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Health psychology Cheat Sheet by

Health belief model, chronic illness, health compromising behavior, CHD, quality of life.

Emotional response

Indivi­duals with chronic illness
disbelief and denial - reinforced if symptoms are minimal
anger and resentment - 'why me?', may see it as a form of punish­ment, may be directed to god, caregiver, doctors, self
anxiety - less info (uncer­tainty) abt illness & treatment increases anxiety
depression - due to loss of health, can increase symptoms and reduce adapta­bility
acceptance - learn to live with it
Family (parents and siblings)
disbelief and denial - doubt diagnosis, consult various doctors
anger and resentment - at self, doctor, patient
anxiety - may become overpr­ote­ctive, preocc­upied with their own health
guilt - feel respon­sible for patient's condt, may project it to patient
depression - more awareness of the condt, breakdown of patient's future expect­ations
acceptance - have adapted, condt is no longer the primary focus
Physicians
avoidance - avoid giving new to family
anger and resentment - time consuming paperwork, at family for expecting immediate assistance
anxiety - accuracy of diagnosis, treatment, their commun­ication of expect­ations
depression - wrong diagnosis, patient death
helple­ssness and guilt - uncertain diagnosis, limited treatment techni­ques, knowing there's no cure (or final stages)

Health belief model

Hochbaum, 1958; Rosens­tock, 1966
Theore­tical framework used to explain and predict health­-re­lated behaviors
Developed to understand why people engage­/don't engage in health behavior change (attit­udinal approach)
2 primary beliefs - severity of illness (precieved health threat) & effect­iveness of the behav change (perceived threat reduction)
percieved health threat (susce­pti­bility, severity)- influenced by 3 factors: general health values (how imp health is to you), specific beliefs abt personal vulner­ability to a illness (possi­bility of illness), beliefs abt conseq­uences of illness
percieved threat reduction (benefits, barriers)- belief of effect­iveness of behav change

Components of HBM -
1. modifying variables: demogr­aphics, psycho­logical - affects perceptions
2. perceived suscep­tib­ility - how likely you think you can have an illness
3. percieved severity - how dangerous an illness can be
4. percieved benefits - direct­/im­med­iat­e,t­angible and indire­ct/­lon­g-t­erm­,ab­stract
5. percieved barrie­rs/­costs- what they loose due to the change (change happens when action outweighs barriers)
6. health motivation - personal importance to health
7. cues to action (bypasses all percep­tions - internal (physi­olo­gical - pain etc) or external (media etc))
8. action

Support for HBM- research provides support for:
1. Influence of indiv's percieved suscep­tib­ility on health behav change
2. Percieved barriers and suscep­tib­ility are best redictors of healthy behav
3. Role of cues of action (external - inform­ational input (warni­ngs­,kn­owl­edge)) in predicting health behav

Confli­cting findings- Some research showed that behav change was related to low percieved severity

Criticisms of HBM-
1. Only focuses on conscious processing of info
2. Not much emphasis on social­,en­vi,­eco­nomic factors
3. Its a static approach to health belief - no room for change
4. Did not include influence of health belief

Health compro­mising behavior

Substance abuse and addiction
Compulsive engagement in a harmful activi­ty/­sub­stance use despite it's negative conseq­uences - occurs when a person has ­become physic­all­y/p­syc­hol­ogi­cally dependent on a substance due to it's repeated use over time
Activates the mesolimbic pathway, a reward pathway that activates motivated behavior due to excessive release of dopamine
A gene transc­ription factor, FOSB (a protein coding gene) - common factor involved in addiction

