Introduction to Health Psychology
Health psychology examines the relationship between psychological factors and physical health. How does stress affect your body? Why do some people cope better than others? This field bridges mind and body.
Health and illness result from the interaction of:
🧬 Biological
Genetics, viruses, brain chemistry, immune function
🧠 Psychological
Stress, coping, personality, beliefs, emotions
👥 Social
Culture, family, socioeconomic status, support systems
| Type | Description | Example |
|---|---|---|
| Catastrophes | Unpredictable, large-scale events | Natural disasters, wars, terrorist attacks |
| Significant Life Changes | Major transitions requiring adjustment | Death of loved one, divorce, job loss, moving |
| Daily Hassles | Everyday annoyances that accumulate | Traffic, deadlines, arguments, losing keys |
Research shows daily hassles may actually be more harmful to health than major life events because of their chronic nature.
- Cortisol: Stress hormone that, when chronically elevated, suppresses immune function
- Coronary heart disease: Linked to chronic stress; Type A personality (competitive, hostile) at higher risk
- Immune suppression: Stress reduces lymphocyte production, increasing susceptibility to illness
- Telomere shortening: Chronic stress accelerates cellular aging
🎯 Problem-Focused Coping
Directly addressing the stressor
Making a study plan for an exam
Best when: situation is controllable
💭 Emotion-Focused Coping
Managing emotional response to stressor
Talking to a friend about exam anxiety
Best when: situation is uncontrollable
- GAS stages: Alarm → Resistance → Exhaustion (know the characteristics of each)
- Type A vs. Type B: Type A (competitive, impatient, hostile) linked to heart disease; hostility is the most toxic component
- Tend-and-befriend: Alternative stress response (especially in women) involving nurturing and seeking social support
1) A student has been studying nonstop for finals for 3 weeks and now catches a cold. According to Selye, what GAS stage are they likely in?
2) Your friend can't change that their parent is ill, but they're very anxious. What type of coping would be most helpful?
Show Answers
1) Exhaustion stage—prolonged stress has depleted their body's resources, making them vulnerable to illness as the immune system is compromised.
2) Emotion-focused coping would be most helpful since the situation (parent's illness) is largely uncontrollable. This might include talking about feelings, seeking social support, or relaxation techniques.
Positive Psychology
Rather than focusing solely on problems and disorders, positive psychology studies what makes life worth living—the strengths and virtues that enable individuals and communities to thrive.
| Component | Description | Example |
|---|---|---|
| Positive Emotions | Experiencing joy, gratitude, hope, love | Savoring good moments, expressing gratitude |
| Engagement | Being fully absorbed in activities (flow) | Losing track of time while doing something you love |
| Relationships | Having meaningful connections with others | Close friendships, supportive family |
| Meaning | Belonging to something larger than self | Religion, causes, community service |
| Accomplishment | Pursuing and achieving goals | Mastering skills, completing projects |
What DOES predict happiness:
- Strong social relationships
- Meaningful work/engagement
- Gratitude practice
- Acts of kindness
- Exercise
- Adequate sleep
- Optimistic explanatory style
What DOESN'T predict happiness (as much as we think):
- Money (beyond meeting basic needs)
- Age (happiness is relatively stable)
- Physical attractiveness
- Climate
- Education level
- Having children (mixed findings)
• Optimists: See setbacks as temporary, specific, and external ("This one test was hard")
• Pessimists: See setbacks as permanent, pervasive, and personal ("I'm stupid and always fail")
Identified 24 character strengths across 6 core virtues:
Wisdom
Creativity, curiosity, judgment, love of learning
Courage
Bravery, persistence, integrity, zest
Humanity
Love, kindness, social intelligence
Justice
Teamwork, fairness, leadership
Temperance
Forgiveness, humility, prudence, self-regulation
Transcendence
Appreciation of beauty, gratitude, hope, humor, spirituality
- Flow requires: Clear goals, immediate feedback, challenge-skill balance.
- Subjective well-being = self-reported happiness and life satisfaction.
- Adaptation-level phenomenon: Our tendency to judge experiences relative to a neutral level we're used to.
1) A video game is too easy and a player feels bored. According to flow theory, what needs to change?
2) Why doesn't winning the lottery lead to long-term happiness?
Show Answers
1) The challenge level needs to increase to match the player's skill level. Flow occurs when challenge and skill are balanced—too little challenge = boredom; too much = anxiety.
2) The hedonic treadmill (or adaptation-level phenomenon)—people adapt to new circumstances and return to their baseline happiness level. Initial excitement fades as the new situation becomes "normal."
