Читать книгу Psychological Aspects In Time Of Pandemic - Juan Moisés De La Serna, Dr. Juan Moisés De La Serna, Paul Valent - Страница 8

One of the most difficult phenomena for people to face is in terms of the adoption of healthy behaviour, which requires some time to accept, understand and assume.

Unlike other phenomena such as the latest trends, which have the ability to motivate the population, when it comes to health, the authorities are often faced with minimal success in their awareness campaigns. Such campaigns aimed at the recommendation of the adoption of healthy habits and behaviour are usually accompanied by restrictions and even penalties for those who do not comply.

However, the population struggles to see any ‘benefits’ in the short term, resulting in a reduction in any ‘interest’ and motivation for the adoption of these new habits, to the extent they may not even carry them out at all, thus failing to comply with the authorities’ recommendations.

Whilst health is an aspect of concern to society, the concept of prevention is not always understood and accepted in the same way, especially when it comes to the adoption of some behaviours which tend to go against those which are customary (MinInteriorAR, 2020) (See Illustration 10).

Illustration 10. Tweet - Prohibited Activities

[Look after your health and your family’s. Always remember not to share your mate ¹, your utensils and other personal objects. Learn more at bit.ly/Coronavirus-Co ]\]

In the case of COVID-19, the population has been asked to ‘abandon’ some practices and adopt new ones. Going against ‘routine’, has made it difficult for many at first to adopt these recommended measures. This is because, sometimes, despite medical guidelines, the population does not acknowledge the risks to their health of certain behaviours, as previously mentioned. One such instance is in the practice of artificial tanning with UVA rays, an activity that has greatly increased in certain countries over recent years.

In some places being tanned has become something of a status symbol. One employee, having enjoyed a few days at the beach may return to work nice and brown, whilst the rest of the office, who have not been so lucky are still white and pale. On the contrary, in other places, being tanned is a sign of a lower social status, since the sun burns the skin of outside workers, giving it that characteristic brown colour, whilst other less manual jobs do not leave that ‘imprint’ on the body. It can therefore become a signal as to the economic status of the consumer, differentiating between those who can afford it and those who can’t.

In Western society today the first approach dominates, that is people feel good about themselves when tanned, something which takes time and in some cases money, to achieve. To meet this demand, a number of establishments have emerged, with UVA lamps which produce the same effect on the skin after one or more exposure sessions. And so, with this UVA ray system, the same tanned appearance is achieved as if one had gone on a relaxing beach holiday in the sun.

So, simply by spending a few minutes inside one of these devices, one can enjoy the ‘benefits’ of being considered of a higher economic status.

Illustration 11. Tweet - Relation between UVA rays and cancer.

[UVA rays cause cancer]

Despite the popularity of this system, in recent years medical research has been compiled which has discovered associations between the excessive use of UVA rays and skin cancer. Therefore, people who use and, more importantly, abuse these tanning sessions are voluntarily putting themselves at risk to skin diseases (adgs125, 2019) (See Illustration 11).

An investigation has been carried out to assess the psychological impacts of the usage of UVA rays by the Department of Dermatology, Warren Alpert Medical School; Department of Epidemiology, School of Public Health; Medical Centre, Providence VA Medical Centre; and the Department of Psychiatry and Human Behaviour, Warren Alpert Medical School, Brown University; together with Division of Network Medicine, Brigham Hospital; Department of Nutrition and Department of Epidemiology, Harvard School of Public Health; together with the Division of Adolescent Medicine, Boston Children’s Hospital; Department of Dermatology, Rhode Island Hospital (EE.UU.) together with the Department of Occupational and Environmental Health Sciences, Faculty of Public Health, University of Peking (China) (Li et al., 2017).

The study involved 67,910 women between the ages of 25 and 35 who were asked regards the frequency with which they used UVA ray tanning rooms. The aim of the study was to determine if there was an association between frequent indoor tanning and other mental disorders such as food addiction. To this end the Yale Food Addiction Scale was used (Flint et al, 2014). The participants’ clinical history as to whether or not they had suffered from depression was also taken into account.

The results showed a significant relationship between the presence of depression and greater use of UV rays. Also demonstrated was a significant relationship between the abuse of UV rays and symptoms associated with eating disorders, particularly anorexia.

As with other activities, the use of this type of service may be considered normal, except when control is lost and it becomes an addiction, that is to say it is being undertaken for its own sake, rather than for the benefits it may bring. Such behavioural addiction to tanning is called tanorexia. In this instance, the depressive symptoms appear to play a fundamental role in the formation or maintenance of the addiction to UVA rays, as if the individual attempts to ‘offset’ their state of mind by giving a ‘better’ image of themself to others.

