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Health psychology

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Choose 4 titles from the following 8. Each answer should be 500 words long and has a maximum of 25 marks assigned – equating to 2000 words overall. You will receive feedback in the form of a standard feedback sheet (see below) 1. What are the strengths and weaknesses of The Theory of Planned Behaviour model in predicting condom use to prevent sexually transmitted disease?

Theory of planned behaviour is a theory that attempts to relate health attitudes directly to behaviour (Ajzen, 1991). This essay will discuss strengths and weaknesses of Ajzen’s theory of planned behaviour model in predicting condom use and to prevent sexually transmitted diseases. Sutton, McVey and Glanz (1999) used the theory of planned behavior to predict the condom use intentions of young English people, and TPB does not only predicts the majority of the population it can also predict the condom usage behaviours minorities such as immigrants (Salabarria-Pena, Lee, Montgomery, Hopp & Muralles, 2003), yet the meta-analysis of Albarracin, Johnson, Fishbein and Muellerleile (2001) argued that TPB is efficient at predicting wide-range of health behaviours except for condom use because there is not enough considerable evidence. On the other hand the findings of Armitage and Conner (2001) suggests that TPB predicts between 21 and 36 per cent in actual behaviour for either health or non-health-related behaviours and between 40 and 50 per cent of variance in behavioural intention, however condom usage requires relational/coordinative decision making and social pressures influences this decision whereas TPB explains human behaviours on an individual rationality (Cho, 2008). TPB is not the only social health model that predicts health behaviours when TPB is compared with, the health belief model (HBM), HBM offered a better prediction of condom use behaviour because HBM explains human behaviours with cognitive elements such as outcome expectation, perceived threat and self-efficacy (Becker, 1974) but Wandersman and Boyd (1991) claimed that personal normative belief is an important predictor of condom use behaviour, yet critics of social cognition theories have argued that the theories are effectively irrefutable and tautological (Ogden,2003). Moreover, Marks (2006) suggested that the published studies used null hypothesis elimination with small samples of university pupil or smaller samples of patients and the validity, power, generalizability and power of these studies is questionable. Flowers, Sheeran, Beail and Smith (1997) theorizes sexual activity as social activity and in order to determine one`s choice of sexual acts context of the activity should be taken into account, also Rhodes (1995) draw attention to the situations where constraints and habits prevent the possibility of calculated decision making. Coleman et al., (2001) made a contemporary input and said that gay men shows compulsive behaviour and they prioritize the emotions rather than avoiding sexually transmitted disease. TPB has methodological flaws that might cause problems in predicting condom usage behaviours. The studies examining the capability of the TPB usually address only a specific health behaviour (Bryan, Fisher and Fisher, 2002) and majority of the research about the theory of planned behaviour do not considers the importance of performing a health behaviour on a long-term basis, however health behaviours are not immediately observable, health behaviours have to be performed repeatedly in order to increase the benefits. (Rivis & Sheeran, 2003) Also, it is argued that past behavior determines the current behaviours rather than the cognitions described by TPB (Sutton, 1994). Lastly, Spring et al. (2004) argued that using self-selected participants in studies related to TPB can bias the study towards positive findings and interfere with the generalizability. References

Albarracin, D., Johnson, B. T., Fishbein, M., & Muellerleile, P. A. (2001). Theories of reasoned action and planned behavior as models of condom use: a meta-analysis. Psychological bulletin, 127(1), 142. Ajzen, I. (1991). The theory of planned behavior. Organizational behavior and human decision processes, 50(2), 179-211.

Armitage, C.J and Conner, M. (2001) Efficacy of the theory of planned behaviour: a meta- analytic review. British Jorunal of Social Psychology, 40,471-499
Becker, M. H. (1974). The health belief model and personal health behavior. Thorofare, NJ: Charles B. Slack.
Boyd, B., & Wandersman, A. (1991). Predicting Undergraduate Condom Use with the Fishbein and Ajzen and the Triandis Attitude‐Behavior Models: Implications for Public Health Interventions1. Journal of Applied Social Psychology, 21(22), 1810-1830. Coleman, E., Horvath, K. J., Miner, M., Ross, M. W., Oakes, M., & Rosser, B. S. (2010). Compulsive sexual behavior and risk for unsafe sex among internet using men who have sex with men. Archives of sexual behavior, 39(5), 1045-1053.

