Health Psychology Causes of death have dramatically shifted in the past 100 years from contagious diseases (TB,

, flu, typhoid, malaria, polio) to chronic lifestyle diseases (heart disease, cancer, stroke). Along with these changes, our attitudes about disease have shifted to understanding our responsibility in living well to keep ourselves healthy. The biopsychosocial model suggests that physical illness is caused by a complex interaction of biological, psychological, and sociocultural factors. Health psychology is concerned with how psychosocial factors relate to promotion and maintenance of health, through causation, prevention, and treatment of illness. Stress and Personality Coronary Heart disease- results from a reduction of blood blow through coronary arteries, which supply the heart with blood. Artherosclerosis is the gradual narrowing of the coronary arteries, due to fatty deposits built up on the walls of the arteries. Once clogged, a loose clot can

cause stroke. It can also result in myocardial ischemia- interruption of blood flow causing painangina. Myocardial infarction is a full-fledged heart attack. Risk factors smoking, sedentary lifestyle, high cholesterol, high blood pressure. Psychological links to heart disease include Type A personality1) competitive orientation 2) impatience and time urgency 3) anger and hostility Type B personality is more relaxed, patient, easygoing, amicable toward others. Type As are hard-driving perfectionists who cant even relax during vacation. They have a short fuse and often alienate others in their drive for achievement, for the win. The aspect of the personality that is most deadly is their cynical hostility. (Hi-anger subjects had 3X as many coronary events as lo-anger subjects.) Anger-prone people are more physiologically reactive, causing more severe swings in heart rate and BP. This puts increased pressure on the coronary system. They also find reasons to react angrily that more placid people dont notice or choose to react to. Their lifeview sees more reasons to be angry, more hassles, sees setbacks as personally directed, and have more

conflicts with loved ones. Social support is an important coping device and these people cant develop a safe system. Their cynicism also contributes to poorer health habits- more often smoke, use alcohol, coffee and be overweight. Another contributor is physiological reactivity- which is biologically programmed for the most part. Hot reactors simply have an overly reactive CV response to stress. If you add cynical hostility, which causes people to feel difficulties are a personal problem, something directed at them, you can see how this combination will contribute to stress on the cardiovascular system. Anger is a frequent trigger for heart attacks. Heres where exercise and better physical habits can protect people against the weaknesses of their own system. Depression is another risk factor for heart disease. It doubles ones chance for heart disease. Cancer is a malignant cell overgrowth, which can occur in many organ systems of the body. Once the overgrowth damages adjacent tissues, it can interfere with normal functioning in the necessary organ. Theres no convincing evidence that stress triggers cancer. Cancer is slow to develop, so the point in time when it begins is difficult to trace.

There may be links to coping patterns, though. The cancer-prone personality has a repressive, avoidant coping strategy to deal with stress. They tend to repress angry, difficult emotions, rather than express them and possibly force some changes in difficult situations. If they dont get some counseling to help them cope more effectively with change, they will see the course of the illness progress more rapidly. Group therapy is well accepted treatment protocol for women with breast cancer. The immune system is the bodys defensive reaction to invasion by bacteria, viruses, other foreign substances. Some coping styles and emotional patterns seem to associate with certain organ systems. Stress seems to compromise the immune system, also, so certain illnesses are stress-related. It seems to open the body up to infections that could have been fought effectively had the person not succumbed to stress. Even so, the effects of stress are not strong as a correlation to infection. It is a complex interplay of biological, genetic, and environmental factors that create illness. Lifestyle choices-people tend to underestimate the risks associated with their poor health habits. They may be aware of the dangers intellectually, but they live in denial regarding their own risks.

