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Health Psych IB style
Transcript of Health Psych IB style
-Discuss physiological, psychological and social aspects of stress.
-Evaluate strategies for coping with stress (for example, stress inoculation therapy, hardiness training,
yoga and meditation). Substance abuse, addictive behaviour and obesity • Explain factors related to the development of substance abuse or addictive behaviour.
• Examine prevention strategies and treatments for substance abuse and addictive behaviour (for
example, Alcoholics Anonymous, family therapy, drugs and biopsychosocial treatments).
• Discuss factors related to overeating and the development of obesity.
• Discuss prevention strategies and treatments for overeating and obesity. General framework
(applicable to all topics in the option) -To what extent do biological, cognitive and sociocultural factors influence health related behaviour?
-Evaluate psychological research (that is, theories and/or studies) relevant to health psychology. Health promotion -Examine models and theories of health promotion (for example, health belief model, stages of change
model, theory of reasoned action).
-Discuss the effectiveness of health promotion strategies (for example, measurement of outcomes,
cultural blindness, cognitive dissonance). according to Selye (1956) stress refers to a failure to respond appropriately to emotional or physical threats -stress is a deeply personal experience
-shares with emotion the three components of subjective interpretative experience (physiological reaction, cognitive reaction and behavioral expression)
-stressors can be defined as any event, real or imagined, cognitive, environmental or biological that leads to stress Genders react differently to stress.
-Frankenhauser (1976) reported boys have adrenaline rushes in exams that take longer to return to normal, whereas girls had a gentler, lower increase and returned to normal much quicker psychoneuroimunology is used to describe the interactions between psychology and the physiological systems.
-Powell (1967) found that children who had been exposed to significant stress in their home life (marital discord, alcoholism, abuse) had impaired growth due to a lowering of production of the growth hormone in the pituitary gland.
-Stone (1987) correlated negative life experience with respiratory illness while also arguing positive life experiences decline in the run up to serious illness. For a situation to be stressful it must be recognized as such (Lazarus, 1966). Any event, real or imagined, can be perceived as stressful
-Kagan (2007) demonstrates how humans have complex semantic concepts for things that do not exist Expectations of physical health have been shown to have an impact on health outcomes.
-Reed (1999) HIV+ men who are bereaved stay healthier longer if they remain optimistic about their own future Humans are sensitive to changes in their social environment.
-Holmes and Rahe (1967) stress scale of life events. The higher the score on the scale the likelihood of health problems increases National Institute for Occupational Safety and Health (NIOSH) (1999)m workforce stress can be defined as harmful physical and emotional responses that occur when there is a poor match between job demands and the skills and resources, or personal needs of the worker. de-individuation-losing their identity when working for a large corporation which demand that employees express themselves in a certain way.
-Rutter and Fielding (1988) who positively correlated the suppression of emotions in the workplace with stress and negatively correlated the suppression with job satisfaction Stress inoculation training (SIT): developed by Meichenbaum in the 70's.
-3 distinct phases
(1) Conceptualization phase-collaborative relationship is established between the client and the therapist using Socratic-type exchanges. Clients learn which aspects are changeable and which are not.
(2) Skills acquisition and rehearsal phase- skills are offered and rehearsed. Include emotional self-regulation, cognitive restructuring, problem-solving, interpersonal communication skills, attention diversion procedures, using social support systems and fostering meaning-related activities
(3) Application and follow through phase- provides opportunities for the clients to imagine stressful events and apply the variety of coping skills across increasing levels of stress Evaluation of SIT
-comes under cognitive-behavioral (behavioral meaning behavior and reward/punishment following or stimulus and response) therapy.
-advantage is that it accepts the stress an an individual can experience is often unavoidable and tailors therapy to that individual
-takes a lot of time and money and is not suited to all lifestyles. Fits North American cultures well Yoga: mental and physical disciplines from India.
-Hatha yoga from Swatmarama (15th, 16th C Yogi) and promoted concepts of
-asana to promote physical flexibility
-pranayama which is subtle energy control to promote breathing
-nadis channels the flow of consciousness through the body
kundalini is the pure desire that yoga can awaken to allow the individual to be more in touch with the world Evaluation of Yoga: Cohen (2006) said it improves quality of life by providing exercise, relaxation and self-awareness.