Cho BH (2008) Sexuality Risk & HIV/AIDS. Nanam Publications, Seoul, Korea. Flowers, P., Sheeran, P., Beail, N., & Smith, J. A. (1997). The role of psychosocial factors in HIV risk- reduction among gay and bisexual men: A quantitative review. Psychology and Health, 12(2), 197-230. Fisher, J. D., Fisher, W. A., Bryan, A. D., & Misovich, S. J. (2002). Information-motivation-behavioral skills model-based HIV risk behavior change intervention for inner-city high school youth. Health Psychology, 21(2), 177. Marks, D. F. (2006). The case for a pluralist health psychology. Journal of health psychology,11,367-372 Ogden, J. (2003). Some problems with social cognition models: A pragmatic and conceptual analysis. Health Psyhology,22,424-428

Rhodes, T. (1995). Theorizing and researching ‘risk’: notes on the social relations of risk in heroin

users’ lifestyles. AIDS: Safety, sexuality and risk, 125-143

Salabarría-Peña, Y., Lee, J. W., Montgomery, S. B., Hopp, H. W., & Muralles, A. A. (2003). Determinants of female and male condom use among immigrant women of Central American descent. AIDS and Behavior, 7(2), 163-174. Sutton, S. (1994). The past predicts the future: Interpreting behaviour–behaviour relationships in social psychological models of health behaviour.

Sutton, S., McVey, D., & Glanz, A. (1999). A comparative test of the theory of reasoned action and the theory of planned behavior in the prediction of condom use intentions in a national sample of English young people. Health Psychology, 18, 72–81. Spring, B., Doran, N., Pagoto, S., Schneider, K., Pingitore, R., & Hedeker, D. (2004). Randomized controlled trial for behavioral smoking and weight control treatment: effect of concurrent versus sequential intervention. Journal of Consulting and Clinical Psychology, 72(5), 785.

Critically discuss the influence of social factors associated with onset and maintenance of alcohol dependence.

The cost and availability of alcohol and drugs openly impact overall types of use (Godfrey & Maynard, 1988), another factor associated with young people`s onset and maintenance of alcohol dependence is parental influence (Van den Eijnden, Van den Mheen,Vet & Vermulst, 2011) Also the family could be a risk or protective factor in the development of drinking patterns. Individuals with supportive families are less likely to have problems with alcohol when compared to the people with un-supporting families (Bu, Watten, Foxcroft, Ingebrigtsen, & Relling, 2002). Martino, Ellickson, & McCaffrey (2009) argued that friends and peers plays a substantial role in young people`s drinking behaviour and alcohol dependence, however Eccles and Barber (1999) argued that young people who are interested in extracurricular activities are less likely to develop problems related to alcohol, although Lorente, Souville, Griffet and Grelot (2004) conducted studies among French adolescents who participate in sports and their alcohol consumption, they noted that adolescents who participate in sports may be more inclined to risky drinking practices. A previous study conducted by Leichliter,Meilman, Presley and Cashin (1998) showed the alcohol use of students with diverse levels of college athletics, this supports the claim of Souville, Griffet and Grelot. People who drink to overcome negative feelings and emotions experience high rates of problems related to alcohol dependence and addiction, on the other hand people who drink for social motives is less likely to be associated with problems with alcohol dependence (Kuntsche, Knibbe,Gmel & Engels,2005;Kuntsche,Stewart & Cooper,2008)

References
Bu, E. H., Watten, R. G., Foxcroft, D. R., Ingebrigtsen, J. E., & Relling, G. (2002). Teenage alcohol and intoxication debut: The impact of family socialization factors, living area and participation in organized sports. Alcohol and alcoholism, 37(1), 74-80. Eccles, J. S., & Barber, B. L. (1999). Student council, volunteering, basketball, or marching band: What kind of extracurricular involvement matters? Journal of Youth and Adolescence, 6, 281-294.

