Mod1all

Health Psychology: Module 1: 

Health Psychology: Module 1

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“Physical Health” Observable, physical symptoms “Mental Health” “psychological” factors Probably best example of intersection: stress

Alternative views on “alternative” medicine: 

Alternative views on “alternative” medicine Lance Armstrong What does “alternative” mean, exactly? Several issues here Experimental evidence weighted vs. not Western vs. non-western medicine “Focused” vs. “holistic” approaches

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Regardless of whether the treatment is “traditional” or “alternative”, avoid anecdotal evidence! Many ailments get better on their own Introduces STRONG confound of time i.e. the build-up of any drug in your system, and the passage of time, are always perfectly confounded Try to resist temptation for self-blame if treatments don’t work

stress: 

stress

Possible to “rank” stressful events?: 

Possible to “rank” stressful events? Holmes & Rahe (1967) Death of a spouse—100 Divorce—73 Marriage—50 Getting fired—47 Change in residence—20 Christmas—12

problems: 

problems Third variable problems Sample What’s key is how event is perceived. Personality trait Health problems p(events)

Great study by Cohen et al. (1991): 

Great study by Cohen et al. (1991) Psychological stress index 50% 25% Percent who caught cold

some causal evidence: 

some causal evidence Cacioppo 1998 Pre-measure  stress  post-measure

Perceived control and health: 

Perceived control and health Again, power of correlational vs. experimental designs Some causal evidence Langer and Rodin (1977; p. 513) Nursing home study Random assignment to high personal (and lasting) control vs. no treatment (baseline). 15 months later: mortality (death) rate in high control condition: 15% Mortality rate in baseline condition: 30%

A very disturbing follow up study: 

A very disturbing follow up study Schulz and Hanusa (1978; p. 483-484) Somewhat similar to Langer and Rodin (1977): Random assignment to high control, vs. baseline But: when study was over, sense of control was removed; i.e. temporary control Death rate among baseline (never had control increased): 0% Mortality rate among temporary control: 20%

Risk perception and mood: 

Risk perception and mood

Johnson & Tversky (1983):(specific) cognitive vs. (general) affective routes: 

Johnson & Tversky (1983): (specific) cognitive vs. (general) affective routes Read about case of cancer cancer lightning earthquakes Cognitive/priming hypothesis Not supported

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Read about case of cancer cancer lightning earthquakes Generalized affect hypothesis supported

Study 2: 

Study 2 Unrelated mood manipulation Positive mood Negative mood Decreased risk increased risk

Gender differences in coping with stress: 

Gender differences in coping with stress Fight or flight (Cannon, 1932) Norepinephrine, epinephrine Little-known fact about experimental work—most done on males (e.g., male rats)—Taylor et al., 2000 Females “Tend and befriend” More likely to produce oxytocin (calming, promotes affiliation) Caution

Optimism, health and accuracy: 

Optimism, health and accuracy Optimism Unrealistic optimism The “above average” effect (Weinstein, 1980) Health and accuracy Trade offs

Message framing: 

Positive vs. negative Key variable: Detection vs. prevention Detection (e.g. for cancer): negative framing works better Prevention (e.g. putting on suncreen: positive framing Message framing

Applied focus:how can we motivate people to engage in healthy behavior?: 

Applied focus: how can we motivate people to engage in healthy behavior? e.g., BSE greatly increases early detection of cancer, yet relatively few women do so Message framing Let X = healthy behavior Positive framing (gain): “If you do X, good outcome” Negative framing (loss): “If you don’t do X, bad outcome” Detection behavior

(Myerowitz & Chaiken, 1987): 

(Myerowitz & Chaiken, 1987) Positive (gain) framing “By doing BSE now, you can learn what your body normally feels like so that you will be better prepared to noticed any small, abnormal changes that might occur as you get older. Research shows that women who do BSE have an increased chance of finding a tumor in the early, more treatable stage of the disease.” Negative (loss) framing “By not doing BSE now, you will not learn what your body normally feels like so that you will be ill prepared to noticed any small, abnormal changes that might occur as you get older. Research shows that women who do not do BSE have an decreased chance of finding a tumor in the early, more treatable stage of the disease.” Detection behavior

design: 

design Framing manipulation: Gain Loss Control (no message) Immediate follow-up 4 MONTHS later: follow up questionnaire on behavior Detection behavior

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CONTROL Intention to perform BSE Actual BSE behavior GAIN (PF) Intention to perform BSE Actual BSE behavior LOSS (NF) Intention to perform BSE Actual BSE behavior Immediate 5.95 6.83 5.18 4 months later 3.95 5.48 3.47 .74 1.42 .75 Detection behavior

Replications and extensions for detection behaviors: 

Replications and extensions for detection behaviors Negative framing superior to positive framing: Encouraging self-exams for skin cancer (Block & Keller, 1995) HIV testing (Kalichman & Coley)

prevention behaviors: 

prevention behaviors Prevention focuses on averting the onset of a health problem Provide people with the opportunity to maintain their present healthy status and to reduce risk of future illness Here, positively-framed messages are more effective

Examples : 