-Lasater (1995) in her book Relax and Renew: Restful Yoga for Stressful Times argues that the use of props provides a supportive environment for relaxation, each restorative sequence is designed to move the spine in all directions giving the back flexibility, includes inverted pose which reverses the effects of gravity on the body, it stimulates and soothes the organs
-stress is often specific. Marital stress may need marital counseling not yoga. Harfiel et al., 2010: organized a randomized controlled trial in the UK. 48 employees placed in either yoga group or wait-list group. Yoga group was offered six weeks of hour long lunch sessions. Wait-list group received nothing. Yoga group reported significant improvements in feelings of clear-mindedness, composure, elation, energy and confidence. Also reported increased life purpose and satisfaction and feelings of greater self-confidence in stressful situations.
http://aphdinyoga.wordpress.com/2011/08/04/yoga-and-its-effect-on-stress/ Acute stressors: appear suddenly, do not last long or call immediate attention Chronic Stressors: last for a long time and are a constant source of worry. Affects in damaging ways. Social self-preservation theory, suggested by Kemeny et al. (2005), that one's "social self"or to social esteem and status, are associated with specific negative cognitive and affective responses, such as shame and humilation. psychoneuroimmunology (PNI)-based on the assumption that an individual's psychological state can influence the immune system via the nervous system. A substance is anything an individual ingests to alter their cognition, behavior or affective state (mood). a person is said to be addicted when their behavior leads to a significant impairment of their ability to meet their obligations in employment, relationships or the community Alcoholism: a disabiling addictive disorder characterized by a compulsive need for alcohol that leads to negative effects on the drinker's physical, emotional and social health.
seen by Western societies as a treatable disease Physiological Factors contributing to alcoholism:
(1) genetics-prevalent in male bloodlines. According to CDC 17% of men and 8% of women become alcoholics in their lifetime
(2) addiction linked to risk behavior, low inhibition, resistance to punishment and tendency to favor short-term rewards over long-term rewards
(3) more likely to develop in those exposed to drug early
(4) significant differences in rates of alcoholism across cultures and racial lines Cognitive and sociocultural factors contributing to alcoholism
-Been around for 12000 years. Engrained into culture with reinforcement, punishment and observational learning.
-drinking is a social norm. Pub life in UK, characters in t.v. and movies, culture at SME
-Chen et al. (2005) children and teenagers respond to advertisements featuring animals, humor, music and celebrities. Suggest alcohol advertisers should use less appealing things for kids/teenagers. Hill and Casswell (2001) outline how underage drinking is more likely to lead to alcohol problems in later life because young people are expecting positive consequences from alcohol use.
Snyder et al. (2006) found that youths who saw more alcohol advertisements drank more on average. Young people from markets with more advertisements showed increased drinking levels in their 20's, while drinking plateaus in early 20's for other markets.
Is this common sense? Don't alcohol manufacturers want to attract new consumers and maintain current ones. Social learning theory. Prevention strategy in the UK:
-advertisers are not allowed to promote alcohol to under 18s and this includes any context, medium or content which might appeal to under 18s (text messages)
-no medium can be used to promote alcohol if more than 25% of its regular audience is under 18 (children's networks, some magazines and tv shows)
-in adverts promoting alcohol none of the models should look under 25 or acting in a way deemed adolescent.
-adverts cannot reflect the culture of people who are under 18 in a way that would promote drinking (pop stars who appeal to kids can not be used in advertising)
cited from KidsAndAdvertising 2010 AA: Founded in OH in the 1930's by Bill Wilson and Dr. Bob Smith
12 step program
1.We admitted we were powerless over alcohol - that our lives had become unmanageable.
2.Came to believe that a Power greater than ourselves could restore us to sanity.
3.Made a decision to turn our will and our lives over to the care of God as we understood Him.
4.Made a searching and fearless moral inventory of ourselves.
5.Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6.Were entirely ready to have God remove all these defects of character.
7.Humbly asked Him to remove our shortcomings.
8.Made a list of all persons we had harmed, and became willing to make amends to them all.
9.Made direct amends to such people wherever possible, except when to do so would injure them or others.
10.Continued to take personal inventory, and when we were wrong, promptly admitted it.
