Option in IB Psychology
Standard Category 4
HEALTH PSYCHOLOGY
1
Health Psychology
Health psychology is a field of psychology that
contributes to behavioral medicine & applied
psychology. It is the scientific study of
psychological processes related to health and
health care.
-In the modern Western world most diseases are
associated with life-style choice so health focuses
on health promotion
- Concerned with how dif. factors: biology,
behavior, sociocultural factors etc. influence health
and dev. of illnesses
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Behavioral Medicine
Centers for Disease Control (CDC) claim that half
of the deaths in the US are due to people’s
behaviors (smoking, alcoholism, unprotected sex,
insufficient exercise, drugs, and poor nutrition).
Psychologists and physicians have thus
developed an interdisciplinary field of behavioral
medicine that integrates behavioral knowledge
with medical knowledge.
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A lot of health comes down to…
Habits
 What is a habit?
 Keys: Pervasive, Automatic, Powerful but
Delicate, Malleable

https://www.youtube.com/watch?v=ouubuoHtrF4

https://www.youtube.com/watch?v=MFzDaBzBlL0
 How do they form and what do they teach
us?
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E.P.
 1993, Eugene Pauly (71)– viral infection in
brain – resulting amnesia meant nothing for
last 3 decades or anything new
 Would introduce himself to his doctors every
time, make breakfast 4-5 times a day, could
carry on conversations, still intellectually
sharp, constantly repeated questions to his
wife
 Took daily walks with wife – one day he
disappeared only to be found at home an
hour later – how’d he get there – habit!
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Basal Ganglia – Striatum vs. Neocortex
 1990’s MIT – study rats learning mazes – brain &
BG went nuts when learning
 Over time as they learned – brain activity in
decision and even memory centers went quiet
 BG stores habits even when rest of brain is quiet
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Graph of habit to your brain
 This is the brain activity in the rats
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Chunking
 Brain converts sequences of actions into automatic
routines – root of habits
 Some simple – toothpaste toothbrush in mouth
 Some complex – backing out of a driveway
 It’s actually scary how mindlessly you can do this
 Habits emerge like this as our brains look for
shortcuts to save effort
 BG determines when habits take over, ramp down
activity and then kick it up when habit ends
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Process of a Habit – 3 steps
1. Cue: triggers brain to go into auto mode
2. Routine: could be physical, mental or
emotional
3. Reward: helps brain figure out that this loop
is worth remembering
- Over time this becomes more automatic
ROUTINE
CUE
Click
REWARD
THE HABIT LOOP
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Habits
 Habits never really leave – change it up for a
while (move the mouse’s chocolate) it’ll
adjust but if you put it back where it used to
be (Neocortex) – habit kicks right back in
(Striatum & Sensory Motor Cortex Loop)
 Problem is brain can’t tell dif. b/w good and
bad habits – so it’s hard to create exercise
habits or change eating habits – old patterns
are always there
 Proof of habits pg. 21-25 in Power of Habit
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Research on habits
 Cues can be almost anything-candy,
commercial, a place, time of day an emotion,
people etc
 Routines can be complex or simple –
emotional routines can be measured in
milliseconds
 Rewards range from physical sensations
(food, drugs etc.) to emotional payoffs
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Habits over common sense
 Mice shocked or nauseated by pathway to food,
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but habit so ingrained they couldn’t stop
Human analogy – people eating fast food
Starts as convenience, it’s inexpensive, tastes
great
Gradual increase of # of times
McDonalds tries to capitalize on this – same
architecture, same menu, immediate reward (fries
disintegrate immediately
But, delicate – if local restaurant closes, habit dies,
not shifted to a new place
http://www.youtube.com/watch?v=6YDTfEhChgw
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In a word it’s about craving
 Story of Pepsodent
 Story of Febreze
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Cravings derive from
conditioning
 Most common thought is Pavlov’s dog
 Salivates to the sound of a bell
 Classical conditioning
Little Albert Video
http://www.youtube.com/watch?v=nE8pFWP5QDM
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Watson
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Operant & Classical Conditioning
1. Classical conditioning
forms associations
between stimuli (CS
and US). Operant
conditioning, on the
other hand, forms an
association between
behaviors and the
resulting events.
