First Test

Question 1

Risk factors

Answer 1

Characteristics or conditions that are associated with the development of disease or injury
Can be biological or behavioral

Question 2

Behavioral Risks

Answer 2

Any behavior in which we engage that places us at greater risk for the development of disease or illness
e.g., smoking, excessive etoh use, lack of exercise, obesity

Question 3

Risk Factors (2)

Answer 3

Positive correlation between health and # of healthful behaviors (at all ages)
Negative correlation between health behaviors and death (particularly in older age)
So, why don’t people do what is good for them??

Question 4

Personality

Answer 4

a person’s cognitive, affective, or behavioral tendencies that are fairly stable across time

Question 5

The Biomedical Model

Answer 5

Plato—Mind and body are separate entities
View adopted in 19th century & dominant in medicine today
All diseases can be explained by disturbances in physiological processes (injury, biochemical imbalances, infection)
Disease affects the body
NOT psychological and social processes
Does not account for individual differences in each person

Question 6

Psychosomatic medicine (1930s)

Answer 6

Founded by physicians
Mind & body are both involved in illness
Originally psychoanalytically influenced
Now focus is on interrelationships among physical, psychological, and social influences on illness

Question 7

Health Psychology Goals

Answer 7

Goals
To promote & maintain health
To prevent & treat illness
To identify the causes and correlates of health & illness
To analyze and improve health care systems & health policy

Question 8

Engel’s Arguments

Answer 8

The biomedical approach is reductionist , reducing patients to a sum of physical and medically validated symptoms
“Reductionism is particularly harmful when it neglects the impact of nonbiological circumstances on biological processes” (Holman, 1976)

Variability in clinical expression of a disease, as well as personal experience with a disease, is not fully accounted for by medical markers of the disease
E.g., We can’t tell how diabetes is affecting day to day life just by looking at blood glucose level
Patients can communicate important information about their illness and treatment experience that cannot be gained from medical tests alone.
E.g., Knowing that a patient has a high blood glucose level won’t tell us anything about their ability to reliability take their insulin!
Medical treatment does not always alleviate symptoms, even in the face of biological improvement
Example: The patient who no longer shows objective signs of injury to the knee, but still reports high levels of pain at the injury site.
Physicians who can instill peace of mind into their patients will have patients who:
Are more likely to follow treatment recommendations
Show greater signs of improvement

Question 9

The Biopsychosocial Perspective

Answer 9

Holistic approach to health that expands the biomedical model by including biological, psychological, and social factors as important influences on health
Takes the whole person into account
All factors affect and are affected by a person’s health

Question 10

Transaction

Answer 10

A continuous interaction between the person and his/her environment
Emotions, cognitions, & behaviors influence the stress experience

Question 11

Stress

Answer 11

When the demands of a situation are perceived as greater than available resources to manage the situation (Lazarus & Folkman, 1984)
Resources include an evaluation of biological, psychological, & social systems

Question 12

Biological Aspects of Stress

Answer 12

Reactivity
Change from baseline in our body’s physiological state when we encounter a stressful stimulus
Increased heart rate, respiration, etc.
Governed by the sympathetic nervous system (SNS) and endocrine system

Question 13

Sympathetic Nervous System (SNS)

Answer 13

Responsible for arousal of the body and mobilization of energy in stressful situations

Question 14

Parasympathetic Nervous System (PNS)

Answer 14

Responsible for calming the body

Works together with the SNS to maintain equilibrium in the nervous system

Question 15

During stress

Answer 15

CRF/CRH (corticotropin releasing hormone): Produced in the hypothalamus and secreted by the paraventricular nucleus (PVN)
Sent to pituitary gland to stimulate release of adrenocorticotropic hormone (ACTH)
Suppresses appetite, increases anxiety, improves selective attention

Question 16

Pituitary Gland

Answer 16

Master gland”

Receives chemical messages from hypothalamus & controls secretion of all other endocrine glands

Question 17

ACTH

Answer 17

Follows diurnal rhythm—higher levels in the a.m., declining through the day
Released during times of stress to stimulate cortisol release by the adrenal glands

Question 18

Adrenal Glands

Answer 18

Located on top of kidneys

Question 19

Cortisol (corticosteroid)

Answer 19

Helps reduce swelling that results from injury (physiological stress)

Question 20

Epinephrine & norepinephrine (catecholamines)

Answer 20

Responsible for bodily reactions that prepare the body to confront stress
Increased heart/respiration rate, increased sugar production for quick energy

Question 21

General Adaptation Syndrome (Selye)

Answer 21

Body’s response to prolonged stress
Fight or flight
Immediately helpful, but damaging if prolonged
Fight or flight is only the initial response

Question 22

Allostatic Load

Answer 22

Accumulated effects of physiological strain due to stress on the body over
Includes hormone, immune system, cardiovascular changes
Negative correlation with health status in children and elderly (Johnston-Brooks et al., 1999)

Question 23

Allostatic Load Influencing Factors

Answer 23

Amount of exposure—frequency, intensity, and duration matters
Magnitude of reactivity—individual differences in physiological responses to stress
Rate of recovery—ruminating or worrying prolongs reactivity
Resource restoration—sleep is a major part of restorative process

Question 24

Accumulated Effects Over Time

Answer 24

Severe and ongoing childhood stress can change the body’s reactivity over time
Greater stress response (Gilbert et al., 2015)
Slower recovery (McCrory et al., 2015)
Greater risk of illness in adulthood (Miller, Chen, & Parker, 2011)
Higher levels of allostatic load in adulthood (Gruenwald & colleagues, 2012)
Evidence of faster aging processes (Kiecolt-Glaser et al., 2011)

Question 25

Cognitive Appraisal (Lazarus, 1999; Lazarus & Folkman, 1984)

Answer 25

Accounts for individual differences in response to a stressor Primary appraisal Evaluation of the significance of the stressor Is it stressful, challenging, controllable, positive, etc.? What is the expectation for future harm? “How will this affect me?” Harm-loss How much damage has already occurred? Threat What additional damage is likely to occur? Challenge What is the opportunity for achievement or gain?

