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Bishop‟s University

PSY 277B: PHYSICAL AND MENTAL HEALTH, 2013

Instructor: Dr Leo Standing (phone ext. 2456) Mail: black wallbox outside Nicolls 205

Email: lstandin@ubishops.ca

Office hours: Nicolls 205 Mon-Thurs, 1:30 - 2:30 p.m. (Other times, and Fri: by appointment)

Prerequisites:

- Psy 101A and Psy 102B, or CEGEP equivalents, and CEGEP Human Biology (or equivalent)

- PBI 275a or PBI 276b

Required book:

Karren, K. J. et al. (2009). Mind/body health: The effects of attitudes, emotions, and relationships. San

Francisco, CA: Benjamin Cummings. (4th edition, or earlier).

Recommended books

Goldacre, B. (2011). Bad Science: Quacks, Hacks, and Big Pharma Flacks. Toronto, ON: Emblem Editions.

Brannon, L., & Feist, J. (2009). Health psychology: An introduction to behavior and health (7th ed). Belmont,

CA: Thomson Wadsworth. (Or, any equivalent health psychology textbook for general reference).

The course materials and readings articles are available on the web, using Moodle.

- Go to the main BU web page, then Moodle.

Course goals:

This course examines the interactions of physical and mental health, e.g. the links between cardiac problems and

depression, or between personality traits and health. Issues related to methodology will be covered,

especially expectancy and placebo effects. Factual data will be emphasized, plus selected articles from the

psychological and medical literature. Everyday applications will also be examined.

Classroom civility: the learning process benefits when people arrive on time, without food, and direct all

comments to the instructor. (Also, please do the assigned reading before each class).

"A classroom has the sanctity of a hospital and the holiness of a house of God. Behave here as

you would there."

Proposed grading scheme: (No supplemental exam). Quiz dates are provisional: check in class.

2 progress tests: Wed Jan 30, and Wed, Mar 13. (Short-answer format) (12 each) 24

Final exam (essay and short-answer format): whole syllabus 40

Participation (including presentation of a readings article – 10 min) 12

Term paper (3000 words, due Mon, Feb 25, in class) 20

References check for term paper (Mon, Feb 4) 4

(Submit printed abstracts or articles, and the contents page for books) -------

100

Term paper extensions. These are available only in cases of illness or compassionate grounds: please get a clinic

note, and contact the instructor (“Taking a trip” is not a valid excuse).

On Thurs, Apr 11, there will be a makeup exam in essay form for the midterm or progress tests, for people on the

sick list (and others, but with a 10% penalty deducted). Tests use essay and short-answer items.

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ORIENTATION TO HEALTH PSYCHOLOGY

We are looking for objective findings related to physical and mental health in the academic literature,

but on occasion personal experiences and observations are also of interest.

Privacy concerns make it inappropriate to refer to a specific individual by name in classroom

discussions, whether this person is yourself or someone you know. Instead, we follow the standard

impersonal style of medical journals, which always refers to a case, not a person. For example,

"This individual was a 25 year old female, suffering from chronic asthma..."

Some medical terms and video images will be involved, and topics like death and dying. You should

consider whether you are comfortable with this.

Try to make positive suggestions to promote healthy living, without being judgmental. The campus

environment and the surrounding world are in many ways quite unhealthy places to be, and we

should think of ways to counter this.

Everyone's life is important, whether they are a 20 year film star or an 80 year old African leper.

Always use “critical thinking”: do not blindly accept a claim just because someone, however eminent

or trusted, says that it is true. This applies both to orthodox and alternative medicine. Ask yourself

some basic questions about the source of the message, the evidence presented, its compatibility

with other knowledge, and so on. The gold standard of evidence would be a double-blind controlled

experiment that has been published in a reputable peer-reviewed journal. Usually we have to use a

much lower standard of evidence than this.

If it sounds too good to be true, then it is probably untrue.

The Laws of Ecology apply also to health psychology:

- All things are interconnected.

- Everything goes somewhere.

- There‟s no such thing as a free lunch.

- Nature bats last.

Remember, it's your life.

Nothing beats a smile.