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Operant & Classical Conditioning
2.
3.
Classical conditioning involves respondent
behavior that occurs as an automatic
response to a certain stimulus. Operant
conditioning involves operant behavior, a
behavior that operates on the environment,
producing rewarding or punishing stimuli.
Key Questions – Is organism learning assoc.
b/w events that it doesn’t control?
- Is it learning assoc. b/w its behavior &
resulting experiences?
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Operant Conditioning
Skinner’s Experiments
B. F. Skinner’s experiments extend Thorndike’s
thinking, especially his law of effect. This law
states that rewarded behavior is likely to occur
again.
Yale University Library
B.F. Skinner Video
Operant Conditioning Clip 1
Operant Conditioning Clip 2
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http://deathandtaxesmag.wpengine.netdna-cdn.com/wp-content/uploads/
2013/05/bigstock-dog-running-6241804_900.jpg
Cravings
 So – want to create powerful habits? Here’s how
#1 – “Find a simple & obvious cue”
- Filmy teeth
- Leave out running clothes
#2 – “Clearly define the rewards”
- Clean, fresh feeling
- Midday treat, satisfaction of recording
the time/distance, endorphin rush
#3 – Cue has to trigger routine and craving
- Anticipation & expectation of clean mouth,
treat, satisfaction or high
The Power of Habit by Charles Duhigg
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Cravings
 What are your cravings and what are their cues?
 Possibles
 Box or plate of treats on a table - carbs
 Email/text/FB alert chime/vibration 
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interaction
Smell of coffee – caffeine, relaxation, Gw/DT
Kids/friends unfinished dinner plate – food
A cluttered room, a disordered desk,
unkempt couch pillows etc. – order
Stress - chocolate
Me asking you what you crave - whatever
A bed – SLEEP!
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http://coach.healthytrim.com/can-you-step-on-the-scale-too-often/
Want to craft
new habits?
 National Weight control registry –
studied 6000 people
 78% ate breakfast every morning triggered by
time of day
 Most successful dieters envisioned the reward
– bikini body, pride in stepping on the scale
each day etc.
 Became mildly obsessive, but the craving for
that reward overrode temptations
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Bidirectional Model &
Neuroplasticity
 BiD Model – biology & the environment
influence each other in a reciprocal relationship
 Neuroplasticity – brain changes in response to
environment is critical in health psych
 In particular stress’s relationship to the brain are
critical to understanding health psych – for
example stress affects neurotransmitters & can
actually shrink the hippocampus
 Hippocampus: long-term memory & spatial navigation
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Stress
Stress is any circumstance, real or imagined, that
threatens a person’s well-being.
- It’s worth noting that according to Robert Sapolsky,
humans are the only species that can imagine stress (clip
– stress response savior to killer)
- Physiological experiences of stress (getting fired) =
cognitive experiences of stress (thinking about getting
canned)
Lee Stone/ Corbis
When we feel severe stress, our ability to cope with it is impaired.
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Stress and Stressors
Stress is not merely a stimulus or a response. It is
a process by which we appraise and cope with
environmental threats and challenges.
Bob Daemmrich/ The Image Works
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Stress and Stressors
 Acute stressors= appear suddenly, require
immediate attention and are short term in
duration
 Example?
 Return to homeostasis
 Chronic stressors= Last for a long time and are a
constant worry
 Example?
 No return to homeostasis
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Physiological Stress - The
Stress Response System
William Canon (1914)
proposed that the
stress response was a
fight-or-flight response
marked by the
outpouring of
epinephrine and
norepinephrine from the
inner adrenal glands,
increasing heart and
respiration rates,
mobilizing glucose and
fat, and dulling pain.
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General Adaptation Syndrome
According to Hans Selye,
a stress response to any kind of
stimulation is similar. The stressed individual goes
through three phases.
