LIFE SPAN DEVELOPMENT AND HEALTH

Developmental Health Psychology: Studies the interrelationship of health and aging.

The challenges to health, the types of illnesses encountered, and the causes of death
vary according to age.

Stages of Development

S. Developmental Health Status and Risk Factors

no Periods Risk factors related to birth defects called teratogens.
What is healthy for the mother is healthy for her fetus.
1 Infancy Teratogens are related to low birth weight.
(birth to 2) Delivery before the 37thweek is considered preterm birth. Preterm
babies usually weigh less than 2.5kg.
80% of babies weighing less than 2 pounds at birth die.
New born who weighed less than 3 pounds may have normal IQ
scores and may be doing well at 5 years of age. Mild impairment of
cognitive impairment is also found.
Maternal risk factors and psychosocial, structural and
sociodemographic variables are associated with low birth weight.
2 Early Average colds between 7-8 a years largely due to the immaturity of their
childhood immune systems.
(2-6 years) Exposure is also a major risk factor in illness.
3 Middle As the immune system matures, the frequency of colds deceases slightly
childhood in middle childhood to about 6 per year.
(6-12 years)
4 Adolescence Accidents remain the leading cause of death. Intoxication is related to
(13-20 years) motor vehicle accidents.
Suicide and homicide.
Lack of social support, family conflicts, job problems are related to
depression.
More girls than boys attempted suicide.
Low socio-economic status is a major risk factor for homicide, while it is
not for suicide.
5 Young Automobile accidents remain an important cause of death.
adulthood After 35 years, the life style diseases-coronary artery disease, cerebral
(20-40 years) vascular and cancer.
Men are twice as likely as women to die in young adulthood. Strong
relationship between social class, education and preventive health
practices.
6 Middle The lifestyle diseases are firmly entrenched at the top 3 causes of death.
Adulthood Death rate doubles from 35-45 years of age and it doubles again from 45-
(40-65 years) 55.
Chance of dying from heart attack and strokes decreased.
Lung cancer gone up so dramatically.
The reduction of reserved capacity.
Tolerance, vital lung capacity, cellular immunity and kidney function
 have declined leaving less resistance to physical challenges.
Climacteric Change
Long term health risk is the development of osteoporosis.
Men usually maintain their reproductive capability till 60 years of age
but some reduction in fertility and frequency of orgasm does occur.
7 Later 45% deaths due to heart diseases. Cancer 20% and stroke 11%.
Adulthood Chronic conditions but report fewer colds and influenza.
(above 65)

3 Variables Related to Health

Developmental Stress Personal Control Social Support

Periods Stress involving 3 Is the ability to exert an Involves both the
components: influence on events in quantity and quality of
environmental one’s life. one’s relationship.
circumstances, cognitive It may influence the
appraisal of these immune system.
circumstances, internal
physiological responses.
Infancy Contraction of placenta, Lowest level of personal Amount and quality of
(birth to 2) umbilical cord and head control is during infancy. stimulation in the early
are compressed during environment influence
delivery resulting in the development of the
deprivation for oxygen. brain, weight, height and
Its prolongation leads emotional well-being.
towards brain damage or Attachment provides
death. security on which later
The newborn’s adrenal independence is based.
glands release up to 10 Failure to thrive.
times more
catecholamine at birth
than do men who are
exercising.
1-4 years are critical
period.
Early School, family stressors, Between 6-12 they Poverty is a barrier to
childhood divorce, single parent become more adequate prenatal
(2-6 years) prove to be more independent, develop maternal nutrition and
Middle effective as compare to cognitive capacity. health care.
both conflicting parent. Piaget’s description.
childhood
(6-12 years)
Adolescence Stress related to Cognitive abilities and Wider friendship network
(13-20 years) depression and the high independence. increases the potential for
suicide rate among Potential for personal social support.
adolescents as well as to growth and control. Values and behaviors of
substance abuse and Experience for coping. one’s peer group may or
eating disorders. may not enhance health
Physical and sexual and well being.
 maturation
Cultural and societal
expectations, peer
pressure. Teenage
mothers are more likely
to suffer stress.
Young Life transitions such as Assume personal control Married people are
adulthood developing relationships, of their health. healthier than single
(20-40 years) career making, getting Young adults have individuals.
married and having cognitive abilities, Men have better survival
children. Changes in independence and coping if they are married.
dynamics of family experiences to exercise Women have better
relationships. personal control. survival if they engage in
Middle Stress continues at its Experience and wisdom religious activities.
Adulthood highest level early in this seem to make up for the Quality of social support
(40-65 years) period. Marital decline in physical is important.
satisfaction declines. It abilities during middle
increases when children adulthood.
grown up. Accumulated
life experiences.
Later Ages between 65-74 Personal control begins 55 of older people have
Adulthood have the highest rate decline never married. Those
(above 65) attempted suicide. Older Institutionalization of the who married have life
men seem to be oriented elderly. satisfaction. Divorce is
toward self destruction, Older adults are less extremely rare in later
suicidal thoughts and self anxious than others. adulthood. Divorced in
neglect. Poor planning Less pressure in living. have higher death rates
and poor adjustment. and mental illness.
Stress from grief can
affect immune system.
 MODELS OF HEALTH RELATED BEHAVIORS

HEALTH RELATED BEHAVIORS

KASL & Cobb (1966) classified health related behaviors in 3 categories.