11.Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12.Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs. Twelve-step programs have been adopted by other groups. Can be adapted to any culture and there is an emphasis on spirituality and surrendering free-will, first to the power of the addiction and secondly to the power of a sponsor and a notion of God.
Draws criticism and praise for non-health care professionals offering support/advise. Former addicts helping current addicts.
Lack of subtlety in meetings, not all attendees are full-blown alcoholics but will be forced to see themselves as such.
Disease approach and definitive notion of abstinence reduce the chances of all those in need receiving appropriate help. Cutting it out completely is not always the best option (Shute, 1997) Disulfriam is considered the most effective drug for dealing with alcoholism. Blocks the enzyme acetaldehyde dehydrogenase from converting acohol into the relatively harmless acetic acid.
-Effect of disulfiram is to cause an instant and intense 'hangover' in anyone who drinks alcohol while taking it. Krampe et al. (2006) conducted a 9 year study and found an abstinence rate of over 50% with the drug.
(symptoms include shortness of breath, nausea, vomiting, throbbing headache, visual disturbance, mental confusion, postural fainting and circulatory collapse. The Sinclair Method is a treatment for alcoholism that involves the use of opiate antagonists such as naltrexone or nalmefene while continuing normal drinking habits in order to decrease the craving for alcohol over time. It relies upon a mechanism called pharmacological extinction, which works by blocking the positive reinforcement effects of ethanol-triggered endorphin in the brain. Proponents claim that thousands of patients have been cured by the Sinclair Method since the early 1990s BPS-an eclectic approach to treatment.
Assumes all three (biological, psychological and social) play a part so all three should be part of treatment. Clinician distinguish between volition (personal need, desire, motivation) and biologically deterministic elements (genetic predisposition and brain chemistry). Tavakoli (2009) suggests treatments should take place under the notion of case formulation.
Case Formulation is a more personalized approach to patients that includes historical data, medical examination and a variety of other relevant details Tavakoli puts the perspective model forward. 4 Perspectives
1. the disease perspective- what a patient has in terms of an identifiable illness
2. the dimensional perspective- what a patient is in terms of their temperament and intellect
3. the behavioral perspective- what a patient does in terms of the goal-directed, goal-driven features of their life
4. the life story perspective- what a patient encounters in terms of their life story and the meaning they assign to events in their life. Obesity: WHO defines it as a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health According to US Centers for Disease Control and Prevention:
-between the periods of 1971-74 and 1999-2002 number of overweight teenagers soared from 6%-16%
-between 2003-2006, 11.3% of children and adolescents were obese and 16.3% were overweight
-the obesity condition known as adult-onset diabetes was renamed type II diabetes, because the disease is increasing in teenagers
-between the periods of 1976-80 and 1999-2002 the rate of adult obesity more than doubled, rising from 15%-31%
-the overall rate of obesity and being overweight in the USA were 47% in 1976-80 and 65% in 1999-2002.
-this overall rate continues to rise since 2002, although some studies show the recent rise has not been statistically significant. Countries experiencing obesity crisis have access to cheap processes food. 3 decades ago fewer than 10% of people in the UK were obese now it is 25%.
But not everyone is getting heavier and not everyone is forced to eat poor food and not exercise. Sociocultural Factors related to obesity Sedentary lifestyle-work now means little energy expended at work as well as after work.
Wilkinson (2005) looked at 12000 3 year olds either raised by parents or grandparents and discovered that the rate of obesity is higher by 34% if raised by grandparents Secondhand obesity- notion that children learn to be obese. Example of how Bandurian modeling concept can lead to a corrosive behavior being passed on to a child. Fat acceptance movement (fat power) is a concerted effort to normalize obesity in society. Tries to link the notion that body size is not linked to health.
Can be split into those who are fat and want to lose weight and those that want civil rights for fat people and a wider acceptance of obesity. Social learning theory applied to processed foods:
2004 Coca-Cola spent $2.2 billion on promotions and sold $22 billion worth of products
1999 Pepsi's chief of marketing states 8-12 demographic is a priority
Schlosser (2001) outlines how school age children are targeted while they are still developing their taste preferences
Companies pay US school districts for marketing rights.
