HEED321 Midterm Flashcards
(238 cards)
1
Q
What are some problems related to behavior?
A
Illness and chronic conditions
Mental health issues
Addictions
Social and interpersonal problems
Financial issues
Environmental
2
Q
What are some reasons that people don’t change their behavior?
A
Stress makes it hard to think
Emotions drive a lot of our behaviour
Not like the behaviour
Lack knowledge or information
Not have the skills
Be motivated by other things
Not believe in the positive health behaviour
People important to us don’t do or believe in the behaviour
3
Q
What are the 5 key steps to behaviour change?
A
Identify the problem
Identify the behaviour that needs to change
Identify the theory based constructs on how a behaviour change technique might work in changing behaviour
Create an intervention to use that technique with a target population or individual
Evaluate the efficacy and effectiveness of the intervention
4
Q
What is Efficacy?
A
Does an intervention work in ideal circumstances? (pilot studies, lab-based, internally valid)
5
Q
What is Effectiveness?
A
Does an intervention work in the real
world? (tested after efficacy has been established)
6
Q
What does controlling for mean in research?
A
The results are independent of these variables
7
Q
A person who does all four of these has the health of someone 14 years younger than a person who does none of these behaviours
A
Not smoking
Physical activity
Moderate (or no) alcohol consumption
Eating your fruits and vegetables
Also sleep
8
Q
What are the goals of Health Psychology?
A
To promote health and prevent illness
Study psychological aspects of prevention and treatment of illness
9
Q
What is the focus of Health Psychology?
A
To understand etiologic and diagnostic correlates of health, illness and dysfunction
10
Q
What are the priorities of Health Psychology?
A
Improve health by focusing on delivery systems and policy.
11
Q
What are Individual processes and what do they influence?
A
Perceptions, beliefs and behaviours.
Influences:
- Biological processes (direct effects on health outcomes)
- Health behaviours (indirect effects on health outcomes)
12
Q
What Social processes have an indirect effect on health outcomes?
A
Perceptions, beliefs and behaviours
13
Q
What social processes have an indirect and direct effect on health outcomes?
A
Health care delivery
14
Q
What is Epidemiology?
A
The study of the frequency, distribution, and causes of diseases in a population. (includes physical and social environment).
15
Q
By understanding these factors, health psychologists can better target specific factors or populations in their work.
A
Epidemiology
16
Q
What is Clinical psychology?
A
Concerned with mental health (generally) and requires very specific training, certifications and licenses
17
Q
What is health psychology?
A
Psychological factors that relate to health. Not physical pathology: this is for physicians.
18
Q
What is health psychology associated with?
A
Science and theory
19
Q
What is the goal of health psychology?
A
To develop explanatory models for behaviors that are known to link with health outcomes
20
Q
What do the models of health psychology address?
A
The cognitions and social circumstances that influence behaviours.
21
Q
What is the foundation of “evidence-based-practice”
A
- Scientific assessment of the health psychology models is undertaken
- The models are used to guide the development of interventions
22
Q
What are behavioural factors also associated with?
A
Physiological processes
23
Q
Based on the models of physiological function and adaptation, what factors influence physiological processes?
A
Psychological and social
24
Q
What are the 4 foundations of health psychology?
A
Behavioural psychology
Cognitive psychology
Social psychology
Health psychology
25
What is Behavioural psychology?
That we can change the ‘conditions’ surrounding the performance of a behaviour and the behaviour will change (Classical behaviourism: reward/punishment)
26
What is Cognitive psychology?
What we believe (to be ‘true’) influences both our behaviour and our health - representations of ‘reality’ influence our behaviours
27
What is Social psychology?
That how we interact with others influences our physiological processes, our behaviours, and our health
28
What is health psychology?
Influence of the interaction of biological processes, psychological processes, social processes and social contexts; this is the biopsychosocial model!!
29
What are beliefs?
consequential thinking about the relationships between objects or events
30
What are values?
evaluative judgments
31
Which 3 factors interact and influence health and illness?
- Psychological factors
- Social factors
- Biological factors
32
What happens when factors directly affect health?
Autonomic (e.g., changes in blood pressures) and hormonal (neuroendocrine responses) changes
33
What happens when factors indirectly affect health?
Changes in behaviour
34
What is the physiological stress response?
In response to a stressor Hypothalamic‐pituitary‐adrenal axis (HPA) and the SympatheticAutonomic Nervous System are activated (sympathetic adrenal medullary system; SAM)
35
What is SAM?
