Chapter 17

CHAPTER SEVENTEEN: HEALTH PSYCHOLOGY

Learning Objectives

LO 17.1: Describe the scope of health psychology and behavioral medicine.

LO 17.2:Describe the various theoretical models of change.

LO 17.3:Discuss psychological and social tools that promote effective life change.

LO 17.4:Describe how stress can affect personal wellness and identify strategies

to control it.

LO 17.5:Describe how decisions about physical activity, diet and nutrition, and smoking affect health and well-being.

  1. Chapter Overview
  2. Chapter Features
  3. Connections
  4. Teaching the Chapter
  5. Lecture Outlines by Section
  6. Suggested Activities
  7. Critical Thinking Questions
  8. Polling Questions
  9. Apply Your Knowledge
  10. Suggested Readings and Media
  11. Activity Handouts
  12. Answer Key to Activity Handouts

Chapter Overview

Experiencing Psychology: Is It a Disease or Just Gas?

  • Studies show what happens when physical symptoms are labeled as diseases; psychological factors can influence our health-related decisions.
  • Decision making is a psychological process even when it involves choices about medical treatments or between unhealthy and healthy behaviors.
  1. Health Psychology and Behavioral Medicine
  • Health psychologyis about the role that psychology plays in an individual’s health and in preventing and treating illness.
  • Behavioral medicine focuses on developing and integrating behavioral and biomedical knowledge to promote health and reduce illness.
  • Health promotion involves helping people change their lifestyle to optimize health and assisting them in achieving balance in physical, emotional, social, spiritual, and intellectual health.
  • Public healthis concerned with studying health and disease in large populations and designing interventions for health promotion and ensuring that all populations have access to cost-effective healthcare, health promotion services, and health behavioral resources.
  1. The Biopsychosocial Model
  1. Health psychology includes biological, psychological, and social factors in health.
  2. The autonomic nervous system.
  3. Using problem-solving strategies to confront life’s difficulties takes the psychological side of stress.
  4. The social aspect of stress is seen in social support.
  1. The Relationship Between the Mind and Body
  1. The mind definitely affects health and wellness, but the body also influences the mind.
  2. The wayindividuals feel physically may affect the way they think.
  3. Health and wellness may influence psychological experiences such as cognitive abilities, stress, and coping.
  1. Making Positive Life Changes
  • Health behaviors are practices that influence physical well-being, such as having a healthier attitude about stress, exercising, dieting, not smoking, drinking in moderation, and practicing safe sex.
  • Theoretical Models of Change
  1. The theory of reasoned action states that effective change requires people to have specific intentions about their behaviors. They should also have a positive attitude about the new behavior, and their social group should be positive about it as well.
  2. The theory of planned behavior includes fundamental components from the theory of reasoned action, but also includes the person’s perceptions of control over the outcome.
  3. The Stages of Change Model
  • The stages of change modelinvolves the process by which people give up bad habits and take on a healthier lifestyle.
  • The five steps in the model take into account that changes are not made overnight, but they take place over a series of stages.
  • Precontemplation

a.The precontemplation stage occurs when people are not yet thinking about making a change.

b.They aren’t aware that they have a problematic behavior that requires a change.

c.The key at this stage is consciousness-raising, where the goal is to get individuals to realize that their behavior is a problem.

d.It is not unusual for individuals to show signs of denial.