Smoking 26%M and 22%F still smoke. Smoking 2 packs/day will shorten life expectancy for a male by 8.3 years. Risk increases with exposure, numbers of cigarettes smoked and amount of tar/ nicotine in them. It elevates risk for: lung cancer, heart disease, oral, bladder, kidney cancer, cancer of larynx, esophagus, pancreas, arteriosclerosis, hypertension, stroke, bronchitis, emphysema. Those exposed to second-hand smoke are also at increased risk for lung cancer, heart disease and breast cancer in women. Young children also are at risk for asthma and SIDS when exposed. If people give up smoking their risks decline to normal after 15 years. It is such an addictive substance, though, that people have a hard time giving it up. (Only 25% succeed). Most attempt several times before being successful. Nicotine substitutes, patches, gum arent terribly helpful. Drinking- about 50% of adults in US drink. 85% of college students drink. 50% M/ 39% F binge drink. There are a variety of motivations, but for many it is to loosen up their inhibitions, to escape effects of stress or depression (ironically, since alcohol is a depressant). Others do it to be accepted in their peer group. Many have had it modeled in their families as a coping device.

Effects: short-term- hangover, overdoses, poor judgment leading to accidents, drownings, DUIs. Drunk driving costs 12,000 lives per year. Car accidents are leading cause of death of young adults. Others become argumentative and aggressive. Alcohol is involved in 90% of student rapes and 95% of violent crime on campus. It also relates to unsafe sexual behavior. Long-term- alcohol dependence is a chronic, progressive disorder marked by compulsion to drink and impaired control over drinking that affect health and social behavior. 5-10% are chronic alcohol abusers, 10% are alcoholics. It associates with risk for CVD, hypertension, stroke, various cancers, oral, stomach, pancreatic, colo-rectal cancers. Cirrhosis of the liver, malnutrition, fetal alcohol syndrome in babies of drinking mothers, brain damage to the point of producing delirium, dementia and psychosis. Beyond that, there is the effect on family members who are alienated and wounded by an out of control drinker. Drinking increases risks of violence and sexual abuse in homes. Spouses and children feel helpless to protect themselves or change the drinker, short of leaving him/her. Its also related to job problems since it relates to absenteeism and lost productivity. Alcoholism costs the economy $166B annually.

Overeating- obesity is considered being 20% above their ideal weight. As many as 1/3 of Americans could qualify as obese. The irony is that the more the culture obsesses over thinness, the bigger we grow. Obesity affects mortality in incidence of heart disease, diabetes, hypertension, respiratory problems, gallbladder disease, stroke, arthritis, muscle and joint pain, back problems. Once again, this is a condition that relates to heredity, life habits, and biology. 1)Heredity genetic predisposition is found to be stronger than environmental effects (kinship studies) Basal metabolic rate is the bodys rate of energy output at rest. Those with lower metabolic rates are at higher risk for obesity. 2) Excessive eating and inadequate exerciseinput from diet consistently outweighs output from exercise. Too much sedentary activities. Our fastfood lifestyle is high fat and very tasty, so people look to food to moderate mood in an accessible format. 3) Set point- the bodys natural point of stability in body weight. The body monitors fat-cell levels to keep them stable, which means it will compensate in efficiency when exposed to malnutrition (a diet) by cutting down on metabolic needs. 4) Dietary restraint- restrained eaters work at controlling their eating impulses. When their control

is disrupted by stress, etc, they become disinhibited and eat to excess. They feel either in control or completely out of control, so forget itDrinking and emotional disruptions can disturb this control. YoYo dieting also contributes to long-term problems with overweight. Fad diets can compromise health (all protein diets stress the heart) Moderate, consistent weight loss programs increase health. Even a 10% weight loss relates to reduced medical risks. Exercise is considered the most consistent and helpful way to reduce weight and increase muscle mass and bone density. Nutrition-all the ways the body accesses nutrients needed for survival and growth. Healthy diet relates to lower mortality rate. 1) Foods that increase cholesterol (eggs, cheese, butter, shellfish, sausage and high fat meats) increase risk of CVD. Low fiber diet relates to CVD and colo-rectal cancer, polyps, etc. 2) High salt intake- hypertension 3) High caffeine- risk for hypertension, breast lumps. 4) High-fat diet- cancer, especially prostate cancer, colo-rectal cancer, breast cancer 5) Low calcium intake- osteoporosis later 6) High Vitamin E reduces risk for CVD.

