Difficulty: Introductory | Prerequisites: Psychological Disorders notes (Doc 3 in this series).
This unit covers two related areas: how psychological disorders are treated (with a focus on electroconvulsive therapy and the placebo effect) and how psychological factors influence physical health and coping with stress. Health psychology sits at the boundary between clinical psychology and medicine, examining why some people handle stress well and others do not, and what cognitive variables (optimism, self-efficacy, perceived control) predict better health outcomes. This is typically the lighter section of Exam 3 in terms of volume, but the concepts are straightforward and score well if you know them.
ECT remains a treatment option for severe, treatment-resistant depression. The placebo effect demonstrates how expectations alone can produce real improvement. Health psychology shows that how you think about stress matters as much as the stress itself: optimism, self-efficacy, and perceived control are all linked to better coping and health, while Type A behaviour patterns are associated with increased stress-related illness. Coping strategies fall into two camps: problem-focused (tackling the stressor) and emotion-focused (managing your emotional response).
Electroconvulsive Therapy (ECT)
A biomedical treatment for severe depression that involves passing a brief, controlled electric current through the brain to induce a seizure. Modern ECT uses anaesthesia and muscle relaxants, so the procedure bears little resemblance to its historical depictions. Think of it as a last-resort treatment when medications and therapy have not worked.
Placebo Effect
Improvement in symptoms due to the patient's expectations of treatment rather than the treatment itself. In simple terms, believing you are receiving effective treatment can produce real, measurable changes in how you feel.
Suicide Prevention
A public health approach involving awareness, support networks, and professional intervention to reduce suicide risk. Key principles include taking all expressions of suicidal intent seriously, connecting individuals with professional help, and reducing access to means.
Stress
The body's response to perceived threats or demands. Stress can be acute (short-term, triggered by a specific event) or chronic (long-term, from ongoing pressures). The stress response involves the sympathetic nervous system and the release of cortisol.
Problem-Focused Coping
A coping strategy that addresses the source of stress directly by taking action to change the situation. In simple terms, if the problem is that you have too much work, problem-focused coping means making a plan, delegating tasks, or asking for an extension.
Emotion-Focused Coping
A coping strategy that manages the emotional response to stress rather than the stressor itself. Think of it as techniques like deep breathing, seeking emotional support, or reappraising the situation to feel less overwhelmed.
Type A Behaviour Pattern
A behavioural style characterised by competitiveness, urgency, hostility, and aggression. Associated with higher risk of stress-related health problems, particularly cardiovascular disease. In simple terms, the "always on, always rushing" personality profile.
Optimism
A general expectation that good outcomes will occur. Linked to better physical health, more effective coping, and greater persistence in the face of setbacks. Think of it as a cognitive style, not just a mood.
Self-Efficacy
Belief in your own ability to succeed in specific situations or accomplish particular tasks. In simple terms, it is the difference between "I can handle this" and "I am not sure I can do this," and it predicts whether you will try and how long you will persist.
Perceived Control
The belief that you have influence over your environment and outcomes. Linked to lower stress, better coping, and improved health. In simple terms, feeling that you have a say in what happens to you buffers against the negative effects of stress.
Electroconvulsive therapy (ECT)
Used primarily for severe, treatment-resistant major depression
Modern procedure: general anaesthesia, muscle relaxants, brief electrical stimulation
Side effects can include short-term memory loss; long-term effects are debated
Effective in many cases where medication and psychotherapy have failed
Placebo effect
Demonstrates the power of expectation in treatment outcomes
Placebo-controlled trials are the gold standard for testing whether a treatment works beyond expectation alone
The effect is real and measurable; it is not "just in the patient's head" in a dismissive sense. Brain imaging studies show actual changes in neural activity.
The stress response
Triggered by perceived threats (stressors), not necessarily actual danger
Acute stress activates the fight-or-flight response (sympathetic nervous system)
Chronic stress keeps cortisol levels elevated, which impairs immune function, disrupts sleep, and contributes to cardiovascular problems
Two coping strategies
Problem-focused: change the situation. Most effective when you have some control over the stressor.
Emotion-focused: manage your feelings about the situation. More useful when the stressor is beyond your control.
Most people use a mix of both. Neither is universally better; the match between strategy and situation matters.