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READINGS ARTICLES, 2013 (on Moodle)

Folder

GROUP A: INTRODUCTION INTRO

! Intro - Dangers of orthodox medicine - Lethal Rx drug overdoses – CDC_Paulozzi 12

! Intro - Homeopathy - Less is more - explains fallacies_Schwarcz 12

! Mental - Acetaminophen reduces social pain_DeWall 10.pdf

! Mental - GMH2 - Mental health Resources are only 1% for 14% of illness_Saxena 07

! Mental - Mind-body - Comparing mental well-being with biological_Ryff 04

! Mental - Reduce both Depression and Diabetes type 2 with milnacipran SNRI_Abrahamian 12

GROUP B: GENERAL FACTORS GENERAL

! Mental - Cardiac - Depression raises deaths from heart disease - Good figures_Ahto 07.pdf

! Mental - Inflammation is Link between Depression, Heart Disease, Stroke - Halaris_Anderson 09.pdf

! Mental - Mere viewing of disease stimulates immune response_Schaller 10.pdf

! Mental - Mind-body - Being lonely is bad for your heart and CVS_Rackl 06.pdf

! Mental - Why placebos work wonders_Wang 12.pdf

! Mind-body - Stress - Recovery of ovarian activity produced by CBT_Berga 03.pdf

GROUP C: SPECIFIC FACTORS SPECIFIC

! Mental - Cardiac - Optimism & cynicism change cardiac disease by c.30pc_Tindle 2009.pdf

! Mental - Depression - Exercise reduces depression in RCT_Dunn 05.pdf

! Mental - Depression in adulthood is twice as likely for those abused as children - Danese_Jha 11.pdf

! Mental - Environment - Moving out of poverty reduces disease risk 20pc - RCT_CTV 11.pdf

! Mental - Lifestyle - Good benefits of 2 week program - diet, exercise, etc_Small 06.pdf

! Mental - Social support - Aging - Hogewey, the village where people have dementia_Henley 12.pdf

GROUP D: MENTAL ILLNESSES MENTAL

! Mental - Depression - Meta analysis - SJW as good as SSRI_Linde 05.pdf

! Mental - Depression - SSRIs work only for severe cases - Meta analysis_Kirsch 08.pdf

! Mental - Diet - Omega3 fights depression - Lesperance_Wilton 10.pdf

! Mental - Dodo Bird, Phoenix, or Urban Legend re Psychotherapy_Hunsley 02.pdf

! Mental - Lifestyle changes have strong benefits for psychopathologies_Walsh 11.pdf

! Mental - Mind-body - Treating depression benefits heart and diabetes - Lin_Ostrom 11.pdf

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Term Paper Topics, 2013

Select any TWO topics below. Answer each question as a separate section of your paper, and start a new page

for it. For each of the two topics, write about 5 pages plus a references page showing at least 6 solid primary

sources. The total length excluding the title page should be about 10 pages of text (3000 words), with at least

12 solid references. Keep copies of your paper on two different drives. START NOW ON YOUR PAPER!

Provide a few graphs (better than tables): download or scan them. Place the graphs after each References list:

put each on a separate page, marked with the reference source. Refer clearly to all graphs in the text.

Give factual evidence: research articles and meta-analyses from medical and psychological journals (not

newspaper articles), and some critical argument. For each topic, present both sides of the argument, and

present a coherent final conclusion. Please read all the handouts.

- For the References Check please submit an envelope containing all your articles, printed on paper (or, at least

the abstract page).

- Follow the general APA format of the model term papers that are provided on Moodle. Always retain a printed

copy, and the computer file. There is a wallbox for drop-offs outside my office door.

No other topic will be accepted unless approved in writing by the instructor by Jan 31. (To choose your own

topic, submit a written idea, with some references. This must pose a meaningful 'yes/no' question).

1. Is chronic fatigue syndrome (CFS) a real disease, with a physical component?

2. Are there demonstrable mental and physical benefits from yoga?

3. Is homeopathy simply a placebo effect? Has any direct benefit from it been found in a scientifically

rigorous way?

4. Does humour produce demonstrable physical and mental benefits?

5. Do more intelligent people (in terms of IQ) live longer (with other variables controlled)?

6. Do people who engage in „catastrophizing‟ in their view of the world die younger?

7. Is there a psychogenic basis for disorders such as Crohn‟s disease and irritable bowel syndrome?

8. Are medical and psychiatric diagnoses often incorrect?

9. Do happy people live longer (with other variables controlled)?

10. If you sleep too little, does this cause physical and mental illness?

11. Does music reduce physical pain and depression?

12. Is happiness increased by health, and by wealth?

13. Can hypnosis reduce pain?

14. Does a diet with extra omega-3 fats benefit children with behaviour problems, such as ADD?

15. Is schizophrenia caused by a physical illness, e.g. toxoplasmosis?

/continue

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Note:

1. Please read all the course handouts and the model essays in Moodle.

2. Give references in the correct format to relevant academic articles, books, and web sites. Follow precisely

the APA format, as in the handouts. Your argument must be supported by detailed references throughout (at

least 12 different primary sources, mainly journal articles). Do not cite web pages unless clearly reputable

(and use no more than 1 per topic). Use newspaper articles, and text books, only as leads to actual research

papers.

