Psychology and Physical Health

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• Chapter 14
• Psychology and Physical Health
• Hostility and Coronary Risk
• Habits, Lifestyle and Health
• Reactions to Illness

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What is Health Psychology?

• Health psychology is concerned with how
  psychological factors relate to the promotion and
  maintenance of health, and with the causation,
  prevention, and treatment of illness.
• The biopsychosocial model holds that illness is
  caused by a complex interaction of biological,
  psychological, and sociocultural factors.

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• Hostility and Coronary Risk
• Research suggests a link between coronary risk
  and a behavior pattern termed the Type A
  Personality.
• Type A Personality has three components
• A competitive orientation.
• Impatience and a sense of time urgency.
• Anger and hostility.

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• Hostility and Coronary Risk, continued
• The anger hostility component of Type A
  behavior has the strongest link to coronary
  disease.
• Research shows that individuals with
  above-average hostility scores were twice as
  likely to have atherosclerosis than were those
  with below-averages hostility scores

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• Figure 14.5. Anger and coronary risk. Working
  with a large sample of healthy men and women who
  were followed for a median of 4.5 years, Williams
  et al. (2000) found an association between trait
  anger and the likelihood of a coronary event.
  Among subjects who manifested normal blood
  pressure at the beginning of the study, a
  moderate anger level was associated with a 46
  percent increase in coronary attacks, and a high
  level of anger nearly tripled participants risk
  for coronary disease. (Based on data in William
  et al., 2000)

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• Emotional Reactions and Heart Disease
• Stress, and its resulting strong emotions, seems
  to tax the heart.
• Even brief periods of stress can trigger acute
  cardiac symptoms such as angina (chest pain).
• When interviewed after surviving a heart attack,
  many patients say that an episode of anger
  triggered the symptoms.

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• Depression and Heart Disease
• Recent studies suggest that depression may cause
  heart disease.
• Overall, it seems that depression doubles ones
  changes of developing heart disease.
• Depression also seems to affect how heart disease
  progresses and is associated with worse outcomes
  in cardiology patients.

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• Stress and Immune Function
• The immune response is the bodys defensive
  reaction to invasion by bacteria, viral agents,
  or other foreign substances.
• A large body of experimental research indicates
  that stress can impair immune functioning in
  animals.
• Similar immune suppression may also occur in
  humans.

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Habits, Lifestyle and Health

• As shown in Figure 14.9, unhealthy habits account
  for the most premature deaths.
• Other leading behavioral causes of death include
• Alcohol consumption.
• Unsafe driving.
• Risky sexual behavior.
• Illicit drug use.

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• Figure 14.8. Mortality due to health-impairing
  behaviors. Synthesizing data from many sources,
  Mokdad and colleagues (2004) estimated the number
  of annual deaths in the United States
  attributable to various health-impairing
  behaviors in an interesting article published in
  The Journal of the American Medical Association.
  As you can see, smoking and obesity are the
  leading causes of preventable mortality. However,
  their mortality estimate for obesity has proven
  controversial and is the subject of some debate
  (some experts argue that their estimate is too
  high). (Data from Mokdad et al., 2004)

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• Smoking
• Health effects associated with smoking include
• Greater risk of premature death
• Lung cancer, as well as higher risk for many
  other cancers in the body.
• Hypertension, stroke and other cardiac diseases
• Giving up Smoking
• If people give up smoking, studies show that
  their health risks decline reasonably quickly,
  reaching normal levels after about 15 years
• Quitting smoking is difficult, however, and many
  people fail several times before succeeding.

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• Drinking
• Why do People Drink?
• Drinking is widely endorsed in our culture and is
  viewed as a desirable social ritual.
• Drinking dulls negative emotions such as tension,
  worry, anxiety and depression.
• Alcohol makes people feel more relaxed in social
  settings.
• To keep friends and company.

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• Drinking, continued
• Short-term Risks and Problems
• The hangover, which includes headache,
  dizziness, nausea and vomiting.
• Life-threatening overdoses. This is especially
  problematic when alcohol is mixed with a sedative
  or narcotic drugs.
• Poor judgment, reduced intellectual functioning.
• Poor motor coordination.
• Increased anger.