 ILLNESS BEHAVIOR SICK ROLE BEHAVIOR

HEALTH BEHAVIOR

 Actions that people engage Focus on illness and
Health

promotion or
in when faced with disease rather than
disease
 prevention

uncertainty in order to on prevention.
behavior
 clarify and understand their
 in the absence of
Action status. Actions to restore or
 rehabilitate health
signsand symptoms Seeking advice from family
aimed taken by people who
 at remaining well and friends as well as from
or improving
 their state of have been labeled as
people who have
well-being. knowledge and training in ill.
health care. People who occupy
Learn at an early age
through observation and Help seeking and the sick role have
reinforcement information seeking certain rights and
behavior privileges and in
return they must
fulfill certain duties or
obligations.
HEALTH BELIEF MODEL
It grew out to understand why people often failed to take advantage of available
programs and services.
The Health Belief Model (HBM) is another extensively researched model of health
behavior (Hochbaum & Rosenstock, 1952). The HBM attempts to predict health-related
behavior in terms of certain belief patterns. A person's motivation to undertake a health
behavior can be divided into three categories: individual perceptions, modifying factors,
and likelihood of action.
Individual perceptions are factors that affect the perception of illness and with the
importance of health to the individual, perceived susceptibility, and perceived
severity. Modifying factors include demographic variables, perceived threat, and
cues to action.
The likelihood of action is the perceived benefits minus the perceived barriers of
taking the recommended health action. The combination of these factors causes a response
that often manifests into the likelihood of that behavior occurring (Janz & Becker, 1984;
Rosenstock & Strecher, 1988).
Based on value-expectancy formulation: people will take action when behavior leads to an
outcome that is valued and when they have an expectancy that the outcome can be achieved.
Other factors such as personality characteristics, knowledge about and interest in health,
past experience.

PERCEIVED SUSCEPTIBILIY
PERCEIVED THREAT
Degree to which people feel
vulnerable to a given health
problem

PERCEIVED SEVERITY

Seriousness of contracting an
SELF- EFFICAC Y
illness
Person’s belief that she can
successfully accomplish the
PERCEIVED BENEFIT action required to achieve a
BEHAVIOR
goal
People take action when they
feel it is likely to work
EFFICCY OF THE
PERCEIVED BARRIERS BEHAVIOR

Drawbacks of a given course

of action
++

(Becker, 1974 & Rosenstock, 1966)

 THE THEORY OF REASONED ACTION (Ajzen, & Fishbein, 1977)

 Its extension is the Theory of Planned Behavior (TPB)

 TPB- approach for understanding and predicting when and why people take health
related actions.
 Understand the role that cognitive factors, especially attitudes, played in deciding to
take action.
 The best way to predict behavior is to know a person’s behavioral intensions.
 Intensions are the product of three factors
(1) Attitude towards the behavior
(2) Subjective norms
(3) Perceived norms

BELIEF THAT THE

BEHAVIOR LEADS TO
ATTITUDE TOWARDS
CERTAIN OUTCOME
THE BEHAVIOR

EVALUATION OF THE
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OUTCOME AS POSITIVE
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MOTIVATION TO COMPLY
WITH THEM
(Ajzen, & Fishbein, 1977)

DEALING WITH THE SYMPTOMS

Decisions and actions relating to symptoms and disease can be thought of as part of a three
stage process:
BECOMING AWARE OF SENSATIONS INTERPRETING SYMPTOMS PLANNING AND TAKING ACTIONS

Common sense epidemiology: Prototypes and

Strong, Novel & Persistent generating hypothesis about expectancies:
Pain, disruptive the nature of their problem Disease prototype:
The more attention is paid to and engage in a search for Idealized conceptions of
external stimuli, the less is additional information. what symptoms go
attended
The typestoand
theexpectancies
bodily sensation. Cognitive elements have 5 together for any health
Individual differences (mood, elements. problem
dispositions). 1. Identity Medical status student’s
Who felt momentarily sad, report 2. Time line (Bishop, 1990)
more aches and pain, discomfort 3. Consequences The role of culture
than people who felt happy 4. Cause
(Salovey & Birnbaum, 1989). 5. Cure
 Interpretation of bodily sensations
If signal is too weak

If person is distracted

Not noticed Dispositional and

momentary status
No action

Interpretation as Decision
symptom required as to
help-seeking
Attribution
Physical changes Labeling of process via
sensation external search

Interpretation as No health related

Formulation of nonsymptom action necessary
hypothesis based
on expectations
and past
experiences (Cioffi, 1991)

