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• Study notes from PSYC 172

Introducing Health Psychology

• Health psychology focuses on individual behaviors and lifestyles affecting physical health.
• Lifestyle includes various factors with nutrition being a key component.

Patterns of Disease and Death

• Infectious diseases were the leading cause of death until the 1900s and include organisms like bacteria, parasites, and fungi.
• The discovery of penicillin and antibiotics helped reduce infectious diseases.
• Chronic diseases are currently the leading cause of death in the 2000s like heart disease, stroke, and cancer.
• Life expectancy from 1900 to 2019 increased from 47.3 to 78.9 years due to disease prevention, vaccines, drinking water, nutrition, and sewage disposal.
• Infant mortality rate has decreased due to advanced medicine, contributing to increased overall life expectancy.
• The 2020-2021 pandemic led to a dip in life expectancy to 77.0 due to the pandemic, injury, and heart/liver diseases
• A slight increase in life expectancy to 77.5 was recorded in 2022.
• Natural opioids include opium, heroin, morphine, and codeine
• Synthetic opioids include methadone compounds
• Each opioid type has different strength, speed of action, and tolerance levels.
• Opioids cause CNS depression by slowing down body functions where attaching to endorphin brain receptors leads to needing more for pleasure/calm.

Dangers of Opioids

• Overdose is an immediate danger as it closes the respiratory center in the brain.
• Naloxone is administered as an opioid antagonist in overdose situations.
• Impurity/infection can occur from unhygienic equipment use.
• From 1999 to 2019, the U.S. saw approximately 500,000 overdose deaths involving opioids more than the 58,220 deaths in the Vietnam War.
• The first wave was the rise in prescriptions starting in the 1990s.
• The second wave was the rise in heroin deaths in 2010 as heroin was cheaper and used to help quit cigarettes.
• The third wave was in 2013 with the rise in synthetic opioid deaths where fentanyl entered the drug scene and was used independently or to cut other drugs.

Conducting Health Research

• The biomedical model views health as the absence of disease, focusing on physical/biological aspects.
• The infectious disease model equates no infection with being healthy, disregarding chronic diseases.
• A pathogenic‐based model is where disease results from exposure to a pathogen
• The biopsychosocial model attributes disease to a combination of biological, psychological, and social influences.
• The Chronic Disease Model acknowledges psychological and social factors.
• Psychological factors include fatalism.
• Social factors include things in your environment that give you a certain behavior.
• Obesity has overlapping factors like food deserts and target marketing, and obesity and chronic disease lead to a person being more vulnerable to covid and other infectious diseases

Misconceptions of Research Findings

• The French paradox observes high saturated fat consumption without high rates of cardiovascular disease.
• It was attributed to wine consumption, but, the french consumed a lot of veggies and french log data about heart attacks differently and are therefore not comparable
• Serge renaud, French researcher, disconnected consumption of french high saturated fat and low rates of cardiovascular disease
• Large red wine consumption was attributed
• The diet-heart hypothesis suggesting saturated fat increases serum cholesterol and heart attacks has been disproven with unpublished data from the Minnesota Coronary Experiment (MCE) (1968-1973).
• Correlation does not determine causation in psychology.
• Cholesterol levels may or may not indicate heart attack risk, disproving the idea that consuming less cholesterol lowers blood cholesterol and dietary guidelines have recommended low cholesterol for 50+ years.
• Causal relationships have been completely invalidated.
• The placebo effect shows an inactive substance or condition appears to be an active treatment
• Belief in treatment effectiveness enhances that effectiveness where placebo effect accounts for about 35% of treatment effect.
• Placebos can lead to positive health outcomes for migraines, pain, depression, anxiety, insomnia, asthma, and hypertension.
• Treatments are effective when they outperform the placebo where determining treatment effectiveness involves directly comparing treatment vs. placebo in two groups
• Beliefs about the treatment affect its effectiveness and placebo research works best with medication.

Medical Research Funding

• Coca-Cola worked with researchers to disprove bad relationships, providing $3 million to the academy, but they are sneaky allies.
• Aduhelm is a drug for Alzheimer's where roughly six million Americans have Alzheimer's
• Drugs typically delay cognitive decline by months and Aduhelm (Biogen) had two failed clinical trials stopped in March 2019 because they were ineffective.
• Significant side effects and brain bleeding occurred.
• Biogen argued a higher dose was effective in October 2019 even though data was unpublished.
• The FDA advisory committee voted against approving Aduhelm in November 2020 due to a lack of demonstrated effectiveness.
• FDA accelerated approval of Aduhelm in June 2021.
• Biogen was required to complete a clinical trial proving effectiveness in 10 years, can sell immediately (at $56,000/year).
• Federal investigation into FDA approval process began in July 2021
• FDA approval went forward in Jan 2023, the effect was so small it is barely significant

