Health and Behavior Theories

Health and Behavior Theories

• Most behaviors impact health positively (healthy behaviors) or negatively (health-risk behaviors), either directly or indirectly, and immediately or over time.
• The Health Belief Model (HBM) assumes health behavior decisions are based on perceived susceptibility and severity of a health threat, perceived benefits and barriers to treatment, and cues to action.
• The Theory of Planned Behavior (TPB) states that measuring behavioral intention is the best way to predict a health behavior, which is influenced by attitude toward the behavior, subjective norm, and perceived behavioral control.
• The Transtheoretical Model (TTM) outlines five stages of behavior change: precontemplation, contemplation, preparation, action, and maintenance.
• The Health Action Process Approach (HAPA) has two phases: goal-setting and goal-pursuit.

Prevention

• Primary prevention prevents disease or injury from occurring in the first place.
• Secondary prevention treats illness early in its course.
• Tertiary prevention contains damage once a disease has progressed.
• Health psychologists aim to shorten the duration of disability, illness, or pain (morbidity) in older age, focusing on healthy life expectancy.
• Family factors like connectedness, conflict, and nurturance significantly influence individual health behavior.
• Community organizations can promote health-enhancing behaviors.
• Message framing is critical in health education, using either gain-framed (positive outcomes) or loss-framed (negative outcomes) messages.
• Tailoring health messages to individuals is effective for behavior change.
• Fear-arousing messages can backfire and reduce the likelihood of adopting a health behavior.
• Behavioral interventions target conditions that elicit and maintain health behaviors.
• Self-monitoring is often the initial step in promoting behavior change.
• Stimulus-control interventions involve removing discriminative stimuli from the environment and establishing new stimuli linked to reinforcement for healthier choices.
• Many organizations offer work-site wellness programs.
• These programs' costs are offset by reduced work-related injuries, absenteeism, and worker turnover.

Positive Psychology and Thriving

• Positive psychology promotes a strength-based, preventive approach.
• Adversity can lead to greater psychological or physical well-being.
• Constant arousal (allostatic load) and prolonged elevation of catabolic hormones can weaken immunity and promote illness.
• Resilience is the brain and body's ability to withstand challenges to homeostasis.
• Dysregulation of neuroendocrine systems can accelerate chronic illnesses like depression and cardiovascular disease.
• Neuroendocrine adaptations are crucial for resilience.
• The brain responds to hormonal and neural feedback, shaping its structure and function (biological embedding).
• Psychosocial factors linked to enhanced immunity include self-esteem, perceived competence, self-efficacy, self-enhancement, social engagement, relaxation, spirituality, curiosity, and a sense of control.
• Curiosity may aid healthy aging by helping older adults use active coping strategies.
• Some suggest that positive psychologists should consider the interpersonal context, as psychological traits may depend on the context in which they operate.

Physical Activity, Exercise, and Fitness

• Exercise and fitness increase strength, maintain bone density and healthy weight, and reduce the risk of chronic illnesses.
• Exercise reduces anxiety and stress, boosts self-esteem and self-efficacy, increases vigor, improves cognitive function, and protects against neurocognitive disorders, depression, and anxiety.
• Cognitive benefits of exercise are especially important for older adults.
• Barriers to exercise for older adults include ageist stereotypes, lack of confidence, motivation, and myths about its effects.
• Marginalized groups have lower physical activity levels, especially minoritized women.
• Lower socioeconomic status is also associated with lower physical activity levels.
• People are more likely to stick with exercise programs if they enjoy it, have a habit of exercising, have family support and a strong sense of self-efficacy, and believe in taking responsibility for their health.
• Effective interventions match readiness stages, emphasize behavioral strategies, and target community barriers in an ecological approach.
• Health psychologists help nurses promote exercise to their patients.
• Exercise can lead to injury and, if compulsive, can be addictive.
• Compulsive exercise is sometimes used to manage personal or emotional problems.

Sleep

• Newborns sleep 15 to 17 hours a day due to immature brain areas.
• Sleep duration decreases as babies' brains develop.
• Short sleep is linked to race/ethnicity, workplace and neighborhood issues, and other social factors.
• Stressful events at work or home are associated with poor sleep.
• One third of adults experience occasional sleep problems, and 1 in 10 (1 in 4 older adults) has insomnia.
• Chronic sleep debt increases body weight, suppresses immune function, and affects metabolic, neural, and endocrine functions, mimicking accelerated aging.
• The brain uses sleep to repair damage, replenish energy, and promote neurogenesis.
• DSM-5 lists 11 sleep disorder categories, including insomnia, narcolepsy, and sleep apnea.
• Cognitive Behavioral Therapy for Insomnia (CBT-I) improves sleep without pills.
• Sleep hygiene focuses on lifestyle behaviors that influence sleep, like alcohol consumption, caffeine intake, exercise, and relaxation techniques.

Injury Control and Prevention

• Injury risk and injury-related deaths vary across the lifespan.
• Most injury-related deaths are from unintentional injuries.
• External causes account for more deaths in younger people, while chronic conditions account for more in older age groups.
• Poor decision-making during adolescence is due to the limbic system (emotions) maturing before the prefrontal cortex (emotional regulation and impulse control).

