(Solution Manual) Health Psychology Biopsychosocial Interactions

Sarafino, Smith, 8

Medicine

Solution Manual

8th Edition

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Author(s): Sarafino, Smith

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Solutions Manual for Health Psychology Biopsychosocial Interactions, 8e Edward Sarafino, Timothy Smith (All Chapters ) 1 CHAPTER 1 AN OVERVIEW OF PSYCHOLOGY AND HEALTH CHAPTER OUTLINE I. What is H ealth? A. Section Introduction 1. Common definitions of health focus on lack of : a. objective signs of illness - e.g., high blood pressure b. subjective symptoms of illness - e.g., pain or nausea B. An Illness/Wellness C ontinuum 1. The concepts of health and s ickness overlap 2. Antonovsky p roposes an illness/wellness continuum with polar ends of death /illness/disability v. optimal wellness a. nee d to change focus from what makes people sick to what keeps people well 3. Health = the positive state of physical, mental and social well -being that varies over time along a continuum C. Illness Today and in the Past 1. In industr ialized nations, people live longer than in past and suffer from different patterns of illnesses 2. Until t his century, people in North America died from mainly dietary and infectious diseases a. dietary illnesses : illnesses resulting from malnutrition suc h as beriberi (lack of vitamin B1) b. infectious diseases : acute illnesses caused by harmful matter or microorganisms (bacteria or viruses); main cause of death in most of world today 3. History of diseases in US a. 18th century : epidemics of smallpox, diphtheria, yellow fever, measles and influenza killed thous ands, esp. children i. infectious diseases such as malaria and dysentery weakened victims and made them susceptible to other fatal diseases ii. such diseases were introduced to America by European settlers 1) Native Americans died at high rates due to lack of previous exposure and natural immunity; lack of immunity probably due to low degree of genetic variation b. 19th century : new infectious disease beginning to emerge (e.g., tuberculosis) i. decrease in deaths from infectious diseases by end of 19th century ii. cause of decline 2 1) improved personal hygiene 2) better nutrition resulting in greater resistance to disease 3) public health innov ation (e.g., water purification and sewage treatment facilities) 4) increased persona l concern about health and following advice of health reformers c. 20th century : death rate due to infectious disease declined and average life expectancy increased i. increase in infant life expectancy from 48 years to 77 years ii. chronic disease leading cause of health problems and half of all deaths in developed countries 1) definition = degenerative illnesses that develop or persist over long period of time 2) examples = heart disease, cancer, stroke 3) reasons = increase in industrialization increases stress and exposure to harmful chemical s; longer life span places people at higher risk for chronic disease 4. Main causes of death across the life span a. children – accidental injury , cancer, & congenital abnormalities b. adolescents – accidental injury, homicide, suicide II. Viewpoints from History: Physiology, Disease Processes, and the Mind A. Early Cultures 1. Belief that physical and mental illness caused by mystical forces (e.g., evil spirits) a. speculative evidence - use of trephination to allow spirits to escape B. Ancient Greece and Rome 1. Hippocrates’ humoral theory a. health was due to harmony or balance of four humors whereas illness was the result o f an imbalance of bodily fluids b. health recommendations included good diet, avoiding excesses to keeps humors in balance 2. Introduction of t he mind/body problem a. Greek philos ophers, including Plato, argued that the mind and body are separate entities (mind has little impact on the body and its state of health) 3. Influence of Galen a. believed in humoral theory and mind -body split b. innovations attributed to Galen - animal di ssections to discover how systems work, localization of illness, and belief that different disease have different effects C. The Middle Ages 1. With collapse of Roman Empire, advancement of knowledge and culture slowed dramatically 2. Impact of the Church on slow ing development of medical knowledge 3 a. prohibition on human and animal dissection b. belief that creatures with a soul were set apart from ordinary laws of the universe 3. Illness was believed to be a punishment for sin a. medical treatments involving use of torture to drive evil spirits out of body were done by clergy under this belief 4. Influence of St. Thomas Aquinas a. church scholar who saw the mind and body as interrelated unit that forms whole person D. The Renaissance and After 1. Period witnessed rebirth of inquiry, culture, politics, belief in “human - centered” focus; set stage for changes in philosophy o nce scientif ic revolution began 2. Influence of Descartes a. advan ced notion of "body as machine" and described mechanics of body action and sensation b. believed the mind and body, although separate entities, communicated through pineal gland c. argued soul left huma ns at death; therefore dissection on humans acceptable 3. Changes in science & medicine a. knowledge increased due to technological improvements (e.g., microscope) and use of dissection b. rejection of humoral theo ry and development of new theories due to increased knowledge of body functions and discovery of microorganisms c. surgical practice improved by antiseptics & anesthesia d. status of hospital changed to "place of healing" along with more respect for abilit y of doctors to heal 4. Biomedical model a. new approach to conceptualizing health/illness that proposes physiological problem s cause afflictions of the body b. health/il lness of body separated from psychologica l/social experience of the mind c. dominant perspective in medicine since 19th century III. Seeing