Psyc 412 1st Edition Lecture 11Outline of Last Lecture I. Coping II. Personality and copingIII. Moderators of the stress experienceIV. Negative Affectivity and coping/healthV. Optimism and coping/healthVI. Psychological control and coping/healthVII. Religion and copingVIII. Coping StyleIX. Problem-focused versus Emotion-focused X. Resources and coping XI. Flexibility in CopingXII. Ways of measuring coping outcomesXIII. Social Support and Coping/healthXIV. Direct effects versus Buffering hypothesis XV. Matching hypothesisXVI. Disclosure and coping/healthXVII. Coping InterventionsOutline of Current Lecture I. Recognition and interpretation of symptoms/health threatsII. Medical student syndromeIII. Cognitive representations of illnessIV. Lay referral networksV. Complementary and Alternative Medicine VI. The Internet and health VII. Benotsch (2004) study VIII. Utilization of health services IX. Worried wellX. SomaticizersXI. MalingeringXII. Factitious disorder (Munchausen syndrome), Munchausen syndrome by proxyXIII. Delay in seeking medical careCurrent Lecture- Some people are more likely to notice a symptom than are other people - Hypochondriacs: are convinced that normal bodily symptoms are indicators of illnesso Most common symptoms: back pain, joint pain, pain in extremities, headache, abdominal symptoms, allergies, cardiovascular symptoms- Cultural differences exist in how quickly and what kind of symptoms are detectedo Anglos report infrequent symptomso Mexican-Americans report frequently-occurring symptoms- Situational factors:o Boring situations make people more attentive tosymptoms than when in interesting situationso Symptoms are noticed more on days at home than on days full of activityo Those who focus on themselves are quickerto notice symptoms- Medical students’ disease: as they study each illness, many medical students imagine theyhave it- Stress can precipitate or aggravate the experience of symptoms- Mood influences self-appraised health- Interpretations of symptoms by different people differs: social and psychological factors can be important in understanding people’s interpretations of their symptoms and their decision to seek treatment- Commonsense model of illness: argues that people hold implicit commonsense beliefs about their symptoms and illnesses that result in organized illness representations or schemas (range from sketchy/inaccurate to extensive/technical/complete)o Coherent conceptions of illness are acquired through medial, personal experience,family and friendso Include basic information about an illness: Identity: label or name of an illness Causes: factors that the person believes gave rise to the illness Consequences: symptoms, treatments that result, implications for quality of life Time line: the length of time the illness is expected to last Control/cure: whether the person believes the illness can be managed or cured through appropriate actions and treatments Coherence: how well these beliefs hang together in a cogent representationof the disordero Most people have 3 models of illness: Acute illness: believed to be caused by specific viral/bacterial agents and is short in duration, with no long-term consequences (flu) Chronic illness: believed to be caused by multiple factors including health habits, and is long in duration with severe consequences (heart disease) Cyclic illness: marked by alternating periods during which there are either no symptoms or many symptoms (herpes)- Lay referral network: an informal network of family and friends who offer their own interpretations of symptoms before any medical attention is soughto Preferred mode of treatment in many communities- Complementary and alternative medicine (CAM): still being catalogued by World Health Organization to identify those that are successful and those that are risky (some don’t work)o Relaxation techniques, chiropracty, massage, imagery, spiritual healing, diets, herbal medicines, self-help groups, energy healing, acupunctureo Many are used in conjunction with conventional therapyo Used by 1 in 3 American adults- The Internet: a lay referral network of its owno More than 100,000 health-related websites- The very young and very elderly use health services most frequently- Women use health services more than men (pregnancy/childbirth; visit different types of doctors)o Men supposed to be “macho” so they don’t get medical help as often- Lower social classes used medical services less than do the more affluent social classeso Costo Not as many well-qualified doctors available for the poor- Whether or not a person seeks treatment for asymptom depends on two factors:o Extent to which the person perceives a threat to healtho The degree to which the person believes healthmeasures will be effective in reducing that threat- Worried well: people who are concerned about physical and mental health, inclined to perceive minor symptoms as serious, and believe that they should take care of their own healtho Commitment to self-care leads them to use health services more- Somaticizers: individuals who express distress and conflict through bodily symptoms- Secondary gains: benefits that come from illnesso Ability to rest, free from unpleasant tasks, to be cared for by others, to take time off of worko Can result in malingering; improper use of medical services- Delay behavior: people live with potentially serious symptoms for months without seeking careo Contributes to high rate of death and disability from heart attackso Delay: the time between when a person recognizes a symptom and when the person obtains treatment Appraisal delay: the time it takes an individual to decide that a symptom isserious Illness delay: the time between the recognition that a symptom implies an illness and the decision to seek treatment Behavioral delay: the time between deciding to seek treatment and actually doing so Medical delay: time that elapses between the person’s calling for an appointment and his/her receiving appropriate medical careo Delaying: more common when symptoms don’t hurt, don’t change quickly, and are not incapacitatingo Treatment delay: 25% of patients delay taking recommended treatments (putting off tests)o Provider delay: occurs when an appropriate test is not undertaken with a patient until after it was needed Mostly result of honest mistakes More likely when a patient deviates from the profile of an average person