 Alarm = heart rate, blood to muscles,
faintness of shock
 Resistance = temperature, blood pressure,
respiration high, outpouring of hormones
 Exhaustion = vulnerable to illness, in extreme
cases collapse and death
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EPA/ Yuri Kochetkov/ Landov
GENERAL ADAPTATION SYNDROME
(GAS)
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Autonomic Nervous System (ANS)
Sympathetic NS
“Arouses”
(fight-or-flight)
Parasympathetic NS
“Calms”
(rest and digest)
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GAS
 Strength of Selye’s theory is that it can
explain extreme fatigue people experience
after long-term stress
 Weakness is that psychological factors play
only a minor role in his model
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GENERAL ADAPTION SYNDROME (GAS)
 BASIC POINT: Prolonged stress can produce
physical deterioration
 Examples:
 Shortening of telomeres in women caring for
children with serious illnesses
 Shrunken hippocampus - abused children, combat
soldiers
 Increased levels of Cortisol which can lead to
depression, memory problems, and weakens
immune system functioning by decreasing t-cells
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Presidents Before & After
See Portraits of
Soldiers Doc
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GENERAL ADAPTATION SYNDROME
(GAS)
 ESSENTIAL POINTS:
 All life events cause some stress
 Stress is not bad per se, but excessive or
unnecessary stress should be avoided
 Stress should be monitored through a battery of
parameters not just a biochemical or behavioral
approach
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Daily Hassles
Rush hour traffic, long lines, job stress, and
becoming burnt-out are the most significant
sources of stress and can damage health
Hypertension among residents of urban ghettos
is high.
What are some of the daily hassles of attending
UAIS?
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Stress and the Heart
Stress that leads to elevated blood pressure (hypertension)
may result in Coronary Heart Disease(CHD) , a clogging
of the vessels that nourish the heart muscle.
Plaque in
coronary artery
Artery
clogged
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CHECKLIST - ANSWER YES OR NO
 Do you find it difficult to restrain yourself from
hurrying others’ speech (finishing their sentences
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for them)?
Do you often try to do more than one thing at a
time (such as eat and read simultaneously)?
Do you often feel guilty if you use extra time to
relax?
Do you tend to get involved in a great number of
projects at once?
Do you find yourself racing through yellow lights
when you drive?
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 Do you need to win in order to derive enjoyment
from games and sports?
 Do you generally move, walk, and eat rapidly?
 Do you agree to take on too many
responsibilities?
 Do you detest waiting in lines?
 Do you have an intense desire to better your
position in life and impress others?
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Holmes-Rahe 1967
 Developed Social Readjustment Rating Scale
based on the stresses of Americans’ lives
 Found surprising agreement among
respondents on how long it would take them
to readjust and accommodate the stressor of
the various events
 High ecological validity based on follow up
studies and established a fairly constant US
etic
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Personality Types
Type A is a term used for competitive, harddriving, impatient, verbally aggressive, and
anger-prone people. Type B refers to easygoing,
relaxed people (Friedman and Rosenman, 1974).
Type A personalities are more likely to develop
coronary heart disease.
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Type A vs Type B
 When harassed, given a challenge, or
threatened with a loss of control:
 Type A’s: more physiologically reactive (hormonal
secretions, pulse rate, blood pressure soar)
 Type B’s: remain calm
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The Big Five Factors
Overtime, psychologists have expanded some of
the factors and traits used to assess personality
types. The factors, known as the “Big Five” are
below:
Conscientiousness
Agreeableness
Neuroticism
Openness
Extraversion
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Endpoints
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Questions about the Big Five
1. How stable are these traits?
Quite stable in adulthood. However,
they change over development.
2. How heritable are they?
Fifty percent or so for each trait.
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3. How about other cultures?
These traits are common across cultures.
4. Can they predict other
personal attributes?
Yes. Conscientious people are morning
type and extraverted are evening type.
4
5
Cognitive Aspects of Stress &
Health
 Positive correlations between Pessimism and
heart disease
www.opportunityisnowhere.com
 Stress and susceptibility to colds
 Stress & dev. of AIDS
 Negative correlation between Stress & Health
 Stress and Immune System Strength
 Stress and cancer?
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Pessimism and Heart Disease
Attributional style – optimism vs. pessimism can
predict poor health later in life. Pessimistic adult
men are twice as likely to develop heart disease
over a 10-year period (Kubzansky et al., 2001).