Sympathetic Adrenal Medullary system
36
What is HPA?
Hypothalamic-pituitary-adrenal axis
37
How does SAM respond to stress?
Fast response to sudden stress (fight or flight):
Increased CV response
Increased respiration
Increased perspiration
Increased blood flow to muscles
Increased muscle strength
Increased mental activity
38
What does HPA stimulate? How?
Hormone production.
- Cortisol secretion increases access to energy stores, increases protein and fat mobilization
- Suppresses immune system and increases blood pressure
- Provides source of fuel to deal with stressful situation
39
What happens if stress is chronic or excessive?
Can lead to illnesses such as CV disease, autoimmune diseases, affective disorders, and major depression
40
What are the two endocrine response systems that are reactive to psychological stress?
HPA & SAM
41
What happens with prolonged or repeated activation of the HPA and SAM systems?
Increased risk for physical and psychiatric disorders
42
What is psychoneuroimmunology?
Association between psychological factors and susceptibility to infections (or other signs of impaired immunity)
43
What is the basic idea of psychoneuroimmunology?
Psychological experiences make us more vulnerable to infection or can protect us from infection (or other signs of impaired immunity)
44
What are the two types of immunity?
- Cell level attack on infectious agents to kill directly
- Antibody immunity-production of cells that specifically bind to infectious agents (produced only when exposed to the agent: mechanism of vaccination)
45
What factors mediate the stress response?
Physical activity
Not smoking
Quality sleep
Good diet
46
What is higher stress associated with?
- High incidence of illness from viral exposure
- More symptoms
- Excessive immune response is associated with more/stronger illness symptoms
- An overactive immune system (associated with autoimmune diseases such as rheumatoid arthritis, lupus) associated with stress
47
What is the solution to pain? (4)
- knowledge
- active redirection
- increased safety
- identify and resolve triggers
48
How is pain a learned response?
* Tissue damage sends nociceptive signals to the brain.
* If the brain senses danger it creates more neural pathways to solve the problem.
* The pain processing pathways get larger and steal resources from other brain areas.
49
What is the 1st Law of Neuroplasticity?
“What fires together wires together.”
Whatever you think, feel or do is hardwired in the brain.
50
How Does the Brain Judge Danger?
* Emotions: fear, anger, anxiety, frustration etc.
* Unresolved trauma
* Personality trait
51
What does nociceptive mean?
There is an injury / something is damaged, signal is going to the brain
52
What does nociplastic mean?
Type of pain when you still have pain after the tissues have healed. Once your brain is sensitized, every little thing is going to hurt more (central sensitization).
53
How does pain modulation work in the brain?
When brain senses danger: amplifies signals coming from body.
Signals are not yet pain, only sense pain when the brain tells you there is danger
54
What is phantom limb pain?
75% of amputees experience extreme pain, even though there isn't damaged tissue.
55
What is the cause and cure for chronic pain?
Neuroplasticity
56
How does understanding that pain does not equal tissue damage change perceived pain?
decreases pain by about 20%
57
How does neural conditioning affect pain?
Triggers like cold, smells, weather changes, foods, physical activity and emotions cause neural conditioning which causes pain. The triggers don't cause pain themselves
58
Is pain real?
* People with brain pain are not faking.
* It is caused by unconscious brain circuits
59
How do you make friends with your pain?
* Pain is the brain’s attempt to keep you safe.
* Opportunity to get to the root cause.
* Observe your pain mindfully.
* Meet sensations with calm, ease, understanding and kindness.
* Train yourself to face them, tolerate them and detach from them
60
Acetylcholine only gets released if you do what?
Pay attention!!
61
What is active redirection?
- Use awareness of pain as an opportunity to actively engage in an activity that:
- Occupies lots of neurons (focused attention). - Is fun, meaningful, creative.
- Overrides pain
62
What is DIM?
Danger in Me (DIMs) refer to experiences associated with danger. DIMs increase pain perception.
63
What is SIM?
Safety in Me (SIMs) refer to experiences associated with safety. SIMs decrease pain perception.
64
How do you identify emotional or situational triggers?
* Ask yourself “why is my brain signaling
danger?”
* Am I angry, sad, scared?
* Am I in a situation that is a reminder of trauma?
* Am I being kind to myself?
65
What types of pain will respond to neuroplasticity?
- fibromyalgia pain
- phantom limb pain
- migraine
- neuropathic pain
- IBS
- arthritis
66
What is the general timeline for neuroplastic healing?