Explaining and Classifying Psychological Disorders
What makes something a psychological disorder? How do we categorize mental illness? Understanding classification systems and perspectives on abnormality is essential for clinical psychology.
A psychological disorder is a syndrome marked by a clinically significant disturbance in cognition, emotion regulation, or behavior. Key criteria (the "3 D's"):
😰 Distress
Causes significant personal suffering
⚠️ Dysfunction
Interferes with daily life, work, relationships
🚫 Deviance
Culturally atypical (but culture matters!)
A fourth "D" often added: Danger (risk to self or others)—though most people with mental illness are NOT dangerous.
The standard classification system for mental disorders in the US, published by the American Psychiatric Association.
- Provides diagnostic criteria for each disorder
- Descriptive (describes symptoms) not explanatory (doesn't explain causes)
- Categorical approach (you either have or don't have a disorder)
- Updated over time as understanding changes
Eight healthy people faked symptoms to get admitted to psychiatric hospitals. Once admitted, they acted normally.
Results: All were admitted (diagnosed with schizophrenia), and none were detected as impostors by staff. They stayed an average of 19 days.
Implications: Highlighted problems with diagnostic reliability and the power of labels. Once labeled "schizophrenic," normal behaviors were interpreted as pathological.
Note: This study has been criticized for methodology, and diagnostic criteria have improved since then.
| Perspective | Cause of Disorder | Treatment Approach |
|---|---|---|
| Biological/Medical | Brain chemistry, genetics, neural abnormalities | Medication, brain stimulation |
| Psychoanalytic | Unconscious conflicts, childhood experiences | Insight therapy, psychoanalysis |
| Behavioral | Learned maladaptive behaviors | Behavior modification, conditioning |
| Cognitive | Distorted thinking patterns | Change thought patterns |
| Humanistic | Blocked personal growth, unmet needs | Supportive therapy, self-actualization |
| Sociocultural | Social/cultural factors, poverty, discrimination | Social change, family/group therapy |
| Biopsychosocial | Interaction of all factors | Integrated approach |
- DSM-5 is the current edition—know what it is and its limitations.
- Medical model views disorders as diseases with biological causes.
- Labeling can create stigma and self-fulfilling prophecies.
1) Someone has a genetic predisposition for depression but only develops it after a major job loss. What model explains this?
2) What's a major criticism of the DSM's categorical approach to diagnosis?
Show Answers
1) The diathesis-stress model—the genetic predisposition (diathesis) interacted with an environmental stressor (job loss) to produce the disorder.
2) The categorical approach implies you either have or don't have a disorder, but many psychological conditions exist on a spectrum. The boundary between "normal" and "disordered" is often arbitrary, and people may have symptoms without meeting full criteria.
Categories of Psychological Disorders
This section covers the major categories of psychological disorders you need to know for the AP exam. For each, understand the symptoms, possible causes, and how they differ from each other.
Characterized by excessive fear, anxiety, and related behavioral disturbances.
Generalized Anxiety Disorder (GAD)
Symptoms: Persistent, excessive worry about many things for 6+ months; difficulty controlling worry; restlessness, fatigue, difficulty concentrating, muscle tension, sleep problems.
Key feature: Free-floating anxiety (not tied to specific trigger)
Panic Disorder
Symptoms: Recurrent, unexpected panic attacks (sudden terror with physical symptoms: racing heart, sweating, trembling, shortness of breath, chest pain)
Key feature: Fear of future attacks; may develop agoraphobia (fear of places where escape might be difficult)
Phobias
Specific Phobia: Intense, irrational fear of a specific object or situation (spiders, heights, blood)
Social Anxiety Disorder: Intense fear of social situations where one might be judged or embarrassed
Key feature: Fear is out of proportion to actual danger; person recognizes this
Obsessive-Compulsive Disorder (OCD)
Obsessions: Unwanted, intrusive thoughts that cause anxiety (contamination fears, need for symmetry, forbidden thoughts)
Compulsions: Repetitive behaviors performed to reduce anxiety (washing, checking, counting, arranging)
Key feature: Person recognizes thoughts/behaviors are excessive but can't stop; compulsions provide temporary relief
Related: Body Dysmorphic Disorder (preoccupation with perceived physical flaws), Hoarding Disorder
Post-Traumatic Stress Disorder (PTSD)