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Social Self-Preservation
Theory
 Kemeny et. al. (2005) threats to social self or
social esteem/status are associated with
negative cognitive affective responses like
shame & humiliation and influence physical
health
 For example, those who are sensitive to
rejection related to their sexuality, gay men
experience more rapid progression of HIV
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PSYCHONEUROIMMUNOLOGY
 The interaction between psychology and
physiology that affects body’s ability to
defend against illness.
 Stressors can impair the immune system and
cardiovascular system
 Immune system plays a critical role in
autoimmune diseases and chronic diseases
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Social Aspects of Stress
 Social settings can cause stress and can be a
source of stress relief
 Families, role models etc can model effective
stress reduction techniques and help develop
positive social relationships
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Coping - Cognitive
 Lazarus & Folkman (1975)
 Transactional model – “transaction” b/w
individual & external world. Only stressful if
perceived as stressful
 Appraisal of cognitive & emotional factors
 Primary appraisal – judgment: irrelevant,
positive, negative?
 Secondary appraisal – different relevant coping
strategies considered
 These appraisal are codependent and continuous
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Coping – Lazarus, 1988
Reducing stress by changing events that cause
stress or by changing how we react to stress is
called problem-focused coping (proactive coping).
Emotion-focused coping (avoiding coping) is
when we cannot change a stressful situation,
and we respond by attending to our own
emotional needs.
Often tough to distinguish b/w the two as they
are often used interdependently
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Stress & Control
 Brady - executive monkey experiment
 Weiss’s rats
 Seligman – learned helplessness
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Coping - Social Support
 Testosterone in men = fight or flight
 Oxytocin in women = tend & befriend (Taylor)
 Tend = nurturing activities
 Befriend = seeking social support
 How might culture affect social support?
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Aerobic Exercise
Can aerobic exercise
boost spirits? Many
studies suggest that
aerobic exercise can
elevate mood and wellbeing because aerobic
exercise raises energy,
increases selfconfidence, and lowers
tension, depression, and
anxiety.
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Biofeedback, Relaxation, and Meditation
Biofeedback systems use
electronic devices to
inform people about their
physiological responses
and gives them the chance
to bring their response to a
healthier range.
Relaxation and meditation
have similar effects in
reducing tension and
anxiety.
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Life-Style
Ghislain and Marie David De Lossy/ Getty Images
Modifying a Type-A lifestyle may reduce the
recurrence of heart attacks.
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Spirituality & Faith Communities
Regular religious attendance has been a reliable
predictor of a longer life span with a reduced
risk of dying.
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Intervening Factors
Investigators suggest there are three factors that
connect religious involvement and better health.
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 Application question –
Intro to Addiction
& Obesity
given what you know about classical
conditioning how might
it play a role in a person
developing an addiction?
 Write down a specific
scenario that you think
could lead to a
classically conditioned
addiction.
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Substance Abuse
 What is a substance?
 Defined as anything a person ingests
to alter mood, cognition or behavior
 Most substances can produce
dependence
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Addiction
 What is addiction?
 Suggests an individual cannot control his/her
behavior
 Characterized by behavioral & other
responses that always include compulsion to
use substance continuously to experience the
psych/phys effects and avoid discomfort in its
absence
 To what can one be addicted?
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Psychological vs. Physiological
Addiction
Phys: 1. Tolerance
- Needing more to achieve the same
effect
2. Withdrawal
- What one experiences when
substance is not taken
Examples?
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Psych vs. Phys
Psych: Craving
- Strong desire to do the behavior
often triggered by environmental
factors, mood, psychological state
etc.
- Examples?
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ToKonnectionTM
 Can people be held responsible for
smoking if they have no control over
their behavior?
 Should the public support treatments
of tobacco-related diseases that
follow addiction, such as lung cancer?
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Why Do People Smoke? Bio
 Active ingredient is nicotine (1-2mg per cig.)
 Stimulates release of adrenaline…effect?
 Heart rate up etc.
 Stimulates release of dopamine…effect?
 Pleasure (short term – wears off quickly…then
what?)
 Acts on acetylcholine receptors in brain.
Mimics &reduces natural production-effect?
