PSY 3206 Health Psychology Final Exam Study Guide

Lectures (12-22)

1. Adjustment to Illness
a. How does demand v and control in a person’s job affect their health? Which
occupation types have the worst effects on people’s health?
high control/low demand: low strain
low control/ low demand: passive
high control/high demand: active
low control/high demand: high strain
high strain: highest risk for stroke/ ex: waitress
b. How does finding meaning affect health? (hint: slides 29-30)
major shift in values, priorities, or perspectives in response to the loss --
things like a greater appreciation for loved ones, an enhanced sense of living in
the present, a perception of life as fragile and precious, a commitment to
enjoying life, and an enhanced sense of spirituality or faith
Better Immune system function for those who found meaning
15/40 men died during study; only 3 of these 15 had found meaning
c. What was the main finding of the study about giving elderly people in
nursing homes their choice of a plant to take care of?
Receive plant that nurses take care of
Choose plant to take care of themselves
Results
Residents in active control vs. passive condition
Were: Happier, more active, and more alert 1 month later
Less likely to have died 18 months later
d. How does trauma writing affect health?
Subjects in the trauma vs. trivial writing conditions
had:
Fewer Health Care Center visits 6 weeks later
Improved immune system functioning
Symptoms improved after writing
e. How does inhibiting personal information affect health?
HIV+ gay males divided into groups based on disclosure status:
In the closet,Out of the closet
Immune system function declines more quickly for closeted men
Onset of AIDS and death occur more quickly for closeted men
f. How does self-affirmation writing affect health?
Affirming the self led to fewer physical symptoms
and fewer cancer-related doctor visits 3 months later.
Self-affirmation leads to a less intense response to acute stress. (Don't overreact)
2. Placebos
a. What are the conditions under which placebos work (e.g., does how the drug
taste matter?)
1.How the health-care provider behaves
2.Characteristics of the patient
3.Situational factors/characteristics of the placebo
4.Social norms
Characteristics of the placebo-Medical settings>Non-medical
Complicated instructions>Simple instructions
Drugs>Behavior change
Expensive pill>Pill on sale
Injections>Capsules>Tablets
Yucky tasting pills>Good tasting pills
Pill Color Matters!
Cool colors: Tranquilizing or sedating
Hot colors: Stimulating
b. In the study of placebo effects that tried to disentangle the effects of
expectations from the effects of conditioning, what was concluded?
1. Natural history -No Change
2. Placebo + Expectation of less pain=Less Pain
3. Placebo + Expectation of more pain=More Pain
4. Conditioned less pain+Expectation of less pain (The effects added up)=Much Less Pain
5. Conditioned less pain + Expectation of more pain=More Pain
c. What are the different explanations/theories for the placebo effect?
Decrease anxiety
Endorphin release
Classical conditioning
Expectations
The more believable the placebo, the more likely it is to work
A placebo can do the opposite of the active drug.
You don’t typically see placebo effects in the absence of an expectation
3. Pain
a. Know the definitions for pain, suffering, and nociception, and know the
meaning of the Venn diagram presented in lecture (i.e., how do these three
concepts overlap?).
Pain
a conscious experience
-can occur without a pain stimulus
-pain stimulus doesn't always cause pain
-a person can be in pain without exhibiting pain behaviors
-a person can exhibit pain behaviors without being in pain
Suffering
an emotional response
-suffering can happen in the absence of pain
-pain can happen without suffering
Nociceptors
register mechanical (crushing), chemical (poison) and thermal (burns) stimuli
Sensory receptors for pain
-activation thresholds are the same within species
-attached to 2 types of fibers: a-delta fibers, C fibers
b. What are A-delta fibers and how are they linked to pain?
warning alarm to MOVE IT! -fast, sharp, localized pain, doesn't need to reach brain via
signals to cause muscle movement
c. What are C fibers and how are they linked to pain?
signal that injury has occurred. -slow, persistent, diffuse pain to mark injury for wound
tending after danger has passed
d. What are the myths about pain?
