Announcements Psychological Factors in Health and Illness Lecture

Transcription

1 Announcements Test score data will be released later Exam viewing form passed around- viewing times today and Thursday Everyone did well on health care issue section of test; if you didn t do well on that question reassess time you are spending on this class Application of intervention questions for a person with alcoholism- example of question that requires memorization and application o More of these types of questions on final o Know basic concepts and then take it to the next level Question disappointed in: 3 preventative approaches o Medical, behavioral influence, and environmental measure o Specifically in class she told everyone it would be on test Matt cannot change scores; only can take concerns Thursday- quiz over Brenner at 9:30AM SHARP! o On website Reading focus area for this week will be posted after the quiz on Thursday Psychological Factors in Health and Illness Lecture C. Need to assess D. Never should be considered normal and ignored But you shouldn t over pathologize well either If they are coping well, then maybe they are Tricky issue, not so obvious Training, supervision, and experience helps tease out if client is in need of intervention or not Not a clear yes or not, may be in between E. Physical illnesses may present with psychological symptoms Last time we talked about this with demographics- with women, it s all in your head It s tricky because it could look like depression but it s a physical illness Or a person can have stomach aches but actually be really depressed Depressive o Thyroid disorders o Epilepsy o Multiple sclerosis o Lupus! Biopsychosocial model- multidisciplinary team approach is important and should happen more often! Great to have collaboration! In our system, it s not as easy as that, especially on an out-patient basis! If person presents with depression, ask the last time they had a physical, ask if they have been diagnosed with these things

2 ! May work with them as if it is just depression but in the meantime, make sure we don t have other issue going on by doing a physical in tandem! Some haven t had physical in a long time; adults don t do yearly physical! Depression can be another reason to go see physician to do basic tests Anxiety symptoms o Thyroid disorders! Simple blood test o Seizure disorders! Epilepsy o Hypoglycemia! Low blood sugar! If they are irritable or cranky, then ask about their eating pattern! Maybe if you dietary changes you ll feel better, can be simple sometimes Anger outbursts o Epilepsy! Think of seizure disorders (where people lay on ground shaking)! But other kinds of epilepsy could be staring off into space! Some seizures aren t noticeable! May say they are getting irritable and having trouble focusing, sleep is disrupted- could be having mini-seizures without them knowing that o Lupus o Alzheimer s! Grandpa used to be so happy and now he has a short fuse! Sometimes they may be getting older and less patient but also could be sign of Alzheimer s III. Personality variables A. Overview Vulnerability or protection in relation to health and illness o Found that some personality patterns seem to be correlated with certain kinds of health problems o Some personality patterns lead to live healthier lives Definition of personality o A person s enduring set of habits and thinking, feeling, and acting o Enduring- carries through time; you don t have a different personality each week; if you do, that could be sign of disorder o Personality is fairly stable over time o Thinking, feeling, and acting- saying someone is an emotional person, then you are describing feeling part of personality o Saying someone is rigid-thinking, or wild and crazy- behavioral o Ask yourself 3 words to describe yourself, what a stranger would say, what your mom would say- good diagnostic question Made up of various components o That s what makes personality so tricky, not just one entity o With some people, you can pick out certain parts of personality, i.e. they are so shy