Godfrey, C., & Maynard, A. (1988). An economic theory of alcohol consumption and abuse. Theories on Alcoholism. Toronto: Addiction Research Foundation.
Kuntsche, E., Knibbe, R., Gmel, G., & Engels, R. (2005). Why do young people drink? A review of drinking motives. Clinical psychology review, 25(7), 841-861. Kuntsche, E., Stewart, S. H., & Cooper, M. L. (2008). How stable is the motive-alcohol use link? A cross-national validation of the Drinking Motives Questionnaire Revised among adolescents from Switzerland, Canada, and the United States. Journal of Studies on Alcohol and Drugs, 69(3), 388. Leichliter, J. S., Meilman, P. W., Presley, C. A., & Cashin, J. R. (1998). Alcohol use and related consequences among students with varying levels of involvement in college athletics. Journal of American College Health, 46(6), 257-262. Lorente, F. O., Souville, M., Griffet, J., & Grélot, L. (2004). Participation in sports and alcohol consumption among French adolescents. Addictive behaviors, 29(5), 941-946. Martino, S. C., Ellickson, P. L., & McCaffrey, D. F. (2009). Multiple trajectories of peer and parental influence and their association with the development of adolescent heavy drinking. Addictive behaviors, 34(8), 693-700.

Eijnden, R. V. D., Van De Mheen, D., Vet, R., & Vermulst, A. (2011). Alcohol-specific parenting and adolescents' alcohol-related problems: the interacting role of alcohol availability at home and parental rules. Journal of studies on alcohol and drugs, 72(3), 408.

Give a supported argument for the inclusion of environmental factors within the Bio-Psycho-Social model understanding of stress. Many scholars have raised the dilemma of whether the strain and stress of modern civilization are particularly harmful, because of their difference from the type of environmental settings which humans evolved as species (Esser, 1974; Boyden, 1970; Dubos, 1965). This essay is going to give a supported argument for the inclusion of environmental factors within the Bio-Psycho-Social model understanding of stress. The environmental stressors that cause stress will be discussed and criticised. Santrock (2007) argued that combination of social, psychological and biological factors can help understand health rather than purely biological terms ,yet Engel (1977) claimed that in order to understand how behaviour and biology interact scientists should move from groups to individuals, Engel claimed that there are various aspects of life which have an impact on health involving such factors as work, relationships, living environment, community, knowledge and practice of health-promoting or health-damaging behaviour. Sells (1963) also supported Engel`s claim by arguing stress can be influenced by physical environments which have everlasting characteristic. Previous research of environmental stress all accent that stress in mainly a relational concept signifying an imbalance between individuals` goals and environmental opportunities (Evans,Colome & Shearer 1988;Lazarus & Cohen, 1977), Kryter (1994) claimed that increased noise levels can increase workplace accident rates, stimulate aggression and create stress. Cohen and Weinstein (1982) supported Kryter’s claims by saying that noise is an environmental stressor; moreover their study shows that unpredictable and loud noise exposure increases skin conductance and heart rate, the Munich Airport Study (Evans, Hygge & Bullinger,1995) showed that noise-exposed children had significantly higher endocrine levels indicating increased levels of stress, Latter finding of Heathrow study is consistent with this study (Haines et al,. 2001) Lastly Brandenberger , Follenius, Wittersheim and Salame(1980) found that raised cortisol levels are linked with noise.

Another environmental stress factor is crowding, crowding is a psychological state that occurs when needs for space exceed the available supply (Stokols,1972) .Crowding is usually accompanied by negative effects such as stress, anxiety and tension (Freedman,1975). A study measuring endocrine levels under different density conditions noted catecholamine’s were elevated (Singer,Lundberg & Frankenhauser,1978). Also, another study found that crowded shoppers have increased levels of cortisol (Heshka & Pylypuk,1975), however Aillo, Epstein and Karlin (1975) did not find an increase in crowded dormitory residences. Lastly, Evans (1988) found that heart rate, blood pressure and skin conductance increases related with density.

