While not widely recognized, the field of Affective Determinants of Health (ADoH) is gaining popularity due to an increased understanding of its pivotal role in shaping a person’s health behaviors. For many years, health behavior theories emphasized the role of conscious, behavior-specific cognitions as the main determinants of health behaviors. However, their effectiveness in behavior change interventions has been limited.
To better comprehend what truly drives a person’s health behavior, the recent focus has shifted to nonconscious psychological processes like moods and emotions – the affective determinants that significantly influence our health behaviors. It’s crucial to acknowledge that up to 50% of a person’s overall health is driven by these behaviors.
Though the interactivity of mental states and physical health has long been recognized generally, the field of affective determinants of health is relatively new, tracing back to the early 1980’s with the publication of Stress, appraisal, and coping by R. S. Lazarus and S. Folkman. However, it wasn’t until the late 20th century that the term gained momentum.
Since then, a growing body of research has demonstrated the ways emotions can influence health. These include:
- Influencing our health behaviors. For instance, people experiencing negative emotions like anxiety or depression are more likely to engage in unhealthy behaviors, such as smoking or overeating.
- Influencing our physiological responses. Strong emotions can trigger the release of hormones and other chemicals that directly impact our health. For example, prolonged exposure to stress hormones can increase the risk of developing heart disease and other chronic health conditions.
- Influencing our social interactions. Our emotions can shape the way we interact with others, which can, in turn, affect our health. For instance, people experiencing social isolation are more likely to have poor health outcomes.
In a strict medical context, affect typically refers to the observable expression of emotions.
Affect also has a broader interpretation encompassing a wide range of emotions, moods, and sensations influencing our physiological responses. These affects are subjectively experienced by individuals, with varying levels of intensity and valences, i.e., negative or positive reactions.
Impact of Affects
Let’s take a closer look at the specific affects: stress, depression, anxiety, loneliness, irritability, fatigue, pain, and malaise. These are universally experienced emotions and sensations, part of the human experience. Each one, with its own physiological impact. While not a comprehensive breakdown, the list below provides a brief description of how affects interaction with our physiological responses:
- Stress: Chronic stress can disrupt various body systems and increase the risk of different conditions, including cardiovascular disease and obesity. Chronic stress has also been identified as a major contributor to substance abuse and interpersonal violence. Additionally, it is implicated in poor medication treatment adherence.
- Anxiety: Anxiety has been linked to several chronic illnesses, including heart disease and gastrointestinal conditions. It is also a contributing factor to substance abuse, smoking, overeating, and poor medication adherence.
- Loneliness: Loneliness can lead to depression, alcoholism, cardiovascular disease, obesity, inflammatory disease, stroke, and suicide, among other conditions. It is also identified as a potential risk factor for Dementia of the Alzheimer’s Type (DAT).
- Irritability: Irritability can lead to greater cardiovascular reactivity to stress, reduced quality of life, heightened risk of suicide, lower educational achievement, and could indicate the presence or development of bipolar mood disorder.
- Depression: Depression can contribute to and exacerbate pain-related conditions, cardiovascular disease, heart failure, coronary artery disease, gastrointestinal problems, inflammatory conditions, autoimmune disorders, including Type 2 diabetes, and has implications for sleep dysfunctions like insomnia.
- Pain: Pain has been identified as a risk factor for opioid abuse and has been implicated in poor medication adherence. Pain that interferes with daily life has also been identified as a significant risk factor for premature death.
- Fatigue: Chronic fatigue has implications for treatment non-adherence, increased risk for work-related injuries, and is indicative in the development of a host of medical disorders including diabetes, cardiovascular diseases, obesity, and adverse reproductive outcomes.
- Malaise: Self-appraised general health is a powerful predictor of future morbidity and mortality. Ironically, a high sense of wellness can negatively impact treatment adherence due to a diminished subjective sense of disease management importance.
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How Affective Determinants Of Health Impact Our Health
By recognizing these affects as potential signs of underlying mental health disorders or physical ailments, we can better address significant hurdles in treatment adherence and manage unhealthy coping mechanisms. This can pave the way for effective, patient-centric care interventions.
Screening for Affects
Screening for ADoH helps identify experiences that require further investigation, provides a more nuanced approach to differential diagnosis, and facilitates appropriate referrals. Additionally, regular screening enables progress monitoring and documents the efficacy of various therapeutic strategies. Crucially, it can identify individuals at a heightened risk for developing or exacerbating chronic health conditions.
Overall, ADoH offer an invaluable perspective on our health. By recognizing their importance, understanding specific affects, and incorporating screening strategies, we can enhance healthcare delivery and patient outcomes significantly. Whether as therapists, social workers, health coaches, educators, community health workers, or care coordinators, acknowledging these powerful influences is a crucial step towards comprehensive, patient-centered care.
The field of ADoH has immense potential to revolutionize healthcare. By expanding our healthcare models to include affects that drive health behavior, we can ensure better health outcomes for individuals and populations alike. It’s time we brought these overlooked health determinants to the forefront of our healthcare strategies and acknowledge their pivotal role in shaping our health.