Start: nothing
4 weeks: Immediate effect
8-12 weeks: Residual effect
12-24 weeks: Unplanned effect
6 months: Less pain overall
67
What was the conclusion to take away about managing chronic pain?
* Chronic pain is caused by the brain and can be healed by the brain.
* 1 hour/day of active redirection can be curative.
* All types of chronic pain of all durations respond.
68
What is the leading cause of long term sickness?
Stress
69
What are the 3 different early approaches to stress?
- Engineering approach: stimulus-based
- Response based: physiological response
- Transactional approach: interactional appraisal
70
What is the engineering approach?
- Stress is in the environment
- Any event that produces strain or pressure
- Larger the strain – larger the stress response
- Assumes non-demanding environments are never stressful
- Assumes stress reactions are ‘automatic’ and ‘unconscious’
71
Why is the engineering approach problematic?
- Problematic:
Assuming non-demanding environments are not stressful is wrong
No consideration of psychological mediation
72
What is the response-based approach?
- Considers stress to be the physiological reaction (e.g., increased HR, sweating, etc)
- Stress has occurred if the person has the response
73
Why is the response-based approach problematic?
Does not account for psychological mediation
74
What is GAS?
General Adaptation Syndrome
75
What are the 3 steps in the GAS stress response?
1. Alarm – reaction to a threat (fight or flight)
2. Resistance – prolonged exposure to the threat the response is to try to return to homeostasis)
3. Exhaustion – if the threat is not overcome, physiological resources are depleted.
76
What is the problem with GAS?
Doesn’t take into account that people may respond differently to the same stressor.
77
What are the 2 fundamental prerequisites for life?
Adaptability and resistance
78
What are the problems with the early approaches to stress?
- Primarily physiological
- ‘direct effects’ explanations
- Do not take into account behavioural effects of stress
- Does not account for coping efforts or strategies
- All stressors do not produce the same process
79
What is the contemporary stress theory?
When we encounter a stressor we have a physiological response (i.e., allostasis); when the stressor is gone, the allostatic response ends.
80
What is allostasis?
- An adaptive mechanism that helps individuals cope with stressors through physiological and behavioral processes
- The process where HPA axis (which produces cortisol), the autonomic nervous system, and our cardiovascular, metabolic, and immune systems protect our body by adapting to internal and external stress
81
What is Allostatic load?
“The physiological costs of chronic exposure to heightened neuroendocrine response that results from chronic stress”
- occurs when the allostatic response remains, even after the stressor is gone
82
What does the allostatic load include?
Four main biological systems (cardiovascular, metabolic, immune/inflammatory, and neuroendocrine)
83
What are 6 signs of high allostatic load?
Decreases in cell-mediated immunity
Inability to ‘shut off’ cortisol response
Lowered HR variability
Elevated epinephrine levels
Memory problems
High blood pressure
84
What is a simple definition of allostatic load?
Wear and tear the body experiences due to repeated stress exposure
85
What are the four situations associated with
allostatic load?
Repeated ‘hits’ from multiple stressors
Lack of adaptation
Prolonged response
Inadequate response
86
What is Repeated ‘hits’ from multiple stressors
Causes ‘wear and tear’ on the stress response system
87
What is Lack of adaptation?
The stress response fails to fully recover between ‘hits’ and you never get habituated to stressors; big stress response every time the stressor is present
88
What is Prolonged response?
The stress response stays continuously on high, long after the stressor is gone
89
What is Inadequate response
Too much stress can result in the inability to respond normally to stress in the future
90
What are the six unhealthy lifestyle risk factors associated with allostatic load?
Physical inactivity, alcohol and drug abuse, smoking, poor sleep quality, and unhealthy eating habits
91
Individuals may cope with stressful situations by adopting which 3 health-damaging modifiable lifestyle behaviors?
- Overconsumption of food high in saturated fat and refined sugar to activate the brain reward system
- Smoke cigarettes or overconsume alcohol to cope with negative emotions from stressors
- Less likely to exercise
92
What is the current stress definition? (probably on midterm!!!!)
Stress is the (negative) emotional experience followed by biochemical, physiological, cognitive, and behavioural changes that work toward either changing the stressful event or adapting to its effects.
93
What is the transactional approach?
Relationship between the person and the environment. Includes appraisal by the person that a particular environment is threatening, exceeds his/her resources, demanding.
94
What 4 things do you need to examine with the Transactional approach?
- Individual
- Individual’s reaction to environment
- Environment
- Outcome of the interaction
95
What 2 variables does the transactional theory include?