2. PsycINFO: first use the Thesaurus to find the correct search term. Then, for example, search for „neoplasms‟

in the DE field. (Avoid free text searches, like 'cancer'). You can combine these search terms. Examples:

'caffeine AND stress' / „rats OR mice‟ / „drugs NOT alcohol‟.

In PUBMED: use the Limits tab to improve your search (e.g., specify that you want only papers in

English/French, randomized controlled trials and meta-analyses). As with PsycINFO, use these abstracts to

obtain the actual articles, either on-line through the BU library page, or through Inter-Library Loan.

3. Content: provide factual evidence, including some actual numbers (e.g. means or percentages), and cite

references to support each point. Do not make vague, unsupported generalizations. Do not waste space on

elementary material or trivia. Avoid "direct quotations". Do not use secondary sources. Do not change the

titles.

4. Sources: "Get started right now!" Use the Inter-Library Loan service where needed. If requested, you must

provide, with the essay a photocopy of the title page (only) for every cited article or book. If you can obtain

only the PsycInfo abstract, clearly specify this in the reference list.

5. Style: all errors in style (grammar, spelling, punctuation, etc.) will be penalized, on the basis of a sample

page. Use the Writing Centre where needed. Revise constantly, and repeatedly proof-read the paper!

Penalties (subtracted from 100):

Late submission 5 per working day

No references in the text 50

No references listed at the end 50

No title pages (on request) for sources used 50

Uncheckable sources 10 per source (WWW addresses must be exact)

Unapproved topic 100

Style errors (above 3, on a sample page) 1 per error

- Plagiarism may result in a course grade of zero. An essay is not a cut-and-paste job.

See http://www.indiana.edu/~wts/pamphlets/plagiarism.shtml

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PSY 277B Course Units (A-D), 2013

A. INTRODUCTION TO MIND-BODY PROCESSES

1. The BPS model vs. the biomedical model of health (Ch.1)

a. The traditional biomedical view

b. The rise of the BPS approach (the biopsychosocial model)

c. Behavioural medicine vs. health psychology

d. Disease today is largely chronic, not acute: mental factors become more important

e. ‘The Death of Ivan Ilych’ by Leo Tolstoy

- note how biology, psychology, and social factors have combined effects

2. What is the meaning of health today?

a. Changing views of what is a healthy person

b. The search for objective causes of health, cf. „magical thinking‟

c. Self-education re health today

- how Norman Cousins claims to have saved his life

3. Science and Pseudoscience (Goldacre)

a. What is evidence-based medicine?

b. Speculation vs. science (e.g. psychogenealogy, Rolfing, homeopathy…)

c. Why are there so many invalid treatments? The problem of exploitation

d. Does pseudoscience cause harm to people? (cf. orthodox science)

4. Placebo effects;

a. Psychosomatic illness; somatization

b. Placebos, in orthodox and alternative medicine

c. Is the placebo effect „real‟?

d. The operation of placebo effects in all paradigms, including mind/body studies

5. The „mind-body‟ problem:

a. The holistic view vs. classical dualism

b. Is the mind-body „problem‟ actually a pseudo-problem?

c. The problem of free will

d. Our limited self-knowledge

e. Human inability to predict our reactions or the causes of them (Gilbert)

f. The nature of human consciousness and self-awareness

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B. GENERAL FACTORS IN MENTAL-PHYSICAL HEALTH

1. Mind-immune system-hormone system interaction

a. The surprising power of the mind-body connection: big effect sizes (cf. many drugs)

b. Psychoneuroimmunology, or PNI (Ch.1)

c. Why is the immune system important?

d. How does the immune system interact with mental and physical processes?

e. Emotions and heart disease

f. Promoting longevity

2. Stress (Ch.2)

a. What is a stressor? (Selye)

b. What is stress? (Distress vs. eustress)

c. How the mind and body react to stress, short- and long-term

d. Psychological factors that can reduce, or increase, stress reactions

e. The importance of appraisal (Lazarus)

