PSYC 314 Mid 2

Chronic/fatal diseases (cancer, heart disease, etc)

Wellness

Maintain or improve health (or prevent disease and illness)

Any activity people undertake to maintain or improve current good health and avoid illness

Any activity ill people undertake to determine problem and find a remedy – how you respond to symptoms

Any activity people undertake to treat or adjust to a health problem

Physical inactivity
Poor diet and nutrition
Cigarette smoking
Alcohol consumption
Unprotected sex
Excessive sun exposure
Poor sleeping habits
Infrequent handwashing
Poor oral hygiene
Not seeking medical care
Poor road safety

lifestyle and health

Smoking cigarettes
Drinking excessive amounts of alcohol
Being obese
Being physically inactive
Eating between meals
Not eating breakfast
Sleeping fewer or more than 7-8 hours/night

Can lead to more overeating later in the day

Depression, less time for exercise, drinking, etc

Current smoker
History of divorce
History of alcohol abuse
Recent financial difficulties
History of unemployment
Previous history as a smoker
Lower life satisfaction
Never married
History of food stamps
Negative affectivity

Higher carbohydrate and lower total fat intake each associated with higher mortality

Fruit, vegetables and legumes associated with lower mortality

Ultra-processed foods associated with inflammatory bowel disease

Too many carbs = eating bad, unhealthy foods
Too little carbs = leaving out good carbs, eating less fibre, etc

Actions taken to avoid disease or injury (or prevent onset of illness)

Exercise
Wearing seatbelt
Flossing
immunization/vaccination
Handwashing
Physical distancing
Wearing mask

individual or society

Any attempt to identify disease or illness early on; treat disease or illness early on to treat it

Managing injury or disease that cannot be treated, attempting to manage illness/injury to prevent further decline and to attempt rehabilitation

primary

On the outcome of two assessments the person makes:
- The threat associated with a health problem
- Pros and cons of taking action

Percieved Seriousness
Percieved Vulnerabilities
Cues to actions and reminders

Belief that benefits outweight the costs

Percieved Threat

Percieved Benefits and Barriers

Can perceiving physiological risk be harmful psychologically?

Attitude regarding the behaviour

Subjective Norm

Perceived Behavioural Control

Judgment of whether the behaviour is good or bad

Appropriateness or acceptability of behaviour

Based on beliefs about others opinions, social norms

Success

Occurs in stages, rather than a single event

Precontemplation – No intention to change behaviour.

Contemplation – Aware of the need to change, considering it.

Preparation – Ready to change, planning to act soon.

Action – Actively modifying behaviour.

Maintenance – Sustaining change and preventing relapse.

Precontemplation: No plan to vaccinate in next 3 months.

Contemplation: Considering vaccination.

Preparation: Scheduled or trying to schedule.

Action: Received dose(s), scheduled second.

Maintenance: Staying up to date with boosters.

Provide tailored information (e.g., health risks in precontemplation).

Address perceived barriers (e.g., fear, access).

Plan for implementation challenges (e.g., cravings, lapses).

Desires, hopes, fears, disgust, status, affiliation

Emotionally-biased reasoning where people seek evidence that supports desired beliefs and reject contradictory information

It can lead to denial of health risks and resistance to adopting healthier behaviours.

Disgust – Avoid contamination.

Nurture – Care for children.

Status – Appear superior.

Affiliation – Fit in socially

Handwashing with soap increased by 31% and was sustained for 12 months

“Hand hygiene prevents patients from catching diseases” was most effective
— empathy-driven messaging worked best

Higher empathic responding predicts greater uptake of behaviours like handwashing, distancing, and vaccination.

Empathy interacted with perceived threat to predict precautionary behaviour.

Reduces prejudice, stereotypes, aggression.

Mitigates pandemic-related discrimination.

Enhances support for the sick.

Herd immunity protects vulnerable individuals. Empathy motivates people to vaccinate for community protection.

The more that chains of infection are disrupted, protecting the population at large

Low empathy

Callousness

Deceitfulness

Risk-taking (psychopathy)

Narcissism was linked to less prevention and more hoarding during COVID-19

Men were less likely to wear masks when not mandatory.

Masks were seen as shameful, uncool, weak, stigmatized.

Emphasizing community protection (“your community”) was more effective than personal or national appeals.

