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Health. Social Psychology Chapter 14 December 10, 2004 Class #14. Health Psychology. The application of psychology to the promotion of physical health and the prevention and treatment of illness Social psychological principles now involved in health issues…that wasn’t always the case

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Health

Health

Social Psychology

Chapter 14

December 10, 2004

Class #14


Health psychology

Health Psychology

  • The application of psychology to the promotion of physical health and the prevention and treatment of illness

    • Social psychological principles now involved in health issues…that wasn’t always the case

    • Modification of one’s lifestyle, outlook, and behavior can lessen risk of such things as heart disease, cancer, strokes, accidents, AIDS, etc.

    • From following slide you can view the change in US insofar as leading causes of death 


Leading causes of death 1900 2000

Leading Causes of Death, 1900-2000


Stress

Stress

  • The whole process by which we appraise and respond to events that threaten or challenge us

  • An unpleasant state of arousal that arises when we perceive that the demands of an event threaten our ability to cope effectively

  • Subjective appraisal of the situation determines:

    • How we will experience the stress

    • What coping strategies we will use


Major types of stressors

Major Types of Stressors

  • Catastrophes

    • Unpredictable, large scale events

      • Natural disasters

    • Cataclysmic events

      • Sudden, without warning

        • Ex: WTC tragedy

  • Significant Life Changes

  • Daily Hassles


Scarring effects of natural disasters

Scarring Effects of Natural Disasters

  • Krug et al. (1998)

    • These researchers analyzed counties that had experienced disasters

      • Before/after research revealed some alarming numbers

      • See next slide 


Krug et al 1998

Krug et al. (1998)


Posttraumatic stress disorder ptsd

Posttraumatic Stress Disorder (PTSD)

  • Up to 70% of adults in U.S. have experienced at least one major trauma (extreme stressor) in their lives…

    • Examples:

      • serious accident/natural disaster

      • rape or criminal assault

      • combat exposure

      • child sexual or physical abuse and/or severe neglect

      • hostage/imprisonment/ torture

      • sudden unexpected death of a loved one


Health

PTSD

  • Five factors are necessary for diagnosis:

    • The person must have experienced or witnessed an extreme stressor

    • Re-experiencing of the traumatic event

    • Avoidance and emotional numbing

    • Increased arousal

    • Set of symptoms that have lasted at least one month


Significant life changes

Significant Life Changes

  • Change itself may cause stress by forcing us to adapt to new circumstances

    • Is change, positive or negative, necessarily harmful?

      • No support that positive “stressors” are as harmful as negative stressors

      • Impact of change depends on person and how change is interpreted


The hassles of everyday life

The Hassles of Everyday Life

  • Most common source of stress arises from the daily hassles that irritate us

    • Ex: Environmental factors

  • “Microstressors” place a constant strain on us

    • The accumulation of daily hassles contributes more to illness than do major life events


Dormitory life

Dormitory Life

  • Baum & Valins (1977)

    • These researchers compared two layouts of dormitory in university residences…

      • One was based on a long corridor design, with 17 rooms opening off a single corridor, whereas the other was a suite of three rooms opening off a communal area

      • The total space per student was about the same in the two designs and the facilities were similar, but student s in the long corridor style residence complained more about being crowded and about having to avoid unwanted social contact

      • They withdrew from social contact even when they were away from the residence


Dormitory life1

Dormitory Life

  • Baum & Valins (1977)

    • Traditional dorms appear to be more stressful than newer suite style


They demolished this dorm

They demolished this dorm…

  • In one case, a 26 floor, 1,300 student residence, Sander Hall, was demolished at the University of Cincinnati in 1991 because of persistent problems of violence and vandalism


Karlin et al 1979

Karlin et al. (1979)

  • Students who are accommodated 3 to a room intended for 2 suffer less contentment and lower grades


Watch your blood pressure

Watch your Blood Pressure…

  • Evans (1979)

    • Compared ten person groups of people

    • Some were in rooms 20 x 30 feet, while others were in rooms 8 by 12 feet

      • Results:

        • The people packed into small rooms had higher pulse rates and blood pressure


Is noise stressful

Is noise stressful???

  • Research indicates that living in a busy city, near a highway, airport, etc. can have detrimental effects


How does stress affect the body

How Does Stress Affect the Body?

  • Selye (1976)

    • His General Adaptation Syndrome model illustrates the effects of stress

    • Selye felt that the body’s adaptive response to stress was very general – like a burglar alarm that would sound off no matter what intruded

    • His model has three overlapping stages - alarm, resistance, and exhaustion


The general adaptation syndrome

The General Adaptation Syndrome


Phase 1 alarm reaction

Phase 1: Alarm Reaction

  • Alarm reaction caused by a sudden activation of your sympathetic nervous system (this is the part of the autonomous nervous system that arouses the body (increases HR, BP, etc.)

