CHAPTER 8.pdf

2/16/2010 1 Health Psychology, 7th ed. Shelly E. Taylor ? Individual differences in personality ? Some people are consistently more likely to notice symptoms than other people ? Cultural differences ? Anglos report infrequent symptoms ? Mexicans report frequently-occurring symptoms ? Attentional differences ? Those who focus on themselves are quicker to notice symptoms than those focused externally Haudenschield: Psych 531 2 ? Situational factors ? Boring situations make people more attentive to symptoms than when in interesting situations ? Symptoms are noticed more on days at home than on days full of activity Haudenschield: Psych 531 3 2/16/2010 2 ? Stress: ? Precipitates / aggravates the experience of symptoms ? Interpretation of stress-induced physiological changes as signs of illness / disease ? Mood ? People in positive moods (even those with diagnosed illness) report fewer symptoms than people in negative moods ? Relative to those in good moods, those in a negative mood: Haudenschield: Psych 531 4 ? Interpretation of symptoms ? A psychological process ? Prior experience ? Expectations ? Seriousness of symptoms Haudenschield: Psych 531 5 ? Illness Representations / Schemas: ? May be sketchy & inaccurate or technical & complete ? Develop early in life ? Influence: Haudenschield: Psych 531 6 2/16/2010 3 ? Generally include: ? Most people have 3 models of illness: ? Acute: ? Chronic: ? Cyclic: Haudenschield: Psych 531 7 ? Lay referral network: An informal network of family and friends who offer an interpretation of symptoms well before medical treatment is sought ? The preferred mode of treatment in many communities Haudenschield: Psych 531 8 ? Complementary and Alternative Medicine (CAM) ? On the rise worldwide ? Used by one in three American adults ? Use is often not disclosed to physicians Haudenschield: Psych 531 9 2/16/2010 4 ? The Internet ? A lay referral network of its own ? More than 100,000 health-related websites ? Most physicians believe the Internet affects health care positively ? Must use caution when using internet-based health information Haudenschield: Psych 531 10 ? Age ? Gender ? Women use medical services more frequently than men ? Pregnancy and childbirth ? Social class and culture ? Lower social classes use medical service less than the affluent ? Financial reasons / Only seek treatment in emergency situations ? Beliefs about the illness lead some people to use the lay referral system instead of formal treatment Haudenschield: Psych 531 11 ? Social psychological factors ? Health Belief Model: whether or not a person seeks treatment for a symptom depends on two factors Haudenschield: Psych 531 12 2/16/2010 5 ? Use of health services influenced by socialization (parents / peers) ? Interpersonal factors ? Social interference: ? Social sanctioning: Haudenschield: Psych 531 13 ? Using health services for emotional disturbances ? As many as 67% of physician visits are for primarily psychological (rather than primarily medical) complaints ? Stress, anxiety disorders, & clinical depression ? Can create a number of physical symptoms ? Lead to multiple visits ? Slow recovery ? Prolonged hospital stays ? Unnecessary tests / treatments ? Psychiatric diagnoses continue to be underrecognized / underdiagnosed in primary care Haudenschield: Psych 531 14 ? The ?worried well?: concerned about physical and mental health; inclined to perceive minor symptoms as serious and believe they should take care of their own health ? Leads to increased use of health services Haudenschield: Psych 531 15 2/16/2010 6 ? Somatization Disorder: ? no medical cause or complaints / impairment are in excess of what would be expected of the med condition; ? symptoms not intentionally produced Haudenschield: Psych 531 16 ? Hypochondriasis (Health Anxiety): Haudenschield: Psych 531 17 ? Conversion Disorder: ? No evidence of GMC ? Symptoms are not intentionally produced ? Pain Disorder: Haudenschield: Psych 531 18 2/16/2010 7 ? Factitious (Munchausen?s) Disorder: ? Malingering: Haudenschield: Psych 531 19 ? Delay behavior ? Person may live with one or more serious symptoms for months without seeking care ? Delay: time between recognition of a symptom and presentation for treatment ? Appraisal delay: time it takes an individual to decide a symptom is serious ? Illness delay: time between recognition that a symptom implies illness & decision to seek treatment ? Behavioral delay: time between deciding to seek treatment & actually doing so ? Medical delay: time that elapses between a patient?s call & receiving medical care Haudenschield: Psych 531 20 ? Who delays? Haudenschield: Psych 531 21 2/16/2010 8 ? Symptoms and delaying: ? Individuals delay seeking treatment for previous symptoms that were not serious and seek treatment for new symptoms ? Seeking treatment is delayed if symptoms are easily accommodated and do not provoke alarm ? Treatment delay ? 25% of patients delay recommended treatments ? Provider delay ? Health care practitioners account for 15% of all delay behavior Haudenschield: Psych 531 22 Samantha Chapter 1 What Is Health Psychology?