  1. Contemplation
  1. In the contemplation stage individuals realize they have a problem, but they aren’t yet ready to make a change. They are thinking about the change.
  2. They might reevaluate themselves and have mixed feelings about giving up the problem behavior.
  3. They may look at the short-term gains of the harmful behavior and weigh that against the long-term benefits of changing.
  1. Preparation/Determination
  1. In the preparation/determinationstage, the individuals are getting ready to make a change.
  2. Self-belief and the belief of their ability to see the change through are important.
  3. They start to explore options of how to start making the change.
  1. Action/Will Power
  1. In the action/will-power stage, individuals make the commitment to change and then enact a plan to start taking action.
  2. An important aspect of this stage is to find ways to support the new and healthier lifestyle. The individuals should find reinforcements and rewards for making the change.
  3. Social support through family and friends can help with encouraging words and supportive behaviors.
  1. The individuals should focus on alternative behaviors that take the place of the problem behavior.
  1. Maintenance
  1. In the maintenance stage, the individuals have succeeded in avoiding temptation and they are now consistently pursuing their new and healthy behavior.
  2. Relapse occurs when there is a return to the formal problem behavior. The individuals may become aware of situations that tempt them and avoid those situations.
  3. Transcendence occurs when the individuals are no longer actively thinking about maintaining the change; instead it has become part of them.
  1. Relapse
  1. Real change takes many attempts, and relapse is a common occurrence in any aspect of change.
  2. When a relapse occurs, an individual has an opportunity to learn from it, to think about what led up to the relapse, and then to revise a strategy of how to prevent it from occurring again.
  1. Evaluation of the Stages of Change Model
  2. The stages of change model has been applied successfully to a broad range of behaviors, including cigarette smoking, exercise, safe-sex practices, marijuanause in teenagers, substanceuse more broadly, and weight loss.
  3. However, its application is controversial in terms of how people move through the stages—sequentially as proposed or independently of each other. Furthermore, critics state that the model refers more to attitude change than behavior change.
  1. Resources for Effective Life Change

A. Motivation

  1. The tools for motivation involve changing for the right reasons. Change is most effective when individualsare changing for themselves.
  2. Research has shown that when individuals have an environment where they are in control, more autonomous, and more competent, there are enhanced outcomes for healthy behaviors.
  3. Implementation intentions are strategies for dealing with the challenges of making a life change as an individual and are more successful than others negotiating the road to change.
  4. Getting feedback on how someone is doing is important in the pursuit of any goal or change.
  1. Social Relationships
  2. Social supportis one way to make a difference in our lives and provides us information and feedback from others indicating that one is loved and cared for, esteemed and valued.
  3. Social support has three type of benefits:
  4. Tangible assistance: family and friends can provide goods and services in stressful circumstances.
  5. Information: individuals who provide support can also recommend specific actions and plans to help a person under stress cope more successfully.
  6. Emotional support: individuals can provide reassurance of value and love to those under stress or tough times.

3.Getting support from others is as equally important as giving support to others. However, research on finding links between social support and health are not always so clear-cut.

  1. Religious Faith
  1. Weekly religious attendance has led to healthy behaviors.
  2. Research has shown religious participation is associated with living longer.
  3. Religious affiliation is also helpful because of the social support that comes along with it. It can be helpful in promoting hope and stimulating life changes.
  1. Towards a Healthier Mind (and Body): Controlling Stress
  1. Stress and Its Stages
  2. Stress is the response to stressors, which are events that threaten an individual’s coping abilities.
  3. General adaptation syndrome (GAS) is the common effect on the body when demands are placed on it. There are three stages to general adaptation syndrome: the alarm stage, the resistance stage, and the exhaustion stage. In the alarm stage, there is a temporary state of shock where resistance to illness and stress falls below normal. In the resistance stage, glands throughout the body begin to develop hormones that protect the body. In the exhaustion stage, the wear and tear on the body takes its toll.
  4. The body system that plays the greatest role in GAS is the hypothalamic-pituitary-adrenal axis (HPA axis), which is a complex set of interactions among the hypothalamus, pituitary gland, and the adrenal glands.
  5. Stress and the Immune System

1.Chronic stress can have negative effects on the immune system.

  1. Psychoneuroimmunology looks at the connections among psychological factors, the nervous system, and the immune system.
  2. Acute stressors, which are fast acting and one-time life events, can cause immunological changes. Chronic stressors, which are longer lasting, are related to an increasing downturn in the immune system’s response rather than adaptation.
  3. Stressful situations lower the efficiency of the immune system and therefore individuals are more susceptible to diseases.
  4. Stress directly causes disease-producing processes.
  5. Stressful situations may cause dormant viruses to activate that diminish the individual’s ability to cope with disease.
  1. Stress and Cardiovascular Disease

1.Chronic emotional stress is related to highblood pressure, heart disease, and early death.