Planning and Taking Actions

Once people recognize a set of symptoms and realization of their severity they have some
options:
- Ignoring the symptom
- Denying
- Hoping that symptom will go away
- May seek help from lay referral network (family and friends)
- Seeking help from spiritual healers, herbalist

FACTORS THAT INFLUENCE BEHAVIOR

DELAYING BEHAVIOR MODEL

Model of Delay Behavior by Martin Safer

Recognition Am I ill Do I need to Is the cure Seeking help

of symptom see a health worth the
TRIGGERS TO ACTION professional costs involved
 Zole (1973) described 5 triggers to action. His work is combined with Jones et al, 1981.
These cues can be conceptualized in 2 broadly defined sources.
Person’s Symptoms Person’s Circumstances
Symptoms trigger behavior in several ways Circumstances determine action in several ways
1. Physical and perceptual characteristics of 1. Interpersonal crisis
symptoms 2. Financial circumstances
2. Appraisal of symptoms 3. Encouragement by others
3. Effects or consequences of symptoms
The Transtheoretical Model (Stages of Change) Prochaska and Velicer (1997)
 Transtheoretical Model (TTM) focuses on the decision-making of the individual and
is a model of intentional change.
 The TTM operates on the assumption that people do not change behaviors quickly
and decisively. Rather, change in behavior, especially habitual behavior, occurs
continuously through a cyclical process.
 The TTM is not a theory but a model; different behavioral theories and constructs can
be applied to various stages of the model where they may be most effective.
 The TTM posits that individuals move through six stages of change:
1.Precontemplation, 2.Contemplation, 3.Preparation, 4.Action, 5.Maintenance, and
6.Termination.
 Termination was not part of the original model and is less often used in application of
stages of change for health-related behaviors.
 For each stage of change, different intervention strategies are most effective at
moving the person to the next stage of change and subsequently through the model to
maintenance, the ideal stage of behavior.
 To progress through the stages of change, people apply cognitive, affective, and
evaluative processes. Ten processes of change have been identified with some
processes being more relevant to a specific stage of change than other processes.
1. Precontemplation - people do not intend to take action in the foreseeable future
(defined as within the next 6 months). People are often unaware that their behavior is
problematic or produces negative consequences. People in this stage often
underestimate the pros of changing behavior and place too much emphasis on the
cons of changing behavior.
2. Contemplation - people are intending to start the healthy behavior in the foreseeable
future (defined as within the next 6 months). People recognize that their behavior may
be problematic, and a more thoughtful and practical consideration of the pros and
cons of changing the behavior takes place, with equal emphasis placed on both. Even
with this recognition, people may still feel ambivalent toward changing their
behavior.
3. Preparation (Determination) - people are ready to take action within the next 30
days. People start to take small steps toward the behavior change, and they believe
changing their behavior can lead to a healthier life.
4. Action - people have recently changed their behavior (defined as within the last 6
months) and intend to keep moving forward with that behavior change. People may
exhibit this by modifying their problem behavior or acquiring new healthy behaviors.
5. Maintenance - people have sustained their behavior change for a while (defined as
more than 6 months) and intend to maintain the behavior change going forward.
People in this stage work to prevent relapse to earlier stages.
6. Termination - people have no desire to return to their unhealthy behaviors and are
sure they will not relapse. Since this is rarely reached, and people tend to stay in the
maintenance stage, this stage is often not considered in health promotion programs.
(Prochaska & Velicer,1997)

ADHERENCE
1. Adherence or compliance refers to the extent to which a person’s behavior is
consistent with or follows from expert advice, most typically that of a health
care practitioner.,
2. To measure adherence one method is the pills count, use of biochemical
analysis and chemical markers.
3. Adherence rates with demographic and personality factors have generated
findings that are week, inconsistent or nonexistent.
4. In general, rates of adherence are higher for acute rather than chronic illnesses.
5. Good communication and high adherence go hand in hand.
6. Too much information, patients may become overwhelmed.
7. Physician has to decide what information is most essential, explain this as
possible, check for understanding, and supply written information as a backup
to what was said.
8. To improve Patient-practitioner interaction (1) emotional atmosphere and level
of comfort and attachment created between patient and practitioner (2) task
related functions involved with providing complete, accurate and useful
information.
9. Positive feelings and a perception that one’s physician is warm and caring have
been associated with adherence, appointment keeping and life style changes.
10. Patients to wait a long time are associated with low adherence.
11. Abstract information does not significantly improve compliance.
12. Physician must check for understanding, invite question asking and supplement
verbal instructions with written information.
13. To improve adherence, medication calendars, drug reminder chart, special pill
dispensers are useful.
14. Patient contract contain an outline of expected behavior and specific goals that
the patient and practitioner have agreed on as well as rewards for meeting the
goal. Goals should be clear, specific and realistic.
15. Family members should be involved in treatment as a source of encouragement