Introduction to Health Psychology
Introduction to Health Psychology
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This 18 page Reader was uploaded by Catherine Kennedy on Friday April 4, 2014. The Reader belongs to a course at University of California - Los Angeles taught by a professor in Fall. Since its upload, it has received 269 views.
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Date Created: 04/04/14
Tuesday April 1 2014 Lecture 1 Overview and Methods Course Information also on syllabus o No textbook 0 Readings free and posted online 0 Popular press 0 Light on homework heavy on attendance 0 TopHat 30 O 75 response rate for full credit 0 Sometimes you must get the correct answer to receive full credit 0 Exams 70 0 April 22 May 13 June 11 0 Exam grade will be calculated based on your top two exam scores 0 No makeup exams o Cheating 0 Do not cheat 0 Do not look like you39re cheating 0 Extras 0 Submitting test questions 0 Participate in studies 0 DISH Lab research assistant 0 httpwwwdishaborg Social Status and Health 0 Compared Academy Award winners to other actors in same films 0 Winners lived 4 years longer than other actors 0 Multiple winners lived 65 years longer 0 The higher status in society the longer you will live Bidirectional Relationship 0 Health psychology looks at the interplay between psychology and physical health 0 The effects of physical health on psychological functioning O The effects of psychological factors on physical health What is Health Psychology 0 Health psychology is the scientific contribution of psychology to O The promotion and maintenance of health 0 Health the state of complete physical mental and social wellbeing O The prevention and treatment of illness also psychologicalsocial causes Tuesday April 1 2014 O The identification of the causes of health illness and dysfunction 0 The analysis and improvement of the health care system Two Brilliant Health Scientists 0 Steve Cole 0 Margaret Kemeny AIDS in the Late 19805 0 At first it was called the 4H disease then it was called GRID stigma o No HAART death 0 Pushed people to quotstay in the closetquot lest they face rejection closeted HlV gay men die faster AIDS and HIV mortallilty T lglgsel AIDS oeath 9 Ills T i 4 E I 8 130 me 5lllIl39lGE MACS entry 3ears Estimated Ila AIDSfree I Surviving 0 D12 04 I5 0310 Fig Times to AIIJS diagnosis anal rnor ta1itar Es iimates lZJErSEil on model controlling for hliuobehavioral l3ll IiI1Iquot C lE I39fl5l39lCS1 listedl in Table 1 S urquotIrimr functions are trunated at median Event time to fElnilillEI ltE comparison and to avoilil extrapolation ll39Ei i39Eil39llZl Uhsertred data 0 Those more sensitive to rejection died faster 0 Increased exposure to stress more fightorflight responses 0 Higher adrenalineepinephrine levels increase HIV replication Rejection Sensitivity Scale 0 Sample question 0 quotRate your discomfort in each situation3939 0 Having straight friends in your home with your partner present 0 Going out in public with a group of gay men 0 Having a job interview where one39s marital status is discussed Lecture 1 Tuesday April 1 2014 Lecture 1 Ai Onset E E U3 Ci 3 E E E C E a HEIigl HllIJllu lE Eililly E lrrpcurtIian summing l 4 i394h lJhu31hmdvi11ii iD LiF LilhLhE1 dlE b i l 2 3 4 sis u 3 lat TU Fears since entry Complication o 1996 Highly Active Antiretroviral Therapy HAART arrives 0 HIV no longer a death system Small Response A Big RGSPONSG C r39OpOO8 039 O Q 33 ES E5 lquotl 3 l 08 O O r f39 26 4 E 3 o x do I D39 75 D 004 3 15 E 3310 O quot 32 0 DE 5quot 023 O mo l 5 U9 0 C C 0 l 5 Tuesday April 1 2014 Lecture 1 3000 1600 2500 A 1200 E 2000 Ba 5 V 1500 800 V O 1000 400 500 o O 0 2 4 6 8 0 2 4 6 8 Days postinfection lnflamatory Bacterial Gmwh factms cytokines product stress Mitogens 39 ltgt3 vo K Proteolytic degradation Cell Survival lnflamation Cell proliferation Immunity Correlation Studies Nearly all studies linking some sort of psychological variable to health are correlational studies as one variable goes up another variable goes up or down 0 Only answer questions about whether two variables are related Correlation does not imply causation Tuesday April 1 2014 Lecture 1 0 Easy to misinterpret a correlational finding as a causal finding 0 A lot of the time the things we want to know can only be answered by correlational studies 0 Important to know the distinction between correlation and causation especially in health research 0 Popular press tends to automatically convert a correlation into a causation Example Wine and Health Helartim Risk of Death byAmount oil Wne Grnmbaek at al 1995 Hellatlve Risk of Death ommammw mS E Never ll39u39liin1ll1l3r wesmnyl 12 Driiinlis per day 35 imrnnks per day Wine Intake 0 Negative correlation between wine consumption and risk of