Seeking and Receiving Healthcare

• Universal Healthcare Definition: “all individuals and communities receive the health services they need without suffering financial hardship"
• Socialized medicine involves government-owned hospitals.
• Single-payer systems involve government health insurance.
• UHC reduces bankruptcy, improves access, and decreases risk of bankruptcy.
• Criticisms of UHC include decreased overall quality and variety of care and government funding is required
• Value-based Care involves global payments and fee for service where pay per visit/procedure

Factors Influencing Healthcare

• Decrease load on emergency care is something to shift to preventative care
• Factors that affect who is likely to seek care includes, socioeconomic factors and stigma
• Women and young adults will more likely seek care and higher socioeconomic status will more likely seek treatment often
• Race based care - adverse beliefs against African American patients

Important Legislation

• The Affordable Care Act ensures consumer protection, increased access through Medicaid options and alternatives to employer market, and improved/preventative care
• The No Surprises Act involves billing protections for patients and restricts balance billing and prevents surprise bills after services
• The Mental Health Parity and Addiction Equity Act ensures equal coverage of MH and addiction treatment
• MH treatment includes outpatient, inpatient, and residential.

Role of Health Psychology in the Healthcare System

• Navigating the system involves health Psychologists helping children and parents manage stressful experiences and providing patient information/control to decrease anxiety in hospital
• Health Psychologists help children and parents manage stressful experiences and providing patient information/control to decrease anxiety in hospital situations
• It is important to have an advocate for your needs when hospitalized

Receiving Health Care

• Factors influencing who is most likely to receive medical care include personal factors, gender, age, socioeconomic and ethnic background, stigma, and symptom characteristics.
• Types of adherence: a medical regime, lifestyle practices and going to the doctors regularly.
• Symptom characteristics influence seeking medical attention where more attention is sought when symptoms are visible, severe, and interfere with everyday life.
• Goals of adherence: maintain patient health, improve health, prevent/ minimize risks for longetivity, reduce costs and enhance autonomny

Adhering to Healthy Behaviors

• Some Patients may prioritize increasing lifespan and others the quality of life. Health span: the number of years without serious disease Vs life span the years lived

Barriers of Adherence

• Cost, medical care, medications Symptoms change or dissapear
• Patient-Provider Communication must be clear

Health Behavior Theories

• People progress and regress through five stages of change: pre-contemplation, contemplation, preparation, action, maintenance
• Clinical method evolved from stage model, goal: activate patient's motivation for change and adherence to treatment
• SMART Goals: specific measurable achievable result focused time bound

Impacts of Stress

• Psychological: can make individuals feel anxious angry, sad, cause depression and changes in hormones.
• Types: Fight, Flight, Freeze or Fawn
• Physiological: hypertension, asthma, ulcers, poor-functioning immune system, and death causing the body to become tense, activated, shut down and lethargic or waves of both

Gut Relation to Stress

• Neurotransmitter production: Dopamine - pleasure, addiction, and Serotonin - mood balance, depression.
• Vagus nerve and communication: communication between the brain and internal organs
• Two pathways: Ventral vagal pathway = socialize and Dorsal vagal pathway = shut down due to overwhelm
• Gut health = mood and cognitive health

Stress Hormones

• Occurs in the endocrine system.
• Adrenaline is produced in the adrenal medulla, is a good index for stress, and can be measured in urine.
• Noradrenaline: maintains blood pressure, memory, and sleep.
• Cortisol: index for stress, measured through either saliva or urine

General Adaptation System

• The body's generalized attempt at defending against a stressor occurs in three stages
• Continued stress will cause prolonged resistance, which may result in ulcers hypertension, asthma, and a poor-functioning immune system
• Alarm stage: the initial response to the stressor
• The body mobilizes to defend against the stressor during the resistance and exhaustion stages.
• Exhaustion is an ongoing response to stress which leads to depleted resources for the body.

Lazarus' View of Stress

• Stress determined by the individual and their perception of the event. Stress is interactional
• Stress is determined by the individual and a person's appraisal of what is stressful
• Coping is a process due to it constantly changing.
• Coping strategies: (CBT), animals and nature, emotional disclosure, nutrition, and mindfulness.

Understanding Stress, Immunity, and Disease

• Psychoneuroimmunology focuses on the relationship between various stressors and function of immune system.
• The systems involved include the immune, endocrine, and nervous system.
• Weathering hypothesis leads to greater risk for certain conditions for certain ethnic groups in America.
• Biomarkers of stress: Hypertension, diabetes, strokes Black patients are 6 years more weathered

Key factors to understand for weathering

• Mexican immigrants show weathering if in the US for more than a decade with changes occurring 6-10 years.
• Lymphatic system components - Lymph nodes, tonsils, spleen, bone marrow Lymph nodes: filter lymph fluid
• Lymphocytes: type of white blood cells producing antiboides
• Immunotherapy: treatment of disease by activating or suppressing the immune system.
• Cancer Cells can metastasize through the lymphatic system.
• Drainage of excess fluid from cancer cells can cause lymphatic swelling.