3 o But some people you know really well but you can t come up with one word to describe them o Some components are more salient in terms of health and illness Personality and components: constructs o Construct- a label given to a hypothetical characteristic o Not anything we can really see or feel; not tangible o But it s something we think people have, i.e. intelligence o Most people have heard term of personality but something humans have made up from being around other people o Cannot directly measure, like height or weight o Sometimes you can t put it into words o Over time we develop more and more words to describe personality Genetic influences o More sophisticated genetic research gets, the more we find so many things are related to genes o Can t say personality is 50% nature and 50% nurture o But probably at least half of what you see in a person, whether intelligence or personality, has a genetic root o We re born for a tendency for o You may have pessimism gene; does that mean you have to be a pessimist? No, depends on what you happened along the way [negative environment vs. positive environment] o Could experience outweigh genetic pull? Absolutely o Genetic influences but doesn t mean we are set in stone o Can you become very introverted to extroverted? Maybe not, too much of a pull; but you can work on that Development o Personality thought to be developed by a combination of nature and nurture o An older sibling may have a lot of similarities with the younger siblings but can still have a big difference o How do people develop personality? A lot of theories and research o Some people can go through the most awful experiences, and they are pretty optimistic and hardy o Others you may think they live a wonderful life but they are very negative and worried o You can t say because of environment they are a certain way because it s not the case Relatively stable, though generally open to change o Enduring, but that doesn t mean it is set in stone o Sometimes people change over time o Parents can get nervous with the way child is, but children are fluid and can change the way they are o May change because it does, because something happens, or you make conscious decision Measurement o A lot of times we don t need to do in depth measure to get a feel for someone s personality o You can just talk to a person and get a sense of how they are; informal conversation, observation can tell us a lot about a person s personality

4 o If we do want to get more in depth and quantitative, we can do an interview o Sometimes you can just ask them what their personality is like? Pick 3 words your roommate would use to describe yourself? o You can learn a lot right away from one little description o And then there are multitude of personality tests; literally hundreds of personality tests, some are more comprehensive (broad), or focused (specific test, more pathology focused or normative) o For our purposes hundreds of personality tests, different measures we can use if we want to assess personality Use caution o Use caution (critical thinking) when you read about findings related to personality patterns and certain illnesses o If you are reading a study, pessimism causes lung cancer, get critical thinking on- what are their measures? How big was sample size? How many people actually fit with construct of personality as it was measured? How many cases don t fit? o There are exceptions to a study s finding B. Distress-prone patterns Make more vulnerable to illness and poor coping Common thread in all o People who have them are accustomed to not feeling good; accustomed to feel tense, unhappy, in crisis o Not just that they are distressed-prone but it has become normal for them to feel that way Examples o Type A! Researched the most! Insecurity of status and drive to achieve- never feeling quite good enough, must always work harder! Time urgency- feeling like you have to hurry and cannot wait in line! Oftentimes it is related to free floating hostility- angry at the world and ready to attack! Love of competition and desire to dominate! perfectionism! Linked with a number of health problems and poor coping- higher rates of cigarette smoking and alcohol use, not a good diet o Hostility (subcomponent of Type A and also stands out on their own)! Particularly detrimental personality pattern for health! 3 main components: cynicism towards others motives and values, frequently aroused angry feelings, and tendency to express those angry feelings toward others! cynical outlook, feelings of anger, and anger expression! a lot of research support saying hostility makes you vulnerable to developing heart related problems o perfectionism! mentioned in reading o pessimism! tendency to see things in a more negative view

5 o external locus of control! mentioned in reading C. Distress-resistant patterns Buffering effects or assist in good coping Examples o Type B! You are not a Type A personality! Some people think means it is the opposite- not competitive, lazybut it is not that o Optimism! If you are more optimistic, then you have a more positive outlook, see future as more positive, sees glass half-empty than half-full! If you see glass as half-full, you are more likely to cope better and have better outcomes o Hardiness (Kobasa and Maddi)! Consists of the 3 C s! Sets apart those who survive change without illness! Basic premise: people go through stressful changes, and some people do okay despite that an don t get sick; whereas with others, it does lead to illness! Can go through stressful events and changes and they come out okay- why is that? They possess the 3 C s! 1 st C: Challenge expectation that it is normal for life to change and that changes will stimulate personal growth " ex: best friend moves away and that is just part of life, and may say that is a good thing " what doesn t kill you makes you stronger! 2 nd C: Commitment- tendency to involve oneself in whatever one is doing " ex: if you are taking this class, then you are here and reading " once you commit to it, you actually really do it! 3 rd C: Control tendency to act and believe as if one can influence events and reactions to events! where are you on these things and can you change them? o Internal locus of control! You feel like you can influence what happens to you or at least how you react to it! You can make choices, you are not a puppet in this world! You are in control of your own destiny Film Psychology- The Human Experience- Stress, health and coping Dora Rodriguez- fighting breast cancer Set good example of dealing with stress Health psychology- studies how psychological factors such as stress influence health, illness, and treatment Stress is a common term we use all the time, but very complex idea Health psychologist definition- 3 components