3. Emotions: anger, worry, depression

a. Anger vs. hostility – their effects on the body, especially the CV system (Ch.4)

- is it better to express anger or bottle it up?

b. Worry, anxiety, and fear (Ch.5)

- somaticizing: effects on the body

c. Depression: major health problem, sometimes with deadly consequences (Ch.6)

- what people can do to cope with depression in themselves and others

4. Cognitive styles

a. Explanatory style: how you interpret events in the world (Ch.17)

b. Locus of control: the benefits of being Internal rather than External (Ch.18)

- self-efficacy: a similar concept

c. Humour, as compared to wit (Ch.19)

- how humour can benefit health

5. Spirituality (Ch.14)

a. Spirituality vs. formal religion

b. Does it help patients if someone prays for them?

c. Spirituality and the placebo effect

d. The wise mind/ego mind

e. The relaxation reponse; forgiveness

f. Church affiliation and health

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C. SPECIFIC FACTORS IN MENTAL-PHYSICAL HEALTH

1. Genetics (pp. 100-101, 150-153), development, and aging

a. Gene-environment interaction („dandelion‟ and „orchid‟ children)

b. Twin studies and deprivation studies

c. Some genetic limitations on human potential

2. Personality (Chs. 3, 8, 15, 16)

a. Personality types A, B and D: impact on health and cardiac system

b. Disease-resistant or „hardy‟ personality (Kobasa)

- is hardiness determined by genetic factors exclusively?

c. Altruism: how it benefits both the helper and the recipient

d. Optimism: its benefits for health and life

- can we have excessive optimism? (Ehrenreich)

3. Lifestyle, sleep, diet, exercise (Chs. 7, 20)

a. Sleeping well without medication

b. Eating and drinking well

c. Exercise is essential, preferably aerobic

4. Sociocultural and social support (Chs. 9, 10, 11, 12)

a. Social support predicts mortality (Alameda County study)

b. Loneliness: causes and consequences of the rise of loneliness today

- ways of coping with loneliness

- the power of pets, music, and the internet, etc

c. How marriage is good for most people, but bad for others

d. The family today: under siege, but still produces powerful benefits

5. Life events (Ch. 13)

a. Grief and bereavement: how they alter mental and physical health

b. The inevitability of loss in human life:

- different kinds of loss besides death

c. Coping with loss and the course of recovery

d. How long will recovery take? Can it be promoted?

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D. MENTAL ILLNESSES; BEHAVIOURAL MEDICINE (CH 21, 22)

1. Mood disorders and depression

a. Prevalence of mental disorders: high and rising

b. The rise of cognitive behavioural therapy for most mental disorders (CBT)

c. The various forms of depression - an evolutionary puzzle

d. The major health burden of depressive illness

e. Physical effect of depression (especially re cardiac health and longevity)

f. Mental effects of depression (especially re pain, alcohol abuse, etc)

g. The many forms of therapy for depression today (and other mental disorders)

h. Anxiety and phobias:

- varieties of anxiety disorder

- effects of anxiety on health

- therapy

2. Other problems:

a. Personality disorders (DSM-IV categories)

b. Psychoses, e.g. schizophrenia

c. PTSD, ADD, etc.

3. Behavioural medicine treatment (Ch. 21)

a. Stress and its effects

b. Meditation and the relaxation response

c. Effects on specific illnesses

d. Health care delivery and costs

4. Implementing resilience (Ch. 22):

a. Promoting personal control

b. Ways to change behaviour

c. Promoting healthier life-styles

d. Does the mind/body approach always change the course of disease?

5. Some overall conclusions re mind/body health

a. The strong benefits of understanding the mental component of physical illness

- and vice-versa

b. The historical perspective:

- has modern medicine reached an impasse?

- prevention vs. cure; drugs and technology vs. behaviour change

- are there grounds for optimism?

- the growth of pseudoscience; pros and cons of alternative medicine (Goldacre)

c. Improving the life of the individual vs. improving society

- economic and political realities

- health as an altruistic endeavour in an acquisitive society

- the urgent need for greater social justice, nationally and globally

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Resources for Health Psychology

Journals (Use the BU Library search pages)

Relevant articles appear in many psychology journals, especially those in social psychology. Use

PsycInfo to locate journals and books, via the BU Library web page. If we do not stock a needed

title, use Inter-Library Loan to obtain a photocopy of the article.