a Need: Psychology’s Role in Health A. Section Introduction 1. Biomedical model led to: a. development of vaccines and reduction in infectious disease b. development of antibiotics and cures to illnesses from bacterial infection 2. Despite advances, bio medical model needs improvement B. Problems in the Health Care System 1. Health care costs comprise an increas ing percentage of the GD P 2. Chronic diseases a re now the main health problems a. improvements in t reatment s have been modest 3. People have changed 4 a. higher levels of knowledge, more motivation, better able to afford medical care b. “the person ” still left out of biomedical model C. “The Person” in Health and Illness 1. Section i ntroduction a. individual differences in tendency toward illness due to: i. biomedical sources such as physiological processes or exposure to microorganisms ii. psychological and social factors 2. Lifestyle and i llness a. lifestyle modifications (changes in everyday patterns of behavior) may affect characteristics associated with health problems b. risk factors = biological or behavioral characteristics/conditions associated with development of a disease or injury i. biological risk factor example : inherited genes ii. behavioral risk factor examples: smoking, eating high saturated fat diet iii. having more risk factors are associated with (but don’t necessarily cause) higher l ikelihood of developing disease c. behavioral risk factors associated wit h five leading causes of death: i. heart disease = smoking, high dietary cholesterol, obesity, lack of exercise ii. cancer = smoking, high alcohol use, diet iii. stroke = smoking, high dietary cholesterol, lack of exercise iv. Chronic Obstructive Pulmonary Disease ( COPD ) = smoking v. accidents = alcohol/drug use, not using seat belts d. lifestyle contributes to health problems and high medical costs i. society bears burden of medical costs through public and private insurance programs e. influence of lifestyle factors on health i. seven lifestyle practices related to current and future health 1) practicing all seven practices resulted in health simila r to younger persons 2) incidence of death decreased as number of health practices increased, esp. for older persons f. why people persi st in unhealthy behaviors i. immediate pleasures of less healthful behavior ii. remote negative consequences iii. soc ial pressures to engage in unhealthful practice iv. strong habit of behavior (e.g., addiction or dependency) v. lack of awareness of dangers associated with health behaviors or how to change behavior 3. Personality and i llness a. personality = person’s cognitive, affective, or behavioral tendencies that are fairly stable across time/situation b. evidence linking personality traits to health 5 i. low levels of conscientiousness and poor mental health linked to heart disease ii. anxiety, depression, anger/hostility or pessimism linked to variety of diseases, esp. heart disease iii. negative emotions linked to reaction to stress 1) positive emotions (e.g., optimism, hopefulness) linked to lower illness rates, quicker recovery w hen ill c. illness may affect p ersonality and emotional states i. reaction to serious illness/disability may be anxiety, depression, anger and hopelessness ii. overcoming negative thoughts/feelings may increase recovery D. How the Role of Psychology Emerg ed 1. Section i ntroduction a. ancient Greeks connected medicine and psychology b. Freud felt physical symptoms could be an expression of unconscious conflicts i. evidence - conversion hysteria c. need for explanation led to development of field of psychos omatic medicine 2. Psychosomatic m edicine a. field, formed in 1930s, concerned with the interrelationships among the psychological and social factors, the biological and physiological functions of illness, and the development & course of illness b. theoretical foundation is psychoanalytic with a focus on psychoanalytic interpretation of specific, real health problems 3. Behavioral m edicine and h ealth psychology a. fields emerged in 1970s to study role of psychology in illness b. behavioral medicine : an interdisciplinary field involving psychology, sociology, medicine & others i. theoretical foundations in cla ssical and operant conditioning ii. evidence that psychol ogical events influence bodily functions and that people can learn to control physiological systems supported the link between mind and body 1) conditioning methods important in therapeutic approaches (e.g., biofeedback) used to modify behaviors and emotio ns c. health psychology : recently developed sub -discipline in psychology also emphasizing behaviorism i. primary goals of health psychology 1) promote and maintain health by studying facto rs involved unhealthy behaviors 2) prevent illness by reducing risk factors, and to treat those with illnesses 6 3) identify the causes and diagnostic correlates of health, i llness, and related dysfunction 4) analyze and improve health care systems and health policy 4. An integration a. general similarity : all have similar goals, study si milar topics, & share same knowledge ; shared belief that health & illness results from biological, psychological and social forces b. how they differ : separate organizations; varying emphasis on specific topics/viewpoints i. psychosomatic medicine – continued close ties to medicine and application of psychiatry ii. behavioral medicine – focus on interventions that do not use drugs or surgery iii. healt h psychology – relies on information from other subdisciplines in psychology to identify/alter lifestyle and emotional processes related to illness E. Health Psychology: The Profession 1. Work l ocations and primary a ctivities a. clinics and hospitals – providing direct help to patients b. academic departments – indirect help through research, teaching and consulting 2. Nature of clinic/hospital work a. promoting emotional & social adjustment to illness or disability