McDonalds operates more playgrounds designed to attract children and their parents
Coca-Cola was the exclusive marketing partner for Harry Potter Schlosser (2001) Fast Food Nation: soft drinks are a cultprit
1978 teenage males drank 7 oz. a day, today they drink 3x the amount
empty calories with no nutritional benefit
20 years ago the teenage male drank twice as much milk as soft drinks and today they drink twice as many soft drinks as milk. Biological Factors related to obesity: most cases are caused by poor diet, lack of exercise and lack of self-discipline. Minority caused by physiological abnormalities
hypothyroidism-under active thyroid
very rare genetic disorders including Froehlich's syndrome in boys, Laurence-Moon-Biedl syndrome and Prader-Willis syndrome There are genetic predispositions towards large or small appetite that have influence
Chances of a thin parent having an overweight child are about 7% (Garn et al. 1981) Obesity in the media David Kessler argues that people are becoming conditioned hypereaters. 'conditioned' because food intake becomes a response to widely available food, 'hyper' because the eating is excessive and hard to control.
-higher sugar, fat and salt intake make the individual want to eat more as they make the intake of food compelling for the brain bliss point-people get the greatest pleasure from sugar, fat or salt here. Corporations deliberately design food to create a bliss point, making a product high in a hedonic value.
Food is either 'loaded' into a core ingredient or 'layered' on top of it. Cognitive Factors related to obesity Hard to maintain healthy lifestyles in face of corporate advertising, peer pressure, food bliss points and shifting societal norms.
Individuals with high self-acceptance are likely not going to change
Binge eating disorder (BED) affects approximately 2% of adults in the US. People suffering from BED seek comfort in food and large amounts of it.
Binge eaters tend to have other psychological disorders and most commonly depression (Marcus, 1995) Prevention Strategy: Education Education only works for people who want to lose weight.
'No food is a bad food in moderation' is not a good concept, especially for kids.
Many people remain ignorant about the food industry in terms of how food is produced and where it comes from. Political Intervention Food labels in US required to have information so consumers can make informed choices
Commercial zoning si now regulating where fast food outlets can open are under control of national and local governments.
Traditionally fast food places are located in poor economic areas. Supermarkets have been linked with healthier diets when a greater range of food is available. The Institute of Medicine of the National Academics (2005) report, Preventing Childhood Obesity, argues that local and state governments should work with communities to support partnerships and networks that expand availability of and access to healthy foods. Grass roots movement Campaign to end obesity, Two Angry Moms, Queen of Hearts Foundation, etc. have made a significant contribution to the community landscape via media appearances, school visits and local organizing. Many school districts in the US have now banned soft drink, junk foods and sweets from school vending machines and cafeterias in response to pressure from parents and anti-obesity groups Treatments for obesity Dieting is associated with a food programme designed to limit energy intake to a level below the rate of energy use
There are many types of diets:
very low-energy diets (VLEDs) aim to supply very little energy in the form of calories but provide all essential nutrients. Have to be done with strict medical supervision
low-energy diets (LEDs) set caloric intake at 800-1500 calories a day and thus allow for greater use of natural foods. set habits and routines for greater long term health
low-fat diets (LFDs) reduce fat content but promote protein, complex carbs and fiber. Less effective for obese patients, but effective for overweight people
low-carbohydrate diets (LCDs) reduce carb intake but promote high levels of protein consumption. Induce weight loss for obese patients, but negative health risks for cardiovascular factors as well as poor long-term benefits
alcohol abstinence has been shown to help weight loss since alcohol suppresses fat oxidation Self-help groups:
-Overeaters Anonymous (OA) is similar to AA. Same 12 step program to work with all types of eating disorders
-Westphal and Smith (1996) report an average weight drop of 21 pounds.
-Ronel and Libman (2003) found a cognitive shift in thinking of successful members
experience of self
universal order of God
relationship with others
perception of the problem Surgery
Gastric bypass procedure that reduce the functional volume of the stomach. Aim to reduce amount of food being consumed.
physiological change is dramatic. Adams et. al (2007) researched 43 post op patients and found that almost all of them tested positive for a hydrogen breath test. Suggests overgrowth of bacteria in the small intestine which causes nausea and vomiting. Prohibit absorption of mineral and nutrients.
