Health psychology

• is concerned with how different factors, such as lifestyle and social context, may influence illness and the well being of the entire person.

• Key aim:to promote understanding of appropriate

behaviour that leads to a healthier lifestyle.

Healthiness: more than the absence of illness (WHO, 1948)

• Important for health psychologists to take wider factors into account when addressing human behaviour:

• Differences in attitudes towards health-related behaviour among different cultures and variations in the incidence of health problems such as stress, eating disorders and substance abuse.

Factors influencing health:

• Socio-cultural and political factors, e.g. influence of family norms on eating habits, alcohol intake and exercise,influence of corporations on government policy (lobbying)

• Biological factors, e.g. appetite control centres in the brain, metabolic rate

• Cognitive factors, e.g. health beliefs.

Health psychology

• Learning outcomes:

• Discuss to what extend biological, cognitive and sociocultural factors influence health behaviour.

• Evaluate psych. research (theories/studies) relevant to health psychology.

Stress

• Seyle (1956): Stress refers to a failure to respond appropriately to emotional or physical threats.

• They cause physiological, cognitive and behavioural changes.

• Stress can be the result of imagined realities!• Definition stressor: any as challenging perceived

event which causes stress.• Acute vs. chronic stressors (>distress)

Learning outcomes:

• Describe stressors (include a definition of stress).

• Discuss physiological, psychological and social aspects of stress.

• > read assesment advice p. 226

Physiological aspects of stress

• http://www.simplypsychology.org/stress-immune.html

• Evaluation:

Physiological aspects of stress• Gender differences:

Frankenhauser et al (1976) reported boys have adrenaline rushes in exams that take longer to return to normal, whereas girls had a gentler, lower increase and returned to normal much quicker.

• Long-term stress has a negative outcome on physical health, e.g. an increase in cortisol.

• Psychoneuroimmunology:the interaction between psychological processes and the nervous and immune systems of the human body.

• Psychological states lead to physiological changes! Children who have had been exposed to significant stress in their home life can have impaired growth due to a lowering of the production of growth hormone in the pituitary gland (Powell, Brasel, & Blizzard, 1967).

Cognitive aspects of stress

• Lazarus (1966) argued for a situation to be stressful, it must be considered or appraised as such >> a clear cognitive component.

• Expectations on physical health have been shown to have an impact on health outcomes. (Reed et al.´s 1999 study on HIV-positive people).

• Attributional styles influence state of health according to Kamen and Seligman (1987).

Social aspects of stress

• Humans are social animals and as such we are acutely sensitive to changes in our social environment.

• Social self-preservation theory by Kemeny et al. (2005):

Threats on the social-self are responded with negative cognitive and emotional responses which affect physical health.

Think!

What have doctors, prostitutes and teachers in common?

Answer:

.

Social aspects of stress: Stress at the workplace

• … are harmful physical and emotional responses that occur when there is a poor match between job demands and the skills and resources, or personal needs of the worker (National Institute for Occupational Safety and Health ((NIOSH)) 1999).

• De-individuation occurs when people feel they lose their identity as they work in a certain field that demands they express themselves in a certain way (Ovisignkina, 1976; Perrow, 1984).

• Job autonomy:The lack of the ability to make decisions about their own lives has been shown to experience greater levels of stress.>> Empirical support:Theorell et al (1985) found greater blood pressure in high demand-low control occupations such as waiters and cooks.

Two ways of coping:

• Problem-focused coping:Aim is to change the stressor.

• Emotion-focused coping:Aim is to handle the stressor.

• > Your examples?

Stress Inoculation Training (SIT)

• by Meichenbaum in the 1970s (later improved)

• A form of cognitive-behavioural therapy as it changes thought and behaviour.

• Training should come before the onset of extreme anxiety to be most effective.

• SIT is to be individually tailored to the needs of the person suffering stress.

3 phases of SIT:• 1. Conceptualisation phase: A collaborative relationship is established between the client and the therapist.The therapist educates the client about the nature and impact of stress. • Re-conceptualisation: Interviewing, psychological testing, client self-monitoring, and reading materials.Then the clients' stress response is re-conceptualised: This is individually tailored to the client's specific problem.Identifying the sources of anxiety and ways to combat them.

A new model must be agreed upon:which lends to a specific intervention,is characterised as hopeful and helpful for the client.

2. Skills acquisition and rehearsal phase

• Skills for coping with the stress are offered and rehearsed, e.g.

emotional self-regulation, self-soothing and acceptance, relaxation training, self-instructional training, cognitive restructuring, problem-solving, interpersonal communication skills training, attention diversion procedures, using social support systems and fostering meaning-related activities.TASK: Choose 3 skills and identify the genuine problem.

3. Application and follow through phase

• Provides opportunities for the client to imagine stressful events and apply the variety of coping skills across increasing levels of stress.

• Possible techniques:imagery and behavioural rehearsal, modelling, role playing.

TASK:

• In pairs, make up an example of such a SIT.• If you like to, act it out in class.

Evaluation of SIT

• SIT accepts the stress an individual can experience is often unavoidable –

such as a work environment. • It tailors the therapy to the needs of the client with the active

cooperation of the client themselves. • The client-centred approach inherent within SIT promotes equality

between client and therapist and empowers the individual to take control of their stress management.

• It posits emotional and cognitive awareness at the forefront of the therapeutic environment thereby increasing the chances of long term success.

Evaluation of SIT

• Individuals will always vary in how they respond to treatment

and some may not be able to cope with the stressors present in their environment regardless of the training they undertake.

• SIT takes time and money and is not suited for the lifestyles of everyone.

• If carried out properly it is a rigorous program requiring high levels of commitment and motivation.

• The therapy requires a discussion of feelings and personal thoughts, lending itself more suitable for some cultures more than others.

