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Chapter 14
Health Psychology
Health Behaviors
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The major health problems in
industrialized nations today are
“preventable” diseases that are
influenced by lifestyle choices people
make.
Health Behaviors
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Health behaviors are actions
undertaken by healthy people to
enhance or maintain their good
health.
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Eating healthy foods, exercising, avoiding
substance abuse, getting enough sleep,
controlling weight, using sunscreen,
practicing safe sex, getting health screening
tests
Health Behaviors
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The more health behaviors people
practice, the fewer illness and the
more energy they have.
College students are some of the
worst offenders because the disease
consequences seem so remote.
Health Behaviors
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Five sets of attitudes affect health
behaviors:
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General Health Values
Perceptions of threat posed by diseases
Belief in personal vulnerability to disease
Self-Efficacy
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Response Efficacy
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Belief one can perform a health behavior
Belief that the health behavior will reduce the threat
of disease
For a health behavior to occur, all of these
beliefs must fall into place
Health Behaviors
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Some factors undermine even the
best intentions to practice health
behaviors
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Strong situational influences (e.g., peer
pressure to drink or smoke)
Negative mood
Alcohol
Immediate costs & rewards of behavior
Health Behaviors
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The health attitude-health behavior
model suggests that people are using
systematic processing to make health
decisions.

This is true when a health issue is
perceived as self-relevant, but when the
issue is not seen as self-relevant,
heuristic processing is used.
Health Behaviors
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For people who live at low income
levels, the cost of preventative
health care and limitations on access
to health care are much more
important determinants of health
behavior than are attitudes.
Stress and Illness

Stress is a negative emotional
experience accompanied by
predictable physiological, biochemical,
and behavioral changes
Stress and Illness
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Stress is, to some degree, in the eye
of the beholder.
EXTERNAL RESOURCES OR IMPEDIMENTS
Money &
Time
Stressful
event
Appraisal
of stressor
Usual
Coping Style
Social
Support
Coping
responses
Other life
stressors
Coping
Outcomes
Other personality
factors
INTERNAL RESOURCES OR IMPEDIEMENTS
Stress and Illness
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Some events are more likely than
others to be appraised as stressful
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Events that require a person to change
or expend resources
Unpleasant or negative events,
Uncontrollable or unpredictable events
Ambiguous events
Unresolvable events
Stress and Illness
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In the short term, acute stress
produces emotional distress and
physiological strain
In the long term, chronic stress may
lay the groundwork for future illness
Stress and Illness
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Major stressful life events have been
associated with the onset of illness
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Life events that require one to make
more changes (getting divorced or
getting married) are more stressful than
those that produce few life changes
The more life events, and the greater
their impact, the greater a person’s
vulnerability to illness
Stress and Illness
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Daily Hassles such as getting stuck in
traffic jams or having interpersonal
conflicts may have a cumulative
negative effect on health.
Stress and Illness
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Chronic Stressors such as living in
noisy, crowded, crime-filled
environments may, over time, have a
cumulative negative effect on health.
Coping With Stress
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Coping is the process of attempting
to manage demands that are viewed
as taxing or exceeding our resources
(Lazarus & Folkman, 1984)
Coping With Stress
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Coping is a dynamic process
Coping begins with the appraisals we
make of the situations we cope with.
These appraisals influence how people
will try to cope.
Coping With Stress
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Indicators of Successful Coping
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Reduced physiological arousal
Quick return to previous life activities
Reduced psychological distress
Successful coping depends on both
internal and external resources
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Internal resources include coping styles
and personality attributes
External resources include money, time,
social support
Coping With Stress
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Coping Styles
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Minimizing or avoiding threats
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May be effective in the short-term but may
exacerbate long-term stress
May be associated with increased
physiological activation & poor health
Confronting threats
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May deal more effectively with threats in
the long-term, but at a short-term cost of
greater anxiety
Generally more effective
Coping With Stress
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Cynical Hostility (characterized by
suspiciousness, resentment, anger,
antagonism, and distrust of others) is
a risk factor for the development of
coronary heart disease.
Coping With Stress
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Several personality resources may
help people improve adjustment to
stressful events
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Dispositional optimism
Hardiness
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Commitment, Control, Challenge
Conscientiousness
Writing or talking about traumatic
events
Religion
Coping With Stress
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Social Support may mute the effects
of stress and enhance health.
Coping With Stress
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Sources of Social Support
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Spouse or Partner
Family Members
Friends
Social & Community Contacts
Churches & Synagogues
Co-workers or job supervisors
Coping With Stress
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Ways Social Support Helps
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Emotional: liking, love, empathy
Instrumental Aid: provision of goods or
services during stressful times
Information about the stressor
Information that aids self-evaluation
Coping With Stress
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Effects of Social Support
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Lowers likelihood of illness
Speeds recovery from illness
Encourages good health practices
Improves immune function
Reduces physiological response to stress
Coping With Stress
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Social Support Caveats:
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Support only helps when it is supportive.
Conflictual relationships can hurt, not
help.
Social support may be most effective
when it is “invisible.” If it is apparent
that others are going out of their way,
there are emotional costs.
Coping With Stress
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Stress Management Programs
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Discuss role of appraisal
Behavior observation & recording
Examine controlling conditions
Recognize negative self-talk
Set goals and target behaviors
Engage in positive self-talk
Learn how to reduce physiological response
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Meditation, muscle relaxation, guided imagery
Symptoms, Illness, & Treatment
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Deciding that one is ill is both a social
and a psychological process.
Symptoms, Illness, & Treatment
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Labeling symptoms as illness depends on
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Noticing symptoms
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Expectations that guide the interpretation
of information
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Self-focused, isolated, inactive, boring
situation more likely to notice
Vary by individual and cultural beliefs
Mood and Life Satisfaction
Prior Experience
Symptoms, Illness, & Treatment
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Patients form illness schemas to
understand their symptoms and how to
manage them
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Illness can be viewed as acute, chronic, or
cyclic
Sometimes people adopt inappropriate models
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E.g., high blood pressure is chronic but there are few
obvious symptoms, so patients may view it as cyclic;
this leads them to abandon medication that they need
Symptoms, Illness, & Treatment
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Faulty communication can cause
problems between doctors and
patients
Symptoms, Illness, & Treatment
Doctors may:
Patients may:
Use jargon
Fail to pay attention
Depersonalize
Read too much into
a dr.’s comments
Symptoms, Illness, & Treatment
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Patients often fail to follow doctor’s
advice. Why?
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Dissatisfaction with care
Lack of understanding
Non-“Medical”-seeming treatments
Long time course of treatment
Difficulty of changing habits
Symptoms, Illness, & Treatment
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Training doctors to communicate
more effectively could help
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Provide jargon-free information
Ask patient to repeat the information to
ensure understanding
Use nonverbal signals of friendliness
Rely on “legitimate power” and “referent
power”
Symptoms, Illness, & Treatment
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Providing patients with a sense of
psychological control during medical
procedures helps adjustment and
leads to improved recovery time
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Tell them about steps they can take to
control the unpleasantness of the
procedure or to control their own
reactions
Chronic Illness
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Most of us will eventually develop at
least one chronic disease that may
alter our daily lives for years
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Self-blame may be maladaptive for some
disorders but not others
Blaming other people is associated with
poor adjustment
Feeling psychological control is adaptive
Chronic Illness
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Chronic disease can produce both
negative and positive outcomes
Negative
Positive
Physical Changes Increased selfconfidence
Loss of Income Feeling strong
Relationship
Changes
Increased
Compassion