death 0 As wine consumption goes up relative risk of death goes down 0 Possible explanations 1 Drinking wine causes better health 2 Being in better health causes people to drink wine 3 Something else a confound causes people to both be in good health and drink wine 0 eg maybe being wealthy allows people to both healthy and capable of drinking more wine 0 or third variables are everywhere but are hard to single out Example Drownings and Ice Cream Tuesday April 1 2014 Lecture 1 Correlation Between Number of Drownings in Santa Monica and theAmount of Ice Cream Sold There 30 25 20 15 Ellrownlings 1D D 5 1 U 1 5 20 25 30 Tons of Ice Crealm Sold 0 Positive correlation between the number of drownings in Santa Monica and the amount of ice cream sold in Santa Monica 0 Possibleexplanations 1 Drownings cause ice cream sales 2 Ice cream sales cause drownings 3 Something else such as summertime causes increases in both the number of drownings and the amount of ice cream sold 0 More plausible explanation Example Dieting and Stress 0 There is a finding that dieting is correlated with stress 0 Hypothesis Dieting causes stress 0 the more quotdietyquot people are the more stressed they are 0 Have people respond to statements related to dieting and stress such as O 3939I am on a dietquot 0 3939I try to eat less to lose weightquot 0 3939I have rule for what I can eat so I lose weightquot 0 3939In the last hour I felt stressedquot 0 Reverse causation Stress makes you diet 0 Maybe instead of dieting causing stress stress causes a person to diet because it gives them a sense of control over at least one aspect of their life 0 Possible confounds 0 Teenage girl 0 Diet to keep a slim figure 0 Feel stressed out while going through adolescence 0 UCLA wrestler 0 Try to lose weight in order to get into a lower weight class 0 Feel stressed about an upcoming meet True Experiments Tuesday April 1 2014 Lecture 1 o The ONLY way to conclude causality 1 Manipulate variable A 2 Hold everything else constant Random assignment to conditions 0 Control for every possible confound by randomly assigning subjects to conditions 3 Manipulate variable B 0 Then you can say that changes in variable B were caused by manipulation of variable A 0 Random assignment is necessary for causality to be implied Example Does dieting cause stress Raindlom assignment Diet Group Control Group l Change inn stress l Sef reported stress Cortisol stress hormone o Randomly assign subjects to diet group or control group 0 Measure change in stress 0 Results dieting group had increases in both selfreported stress and in the stress hormone Cortisol Random Assignment Ethical amp Practical complications 0 In health psychology random assignment is usually not an option 0 Unable to randomly assign people to 0 Drink red wine for decades or not 0 Come out of the closet or not 0 Win an academy award or not 0 Get cancer or not Common QuasiExperimental Designs 0 Randomly assign at least one thing but not other things 0 Examples 0 Randomly assign cancer patients or noncancer patients to psychotherapy or control 0 Randomly assign men and women to social support interventions or control 0 Randomly assign old and young individuals to exercise program or control 0 Randomly assign people with high or low social support to cold virus or saline Example Understanding dieters Tuesday April 1 2014 Lecture 1 o Randomly assigned dieters or nondieters to drink a milkshake or not 0 See who eats more afterwards 0 Results 0 Dieters fall off track but they compensate later on roller coaster pattern 0 Nondieters consume a more steady caloric load Longitudinal Observational Design 0 Randomly assign nothing but you follow people over time look back in time 0 Subtype of longitudinal observational studies 0 Not as good as longitudinal studies that follow people over time 0 Not making a hypothesis beforehand 0 People may make their hypotheses as they find supportive data as opposed to making a hypothesis beforehand and finding evidence that either supports or refutes It 0 Example 0 Hypothesis A Tall buildings are vulnerable to terrorist attacks so we are going to observe tall buildings to see if they get attacked O Hypothesis B tall buildings are vulnerable to terrorist attacks so we looked at the tallness of buildings and found that they were attacked Example National Growth and Health Study I gt Age 10 19 Participants V F 1209 black 1166 white 2375 girls total After stress increases Does weight increase I A Age in l9 0 Increases in stress positively correlated with increases in weight 0 Attempting to predict what kind of people are more prone to being a stresseater The Four Types Tuesday April 1 2014 Lecture 1 Least Causalll iCorrelational Rertrorspectiiurei llongitudiniall oabevervational llIDl llglllIlLlltllllillall