1. Intra-individual (person level)
- Appraisal (appraise an environment as threatening for a stress response, if no perceived threat – no stress response)
2. Coping
- Long-term adaptation of the person to the stressor, including appraisals of future threat
96
How does the transactional theory consider stress?
As a complex process.
Interaction of person, environment, appraisal and coping (complex)
Requires assessment over time (process)
97
What is primary appraisal?
Evaluation of the significance of a stressor or threat; how much is at stake? Evaluating the risk of harm or loss.
98
What is secondary appraisal?
Evaluation of the controllability of the stressor AND a person’s coping resources. Also the resources a person believes they have to deal with the threat
99
What are examples of life events vs. daily hassles?
Life events:
Marital problems; difficult home life
Change in financial state
Death of someone close to you
Job problems
Daily hassles:
Losing your keys
Forgetting your purse/wallet
Unpleasant interpersonal interactions
Waiting in traffic
100
What are the direct effects of daily hassles?
-Activated stress response
- Increased negative affect
- Decreased positive affect
- Agitation
- Raised cortisol levels (frequent & excessive cortisol associated with ‘wear and tear’ on immune and CV systems)
101
What are the indirect effects of daily hassles?
- Poor behaviour choices
- Frequent hassles can lead to chronic poor behavioural choices
- Exacerbates chronic conditions:
1. Stress associated with increased symptoms of some diseases (e.g., arthritis) & pain
2. Poorer self-care (Medication or treatment)
102
What is the Stress reactivity hypothesis?
Those who have big physiological and emotional stress responses (high stress reactors) are more likely to develop ill health
- Blunted reactivity may also lead to ill health (inadequate stress response forms allostatic load)
103
What is Stress recovery?
How long it takes to return to ‘normal’ after a stress response. The longer it takes, the greater the likelihood of ill health (allostatic load)
104
How is reactivity determined? What affects reactivity?
Partly genetically determined.
Situational factors can also affect reactivity. ex. Greater CV reactivity to a stressor after consumption of a high fat meal.
105
Where are 3 places stress is located?
- The environment
- In appraisal
- Emotional or physiological response.
These 3 are Interactive and frequently changing
106
What is the Conservation of Resources (COR) Theory?
- “stress” is a reaction to loss, a threat to loss,
or a failure to gain resources following an investment of resources.
- Less emphasis on appraisal (transactional theory) and more on resources people have or may lose
When stressed, people try to minimize their losses.
When there is no stress, people try to build their resources.
BUT – losing resources has a bigger impact than gaining them.
107
What is emphasized in COR?
Proactive coping
108
What is resource caravans?
Different resources are linked and ‘travel’ with us
e.g., self-efficacy is related to social support and both are there when we need them.
109
What are resources related to in COR?
Resilience
110
What is Perseveration cognition?
How much do you ruminate and worry? These and repetitive thinking could prolong the stress response or making short-term responses worse
111
What is greater worry intensity related to?
More somatic complaints and intensity mediated the relationship between stress and somatic complaints
112
What are the 4 stress ingredients?
NUTS
NOVELTY (Something new you have not experienced before)
UNPREDICTABILITY Something you had no way of knowing it would occur
THREAT TO THE EGO Your competence as a person is called into question
SENSE OF CONTROL You feel you have little or not control over the situation
113
Do men or women seem to have a higher stress response?
Men typically respond higher to stress than women (higher cortisol response)
Women seemed to cope quicker
114
What was the key biological factor measured in the trier social stress test?
Cortisol
115
What was the main psychological factor mentioned several times in the social stress test?
Coping
116
What are the 14 coping strategies?
Self-distraction
Active coping
Denial
Substance Use
Emotional support
Instrumental support
Behavioral disengagement
Venting
Positive reframing
Planning
Humor
Acceptance
Religion
Self-blame
117
Which type of coping is related to higher distress and riskier behaviours?
Avoidant coping
118
Which type of coping is related to fewer risky behaviors and greater psychological health?
Active coping
119
What is the key part of transactional theory?
Changing cognitive and behavioral efforts to manage specific demands that are appraised as stressful / exceeding a person’s resources
120
What is the basis for coping and what does it lead to?
Appraisal! Leads to emotional responses and behaviours.
121
What coping strategy is this? I've been turning to work or other activities to take my mind off things.
I've been doing something to think about it less, such as going to movies, watching TV, reading, daydreaming, sleeping, or shopping.