7) Nutritional patterns relate to development of gallstones, kidney stones, gout, ulcer, rheumatoid arthritis. We are remarkably poorly educated about nutritionmost malnutrition in this country relates to poor lifestyle choices, not poverty. In general: 1) Consume a balanced variety of foods, including high fiber foods (raw veggies and fruit) 2) Avoid fat, sugar and salt by minimizing fast foods and highly processed foods. 3) Increase complex carbohydrates, unsaturated fats, natural sugars. (Fish, chicken, turkey, trim fat off meat, use skim milk, olive oil) Exercise doesnt have to be excessive to be useful physically 30 min. walk per day relates to longevity- it enhances CV function, reduces obesity, colon cancer risk, breast and reproductive cancers. It moderates effects of stress, minimizes depression. It improves mood, self-esteem, work efficiency. 1) Find an activity that you enjoy. 2) Increase activity gradually. 3) Exercise regularly, not in spurts. 4) Reinforce yourself for exercising. 5) Dont get into a competition trap.

AIDS- a disorder in which the immune system in gradually weakened and disables by HIV virus. It finally cant fight opportunistic infections, leaving the person at the mercy of a variety of illnesses. New drugs have prolonged survival but havent cured AIDS. (Recently found to be related to the infection that caused the Black Plague in medieval times.) High-risk behaviors- contact with bodily fluids, sexual contact, shared needles by IV drug users. Male to female transmission is 8X more likely than female to male transmission. It is not readily transferred through casual contact. HIV carriers may remain symptom-free for years before they show signs of AIDS. The more partners you have, the higher your risk. Use of condoms is important in reducing risk. Anal sex increases risk. High risk behaviors have increased in the last few years as people think the disease is under control. Psychological reactions to Illness Some people rush to a doctor with every symptom, others dont go unless they feel almost dead. How we perceive risk differs in different people. Those higher in anxiety and neuroticism report more symptoms of illness than others. People are more likely to seek treatment when their symptoms are unfamiliar, frightening, or disruptive of their normal activities. Also if friends/ family

encourage one to seek help, people will more likely go to the doctor. Delays of diagnosis and treatment can reduce the chance of cure in some illnesses. Many people minimize symptoms even when they are severe. It is particularly a problem for men, who are socialized to feel indestructible. Other people revel in the role of sick person. (60% of visits to doctors have little medical basis) What is the payoff of being sick? 1) absolves people from responsibility for duties 2) allows them to avoid demands of others 3) a face-saving excuse for failures 4) puts them at the center of attention, gets them affection, sympathy. So many people actually sabotage their treatment to prolong the sickness. People who are more assertive in finding the appropriate treatment, get second opinions, assert their personal needs in treatment have a better prognosis for illness. Passive acceptance of a doctor as god is not helpful. Noncompliance is a problem for patients 30 60% of the time. Poor communication with doctors is a problem for many patients. Drug Abuse- recreational use of a variety of drugs. Drug tolerance is a progressive decrease in a persons responsiveness to a drug with continued use.

As the user becomes more tolerant s/he will begin using larger doses of the drug to gain the desired effect. Physical dependence occurs when a person must continue to use a drug to avoid withdrawal. This varies according to properties of the drug. Psychological dependence occurs when a person must continue to use to satisfy mental and emotional cravings. Overdose occurs with excessive dosing of a drug to the point it threatens life. (Even water can be fatal, if you take too much, too fast for the body to process). Most overdoses are a result of combinations of drugs, slowing the heart and breathing to a halt, or speeding the heart to the point of stroke. Narcotics- opiates are drugs derived from opium that are capable of relieving pain. Heroin, morphine, codeine, Demerol, methadone. Heroin is used intravenously to give a sense of euphoria and escape from reality. High risk for both types of dependence. A drug-centered lifestyle seems to attach to use, criminality, marginally living on the streets. ODing is high risk, along with developing other infections.