b. helping patients manage health p roblems by teaching psychological methods of intervention (e.g., controlling pain) 3. Research and teaching a. providing information from research about lifestyle & personality factors that contribute to health and illness b. designing interventions to pro mote health c. educating medical personnel about psychosocial needs of patients 4. Educational/training requirements a. doctoral degree in psychology b. clinical health psychology = APA accredited specialty c. state licensing & board certification availabl e IV. Current Perspectives on Health and Illness A. Section Introduction 1. The biopsychosocial model expands on the biomedical model and involves the interplay of biological, psychological, and so cial aspects of a person’s life 2. Model assumes 3 factors affect and are affected by health/illness. B. The Biopsychosocial Perspective 1. The role of b iological f actors a. involves the study of inherited genetic materials and processes as well as physiologic functioning including structu ral defects and immuniological activity 7 b. healthful functioning of body depends on how component physical systems in body operate and interact with each other 2. The role of psychological f actors a. role of lifestyle and personality involves describing be havior and mental processes – the focus of psychology i. cognition - mental activities of perception, thought, belief systems, decision -making influence health/illness experience ii. emotions - positive & negative emotional states influence and are influen ced by health/illness 1) influence decisions to seek treatment iii. motivation - defined as why people do what they do 1) part of explanation for adaptive and maladaptive health behaviors, participation in health intervention programs 3. The role of social f actors a. peer pressure related to adolescents engaging in smoking and drinking b. society establishes health values resu lting in both positive and negative behaviors ( e.g., mass media promotions ) c. community values and community’s environmental characteristics influence extent to which its members engage in health -related behaviors d. family - socialization provides strong influence on the health - related behaviors, attitu des, and beliefs of its members 4. The concept of “s ystems” a. addressing the “whole person” acknowledges that people and reasons for their behavior are complex b. a holistic approach considers all aspects of a person’s life as a total entity and is consistent with the biopsychosocial approach c. system = a dynamic entity of continuously interrelated components with smaller components nested within larger components (i.e., levels) i. events in one system inf luences events in other systems C. Life-Span and Gender Perspective 1. Life-span perspective - an approach in which a person is considered in the context of their prior development, current development, and likely future d evelopment a. illnesses experienced vary with age b. pediatrics and geriatrics = branches of medicine dedicated to health/illness of children and elderly c. biopsychosocial systems change as we age i. biological - e.g., p hysiological growth & decline ii. psychological - e.g., cognitive changes influence knowledge , ability to think, accepting responsibility for change, understanding implications of illness & rationale for changing health -related behaviors 8 iii. social - e.g., shift in health care -giving responsibilities from care -givers to self ; influences of peers or important others on behavior 2. Gender perspective – an approach that looks at how males and females differ in terms of biological functioning, health -related behaviors, social relationships, and risk for specific illnesses. V. Relating Health Psychology to Other Science Fields A. Related Fields 1. Epidemiology - scientific study of the distribution and frequency of disease and injury a. investigate oc currence of illness and attempt to determine why it was distributed among the people it affected b. epidemiological terminology used to describe findings i. mortality - number of deaths, usually on a large scale ii. morbidity - any illness, injury, or disability iii. prevalence - the number of cases including both continuing and new cases at a given time iv. incidence - the number of new cases of illness, infection, or disability in a period of time v. epidemic - the rapid inc rease in incidence c. use of term “rate” adds relativity to meaning (e.g., mortality rate = number of deaths per number of people in a given population during specified period of time) 2. Public health - field concerned with protecting, maintaining and improving health in the community through o rganizes effort. a. engaged in conducting research and establishing programs to promote and provide health -related services b. studies health/illness in context of the community as a social system 3. Sociology - evaluates the impact of social factors on gr oups or communities of people. a. medical sociology is concerned with social factors involved with distribution of illness, social reactions to illness, socioeconomic factors of health care use, ways in which hospital services/medical practices are organiz ed 4. Anthropology - the study of cultures a. medical anthropology - study of cross -cultural differences in health, illness and health care. 5. Impact of other disciplines on health psychology a. the perspectives from other fields provide a broad perspecti ve on health/illness and are incorporated into the discipline for explaining influences on health and illness B. Health and Psychology Across Cultures 1. Health and illness vary across history since, over time, lifestyles in cultures change 2. Sociocultural differences in h ealth 9 a. “sociocultural ” refers to social and cultural factors, such as ethnic and income varia tions within and across nations b. sociocultural differences have been observed in illness patte rns, diets, and he alth-related