Myth #1 infants don't feel pain
myth #2 children don't feel pain as intensely as adults do
myth #3 opioids cannot be used to treat pain safely and without serious risk of addiction
myth #4 dont take pain killers until the pain becomes severe
-pain is easier to prevent than control,waiting until the pain is out of control makes it more
difficult to treat the pain
myth #5 pain is a normal part of the aging process (elders believe this and they are less likely to
report pain as well)
Myth #6 Pain Without Physical Cause Is A Sign Of Psychological Problems
Not all pain has a physical cause.
85% of people with chronic back pain have no
identifiable physical cause of
95% of people with chronic headaches have no
identifiable physical cause of the pain
Myth 7: The longer you have pain the more painful the memory
Myth #8: Pain Will Never Kill You
Pain CAN Harm You
In rats:
Pain suppresses immune function
Pain enhances tumor growth
In humans:
Effective postoperative pain management enhances immune function
Pain is a source of stress which causes pain
e. Know the sources of chronic pain and how it can change over time
Like a broken alarm that rings continuously despite no fire, signaling only its own brokenness
Intensity bears no relation to the amount of tissue damage
Not protective
Changes in brain Overtime:
Alters (shrinking) brain structures that modulate pain.
f. Know how opioids can be used safely to treat pain.
By Using Prescription Guidelines:
Developed guidelines for opioid use after surgery
Specified the number of pills to prescribe for each of five operations
Taught the guidelines to other doctors

4. Personality and Health

a. How does neuroticism affect health?
Neuroticism is a tendency to worry excessively
over relatively minor events and setbacks.
Neuroticism is linked to depression, BUT not the cause of health may lead to poor health
behaviors
Neuroticism is related to poor stress management.
b. How does conscientiousness affect health?
Conscientiousness is the tendency to be
careful, deliberate, self-disciplined, thorough, and organized
Terman study- followed 1500 kids with high IQ’s
Conscientiousness was the single best predictor of longevity
Conscientious kids were less likely to smoke, drink, or drive dangerously.
c. What is Type A personality and what are the health behaviors and outcomes
associated with Type A personalities?
Exaggerated sense of time urgency and always create deadlines
Sense of competitiveness and ambition
Aggressive and hostile
Western Collaborative Group Study
Interviewed 3,000+ men, ages 39-59
Type A men were twice as likely to get and die of heart disease
People with Type A personalities have a larger
physiological stress response:
Larger heart rate increases
Larger blood pressure increases
d. How does optimism affect health?
Optimism is the belief that one will generally experience good outcomes. They use more health-
promoting behaviors. Annual exams,Healthy diet,Immunizations, Medication
Optimists engage in fewer risky behaviors
don’t get distressed by symptoms
Optimists engage in adaptive coping
More optimism=better immune function
e. How do mindsets affect health?
Mindsets are general belief about how changeable people’s various attributes are.
Fixed (aka Entity)Mindset:The belief that human attributes are relatively static and
unchangeable
Growth (aka Incremental)Mindset:The belief that human attributes can be cultivated and
changed over time
people with growth mindsets are better at achieving health goals like
Fruit consumption,Vegetable Consumption, Exercise
Mindsets affect your health through health behaviors.
5. Gender, Age, and Health
a. What are the repercussions of men’s health being the standard by which
women’s health is evaluated?
1. illnesses are noticed late in women: heart disease and HIV
2. patterns of health that differ in women are considered problematic:
Hypoglycemia(healthy blood sugar for women is lower than men)
3. things that are unhealthy in men are assumed to be unhealthy in women: overweight,
cholesterol
4.Drugs don't work as well in women: dosing, effectiveness, side effects
Dosage calculated based on men
Tested on all or mostly men
b. How do the different health patterns of males and females vary by age?
-from ages 15-34: males are dying at almost a triple rate than females
c. What are the patterns of mortality and morbidity for men versus women?
Healthier in the case of mortality: life span, death rates, causes. Females
(females are sick more often, but with less serious ailments)
Healthier in the case of morbidity: disability, hospital usage, physician visits. Males
(males are sick less often, but with more serious ailments)
d. How is gender linked to utilization of the medical system?
Do not admit to being sick (i.e., cultural norms; can’t miss work)
Less likely to notice symptoms
Not urged to have yearly exams (i.e., women’s wellness exams)
Less likely to interact with Dr’s when taking care of kids or elderly
6. Culture and Health
a. How is SES linked to health? What accounts for the SES-health relationship?