Following: Exposure to traumatic event (combat, assault, disaster, accident)
Symptoms:
- Intrusion: Flashbacks, nightmares, intrusive memories
- Avoidance: Avoiding reminders of trauma
- Negative cognitions/mood: Guilt, shame, detachment
- Hyperarousal: Easily startled, hypervigilance, sleep problems
Duration: Symptoms persist for more than 1 month
Major Depressive Disorder (MDD)
Symptoms (5+ for 2+ weeks):
- Depressed mood most of the day
- Loss of interest/pleasure (anhedonia)
- Weight/appetite changes
- Sleep disturbance (insomnia or hypersomnia)
- Psychomotor agitation or retardation
- Fatigue
- Feelings of worthlessness or guilt
- Difficulty concentrating
- Thoughts of death/suicide
Biological factors: Low serotonin, norepinephrine; genetic predisposition
Persistent Depressive Disorder (Dysthymia)
Key feature: Chronic, less severe depression lasting 2+ years
Symptoms: Sad mood plus 2+ symptoms: appetite changes, sleep problems, fatigue, low self-esteem, poor concentration, hopelessness
Bipolar Disorder
Manic Episode Symptoms:
- Inflated self-esteem/grandiosity
- Decreased need for sleep
- Pressured speech (talking fast)
- Racing thoughts
- Distractibility
- Increased goal-directed activity
- Risky behavior (spending sprees, sexual indiscretions)
Bipolar I: Full manic episodes (may include depressive episodes)
Bipolar II: Hypomanic episodes (less severe) + depressive episodes
Key difference from MDD: Presence of manic or hypomanic episodes
Schizophrenia
Positive Symptoms (presence of abnormal experiences):
- Delusions: False beliefs (persecution, grandeur, reference)
- Hallucinations: False sensory experiences (usually auditory—hearing voices)
- Disorganized speech: Word salad, loose associations
- Disorganized/catatonic behavior: Unpredictable, inappropriate
Negative Symptoms (absence of normal functions):
- Flat affect (reduced emotional expression)
- Avolition (lack of motivation)
- Alogia (poverty of speech)
- Anhedonia (inability to feel pleasure)
- Social withdrawal
Biological factors: Excess dopamine activity; enlarged ventricles; genetic component
Disruptions in consciousness, memory, identity, or perception.
Dissociative Identity Disorder (DID)
Formerly "Multiple Personality Disorder"
Two or more distinct personality states; gaps in memory
Controversial: Some question if it's genuine vs. therapist-induced
Dissociative Amnesia
Inability to recall important personal information, usually after trauma
May include dissociative fugue (sudden travel + identity confusion)
Enduring patterns of inner experience and behavior that deviate from cultural expectations, are inflexible, and cause distress/impairment.
| Cluster | Disorders | Characteristics |
|---|---|---|
| Cluster A (Odd/Eccentric) | Paranoid, Schizoid, Schizotypal | Distrust, social detachment, peculiar beliefs |
| Cluster B (Dramatic/Erratic) | Antisocial, Borderline, Histrionic, Narcissistic | Impulsivity, emotional instability, attention-seeking |
| Cluster C (Anxious/Fearful) | Avoidant, Dependent, Obsessive-Compulsive (OCPD) | Fear, excessive need for approval, rigid control |
| Disorder | Key Features |
|---|---|
| Anorexia Nervosa | Restriction of food intake; significantly low body weight; intense fear of gaining weight; distorted body image |
| Bulimia Nervosa | Binge eating followed by compensatory behaviors (purging, fasting, excessive exercise); weight usually normal |
| Binge-Eating Disorder | Recurrent binge eating without compensatory behaviors; feelings of distress, shame, guilt |
- Know positive vs. negative symptoms of schizophrenia—frequently tested!
- GAD = free-floating anxiety; Panic = sudden attacks; Phobias = specific triggers
- Bipolar vs. Depression: The presence of manic episodes distinguishes them
- OCD vs. OCPD: OCD = ego-dystonic (unwanted); OCPD = ego-syntonic (person thinks it's fine)
1) A person hears voices telling them they're being watched by the government. Are these positive or negative symptoms of schizophrenia?
2) What's the key difference between Anorexia Nervosa and Bulimia Nervosa?
Show Answers
1) Positive symptoms—they include hallucinations (hearing voices) and delusions (paranoid belief about government). "Positive" means the presence of abnormal experiences, not that they're good.
2) Body weight: People with anorexia have significantly low body weight due to severe restriction. People with bulimia typically maintain normal or above-normal weight because binge-purge cycles don't result in the same caloric deficit.
Treatment of Psychological Disorders
Treatment approaches range from medication to talk therapy to brain stimulation. The best approach often depends on the specific disorder and individual, and many people benefit from combining treatments.