2.Individuals who live in a chronically stressful condition are more likely to start smoking, overeat, and not exercise.

  1. Stress and Cancer
  1. Stress has been related to cancer risk. Stress sets in motion the biological changes that are involved in the autonomic, endocrine, and immune systems.
  1. Coping with Stress

1.Not all of us perceivethe same event as stressful due to the way we “think” about the experience. This is known as our cognitive appraisal of the situation.

2.Coping means managing difficult circumstances, expending effort to solve life’s problems, and seeking to master or reduce stress.

3.Types of Coping:

  1. Problem-focused coping refers to the strategies we use to handle the problem facing us directly.
  2. Emotion-focused coping refers to responding to the stress you are feeling by trying to manage your emotional reaction rather than confronting the problem directly.
  1. Strategies for Successful Coping

1.Successful coping is associated with many factors, including a sense of personal control, a healthy immune system, personal resources, and positive emotions.

2.Multiple coping strategies often work better than one strategy when managing stress.

3.Optimism plays an important role in effective coping. The expectancy that good things are more likely to occur in the future than bad things is known as optimism.

4.Hardiness is a personality characteristic that is symbolic of commitment and control over the situation and a perception of problems as challenges rather than threats.

5.Links among hardiness, stress, and illness were the focus of the Chicago Stress Project.

6.Once way to avoid the effects of stress is by changing the way we think. A significant stressor in life is illness.

  1. Stress Management Programs

1.A stress management program teaches individuals how to appraise a stressful situation, how to develop the skills for coping with stress, and then how to put these skills to use.

2.Employers realize the effect that stress can have on productivity, so stress management programs are often offered at the workplace through some sort of workshop.

3.Research has shown a reduction in blood pressure in individuals that took part in a stress management program.

  1. Towards a Healthier Body (and Mind): Behaving As If Your Life Depends Upon It
  2. Becoming Physically Active
  1. Daily tasks have become increasingly easy through technology such as the Internet, and therefore, individuals have become less active.
  2. Sedentary lifestyles have been associated with at least 17 illnesses.
  3. Any activity that expends physical energy can be a part of a healthy lifestyle.
  4. Being physically active has been associated with positive outcomes such as a lower probability of cardiovascular disease, weight loss in overweight individuals, improved cognitive functioning, positive coping skills with stress, and less depression.
  5. Exercise is structured activity where the goal is to improve health.
  6. Aerobic exercise is a sustained activity that stimulates the heart and lung functioning.
  7. Experts have stated that if individuals burn more than 2,000 calories in a week they can lower their risk of a heart attack by two-thirds.The experts recommend that adults engage in 30 minutes or more of moderate exercise on most, if not all, days of the week.
  8. A major obstacle to promoting exercise in the U.S. is that many of our larger cities are not designed in ways that promote walking or cycling.
  9. Individuals should not limit themselves to just a few types of exercise.
  10. A key to keeping up with exercise is to chart the progress.
  11. Eating Right
  1. The percentage of individuals who are overweight or obese increased by 70 percent in 2008. At this rate, it has been estimated that by 2030, up to 86 percent of people could be overweight or obese.
  2. Exercising regularly is a great way to lose weight. Making healthy dietary choices is another.
  3. Nutritionists believe that proper nutrition involves more than eating the appropriate number of calories.
  4. Research has shown that self-efficacy and positive expectations produce a greater weight loss.
  5. Successful weight loss requires monitoring progress, which includes counting calories and fat grams.
  6. Diet programs that offer weight loss with no effort, no hunger, and no real change are not realistic.
  7. One key point to losing weight and maintaining the weight loss is to actually eat, specifically to eat breakfast. Also, choosing foods from all food groups and showing consistency in what and how much is consumed is important in weight loss and maintenance.
  8. Quitting Smoking
  1. Smoking is associated with 30 percent of cancer deaths, 21 percent of heart disease deaths, and 82 percent of chronic pulmonary disease deaths.
  2. Men are more likely to smoke than women.
  3. Nicotine increases the smoker’s energy and alertness, which is pleasurable and a reinforcing experience. It also stimulates neurotransmitters that can have a calming or pain-reducing effect.
  4. There are a variety of ways to quit smoking such as going cold turkey, using a substitute source of nicotine, and seeking therapeutic help.
  5. Using behavior modification has also been used in quitting smoking.
  1. Psychology and Your Good Life
  2. Health psychology serves to illustrate how your mental and physical aspects intertwine and influence each other.
  3. As a human being, both your mind and body affect each other. Caring for your mind is worthy of being a life mission.
  4. Everyday experiences become complex when we put them into the context of our life.

