Health and Behaviour

Defining Health and Illness

Understanding health and illness is foundational in health psychology, which examines the interplay between physical, mental, and social well-being.

• Health: Defined by the World Health Organization (WHO, 2007) as a state of complete physical, mental, and social well-being, not merely the absence of disease.

• Illness: The presence of a physical or mental disease or impairment.

• Self-assessment: Individuals may rate their own health based on subjective and objective criteria.

Health-Related Quality of Life (HRQOL)

HRQOL is a multidimensional concept that considers both functional abilities and subjective well-being.

• Functioning: Self-care, role fulfillment, social participation.

• Well-being: Emotional well-being, pain levels, energy.

Health Psychology

Health psychology studies how behaviour and decisions impact health, survival, and well-being.

• Examines both positive and negative impacts of human behaviour.

• Most premature deaths in the 20th and 21st centuries are linked to lifestyle factors.

• Common causes of death: tobacco use, alcohol use, obesity, inactivity (heart disease, cancer, stroke, diabetes).

Approaches to Health and Illness

Biomedical Model

• Focuses on illness and biological factors.

Biopsychosocial Model

• Considers biological, psychological, and social factors in health and illness.

• Endorsed by most health professionals; increasingly referred to as the biopsychosocial-cultural model.

Health Psychology

• Explores psychological influences on health, illness, and responses to health challenges.

Acute and Chronic Conditions

Acute Disease

• Temporary conditions that develop quickly and cause rapid changes in health.

Chronic Disease

• Lasts at least three months; may require ongoing support (e.g., physiotherapy, occupational therapy).

Health Issues

Cancer

• Leading cause of death in Canada.

• Risk factors: Unhealthy diet, smoking, excessive alcohol, early sexual activity, especially in females.

• Coping: Medical treatment plus maintaining quality of life.

AIDS (Acquired Immune Deficiency Syndrome)

• Caused by HIV (human immunodeficiency virus).

• HIV attacks the immune system until it becomes non-functional.

• No cure or vaccine.

• Treatment: HAART (highly active antiretroviral therapy), education, psychotherapy, self-help groups, antidepressants, anti-anxiety drugs.

Lifestyle and Health

Smoking

• Nicotine: Highly addictive; stimulates reward circuitry (positive reinforcement) and reduces withdrawal symptoms (negative reinforcement).

• Associated with lung cancer, coronary heart disease.

• Life expectancy of smokers is 7-14 years shorter than nonsmokers.

• Declining cigarette use, but increased vaping among youth.

Obesity

• "Freshman 15": Average extra 6 pounds gained by students.

• 27% of Canadians are obese.

• Linked to cardiovascular disease, diabetes, osteoarthritis, some cancers.

• Body Mass Index (BMI): Used to define healthy weights.

• Genetic contribution to weight: 50-90%.

• Weight gain: Positive energy balance (calories in > calories out).

Alcohol

• Abuse/dependence more common in men; influenced by genetics.

• Can cause cirrhosis of the liver.

• Alcohol during pregnancy affects fetal development.

• Both genetic and environmental factors play a role.

Exercise

• Aerobic exercise (running, swimming, rowing) recommended for at least 2.5 hours/week.

• Only 2 in 10 adults and 1 in 10 children/youth meet recommendations.

• Strength training increases muscle and bone strength, reduces sarcopenia and osteoporosis.

• Moderates effects of aging on muscles and bones.

Meditation and Relaxation

• Focused attention/open-monitoring.

• Mindfulness-based stress reduction.

• Integrated mind-body training.

Psychosocial Influences on Health

Social Determinants

• Access to quality healthcare is not universal in Canada.

• Biases exist in all aspects of health.

Poverty

• Less access to healthcare, lack of control, magnified by stress, poorer diets.

Discrimination

• Uncontrollable and unpredictable; increases blood pressure and unhealthy behaviours.

Interpersonal Relationships

• Social Resilience: Ability to maintain positive relationships and recover from social isolation and stressors.

• Social Isolation: As risky as smoking, obesity, high blood pressure.

• Marriage tends to increase longevity but can also be a source of stress.

Stress and Illness

Stress and Stressors

Stress is a physiological and psychological response to a stressor that threatens or challenges coping abilities.

• Requires adaptation or adjustment.

• Stressors: Events capable of producing physical or emotional stress.