Treat disorders by altering brain chemistry or function.
| Drug Class | Used For | Mechanism | Examples |
|---|---|---|---|
| Antidepressants | Depression, anxiety | SSRIs: Block serotonin reuptake SNRIs: Block serotonin & norepinephrine reuptake |
Prozac, Zoloft, Lexapro |
| Antipsychotics | Schizophrenia, bipolar | Block dopamine receptors (traditional) or dopamine + serotonin (atypical) | Thorazine, Clozapine, Risperdal |
| Anti-anxiety (Anxiolytics) | Anxiety disorders | Enhance GABA (inhibitory neurotransmitter) | Xanax, Valium, Ativan (benzodiazepines) |
| Mood Stabilizers | Bipolar disorder | Stabilize mood swings (mechanism not fully understood) | Lithium, Depakote |
| Stimulants | ADHD | Increase dopamine and norepinephrine | Adderall, Ritalin |
⚡ Electroconvulsive Therapy (ECT)
What: Brief electrical current through brain induces seizure
Used for: Severe, treatment-resistant depression
Side effects: Short-term memory loss, confusion
Modern ECT is much safer than historical portrayals
🧲 Transcranial Magnetic Stimulation (TMS)
What: Magnetic pulses stimulate brain regions
Used for: Depression
Advantages: Non-invasive, fewer side effects than ECT
Treatment involving psychological techniques; "talk therapy."
Psychoanalytic/Psychodynamic Therapy
Goal: Bring unconscious conflicts to consciousness; gain insight
Techniques:
- Free association: Say whatever comes to mind
- Dream analysis: Interpret hidden meanings
- Transference: Analyzing feelings toward therapist as reflecting other relationships
- Interpretation: Therapist explains unconscious meaning
Criticism: Long-term, expensive, limited empirical support for effectiveness
Humanistic Therapies
Goal: Promote self-understanding and personal growth
Carl Rogers' Client-Centered Therapy:
- Unconditional positive regard: Accept client without judgment
- Empathy: Deeply understand client's feelings
- Genuineness: Be authentic and transparent
- Active listening: Reflect feelings back to client
Key feature: Non-directive; therapist facilitates, client leads
Behavior Therapies
Goal: Change maladaptive behaviors through learning principles
Techniques:
- Systematic desensitization: Gradual exposure to feared stimulus while relaxed (for phobias)
- Exposure therapy: Direct confrontation with feared stimulus
- Flooding: Intense, prolonged exposure
- Aversion therapy: Pair unwanted behavior with unpleasant stimulus
- Token economy: Reward desired behaviors with tokens (operant conditioning)
Cognitive Therapy
Goal: Identify and change distorted thinking patterns
Aaron Beck's Cognitive Therapy:
- Identify automatic negative thoughts
- Challenge cognitive distortions (all-or-nothing thinking, catastrophizing, etc.)
- Replace with more realistic thoughts
Albert Ellis' Rational Emotive Behavior Therapy (REBT):
- ABC Model: Activating event → Belief → Consequence
- It's not events that disturb us, but our interpretation of events
- Challenge irrational beliefs
👥 Group Therapy
Benefits: Cost-effective, social support, realize others share problems, practice social skills
Example: Support groups, group CBT
👨👩👧 Family Therapy
Goal: Improve family communication and dynamics
View: Individual's problem reflects family system dysfunction
- Meta-analyses show: Psychotherapy is generally effective; most people improve more than untreated controls
- Dodo bird verdict: "All have won, all must have prizes"—different therapies show similar effectiveness for many conditions
- Evidence-based practice: Integrating best research evidence with clinical expertise and patient values
- Common factors: Therapeutic alliance, hope, empathy matter across all approaches
- SSRIs increase serotonin availability (block reuptake); first-line treatment for depression/anxiety.
- Systematic desensitization uses classical conditioning principles (counterconditioning).
- CBT is the most empirically supported treatment for many disorders.
- Know each therapy's theoretical basis: Psychoanalytic = unconscious; Humanistic = self-actualization; Behavioral = learning; Cognitive = thoughts.
1) A patient with schizophrenia is given medication that blocks dopamine receptors. What class of drug is this?
2) A therapist helps a client identify the thought "If I fail this test, my life is over" as catastrophizing and challenges them to think more realistically. What type of therapy is this?
Show Answers
1) Antipsychotic medication. Traditional antipsychotics work primarily by blocking dopamine receptors, which helps reduce positive symptoms like hallucinations and delusions.
2) Cognitive therapy (or CBT). The therapist is identifying a cognitive distortion (catastrophizing) and helping the client challenge and replace it with more realistic thinking—a core technique of cognitive approaches.