Sedatives- sleep-inducing drugs that slow the CNS. Downers- barbiturates such as valium. Also used in connection with alcohol that increases risk of ODing. Produces a relaxed state. Also affects cognitive judgment, leading to risk of OD, and accidents. Stimulants- drugs that increase CNS activity. Cocaine, amphetamines, (speed), crack. Cocaine is snorted and freebased. Crack is smoked, giving a quick high, but is more addictive. Crank is a powder that can be snorted or injected. Ice (methamphetamine) is smokable. Speed high can last hours, cocaine is briefer (20-30 min.) Produce euphoria that leads people to feel powerful, energetic. Produces psychological dependence. Reduces need for sleep, food, and puts one at risk for stroke, heart attack, CVD. Can lead to amphetamine/ cocaine psychosis with paranoia and aggression. Hallucinogens- affect mental/ emotional function, distorts sensory/ perceptual experience. LSD (synthetic), mescaline (from peyote), psilocybin (mushrooms). Can produce euphoria, but can also result in fears, paranoia. Not addictive, but can affect personal safety, as judgment is impaired. Flashbacks also occur later. Can result in psych. Disorders.

Marijuana- cannabis is the hemp plant used to produce marijuana, hashish, and THC. Effects build up with continued use. Produces mild euphoria, distortions of perceptions. Diminishes cognition, short term memory, coordination. Produces dependence, as well as anxiety and depression in some. Smoke carries more carcinogens than tobacco. Ecstasy (MDMA)- synthesized compound similar to amphetamines and hallucinogens. Produces sense of connection to other people, need for touch, energy. Many toxins in the drug, depending on how its produced. Relates to stroke and heart attack, seizures, liver damage, sleep disorders, depression, anxiety hostility. Long-term effects on cognition and memory, ability to learn.

Health Psychology Causes of death have dramatically shifted in the past 100 years from contagious diseases (TB, flu, typhoid, malaria, polio) to chronic lifestyle diseases (heart disease, cancer, stroke). The biopsychosocial model suggests that physical illness is caused by a complex interaction of biological, psychological, and sociocultural factors. Health psychology is concerned with how psychosocial factors relate to promotion and maintenance of health, through causation, prevention, and treatment of illness. Stress and Personality Coronary Heart disease- results from a reduction of blood blow through coronary arteries, which supply the heart with blood.

Artherosclerosis is the gradual narrowing of the coronary arteries, due to fatty deposits built up on the walls of the arteries. It can also result in myocardial ischemiainterruption of blood flow causing pain- angina. Myocardial infarction is a full-fledged heart attack. Risk factors smoking, sedentary lifestyle, high cholesterol, high blood pressure. Psychological links to heart disease include Type A personality1)competitive orientation 2)impatience and time urgency 3)anger and hostility Type B personality is more relaxed, patient, easygoing, amicable toward others. Type As are hard-driving perfectionists who cant even relax during vacation. The aspect of the personality that is most deadly is their cynical hostility. (Hi-anger subjects had 3X as many coronary events as lo-anger subjects.)

Other risk factors: Hot reactors simply have an overly reactive CV response to stress. If you add cynical hostility, which causes people to feel difficulties are a personal problem, something directed at them, you can see how this combination will contribute to stress on the cardiovascular system. Anger is a frequent trigger for heart attacks. Heres where exercise and better physical habits can protect people against the weaknesses of their own system. Depression is another risk factor for heart disease. It doubles ones chance for heart disease. Cancer is a malignant cell overgrowth, which can occur in many organ systems of the body. The cancer-prone personality has a repressive, avoidant coping strategy to deal with stress. The immune system is the bodys defensive reaction to invasion by bacteria, viruses, other foreign substances. Some coping styles and emotional patterns seem to associate with certain organ systems.

Lifestyle choices-people tend to underestimate the risks associated with their poor health habits. They may be aware of the dangers intellectually, but they live in denial regarding their own risks. Smoking 26%M and 22%F still smoke. Smoking 2 packs/day will shorten life expectancy for a male by 8.3 years. . It elevates risk for: lung cancer, heart disease, oral, bladder, kidney cancer, cancer of larynx, esophagus, pancreas, arteriosclerosis, hypertension, stroke, bronchitis, emphysema. If people give up smoking their risks decline to normal after 15 years. Drinking- about 50% of adults in US drink. 85% of college students drink. 50% M/ 39% F binge drink. Effects: short-term- hangover, overdoses, poor judgment leading to accidents, drownings, DUIs. Drunk driving costs 12,000 lives per year. Car accidents are leading cause of death of young adults.