beliefs and values 3. Sociocultural differences in health b eliefs an d behavior a. ideas about cause of illness vary across time and culture i. affect s beliefs about a ppropriate treatment approaches ii. example : beliefs about balance of yin and yang and the use of acupuncture to correct their balance b. religious beli efs affect health practices i. example : Jehovah’s Witnesses reject use of blood; Christian Scientists re ject use of medicine entirely ; Seventh Day Adventists view body as “temple” and urge followers to take care of their bodies VII. Research Methods A. Section Introduction 1. Theory = tentative explanation of why and under what circum stances certain phenomena occur a. characteristics of a "useful" theory i. clearly stated ii. bring s together or organizes known facts iii. relate s information that previously seemed unrelated iv. enable s us to make predictions b. role of theory i. guides research by providing a "roa dmap" of relationships to study 2. Variables - characteristic s of people, eve nts, or objects that may change a. independent variable - the variable manipulated direc tly and independentl y of variables not in the study b. dependent variable - some outcome that is measured and is dependent on the effects of the m anipulated independent variable B. Experiments 1. Experiment: a controlled study in which the researcher manipulates a variable to study its effects on another variable 2. The e xperime ntal method: a hypothetical e xample a. a prediction or hypothesis of a theory is developed and tested b. participan ts are assigned rand omly to groups in order to distribute characteri stics equally across the groups c. experimental group receives the trea tment or procedure being tested d. control group does not receive the trea tment or procedure being tested e. placebo, an inert substance, may be given to a third group to test for the effects of expectations 10 f. double -blind approach, where neither subject nor experimenter know assignment to condition, may be used to control for experimenter demand 3. Criteria for cause -effect conclusion a. levels of independent and dependent variables corresponded or varied toget her b. cause preceded the effect c. other plausible causes ruled out 4. Comparing experimental and nonexperimental m ethods a. determining caus ation i. in experiments, causation may be test ed because an IV is manipulated ii. in nonexperimental methods, causation may not be tested because an IV is not manipulated b. nonexperimental methods are useful when it is not possible, feasible, or ethical t o manipulate a variable of interest, or when an association between variables is to be demonstrated C. Correlational Studies 1. When aim of research requires only that association between variables be sho wn, correlational research used a. example : research on risk factors 2. “Correlation ” refers to the joint relation that exists between variables. a. correlation coefficien t can range from +1.00 to -1.00 i. absolute value of coefficient indicates strength of the association b. positive correlation indicates that high scores on one variable are associated with high scores on another c. negative correlation indicates that high scores on one variable tend to be associated with low scores on the other variable d. because one can’t manipulate the variables of interest, causal statement can’t be made 3. Correlational studies are useful for a. examining existing relationships and variables that cannot be manipula ted b. developing hypotheses c. generating pre dictive information D. Quasi -Experimental Studies 1. Quasi -experimental studies are similar to experiments except a. variables that define the group are not manipulated (e.g., gender) b. participan ts cannot be randomly assigned to the groups c. conclusions from quasi -experimental studies a re correlational and not causal 2. Retrospective and prospective a pproaches a. retrospective – look back at past history of people who have developed a particular illness is compared to tha t of members of a control group i. purpose - to find commonalities in people's histories that may suggest why they developed a disease 11 ii. shortcoming – faulty memory may contribute to inaccurate reports b. prospective – look forward in lives of individuals to determine if differences in variable at one point in time are related to differences in anothe r variable at a later time i. more plausible causal c onnection ii. is potentially costly and time -consuming approach c. approaches developed by epidemiologists and used to identify risk factors for specific illnesses 3. Developmental a pproaches a. approaches designed to study differences between people of different ages or of the same people across time i. cross-sectional approach - individuals at different ages are observed at about the same time ii. longitudinal approach - the repeated observation o f the same individuals over time 1) like prospective approa ch, potentially costly and time-consuming 2) subject to loss of participants over time 3) valuable approach to examine change and stability in lives of participants b. cohort effect - generational effect due to historical exp eriences of a group of subjects 4. Single -subject a pproaches a. case study - in-depth examination of an individual from a person’s history, interviews, and current observation i. useful for describing development and treatment of an unusual problem b. single -subject design – a single participant study i. initial assessment is made before and after some intervention is made ii. useful in determining effectiveness of new treatment method c. disadvantages of single -subject approaches i. low generalizability d. advantages i. stimulates development of new treatments ii. suggests new topics for research E. Genetics Research 1. Genetic materials and t ransmission a. chromosomes – threadlike structures that contain genes b. genes – contain discrete particles of DNA i. genetic information is transmitted from parent to child ii. dominant genes – single gene o f a gene pair that contributes to the presence of a trait iii. recessive genes – when two identical genes in a gene pair contribute to the presence of a trait 12 c. DNA – basic substance of all genetic material that determines growth pattern and physical stru ctures. 