 Muscle action, learning, memory
 Smoking is also a result of genetic factors
particularly age of starting smoking and
the vulnerability of juvenile brains to
addiction
Why Do People Smoke? Cog & Soc
1. People smoke because it is socially rewarding.
2. If you think it’s cool you’re more likely to start
- 6000 kids under 18 start smoking daily
3. Social Learning Theory
- Parental Smoking one of highest predictors
- US - 80% of 12-14 yr. olds whose parents don’t
smoke never smoked. If parents had smoked ½
had tried it. UK too.
- Parental attitude matters too – strongly against
it? Kids 7x less likely to start
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Peer-Group Pressure
 Remember developmental psych?
 Parents don’t matter – peers do
 Unger et. al. (2001) – cross cultural on CA
teens – European Americans who had close
peers who smoked were more likely to smoke
than Hispanic or Asian Americans
 Individualist cultures create own youth
culture – rebellious. Collectivist culture –
parental bond is important
Social Class
 In most cultures – strong association between
lower socio-econ class and smoking
Prevention
 Prevention strategies?
 Bans/restricted advertising
 Education campaigns (WHO est. 2/3 countries
don’t know the damaging effects)
 Counteract imagery & positive association –
car sponsorships with Indy car and NASCAR
 Raise taxes on tobacco
 Banning smoking in public
Treatment
 Nicotine Replacement Therapy
 Helps prevent short term relapse
 Zyban – helps relieve symptoms
 Individualistic treatments – combo of many
things
Obesity
 THINK – don’t speak – what percentage of adult
Americans are obese? Children 2-19?
 35.7%of adults and 16.9% of children age 2 to 19
are obese, as the Centers for Disease Control
and Prevention (CDC) reported earlier this year
(September 2013).
 State-by-state data projections from the CDC to
say in every state, that rate will reach at least
44% by 2030. In 13 of them, that number would
exceed 60%.
http://www.reuters.com/article/2012/09/18/us-obesity-usidUSBRE88H0RA20120918
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Defining Obesity &
Overweight
 Obesity is defined as having a body mass
index (BMI) above 30. Overweight means a
BMI of 25 to 29.9. BMI is calculated by taking
weight in pounds and dividing it by the
square of height in inches, and multiplying
the result by 703. (Cuz – why not?)
 For instance, someone who is 5 feet, 5 inches
tall and weighs 185 pounds has a BMI of 30.8
 Or use Weight in Kg/Height in Meters2
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 THINK – don’t speak – what percentage of adults
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Americans are overweight?
Most estimates put it at about 2/3 or 66%
THINK – don’t speak – what percentage of adults
Americans are severely obese (>100lbs over a healthy
weight)?
Around 6.6% 1
Interestingly age is not a factor, but gender is
THINK – don’t speak – what countries trail the US in
heaviness?
Mexico, UK, Australia, Slovakia, New Zealand, Czech
Republic & Portugal all above 40% in 2009
Bonus Question – which of the countries above just
passed the US on the fattest countries list in 2013?
Answer: Mexico
1 - http://www.usatoday.com/story/news/nation/2012/10/01/severely-obese-americans-increasing/1606469/
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Discuss
 Why do you think Obesity is an epidemic in the US?
 Why do you think it’s a problem in developing as
well as developed nations elsewhere?
 What factors do you think contribute to obesity –
physiological, cognitive, socio-cult?
 Plot the reasons on the board
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Why is obesity
an epidemic?
 Not a simple answer
 Most researchers say that environmental
factors – availability of food, proportion of fat
in one’s diet, lack of exercise etc. are among
the major causes
 Let’s see what Jamie Oliver says about the
environmental factors – namely, food.
 There are other contributing factors though.
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Physiological
 Genetic predisposition – one obese parent =
 40% obese, two obese parents = 80%, while thin
parents having overweight kids = 7% (Garn, et.
al. 1981)
 How study this link? Identical Twins
 Stunkard (1990) studied 93 sets BMI’s & found
that genetic factors accounted for 66-70% of
variance in body weight but found genetics
played a greater role for slim rather than obese
twins
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Gross
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Physiological cont’d
 Genetic factors are there but the exact role is
still not known
 One theory is metabolism is genetic but its
inconclusive
 Another theory is amount of fat cells and
individual has but it’s unclear
 Finally, the evolutionary theory – fat is storage
for lean times, but now largely unnecessary –
food is everywhere & we’re less active
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Physiological
 The last area of focus is with the hormone
Leptin.