Self-distraction
122
What coping strategy is this? I've been concentrating my efforts on doing something about the situation I'm in.
I've been taking action to try to make the situation better.
Active coping
123
What coping strategy is this?
I've been saying to myself "this isn't real.".
I've been refusing to believe that it has happened
Denial
124
What coping strategy is this?
I've been using alcohol or other drugs to make myself feel better.
I've been using alcohol or other drugs to help me get through it.
Substance Use
125
What coping strategy is this?
I've been getting emotional support from others.
I've been getting comfort and understanding from someone.
Emotional support
126
What coping strategy is this?
I’ve been getting help and advice from other people.
I’ve been trying to get advice or help from other people about what to do.
Instrumental Support
127
What coping strategy is this?
I've been giving up trying to deal with it.
I've been giving up the attempt to cope.
Behavioural disengagement
128
What coping strategy is this?
I've been saying things to let my unpleasant feelings escape.
I've been expressing my negative feelings.
Venting
129
What coping strategy is this?
I've been trying to see it in a different light, to make it seem more positive.
I've been looking for something good in what is happening.
Positive Reframing
130
What coping strategy is this?
I've been trying to come up with a strategy about what to do.
I've been thinking hard about what steps to take.
Planning
131
What coping strategy is this?
I've been making jokes about it.
I've been making fun of the situation.
Humor
132
What coping strategy is this?
I've been accepting the reality of the fact that it has happened.
I've been learning to live with it.
Acceptance
133
What coping strategy is this?
I've been trying to find comfort in my religion or spiritual beliefs.
I've been praying or meditating.
Religion
134
What coping strategy is this?
I've been criticizing myself.
I’ve been blaming myself for things that happened.
Self-Blame
135
What 2 things are important for appraisals with health stressors?
Susceptibility and severity
136
If the stressful situation can be changed, which strategy is the most adaptive?
Problem focused
137
When stressor can’t be changed, which strategy is the most adaptive?
Emotion-based are most adaptive alone or with problem-based strategies
138
If stressor is highly threatening AND uncontrollable, which strategy will most likely be used?
Disengaging coping strategies (e.g., distraction, denial, disengagement)
139
Which strategies were associated with post-event growth?
The use of acceptance, planning, emotional and instrumental support, and reframing
140
Which strategies were related to worse affect after the event which was related to the development of illness symptoms?
Venting and disengagement
141
What are the 2 steps in making a plan to deal with stressors?
(a) Reduce the probability that the stressor will occur (environmental or context management)
(b) Improve your coping responses to alleviate the immediate stressor & to reduce probability of exacerbating the situation
142
What are the 3 types of adaptations that come with coping?
1. Emotional well-being – worry, positive or negative affect
2. Functional status – physical outcomes (cortisol levels)
3. Health behaviors – seeking care, communicating with health providers, adherence to medication or treatments (physio)
143
What are coping strategies?
The cope inventory of ways of coping
Related to skills, resources
Can be learned, recruited, adjusted
144
What are coping styles?
Coping tendencies
‘Typical’ coping behaviour
Related to personality
Difficult to address or change
145
What are the 4 types of active coping styles?
- Instrumental/ Problem-focused - confrontative (Doing things directly related to the problem)
- Emotion focused (Ruminating about the emotions)
- Emotional-approach (Doing things to “work through” the emotions)
- Palliative (Doing things to make yourself feel better)
146
What are the 2 types of passive coping styles?
- Avoidance (Daydreaming)
- Procrastination (Engaging in irrelevant tasks)
147
What are Repressors?
- Unconsciously direct attention away from threatening information
- Not aware of physiological activation because they rapidly avoid or distract themselves, sometimes without even being aware
148
What are Monitors?
- High monitors seek information
- Visit physicians more and demand more tests (managing uncertainty)
149
What are Blunters?
- Actively avoid the threat or the problem
- Want minimal information
150
What is Message matching?
Seems to be more critical to blunters – giving them too much information increases their distress more than giving too little information to monitors
151
What is Benefit finding?
Seeing that relationships have improved after a major illness – related to optimism and positive affect and long-term health benefits
152
What is resilience?
Ability to recover and remain healthy after a stressful event (not a personality trait). Defined by the outcome (healthy functioning)
153
What are 3 ways Positive affect can enhance adaptation and coping?
- Can help build resources
- Proves a buffer against stress
- Interrupts negative rumination
154
What 3 things contribute to resilience?
- Coping
- Social networks
- Income & education (more resources)
155
Adaptive strategies are almost always?