6 1 st - type of event, situation that the person is in, and usually has some negative connotation Potential there for loss, threat of loss, or person has already lost something Aspect of defining stress- appraisal of situation Two people can face same situation- one sees it as stressful, the other does not 2 nd - Stress is a discrepancy between what situation demands to handle it and what you feel resources are If you feel discrepancy, you feel a lot more stress than someone who thinks they have possibility of handling stress 3 rd - stress is a set of physiological reactions o When people are under stress, release of catecholamines (stress hormones) o Catecholamines lead to general system arousal- heart rate increase, blood pressure may go up, feel tense, skin conductance o And direct physiological arousal Not all stress springs from traumatic events Two kinds of stress- acute stress and chronic stress o Acute stress- changes that take place because everything is going along steadily and a change happens; potentially disruptive and in that sense it s stressful o Chronic stress- continuing mismatches between what you want and what you get! Ex: may think of yourself as a creative person who is stuck in a routine job; every day you experience conflict between who you are and what s happening to you Biopsychosocial model- health is determined by complex interaction of biological, psychological, and social factors Dora- biologically she has breast cancer, psychologically her mental approach was remarkably hardy, and socially she interacts in a certain way with other people (wants to help others) Optimistic vs. pessimistic explanatory styles o Optimistic- if you face failure, then you externalize blame; if you are having success, you take credit for it; tends to look on bright side of things, and consequently, you have better chance of keeping stress under control so that it doesn t overwhelm you and you can preserve your health a little bit o Pessimist- opposite- take responsibility for failure and not see connection with stress; sees glass as half empty; when stressful circumstances happen, they make it worse by concentrating on worst features, which increases sense of stress and likelihood they will get sick over it Pessimists face more stress than optimists; but main problem is whether optimist is experiencing less stress because of denial or leading him to solve the problem If problem is experiencing less stress because of denial, then it will lead to illness; even if you don t acknowledge stressful circumstance body can still react to it

7 Having sense of control can decrease stress; less you feel you can control a situation, more likely you will experience more stress With breast cancer, you can go on the internet and educate yourself about symptoms and how to plan for side effects Coping- ways in which we try to change circumstances or our interpretation of circumstances to make them more favorable and less threatening Problem-focused coping- you address stressful circumstance as a problem and try to solve it; once you solve problem stress has diminished Emotion-focused coping- you say to yourself you can t do anything about the problem and all you can do is worry about how it makes you feel; you address emotions and try to see if you can solve bad feelings without doing anything about stressful circumstance Positive appraisal- when we use this, we try to minimize negative emotional aspects of situation and also try to create positive meaning by focusing on personal growth Some individuals find meaning in negative experience and use experience to try to help other people- common way in coping Support groups is a helpful thing for variety of individuals who may find opportunity to talk about experiences within support group Positive appraisal is not denial- people understand how negative situation is and can tell you how traumatic experience is, but they have chosen not to dwell on worst part of it and instead focus on parts that have been beneficial for them There s always potential to learn on our own how to handle things better; people felt in response to difficult situations that they have grown and gotten better at handling things, and changed priorities Doesn t happen to everyone but some people grow into that Most us find we need to talk to someone else about experiences, and most people speak to intimates, family members, and coworkers Insatiable need to talk about experiences to facilitate understanding and adjustment Social network is extremely important, when people try to support they are mostly well intentioned, but doesn t always mean it will be effective Problematic when an elderly person or is chronically ill, if family members or caregivers are over protective, and do too much for them Gives the message that the person is not capable