Intentionally falsified medical info of 12 study subjects in order to demonstrate a link
- Unnecessary invasive procedures on the children study subjects
- Ethically not approved fully

Paid by a law firm looking to sue vaccine manufacturer

No link with childhood leukemia
No link between MMR vaccine and autism
No link between hepatitis B vaccine and multiple sclerosis

Fear/perceived dangers in vaccines, disgust of blood or needles
Primal emotions, highly motivated actions

Mistrust in medical community (doctors), low trust in general
- People who are less trusting of others (more likely to believe others are out to get them)

Reliance on religious beliefs, alternative medicine (God decides their health/can heal them)

Seeing/consulting medical practitioner telling them to avoid vaccines

Tendency to believe in conspiracy theories
Low agreeableness, low trusting of others, higher suspiciousness of others
Belief that world is a dangerous place
alone/isolated; rejected socially → more likely to have conspiracy thinking

Narcissism → believe they know better than others; do not want to appear vulnerable; attention seeking
- Low in humility – no advice from others, they know less than themselves

Low tolerance/negative reaction for perceived infringements on personal rights and freedoms

Individualism and narcissism are correlated with anti-vaccine attitudes and defiance of COVID-19 precautions like mask-wearing

People out for themselves/only thinking and caring about themselves
Their “rights and freedom” outweighs their health

Cognitive bias where people with limited knowledge or competence in intellectual/social domain greatly overestimate their own knowledge/competence in that domain

Among those with low levels of knowledge about vaccines and diseases

Reinforcing bias?
Low knowledge → worse understanding
Clash of ideas (think everything they do not believe in is threat to their own beliefs/themselves)

Parents of vaccine injured children so loud online that they make it seem like occurrence much more common

Cognitive bias that causes people who encounter evidence that challenges their beliefs to reject that evidence and strengthen their support of their original stance

Info on disease threat, rather than debunking vaccination myths, works best to change attitudes about vaccines

Emotionally evocative and contain personalized stories (for motivation)

Assumes that people will be motivated to improve a health behaviour if they have the correct information

Effective in neighbourhoods/communities with worse education on how to stay healthy/engage with healthy behaviours

Refers to whether the information emphasizes the benefits (gains) or costs (losses) associated with a behaviour

Experiencing desirable consequences and avoiding negative ones

Gain-framed messages work best for motivating behaviours that serve to prevent or recover from illness or injury (use condoms, perform physical therapy)

Experiencing undesirable consequences and avoiding positive ones

Loss-framed messages seem to work best for behaviours that occur infrequently and serve to detect a health problem early (drinking and driving, getting a mammogram)

Uncertain (e.g. COVID 19 vaccine)

Gain framed messages

Loss framed messages

Assumes instilling fear will lead to change

Emphasize consequences (Bad ad = point trying to be made, but not clear; needs consumers to think)

Include personal testimonial

Provide specific instructions

Boost self efficacy before urging them to change

Behavioural methods focus on helping people manage the antecedents and consequences of a behaviour

Cognitive methods focus on changing people’s thought process

That promotes self-observation and self-monitoring to increase awareness and control of negative thoughts and harmful behaviours

Goal: regulation of thoughts, attitudes, beliefs, emotions, and behaviours through personal coping strategies

Clients can eventually apply these methods themselves (while not under direct supervision of therapist)

“I can’t relax without my alcohol”
“My friends find me boring when I’m sober”

Negative experiences, specific social situations, locations etc
- Trauma, sadness; drinking with coworkers; passing favorite bar

“I know I can’t stop drinking once I start”
“Lots of people have fun without alcohol”
“My friends like me for my personality, not my drinking”

An instance of backsliding which does not indicate failure

Falling back to one’s original pattern of undesirable behaviour; very common when people try to change long term habits

Experiencing a lapse can ruin one’s confidence in remaining abstinent and can lead to a full relapse

Self management program in which clients…
- Learn to identify high risk situations by generating a list of conditions that lead to lapses
- Acquire coping skills through training that will enable the person to deal with high-risk situations and avoid lapses
- Practice coping skills in high-risk situations under therapist supervision

One-on-one counselling style designed to help individuals explore and resolve their ambivalence in changing a behavior

Clients own experiences/perspective considered throughout

Decisional balance: clients list reasons for and against changing behaviours; then discuss

Personalized feedback: clients receive information on their pattern of problem behaviour, comparisons with norms and risks of behaviour

Nutritional guidelines
Seatbelt laws, road safety
School vaccination programs
Smoking prohibitions
Taxation of alcohol to increase cost
Restricting alcohol to adults
Eliminating trans fats in foods
Vaccine mandate / passports

Aims to reduce the negative consequences of a substance/drug use; and to treat people who use drugs with respect and dignity

Substance use refers to the consumption of drugs or alcohol.