SES = Income, education, prestige of occupation
- lower SES, more likely to die from cardiovascular disease
- lower SES, more likely to die
- lower SES, more likely to get ill
-not due to a healthcare/poverty
-bad health does not lead to lower SES
-SES influences physical/social environments that lead to physiological responses
-lower SES = higher cortisol production
b. How is acculturation linked to health for immigrants in the United States?
the more acculturation to US:
- more smoking
- more alcohol consumption
- more other substance use
- less cancer screening
- more premature births and low birthweight
- more hypertension
-more obesity
- more HIV/aids
Paradox: newer immigrants tend to have fewer resources, but better health outcomes
c. What is the best way to assess race?
-commonly accepted as social construction of groups based on observable phenotypic
characteristics
-self-reported race: best way to operationalize race
d. What are the problems associated with generalizing about the health of
different racial or ethnic groups?
1.Confounding of SES with ethnicity/race.
2.Categories are broad and heterogeneous
e.g., Latino includes Dominicans and Mexicans
e.g., Asian includes Chinese, Japanese, Korean, Vietnamese, Hmong
3. Groups differ in the degree of exposure to and identification
with mainstream American culture
7. Psychology of Eating
a. What was the Ancel Key’s semi-starvation study, and what were the
interesting findings associated with the study?
-36 participants during WWII
set a metabolic baseline for three months, study the physical and mental effects of starvation on the
volunteers for six months, and then study the physical and mental effects of different refeeding
protocols on them for three months.[14]The participants would first be placed on the three-month
baseline diet of 3200 calories after which their calories were reduced to 1800 calories/day while
expending 3000 calories in activities such as walking. The final three months were a refeeding
period where the volunteers were divided into four groups, each receiving a different caloric intake
-controlled diet : 3 months, semi starvation: 6 months, controlled rehabilitation diet
eating: 3 months, free eating rehab: 3 months
Results:
-weight comes on quicker than it came off
-food obsession
-eating rituals
-weak/tired/irritable/ anxious
-no self control
-self centered
-apathetic/clinical depression
-psychotic reactions in 1/6th of subjects
b. According to a study of kids who were allowed to eat whatever they wanted
for several days, what are typical child eating habits?
Amount of calories per meal: highly variable
Amount of calories day by day: highly stable
*children regulate intake by day
c. What are the findings of the study that looks at dieters and non-dieters and
whether they had a milkshake preload or not? (hint: look at the different
conditions/contextual factors, such as another person being in the room)
Milkshake study done on non dieters. results
The eating of non-dieters is influenced more by hunger than by cognitive, social or
emotional factors:
- they eat less after a preload
- it doesn't matter whether they think the preload is high fat
- it doesn't matter if another person is in the room
- it doesn't matter if they are stressed
Milkshake study done on dieters. results
the eating of dieters is influenced more by cognitive, social and emotional factors than
by hunger:
- they eat more after a preload
- they eat more if they think the preload is high fat
- they don't eat more if they think the preload is low fat
- they don't eat more after a preload if there is another person in the room
- they eat more after stress
8. Diet and Exercise
a. How has the percent of obese people in America varied over time?
1960: ~10 percent
2010: ~40 percent
Definition of diet success has also changed over the years
b. Before recommending that obese people go on diets, what questions should
be asked and why?
-is dieting safe?
-is dieting effective?
-is obesity unhealthy?
c. Why does stress cause diets to fail?
Stress causes: decreased physical activity
-HPA activation
-SNS activation
-negative health behaviors
-increased intake
which all cause: weight regain
d. What do long-term diet studies with control groups show?
long-term diet study with control group results?
- avg. weight change for dieters: lost 2 lbs
- avg, weight change for controls: gained 1lb
long-term diet study without control group results?
- initial weight loss: 39 lbs
- ultimate gain back: 32 lbs
e. What are the biases that can affect results of diet studies?