  • Mobilizes energy in stressful situations

    • So, your body recognizes danger and mobilizes for a "fight-or-flight" situation…

      • System is activated but since you are in temporary shock – your resistance drops below normal – usually minor and short-term

      • Therefore, the person may show various symptoms of stress -- headaches, fever, fatigue, sore muscles, shortness of breath, diarrhea, upset stomach, etc.


Phase 2 resistance time to fight the challenge

Phase 2: ResistanceTime to fight the challenge

  • Your body responds to the challenge with an outpouring of stress hormones causing your temperature, blood pressure, heart rate, and respiration all remain high

  • Everything is in full force to help you cope with the stressors

  • As body defenses stabilize, the symptoms of alarm seem to disappear

  • The adjustment to stress and the outward appearance of normality are maintained at high cost…

    • During this resistance stage, the body is more able to cope with the original stress

    • However, its resistance to any other stress is lowered


Phase 3 exhaustion

Phase 3: Exhaustion

  • During this phase, the individual reservoir of resources is becoming depleted

    • The person is especially vulnerable to diseases and in extreme cases collapse and death (immune system is being challenged by the long-term stress)

      • Example: Heart attack


What stress does to the heart

What Stress Does to the Heart

  • Type A Behavior Pattern:

    • Characterized by extremes of competitive striving for achievement, a sense of time urgency, hostility, and aggression

    • A risk factor for coronary heart disease (CHD)?

    • Hostility appears to be the main toxic ingredient in CHD


How hostile is your pattern of behavior

How “Hostile” Is Your Pattern of Behavior?

From Anger Kills: 17 Strategies by Redford B. Williams, M.D., and Virginia Williams, Ph.D. Used by permission of Prentice-Hall, Inc., Upper Saddle River, NJ.


Specific types of personalities

Specific Types of Personalities…

  • Friedman & Rosenman (1959)

    • Summarized years of research to come up with the much publicized Type A and Type B personalities


Type a

Type A

  • Has a chronic sense of time urgency

    • Rushed and hurried, this person is always "on edge"

  • Has quick and abrupt speech

    • Often interrupting others

  • Is very competitive

    • Even in noncompetitive situations

  • Is a hard-driving, achievement-oriented, and status-conscious person

  • Frequently becomes hostile and aggressive


Type b

Type B

  • This person has an easier-going lifestyle

    • Is much more able to sit back and relax

  • Less competitive

  • More understanding and forgiving

  • Enjoy leisure and weekends more


Some differences

Some Differences…

  • The most important difference is that Type A men are 2-3 times more likely to suffer angina, heart attacks, or sudden death than type B men

  • Type A smoke more, sleep less, drink more coffee, walk faster, work later, drink less milk, etc.


Situational difference here as well

Situational difference here as well…

  • Interestingly, in relaxed situations, HR, BP, hormonal secretions, etc. are very similar…

  • But when harassed…watch out…

    • Given a difficult challenge, threatened with loss of freedom or control we see big differences…

      • Type A’s are much more physiologically reactive as HR, BP, hormonal secretions, etc. -- SOAR!

      • Type B’s remain at moderate levels

        • Example: Williams (1989)

          • Subjects asked to do simple math problems

          • Type A’s stress-hormone levels rose to more than double the Type B’s


Why is hostility and chd linked

Why Is Hostility and CHD Linked?

  • Cardiovascular system becomes overworked

  • Hostile people are less health conscious

  • Hostile people are physiologically reactive

    • In tense social situations they exhibit more intense cardiovascular reactions


What stress does to the immune system

What Stress Does to the Immune System

  • Stress compromises the body’s immune system

  • Psychoneuroimmunology (PNI): A subfield of psychology that examines the links among psychological factors, the brain and nervous system, and the immune system


Stress and the immune system

Stress and the Immune System

  • The immune system is the body’s first line of defense against invading substances and microorganisms

    • Stress can impair or suppress the immune system

  • Social support and other stress-mediating factors can help sustain one’s immune system

    • Social support may prevent illness by providing an outlet for the person under stress


Social support

Social Support

  • Quality of social support can influence one’s ability to cope with stress…

    • Those who have close relationships with friends, relatives, religious organizations, self-help groups, etc. usually benefit and can be helped through a tough time

    • This type of support is crucial for trauma victims

      • Posttraumatic Stress Disorder

  • Having too much support or the wrong kind of support can be as bad as not having enough support

    • How can this be?