2. Twin and a doption s tudies a. types of twins i. monozygotic (MZ) twins – twins conceived together who have identical genetic material ii. dizygotic (DZ) twins – twins conceived separately and have no more genetically similar than singly born siblings b. twin studies – research on hereditary factors that focuses on differences in MZ twins compared to differences in DZ twins i. since MZ twins share same genetic material, differences between them are assumed due to environmental factors ii. differences observed in DZ twins assumed to be due to both genetic and environmental factors iii. if assume MZ and same -sexed DZ twins have equal environmental experience, can measure genetic influence by subtracting differences from MZ pair from differences from DZ pair c. adoption stud ies – research in compare traits of adopted children with those of both natural and adoptive parents i. if children are more similar to their natural parents than to adoptive, assume this is due to genetic influence d. conclusions observed from twin and adoption studies i. heredity affects physical characteristics & physiological functioning ii. genetic disorders affect levels of cholesterol & thus heart disease iii. heredity has greatest impact early in life; lifestyle & habits affects health in later l ife iv. environmental factors play a greater role than genetics in cancer development 3. Linking specific genes and diseases a. examples of genes related to disease i. sickle -cell anemia – sickle -shaped red blood cells due to presence of recessive gene in some African Americans ii. phenylketonuria – inherited disease in which baby’s body fails to produce enzyme necessary for metabolizing the toxic amino acid phenylalanine iii. oncogenes – genes related to development of cancer 4. Epigenetic Effects a. epigenetics – process in which chemical structures within or around DNA govern how, when, and how much a gene acts i. can be passed on to offspring ii. environmental events can change epi genetic process iii. epigenetic changes can influence response to stress, ability to learn and remember, and development of health problems F. Deciding which method is best 13 1. Each method h as disadvantages and advantages a. experiments : can uncover cause -effect relationships but done in artificial conditions (not like real -world settings) i. ecological momentary assessment - a procedural method , using pagers to cue and collect data from individuals periodically during the day, that might hel p correct artificiality problem 2. Combining experimental and nonexperimental method s in same study may be possible and desirable a. example : does reading information on health effects of excessive cholesterol induce people to change their diets i. experimental manipulation = reading cholesterol information in experimental group v. reading other literature in control group ii. quasi -experiment al measure = age of participants 14 DISCUSSION TOPICS 1. Cultural Differences in Defining Health The introductory topic in Chapter 1 centers on developing a definition for health. Sarafino places common beliefs in the absence of illness as indicator s of health in contrast with Antonovsky's illness/wellness continuum. David Matsumoto (2000) expands on these themes to the extent that he sees them as being embedded in a cultural context. For example, Matsumoto notes that the medical model, the traditi onally popular view of illness in the US, focuses on disease that results from some "specific, identifiable cause originating inside the body" and treatment of disease then requires eliminating the pathogens that "exist within a person's body." Health is therefore the lack of disease within the body. Matsumoto goes on the describe definitions of health as they occur in other cultures. In Asian cultures, he suggests, health is defined as the "balance between self and nature and across the individual's vari ous roles in life." The synergy between nature, self, and others can result in a positive state called health. Matsumoto connects this vision with current definitional debates occurring in the US and ties it to the emergence of biobehavioral medicine and health psychology. As part of a discussion session, have students consider the theme of "residing within the body". How have we seen similar explanations in mental health? How is it more generally linked to causal explanations that are common in our cult ure? Source : Matsumoto, D. (2000). Culture and psychology: People around the world . (2nd ed.). (pg. 230). Stamford, CT: Wadsworth. 2. Sex and Gender Bias in Animal and Human Research . Since Chapter 1 introduces research methodologies to the student, this would seem to be an appropriate section to discuss the claims of sex and gender bias in clinical research using animal and human participants. Reviews on the topic by Rodin and Ickovic s (1990) and Sechzer and colleagues (1994) might serve as the basis for the presentation. While they both highlight the efforts to change requirements for participant inclusion in human research, Sechzer and her colleagues note particular problems in anim al research with respect to the under -representation of female animal subjects in studies, lack of information regarding the sex/gender of participants in studies, and overgeneralization of findings drawn from male samples to females. Standards for report ing of findings are presented. Sources: Rodin, J., & Ickovics, J.R. (1990). Women's health: Review and research agenda as we approach the 21st century. American Psychologist, 45(9) , 1018 -1034. Sechzer, J.A., Rabinowitz, V.C., Denmark, F.L., McGinn, M.F., Weeks, B.M., and Wilkens, C.L. (1994). Sex and gender bias in animal research and in clinical studies of cancer, cardiovascular disease and depression. In J.A. Sechzer, A. Griffin, and S. Pfaf flin (Eds.), Forging a women's health research agenda: Policy issues for the 1990s . New York: New York Academy of Sciences. 