1. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 1 Schema: Basic models  Jean Piaget  Schema (“scheme”): The representation in the mind of a coherent set of perceptions, ideas, and actions. Basic homeostatic device  adapt to new information and  ensure stability over time and context  The development of knowledge structures: Assimilation Incorporate new experience into existing cognitive structures Stereotypes “Action schema” “Response generalization”Assimilation Incorporate new experience into existing cognitive structures Stereotypes “Action schema” “Response generalization”Accommodation Modify cognitive structure to include new categories Attitude change Verbal / experiential learningAccommodation Modify cognitive structure to include new categories Attitude change Verbal / experiential learning

2. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 2 Markus  “Self-schema”  Consistent cognitive structure (“self-attitude”, beliefs about self & others  Primed by affective or contextual cues  Core mechanism for Filtering & interpreting social information about self & others Maintaining organized self-perception Lowers threshold for recognition & recall Lowers Rx time, errors  Central to recognition & response to health threat Unrealistic / unique optimism and pct. Vulnerability “Schema change”  maintenance

3. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 3 Fingerhut’s model

4. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 4 Self-regulation: Basic cybernetic frame Behavioral intentions Behavioral standards Self-monitoring of ongoing behavior Actual behavior Available feedback Behavioral “Comparator” Self schema “Self-discrepancies”

5. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 5 Ideal Higgen’s self-discrepancy model ActualOught Attributes that directly describe the self Ongoing behavior / behavioral dispositions Attitudes & beliefs Affective states Attributes that represent your... Hopes Aspirations Wishes Attributes that key others (reference group) believes you should posses. Sense of duty Obligations Responsibilities

6. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 6 Ideal Higgen’s self-discrepancy model ActualOught Standpoints: “internal” OwnOtherOwnOtherOwnOther v. “external”

7. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 7 Ideal Higgen’s self-discrepancy model ActualOught OwnOtherOwnOtherOwnOther Basic “self-schema” or self-concept Simple self-perception Perception of other’s view of self “Self-guides”: Internal & external standards Normative reference group: Norms x values term Motivations: Intrinsic versus extrinsic

8. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 8 “Self-schemea” the basic cybernetic frame Behavioral intentions Behavioral standards Self-monitoring of ongoing behavior Actual behavior Available feedback Behavioral “Comparator” “Actual” self Self-perceived Via perceptions of others “Ideal” self “Ought” self Intrinsic goals / aspirations Extrinsic values / demands

9. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 9 Self-discrepancies Behavioral intentions Behavioral standards Self-monitoring of ongoing behavior Actual behavior Available feedback Behavioral “Comparator” Perceived self-discrepancy Real discrepancy between standards & outcomes Chronic availability of standards & behavioral outcomes Priming of ideal / ought standards

10. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 10 Ideal Self-discrepancies, 2 ActualOught Depression, disappointment OwnOtherOwnOtherOwnOther Dejection, loss of esteem Fear, perceived threat Guilt, self-recrimination Anxiety, fear, social anxiety Depression, sadness, self-disappointment

11. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 11 The feared self  Discrepancies and goals:  Actual  ought: behavior shaped toward an outcome by avoidance of negative consequences Guilt, extrinsic motivation Initiation of + behavior likely short term  Actual  Ideal: Behavior shaped by approach of personal goals “Personal striving”, intrinsic motivation Initiation  maintenance  The feared self: Behavior shaped only by avoidance ; no outcome structure

12. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 12 Multiple motives for behavior  Feared self: Diffuse avoidance motives  Ideal / ought self: structures behavior toward approach goal  Combination of avoidant (feared self- based) and approach (ideal / ought –based) motives sum to create behavioral disposition.

13. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 13 Approach – Avoidance conflicts Kurt Lewin, Dollard & Miller:  Approach or avoidance of a goal (or state..) have drive states or strengths  The strength of a drive increases as the animal gets closer to the goal  Avoidance gradients (“BAS”) are steeper than approach (“BIS”) gradients  Negative information is more salient  Pain / avoidance / fear is a stronger motivator than positive affect  As long as one drive predominates action follows.  People can have >1 gradient  If no drive is predominant  state of equilibrium  Resolving equilibrium requires a shift in goals or self-a wareness

14. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 14 Approach gradient NearFar Distance from goal Drive strength Single motive toward a goal: no conflict reliable behavioral outcome Single motive toward a goal: no conflict reliable behavioral outcome Reward sensitivity (BAS) Varies by goal (“schema”) within person Varies between people (individual difference / “personality” variable) Varies by goal (“schema”) within person Varies between people (individual difference / “personality” variable)

15. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 15 Avoidance gradient NearFar Distance from goal Drive strength Also single motive Punishment sensitivity (BIS)

16. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 16 Two Approach Goals NearFar Distance from goal Drive strength Two conflicting goals, but gradients differ enough that conflict is resolved, no equilibrium state

17. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 17 Two Behavioral Goals: Approach – Approach Conflict NearFar Distance from goal Drive strength Approach gradients cross as the subject gets closer to the goals. Resulting equilibrium requires shift in goal strengths. Approach gradients cross as the subject gets closer to the goals. Resulting equilibrium requires shift in goal strengths.

18. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 18 Approach motives positive conceptualizations, reward sensitivity more salient to distant & abstract goals. Approach motives positive conceptualizations, reward sensitivity more salient to distant & abstract goals. Approach – Avoidance Conflict NearFar Distance from goal Drive strength Resolving equilibrium: “Not think” response: cognitive escape, drug use… Change salience of + or – information Value – attitude congruence:  frame concrete behavior in terms of higher-order goal  “assimilate” behavior into self-schema Resolving equilibrium: “Not think” response: cognitive escape, drug use… Change salience of + or – information Value – attitude congruence:  frame concrete behavior in terms of higher-order goal  “assimilate” behavior into self-schema Avoidance concern over negative consequences punishment sensitivity salient to proximal & concrete goals. Avoidance concern over negative consequences punishment sensitivity salient to proximal & concrete goals.

19. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 19 Multiple “self-schema” and approach – avoidance goals NearFar Distance from goal Drive strength Multiple approach & avoidant sub-goals Lead to overall goal pursuit / avoidance

20. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 20 Leventhal’s “Common Sense” model: Normative or individual cognitive schema“Disturbance” term in cybernetic model Response to “hot” cognition: affective reactivity Causal attributions, outcome & efficacy expectancies, information seeking Capacity for approach (instrumental) or avoidant (affective) coping responses Approach / avoidant “goals” vis-à-vis “behavioral comparator”.

21. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 21 Health threats and self-regulation Behavioral intentions Behavioral standards Self-monitoring of ongoing behavior Actual behavior Available feedback Behavioral “Comparator” Cognitive & affective representation of health threat Disturbance, threat info.

22. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 22 Health beliefs in a cybernetic frame Behavioral intentions Behavioral standards Self-monitoring of ongoing behavior Actual behavior Available feedback Behavioral “Comparator” Cognitive & affective representation of health threat Disturbance, threat info. Problem recognition: is there a problem? “Cues to action”: availability of health information Sensitivity to physical or ψ status (e.g., “ψ mindedness”) Social norms  visibility of impairment or change Problem recognition: is there a problem? “Cues to action”: availability of health information Sensitivity to physical or ψ status (e.g., “ψ mindedness”) Social norms  visibility of impairment or change

23. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 23 Health beliefs in a cybernetic frame Behavioral intentions Behavioral standards Self-monitoring of ongoing behavior Actual behavior Available feedback Behavioral “Comparator” Problem Definition: What is it? Simple knowledge & beliefs Negative v. positive definitions Health v. Illness Physical v. behavioral Causal attributions (internal / stable v. external / unstable) Problem Definition: What is it? Simple knowledge & beliefs Negative v. positive definitions Health v. Illness Physical v. behavioral Causal attributions (internal / stable v. external / unstable) Cognitive & affective representation of health threat Disturbance, threat info.

24. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 24 Health beliefs in a cybernetic frame Behavioral intentions Behavioral standards Self-monitoring of ongoing behavior Actual behavior Available feedback Behavioral “Comparator” Cognitive & affective representation of health threat Disturbance, threat info. Problem solving strategies Simple health care availability Anticipated stigma Instrumental v. affective coping responses Outcome & self-efficacy expectancies  active coping Expectancies of affect regulation  avoidant coping Problem solving strategies Simple health care availability Anticipated stigma Instrumental v. affective coping responses Outcome & self-efficacy expectancies  active coping Expectancies of affect regulation  avoidant coping

25. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 25 Health beliefs: Protection Motivation Behavioral intentions Behavioral standards Self-monitoring of ongoing behavior Actual behavior Available feedback Behavioral “Comparator” Cognitive & affective representation of health threat Disturbance, threat info. Protection motivation model Threat appraisal HBM constructs: vulnerability & severity of threat “Approach” motivations: intrinsic & extrinsic rewards Threat appraisal HBM constructs: vulnerability & severity of threat “Approach” motivations: intrinsic & extrinsic rewards Coping appraisal Performance & response efficacy “Avoidant” motivations: response cost Coping appraisal Performance & response efficacy “Avoidant” motivations: response cost

26. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 26 Protection motivation  Core construct:  Interaction of Efficacy expectancies x perceived threat.  Sturges et al., 1996: Adolescent’s intention to smoke, by: Experimental threat condition Baseline “active” coping skills.  High threat + low coping  “boomerang” effect

27. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 27 Protection motivation: Wu et al., 1  Integrative heuristic model: key variables  Personal & cultural sources of information  Complex threat appraisals  Coping resources  Motivational “readiness” Rewards / facilitators Costs Begin self-regulating the threat

28. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 28 Protection motivation: Wu et al., 2  Core elements of Health Belief Model:  Health information  Perceived severity  Personal vulnerability  Cues to action?

29. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 29 Protection motivation: Wu et al., 3  Theory of reasoned action:  Norms  Beliefs & attitudes  Self-efficacy  Behavioral intention as core outcome

30. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 30 Illness representations & self-regulation Identity of the disease Cause Timeline Consequences Controllability Internal v. external attribution Chronicity: eventual coping demands “burnout” Chronicity: eventual coping demands “burnout” Perceived severity Perceived vulnerability Perceived severity Perceived vulnerability Expectancies: Outcome Self-efficacy Expectancies: Outcome Self-efficacy Cognitive representation

31. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 31 Illness representations & self-regulation Core dimension: Active / instrumental Affective Avoidant Denial, distancing Self-blame, fatalism Alcohol / drugs, etc. Avoidant Denial, distancing Self-blame, fatalism Alcohol / drugs, etc. “Problem solving” Skills & knowledge Social support self-efficacy Other resources “Problem solving” Skills & knowledge Social support self-efficacy Other resources Identity Cause Timeline Consequences Controllability Cognitive representation Coping resources

32. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 32 Illness representations & self-regulation Cognitive representation Coping resources Identity Cause Timeline Consequences Controllability Affective state Instrumental vs. Affective Positive & negative affect Quality of life “Future orientation”

33. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 33 Illness representations & self-regulation Cognitive representation Coping resources Identity Cause Timeline Consequences Controllability Affective state Instrumental vs. Affective Positive & negative affect Quality of life “Future orientation”

34. Psychology 415; Social Basis of Health Behavior Social / Cognitive & affective models 34 Benyamini: 3-level self-regulation model data