Question 26

Transactional Relationships Between Stress & Psychosocial Factors

Answer 26

Stress & cognition Memory, attention, concentration Thoughts can produce stress, too Stress & emotion Emotions often are used to evaluate stress Reaction depends on appraisal Fear, anxiety, depression, anger Stress & social behavior Nature of stressor can determine changes in prosocial behavior Aggressive behavior often increases (Child abuse)

Question 27

Some Sex Differences in Stress

Answer 27

Women: Report experiencing more stressors than men Greater strain working outside home & managing household responsibilities Men Higher levels of stress reactivity May be situation-specific (e.g., when competence is challenged) Slower rates of recovery

Question 28

Measuring Stress

Answer 28

Physiological measurements Assessing the body’s level of physiological arousal during stress Blood pressure, heart rate, respiration, galvanic skin response (Polygraph measures all of these!) Assess changes in hormone levels through blood, urine, or saliva analysis Advantages: Objective, quantifiable, and reliable Disadvantages: Affected by gender, weight, caffeine intake; may create arousal; expensive

Question 29

Measuring Stress (2)

Answer 29

Life Events Social Readjustment Rating Scale (Holmes & Rahe, 1967) Self-report of major happenings in life that require some degree of psychological adjustment Strengths & weaknesses?

Question 30

Measuring Stress (3)

Answer 30

Daily Hassles Smaller, day-to-day unpleasant occurrences Hassles Scale (Kanner et al., 1981) Assess hassles experienced and their severity E.g., losing something, stuck in traffic More strongly correlated with health than life events

Question 31

Social Support

Answer 31

Comfort, care, & assistance available from others Everyone’s need is different, and may change depending on circumstances Includes received support & perceived support Tends to decline in chronic stress situations

Question 32

Types of Social Support

Answer 32

Emotional (esteem) support Common type of support—encouragement, empathy, concern Buffers the negative emotional impact of stress Instrumental support—giving direct assistance Meals, money, help with household chores Informational—advice, feedback Companionship—spending time together, providing a sense of belonging

Question 33

Does Social Support Reduce Stress?

Answer 33

Greater levels of social support predict: Lower levels of job stress (Cottington & House, 1987) Lower blood pressure on the job (Karlin et al., 2003) Larger nighttime declines in blood pressure (suggesting better restorative sleep; Troxel et al., 2010) Less physiological reactivity while giving a speech (Uchino & Garvey, 1997)

Question 34

Buffering hypothesis (Cohen & Wills, 1985)

Answer 34

Social support protects people from the negative effects of high stress We appraise and respond to stress in a healthier manner w/better support Statistically, stress and SS interact E.g., During periods of high work stress (but not low stress), support is negatively correlated with blood pressure (Karlin, Brondolo, & Schwartz, 2003

Question 35

Direct effects hypothesis (Cohen & Wills, 1985)

Answer 35

Also called main effects hypothesis Social support has a positive impact on health regardless of severity of stress, likely because social support is related to other positive outcomes that affect stress May have good sense of self-esteem and belonging May lead people to adopt healthier lifestyles Also supported by research data

Question 36

Stress Prevention Model

Answer 36

Uchino & Birmingham, 2011 Social support provides resources to individuals that help to avoid or minimize exposure to stressors E.g., Learning to make good choices, interacting with others in constructive ways to minimize conflict

Question 37

Personal Control

Answer 37

Belief that one can make decisions and take actions to produce desirable outcomes & avoid undesirable ones Behavioral control—Ability to take action Cognitive control—Ability to think differently or in a more positive way Modifies relationship between stress & health Significant individual differences Related to lower perceived stress

Question 38

Locus of Control

Answer 38

Attribution of control over one’s successes and failures Internal: We believe we have control over our success & failure External: We believe our success & failure is largely due to external factors or chance Includes self-efficacy (Bandura, 1986) Our beliefs about our ability to accomplish something Prior successes in an area reinforce future attempts

Question 39

Learned Helplessness (Seligman, 1975)

Answer 39

Attributions about bad events can be Internal vs. external—Is the cause due personal inability or environmental factors? Stable vs. unstable—Is the cause long-lasting or temporary? Global vs. specific—Does it affect many areas or just this one?

Question 40

Rodin & Langer, 1976

Answer 40

Experimental study on the effects of responsibility on personal control and health in a nursing home population Tx Group: Choices re: having/caring for a plant, selecting daily activities, moving furniture Control Group: No choices or responsibilities Results: Tx group participants were happier, more active at the end of study and 1.5 years later Tx group participants were healthier and 50% less likely to die before follow-up

Question 41

Type A and Health

Answer 41

Greater stress reactivity & perception of threat (Glass, 1977) Type A is positively correlated with: Mortality Risk for coronary heart disease (CHD) Angina, atherosclerosis, myocardial infarct (MI; Rosenman et al., 1986) White collar jobs Magnitude of correlation often depends on how Type A is measured