Previous research has reported significant relationships between food disorders and depressive symptoms, but in this instance the relationship is mediated by an addictive behaviour, such is the abuse of UVA rays.

According to the conclusions of the study, consideration must be taken with individuals who abuse the use of UVA rays, since it may constitute depressive symptomatology and the suffering of anorexia.

Despite these findings, and the health problems associated with skin cancer discussed earlier, people find it difficult to give up this type of habit, since the short-term benefits of a tanned skin mean any long-term health damage is underestimated.

This type of attitude may also be witnessed in the undertaking of other unhealthy habits or those that entail long-term damage, where the consumer ‘assumes’ the risk, focussing on the short-term benefits, despite warnings from the authorities. For instance, for some years governments around the world have been trying to stop tobacco use. Furthermore, the authorities have had to ‘fight’ against the portrayal of this habit in films and the media where, in recent decades it was seen as socially accepted, despite the harmful effects on the health of the consumer and the people around them, in what is known as passive smoking (@CNPT_E, 2017) (See Illustration 12).

Existing measures tend to act in a dissuasive manner by putting all kinds of obstacles in the way of its consumption, stopping short of prohibition. Its display is limited to certain specially designed areas, the price is increased, and images are included on the packs of the negative health effects. However, some governments have decided to take a step further and employ the same mechanisms that for years served to spread and encourage tobacco use - television advertising. But are anti-tobacco advertisements effective?

Illustration 12. Tweet – Prohibition of Tobacco Advertising.

[ The #EmpaquetadoNeutro removes the advertising from tobacco and helps to reduce the prevalence of smoking in Spain]

This question has been addressed in research undertaken by the Department of Education, Seoul National University and the TESOL Department, Hankuk University of Foreign Studies (South Korea); along with the College of Nursing and Health Innovation, Arizona State University and the Department of Psychology, Jesuit University of Wheeling (USA) (Wilson et al., 2017).

The study involved 58 university students who were split into two groups, the first group viewed two emotionally focussed anti-smoking advertisements, whilst the other group viewed two logical, non- emotional type anti- smoking advertisements. Before and after the viewings all the participants undertook three tests, one related to transformation processes, one to depressive symptoms, and the third regards self-esteem. The results showed no significant differences pre or post viewing, either for the emotional or logical advertising, in any of the variables evaluated, i.e. participants appeared to pay no attention to the information given to them about the harmful effects of tobacco usage.

One of the limitations of the study is in the selection of the population chosen. Undoubtably the advertising is aimed at preventing young people from starting tobacco consumption, but since in many countries young people start smoking from the age of fourteen, a selection of participants from that age group should have been chosen instead of university students.

Despite the above, it should be noted that the effects of advertising are mainly based on repetition of relevant advertisements, to the extent that the information is learned. Therefore, the fact that the advertisements were viewed only once would explain the insufficient effects upon behaviour towards smoking, self-esteem or depressive symptoms.

In the specific case of COVID-19, and to the surprise of some, an unprecedented measure has been adopted, in the prohibition of all advertising regarding gambling. The idea is to prevent people who are spending a lot of time confined to their homes, becoming ‘hooked’ on gambling, which can lead not only to addiction, but also to economic ruin when monetary gambling is involved.

Considering that there are other concerns in a time of health crisis, people may not consider the adoption of such measures to be a priority. However, the government has primarily undertaken them to prevent the negative economic consequences gambling can bring about, not only in the altering of people’s moods which can lead to major depressive disorder, but also economic ruin which may lead to suicide.

Illustration 13. Tweet – Prohibition of Gambling Advertising

[Minister for Consumer Affairs, @garzon ‘’With regards gambling we have detected that there has been a growing incidence of online betting. That is why we have prohibited the advertising of gambling in any medium, except during the hours of 1am to 5am.”]

Such is the importance in the early prevention of behavioural addictions, for, as time passes, it becomes even harder to ‘kick the habit’, and in this particular instance, the new addict would continue to play after lockdown. It is consequently important that such measures are adopted in order to prevent negative effects on the physical and mental health of these potential gamblers (-consummogob,2020) (See Illustration 13).

Although such measures might be thought of as exaggerated or out of place, the reality is that our economic behaviour is governed by a multitude of internal and external variables. For example, one usually thinks about shopping in terms of prices. But how much are people willing to spend to buy things? This and other similar questions are dealt with by Consumer Psychology, a branch of study which analyses the behaviour of the individual when faced with varyingly complex economic decisions. The prototype for such investigations concern games of chance, that is, a situation where money may be won or lost dependent upon probabilities that the researcher manipulates.