Effects of severe stress

Effects of Severe Stress…

  • Occurs when demands are too intense for our coping techniques (or if we perceive them to be too intense)…

    • Lowering of Adaptive Efficiency

    • “Wear and Tear”


Lowering of adaptive efficiency

Lowering of Adaptive Efficiency

  • Physiological Level

    • Severe stress can impair the body’s ability to fight off invading bacteria and viruses

    • We get the flu

  • Psychological Level

    • Makes it difficult or impossible for an individual to see a situation objectively or to perceive the alternatives that are actually available

    • Suicide attempts

  • When we use all our resources to combat one severe stressor, we have less of a tolerance for others


Wear and tear

“Wear and Tear”

  • After we are exposed to a stressful experience, can rest completely restore us to normal levels of functioning?

    • Selye (1976): says no

      • Indelible scar is left

      • Every period of stress adds up


Stress and the common cold

Stress and the common cold…

  • Cohen (1993)

    • The participants supplied information about three things:

      • Numbers of negative life events they had experienced in the last 12 months

      • Perceived stress. A questionnaire measure of how unpredictable, uncontrollable and overloading the individuals found their lives

      • Negative emotions. Ratings of the extent to which they had felt 15 emotions over the last week; distressed, nervous, sad, angry, dissatisfied with self, calm, guilty, scared, angry at self, upset, irritated, depressed, hostile, shaky and content


Cohen 1993

Cohen (1993)

  • The volunteers were then exposed to common cold viruses. Two types of outcome were examined:

    • Infection. Detection of the virus or a significant rise in levels of virus-specific antibodies in nasal samples 2- 6 days after exposure. (It is possible to be infected without becoming ill.)

    • Clinical colds. A clinician's judgment of cold severity based on symptom checklists, body temperature, and numbers of tissues used per day.


Cohen 19931

Cohen (1993)

  • Overall, 82% became infected and 46% developed colds (symptoms)

  • Important findings:

    • High stress participants: 53% developed colds

    • Low stress participants: 40% developed colds

  • Perceived stress and negative affect were associated with infection

  • Stressful life events were associated with development of clinical colds, given infection.


Cohen 1998 stress duration and illness

Cohen (1998): Stress Duration and Illness


Attributional and explanatory styles

Attributional and Explanatory Styles

  • Seligman (1975):

    • Depression results from learned helplessness

  • Abramson et al. (1989):

    • Depression is a state of hopelessness brought on by the negative self-attributions people make for failure.

    • Depressive explanatory style


Hardiness personality style

Hardiness Personality Style

  • Individuals exhibit three characteristics:

    • Commitment

    • Challenge

    • Control

  • Hardiness serves as a buffer against stress

    • Perception of control is most important factor


Perception of control

Perception of Control

  • The expectation that our behaviors can produce satisfying outcomes.

  • Self-efficacy: Feelings of competence

    • A state of mind that varies from one specific task and situation to another.


Optimism and hope

Optimism and Hope

  • Optimism is a generalized tendency to expect positive outcomes

    • Characterized by a nondepressive explanatory style

  • Health can spring from optimism, as evident by the placebo effect


Pollyanna s health

Pollyanna’s Health

  • Positive thinking cannot guarantee good health

    • Victims of illness do not just have a “bad attitude”

  • Limits to positive thinking…

    • Especially if it leads us to see ourselves and events in ways that are not realistic


Coping strategies

Coping Strategies

  • Problem-focused coping

  • Emotion-focused coping

  • Proactive coping


Problem focused coping

Problem-Focused Coping

  • In dealing with essential tasks, it is better to confront and control than to avoid


Problem focused coping stages

Problem-Focused Coping Stages

  • Assessment

    • Identify the sources and effects of stress

  • Goal Setting

    • List the stressors and stress responses to be addressed

    • Designate which stressors are and are not changeable

  • Planning

    • List the specific steps to be taken to cope with stress


Problem focused coping stages1

Problem-Focused Coping Stages

  • Action

    • Implement coping plans

  • Evaluation

    • Determine the changes in stressors and stress responses that have occurred as a result of coping methods

  • Adjustment

    • Alter coping methods to improve results, if necessary


Problem focused might not always a beneficial approach

Problem-Focused might not always a beneficial approach???

  • Why?

    • Can be physiologically taxing

    • Can lead to development of an over-controlling, stress-inducing Type A pattern of behavior


Emotion focused coping shutting down

Emotion-Focused Coping: Shutting Down

  • One way to react to stress is by shutting down and trying to deny or suppress the unpleasant thoughts and feelings

  • Distraction can be an adaptive form of avoidance coping

  • Concealing one’s innermost thoughts and feelings can be physiologically taxing

    • Sometimes can lead to “ironic processes”

      • See next slide 


Try not to think of that little white bear

“Try not to think of that little white bear”

  • Wegner (1994)

    • People just couldn’t keep that image from popping into their head

    • The harder they tried the more difficult it became


Emotion focused coping opening up

Emotion-Focused Coping: Opening Up

  • Two aspects to opening up as an emotional means for coping with stress:

    • One must acknowledge and understand one’s emotional reactions to important events

    • One must express those inner feelings to themselves and others

  • Why might opening up be helpful?

