Psychology 415; Social Basis of Health Behavior Automaticity, escape 1 Controlled v. automatic...

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior

Automaticity, escape 1

Controlled v. automatic behavior: some core constructs

Critical role of associative learning Cognition Affective responses Physiological activation Immune functioning…

Extrinsic stimuli & self-focused attention: Rosemary’s Baby

Fluid, capacity-based conception of “controlled” behaviors or cognitions

Implicit learning

Imitative learning: key role of “mirror neurons” in learning & behavior

Stereotype activation: cue-based perceptual biases

Progressive mechanization in skill learning

Automatic activation of affective responses: “preferences precede inferences…”

Associative learning & goal activation…

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Bargh; goal activation

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Sexual Escape

“Honey, you know it don’t count if I was high..."B.B. King, (1971). How Blues Can You Get.

I think [alcohol & drugs] also helps them to forget about [AIDS]. ...some of them...are able to keep their wits about that in the sense of using safe sex, using a condom. But I think others, it makes it less scary. It makes the experience a lot less frightening in terms of HIV and AIDS and not having that in the forefront of their minds when they’re engaging in the activity.

...there are a lot of ... men who would be so-called straight who

under the influence of alcohol or with them knowing that they’re going to drink so they can go ahead and sleep with another guy…

Well, I don’t like to admit it, but worrying about HIV when I’m out

meeting guys is a drag. When I drink, I don’t worry so much...

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Socio-cultural Models of Sexual Risk / Prevention

Information dissemination Targeted v. general populations

Indigenous information / attitude change methods

Community based dissemination / diffusion

Opinion leaders

Settings

Churches, etc.

‘Stages of change’

pre-contemplation

contemplation

action

maintenance

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Socio-cultural models, cont.

Prevention resources Condom availability

Needle availability

HIV / STI testing

ART treatment

Community Socialization ‘Sexualization’ of gay identification

Implicit v. explicit normative standards

Opportunity & exposure

Drug availability

Risk partner availability

social / personal priorities cost :: utility

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Social / cultural models, 3

Legal & Policy Interventions needle exchange

legalized drug use / sex work

Gay marriage

‘Homophobia’ / discrimination

Medical practice / training

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Person – based models of sexual risk

Simple attitude models: Health beliefs x values "intentions“

Self-efficacy & outcome expectancies Information & skills

RationalOperator:

Motivational: Fear arousal / protection motivation Self-identity & health motive Optimism & perceived vulnerability

e.g., reactive effects of ART.

“Dyscontrol”: Chronic or acute substance abuse Ψ symptoms Sensation seeking / risk taking “Personality disorder“ / impulsivity Childhood sexual abuse / PTSD

sequalae

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Risk: Person – based models

Social network

Partner / peer pressure

Sexual context Local norms Safety availability

Chronic stress

Sexual availability

e.g., internet norms & availability

Coping skills

Avoidant coping

Self-esteem

Bar orientation

Ambivalence

““Stress” Stress” VulnerabilityVulnerability

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Stress –vulnerability

Internet use and sexual risk among MSM

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Internet & sexual risk, 2

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Stress – vulnerability model of MSM drug use

“Escape” expectancies of alcohol / drug use.

“Escape” expectancies of alcohol / drug use.

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Cognitive escape models

VulnerabilityVulnerability Performance standardsPerformance standards Negative affectNegative affect Cognitive restraintCognitive restraint ExpectanciesExpectancies Sensation seekingSensation seeking Cognitive capacityCognitive capacity

Releasing StimuliReleasing Stimuli SettingsSettings Partner characteristicsPartner characteristics Substance useSubstance use Affect / internal statesAffect / internal states Initial “slip”Initial “slip” Financial pressure (?)Financial pressure (?)

Cognitive disengagementCognitive disengagement Concrete action identificationConcrete action identification ““Automatic” behaviorAutomatic” behavior

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


High performance standardsHigh performance standards

Negative affectNegative affect

Escape motive / expectanciesEscape motive / expectancies+ +

Contextual risk inducementsContextual risk inducements

Low level action Low level action identificationidentification

Automatic behaviorAutomatic behavior

Escape process

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Escape, 2

High Performance StandardsHigh Performance Standards Externally imposedExternally imposed

StrongStrong norms & intentions norms & intentions

Inescapable / unalterableInescapable / unalterable

Negative affect re: failuresNegative affect re: failures Perceived personal vulnerability + severityPerceived personal vulnerability + severity

Ought Ought actual | Ideal actual | Ideal actual discrepancies actual discrepancies

Low self-efficacy for instrumental copingLow self-efficacy for instrumental coping

Low outcome expectanciesLow outcome expectancies

““Coping burnout” / fatalismCoping burnout” / fatalism Fear / shameFear / shame Depression Depression / / angeranger

Aversive self-Aversive self-awarenessawareness

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Escape, 3

Escape motive / ExpectanciesEscape motive / Expectancies Sexual / alcohol / drug expectanciesSexual / alcohol / drug expectancies

Avoidant copingAvoidant coping

Cultural / individual support for “escape”Cultural / individual support for “escape”

Drug norms & availabilityDrug norms & availability

Cultural visibility of / norms for health behaviorCultural visibility of / norms for health behavior

Contextual risk inducementsContextual risk inducements Situational “releasing stimuli”Situational “releasing stimuli”

““Exceptional” times / places / peopleExceptional” times / places / people

Physical constraints on communication, safety, negotiationPhysical constraints on communication, safety, negotiation

Normative environmentNormative environment

Implicit / explicit standards for sex, drugs, communicationImplicit / explicit standards for sex, drugs, communication

““We’re all in” syndromeWe’re all in” syndrome

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Escape, 3

Low level action identificationLow level action identificationDeconstructed Action > larger / abstract meaning

Attentional focus Attentional focus

““Mechanics” Mechanics” >> “Meaning” “Meaning”

Reward (gain) sensitivity Reward (gain) sensitivity >> punishment (loss) sensitivity punishment (loss) sensitivity

Context sensitivityContext sensitivity

““Stimulus bound”Stimulus bound”

Sensation seekingSensation seeking

Irrational thoughts (?)Irrational thoughts (?)

Strategic substance useStrategic substance use

Impaired abstract information processingImpaired abstract information processing

Self-fulfilling expectancies of affective responsesSelf-fulfilling expectancies of affective responses

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


Escape, 3

Automatic behaviorAutomatic behavior Core characteristicsCore characteristics

EffortlessEffortless (few attentional demands)(few attentional demands)

UnintentionalUnintentional (independent of larger goals)(independent of larger goals)

AutonomousAutonomous (fixed “action pattern” or “script”)(fixed “action pattern” or “script”)

UncontrollableUncontrollable (resists conscious change)(resists conscious change)

““Automatic” maintenance:Automatic” maintenance: Associative learning: stimulus environment + “not think” Rx.Associative learning: stimulus environment + “not think” Rx.

++ Instrumental learning: strong rewards for cognitive avoidanceInstrumental learning: strong rewards for cognitive avoidance

Death, destruction and despairDeath, destruction and despair(or not…)(or not…)

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


The wages of cognitive escape

Ps

yc

ho

log

y 4

15

; S

oc

ial

Ba

sis

of

He

alt

h B

eh

av

ior


AIM study of drug using MSM

Psychology 415; Social Basis of Health Behavior Automaticity, escape 1 Controlled v. automatic...

Documents

Transcript of Psychology 415; Social Basis of Health Behavior Automaticity, escape 1 Controlled v. automatic...