Health Psychology: Module 1

1. Health Psychology: Module 1

2. “Physical Health” Observable, physical symptoms “Mental Health” “psychological” factors Probably best example of intersection:stress

3. Alternative views on “alternative” medicine • Lance Armstrong • What does “alternative” mean, exactly? • Several issues here • Experimental evidence weighted vs. not • Western vs. non-western medicine • “Focused” vs. “holistic” approaches

4. Regardless of whether the treatment is “traditional” or “alternative”, avoid anecdotal evidence! • Many ailments get better on their own • Introduces STRONG confound of time • i.e. the build-up of any drug in your system, and the passage of time, are always perfectly confounded • Try to resist temptation for self-blame if treatments don’t work

5. stress

6. Possible to “rank” stressful events? • Holmes & Rahe (1967) • Death of a spouse—100 • Divorce—73 • Marriage—50 • Getting fired—47 • Change in residence—20 • Christmas—12

7. problems Health problems p(events) • Third variable problems • Sample • What’s key is how event is perceived. Personality trait

8. Great study by Cohen et al. (1991) Percent who caught cold 50% 25% Psychological stress index

9. some causal evidence • Cacioppo 1998 • Pre-measure  stress  post-measure

10. Perceived control and health • Again, power of correlational vs. experimental designs • Some causal evidence • Langer and Rodin (1977; p. 513) • Nursing home study • Random assignment to high personal (and lasting) control vs. no treatment (baseline). • 15 months later: • mortality (death) rate in high control condition: 15% • Mortality rate in baseline condition: 30%

11. A very disturbing follow up study • Death rate among baseline (never had control increased): • 0% • Mortality rate among temporary control: • 20% • Schulz and Hanusa (1978; p. 483-484) • Somewhat similar to Langer and Rodin (1977): • Random assignment to high control, vs. baseline But: when study was over, sense of control was removed; • i.e. temporary control

12. Risk perception and mood

13. Johnson & Tversky (1983):(specific) cognitive vs. (general) affective routes Cognitive/priming hypothesis cancer Read about case of cancer lightning Not supported earthquakes

14. Generalized affect hypothesis supported cancer Read about case of cancer lightning earthquakes

15. Study 2 Positive mood Decreased risk Unrelated mood manipulation Negative mood increased risk

16. Gender differences in coping with stress • Fight or flight (Cannon, 1932) • Norepinephrine, epinephrine • Little-known fact about experimental work—most done on males (e.g., male rats)—Taylor et al., 2000 • Females • “Tend and befriend” • More likely to produce oxytocin (calming, promotes affiliation) • Caution

17. Optimism, health and accuracy • Optimism • Unrealistic optimism • The “above average” effect (Weinstein, 1980) • Health and accuracy • Trade offs

18. Message framing • Positive vs. negative • Key variable: Detection vs. prevention • Detection (e.g. for cancer): negative framing works better • Prevention (e.g. putting on suncreen: positive framing

19. Detection behavior Applied focus:how can we motivate people to engage in healthy behavior? • e.g., BSE greatly increases early detection of cancer, yet relatively few women do so • Message framing • Let X = healthy behavior • Positive framing (gain): • “If you do X, good outcome” • Negative framing (loss): • “If you don’t do X, bad outcome”

20. Detection behavior (Myerowitz & Chaiken, 1987) • Positive (gain) framing • “By doing BSE now, you can learn what your body normally feels like so that you will be better prepared to noticed any small, abnormal changes that might occur as you get older. Research shows that women who do BSE have an increased chanceof finding a tumor in the early, more treatable stage of the disease.” • Negative (loss) framing • “By not doing BSE now, you will not learn what your body normally feels like so that you will be ill prepared to noticed any small, abnormal changes that might occur as you get older. Research shows that women who do not do BSE have an decreased chance of finding a tumor in the early, more treatable stage of the disease.”

21. Detection behavior design • Framing manipulation: • Gain • Loss • Control (no message) • Immediate follow-up • 4 MONTHS later: follow up questionnaire on behavior

22. Detection behavior Immediate 4 months later • CONTROL • Intention to perform BSE • Actual BSE behavior • GAIN (PF) • Intention to perform BSE • Actual BSE behavior • LOSS (NF) • Intention to perform BSE • Actual BSE behavior 3.47 5.18 .75 3.95 5.95 .74 5.48 6.83 1.42

23. Replications and extensions for detection behaviors • Negative framing superior to positive framing: • Encouraging self-exams for skin cancer (Block & Keller, 1995) • HIV testing (Kalichman & Coley)

24. prevention behaviors • Prevention focuses on averting the onset of a health problem • Provide people with the opportunity to maintain their present healthy status and to reduce risk of future illness • Here, positively-framed messages are more effective