Direct
Problem focused
Distress reduction is always important
156
What is moderation?
When differences within groups lead to differences in outcomes
157
What is the difference between how optimists and pessimists cope?
Optimists: Explaining stress response internally: this is my fault. Use more problem-focused coping leading to better well-being.
Pessimists: respond more externally: why does this always happen to me. Use more avoidant coping, leading to worse well-being
158
What is social support?
Receiving information from others that one is cared for and valued and part of a network of communication and mutual obligations.
- intended by the sender to be helpful, thus
distinguishing it from intentional negative interactions
159
What are the 2 types of social support?
- Structural: simple existence of networks and friends
- Functional: what do these people do in terms of support?
160
How can a supportive environment diminish stress and lead to more positive outcomes? (3)
- Availability of confidants may affect perception of risk (primary appraisal)
- Influence beliefs in ability to cope with the situation and manage difficult emotions (secondary appraisal)
- Protect against stress by providing opportunities to explore other coping options.
161
What does the “direct effects” approach hypothesizes about social support?
Social support has beneficial effects during times of high and low stress. Measured in terms of the number of people one counts as friends, or the number of organizations a person belongs to.
162
What does the “buffering” hypothesis proposes about social support?
Social support is beneficial only when highly stressed. Measured as the degree to which a person feels that they have people they can turn to when needed.
163
What is social isolation?
A lack of social networks
164
What is loneliness?
The perception of social isolation (not necessarily objective isolation)
165
Social isolation has a direct effect on what?
Poor health
166
Who is at high risk of social isolation?
Seniors
167
What is critical with social support?
Perception
168
Are health cognitions easy to change?
Health cognitions are not easy to change, they are just easier to change than many demographic factors or personality traits
169
What are health behaviours?
“any activity undertaken for the purpose of preventing disease or for improving health”
170
What are the 4 types of health behaviours?
1. Health enhancing behaviours
- Exercise
- Healthy eating
2. Health protective behaviours
- Health screening
- Vaccination
- Prophylactic use – condoms, safety goggles
3. Health harming behaviours
- Smoking
- Excessive alcohol consumption
- Risk taking
- Substance abuse
4. Sick role behaviours
- Following prescriptions
- Following proscriptions
171
What 5 things influence health behaviours?
Socio-economic status (SES)
Gender
Age
Personality to some degree
Cognitions and emotions
172
What is the role of theory?
Helps at various stages of intervention process (Planning, implementing, evaluating)
Help find out of why people are not following advice
Provide insight on how to shape strategies
Help identify what needs to be monitored, measured, compared in evaluation
173
What is the key concept in social cognition?
Self-regulation
174
What are the 3 processes of self-regulation?
- Re-evaluation of beliefs
- Self-monitoring
- Goal-setting
175
What are the 2 phases of self-regulation?
- Motivational phases – evaluating benefits and barriers (concludes the decision to pursue a goal or not)
- Volitional phase (putting in a plan to meet the goal)
176
The factors that are included in any theory are based on what 3 things?
- Interests/beliefs of the theorists
- Parsimony
- Nature of the behaviour in question
177
What are the 4 key social cognition models?
- Health belief model
- Protection motivation theory
- Theory of planned behaviour
- Social cognitive theory
178
What are the 6 constructs in the health belief model?
Perceived Susceptibility
Perceived Severity
Barriers/Costs
Benefits
Health Motivation
Cues to Action
179
What is Susceptibility in the HBM?
“I feel that my chance of developing heart disease at some point in my life is… ”
Opinion of chance of getting the disease
180
What is Severity in the HBM?
“I feel heart disease would be a very serious illness for me to develop”
Opinion of how serious a disease and its consequences are
181
What are the Costs/Barriers in the HBM?
Tangible and psychological costs
Barriers are often behaviour specific- e.g., getting to an appointment, or lack of skill to cook healthy
182
What are the Benefits in HBM?
Belief that taking action will reduce risk or seriousness of disease
183
What are the Cues to action in the HBM?
Social and environmental influences on whether the behaviour gets undertaken
184
What are the 5 parts of the sociological framework?
Individual
Interpersonal
Institutional
Community
Public policy
185
What is stigma?
Stigma is experienced with an attribute or a trait that is SOCIALLY devalued and has macro- and micro-level implications on people who have that trait.
186
What is the root cause of stigma?
Blame
187
What is health-stigma?