    • Cathartic experience?

    • Helps to gain insight into the problem?


Proactive coping social support

Proactive Coping: Social Support

  • The helpful coping resources provided by friends and other people

    • Has therapeutic effects on both our psychological and physical health

  • Social support and contact related to longevity


Being popular

Being Popular…

  • Hamrick, Cohen, and Rodriguez (2002)

    • For those under low stress, social connections didn’t matter (no differences)

    • For those under high stress it did (those with more social connections got sick more often)

      • See next slide 


Being popular doesn t always promote health

Being Popular doesn’t always Promote Health

Hamrick, N.S. Cohen, and M.S.Rodriguez (2002)


How should social support be defined

How Should Social Support Be Defined?

  • Simple social contact model

    • How many social contacts does a person have?

  • Intimacy model

    • Does the person have a close relationship with a significant other?

  • Perceived availability

    • Does the person believe that ample support is available when needed?


Social support the religious connection

Social Support: The Religious Connection

  • Religion provides an important source of social and emotional support for many

    • Only 15-20% of world’s population have no religious affiliation

  • There appears to be a link between religiosity and health?

    • Religious individuals tend to outlive their non-religious counterparts…

      • But be careful…


Maybe its time to get on that stair climber again

Maybe, its time to get on that stair climber again…

  • Many recent studies indicate that aerobic exercise (exercise that increases heart and lung fitness) can help reduce stress

  • McCann and Holmes (1984)

    • Mildly depressed female college students

      • Group 1: Aerobic exercise

      • Group 2: Relaxation exercise

      • Group 3: No treatment

    • After 10 week program, the clearly the best results were reported by those in Group 1


Treatment the social ingredients

Treatment: The “Social” Ingredients

  • All healers provide social support

  • All therapies offer a ray of hope

    • All therapies communicate and instill positive expectations

  • Patients can make meaningful choices about the treatment


Prevention

Prevention

  • Getting the message across that some behaviors are very unhealthy

    • Ex: AIDS, smoking, etc

      • Fear appeals

      • Use of celebrities


Aiming for good health

Aiming for Good Health


Subjective well being

Subjective Well-Being

  • One’s happiness, or life satisfaction, as measured by self-report

  • In self-reports, 75% of American adults describe themselves as happy

  • What predicts happiness?

    • Social relationships

    • Employment status

    • Physical health


Income doesn t seem to matter much

Income doesn’t seem to matter much…

  • Increase in income does not lead to increase in subjective well being

    • Most people define themselves as being happy or not happy, regardless of their material wealth


Why doesn t money contribute more to subjective well being

Why Doesn’t Money Contribute More to Subjective Well-Being?

  • Perceptions of wealth are not absolute but relative to certain standards

    • Social comparison theory revisited

  • People use their own recent past as a basis of comparison

    • Adaptation-level theory


Adaptation level phenomenon

Adaptation-Level Phenomenon

  • This is our tendency to judge various stimuli relative to those we have previously experienced

  • Whatever it is that's going on in our life, we immediately adapt to it and then that becomes neutral

  • So if you get a big promotion and raise, you'll think that's wonderful -- for probably a few weeks, and then it becomes neutral... and eventually not enough

    • What once gave pleasure such as a raise in salary, loses its effect


Campbell 1975

Campbell (1975)

  • He felt there was no such thing as an emotional utopia…

    • Well, maybe for awhile but the adaptation principle prevents this from being long-term

      • For example: million-dollar lottery winners return to their earlier level of happiness


Who is happier silver medallists or bronze medallists

Who is happier…Silver medallists or bronze medallists?

  • Our feelings are influenced strongly be how we appraiseour situations…

    • Medvec, Madey, & Gilovich (1995)

      • These researchers analyzed films from 1992 Olympics, and found that athletes who won Bronze medals were happier than those who won Silver medals


A set baseline level of happiness

A Set Baseline Level of Happiness?

  • Personality more important than the situation???

    • Ratings of happiness are higher among identical twins than among fraternal twins

      • Suggests a genetic link

    • Fluctuations in mood that accompany positive and negative life events wear off over time

    • Happiness levels are relatively stable over time and place


Do you feel any differently now than you did 15 weeks ago

Do you feel any differently now than you did 15 weeks ago?

  • We’ve discussed a variety of situational influences…

  • We’ve also looked at personality and how it interacts with the situation…

  • What's more influential insofar as prediction of a person’s behavior is concerned?


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