obeeArvatio nal 39QlLlaEiEEpEI39i mlentall 39l39rIuIE etperiInnlent Moist Causalll Distribution of study design ratings for clinical investigations from the medial and medical journals P0003 0 o 1 to 5 indicates the typequality of research 1 refers to true experiments that are randomly assigned and controlled whereas 5 is the lowest quality research 0 B what science actually conducts O 40 of studies conducted are true experiments 0 A what media actually covers 0 Only 17 of studies covered in media are true experiments 0 Most studies reported by media are only tier 3 studies Categorize the following studies into their correct design quotOscar winners live 4 years longer than nonwinnersquot a Correlational b Longitudinal observational c Quasiexperiment d True experiment Tuesday April 1 2014 Lecture 1 quotWe studied 699 drivers who had cellular telephones and who were involved in motor vehicle collisions resulting in substantial property damage but no personal injury Each person39s cellular telephone calls on the day of the collision and during the previous week were analyzed through the use of detailed billing recordsquot a Correlational b Longitudinalobservational c Quasiexperiment d True experiment quotWe studied the longterm survival of doctors graduating from one medical school over one century n 1521 comparing those who were presidents of their class to those who appeared alphabetically beforeor alphabetically after the president in the graduating class photographquot a Correlational b Longitudinal observational c Quasiexperiment d True experiment quotWe used computer simulations to create two lanes of traffic with identical characteristics except that their congestion varied depending on random starting gapsquot a Correlational b Longitudinal observational c Quasiexperiment d True experiment Thursday April 3 2014 Lecture 2 Biopsychosocial Model amp Stress History Illness through History Stone Age Evil spirits Middle Age God39s Punishment 1700s Capillary Tension 1880s Comfort 1900s Biomedical model Now Biopsychosocial Model Stone Age Evil spirits Thought that disease arose when evil spirits entered through the head Evil spirits would have to be removed through the head using trephination V 1 355 quot 39Z V l39l H 0P 3939 33quot quotquot39quot 3 H u 0 Healed holes suggest that people survived these treatments Thursday April 3 2014 Lecture 2 Middle Age God39s Punishment 0 Driving out evil by torturing the person 0 Same idea as in the stone age but sickness was considered the patient39s fault due to evil actssins 1700s Capillary Tension 0 People thought illnesses were caused by capillary tension capillaries were just discovered o Cure by bloodletting thereby reducing capillary tension 0 Places in the body where you were supposed to relieve the capillary tension 0 While these early treatments seemed savage people may look back on our current treatment methods and find it shocking O Eg today39s treatments for cancer 0 Slash surgery 0 Burn radiation 0 Poison chemo 18805 Comfort 0 Ill people were actually doing worse by bloodletting so the response was to use noninvasive treatments 0 Listening comforting etc Thursday April 3 2014 Lecture 2 19005 Biomedical model 0 Major breakthrough 0 Around 1925 Penicillin was invented O Cured syphilis yl ivy J ltquotr Patient before treatment Patient after treatment 0 All illness has a biomedical cause 0 Illness is based on an organ not functioning correctly or biochemicals in the body being out of balance 0 All illness can be cured with drugs if we just find the right drugs 0 Body is separate from the mind Evaluation of biomedical model 0 Successes acute illnesses infectious disease 0 Tuberculosis Pneumonia Tetanus Typhus Smallpox Malaria O Polio 0 Problem with the biomedical model 0 Not quite enough 0 Good for acute diseases but did not address chronic or longterm diseases OOOOO What is the biggest problem with vaccines a Significant side effects like autism Expensive to make not profitable to pharma Target keeps mutating eg flu Not 100 effective Doctors administer them improperly Explanation o Vaccines do not cause autism 0 Correlation fallacy strikes again 0 Putting the world39s health at risk D99 quot Thursday April 3 2014 What is the most common cause of death in the United States a Obesity b Cancer c Car accidents d Strokes e Cardiovascular disease Most Common Causes of Death Which of these behaviors kills the most people a Smoking b Car crashes c Drugs d Alcohol e STDs eg AIDS Smoking Unhealthy Diet Lackof Exercise Cardiovascular Disease 39 Q Cancers IS Strokes I IS Chronic Lung Disease 39 Q emphysema Unintentional Injuries Alzheimer39s Disease Drinking Alcohol Lecture 2 Injection Drugs Thursday April 3 2014 Lecture 2 Diabetes Pneumonia amp Flu lack of Kidney Disease I