Health-stigma is experienced in relation to a physical, mental or social health condition that is SOCIALLY devalued and has macro- and micro-level implications on people who have that trait.
188
What is weight stigma?
Negative social stereotypes and misconceptions associated with body weight
189
What are some drivers of stigma?
Fear of infection, lack of awareness, social judgement, blame, stereotypes, prejudice
190
What are some facilitators of stigma?
Cultural norms, social and gender norms, equality, health policy
191
What is the impact of weight stigma on behaviours?
1. Avoiding spaces where weight stigma may occur
2. Maladaptive coping behaviours
3. Reduced access to care
192
What are 3 places people experience weight stigma?
* In healthcare
→Dismissive
→Weight-centred
→Assuming failure
* In social spaces
→Looking at your plate
→Weight-centred jokes and comments
* In the media
→ Characterizing larger bodies as comical or ‘non-heroes’
193
What is internalized weight bias?
When someone accepts and self-directs negative stereotypes associated with their weight
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What can be done to target stigma at the individual level?
* Self-reflection to identify biases (including towards self)
* Integrating into medical curricula
* Consider implications of stigma when working one on one
* Critical evaluation of systems
* Lived experience
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What is a fear appeal?
The goal is to create high threat, high efficacy message. Persuasive messages designed to scare people by describing the terrible things that will happen to them if they do not do what the message recommends
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The protection motivation theory is determined by what 2 appraisal processes?
- Threat and coping appraisal
- Appraisals result in adaptive or maladaptive responses
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The Protection motivation theory is an extension of what other theory?
HBM
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What are the 4 constructs in PMT?
- Coping appraisals: Mental representation of recommended behaviour to respond to the threat
- Response costs – what will it ‘cost’ me to do the behaviour?
- Response efficacy – will the behaviour achieve the desired outcome?
- Self-efficacy – am I confident I can do the behaviour?
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What are Adaptive responses in PMT?
-Engages in behaviour likely to reduce the risk
-Sometimes avoiding the ill health behaviour
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What are Maladaptive response in PMT?
- Does not directly tackle the threat
- Taking up an ill-health behaviour
- Failing to address the ill-health behaviour
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When and how do fear appeals work?
- Threats only work when response or self-efficacy is high.
- Using threats when response or self-efficacy is low can undermine attempts to change behaviour
- If you provide a threat you also need to show ways to increase efficacy.
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What are the 3 things human behaviour is guided by?
1. Beliefs about the likely consequences of a behaviour
2. Beliefs about what important others think you should
3. Beliefs about ability to do the behaviour
These beliefs are the foundation of intention
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What are intentions in the TPB?
The immediate antecedent of behavior in the TPB is the intention to perform the behavior in question.
The stronger the intention, the more likely the behaviour will occur.
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What are the 3 components of TPB?
- Attitude = belief about outcomes x evaluation of outcomes
- Subjective norms = normative beliefs x motivation to comply
- Perceived behavioural control = perceived likelihood of occurrence x perceived facilitating/inhibiting power
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What are Attitudes in the two factor model? (TPB)
Beliefs about the behaviour
- Instrumental – the behaviour will lead to a certain outcome (better heart health, or illness prevention e.g., vaccine)
- Experiential – the behaviour will result in a certain experience (like fun e.g., physical activity is fun)
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What are Subjective Norms in the two factor model? (TPB)
Social pressure to do the behaviour
- Injunctive – someone (spouses, friends, physicians etc…) approves or disapproves the of the behaviour
- Descriptive – do people I know or people who are like me do the behaviour?
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What is Perceived behavioural control in the two factor model? (TPB)
- Control beliefs – presence of factors that can facilitate or impede behaviour performance
- Perceived confidence – am I capable of doing this behaviour?
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What is the intention behaviour gap?
Intentions are the “culmination of the decision making process” but good intentions don’t necessarily lead to behaviour:
- Intentions are not stable
- May lack control over the situation
- Time between intention and behaviour
- Lack a motivational plan
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What are Implementation Intentions?
Used to overcome the intention-behaviour gap. If-Then plans.
Different from goals that state an intention to do something.
ex: Goal or intentions: I want to achieve outcome X or perform behaviour Y
ex: Implementation intentions: If I encounter situation Z, then I will perform behaviour Y
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What are the 3 types of responses with Implementation Intentions?
- behavioural response (initiate a response, inhibit a response, intensify a response, switch from one response to another)
- cognitive response (think of something (content), adopt a certain mode of thought (thinking style))
- affective response (adopt a feeling, down-regulate a feeling, up-regulate a feeling, switch from one feeling to another, keep calm)
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When are II's most effective?