15 3. Introducing Alternative and Complementary Medicines . With the growing use of alternative and complementary medicines by hea lth consumers, some discussion of the types of careers available in these fields may expand the discussion introduced by Sarafino in this chapter. One source of information is Dianne Lyons' book on careers in alternative medicine in which she provides an overview of various fields of alternative medicines and profiles schools providing training in these various specialties. She also provides information regarding accreditation, licensure and certification, and professional associations specific to alterna tive medicine specialties. Source: Lyons, D.J.B. (1997). Planning your career in alternative medicine: A guide to degree and certificate programs in alternative health care . Garden City Park, NY: Avery. 4. Cultural Differences in Health Care and Medic al Delivery Systems . The "social" in the biopsychosocial perspective also includes institutionalized forms of health care delivery. Matsumoto contends that health care delivery systems are products of many factors including the country's level of social and economic development, the nature of technological advances and their availability to people, the level of urbanization and industrialization within the country, governmental structure, international trade laws and practices, and demands for privatizati on and public expenditures. He describes the United States as "an example of a country with a relatively high economic level that uses an entrepreneurial system of health care, characterized by a substantial private industry covering individuals as well a s groups." He goes on to attest that "it makes sense that an entrepreneurial system is used in the United States, for example, because of the highly individualistic nature of the American culture." This observation makes for an interesting starting point in a discussion with students regarding the influence that culture has with their health and illness experiences. Source : Matsumoto, D. (2000). Culture and psychology: People around the world . (2nd ed.). (pp. 246-247). Stamford, CT: Wadsworth. 5. Stem Cell Research Debate . The public and scientific debate regarding the use of stem cell derived human embryos highlights the ethical problems in the genetic chase to find solutions for diseases such as diabetes, Parkinson's disease, and spinal cord inju ries. An article in Newsweek magazine (2004) can be used as a starting point for the discussion of genetic processes in health. The political, scientific, and social aspects of the debate are highlighted. Source : Kalb, C., Rosenburg, D., & Ulick, J. (20 04). Stem cell division, Newsweek , 144(17) 42-48. 16 More information for this discussion can be found by going to: http://stemcells.nih.gov/info/ethics.asp - stem cell information from NIH http://www.time.com/time/2001/stemcells/ - Time magazine series on stem cell research ACTIVITY SUGGESTIONS 1. Assess Yourself: What's Your Lifestyle Like? Have students complete Handout #1: What's Your Lifestyle Like? Discuss whether there are p oints of ambiguity or potential weaknesses in these questions. 2. Health Risk Appraisal . A generous number of health risk appraisals can now be completed on -line. HRAs can be easily found by entering the key phrase "Health Risk Appraisal" on most major search engines. Have students complete one and then compare its format to the Assess Yourself exercise above. To extend this exercise, have students pick one or two identified risk areas and develop a plan to improve their functioning on those areas. 3. Journal Comparison . Obtain copies of Psychosomatic Medicine , Journal of Behavioral Medicine , and Health Psychology . Compare and contrast the types of problems studied and the approaches taken. Have the students find at least one example of an experim ent, a quasi -experimental study, a retrospective study, a prospective study, and a case study. In particular, have students report on the gender/sex bias argument presented in Discussion item 2. 4. Health Psychology and Health Care Professions . Studen ts may be interested in finding out more information about Health Psychology and the other health care professions described in the chapter. Have students go to the Division 38 - Health Psychology webpage (http://www.health -psych.org/) and explore the edu cational and training programs for becoming a health psychologist. Another resource that stud ents may consult is the book Career Paths in Psychology: Where your degree can take you by R.J. Sternberg (2006, American Psychological Association). The followin g chapter provides an overview of the work done by clinical psychologists employed in hospital settings: Daly, B.P. , & Brown, R.T. Clinical psychologists in hospitals, pp. 179-200. For other health care professions, the book Career Opportunities in Healthcare by S. Field (2002, New York: Facts on File), has salary, skill requirement, and advancement opportunity information on 70 careers in health including art therapy, athletic training, dance therapy, music therapy, occupatio nal therapy, prosthetistics, physical therapy, rehabilitation counseling, social work, speech pathology and audiology, and therapeutic recreation specialist. Students might find information regarding education and training programs for specific areas of i nterest on -line using sites such as: 17 www.bls.gov/oco/oco1002.htm - U.S. Dep artment of Labor – Bureau of Labor Statistics, Occupational Outlook Handbook of Professional and related occupations 5. The Evolution of Health Psychology as a Field . Have students read each of