 Leptin levels influence appetite and fat
storage.
 When fat mass falls, plasma leptin levels fall
stimulating appetite and suppressing energy
expenditure until fat mass is restored.
 When fat mass increases, Leptin levels
increase, suppressing appetite until weight is
lost
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Sociocultural
 Two major factors – less physical
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activity & eating behavior
Sedentary lifestyle leads to fat build up
2002 est. that 60% of increase is due to less
activity and 40% to caloric increase
What about overeating?
If it’s compulsive then it’s a psych disorder,
otherwise it’s not been demonstrated to be the
main reason
50 yr British study found home food
consumption is decreasing
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 Conclusion is energy-dense, cheap food, labor
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saving devices, motor transport, sedentary work
are the principal causes
Does this controvert the idea that it’s due to
individual indulgence and laziness?
Prentice & Jebb (1995) – key is to change what
we eat (Jamie Oliver)
Daily caloric intake up 25% from 1973-99
Let’s do a portion distortion quiz
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 Visual Measuring: What does a serving size look like?
 One teaspoon of margarine=one dice
Two tablespoons of peanut butter= a ping pong ball
 3 ounces of meat/fish/poultry=a deck of cards
3 ounces of grilled/baked fish= a checkbook
1.5 ounces of cheese=4 stacked dice
1.5 ounces of cheese=2 cheese slices
 One cup of cereal=your fist
One baked potato=a computer mouse
One cup of salad greens= a baseball
One medium fruit= a tennis ball
One ‘dollop’ of whipped cream=one marshmallow
One pancake=a compact disc (blu-ray)
One slice of bread=a cassette tape (ha!)
One piece of cornbread=bar of soap
 ½ cup of ice cream= ½ baseball
½ cup of fresh fruit= ½ baseball
¼ cup of raisins= one large egg
½ cup cooked pasta/rice/potato= ½ baseball
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Cognitive Factors
 Body image, self-esteem, self-
control (individualistic society)
lead to people dieting
 Cultural norms affect body shape
dissatisfaction
 Dieting replaces physiological
hunger with “cognitive
restraint”, but this is not enough
 Cognitive Restraint Theory says
dieting can actually lead to
obesity!
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Dieting = Obesity (wtf?)
 Obese people often chronic dieters
 Break from diet = personal failure or
loss of control
 External cues – smell of food,
emotional events (low weight
loss=depression), social events etc.
contribute to this
 False Hope Syndrome – overly
optimistic about speed of change and
impact on other areas of their lives
 Forget to use past experiences too
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 Weight loss is slow
 Hence more neg. emotion &
giving in to over eating
 One “slip-up” (ICECREAM!) =
failed overall attempt to lose
weight
 All or nothing approach
 Leads to “what-the-hell
effect” i.e. I already blew it so
wth, I might as well eat
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Prevention
 What strategies can you suggest?
1. Healthy Eating – balance/nutrition
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2. Physical Activity
- Get out an play an hour a day- NFL Play 60
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Treatment
 Psychosocial Approach – diet with info on
healthy living exercise, cognitive
restructuring, & relapse prevention
 Stages of change pg. 252-253
 Drug Treatments – appetite suppressants
(increase NT’s to affect mood and appetite –
make you feel full) & lipase inhibitors
(reduction of fat absorption)
 Lots of drug side affects – nausea,
constipation for AS’s and diarrhea for LI’s
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Cognitive –Behavioral
Therapy
 1. Challenge Eating Behaviors
 2. Challenge Cognitions
 3. Long-term weight loss maintenance
 Involves realistic goal setting, alternative
eating conditions/choices, social supports,
motivating and coping skill development etc.
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Surgery
 Gastric bypass (staples
off part of stomach so it
can’t be used for food
absorption) – initially
only 1 oz. eventually
holds 1.5 cups (normal is
about 1 liter) 1 liter = 4.2
cups
 Gastric banding (puts
band around upper part
of stomach so only lower
part gets food)
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