25. prevention behavior Examples • Encouraging use of sun screen (Rothman et al. 1993) • Positive frame: using sunscreen, you greatly reduce the chance of getting cancer later on in life • Negative frame: by not using sunscreen, you greatly increase the chance of getting cancer later on in life

26. prevention behavior Other examples • Exercise (Robberson and Rogers, 1988) • Use of infant car seats (Christopherson & Gyulay, 1981) • Using condoms (Linville et al. 1993)

27. Probability assessment, risk, and health • Again, judgments are biased by what comes to mind first • Flying vs. driving • Lotteries • Wildly inflated perceived risk of vivid accidents (e.g. getting struck by lightning) • AIDS

28. Statistics (as of 1988) Participants’ estimates Risk that woman will contract AIDS with one heterosexual contact with HIV positive male, no condom .2% (1/500) 50% BUT: Why important to wear a condom: Calculation of objective risk is an inexact science (and these data are somewhat dated) Helps prevent: unwanted pregnancy, spread of other STDs (e.g. herpes; 20-30% U.S. population, no cure at current time) 8% of AIDS cases in the United States have been attributed to heterosexual contact. .02% (1/5000) 5% w/condom

29. Illusions and well being: A second look at mental health and reality Main sources: Taylor and Brown, 1988 Rebuttal by Colvin and Block (1994)

30. Overview • Definition of mental health—the standard view • Illusions and biases among healthy “normal” individuals • Taylor and Brown thesis; evidence • Rebuttal by Colvin and Block

31. Previous assumptions about reality and mental health • Psychological health  • Close contact with reality • Reasonably accurate • “The perception of reality is called mentally healthy when what the individual sees corresponds to what is actually there” (Jahoda, 1958) • Seems reasonable, but…

32. Biases in social perception • Most of the time, people do not see the world as it “really is”. • These often take the form of self-serving, flattering portraits of the self • two main classes of findings • Unrealistically positive views of the self • “positivity distortions” • Exaggerated perceptions of personal control

33. I. “positivity distortions” • Above-average effect in ratings, predictions • The future looks bright, especially for me! (Weinstein, 1980) • Comparisons of self-ratings vs. observer ratings • Lewinsohn, Mischel, Chaplin, and Barton (1980) • College students interact with others in get-acquainted setting • Researchers compared ratings of self, vs. ratings by observers • Relative to observers, people saw themselves in flattering terms • For most people, positive personality information is efficiently processed • RTs • Memory • success vs. failure • Attribution • Recall • Estimated commonality of strengths and weaknesses • Weaknesses/faults—seen as relatively common • Strengths—seen as rare and distinctive

34. Who doesn’t show these positive distortions? • Moderately depressed individuals, people with low self esteem • Such people show • More accurate recall of positive vs. negative information • More “even handed” in attributions of self-responsibility • More congruence between self evaluations and appraisals by others

35. II. Illusions of control • Most people infer greater control than they really have • When outcome is objectively random, people still persist in believing that they have personal control • And, once again, this effect disappears among those who are mildly-to-severely depressed individuals

36. Summary and major implications

37. Rebuttal: Colvin and Block (1994)

38. Critique #1 • Taylor and Brown define “healthy” vs. “unhealthy” (“mentally ill”) in a very circumscribed way • Healthy—college students with moderate to strong self esteem • Unhealthy -Mildly depressed college students

39. Critique #2 • Depressed individuals, especially those with moderate to severe levels, may be distorting in the opposite (negative) direction • Thus, it may be a simplification to say that healthy people distort, but unhealthy people don’t distort

40. Positive biases Theoretical neutral (unbiased) point Negative biases extremely negative extremely positive SELF CONCEPT

41. Critique #3: Questions about operationalization of accuracy • Recall that Taylor and Brown claimed that non-depressed individuals show positivity biases, whereas show “even handedness” in self-related processing • But “even handedness” in self processing (e.g. using just as many negative as positive traits to describe the self) is not a very good indicator of accuracy

42. Critique #4: Major problems with Lewinsohn et al. (1980) study • In this paradigm, observers tend to be relatively harsh (negative) when judging others. • Leads to an artifactual appearance of accuracy for people if they happen to be negative in their own appraisals

43. critique #5: excessive positivity/high optimism may not always be healthy • Narcissism • Disappointment • McGraw, Mellers, & Ritov (2004) • Very high self esteem can be associated with excessive aggressiveness, especially with males

44. Taylor and Brown (1988) Attempts to propose new view of mental health and mental illness Positive illusions/biases not necessarily maladaptive Colvin and Block (1994) At least Five major critiques Narrow Definition of healthy vs. unhealthy Problems with distortion hypothesis Definition of accuracy suspect Problems with Lewinsohn et al. (1980) paradigm Downside of excessively high self esteem Summary