Psychological change occurs: most patients are able to actively enjoy participation in family and social activities. Elkins et al. (2005) many who have undergone surgery suffer from depression in the following months due to a change in the role food plays. health belief model (HBM) Model first developed by Rosenstock (1996), rests on assumption that people will engage in health behavior if they understand that a health problem will arise if they do not.
-people first evaluate a threat to their health (fast food) and then engage in a cost-benefit analysis of what actions to follow to either counter the threat or ignore it.
Problems with this model
assumes people are rational when the evidence is sometimes to the contrary.
in western culture we know that smoking causes cancer, binge drinking poses health risks, unprotected sex spreads STDs and all these things still happen.
assumes people care about their health or the health of those they care for.
model ignores physiological determinism. Kessler (2010) argues that food is deliberately designed with the use of chemical enhancers to make it compelling and create a bliss point for the consumer, instilling positive rewards for consumption above need.
assumes people are active thinkers able to make choices within the realm of free will.
considers only perceived obstacles to effective health regulation, not practical obstacles.
Mair et al. (2005) to show how fast food outlets often in abundance in poor neighborhoods where people are less likely to have personal transport for ease of access to a wider range of food choices. Theory of reasoned action (TRA) key assumption of this theory is people do not always indulge in behavior that is in0line with their stated beliefs and intentions. Therefore, potential behavioral outcomes will resonate with different levels of intentional potency for each individual. Theory of planned behavior (TPB) Ajzen (1985) modified TRA into this when he added the concept of perceived behavioral control, including self perception. Self-efficacy theory (SET) Self-efficacy: the belief one can successfully engage in a behavior to produce the desired outcomes
outcome expectancy-a persons estimation that a given behavior will actually lead to those desired outcomes. Bandura (1994)notes people with a strong sense of self-efficacy:
view challenging problems as tasks to be mastered
develop deeper interest in the activities in which they participate
form a stronger sense of commitment to their interest and activities
recover quickly from setbacks and disappointments.
People with a weak self-efficacy
avoid challenging tasks
believe that difficult tasks and situations are beyond their capabilities
focus on personal failings and negative outcomes
quickly lose confidence in their personal abilities Measurement of outcomes: assessment of health promotion strategies and have to be done to determine success. Based on scientific experimental paradigm-does cause lead to effect? has the variable been manipulated? and lead to a measurable effect in terms of the improvement of health? Evidence-based treatment Measurement of outcomes perspective uses EBT and rests on the assumption that research into health campaigns has to produce statistically significant data to show an effect of the health strategy.
attempt to standardize the measurement, considers:
efficacy-relative improvement in health as the result of an intervention in a controlled randomized trial
effectiveness-relative improvement in health as the result of an intervention in a more realistic every day setting Advantages of EBT
differences between efficacy and effectiveness can be identified
can help identify hazardous interventions which may only show up in large data sets
used to monitor changes during treatment over time.
Disadvantages of EBT
requires a clearly defined population and a reasonable control of variables within it. often unrealistic
heavy reliance on the underlying scientific principles is also unrealistic as many non-measurable variable affect health outcomes.
appraisals of health should always consider the everyday and personalized variables that may influence susceptibility to campaigns and the will power to adopt healthier personal habits. Cognitive Dissonance the uncomfortable feeling caused by holding two contradictory beliefs or ideas at the same time. What is needed for health promotion to work.
Forcing this should push people to reflect and examine their lifestyle. Emotional dissonance coined by Hochschild (1983) and refers to when people can maintain a fake emotion (one they do not hold) for presentation in public.
service employees summoning appropriate but unfelt emotions to serve.
"I know my diet makes me obese and I intend to change it" but then tell themselves they have 'fat genes' 1. We admitted we were powerless over alcohol - that our lives had become unmanageable.
2. Came to believe that a Power greater than ourselves could restore us to sanity.
3 Made a decision to turn our will and our lives over to the care of God as we understood Him.
4. Made a searching and fearless moral inventory of ourselves.
5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6. Were entirely ready to have God remove all these defects of character.
7. Humbly asked Him to remove our shortcomings.
8. Made a list of all persons we had harmed, and became willing to make amends to them all.
9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
10. Continued to take personal inventory, and when we were wrong, promptly admitted it.
11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.