Main cause of addiction is due to dependence
Stages - (1) acquired tissue tolerance; (2) adaptive cell metabo­lism; (3) withdrawal and craving; and (4) loss of control.
Factors leading to depend­ence:
reinfo­rcement (+ve: buss/rush of indulging in it, -ve: supresses -ve emotions) avoiding withdrawal symptoms (intense anxiety & halluc­ina­tions, tremors, blood alcohol level drop)
physical dependence - body has adjusted to the substance and incorp­orates the use of that substance into the normal functi­oning of the body’s tissues, involves tolerance
tolerance level increases - leading to more consum­ption for same effects
Craving - strong desire to engage in a behavi­or/­consume a substance, due to physical dependence or envi triggers

Types of addiction:
Substance addictions (opiod, nicotine, marijuana, alcohol) - substance use disorders
four stages of substance use: (1) initia­tion; (2) mainte­nance; (3) cessation; and (4) relapse
Non-su­bst­anc­e/B­eha­vioural addictions (gambling, sexual, internet, shopping) - impulse control disorders

Symptoms of addiction:
1. Behavioral -
changes in appetite, sleep, attitude
frequent, sudden mood swings - angry & irritable (increased lash outs and confli­cts), anxious & paranoid w/o cause
reduced perfor­mance, lack of motivation
periodic hyperactivity
hiding/in denial of certain behavior
2. Physical -
abnormal pupil size & bloodshot eyes
impaired motor coordi­nation and periodic tremors
poor physical appearence and body odour
slurred speech
sudden change in weight
3. Social -
legal issues
personal relati­onship issues
sudden change in friend groups, hobbies, financial status

Risk factors of addiction:
Genetic predis­pos­ition - heredity, altered brain neurons due to envi
Enviro­nment - life experi­ence, peer pressure
Age - teens have increased suscep­tib­ility (more impulsive desicion making), more resistant to treatment and more liable to relapse
Comorb­itity - ppl with comorbid mental disorders (ADHD,­PTSD, depres­sion, anxiety etc)
Drug choice - some are more physically addictive

Screening and assess­ment: Addictions Neuroc­linical Assess­ment, Alcoho­l-S­moking & Substance Involv­ement Test (ASSIST), Drug Abuse Screening Test (DAST-10)
Treatment and manage­ment: CBT, medica­tion, rehabilitation
Alcoholism
Can lead to dependence and addiction
Problem drinking and alcoholism - substance dependence disorders
Alcoholic- someone who is physically addicted to alcohol, symptoms - high tolerance, more craving, withdrawal
Problem drinking- may not have symptoms like alcoho­lics, more social, psycho­log­ical, and medical problems resulting from alcohol

Alcohol consum­ption is linked to:
positive effects -
light and moderate drinkers had lower morbidity and mortality rates reduces coronary heart disease
negative effects -
high blood pressure, stroke, cirrhosis of the liver, some forms of cancer, brain atrophy and consequent deteri­orating cognitive function
facili­tates risky behavior, impaired judgement and desicion making
increase in financial (buying alcohol) and economic (accid­ent­s,f­ights etc) costs, legal issues (DUI, underage drinking, public intoxication)
risk of overdose
interferes with medication - decreases efficiency of meds and increases risk of side effects, can lead to intense outcomes (respi­ratory depres­sion, internal bleeding, excessive sedation)
social isolation and relati­onship problems
can effects genes and fetal develo­pment (FASD - fetal alcohol spectrum disorders)

Treatment:
around 50% - stop on their own
60% treated may relapse
1. clinical -
aversion therapies (negative associ­ation with alcohol - drug antabuse)
contin­gency contra­cting (contract with fam/therapist)
cue exposure procedure (find envi triggers and coping strat)
self management (self monitoring)
2. rehabi­lit­ation -
behavioral therapies (cbt, motiva­tional interv­iewing etc)
group support, indiv counse­lling
detox programmes
Smoking
30 per cent of the adult population
smoking initiated in childhood has an increased chance of lung cancer
Causes: for fun and pleasure, to calm nerves, for confid­ence, due to parental smoking (children 2x likely), peer pressure, hobby - low income women for themselves

smoking symptoms:
positive effects- relaxation and stress relief, confidence
negative effects-
increased risk of cancer
respir­atory and cardio­vas­cular diseases
reduced lung function
reduced fertility, premature aging

