6 important beliefs:
General health values (I’m interested and concerned about having good health, but the
smokers haven’t this health value, they don’t care)
Belief in a “health threat”: influenced by:
Perceived severity of threat (smoking causes lung cancer, which is deadly) Perceived vulnerability to threat (I could die from lung cancer if I smoke) BUT :
“unrealistic optimism” (bad things won’t happen to me)
Response efficacy: the health behavior (quitting) will reduce the threat (if I quit now I won’t
die from lung cancer) if we summarize: can something I do for avoid the threat? BUT Person
might say “it’s too late for me, I have smoked too long, I will get lung cancer even if I quit”.
Self-efficacy: Person is capable of performing the healthy behavior (e.g. I can do it!!)
Outcome beliefs: Weigh costs and benefits of healthy behavior (quitting):
- if benefits exceed costs, will try to quit
- if costs exceed benefits, less likely to try
Important in adolescents: Don’t care about long term negative outcomes of unhealthy
behaviors (e.g. I might die in 40 years… not really convincing).
- Better to emphasize immediate costs (my teeth will be yellow; my clothes will be smelly; I’ll
have a bad breath).
Subjective norms (two elements):
- Normative beliefs: what we think other people want us to do. E.g. family and doctor say yes
qui, but my friends say no (don’t quit).
- Motivation to comply: with these other people (can be high or low)
Intervention: want to add normative pressures to quit and increase motivation to comply
(my family wants me to quit… and I really want to make them happy quitting).
2. The cognitive-behavioral approach to Changing unhealthy behaviors (and beliefs):
A. Basic idea: unhealthy behaviors (and beliefs) are learned; so they can be unlearned (e.g.
reducing unhealthy snacks)
Systematically observe the problem behavior (self-monitoring): record behavior and
circumstances of behavior)
What are the stimuli that control the behavior?
Stimuli in the environment (if, so behavior is under stimulus control); to change the
behavior must change the controlling stimuli, e.g. Turn off TV (if so, remove link
between snacking and TV). / availability of snacks (if so, remove snacks)
The consequences of behavior (behavioral control ).( Cf. skinner and behavior theory,
positive reinforcement and negative reinforcement) e.g. snacking makes you “feel
relaxed” / snacks taste good!
Must introduce new consequences:
- If you remove the behavior you can rewards (compensation) for not snacking (new CD for
- Or you could be received a punishments for snacking (lose money)