Substance misuse involves using substances in a way that causes harm or deviates from medical or social norms (e.g., binge drinking, using illicit drugs).

A state of psychological and/or physical dependence on substances (e.g., alcohol, opioids) or behaviours (e.g., gambling)

Leads to compulsive use despite harmful consequences.

A compulsion to use a substance for its emotional or psychological effects

A physiological adaptation where the body incorporates the substance into normal functioning, leading to tolerance and withdrawal symptoms

Alcohol

Caffeine

Cannabis

Hallucinogens (e.g., PCP, salvia)

Inhalants

Opioids

Sedatives, Hypnotics, Anxiolytics

Stimulants (e.g., meth, cocaine)

Tobacco

Gambling Disorder

Internet Gaming Disorder (provisional)

Needing more alcohol to achieve the same effect.

Physical symptoms (e.g., tremors, nausea, anxiety) when alcohol use is reduced or stopped

Impaired coordination

Reduced cognitive ability

Poor judgment

Aggression

Accidents

Liver damage

Cardiovascular disease

Cancer

Depression

Alcohol Use Disorder

Mixed evidence; some studies show comparable outcomes to other treatments, but experimental support is inconsistent

Meta-analyses show small but statistically significant effects

Strong evidence of effectiveness; outperforms traditional counselling in most studies

Negative emotions (e.g., anger, depression)

Positive emotions (e.g., celebrations)

Cravings

Exposure to alcohol-related cues

Conflict with others

Social pressure

Being in environments associated with past use (e.g., bars)

Decisional Balance: Weighing pros and cons of change.

Personalized Feedback: Comparing client’s behaviour to norms and risks.

Significant reductions in days drunk and continuous drinking at 1-year follow-up.

A public health strategy that aims to reduce the negative consequences of substance use without necessarily requiring abstinence.

Safe injection sites (e.g., Insite in Vancouver)

Safer supply policies

Decriminalization of drug possession

Having a very high amount of body fat relative to lean mass, or a Body Mass Index (BMI) ≥ 30.

BMI = weight (kg) ÷ height² (m²); a measure of weight relative to height

In 2022, 65% of Canadian adults were overweight or obese.

In 2018, 42.4% of U.S. adults were obese; 73.6% were overweight or obese.

Obesity results from complex interactions between biology, behaviour, and environment

Yes, but genetic predisposition typically increases risk by 20–30%; environmental factors are more influential.

Tendency to judge an entire food item as healthier based on one or more narrow attributes that are perceived as healthy

it is labeled as low calorie, organic, or all natural

it comes from a restaurant seen as healthier (menu that has junk food vs menu with same junk food but also salad and other healthy options)

When a healthy item is available compared to when it is not

seeing the salad will fulfil their “nutritional needs”

When given choices, people pick the most popular option (want to avoid making poor decision)

Lower SES

Fewer grocery stores/farmers’ markets

Poor public transportation

Fewer sports facilities

Lower education levels

Poor diet

Physical inactivity

Poor sleep

Excessive screen time

Stress (cortisol)

Interpersonal dynamics

Diet that is very restrictive, supposed to result in very fast weight loss

Most likely not because of burning fat from diet (i.e. water loss)

Low carb (and other restrictive diets) have reduced serotonin

Sustainable, balanced diets that provide optimal amounts of all essential nutrients for the body’s metabolic needs are best

Added/processed sugar

Published results of a study suggesting that non-celiac gluten sensitivity “may exist”

Published results suggesting that there is no such thing (follow up study)

No one cared about this study → people already exploiting gluten free for money

Showed fructans induce symptoms of gluten sensitivity, not gluten (in people who believe they have gluten sensitivity)

Reducing gluten will not help you solve the fructan issue

Increased risk of coronary heart disease for people without gluten sensitivity/celiac

Added/processed sugars are more predictive than dietary fat

Alternative to weight centered/control approach; focus on weight neutral outcomes (healthy behaviours)

Focuses on getting fitness/healthy behaviours

Increased stress, poor coping

Poorer treatment and inadequate care for patients with obesity

Any activity involving sitting, reclining, or lying down that has a very low energy expenditure

Strongly predicts premature death and adverse health independent of low physical activity (measured differently)

Walking just 30 minutes a day

If sedentary behaviour is built up over many years

True

Adults get at least 2 ½ hours of moderate to vigorous physical activity each week

Making physical activity a permanent part of one’s lifestyle.