The environmental stressors have been discussed and criticised and in order to understand and treat stress; the noise and crowdedness should be included in the bio-psycho-social model, however environmental stress factors have limitations as well, firstly there is no stable ecological theory of environmental stress which can cause the experiment approaches to the study of stress and also have to consider that individual differences in the reply to stress in the environment because the influences of premature environment of any organism have superordinate high impact on the organism's orientation to stress (Carson & Driver,1966) The researches which had elder participants are not reliable because, elder participants usually suggested greater sensitivity to their physical surroundings (Lawton, 1980).

References
Aiello, J., Epstein, Y, & Karlin, R. (1975) Field experimental research on human crowding. Sacramento, CA: Western Psychological Association.
Boyden,S.V (1970) The impact of civilazion on the biology of man Toronto, Canada: Unniverity of Toronto Press
Brandenberger G, Follenius M, Wittersheim G, Salame P. (1980) Plasma catecholamines and pituitary adrenal hormones related to mental task demand under quiet and noise conditions. Biol Psychol 10: 239–52 Carson, D. H., & Driver, B. L. (1966). An ecological approach to environmental stress. American Behavioral Scientist.

Cohen, S. & Weinstein,N. (1982). Nonauditory effects of noise on behavior and health. In G.W Evans (Ed.), Environmental stress (pp 45-74) New York: Cambridge University Press Dubos, R (1965) Man adapting. New haven, CT: Yale University Press. Engel, G. L. (1977). The need for a new medical model: a challenge for biomedicine. Science, 196(4286), 129-136.

Evans, G. W., Colome, S. D., & Shearer, D. F. (1988). Psychological reactions to air pollution. Environmental Research, 45(1), 1-15.
Evans, G. W., Hygge, S., & Bullinger, M. (1995). Chronic noise and psychological stress. Psychological Science, 333-338.
Esser, A.H. (1974). Environment and mental health. Science, Medicine and Man, 1, 181-193. Freedman, J (1975).Crowding and behaviour. San Francisco: Freeman

Haines, M. M., Stansfeld, S. A., Brentnall, S., Head, J., Berry, B., Jiggins, M., & Hygge, S. (2001). The West London Schools Study: the effects of chronic aircraft noise exposure on child health. Psychological Medicine, 31(08), 1385-1396. Heshka, S.,& Pylypuk,A. (1975). Human crowding and adrenocortical activity. Quebec, Canada: Canadian Psychological Association

Kryter, K. D. (1994) The handbook of hearing and the effects of noise: physiology,psychology and public health Boston: Academic Press.
Lawton, M.P. (1980) Environment and aging. Monterey, CA: Brooks/Cole. Lazarus, R. S., & Cohen, J. B. (1977). Environmental stress. In Human behavior and environment (pp. 89-127). Springer US.

Santrock, J. W. (2007). A Topical Approach to Human Lifespan Development (3rd Ed.). St. Louis, MO: McGraw-Hill.
Singer, J, Lundberg,U, & Frankenhauser, M. (1978) Stress on the train: A study of urban commuting Stokols, D. (1972). On the distinction between density and crowding: Some implications for future research. Psychological review, 79(3), 275.

Despite the availability of information about healthier lifestyles, why does there remain a gap in health inequalities between socio-economic classes? In UK people living in the richer areas will die an average of seven years late compared to those living in the poorer areas (Heron et al,. 2009). Also, unskilled workers are more likely to die from cancer when compared to professional workers (Cancer Research UK, 2005), these studies have shown the health inequalities between socio-economic classes and this essay will discuss why there is a gap between health inequalities. Wilkins and Marmot (2003) argued that the social predictors of health are; Early childhood

development, stress, unemployment, addiction, availability of health food, active travel, how

ever people with low income cannot access some of the predictors such as healthy food or

active travel. Some people may be even unemployed and this causes a gap between people

who are on the higher status of socio-economic status (SES) and people who are on the lower

end of the SES. Williams (1990) and Sargan (1987) argued that supplying information ap

pears to be a weak stimulus to change human behaviour, however education may be a protect

tion fordiseases, because information can influence problem-solving abilities, values and life-

style behaviours (Liberatos, Link & Kelsey, 1988) yet the study of Winkleby, Jatulis, Frank &

Fortmann (1992) suggests that higher education is the most consistent and strongest predictor of

good health.