Nutrition

• Obesity prevalence has nearly tripled since 1975.
• The number of overweight people globally rivals the number of underfed people.
• The body requires 46 nutrients grouped into proteins, fats, carbohydrates, vitamins, and minerals, in addition to water and caloric energy.
• Poor nutrition is linked to 5 of the 10 leading causes of death: heart disease, cancer, stroke, diabetes, and atherosclerosis.
• Current guidelines recommend a limit of no more than 10% of total daily calories each from added sugar and saturated fat.
• The number of people with multiple chronic conditions has increased across demographics.
• Common combinations of chronic conditions are hypertension and diabetes, hypertension and heart disease, and hypertension and cancer.

Weight Determination

• Basal metabolic rate (BMR) depends on age, gender, weight, and activity level.
• The body closely balances energy intake and expenditure, supporting the concept of a body weight set point.
• Once the number of fat cells increase, they never decrease.
• The arcuate nucleus may regulate appetite and body weight.
• Ghrelin and peptide YY (PYY) are linked to short-term feeding behaviors.
• Leptin and insulin are factors in long-term weight maintenance.

Obesity

• Obesity is a risk factor for many diseases and is second to smoking in mortality rates.
• Body mass index (BMI) is used to measure obesity.
• Abdominal fat (male pattern) is less healthy than lower-body fat (female pattern).
• Weight cycling may be more hazardous than a stable high weight.
• Metabolic syndrome prevalence increases with BMI.
• Susceptibility to common obesity is polygenic.
• The FTO gene may determine whether calories are burned or stored.
• Stress eating may contribute to long-term disease risk.
• Obesity is inversely related to education and occupation level.
• Accessibility of healthy foods can offset the dietary hazards of low income.

Treatment and Prevention of Obesity

• The most successful diets include post-treatment support.
• Behavior modification, such as self-monitoring, is a mainstay of weight-loss programs.
• Maintaining weight with healthy choices and self-monitoring may be difficult due to an obesogenic environment.

Eating Disorders

• Anorexia nervosa is characterized by refusal to maintain a healthy weight, fear of weight gain, and distorted body image.
• Bulimia nervosa involves bingeing followed by purging.
• Binge-eating disorder involves distress about binge-eating episodes without purging.
• Eating disorders are also prevalent in men.
• Males and females with eating disorders have similar issues with body image, age of onset, morbidity, and prognosis but differ in their triggers and behaviors.
• Eating disorders are multifactorial, involving biological, psychological, social, and cultural factors.
• They may be linked to abnormal neurotransmitter levels.
• Treatment addresses both the behavior and attitudes.
• Cognitive-behavioral therapy addresses faulty thinking about food intake, weight, and body image.

Substance Use, Abuse, and Addiction

• Drugs affect behavior by influencing neuron activity at synapses.
• Agonists mimic neurotransmitters, antagonists block them, and others enhance or inhibit reuptake.
• Substance use disorder is characterized by overwhelming involvement with drug use despite adverse consequences.

Models of Addiction

• Biomedical models propose dependence as a chronic disease causing abnormal physical functioning.
• Reward models suggest pleasure motivates repeated drug use.
• Major drugs of abuse overstimulate the brain’s reward system.

Alcohol Use and Abuse

• Alcohol depresses the nervous system, clouds judgment, and is linked to diseases.
• Genes play a role in alcohol dependence, especially in men.
• Psychosocial factors like peer pressure and tension reduction may contribute to problem drinking.
• Behavioral undercontrol and negative emotionality are linked to alcohol dependence.
• Alcohol use disorder (AUD) is defined by behaviors like daily use, inability to cut down, binge drinking, memory loss, and continued drinking despite health problems.
• Alcohol treatment begins with detoxification under medical supervision.
• Counseling, psychotherapy, and support groups like AA may help.
• Pharmacological treatments include aversion therapy and antidepressants.

Tobacco Use and Abuse

• E-cigarettes are vaporizers that simulate smoking without burning tobacco.
• Vaping e-cigarettes may appear safer but still exposes smokers to harmful substances like formaldehyde, acetaldehyde, and toxic metal nanoparticles.
• Cigarette smoking is a preventable cause of death in the Western world.
• Nicotine induces physical dependence and withdrawal.
• Social pressures influence the initiation of smoking.
• Psychological, behavioral, social, and biological variables contribute to the difficulty of quitting.
• The nicotine-titration model suggests smokers maintain a constant nicotine level.
• Prevention programs focusing on refusal skills may be the best solution.
• Antismoking ads provide culturally sensitive nonsmoking peer role models.
• No single treatment is most effective in helping smokers quit.
• Modern treatments deal with psychological factors through relapse prevention and physiological factors through nicotine replacement.

Marijuana

• Marijuana comes from the hemp plant Cannabis sativa, which contains THC.
• THC alters mood, time perception, sensations, thinking, problem-solving, and memory.
• Marijuana use may adversely affect memory, language proficiency, and motivation.
• Heavy THC use may damage the corpus callosum, reduce gray matter volume, and shrink cortical areas that process memory.