the four articles below that demonstrate the changing views within the field of health psychology. Starting with the earliest article by Matarazzo in 1980 introducing the field and the concept of the biopsychosocial model of medicine, each article is an example of how the field has grown in scope and ambition. After students have read each article, discuss in class the implications of each article in terms of what is emphasized and the influence each may have had on the field. A n alternative may be to have the students read different articles and discuss as a class what stood out about the article they read. Johnson, N.G. (2003). Psychology and health: Research, practice, and policy. American Psychologist , 58(8), 670 -677. Matara zzo, J.D. (1980). Behavioral health and behavioral medicine: Frontiers for a new health psychology. American Psychologist , 35(9), 807 -817. Taylor, S.E. (1990). Health psychology: The science and the field. American Psychologist , 45(1), 40 -50. Taylor, S.E. (1987). The progress and prospects of health psychology: Tasks of a maturing discipline. Health Psychology , 6(1), 73 -87. 18 Handout #1 Assess Yourself: What's Your Lifestyle Like? This survey assesses seven aspects of your usual lifestyle. For each of the listed practices, put a check mark in the preceding space if it describes your usual situation. _____ I sleep 7 or 8 hours a day. _____ I eat breakfast almost every day. _____ I rarely eat between meals. _____ I am at or near the appropriate weight. _____ I never smoke cigarettes. _____ I drink alcohol rarely or moderately. _____ I regularly get vigorous physical activity. _____ Total number of check marks. 19 RESOURCES Suggested Readings: Culture, g ender , age and health Aboud, F.E. (1998). Health psychology in global perspective . Thousand Oaks: Sage. Alexander, L. L. (2007). New dimensions in women’s health . Sudbury, MA: Jones and Bartlett. Ammer, C. (2005). The encyclopedia of women’s health . New York: Facts on File. Helman, C. (2007 ). Culture, health, and illness . New York: Oxford University Press . Jacobsen, K.H. (2008). Introduction to global health . Sudbury, MA: Jones and Bartlett. Loue, S. (1999). Gender, ethnicity, and health research. New York: Kluwer Academic/Plenum Publ. Loustaunau, M.O., & Sobo, E.J. (1997). The cultural context of health, illness, and medicine. Westport, CN: Bergin & Garvey. MacLac hlan, M. (2001). Cultivating health: Cultural perspectives on promoting health . New York, NY: John Wiley & Sons Ltd. Marmot, M., & Wilkinson, R.G. (2006). Social determinants of health . Oxford: Oxford University Press. Maxwell, J., Belser, J., & David, D. (2007). A health handbook for women with disabilities. Berkeley, CA: Hesperian. Meyer, I. & Northridge, M.E. (2007). The health of sexual minorities: Public health perspectives on lesbian, gay, bisexual and transgend er populations . New York;London: Springer. National Institutes of Health (2006). Women of color health data book: adolescents to seniors . Bethesda, MD: Office of Research on Women’s Health. Niven, C.A. & Carroll, D. (1993). The health psychology of women . Chur, Switzerland: Harwood Academic. Seear, M. (2007). An introduction to international health . Toronto: Canadian Scholars’ Press. Shankle, M. (2007). The handbook of lesbian, gay, bisex ual, and transgender public health . Binghampton, NY: Haworth Press. Sheikh, A. & Sheikh, K. (1989). Eastern and western approaches to healing: ancient wisdom and modern knowledge . New York: Wiley. US Dept. of Health and Human Services (2005). The healt h and well -being of children in rural areas: a portrait of the nation, 2005 . Rockville, MD: US Dept. of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau. Psychology’s role in health Adler, N., & Matthews, K. (1994). Health psychology: Why do some people get sick and some stay well? In L.W. Porter & M.R. Rosenzweig (Eds.). Annual Review of Psychology . (Vol. 45, pp. 229 -259). Palo Alto, CA: Annual Reviews. Boll, T.J., Frank, R.G., B aum, A. et al. (2004) Handbook of clinical health psychology: Volume 3. Models and perspectives in health psychology . Washington D.C.: American Psychological Association. 20 Boyer, B.A. & Paharia, M. I. (2008). Comprehensive handbook of clinical health psychology. Hoboken, NJ: Wiley & Sons. Freidman, H.S. & Silver, R. (2007). Foundations of health psychology . New York: Oxford University Press. Johnson, N.G. (2003). Psychology and health: Research, practice, and policy. American Psychologist , 58(8), 670 -677. Karoly, P. (1985). Measurement strategies in health psychology . New York: Wiley. Luecken, L.J. & Gallo, L.C. (2008). Handbook of physiological research methods in health psychology . Los Angeles: Sage Publ. Smith, T.W., Orleans, T.C., & Jenkins, D.C. (2004) Prevention and health p romotion: Decades of progress, new challenges, and an emerging a genda. Health Psychology , 23(2) 126 -131. Suls, J. & Wallston, K.A. (2003). Social psychological foundations of health and illness . Malden, MA: Blackwell Publishers Taylor, S.E. (1990). Health psychology: The science and the field. American Psychologist, 45 , 40-50. Current perspectives on health and illness Cook, A.R. (1999). Alternative medicine sourcebook: Basic consumer health information . Detroit, MI: Omnigraphics. Fontanarosa, P.B. (Ed.) (2000). Alternative medicine: An objective assessment . Chicago, IL: American Medical Association. Gesler, W.M. (1991). The cultu ral geography of health care . Pittsburgh, PA: University of Pittsburgh Press. Gordon, J.S. (1996). Manifesto for a new medicine: Your guide to healing partnerships and the wise use of alternative therapies . Reading, MA: Addison - Wesley. Hafferty, F.W. , & McKinlay, J.B. (1993). The changing medical profession: An international perspective. New York: Oxford University Press. Haugen, D. (2008). Alternative medicine . Detroit: Greenhaven Press. Jonas, W.B. & Levin, J.S. (Eds.) (1999). Essentials of co mplementary