Bias 1:
- Independent evidence-people underreport their weight by about 8 pounds, obese
more than that
Bias II:
participation in additional diets
-60% weighed more than start weight at some point, 40% weigh more than start weight
now
9. Sleep
a. How does stress affect sleep? Why does stress affect sleep?
stress = cue to threat in environment
-higher stress --> need to be more vigilant to threats >-lower sleep efficiency, (insomnia)
delayed sleep onset, and more frequent nighttime awakenings
b. What is the main finding of the longitudinal study presented in lecture about
relationship quality, stress exposure, and sleep (slides 18-19)?
people who were in better relationships at age 23 were exposed to fewer stressors at
age 32 and had better sleep quality at 37
c. What are the physical consequences of sleep deprivation?
-drowsiness
-microsleeps/sleep seizures
-colds/flu
-weight gain
-heart disease
-poor athletic performance
d. What are the psychological consequences of sleep deprivation?
-worsens mood
-increases stress/anxiety
-decreases self regulation
-reduced mental functioning
-concentration problems
-memory problems
e. What is sleep hygiene and how can one improve their sleep hygiene?
sleep hygiene: promotion of good sleep habits and regular sleep; maintain regular
wake/sleep schedule 7 days a week
strategies for good sleep:
-avoid caffeine after 2pm
-avoid alcohol 3 hrs before bed
-quit smoking
-exercise in afternoon
-improve bedroom quality
10. Doctor-Patient Communication
a. What kind of doctor-patient communication are patients most satisfied with?
interactions balanced between instrumental /affective communication
Instrumental- task oriented, doctors ask questions, give information
Affective- based on care rather than cure, being encouraging,honesty,showing concern
(nonverbal). Patient looks for nonverbal leaks for information
b. What is medicine’s “dirty little secret”?
-poor patient adherence (patients do not comply to their treatment)
-medication not taken as often and regularly as it should be
-can create antibiotic resistant strains -some evidence that better doc-pt communication
If doctors were enthusiastic about getting mammogram then patients will be 4 times
likely.
c. How can doctors avoid being sued by patients?
-spend longer time with patients
-more statements about what to expect
-more humor/laugh more
-solicit patients opinions more
-check that patients understand you more
-little difference in instrumental communication
-tone of voice more concerned, less dominant
If voice tone was more dominant, doctor was likely to have been sued
If voice tone was more concerned, doctor was unlikely to have been sued.
d. What kind of doctor-patient communication is most likely to increase
compliance with a request?
Treatment decision: doctor's instrumental communication
bad news: doctor's affective behaviors
depends on monitor (patients who want a lot of information and want to be aware)
blunter( shield from information, distract and blunt the sensations)
11. Happiness
a. What are the effective and ineffective strategies for improving your
happiness?
Effective:
-acts of kindness in one whole day not spread out
-donating to charity/buying gift for others
-cultivate a sense of gratitude, but only once a week
-make the good stuff surprising
-visualize your best self
-use humor
-find flow
-exercise
-try not to adapt to good, try to quickly adapt to bed (affective adaptation)
-form good social relationships
b. How does happiness work (hint: set levels of happiness and recent events)?
- a set level of happiness
-fluctuate in response to events
-system set up to adapt
-things that stay the same over long periods of time do not affect our happiness.
Happiness is genetically influenced not genetically fixed.
c. How does money affect happiness?
-income, after basic needs are met, does not affect happiness
-even lottery winners go back to set level of happiness
-spending money on others/charity makes you more happy, and the amount given does
not matter
d. Which individual differences (e.g., gender, ethnicity) affect happiness?
Happiness is not related to:
-gender
-ethnicity
-physical appearance
-number of "good events" that have happened
-income
-ongoing health
happiness IS related to age (older = happier, peak at 65, falls at 75)
e. How can you make your happiness last longer?
-if you don't want an event to affect your emotions: explain it
-if you do want an event to affect your emotions: dont try to explain/understand it
-write about how a happy event might have never happened to you
Articles

Week 5
From harmon
The author supports his viewpoints in the article by demonstrating the experiences of Ms.
Katherine Moser, who at the young age of 23 taken the DNA test to find out whether she
has the gene of Huntington as his grandfather or not. The test was positive and she was
appeared to have the Huntington genes. Ms. Katherine Moser tried to forget about the
genes and the result of the test that concluded, she has the disease of Huntington and
instead of cursing the fact that she will soon within 12 years will experience the symptoms
of the disease, she in her life, found reasons to make life better and productive.