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• Drinking, continued
• Long-term Risks and Social Costs
• Alcohol dependence, or alcoholism is a chronic,
  progressive disorder marked by a growing
  compulsion to drink and impaired control over
  drinking that will eventually interfere with
  health and social behavior.
• See Figure 14.15 for a list of serious health
  problems associated with alcoholism.

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Habits, Lifestyle and Health, continued

• Overeating
• Obesity is a serious risk factor for a number of
  health problems and diseases
• Determinants of Obesity What causes it?
• Genetic factors (heredity) account for the
  majority of cases.
• However, environmental factors (excessive eating
  and a lack of exercise) also contribute.

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• Determinants of Obesity, continued
• Set point theory proposes that the body monitors
  fat-cell levels to keep them (and weight) fairly
  stable.
• When fat stores get low, we have increased hunger
  and decreased metabolism, making it difficult to
  lose weight.
• Settling point is an alternative theory that
  makes more room for long-term benefits of
  lifestyle changes.

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• Determinants of Obesity, continued
• Socioeconomic factors
• Married people are more likely to be overweight
  than are singles.
• More years of education is associated with a
  lower incidence of obesity
• Unemployment is predictive of weight gain.

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• Overeating, continued
• Losing weight
• Losing even small amounts of excessive weight can
  significantly reduce many of the health risks
  associated with obesity.
• Although there are numerous diet plans available,
  you essentially have three options
• Sharply decrease food intake.
• Sharply increase exercise.
• Moderate changes in both diet and exercise (most
  recommended option).

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• Lack of Exercise
• Benefits of Exercise
• Enhanced cardiovascular fitness.
• Avoidance of obesity.
• Decreased risk of colon cancer, and breast and
  reproductive cancer in women.
• Protection from stress.
• Positive effect on mental health.
• Increase in desirable personality traits.

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• Devising an Exercise Program
• Choose an activity you enjoy.
• Increase your participation gradually.
• Exercise regularly without overdoing it.
• Reinforce yourself for exercising.
• Its never too late to begin!

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Reactions to Illness

• The decision to Seek Treatment
• People are most likely to seek treatment for an
  illness if
• The symptoms are unfamiliar.
• The symptoms appear to be serious, last longer
  than expected, or disrupt work and social
  activities.
• Family and friends view symptoms as serious and
  encourage them to get treatment.

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• Seeking Treatment, continued
• The process of seeking treatment has three
  stages
• We must decide that our physical sensations are
  symptoms of illness.
• We must decide that our symptoms warrant medical
  care.
• We have to arrange for medical care (make an
  appointment, prepare to pay, etc.).

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• Seeking Treatment, continued
• The biggest obstacle to receiving treatment is
  procrastination on the part of the patient.
• People procrastinate because they
• Downplay significance of the symptoms.
• Dont want to look foolish if its nothing.
• Worry about bothering their doctor.
• Are reluctant to disrupt their plans.
• Waste time on trivial matters before going to a
  hospital emergency room.

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• The Sick Role
• Some people almost seem to enjoy being sick. They
  have learned that the sick role is associated
  with benefits, such as
• It absolves people from responsibility.
• Fewer demands are placed on sick people.
• Illness can provide a face-saving excuse for
  failure.
• Sick people receive more attention.

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• Communicating with Health Providers
• Good communication with your provider is crucial
  for good medical care.
• Barriers to effective communication include
• Medical visits are very brief.
• Illness and pain are subjective matters that can
  be difficult to describe.
• Doctors use too much medical jargon they
  overestimate the patients comprehension of what
  is being said.

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• Barriers to communication, continued
• Some providers discourage patients from seeking
  information.
• Patients may be too upset or ill to remember what
  symptoms to report or which questions to ask.
• Patients may withhold information for fear of a
  more serious diagnosis.
• In general, patients are too passive.

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• Adherence to Medical Advice
• Many patients fail to adhere to their physicians
  advice and this behavior takes many forms.
• Patients fail to begin a treatment regimen.
• Patients stop the treatment early.
• Patients reduce or increase levels of treatment
  that were prescribed.
• Patients are inconsistent in following treatment
  procedures.

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• Adherence to Medical Advice, continued
• Other factors associated with adherence
• Level of social support
• Self-efficacy
• Ability to remember instructions
• How aversive or difficult the treatment is
• Negative attitudes toward the physician