and alternative medicine . Philadelphia: Williams & Wilkins. Kutner, M. et al (2006). The health literacy of America’ s adults: Results from the 2003 National Assessment of Adult Literacy . Washington, D.C.: U.S. Dept. of Education, National Center for Education Statistics. Lyons, D. (1997). Planning your career in alternative m edicine . Garden City Park, NY: Avery. Mijares, S.G. (2003). Modern psychology and ancient wisdom: Psychological healing practices from the world’s religious traditions . New York: Haworth Press Inc. Pelletier, K.R. (2000). The best alternative medicine: What works? What does not? New York: Simon & Schuster. Shorter, E. (1992). From paralysis to fatigue: A history of psychosomatic illness in the modern era . New York: Free Press. Relating health psychology to other fields de La Cancela, V., Chin, J., & Jenkins, Y. (1998). Commun ity health psychology: Empowerment for diverse communities . New York: Routledge. 21 Kazarian, S.S. & Evans, D.R. (2001). Handbook of cultural health psychology . San Diego, CA: Academic Press. Herman, C.E. (Ed.). (1997). Special issue: Psychological aspe cts of genetic testing. Health Psychology, 16 . Lopez -Casasnovas, G., Rivera, B., & Currais, L. (2005). Health and economic growth: findings and policy implications . Cambridge: MIT Press. Sahler, O.J. & Carr, J.E. (2007). The behavioral sciences and h ealth care . Cambridge, MA: Hogrefe. Journals related to health psychology • Journal of Behavioral Medicine • Journal of Clinical Psychology in Medical Settings • Journal of Health Psychology • Journal of Immigrant H ealth • Journal of I mmigrant and Minority H ealth • Journal of Psychosomatic Medicine 22 Suggested Films and Videos: Psychology’s role in health 1. Achieving Psychosocial Health . (2001, Films for the Humanities and Sciences, 29 min). Explains the elements of psychosocial health. 2. Discovering Psychology (Program 23 -24) (2001, WGBH Educational Foundation, 60 min). Program 23 examines psychological research related to the bio -psycho - social model of medicine. 3. Emotion and illness (1995, Films for the Humanities and Sciences, 30 min). Discusses the role that emotions play on physical health. Current Perspectives on health and illness 1. Alternative Medicine . (2002, Films for t he Humanities and Sciences, 52 min). A look at alternative medicine techniques from practitioners and respected critics. 2. Alternative medicine: Expanding your horizons in healthcare choices . (1995, Aquarius Productions, 29 min). Reviews alternative or complementary health systems, such as naturopathy, homeopathy, Chinese & Indian medicine, and others. 3. Medicine at the Crossroads: The Magic Bullet . (1993, WNET/BBC -TV, 57 min). Looks at the expectation that medicine can provide "a pill" to solve all h ealth problems. 4. Medicine at the Crossroads: Code of Silence. (1993, WNET/BBC -TV, 57 min). Takes the viewer into the world of medical training, cross -cultural experiences with disease, and the patient interface with medical systems. 5. Medicine at the C rossroads: Temple of Science. (1993, WNET/BBC -TV, 57 min). The world of the teaching hospital is highlighted using Johns Hopkins as an example. Sophisticated technological successes and production of leading doctors/scientists are placed in contrast wit h primary care provision. Internet sites of interest: Psychology and Health 1. http://www.apa.org - The American Psychological Association 2. http://www.psychologicalscience.org - American Psychological Society 3. http://www.sbm.org/ -The Society of Behavioral Medicine 4. http://www.apm.org / - The Acade my of Psychosomatic Medicine 5. http://sosig.esrc.bris.ac.uk - Social Science Inform ation Gateway Women and Minority Health 6. http://www.4women.gov – The National Women’ s Health Information Center 7. http://www.pitt.edu/~ejb4/min/ - The Minority H ealth Network 8. http://www.omhrc.gov/OMHRC/index.htm - Office of Minority Health Resource Center 23 Professional Organizations 9. http://www.aapa.org - The American Academy of Physician Assistants 10. http://www.aanp.org - The American Academy of Nurse Practitioners 11. http://www.aota.org - The American Occupatio nal Therapy Association 12. http://www.apta.org - The American Physical Therapy Association 13. http://www.naswdc.org - The National Association of Social Workers 14. http://www.nln.org - The National League for Nursing 15. http://www.who.int - World Health Organization 16. http://www.cdc.gov/nchs - National Center for Health Statistics 17. http://www.census.gov - United States Census Bureau Alternative Medicine 18. http://www.pitt.edu/~cbw/internet.html - Alternative Medicine Resources Index 19. http://www.altmedicine.com/ - Alternative Health News Online 20. http://www.amfoundation.org/ - Alternative Medicine Foundation 24 TEST QUESTIONS True or False F 1. Advances in medical treatment were responsible for a sharp decrease (4) in infectious diseases at the turn of the 20th century. T 2. Today , accidental injury is the leading cause of death in children and (5) adolescents in the United States. F 3. During the Middle Ages, the influence of the Church resulted in many (6) major advancements in medical knowledge . F 4. “Risk factors ” are those biological or behavioral characteristics that are (9) known to caus e a disease. T 5. In the past, p ractitioners of psychosomatic medicine generally used a (10) psychoanalytic model to explain a physical symptom. T 6. One of the goals of health psychology is to have an effect on public (11) policy. T 7. The biopsych osocial model of health and illness is actually an extension (13) of the biomedical model. T 8. The "systems" approach assumes simple systems are embedded (15) within complex systems. F 9. Although sociocultural research has found differences in health beliefs (20) across cultures, disease patterns themselves do not differ . F 10. Quasi -experimental designs allow us to make causal conclusions from (25) existing groups.