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TOPIC IV- SOCIAL PSYCHOLOGY APPLIED TO HEALTH - Psychological factors effect all aspects of our physical wellbeing. - Health psychology is the specialty that studies the physical processes affecting the development , prevention and treatment of physical illness. Stress and Human Health - Stress refers to human responses elicited by physical or psychological events that an individual perceives to be harmful or emotionally upsetting. To reduce the effect of stress people use different types of coping mechanisms and these can either be effective or not. Emotional and Physical Effects of Stress - Stress is any physical or psychological event that is perceived as a potential threat to physical or emotional wellbeing. - Physical illness may be a consequence of stress that is high levels of stress leads to illness, - Effects of stress increase due to a person’s vulnerability and ability to control what happens - According to Lazarus (1966) it is person’s interpretation of an event that influences how stressful they find it. In an experiment he showed people a film of an industrial accident- worker accidentally cuts of his finger- how upsetting the film was depended on how people interpreted it. Lazarus instructed some participants to adopt an intellectual stance when watching the film i.e. concentrating less on the accident and more on the relationship between workers. - Compared to the group that was given no instruction this group was relatively unaffected by the film. - Same as --physician ‘s reaction to blood during on operation. - Cohen et-al divided participants into those high and low in stress levels. they were given nasal drops that contained either a virus that causes common cold or saline (salt water)- they were then quarantined for several days. The pple who were experiencing a great deal of stress in their lives were more likely to catch a cold from the virus. Of those with least amounts of stress 27% got a cold- the study was unethical. Importance of Perceived Control - Perceived control over an event determines whether an event will be stressful or not and how people explain the causes of the event. - PC is the belief that we can influence our environment in ways that determine whether we experience positive or negative outcomes e.g. fear of illness and medical procedures for diagnosis and treatment all constitute sources of stress – to reduce this kind of stress one has to gather as much information as possible concerning the stress. - Knowledge provides a sense of control, even knowing that a procedure will be painful. - Martin Seligman (1967) experiments with dogs looked at the amount of time it took for a dog to learn that pressing a button with their noses turned off electric shock. Most dogs learned this quickly. In the second condition dogs received the same number and duration of shocks but nothing happened when they pressed the button – the First group of dogs could control the shocks but in the second group they could not. - Both groups were put in the same cage and shocks were administered ,those in the first group performed better than these who had not been shocked . However these in group 2 reacted differently they assumed that they could not control the new shocks either and most of them endured the shocks. Explaining Negative Life Events: Learned Helplessness - The second determinant of stress is how people explain to themselves why a negative event occurred e.g. 2 college students who both got poor grades student I said- the professor deliberately made the test diff- will do better next time student 2 said I am not smart enough……………….. - The second student is likely to settle into a state of leaned helplessness, believing that there is nothing he can do to improve his performance. - Making stable, internal and global attributes for negative events leads to depression, reduced effort and difficulty in learning. Direct and indirect Effects of Stress - According to Baum (1994) direct and indirect effects stress lead to illness - The indirect effects occur when the negative emotional effects of stress interfer with health related behavior e.g. eating an unbalanced meal. Stress Indirect effect on health related behavior - - Less compliance with appropriate consumption. Preventive behavior Delay in seeking medical care Avoidance of any medical care - - indirect effect on fitness related behavior ↑ in smoking and alcohol - Choosing less nutritional food to eat - Sleeping less Direct physiological effects - ↑ of amount of fat in the body cell - High blood pressure Decreased immunity to viral and bacterial infection ILLNESS Personality and Health - Individual differences in effects of stress - The dispositional continuum - Diseases prone and self healing personalities - Type A and Type B Personalities write own notes Type A Personality - A cluster of behaviors associated with the development of coronary heart disease - Excessive competitive drive, aggressiveness, impatience and a worrying sense of time urgency- deep seated insecurity. - More coronary heat disease Type B Not excessively competitive- no free floating hostility and no sense of time urgency Less susceptible to coronary heat diseases Coping with Stress - Strategies to deal with stress include 1) eating nutritious food, getting enough sleep and engaging in regular exercise results in fitness. Being fit results in a sense of wellbeing and self efficacy o To achieve the above these is need for strong motivation, commitment and ability to regulate one’s behavior. 