II. Chapter Features

  • Intersection: Health Psychology and Cross-Cultural Psychology: How Does Culture Influence the Meaning of Social Support?
  • Psychological Inquiry: Praying for Good Health
  • Critical Controversy:How Powerful Is the Power of Positive Thinking?
  • Psychological Inquiry: Physical Activity: A Matter of Life and Death

III. Connections

Assignable Through Connect / Assignable Within the Chapter / Instructor Resources
Health Psychology and Behavioral Medicine
LO 17.1: Describe the scope of health psychology and behavioral medicine. / Reading Quiz
Health Psychology (Interactive Learning Activity)
Behavioral Medicine (Learning Exercise)
LearnSmart Module / Critical Thinking Question: #3 / Activity Suggestion:
  • The Biopsychosocial Model
PowerPoints
Apply Your Knowledge: #5, #6
Making Positive Life Changes
LO 17.2: Describe the various theoretical models of change. / Reading Quiz
NewsFlash: Self-Affirmation Can Improve Problem Solving
LearnSmart Module / Critical Thinking Question: #3
Polling Question:#17.1
Handout:#17.1 / Activity Suggestions:
  • The Stages of Change Module
  • Draw Me a Theory
PowerPoints
Apply Your Knowledge: #2
Resources for Effective Life Changes
LO 17.3: Discuss psychological and social tools that promote effective life change. / Reading Quiz
LearnSmart Module / Intersection: Health Psychology and Cross-Cultural Psychology: How Does Culture Influence the Meaning of Social Support?
Psychological Inquiry: Praying for Good Health
Critical Thinking Question: #3
Polling Question:#17.1
Handout:#17.2 / Activity Suggestions:
  • Tools for Life Change
  • Why Is Change So Hard?
PowerPoints
Apply Your Knowledge: #2, #3, #5
Toward a Healthier Mind (and Body): Controlling Stress
LO 17.4: Describe how stress can affect personal wellness and identify strategies to control it. / Reading Quiz
Stress and Coping (Concept Clip)
Chronic Stress and the Brain (Video)
Stress and Coping (Interactive Learning Activity)
Stress in College (Interactive Learning Activity)
NewsFlash: Joplin, MO Tornado and Stress
NewsFlash: Stress of City Life
LearnSmart Module / Critical Controversy: How Powerful Is the Power of Positive Thinking?
Critical Thinking Questions: #1, #2, #3
Polling Question:#17.2 / Activity Suggestions:
  • What Stresses You Out?
  • Stress Vulnerability Quiz
PowerPoints
Apply Your Knowledge: #1, #4
Toward a Healthier Body (and Mind): Behaving As If Your Life Depends Upon It
LO 17.5: Describe how decisions about physical activity, diet and nutrition, and smoking affect health and well-being. / Reading Quiz
LearnSmart Module / Psychological Inquiry: Physical Activity: A Matter of Life and Death
Critical Thinking Questions: #2, #3
Polling Question:#17.1
Handout:#17.3 / Activity Suggestions:
  • Becoming Physically Active and Eating Right
  • Quitting Smoking
  • Fact or Fiction Nutrition Game
  • Smart Choices on the Go
PowerPoints
Apply Your Knowledge: #2, #3

IV. Teaching the Chapter

LO 17.1: Describe the scope of health psychology and behavioral medicine.