Alcohol is involved in 90% of student rapes and 95% of violent crime on campus. It also relates to unsafe sexual behavior. Long-term- alcohol dependence is a chronic, progressive disorder marked by compulsion to drink and impaired control over drinking that affect health and social behavior. 5-10% are chronic alcohol abusers, 10% are alcoholics. It associates with risk for CVD, hypertension, stroke, various cancers, oral, stomach, pancreatic, colo-rectal cancers. Cirrhosis of the liver, malnutrition, fetal alcohol syndrome in babies of drinking mothers, brain damage to the point of producing delirium, dementia and psychosis. Beyond that, there is the effect on family members who are alienated and wounded by an out of control drinker. Drinking increases risks of violence and sexual abuse in homes. Its also related to job problems since it relates to absenteeism and lost productivity. Alcoholism costs the economy $166B annually.

Overeating- obesity is considered being 20% above their ideal weight. As many as 1/3 of Americans could qualify as obese. Factors that contribute to overweight: 1)Heredity genetic predisposition is found to be stronger than environmental effects (kinship studies) Basal metabolic rate is the bodys rate of energy output at rest. Those with lower metabolic rates are at higher risk for obesity. 2) Excessive eating and inadequate exercise- input from diet consistently outweighs output from exercise. 3) Set point- the bodys natural point of stability in body weight. The body monitors fatcell levels to keep them stable, which means it will compensate in efficiency when exposed to malnutrition (a diet) by cutting down on metabolic needs. 4) Dietary restraint- restrained eaters work at controlling their eating impulses. Exercise is considered the most consistent and helpful way to reduce weight and increase muscle mass and bone density.

Nutrition-all the ways the body accesses nutrients needed for survival and growth. Healthy diet relates to lower mortality rate. Exercise doesnt have to be excessive to be useful physically 30 min. walk per day relates to longevity- it enhances CV function, reduces obesity, colon cancer risk, breast and reproductive cancers. It moderates effects of stress, minimizes depression. It improves mood, self-esteem, work efficiency. AIDS- a disorder in which the immune system in gradually weakened and disables by HIV virus. High-risk behaviors- contact with bodily fluids, sexual contact, shared needles by IV drug users. Male to female transmission is 8X more likely than female to male transmission. Psychological reactions to Illness People are more likely to seek treatment when their symptoms are unfamiliar, frightening, or disruptive of their normal

activities. Also if friends/ family encourage one to seek help, people will more likely go to the doctor. Delays of diagnosis and treatment can reduce the chance of cure in some illnesses. Other people revel in the role of sick person. (60% of visits to doctors have little medical basis) What is the payoff of being sick? 1)absolves people from responsibility for duties 2)allows them to avoid demands of others 3)a face-saving excuse for failures 4)puts them at the center of attention, gets them affection, sympathy. So many people actually sabotage their treatment to prolong the sickness. People who are more assertive in finding the appropriate treatment, get second opinions, assert their personal needs in treatment have a better prognosis for illness.

Drug Abuse- recreational use of a variety of drugs. Drug tolerance is a progressive decrease in a persons responsiveness to a drug with continued use. As the user becomes more tolerant s/he will begin using larger doses of the drug to gain the desired effect. Physical dependence occurs when a person must continue to use a drug to avoid withdrawal. This varies according to properties of the drug. Psychological dependence occurs when a person must continue to use to satisfy mental and emotional cravings. Overdose occurs with excessive dosing of a drug to the point it threatens life. Narcotics- opiates are drugs derived from opium that are capable of relieving pain. Heroin, morphine, codeine, Demerol, methadone Sedatives- sleep-inducing drugs that slow the CNS. Downers- barbiturates such as valium.

Stimulants- drugs that increase CNS activity. Cocaine, amphetamines, (speed), crack. Can lead to amphetamine/ cocaine psychosis with paranoia and aggression. Hallucinogens- affect mental/ emotional function, distorts sensory/ perceptual experience. LSD (synthetic), mescaline (from peyote), psilocybin (mushrooms. Flashbacks also occur later. Marijuana- cannabis is the hemp plant used to produce marijuana, hashish, and THC. Ecstasy (MDMA)- synthesized compound similar to amphetamines and hallucinogens. Produces sense of connection to other people, need for touch, energy.