Definitions of Stress

• David Elkind (1981): "The wear and tear on our bodies produced by the process of living."

• Hans Selye (1956): "A non-specific response of the body to any demand made upon it."

General Adaptation Syndrome (GAS)

Hans Selye's model describes the sequence of reactions to stressors.

• Alarm Stage: Sympathetic nervous system releases hormones; emotional reaction; defense forces mobilized.

• Resistance Stage: Physiological efforts to resist or adapt to stressor.

• Exhaustion Stage: If organism fails in efforts to resist stressor.

Types of Stress

Stress Response – 4/5 Fs

• Fight: Facing threat aggressively.

• Flight: Running away from danger.

• Freeze: Unable to move or act against threat.

• Fawn: Acting to please/appease to avoid conflict.

• Flop: Total bodily collapse/disorientation (similar to freeze).

Mechanics of Stress

• HPA Axis: Hypothalamus, pituitary, adrenal axis regulates the fight, flight, freeze, fawn, or flop response.

The Effects of Stress

• Can be acute or chronic.

• Prolonged exposure damages the body via sympathetic nervous system.

• Immune system suppression.

• Cardiovascular disease (increased risk of atherosclerosis, hypertension, LDL cholesterol).

• Some forms of cancer.

• Shortening of telomeres (cellular aging).

PTSD (Post-Traumatic Stress Disorder)

• Results from experiencing or witnessing extreme trauma.

• Primary characteristics: Intrusive re-experiencing, negative mood/cognitions, avoidance of triggers, hyper-arousal/vigilance.

PTSD Comorbidity

• Substance abuse, generalized anxiety disorder, depression, suicide ideology, unemployment, poverty.

• Prevalence: Childhood trauma, military, emergency service workers.

Stress and the Immune System

• Immune System: Body's defense against illness-producing organisms (skin, phagocytes, lymphocytes, macrophages).

• Can be compromised by disorders like AIDS.

• Interacts with psychological functioning.

Psychoneuroimmunology

• Studies the relationship between the immune system and central nervous system.

• Psychological factors (emotions, thinking, behaviour) affect immune function.

• Stress can decrease B and T cell levels; worsen autoimmune diseases.

Stress and Illness – Coronary Heart Disease

• Top cause of death/disability in US and Canada.

• Stress increases inflammation, blood pressure, lowers "good" HDL cholesterol.

• Chronic stress affects heart health indirectly (e.g., sleep, eating, exercise, weight, lifestyle choices).

Coping and Well-Being

Appraising Stressors

Lazarus and Folkman's Psychological Model of Stress emphasizes appraisal.

• Primary Appraisal: Evaluating the significance of a stressor (harm, loss, threat, challenge).

• Secondary Appraisal: Evaluating coping resources and options.

• Stress response depends on outcome of both appraisals and available coping resources.

Personal Factors and Stress

• Optimism: Lowers stress, may reduce illness risk.

• Psychological Hardiness: Seeing stressors as challenges, commitment, control.

• Social Support: Help, information, advice, emotional support; associated with lower anxiety and better stress responses.

Coping Strategies

• Problem-focused coping: Tackling the problem head-on (reducing, modifying, eliminating sources of stress).

• Emotion-focused coping: Dealing with feelings about the stressful event (changing emotional responses).

Resilience and Post-Traumatic Growth

Resilience Defined

• Ability to cultivate strengths to meet life's challenges.

• Helps overcome adversity and beat the odds.

• Not a fixed trait; involves behaviours, thoughts, actions that can be learned.

• Functions well despite challenges or threats.

Protective Factors

• Personal, social, and institutional resources foster competence and development.

• Buffer or reduce risk of negative outcomes.

• Types: Within the individual, within the environment.

Emotional Resilience

• Defined as overcoming stressors or enduring negative events while finding personal meaning.

• Characteristics: Emotional awareness, internal locus of control, support, perseverance, spirituality, optimism, humour.

Post-Traumatic Growth (PTG)

• Positive psychological change after struggling with highly challenging circumstances.

• Involves positive life changes, resilience, and transformation.

• Often reported by cancer survivors.

Domains of Post-Traumatic Growth

1. Improved relationships

2. New possibilities for one's life

3. Greater appreciation for life

4. Greater sense of personal strength

5. Spiritual development