Examples Encouraging use of sun screen (Rothman et al. 1993) Positive frame: using sunscreen, you greatly reduce the chance of getting cancer later on in life Negative frame: by not using sunscreen, you greatly increase the chance of getting cancer later on in life prevention behavior

Other examples : 

Other examples Exercise (Robberson and Rogers, 1988) Use of infant car seats (Christopherson & Gyulay, 1981) Using condoms (Linville et al. 1993) prevention behavior

Probability assessment, risk, and health: 

Probability assessment, risk, and health Again, judgments are biased by what comes to mind first Flying vs. driving Lotteries Wildly inflated perceived risk of vivid accidents (e.g. getting struck by lightning) AIDS

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Risk that woman will contract AIDS with one heterosexual contact with HIV positive male, no condom Statistics (as of 1988) Participants’ estimates .2% (1/500) 50% w/condom .02% (1/5000) 5% BUT: Why important to wear a condom: Calculation of objective risk is an inexact science (and these data are somewhat dated) Helps prevent: unwanted pregnancy, spread of other STDs (e.g. herpes; 20-30% U.S. population, no cure at current time) 8% of AIDS cases in the United States have been attributed to heterosexual contact.

Illusions and well being: A second look at mental health and reality: 

Illusions and well being: A second look at mental health and reality Main sources: Taylor and Brown, 1988 Rebuttal by Colvin and Block (1994)

Overview: 

Overview Definition of mental health—the standard view Illusions and biases among healthy “normal” individuals Taylor and Brown thesis; evidence Rebuttal by Colvin and Block

Previous assumptions about reality and mental health: 

Previous assumptions about reality and mental health Psychological health  Close contact with reality Reasonably accurate “The perception of reality is called mentally healthy when what the individual sees corresponds to what is actually there” (Jahoda, 1958) Seems reasonable, but…

Biases in social perception: 

Biases in social perception Most of the time, people do not see the world as it “really is”. These often take the form of self-serving, flattering portraits of the self two main classes of findings Unrealistically positive views of the self “positivity distortions” Exaggerated perceptions of personal control

I. “positivity distortions”: 

I. “positivity distortions” For most people, positive personality information is efficiently processed RTs Memory success vs. failure Attribution Recall Estimated commonality of strengths and weaknesses Weaknesses/faults—seen as relatively common Strengths—seen as rare and distinctive Above-average effect in ratings, predictions The future looks bright, especially for me! (Weinstein, 1980) Comparisons of self-ratings vs. observer ratings Lewinsohn, Mischel, Chaplin, and Barton (1980) College students interact with others in get-acquainted setting Researchers compared ratings of self, vs. ratings by observers Relative to observers, people saw themselves in flattering terms

Who doesn’t show these positive distortions?: 

Who doesn’t show these positive distortions? Moderately depressed individuals, people with low self esteem Such people show More accurate recall of positive vs. negative information More “even handed” in attributions of self-responsibility More congruence between self evaluations and appraisals by others

II. Illusions of control: 

II. Illusions of control Most people infer greater control than they really have When outcome is objectively random, people still persist in believing that they have personal control And, once again, this effect disappears among those who are mildly-to-severely depressed individuals

Summary and major implications: 

Summary and major implications

Rebuttal: Colvin and Block (1994): 

Rebuttal: Colvin and Block (1994)

Critique #1: 

Critique #1 Taylor and Brown define “healthy” vs. “unhealthy” (“mentally ill”) in a very circumscribed way Healthy—college students with moderate to strong self esteem Unhealthy -Mildly depressed college students

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Depressed individuals, especially those with moderate to severe levels, may be distorting in the opposite (negative) direction Thus, it may be a simplification to say that healthy people distort, but unhealthy people don’t distort Critique #2

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extremely negative extremely positive SELF CONCEPT Theoretical neutral (unbiased) point Positive biases Negative biases

Critique #3: Questions about operationalization of accuracy: 

Critique #3: Questions about operationalization of accuracy Recall that Taylor and Brown claimed that non-depressed individuals show positivity biases, whereas show “even handedness” in self-related processing But “even handedness” in self processing (e.g. using just as many negative as positive traits to describe the self) is not a very good indicator of accuracy

Critique #4: Major problems with Lewinsohn et al. (1980) study: 

Critique #4: Major problems with Lewinsohn et al. (1980) study In this paradigm, observers tend to be relatively harsh (negative) when judging others. Leads to an artifactual appearance of accuracy for people if they happen to be negative in their own appraisals

critique #5: excessive positivity/high optimism may not always be healthy: 

critique #5: excessive positivity/high optimism may not always be healthy Narcissism Disappointment McGraw, Mellers, & Ritov (2004) Very high self esteem can be associated with excessive aggressiveness, especially with males

Summary: 

Summary Taylor and Brown (1988) Attempts to propose new view of mental health and mental illness Positive illusions/biases not necessarily maladaptive Colvin and Block (1994) At least Five major critiques Narrow Definition of healthy vs. unhealthy Problems with distortion hypothesis Definition of accuracy suspect Problems with Lewinsohn et al. (1980) paradigm Downside of excessively high self esteem