From Frakt
The hypothesis that when we believe placebos will heal, they do, at least some extent, is
hard to reject .placebos- mind body connection is strong. Sometimes we need, and can find,
additional help from surgery,medication and other therapies. But for wide common problem
like earaches to knee pain to headaches
From Thernstrom
Chronic pain -- continuous pain lasting longer than six months -- afflicts an estimated 30
million to 50 million Americans, with social costs in disability and lost productivity adding
up to more than $100 billion annually.
Chronic pain is like water damage to a house -- if it goes on long enough, the house
collapses. By the time most patients make their way to a pain clinic, it's very late.'' What
the majority of doctors see in a chronic-pain patient is an overwhelming, off-putting ruin:
a ruined body and a ruined life.
From Winter
In contrast with physical dependence, however, a definition of addiction is harder to
reach. Neuroscientists call it a brain disease. Others think it is simply a choice or a
moral failing. I prefer to say that addiction is a behavioral state of compulsive and
uncontrollable drug craving and seeking. Many of those treated for chronic pain will not
become physically dependent.
From Gladstone
Many ill people with an actual need for drugs like oxycodone cannot get them and are
suffering and dying in pain. While Americans have an epidemic of prescription drug
abuse. The reasons include an absence of medical training,regulations,costs. Asian
countries believe you sustain the pain,work through the pain.
Week 6
From Friedman•That people who are temperamentally pessimistic are more likely to die
of heart disease and other causes than those who are by nature optimistic
•Optimists may simply cope better with adversity and engage in behaviors that are more
likely to promote health, optimists seek social support, biological differences maybe,
from north - what is the opinion of this author?
personality affects your health?
From Edwards-
•There can be striking variations in the way men and women respond to drugs,
•many drugs are tested almost exclusively on males, and the FDA announced that it
was cutting in half the prescribed dose of ambien for women, who remained drowsy for
longer than men after taking this drug
•women have hormonal cycles, smaller organs, higher body fat composition, differences
in gene expression, women face substantially greater risk of developing pain conditions,
women's reports of pain were more likely to be dismissed, more likely to have their pain
characterized as emotional, psychogenic or not real
•sex-based research, focus on why women respond differently to some drugs and
diseases, training physicians to better diagnose and manage womens' pain.
from krulwich- Which gender lives longer? At what points in the life span does this
difference exist? What factors are associated with the difference? What factors are most
responsible for men in their 20's?
•Women
•In every age cohort
•behavioral difference, hormonal, larger size, male weakness,
•Men fight, go to war, dare, accidental, suicidal, violence
from parker-pope - what is the breast cancer racial gap? what are the factors thought to
contribute to the gap?
•With the significant improved survival rates for women w breast cancer, the vast
majority of those gains have largely bypassed black women. Black women are far more
likely to die of the disease
•Institutions providing mammograms to mainly black patients miss as many as half of
breast cancers compared with expected detection rates at academic hospitals, lack of
health insurance, poor, don't learn of disease until is at advanced stages, and many
black women do not seek health care at all
From Goodnough
Minorities tend to receive less treatment for pain than whites, and suffer more disability
as a result. Researchers say minority patients use fewer opioids. Also evidence of racial
bias and stereotyping in recognizing and treating pain among minorities, particular
blacks.

Week 7

From Wansink
Plate shapes and package sizes, lighting and layout, color and convenience: these are
a few of hidden persuaders that can contribute to how much food a person eats. This
review first posits that these environmental factors influence eating because they
increase consumption norms and decrease consumption monitoring. Second, it
suggests that simply increasing awareness and offering nutrition education will be
disappointingly ineffective in changing mindless eating. Third, promising pilot results
from the National Mindless Eating Challenge provide insights into helping move from
mindless eating to mindlessly eating better. changing daily, long-term behavior is the
key to adding years and quality to our lives. This will involve reducing risky behavior and
making changes in exercise and nutrition.
