Pearson BTEC National Applied Psychology: Book 2

Revision summary Content area A Theory 1: Health belief model Key concepts of the HBM Evaluation Rosenstock (1966) developed HBM to explain why people engage in healthy behaviour (or not). Three key questions: 1. Perceived seriousness Change depends on how we perceive outcomes of not changing (e.g. condoms may prevent chlamydia but is seriousness enough to warrant use?). 2. Perceived susceptibility Only change (use condoms) if we see ourselves as realistically vulnerable to illness (chlamydia, HIV/AIDS, etc.). 3. Cost-bene t analysis Balance of… Perceived benefits: advantages of changing behaviour. Perceived barriers: obstacles preventing us changing. Modifying factors Demographic variables (age, gender, religion etc.) affect likelihood of change. Cues to action: internal (e.g. pain) and external (e.g. doctor’s advice). Self-efficacy: change more likely if we believe we have ability to do it. Effectiveness and practical applications Use of HBM shown to increase uptake of bowel and colon screening (Williamson and Wardle 2002). Strong credibility Devised by health researchers and practitioners working with real-life behaviour change, so well accepted. How many models? Not one single model, and research studies often involve different combination of elements (Zimmerman and Vernberg 1994). How rational are we? Model assumes decisions are rational (e.g. cost-benefit analysis) but emotions and habits are important. Becker et al. (1978) Evaluation Aims Use HBM to explain mothers’ compliance with treatment for asthma in their children. Procedure 111 mothers of children with asthma interviewed when attending emergency clinic for asthma attack. Blood samples taken from children to check for presence of asthma medication. Findings Positive correlations between mothers’ compliance to giving medication and: • Perceived seriousness of asthma. • Perceived susceptibility to asthma. • Beliefs about seriousness (e.g. interference with child’s education). Four perceived barriers, e.g. getting prescriptions, child disliking taste. Only two demographic variables mattered: mothers being married and educated. Conclusions Each HBM component useful in predicting treatment compliance even in long-term conditions. Subjective and objective measurements Mothers’ self-reports and blood samples were in agreement, confirms self- report as a valid measure. Nature of data collection Mothers’ responses may have been different under less stressful conditions. Challenges validity. Carpenter (2010) Evaluation Aims Meta-analysis of studies into effect of time on HBM variables and behaviour change. Procedure Selected 18 longitudinal studies. Analysed in terms of time between measuring variables and behaviour change. Also whether each study’s outcome was a treatment or a preventative behaviour. Findings Seriousness: relationship with behaviour change was positive but weak. Susceptibility: no link with behaviour change, except positive effect on compliance with drug treatment. Benefits: positive relationship with behaviour change. Barriers: strongest predictor of behaviour change. Conclusions Little support for HBM. Barriers and benefits were the only components to consistently predict behaviour change. Future directions and applications Review provided focus for future research, showed which parts of HBM most effective. Outdated health belief model HBM has evolved and now more complex and different model from the one analysed in this review (e.g. self-efficacy and cues to action not included in the studies in this analysis), so the study is outdated. Theory 2: Locus of control theory Key concepts of LoC theory Evaluation Rotter (1966) proposed locus of control (LoC) theory. Internal and external LoC Internals: believe that events are under own control, e.g. either success or failure at work is due to their own efforts. Externals: believe that events are outside own control, and explained by e.g. luck, other people, etc. LoC is a continuum. Attributions and health behaviour Attribution is the process of explaining other people’s behaviour and also explaining our own behaviour. Internals and externals attribute own health- related behaviours differently, e.g. addiction could be explained by ability to avoid risk factors (internal) or explained by genes (external). Research support for LoC High externals found to be more conformist, so vulnerable to addiction risk factors (Avtgis 1998). Practical application By age 30 those who were assessed as internal at 10 were less likely to be obese or stressed than externals. Internal LoC protects against stress (Gale et al . 