A crucial cause on health inequalities is the inter-generational causes which are passed from one generation to another. This is mostly about the health behaviour of the mother during pregnancy and behaviour and circumstances as the child raises. (Barker et al,. 1993) Mackenbach (2005) argued not all socio-economic inequalities are a cause of death however he argued the morbidity rates are higher between the ones with lower occupational, income or education level Stress effects the cardiovascular and immune systems, if the individual feels tense frequently they become vulnerable to certain conditions including diabetes, high blood pressure, heart attack, stroke, aggression and depression (Stansfeld & Marmot, 2002) .Waldron (1980) argued housewives rate their health as fair or poor and they usually report more chronic illness than employed women, also poor health can deter a woman from seeking or keeping a job and this can cause housewives to report poor health when compared to employed women. Bennett, Dodd, Flatley, Freeth and Bolling (1995) argued lower socioeconomic groups are more likely to drink full fat milk and this is related with their educational status, Bennett et al., also argued that educational status is associated with fibre intake but not with consumption of fat. Previously, Steptoe, Pollard, and Wardle (1995) had found that both lower and higher income groups showed difference on only two of the nine scales of the Food Choice Questionnaire (FCQ) people with limited incomes pay more attention to the cost of food than richer people, also the low educated group placed more importance on familiarity and price than the individuals who had better education. References

Barker, D. J., Godfrey, K. M., Gluckman, P. D., Harding, J. E., Owens, J. A., & Robinson, J. S. (1993). Fetal nutrition and cardiovascular disease in adult life. The Lancet, 341(8850), 938-941. Bennett, N., Dodd, T., Flatley, J., Freeth, S., & Bolling, K. (1995). Health survey for England 1993. HM Stationery Office

Cancer Research UK (2005) CancerStats: Cancer survival and deprivation. London: Cancer Research UK Heron, M., Hoyert, D. L., Murphy, S. L., Xu, J., Kochanek, K. D., & Tejada-Vera, B. (2009). Deaths: final data for 2006. National vital statistics reports: from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System, 57(14), 1-134.

Liberatos, P., Link, B. G., & Kelsey, J. L. (1988). The measurement of social class in epidemiology. Epidemiologic reviews, 10(1), 87-121.
Mackenbach, J. P. (2006). Health inequalities: Europe in profile. Produced by COI for the Department of Health.
Rhodes, T. (1995). Theorizing and researching ‘risk’: notes on the social relations of risk in heroin users’ lifestyles. AIDS: Safety, sexuality and risk, 125-143. Sagan, L. A. (1987). The health of nations: true causes of sickness and well-being. Steptoe, A., Pollard, T. M., & Wardle, J. (1995). Development of a measure of the motives underlying the selection of food: the food choice questionnaire. Appetite, 25(3), 267-284 Stansfeld, S. A., & Marmot, M. G. (2002). Stress and the heart: Psychosocial pathways to coronary heart disease. BMJ books.

Waldron, I. (1980). Employment and women's health: an analysis of causal relationships. International Journal of Health Services, 10(3), 435-454.
Wilkins R, Marmot M (ed) (2003). "The Social Determinants of Health: The Solid Facts, 2nd ed" (PDF). World Health Organization Europe. Retrieved 2013-03-27.
Winkleby, M. A., Jatulis, D. E., Frank, E., & Fortmann, S. P. (1992). Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. American journal of public health, 82(6), 816-820.

Date for submission of essay:
Friday November 21st 2014

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