It has been demonstrated that there are some people who are conservative in their value judgements, whilst others take more risks. It has also been observed that these personal variables are modified when subjected to temporary or continued consumption of certain addictive substances.

Based on this type of research, other variables, which may be implicated in whether an individual might assume lesser or greater economic costs are analysed, such as obesity. But are there differences in what an individual is willing to pay based on whether or not they are overweight? An answer to this has been sought by research undertaken by the Agricultural and Food Economics Unit, Agricultural Research and Technology Centre of Aragon, Agro-Food Institute of Aragon, University of Zaragoza (Spain), together with the Economic, Agricultural and Food Resources Area, Michigan State University (USA) (De-Magistris, López-Galán, & Caputo, 2016).

The study involved 309 participants, graded as to whether or not they were overweight (those with a body mass index greater than 30 (weight in kilograms divided by height squared) were overweight), and whether or not they accepted their own image in the mirror (using the standardised Body Image State Scale questionnaire (Cash, Fleming, Alindogan, Steadman, & Whitehead, 2002). Four groups were formed, not overweight with acceptance of mirror image; not overweight with non-acceptance of mirror image; overweight with acceptance of mirror image, and overweight with non-acceptance of mirror image.

The study entailed the participants being shown normal or healthy potato crisps, and they had to indicate what price they would be willing to pay for them, with a choice of four pre-set prices.

The results showed that the overweight participants with non-acceptance of their mirror image were those willing to pay the maximum price for a bag of healthy potato crisps, indicating that a willingness to pay for something does not depend solely on price. On the contrary, and as may be understood by the law of supply and demand, other variables such as physiological (overweight) and psychological (personal image) must be taken into account.

Based on these results, in times of lockdown, a gambler may not think of the money they are spending in a logical or reasonable manner, governed by their income and expenditure, but they might well exhibit exorbitant spending behaviour without thinking of any future consequences, thus possibly leading to economic ruin.

For this reason, the aforementioned measures have been very well received amongst anti-gambling associations.

Whilst the measures adopted via the immediate ban on advertising might not appear to be the best way in which to ‘educate’ the public, experience with other types of health interventions have demonstrated that, despite the greatest of invested efforts, changes are often very slow to take effect.

For example, there remains today much to be done towards the eradication of obesity throughout the world. (@ONU_es, 2019) (See Illustration 14).

This is a public health problem increasingly affecting more countries, whether they are in the ‘first world’ or those still developing.

This tends to invalidate the explanatory theories for such obesity (appearing at increasingly younger ages) as due to the superabundance and ease of access to food. Social theories are currently being considered to explain how populations with limited food resources, such as developing countries, suffer these same obesity rates (amongst both adults and children).

Although its effects are not as obvious as other public health problems such as smoking or alcoholism, it has many consequences, particularly upon the quality of life of the patient, whose physical activity gradually becomes limited, due to the accumulation of body fat.

Illustration 14. Tweet- Consequences of Obesity

[Obesity is one of the main triggers for diabetes. USA has more than double the number of overweight adults than the world average. Learn more about the risk factors here #DíaMundialDeLaDiabetespaho.org/hq/index.php?o..

To combat this problem, efforts have been made in ‘educating’ from infancy, so children learn to eat a healthy diet. At the same time, in a supplementary manner, many secondary schools and universities provide specific training regarding good nutrition, highlighting the disorders that may arise, such as anorexia or obesity, amongst others. But should health programmes associated with obesity be customised?

This question has been addressed in research by the University of Calgary together with the Health Services of the University of Alberta (Canada) (Russell-Mayhew et al, 2016).

The study analysed 67 awareness programmes on nutrition taught in secondary schools and universities distributed throughout the country. The content of each course was analysed in order to verify how each one dealt with the specific problem of obesity. The results showed a total lack of coordination between the courses, both in terms of the topic and how it was approached, in such a way that only 30% considered obesity as a public health problem. 85% of the courses were oriented to nursing issues in the field of work performance, whilst only 15% of programmes included information on promotion of health via nutrition and adequate exercise. Few programmes emphasised the social and discrimination problems faced by obese patients.

It must be borne in mind that awareness-raising amongst the population is the first step towards achieving some kind of social change, but, if the programmes aimed at such work are inadequate, the problem of obesity will be difficult to solve. The same is true in the changing of behavioural habits or to prevent future addictions, where it is important that clear and precise information is given, with special emphasis on the mediating psychological aspects, so the individual understands what is being said is for the benefit of them and their future health.