Treatment strate­gies:
Nicotine replac­ement therapy (NRT) - using nicotine patches, gum etc
Behavioral support - support groups, counseling sessions, cbt
Medica­tions- to reduce cravings and withdrawal symptoms (bupropion)

Chronic illness

A long lasting condition that can be controlled but not cured.
Factors: physical symptoms, treatments (compl­ica­tions, outcomes, possible recurr­ence), lifestyle changes (dietary restri­ctions, disrup­tions in normal life - missing classes, leaving jobs etc), monitoring and frequent medical attention
Diffic­ulties in adjustment and coping
Role of psycho­logy:
Biomedical perspe­ctive
psychology is conseq­uence of (caused by) chronic illness
Health psych perspe­ctive
psych plays role in illness from onset to final outcome, including beliefs, behaviors, coping, symptom percep­tion, stress, adapta­tion, and quality of life.

role of psych in CHD

Before CHD onset
beliefs - believe they have low suscep­tib­ility and have less seriou­sness to it, healthy behavior seems effortful

behaviors - diet, exercise, person­ality
CHD
rehabi­lit­ation - changing belief and behavior,
coping with CHD

Quality of life

overall well-being and satisf­action of an individual in various aspects of life
key measure of treatment success
physical and social functi­oning, psycho­logical status, illnes­s/t­rea­tment symptoms
can lead to better health outcomes and higher patient satisf­action
holistic approach to patient care (perso­nalized and patient centered)
physical aspects of the illness + impact on the patient's daily life and overall well-being
help gain knowledge on
specific problems for each disorder

impact of treatments

expectations from medical procedure and likely course of recovery

best healthcare
 

Psycho­logical diffic­ulties

Persistent fear, stress, anxiety of
Illness, it's progre­ssion and long term effects
Dying
Hospitals and/or medical procedures
Excessive mood swings
sadness, anger, irritation
Behavior problems
sleep patterns, appetite, or engaging in risky behaviors
Physical appearence
body image issues
Social diffic­ulties
isolation, bullying
Difficulty in
relati­onships
coping with stress
self-care
decision-making
adjusting to changes

Coronary heart disease (CHD)

occurs when plaque builds up in the walls of the coronary arteries, which supply blood and oxygen to the heart. This buildup can narrow or block the arteries, reducing blood flow to the heart - risk of heart attack
angina
strong pain in the chest, which sometimes radiates down the left arm - occurs when blood flow to the coronary arteries is restricted to such an extent (most blockage) that the heart muscle is starved of oxygen
acute myocardial infarction (AMI)
occurs when blood flow is restricted below a threshold level (moderate block) and some heart tissue is destroyed - blood clot restricts further blood flow to heart
sudden cardiac death
mostly occurs in patients who have already suffered damage to the heart through previous AMIs

Health enhancing behavior

weight control and diet
exercise
yoga
sleep
 

Issues due to chronic illness

Children
may limit child from engaging in activities contri­buting to develo­pment and learning (sports, attending school, going to sleepo­vers) limits are set by medical providers or parents
Adoles­cents
autonomy issues
have to be more dependent on caregivers
limited time spent with peers
self-e­steem issues
Adults
relati­onship issues
can influence overall health, functi­oning and produc­tivity.
families have to cope with pressures of caregiving and fear of losing a loved one
factors - intimacy, finance, housek­eeping, parenting

role of psych in CHD

Before CHD onset
beliefs - believe they have low suscep­tib­ility and have less seriou­sness to it, healthy behavior seems effortful

behaviors - diet, exercise, person­ality
CHD
rehabi­lit­ation - changing belief and behavior (health edu, relaxa­tion, counse­lling, modify risk factors) ,
coping with CHD
Outcome
recovery
quality of life
               
 

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  • Published: 1st August, 2023

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