Negative Impacts of Stress

• Missing sleep, drinking alcohol, smoking, sedentary lifestyle, poor food quality, and social isolation negatively affect the immune system and increase risk of disease.
• Impacts on Self care, social support, energy & time management, gratitude.
• Headaches, infectious diseases, cardiovascular disease, hypertension, ulcers, diabetes, pregnancy, asthma, arthritis are all impacted by stress and Stress may increase number or severity of headaches.
• Gut health is central to overall health and stress impacts digestion via: Eating fast and stress can decrease digestive enzymes.
• ACE (Adverse Childhood Experiences) Study has 3 Categories: abuse, household challenges, neglect. Significant risk of disease and lower life expectancy.

Managing Pain

• Acute pain is brief and Adaptive in that it signals the person to avoid further injury
• Chronic pain endures over months and there is No adaptive reason.
• Posture needs to be managed with ergonomics and can be solved by designing areas and equipment that are effecient and safe.
• A patients common posture problems are Computer / cell phone / lifting / backpack / standing and walking
• Psoas muscles contribute to low back and hip pain and Starts the startle response

Pain Treatment

• Analgesic drugs can potentially cause Tolerance dependence.
• Cannabis shows promise for variety of chronic illness, anxiety, cancer
• Mindfulness Training increase awareness of sensations and pain and physical discomfort and emotions
• Pain is individualized based on Subjective, situational, and cultural life experiences.
• Racial biases exist within the medical system where some groups perceive less pain than others, with African Americans and Hispanic Americans reporting higher pain sensitivity.
• Gender differences show Women have reported lower temperature and blood flow
• Neural gaet in spinal cord regulates the experience of open or closed pain gates

Alternative Approaches to Treatment

• CAMS - Complementary alternative medicines show 30% of adults use health approaches that are not typically part of conventional medicine

Types of CAMS

• Acupuncture
• Ayurveda
• Biofeedback
• Chelation Therapy
• Energy Healing
• Hypnosis
• Massage Therapy
• Naturopathy
• Chiropractic or osteopathic manipulation
• Relaxation and stress management techniques
• Traditional healer
• Movement healer
• Natural herbs
• Vitamins
• Homeopathy
• Special diets
• Yoga, Tai Chi, and Qi Gong Prayer
• Usage: Natural Products: 17.7%, Deep breathing: 10.9%, Yoga, Tai Chi, or Qi Gong

Types of Meditation

• Aims to increase mental awareness, reduce stress, relax the body.
• Transcendental: Sit quietly, origin in india, Mindfulness: buddhism, sit quietly and focus thoughts and sensations.
• Guided: imagery-focus on sensations and breathing, Biofeed back status of systems
• Biofeedback provides feedback about biological systems.Measure beat to beat changes heart rate electromyograph (muscle tension), Thermal (changes in skin temp)

Traditional Medicine

• Traditional Chinese Medicine acupuncture inserting needles and cupping medicine technique
• Ayurvedic Medicine that has Yoga which origins from india
• Integrative Medicine with conventional and alternative medicine and multidisciplinary health teams

Cardiovascular Disease Factors

• Cardiovascular system: Heart - 4 chambers Arteries that carry oxygenated blood AWAY and Veins that carry oxygenated blood AWAY
• Coronary diseases: Atherosclerosis formation of plaques in the arteries arterial:loss of elasticity arteries
• Treatments for CAD:Ischemia restriction of blood flow coronary-artery damage either
• Stroke: Common is clot and Hemorrhagic stroke is bleeding in brain, trouble speaking comprehensing numbness etc
• Transient ischemic attack: mini-stroke to temporary sign goes away, bypass surgery (graphs of arteries improves heart) and Cardiac rehab
• Blood pressure: abnormal high rate
• Treatment for hypertension: medication, diet exercise, and stress

Behavioral Factors in Cancer

• Cancer: group of disease presence, cancer can be inherited and is one leading causes of death, benign (Localized, less threatening) , BenignLocalized, less threatening Malignant: spread, dangerous
• Carcinogenic: substance causes cancer, and is cancer
• Cancer cell : malformed cell doesn't create a tumor.
• Reasons for decreasing cancer : diet and prevention.
• Early detection: checkups,
• Early treatment treatments
• Behavioral risk factors and prevention through campaigns ex. Diet. Mammogram.
• Ultraviolet Lightscreen
• Radical Remission: people unexpected results