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Chapter Fourteen Health

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Chapter Fourteen

Health

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Health Psychology

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

• But isn’t physical illness a purely biological event?

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Figure 14.1: Leading Causes of Death, 1900-2000

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Stress and Health

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Stress

• 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.

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Figure 14.2: The Stress-and-Coping Process

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What Causes Stress?

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Scarring Effects of Natural Disasters (Krug et al., 1998)

0

10

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Increase in

Suicide Rate

Floods Hurricances Earthquakes

Type of Natural Disaster

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Crises and Catastrophes

• Stressors: Anything that causes stress.

• Posttraumatic Stress Disorder (PTSD): A person experiences enduring physical and psychological symptoms after an extremely stressful event.

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Major Life Events

• 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.

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Putting Common Sense to the Test…

The accumulation of daily hassles does more to make people sick than catastrophes or major life changes.

Answer: True… Let’s see why!

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Microstressors: The Hassles of Everyday Life

• Most common source of stress arises from the daily hassles that irritate us.• e.g., environmental factors.

• “Microstressors” place a constant strain on us.• The accumulation of daily hassles contributes

more to illness than do major life events.

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Figure 14.3: Stress in the Dormitory

Baum & Valins, 1977.

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How Does Stress Affect the Body?

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Putting Common Sense to the Test…

Like humans, zebras get ulcers.

Answer: False… Let’s see why!

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Figure 14.4: The General Adaptation Syndrome

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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.

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Table 14.1: 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.

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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.

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Putting Common Sense to the Test…

Stress can weaken the heart, but it cannot affect the immune system.

Answer: False… Let’s see why!

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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.

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Figure 14.5: Pathways from Stress to Illness

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Figure 14.6: Stress Duration and Illness

From A. Baum and S. Valins, Architecture and Social Behavior: Psychological Studies of Social Density.

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Process of Appraisal

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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

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Figure 14.7: Explanatory Styles and Depression

PSYCHOLOGY 3/E by Kassin, Saul, (c) 1997. Reprinted by permission of Prentice-Hall, Inc., Upper Saddle River, NJ.

From Psychology, 3rd Edition by Saul Kassin. Copyright (c) 1997. Reprinted by permission of Prentice-Hall, Inc., Upper Saddle River, NJ.

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Hardiness Personality Style

• Individuals exhibit three characteristics:• Commitment.• Challenge.• Control.

• Hardiness serves as a buffer against stress.• Perception of control is most important factor.

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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.

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Putting Common Sense to the Test…

When it comes to physical health, research does not support popular beliefs

about the power of positive thinking.

Answer: False…Let’s see why!

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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.

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Figure 14.8: Hopelessness and the Risk of Death

TEMP CREDIT LINE: Everson, S. A. et al. (1996). Hopelessness and risk of mortality and incidence of myorcardial infarction and cancer. Psychosomatic Medicine, 58, 121-133. Reprinted by permission.

From S.A. Everson, et al., "Hopelessness and Risk of Mortality and Incidence of Myocardial Infarction and Cancer," Psychosomatic Medicine, Vol. 58, 121-133. Reprinted with permission of Lippincott, Williams & Wilkins.

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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.

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Ways of Coping with Stress

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Table 14.2: Ways of Coping with Stress

From Carver, C.S., M.F. Scheier, and J.K. Weintraub (1989). "Assessing Coping Strategies: A Theoretically Based Approach." Journal of Personality and Social Psychology, 56, 267-283. Copyright (c) 1989 by the American Psychological Association. Reprinted with permission.

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Coping Strategies

• Problem-focused coping

• Emotion-focused coping

• Proactive coping

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Problem-Focused Coping

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

• Why is not always a beneficial approach?• Can be physiologically taxing.• Can lead to development of an over-

controlling, stress-inducing Type A pattern of behavior.

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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.

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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?

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Self-Focus: Getting Trapped vs. Getting Out

• Self-awareness theory revisited.

• A self-perpetuating feedback loop can occur:• Being in a bad mood triggers self-focus.• Self-focus in people with low self-esteem

further worsens the mood.

• Gender differences: Women brood, and men act out.

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Figure 14.9: Aspinwall and Taylor’s Model

of Proactive Coping

From Aspinwall and Taylor (1997) "A Stitch in Time: Self-Regulation and Proactive Coping," Psychological Bulletin, 121, 417-436. Copyright (c) 1997 by the American Psychological Association. Reprinted with permission.

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Putting Common Sense to the Test…

People who have lots of friends are healthier and live longer than those

who live more isolated lives.

Answer: True… Let’s see why!

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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.

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Figure 14.10: Does Being Popular Always Promote Health?

From Hamrick, N.S. Cohen, and M.S.Rodriguez (2002). "Being Popular Can be Healthy or Unhealthy Stress, Social Network Diversity, and Incidence of Upper Respiratory Infection" Health Psychology, 21, 294-298. Copyright (c) 2002 by the American Psychological Association. Reprinted with permission.

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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?

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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.

• Is there a link between religiosity and health?

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Treatment and Prevention

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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.

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Figure 14.11: The Spread of AIDS Across the Globe

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Putting Common Sense to the Test…

As role models, celebrities have great influence over public health-care decisions.

Answer: True…Let’s see why!

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Figure 14.12: Aiming for Good Health

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The Pursuit of Happiness

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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

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Figure 14.13: Wealth and Subjective Well-Being

From Psychology, 3/E by Saul Kassin. Copyright © 1997. Reprinted by permission of Prentice Hall.

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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 revisited.

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A Set Baseline Level of Happiness?

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

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

• Happiness levels are relatively stable over time and place.