2) Coping strategies – two levels (a) Emotion focused coping- attempts to reduce the negative emotional responses elicited by the threat and to increase the positive effect eg crying (b) Problem focused – attempts to deal with the threat itself and to gain control of the situation. 3) Social support and Stress Management - According to Sarason et al (1994) – social support is the physical and typical comfort provided by other people. Responding to Health Related Information (i) - Comprehending and evaluating health related information Usually people make judgments about predicted events and behavior as they are easily available in memory. - News of certain diseases e.g. swine flue or AIDS make people live in fear and such messages are not remembered. Some messages are comforting and positive e.g. finding about cancer treatment- more appealing and easily remembered. - Some messages have both positive and negative effects – malaria and coathametta. - Sometimes we overestimate the threat of diseases and also promise of instant cures are on the basis of availability heuristic ( define Avail Heuristic) (ii) - Rejecting and accepting health related info People do not always accept information they get about health issues even when they accept it is not followed by behavior change – WHY? - The effective content of the health warning is at play e.g of message ‘Cigarettes can kill you’ people usually reject such disturbing and anxiety arousing messages and decide that it is not true. - Health messages should be positively framed, suggesting that altered behavior will result in gain. Positive framing is most effective in motivating preventive behavior whereas negatively framed messages suggesting a loss from failing to act are best for motivating detention behavior - +ve – colgate for a fresher smile -ve- if you do not want to brush your teeth they will fall out. - Thinking of something as frightening as breast cancer can activate defense mechanisms that interfere with a person’s ability to pay attention to a message about early detention remember it and take appropriate action (Miller, 1997) - Beliefs and expectations contribute to whether or not a person engages in the necessary health related behavior e.g. Messages about breast self examination. Many women do not comply with these messages because of- a) Perceived susceptibility to breast cancer –pple may think that they will never get cancer. Increase in susceptibility is possible when patients are given information about risk factors. b) Perceived confidence that one has the ability to carry out a self examination.this can be solved by having the nurse teach the procedure in a one to one interaction with the client. People who ignore health information have a sense of unrealistic optimism or an optimistic bias (that bad things are not going to happen to an individual) Using SP to improve Health habits - people can be persuaded to change their health habits. One approach is attitude change - this can be done by trying to scare people into adapting better health habits e.g we could show people vivid pictures of people dying of AIDS, and send the message that if they do not practice safe sex A&B would happen to them. - Fear appeal can work if they are not too strong and are accompanied by specific information about how best to deal with the problem. - Cindy Struckman – Johnson et al (1994) showed students messages urging people to use condoms and to rate how much the commercials increased the likelihood that they would use condoms with a new sexual partner - The most effective ads were those evoking fear of AIDS e.g. women receiving result that she is +ve. - Actually changing behavior and saying that one will change such behavior are two different things. To change ingrained health habits with fear appeals may be of limited success. - Most of the time there are barriers to change - some people find condoms to be unromantic and reminder of the disease – something they don’t want to be reminded of when they are having sex, Aronson et al (1997) - There is usually strong denial – AIDS is a problem, but we are not at risk. - One way to change behavior is to challenge people`s self esteem so that it becomes to their advantage Psychologically to change their behavior. By doing so, they feel good about themselves- maintaining their self esteem - The theory of cognitive dissonance can be used. - Aronson et al asked students to compose a speech describing the dangers of AIDS and advocating the use of condoms ‘every single time you have sex’ - The speech alone was not enough there was need to make students mindful of the time it was impossible for them to use condoms. - By listing the times it was impossible for them to use condoms-Their self esteem was damaged because of the hypocrisy (saying people should use condoms but failing to do so). - Therefore they tried to fix their damaged self esteem by practicing what they preached. Students in the hypocrisy condition showed the greatest willingness to use condoms in the future and, when given the opportunity, purchased significantly more condoms for their own use than students in the other group. - Therefore the best way to change people’s behavior is to change their interpretation of themselves and the social situation. - In the above case no attempt was made to modify the research participant’s behavior (their use of condoms) directly, they were not rewarded for using condoms and they were not given information about what would happen if they didn’t. Researchers altered the way in which the participants interpreted failure.