Health Psychology, Health Education, Preventive Medicine, and Journal of Health and Social Behavior

are examples of core journals that are available via the BU Library web page. BU subscribes to 110

journals dealing with different aspects of health (most via electronic access), plus many more

periodicals on specific related topics, e.g., nutrition or alcohol.

Web sites (Use Google to locate sites that may have moved)

PubMed / Medline http://www.ncbi.nlm.nih.gov/entrez/query.fcgi 20 million abstracts: VITAL

British Medical Journal http://bmj.bmjjournals.com/ (or ILL in BU Library) major journal

Canadian Medical Association Journal http://www.cmaj.ca/ major journal

Journal of the American Medical Association http://jama.ama-assn.org/ major journal

New England Journal of Medicine: Obtain via BU Library Web site (Ebsco) major journal

PLoS Medicine http://medicine.plosjournals.org/perlserv/?request=index-html major journal

Open Medicine http://www.openmedicine.ca/ major journal (Canadian)

The Lancet http://www.thelancet.com/journals/lancet/issue/current major journal

MedlinePlus http://medlineplus.gov/ health and drug information

National Library of Medicine http://www.nlm.nih.gov/ portal: encyclopedias, etc

Cochrane Reviews http://www.cochrane.org/index0.htm valuable summaries

Stats Canada: http://www.statcan.ca/english/Pgdb/health.htm Canadian health statistics

CDC: Centers for Disease Control and Prevention http://www.cdc.gov/ portal: encyclopedias, etc

Medscape http://www.medscape.com/px/urlinfo good re treatment, etc

WebMD http://my.webmd.com/webmd_today/home/default good re treatment, etc

MedicineNet http://www.medicinenet.com/script/main/hp.asp diseases and treatments

Wikipedia http://en.wikipedia.org/wiki/Main_Page very good health entries

Linus Pauling Nutrient Info http://lpi.oregonstate.edu/infocenter/index.html valuable diet facts

The Visible Human http://www.nlm.nih.gov/research/visible/applications.html remarkable anatomy photos

Hardin MD (text and pictures) http://www.lib.uiowa.edu/hardin/md/ excellent photos & text

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Selected Books (See Library index for specific topics)

Dreher, H. (2003). Mind-body unity: A new vision for mind-body science and medicine. Baltimore:

Johns Hopkins. Hardback. 360 pages.

Brannon, L., & Feist, J. (2009). Health psychology: An introduction to behavior and health (7th

ed).

Belmont, CA: Wadsworth/Thomson.

Cousins, N. (2001). Anatomy of an illness: As perceived by the patient. New York: Norton.

Plant, J. (2003). Your life in your hands: Understanding, preventing and overcoming breast cancer.

London, UK: Virgin Books.

Poole, G., Matheson, D., & Cox, D. (2005). The psychology of health and health care: A Canadian

perspective. Toronto: Pearson.

Porter, R. (2001). The Cambridge illustrated history of medicine. Cambridge, UK: CUP.

Rice, P. L. (1998). Health psychology. Brooks/Cole: Pacific Grove, CA.

Sarafino, E. P. (2002). Health psychology: Biopsychosocial interactions (4th

ed). Hoboken, NJ: Wiley.

Taylor, S. E., & Sirois, F. M. (2011). Health Psychology (2nd Canadian ed.), McGraw-Hill Ryerson.

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Subject: RE: Literature Searches

From: “Lisa Hager” <ldhager@hotmail.com>

Date: Tue, 17 Aug 2004 11:01:07 -0500

SEARCHING THE LITERATURE: AREAS IN WHICH STUDENTS

NEED IMPROVEMENT

1. Creating appropriate search terms (students try to use phrases and treat the data bases like Google)

2. Determining when to use the thesaurus (students use everyday terms rather than the PsychLit

terminology)

3. Checking for misspelled words in search terms (“Gee, I couldn‟t find any articles on derpession”)

4. Failure to use logical operators (Cats OR dogs. Heat AND thirst. Drugs NOT alcohol)

5. Failure to narrow searches (one problem area is that they obtain abstracts of unpublished

dissertations)

6. Stopping search once a minimum number of matches are found

7. Failure to use wildcard characters (* stands for anything. ? stands for a single character)

8. Don‟t do searches based on authors‟ names

9. Need to learn to tree forward (finding articles that have cited a key article; our data base interface

shows how many times an article has been cited by others and thus provides access to a citation index)

10. Need to learn to use treeing backward (our data base interface shows how many references and

allows you to obtain a list of the refs in a particular article so you can obtain primary sources cited in an

article)

Lisa Hager, 2004