Psychology 415; Social Basis of Health Behavior
Controlled v. automatic behavior: some core constructs
 Critical role of associative learning
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Cognition
Affective responses
Physiological activation
Immune functioning…
 Extrinsic stimuli & self-focused attention: Rosemary’s Baby
 Fluid, capacity-based conception of “controlled” behaviors
or cognitions
 Implicit learning
 Imitative learning: key role of “mirror neurons” in learning &
behavior
 Stereotype activation: cue-based perceptual biases
 Progressive mechanization in skill learning
 Automatic activation of affective responses: “preferences
precede inferences…”
 Associative learning & goal activation…
Automaticity, escape
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Psychology 415; Social Basis of Health Behavior
Bargh; goal activation
Automaticity, escape
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Sexual Escape
“Honey, you know it don’t count if I was high..."
Psychology 415; Social Basis of Health Behavior
B.B. King, (1971). How Blues Can You Get.
I think [alcohol & drugs] also helps them to forget about [AIDS].
...some of them...are able to keep their wits about that in the
sense of using safe sex, using a condom. But I think others, it
makes it less scary. It makes the experience a lot less
frightening in terms of HIV and AIDS and not having that in the
forefront of their minds when they’re engaging in the activity.
...there are a lot of ... men who would be so-called straight who
under the influence of alcohol or with them knowing that
they’re going to drink so they can go ahead and sleep with
another guy…
Well, I don’t like to admit it, but worrying about HIV when I’m out
meeting guys is a drag. When I drink, I don’t worry so much...
Automaticity, escape
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Socio-cultural Models of Sexual Risk / Prevention
Psychology 415; Social Basis of Health Behavior
 Information dissemination
 Targeted v. general populations
 Indigenous information / attitude change methods
 Community based dissemination / diffusion
 Opinion leaders
 Settings
 Churches, etc.
 ‘Stages of change’
 pre-contemplation
 contemplation
 action
 maintenance
Automaticity, escape
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Socio-cultural models, cont.
Psychology 415; Social Basis of Health Behavior
 Prevention resources
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Condom availability
Needle availability
HIV / STI testing
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social / personal priorities
cost :: utility
ART treatment
 Community Socialization
 ‘Sexualization’ of gay identification
 Implicit v. explicit normative standards
 Opportunity & exposure
 Drug availability
 Risk partner availability
Automaticity, escape
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Social / cultural models, 3
Psychology 415; Social Basis of Health Behavior
 Legal & Policy Interventions
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needle exchange
legalized drug use / sex work
Gay marriage
‘Homophobia’ / discrimination
Medical practice / training
Automaticity, escape
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Person – based models of sexual risk
 Simple attitude models:
Psychology 415; Social Basis of Health Behavior
Rational
Operator:
 Health beliefs x values  "intentions“
 Self-efficacy & outcome expectancies
 Information & skills
Motivational:
 Fear arousal / protection motivation
 Self-identity & health motive
 Optimism & perceived vulnerability
 e.g., reactive effects of ART.
“Dyscontrol”:
Automaticity, escape
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Chronic or acute substance abuse
Ψ symptoms
Sensation seeking / risk taking
“Personality disorder“ / impulsivity
Childhood sexual abuse / PTSD
sequalae
Risk: Person – based models
Psychology 415; Social Basis of Health Behavior
“Stress”
 Social network
 Partner / peer pressure
 Sexual context
 Local norms
 Safety availability
 Chronic stress
 Sexual availability
 e.g., internet norms &
availability
Automaticity, escape
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Vulnerability
 Coping skills
 Avoidant coping
 Self-esteem
 Bar orientation
 Ambivalence
Stress –vulnerability
Psychology 415; Social Basis of Health Behavior
 Internet use and sexual risk among MSM
Automaticity, escape
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Psychology 415; Social Basis of Health Behavior
Internet & sexual risk, 2
Automaticity, escape
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Psychology 415; Social Basis of Health Behavior
Stress – vulnerability model of MSM drug use
“Escape”
expectancies
of alcohol /
drug use.
Automaticity, escape
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Psychology 415; Social Basis of Health Behavior
Cognitive escape models
Vulnerability
 Performance standards
 Negative affect
 Cognitive restraint
 Expectancies
 Sensation seeking
 Cognitive capacity
Releasing Stimuli
 Settings
 Partner characteristics
 Substance use
 Affect / internal states
 Initial “slip”
 Financial pressure (?)
Cognitive disengagement
 Concrete action identification
 “Automatic” behavior
Automaticity, escape
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Escape process
Psychology 415; Social Basis of Health Behavior
High performance standards
Negative affect
Escape motive / expectancies
+
Contextual risk inducements
Low level action identification
Automatic behavior
Automaticity, escape
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Escape, 2
Psychology 415; Social Basis of Health Behavior
High Performance Standards
 Externally imposed
 Strong norms & intentions
 Inescapable / unalterable
Negative affect re: failures
 Perceived personal vulnerability + severity
 Ought  actual | Ideal  actual discrepancies
 Low self-efficacy for instrumental coping
 Low outcome expectancies
 “Coping burnout” / fatalism
 Fear / shame
 Depression / anger
Automaticity, escape
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Aversive selfawareness
Psychology 415; Social Basis of Health Behavior
Escape, 3
Escape motive / Expectancies
 Sexual / alcohol / drug expectancies
 Avoidant coping
 Cultural / individual support for “escape”
 Drug norms & availability
 Cultural visibility of / norms for health behavior
Contextual risk inducements
 Situational “releasing stimuli”
 “Exceptional” times / places / people
 Physical constraints on communication, safety, negotiation
 Normative environment
 Implicit / explicit standards for sex, drugs, communication
 “We’re all in” syndrome
Automaticity, escape
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Escape, 3
Low level action identification
Psychology 415; Social Basis of Health Behavior
Deconstructed Action > larger / abstract meaning
 Attentional focus
 “Mechanics” > “Meaning”
 Reward (gain) sensitivity > punishment (loss) sensitivity
 Context sensitivity
 “Stimulus bound”
 Sensation seeking
 Irrational thoughts (?)
 Strategic substance use
 Impaired abstract information processing
 Self-fulfilling expectancies of affective responses
Automaticity, escape
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Escape, 3
Psychology 415; Social Basis of Health Behavior
Automatic behavior
 Core characteristics
 Effortless
 Unintentional
 Autonomous
 Uncontrollable
(few attentional demands)
(independent of larger goals)
(fixed “action pattern” or “script”)
(resists conscious change)
 “Automatic” maintenance:
 Associative learning: stimulus environment + “not think” Rx.
+
 Instrumental learning: strong rewards for cognitive avoidance
Death, destruction and despair
(or not…)
Automaticity, escape
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Psychology 415; Social Basis of Health Behavior
The wages of cognitive escape
Automaticity, escape
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Psychology 415; Social Basis of Health Behavior
AIM study of drug using MSM
Automaticity, escape
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