Type A behaviour
The hostility component is the strongest predictor of cardiovascular risk, more than competitiveness or time urgency alone
Type B (relaxed, patient) is the contrasting pattern
Optimism
Optimists tend to use more problem-focused coping and seek social support
Associated with faster recovery from surgery, lower rates of depression, and better immune function
Self-efficacy
Domain-specific: you might have high self-efficacy for academic work but low self-efficacy for public speaking
Built through mastery experiences, vicarious learning (watching others succeed), verbal persuasion, and physiological feedback
Perceived control
Losing perceived control (e.g., institutionalisation, loss of autonomy) is linked to learned helplessness and depression
Even small increases in perceived control (choosing your own schedule, having input into decisions) can improve health outcomes
The placebo effect is why drug trials require double-blind designs. Problem-focused coping strategies are taught in cognitive-behavioural therapy for stress management. Self-efficacy research has shaped how educators and coaches give feedback: emphasising mastery and modelling rather than just verbal encouragement. Perceived control findings have influenced how care homes and hospitals design patient environments to support autonomy.
Students often think ECT is a barbaric, outdated procedure. Modern ECT is performed under general anaesthesia with muscle relaxants and remains one of the most effective treatments for severe depression that has not responded to other interventions.
Students sometimes think the placebo effect means the patient is faking improvement. The effect produces genuine physiological changes; it reflects the power of expectation and belief, not dishonesty.
Students frequently assume problem-focused coping is always better than emotion-focused coping. In reality, emotion-focused coping is more adaptive when the stressor is uncontrollable (e.g., grief, terminal illness).
Students often think self-efficacy is the same as self-esteem. Self-efficacy is domain-specific ("I can do this particular task"), while self-esteem is a global evaluation of self-worth.
⚠️ Know when ECT is used (severe, treatment-resistant depression) and what it involves in its modern form.
⚠️ Be able to distinguish problem-focused from emotion-focused coping in a scenario and explain when each is more appropriate.
⚠️ Understand that the hostility component of Type A behaviour is the strongest predictor of health risk, not competitiveness or time urgency on their own.
⚠️ Self-efficacy, optimism, and perceived control are distinct concepts. Be prepared to match each to its definition or to identify which one a vignette describes.
True or False: ECT is primarily used for mild anxiety disorders.
Answer: False. It is used for severe, treatment-resistant depression.
Fill in the blank: A coping strategy that addresses the source of stress directly is called ______ coping.
Answer: Problem-focused.
True or False: The placebo effect produces only subjective changes, with no measurable physiological effects.
Answer: False. Brain imaging and other measures show real physiological changes.
Fill in the blank: The component of Type A behaviour most strongly linked to cardiovascular risk is ______.
Answer: Hostility.
True or False: Self-efficacy is a global trait that applies equally across all domains of life.
Answer: False. It is domain-specific.
Q: A patient with severe depression has not responded to two different antidepressants or cognitive-behavioural therapy. What biomedical treatment might be considered next, and how does it work?
A: Electroconvulsive therapy (ECT). It involves passing a brief electrical current through the brain under general anaesthesia to induce a controlled seizure, which can relieve depressive symptoms in treatment-resistant cases.
Q: In a clinical trial, a group of patients receiving a sugar pill reports significant reduction in pain. What concept explains this?
A: The placebo effect. The patients' expectation of receiving effective treatment produced real improvements, despite the absence of an active medication.
Q: A student facing a difficult exam creates a detailed study schedule and forms a study group. What type of coping is this?
A: Problem-focused coping. The student is taking direct action to address the source of stress (the upcoming exam).
Q: How do self-efficacy and perceived control differ?
A: Self-efficacy is belief in your ability to perform a specific task or succeed in a particular domain. Perceived control is the broader belief that you have influence over your environment and outcomes. A person might have high perceived control over their life in general but low self-efficacy for a specific skill.
Q: Why is the hostility component of Type A behaviour considered more dangerous than the time-urgency component?
A: Research shows that hostility, rather than time urgency or competitiveness, is the element most strongly associated with cardiovascular disease and other stress-related health problems. Hostility triggers more intense and prolonged physiological stress responses.
Self-efficacy connects directly to self-esteem (covered in the personality and social cognition notes), but the two are distinct: self-esteem is global, self-efficacy is task-specific. Stress and coping relate to the diathesis-stress model from the disorders notes: chronic stress can serve as the environmental trigger that activates a pre-existing vulnerability. The placebo effect is relevant to understanding how cognitive dissonance and expectation shape behaviour (covered in the social influence notes).
Treatment, therapy, electroconvulsive therapy, ECT, placebo effect, placebo, clinical trials, suicide prevention, stress, coping, problem-focused coping, emotion-focused coping, Type A behaviour, Type B behaviour, hostility, cardiovascular risk, optimism, self-efficacy, Bandura, perceived control, learned helplessness, health psychology, stress management, PSY II, Florida International University, Exam 3