Yoga• means to yoke, or to join two things together and hatha means sun

(masculine, active) and moon (feminine, receptive) energy. Therefore, hatha yoga means to join these to powerful forces together.

• Hatha Yoga is what most western people associate with the word yoga and it is the most commonly practiced for mental and physical health.

• Yoga represents a holistic approach to stress reduction:- incorporates physical, cognitive and spiritual concepts- Aim: making the individual more self aware and more aware of the

universe around them. Cosmic awareness in this way, is thought to reduce stress and promotes physical and mental well being.

Evaluation of yoga• Yoga is an expansive term and so it is difficult to give precise evaluations

for the whole practice.

• Yoga can be said to improve quality of life in a very broad sense (Cohen, 2006). It provides exercise, relaxation and self awareness as well as putting the individual in touch with like minded people with regular social interaction. • Most yoga classes consist of a combination of physical exercises, breathing routines, and meditation. These activities make yoga beneficial for people with certain health conditions such as hypertension, asthma, and back problems.

Evaluation of yoga

• Stress often has a very specific source relative the individual

(e.g. marital, occupational) that may need specialist counselling or therapy.

• Yoga is often a holistic lifestyle choice for its practitioners and incorporates many sensible ways to take control of one’s life and live a more peaceful and healthy existence such as adopting new food habits – therefore the Yoga itself cannot be specifically said to produce exacting health benefits.

• The physical exertions are not suitable for everyone.

Coping

Possible essay Q:Evaluate strategies for coping with stress (including a definition of stress).

Examiner’s Hints:Evaluation means balance. You should not just rely on negative aspects of any theory or study but also provide positive evaluations too.When evaluating, be reasonable and considered. Many studies and theories have been constructed over many years by experienced psychologists, dismissing them in one sentence is a not sophisticated.

Substance abuse and addictive behaviour

• Definition „substance“:anything an individual ingests to alter their cognition, behaviour or affective state.

TASK: Make a list of suitable substances.

Substance abuse and addictive behaviour

• … the overindulgence and/or dependence on a drug leading to harmful effects to our physical and mental health, or the welfare of others (Nutt et al, 2007).

Social paradigm: We are addicted when we cannot meet our obligations in employment, relationships and/or the community anymore.

Alcoholism

• … a disabling addictive disorder characterized by a compulsive need for alcohol that leads to negative effects upon the drinker's physical, emotional and social health.

• … is characterized by an incremental physiological tolerance for the drug leading to uncontrolled and increasing consumption.

Alcoholism leads to..

… brain shrinkage, liver disease, strokes, tremors, sleep disruption, amnesia,anti-social, aggressive and irrational behaviour, depression, anxiety, hallucinations and ultimately death.

http://www.youtube.com/watch?v=8jl-o89Z8j8

Some inter-cultural data about alcoholism

• Different rates of alcoholism across cultures and racial lines but yet unclear why.

• More than half of all the deaths in Russia between the ages of 15-54 years are caused by excessive use of alcohol. (UK Medical Research Council)

• In the UK, 9.000 people die from alcohol-related diseases every year (Lister, 2009).

http://www.youtube.com/watch?v=vOFpJN-2tcg

Physiological factors influencing alcoholism

Research usually focuses on identifying an addictive gene.• Alcoholism runs at approximately twice the rate in men

than in women.• Alcoholism does run in families and is particularly prevalent

within male bloodlines. • Addiction is linked to risk taking behaviour, low inhibition,

resistance to punishment and a tendency to favour short term over long term rewards – an explaination why it is more prevalent in men?

• Alcoholism is more likely if you start drinking early as it can influence the development of the adolescent brain.

But: Genetic predisposition does not determine behaviour.

Physiological factors influencing alcoholism II

• The only genes known conclusively to affect drinking code for proteins involved in alcohol metabolism:

40% of Asians have gene variants that code for inactive forms of alcohol dehydrogenase (ADH) and/or aldehyde dehydrogenase (ALDH2). So they cannot break down alcohol efficiently, those with the ALDH2 deficit turn red and feel sick after alcohol consumption.

• Cross (2004) citing Enoch: genetic predisposition manifests in different ways in different racial and cultural groups, e.g. some members of a native American tribe exposed to stressors express a genotype - COMT Met158Met - that actually protects against alcoholism.

The same genotype, when expressed in European men is associated with late-onset alcoholism and increased alcohol consumption.

Empirical Research

• Lingford-Hughes looked at the number of GABA receptors in the brains of alcoholics.

Findings: fewer receptors in the frontal lobes of their brains compared to non-alcoholics. GABA and its receptors are thought to be involved in calming the body, less of them would suggest a greater susceptibility to anxiety and therefore an increased likelihood for alcohol consumption in certain cultural groups (cited in Cross, 2004).Study type? Methodological problem?

Cognitive and sociocultural factors

• Alcohol has been fermented for more than 12,000 years and is an engrained part of many human cultures as a way to alter states of consciousness.

• Drinks cooperations: marketing• Media: films etc.• Social gatherings: parties etc.>> Alcohol as a normal part of existence.?.

Empirical research

• Dring and Hope (2001) studied the impact of alcohol advertising in Ireland:

Findings:• Alcohol advertisements were the favourites by the majority

of teenagers surveyed. • Most believed the majority of the alcohol advertisements

were targeted at young people, because the ads depicted scenes – dancing, lively music, wild activities - identified with young people.

• They interpreted alcohol ads as suggesting alcohol is a gateway to social/sexual success, can alter mood and help.

Possible SAQ

• Explain factors related to the development of substance abuse or addictive behaviour.

• For further info copy Pearson „Psychology“ p. 225-232 (available at the school´s library or Ziga)

Siggi von Lehe (1992):

„When you need some booze,

do not drink it.“