Poorer health habits than others, and lower rate of health enhancing behaviours

Being Low SES/minority causes poor health behaviours, which leads to increased morbidity and morality

Rights:
- Not be productive, get out of work/school
- Receive care and empathy
- Getting out of responsibility
Obligations/Expectations:
- Not getting someone else slcik

Perception (Perceiving some kind of symptom)
Interpretation (Interpretation/appraisal of symptom as something that may be relevant to health)
Decision (Decision to make use of healthcare system)

Appraisal
Illness
Utilization

Utilization

Appraisal

Time between appraising something as relevant to health and deciding to seek out medical care

General population who do not have a particular diagnosis but are overly concerned with their health; BUT are otherwise healthy besides the worrying

Neuroticism

Before people decide to seek formal medical attention, they may typically get advice from friends, relatives, or co-workers

True

Canadians do experience longer-than-average wait times and continue to perform below the international average in access to care (among rich developed nations)

Women
LGBTQIA+ individuals
Indigenous people
Immigrants
Low-income Canadians

Those reporting poor or fair health

Women/people with uteruses use health services more frequently
Lack of physician training on reproductive and gender related health care
They more often report not feeling respected by doctors and nurses
They are also less likely to be adequately treated by doctors
Financial limitations (lower wages, unemployment)

Canadians w/ lower income and education who do use medical services make more doctor visits per year (as well as more ER visits) that higher SES canadians

Low income Canadians tend to have longer wait times in hospitals that their high income counterparts

Scared of being labeled/someone with HIV/AIDS
Disclosure
Biases from doctor/nurses
Inaccuracy of how it is spread

Avoid getting tested → fear of the chance to have HIV

Stigma is widespread
Left out of healthcare initiatives (due to stereotypes)
Left out of sexual health conversations

Monitors and Blunters

More concerned and worried about issue

Seek information
Need to know more

Provide messages that include detailed information about risks & strategies

Overwhelmed by threatening information

Avoid information
Keep it brief, focus on what is most important

Keep messages short, succinct, non-threatening, and in simple terms

Not listen, ignore the patient

Ask only yes-no questions

Depersonalize patient (no eye contact, cold/neutral emotions)

Less likely to follow through
Less likely to take meds
Less likely to return to doctor

Try to see problem and treatment as the patient does (empathy)
Enlist patient cooperation

Emotional exhaustion due to frequent/difficult patients

Harder to be empathetic
Harder to go out of your way to be nice

Condition that results from chronic work strain

Emotional exhaustion
Depersonalization
Low sense of personal accomplishment

Result of emotional exhaustion and depersonalization

Not satisfied with ones work

Empathy makes work more meaningful
If you are more burned out, you are less empathetic

Clinical empathy

Understanding the inner experiences and perspectives of the patient as a separate individual, and communicating this to them

Technical quality of treatment/care (outcome = success)

Quality of interaction with practitioner (nice and empathetic)

Sense of autonomy and informed consent

Permission of patient, know what care is happening, why the treatment is happening, etc.

1. Communication - listening carefully, explaining things effectively.
2. Coordination and communication among care providers.
3. Support and planning for leaving the hospital.

Single-bed hospital rooms result in better physical and mental health outcomes for patients

Sharing room with someone who is going through same procedure as patient

Reduced hypertension
Fewer complications after surgery
Reduced mortality
Improved patient compliance/adherence
Improved use of health services

Any practice that has purported healing effects but is not scientifically based
Used in place of medical treatment

Alternative medicine used in conjunction with conventional medicine with treatment

Manipulated and body methods

Natural Products

Mind-body intervention (Yoga, Meditation, etc)

Natural Products

Manipulated and body methods

Some CAM have harmful side effects
People are profiting from false claims about CAM effectiveness
People may forgo conventional medicine in lieu of CAM

No known cure; CAM says they got a “remedy”
Family/culture believes in and uses CAM [–]
More welcoming space (hospitals seen as scary)
Less wait time
Accessibility (wait times, doctor shortages)
Prefer “natural” things in them (natural remedies)

"any medical procedure that produces an effect in a patient because of its therapeutic intent and not its specific nature, whether chemical or physical" (Liberman, 1962)

Expectation that it will have a benefit

Placebo effect is produced in control group as well; every other difference not overlapping between groups due to control = effect of new drug

Sedative effects.

Stimulant effects

Pain meds

Conditioned to associate certain types to certain things

The better effect we will see (medical formality – medications, machines, uniforms, etc)

Providers who exude warmth, confidence, and empathy get stronger placebo effects than do
remote and formal providers.

The provider's faith in the treatment is another influence on the effectiveness

Problem focused appraisal

Emotion-focused reappraisal