2008). Limited role for LoC in health- related behaviours LoC only relevant in new situations, otherwise previous experience more important. So LoC role exaggerated. Role of LoC is complex Extreme internals stressed by unavoidable events, LoC more complex than once thought (Krause 1986). Rotter (1966) Evaluation Aims Review research into internal/external LoC and devise questionnaire to measure LoC. Procedure Reviewed studies into LoC and other variables (e.g. need to achieve). Reviewed questionnaires of LoC, including his own I-E scale with 29 pairs of statements. Findings I-E scale was reliable and valid measure of LoC. Studies found internals more likely to act to improve environment, non-smokers more likely to be internals. Conclusions LoC is a powerful predictor of many behaviours, affected by factors such as culture and parenting. Comprehensive review Explained why studies produced different findings when looking at same variables (e.g. stress) – because internals and externals respond differently. Useful contribution. Issues of reliability Selected studies may have weaknesses (e.g. social desirability bias), Rotter did not check quality. Abouserie (1994) Evaluation Aims Study academic sources of stress in students, gender differences and links between sources of stress, LoC and self-esteem. Procedure 675 students completed: Academic stress questionnaire (ASQ), Life stress questionnaire (LSQ), LoC scale and Rosenberg self-esteem scale. Findings Academic sources (e.g. exams) most stressful for students, but 12% reported no problem. Higher stress in females. Positive correlation between LoC and academic stress but not life stress. Negative correlation between self-esteem and academic and life stress. Conclusions Most students moderately stressed (academic) but about 10% need professional help. Applications of the research Counselling can help students shift from external to internal, can improve academic progress. Biased questionnaires Students may answer questionnaires to make themselves ‘look good’ (social desirability bias), may explain gender difference because males less likely to admit stress. Krause (1986) Evaluation Aims Test hypothesis that older adults with extreme internal and external LoC experience stressful life events more strongly than moderate internals and externals. Procedure 351 retired people over 65 interviewed and completed questionnaires to measure depression, stressful life events and LoC (open and closed questions). Findings Extreme internals had fewer stressful life events than extreme externals. Both more vulnerable to stress-related depression than moderates. Those who believed in chance (externals) more vulnerable to the effects of stress than internals. Conclusions Internal LoC is a mixed blessing, extreme internals stressed by unavoidable events. Simplistic to think internals cope better. Changed our view of LoC Extreme internals not immune from stress (self-blame), so study presents complex and more accurate view of LoC. Biased sample Ethnic mix not representative of retired people in USA. White under- represented, black/African American over-represented. Cannot generalise to all retired people or people generally. Theories of stress, behavioural addiction and physiological addiction Definitions Defining health, stress and addiction Health and ill health General de nition Complete physical, mental and social well-being, not just absence of disease. Biomedical de nition Physical/biological factors, iIlness is physical disease, health is absence of disease. Associated with technological advances (e.g. brain scanning, chemotherapy). Biopsychosocial de nition An interaction between biological, psychological and social factors. Aims to enhance health, focus on prevention. Influential in treating mental disorders. Health as a continuum Health/ill health are two extremes with many states in between. Stress De ning stress An emotional response to situations of threat. Stressors create stress Physical stressors (environmental), e.g. temperature, noise. Psychological stressors, e.g. life events and daily hassles. The stress response Physiological stress: bodily symptoms, e.g. increased heart rate, sweating, feeling sick. Psychological stress: emotion you experience when a stressor occurs. Perceived ability to cope People react differently to the same stressors. Stress occurs when perceived demands of environment are greater than perceived ability to cope (e.g. exams). Response affected by our perception of internal (e.g. resilience) and external (e.g. social support) coping resources. Addiction De ning addiction Complex mental health disorder, pleasurable despite harmful consequences. Classifying addiction ICD-11 substance use or addictive behaviours. Physiological (e.g. cocaine, caffeine) or behavioural (gambling, gaming). Physiological addiction Physical effects: Withdrawal: experienced when substance/ behaviour stops. Tolerance: higher dose needed for same effect. Behavioural addiction Produces same physical effects as substance addiction (withdrawal, tolerance), e.g. gambling, mobile use. Griffiths’ six components of addiction 1. Physical and psychological dependence (salience): addiction dominates addict’s life. 2. Tolerance: more needed for same effect. 3. Withdrawal: when stopping drug or addictive behaviour. 4. Relapse: after abstinence. 5. Conflict: within self and with others. 6. Mood alteration: positive and negative subjective experiences. 30 Unit 3: Health psychology