From Kolata
The struggles the contestants went through help explain why it has been so hard to
make headway against the nation’s obesity problem, which afflicts more than a third of
American adults. Despite spending billions of dollars on weight-loss drugs and dieting
programs, even the most motivated are working against their own biology.As long as
you are below your initial weight, your body is going to try to get you back.” Slower
metabolisms were not the only reason the contestants regained weight, though. They
constantly battled hunger, cravings and binges. The investigators found at least one
reason: plummeting levels of leptin. Dr. Lee Kaplan, an obesity researcher at Harvard,
says the brain sets the number of calories we consume, and it can be easy for people to
miss that how much they eat matters less than the fact that their bodies want to hold on
to more of those calories.
From Carrol
Exercise is a miracle cure. Based on many randomized controlled trials. exercise
therapy increases aerobic capacity.Exercise has also shown to lower blood pressure in
patient with hypertension and improve cholesterol and triglyceride levels
Exercise improved outcomes from musculoskeletal diseases
From Pilcher & Huffcutt
overall sleep deprivation strongly impairs human functioning. Moreover, we found that
mood is more affected by sleep deprivation than either cognitive or motor performance
and that partial sleep deprivation has a more profound effect on functioning than either
long-term or short-term sleep deprivation. In general, these results indicate that the
effects of sleep deprivation may be underestimated in some narrative reviews,
particularly those concerning the effects of partial sleep deprivation.
Week 8
From Brody- Prognosticating is one of the most challenging tasks doctors face. Unless
patients are critical it is often impossible to provide an accurate prognosis. Out of
fear,ignorance, or concern doctors can tend to be overly optimistic.In general
researchers found doctors tend to overestimate patient survival by a factor of three to
five. Quite separate from the challenge of estimating survival, doctors also find the
process of disclosing the prognosis to their patients difficult. Patients often have things
they want to accomplish before they die, and knowing that their time is short may
prompt them to attend to such matters.Most important patients say is for doctors to stay
with them until the end. Fear of abandonment is especially common.
From Joshi- A doctor's ability to explain,listen and empathize has a profound impact on
a patients care. two out of every three patients are discharged from hospitals without
knowing their diagnosis. 2 year study patient satisfaction with doctors was measured by
questionnaire. It showed a correlation between higher patients satisfaction scores and
better health outcomes and higher patient satisfaction associated with improving heart
attacks,failures. and pneumonia
From Smith- Consistent claims claims that happiness is associated with all sorts of good
life outcomes including and promisingly- good health. Connection between a happy
mind and healthy body- the healthier you are, the better health outcomes occur. But a
new study challenges this. Happiness may not be good for the body as researchers
thought. Researchers found that happiness is associated with selfish "taking" behavior
and that having a sense of meaning in life.
From Weiner- One theory is that, over the past few decades, females have gone from holding
one job(running the house) to two jobs (working full-time plus handling the housework). And a
fast way to trigger happiness is bigger to-do lists — not to mention mounting pressure for
women who want to do it all. Striving for constant contentment is equally unrealistic. Domar lays
it on the line: "If you think you should feel happy nearly all the time, it's going to make you
miserable."
Your strategy: Manage your expectations
Find Your Balance. Don't Try to Buy Happiness. and in their activities (like pursuing a new
hobby). A few months later, those who changed their activities reported more gains in well-
being.
Lose Yourself in the Moment
If you're in a bad mood, try to find your "flow."
Develop an Attitude of Gratitude. Share the Love. Help Yourself by Helping Others. Introduce
Your Body to Your Mind
choose to choose less. too much choice can cause anxiety and lead people to blame
themselves if their decisions don't turn out as well as they expected
From Dunn & Whilans-
Our laboratory’s past research has shown that spending money on others enhances one’s own
happiness, and that the benefits of such “prosocial spending” hold up around the world, from the
United States and Canada to Uganda and India. But could the benefits of giving to others
extend beyond happiness, to health? People who spent money on themselves showed no
change whatsoever, whereas people assigned to use the money in generous ways showed a
significant reduction in blood pressure, financial generosity was linked to lower blood pressure.
a that helping others may act as a buffer against the stresses of daily life. Though it might be
tempting to prescribe generosity as a supplemental treatment for heart disease, more research
is needed.