- They are about taking up a behaviour (e.g., increasing fruit and vegetable intake) compared to reducing an existing behaviour (e.g., limiting snacking)
- When behaviour is measured over a short period
- Among people who have strong planning skills
- The II is more specific and can be mentally imagined.
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What is self-control?
The process of giving precedence to distal, long-term motives over proximal, short-term motives when these motives conflict.
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What are Self-regulatory skills?
Behaviour is goal directed
- Consequences of current action (re-evaluate beliefs), evaluate current behaviour (self-monitoring), set new goals
- Self-efficacy enhancement involves self-regulatory skills
- Cognitive skills can be taught
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What is Action planning?
forming a set of procedures to help enact behaviour
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What is Preparatory planning?
forming plans that enable accessibility to resources needed to obtain a goal
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What is Coping planning?
forming plans to overcome important barriers when starting or maintaining a behaviour is challenging.
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How do goals work to improve performance? (4)
1. Goals help direct attention to goal-relevant activities
2. Once attention is directed to activities, people will exert effort to complete them.
3. Goals motivate people to stick with the effort for longer
4. Goals lead to self-regulation strategies like action plans.
When a goal is activated, previously used strategies to achieve similar goals are activated in long-term memory
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What are the 4 categories of strategies to achieve goals?
- Task specific strategies based on knowledge (e.g., one that’s been used before)
- New strategies
- Search and information processing strategies (e.g., critical thinking)
- Self-regulatory strategies (e.g., planning,
implementation intentions)
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What is the difference between intentions and action planning?
- Intentions represent an individual’s motivation and the degree of effort they are prepared to invest in a behaviour to achieve a goal. (“what” an individual decides to pursue)
- Action planning specifies the when, where, and how of the intended behavior
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How can you increase an action plan's chance for success?
By creating back-up plans
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What are the 4 coping planning steps?
(1) deliver a message about coping planning and its utility
(2) provide an example of a coping plan
(3) consider potential barriers that may impede performance of a target behavior
(4) develop a coping plan to overcome each anticipated barrier or difficulty
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What is the social cognitive theory?
The idea that behavior is guided by external physical stimuli, our responses and how we’re reinforced for that behaviour.
Maintenance of behaviour requires environmental reinforcement AND self-regulation
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What assumptions are made with the social cognitive approach?
- individuals behaviour is based on their perception of the environment/reality
- mediate effects of other broad determinants (e.g., SES)
- perceptions more open to change than other factors such as personality traits
- individuals are rational and make systematic use of information available to them
- Behaviours are learned in social contexts
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What is self-efficacy?
- Situation specific self‐confidence
- Confidence that we are able to perform the behaviours required to produce a certain outcome
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What are Mastery experiences?
having a successful experience at the task (often most powerful source of self-efficacy)
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What are Vicarious experiences?
seeing someone else succeed
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What is Verbal persuasion?
providing information, encouragement
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What are 4 sources of self-efficacy?
- Mastery experiences
- Vicarious experiences
- Verbal persuasion
- Perception of physiological and affective states (physiological arousal)
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Outcome expectations can be considered along which three dimensions?
1. Area of consequence: physical (ex. feel better), social (ex. approval from loved one), and self-evaluative (ex. anticipating feeling proud)
2. Positive or negative consequences
3. Short-term or long-term consequences
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What are goals?
Serve as self-incentives that guide decisions and motivation to do a behaviour
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Which type of goals regulate how much effort is invested in a behaviour?
Proximal goals
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Which type of goals give a purpose and general direction to actions?
Distal goals
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What are Social structural factors?
Impediments (barriers) or opportunities (facilitators) that can come from living conditions, personal circumstances, or political, economic, or environmental systems.
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What influences perceptions of barriers or
facilitators
Self-efficacy
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What is Reciprocal Determinism?
The dynamic and reciprocal interaction of person (individual with a set of learned experiences), environment (external social context), and behavior (responses to stimuli to achieve goals).
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What is Behavioral Capability?
A person's actual ability to perform a behavior through essential knowledge and skills. In order to successfully perform a behavior, a person must know what to do and how to do it. People learn from the consequences of their behavior, which also affects the environment in which they live.
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What do SCT interventions focus on?
Self-efficacy and outcome expectations
Moderators are likely very important
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What is the weakness of the SCT theory?
It doesn’t consider emotions or processes that occur outside of our conscious awareness