Septicemia blood poisoning Suicide Chronic Liver Disease Now Biopsychosocial Model 0 Biological Factors 0 Organs cells tissues biochemicals o Psychological Factors 0 Individuals motivations beliefs attitudes behaviors 0 Social Factors 0 Society culture community family social class Why do we need the biopsychosocial model Engel 1977 0 Having a biomedical defect indicated disease potential not disease existence 0 Beliefs about illness matter 0 Two people with same biomedical problem may have different disease outcomes 0 Successfully treating the biomedical problem doesn39t necessarily make patients healthy 0 Behaviors matter 0 Not just your behaviors but the behaviors of those around you Thursday April 3 2014 Lecture 2 Psychology Hea h What is Stress o 2 a negative emotional experience accompanies by predictable biochemical physiological cognitive and behavioral changes that are directed either toward altering the stressful event or accommodating to its effects 0 A multifaceted phenomenon Ways to Categorize Stressors o things that all animals human or not might list as stressful O eg heat cold pain fatigue injury hunger predators things that generally only humans would consider stressful O eg grades job security money relationships traffic stressors that demand immediate attention and don39t last long 0 Tend to appear suddenly 0 Many physical stressors are acute o stressors that do not require immediate attention but last a long time and are a constant source of worry 0 Most psychological stressors are chronic Four key moments in stress Walter Cannon Fight or flight behavior 0 When an organism perceives a threat they have a physiological response that either allows them to confront stressor fight or to avoidflee from the stressor flight 0 Stress causes physiological changes 0 They help mobilize the body to fight or flee 0 Useful helps you respond quickly 0 Problem disrupts normal functioning Hans Selye general adaptation syndrome more animalcentric o Injected rats with something and found these symptoms Thursday April 3 2014 Lecture 2 O Enlarged adrenal glands O Shrunken lymph nodes 0 Bleeding ulcers 0 Couldn39t find a stressful stimulus that didn39t create these symptoms 0 a nonspecific response of the body to any demand placed upon it 0 Any stressor any organism all the same Holmes and Rahe stressful life events that happened to humans 0 Looked at the set of stressful events that happened people39s lives and then measured their health 0 Used this to see if the number of stressful life events affected a person39s health Death of spouse Gaining a new family member Divorce lvlajor change in nances Maritiall separation Death of close friend Detention in jail Changing work Death of family member Change in argumentsspouse lvlaior personal injuryin ess Getting mortgage Marriage lForecosing on mortgage Being fired at work Promotion or Demotion llvlarital reconciliation Child leaving home Retirement ln aw trouble Change in healthfamilly Crutstanding personal pregnancy achievement z Sexual difficulties Vaca n Christmas 0 Their list included both positive and negative events that caused change in their lives Lazarus stress appraisals 0 According to Lazarus what matters is not what event occurs but how we perceive and interpret that event 0 the process of perceiving and interpreting the event The stress appraisal process 0 Primary appraisal 0 Is the event positive negative or neutral 0 If negative is it harmful threatening or challenging o Challenging assumes you have the resources to confront the event 0 Secondary appraisal 0 Are my coping abilities and resources sufficient to overcome the harm threat or challenge posed by the event 0 For the same exact event two people may appraise it entirely differently What specific kind of stressor does Sir Michael Marmot think is toxic a Romantic relationship stress Financial stress Sleep deprivation Uncontrollable stress Public embarrassment FDPPquot Thursday April 3 2014 In the nonhuman primate studies which of the following was true a Highstatus females get more access to junk food b Lowstatus choose cocaine over food c Highstatus males get more wounds and therefore heal slower d Lowstatus primates react more strongly to emotional faces e Lowstatus primates have smaller hippocampi Appraisals Matter 0 No sound 0 Trauma narrative emphasized pain 0 Denial narrative emphasized joyful ceremony 0 Scientific narrative detached tone Measured heart rate and selfreported stress Who was most stressed as measured by selfreport and heart rate 0 Trauma narrative gt no sound gt denialscientific narratives Lecture 2 All participants watch a subincision video a deep cut is made along the length of bottom of the penis but with different soundtracks
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