Introduction To Health Psychology

Introduction to Health
Psychology
Unit I: Introduction
 Definition and Scope,
 Historical development-A brief history of
medicine,
 Models in health psychology- Biomedical and Bio-
psychosocial model,
 The Mind-Body Connection,
 Psychological factors in Illness and Disease,
 The stages of change model,
 The Health belief model,
 Theories of reasoned action and planned behavior
Changing patterns of illness
 1900s - infectious diseases main cause of
death (acute conditions)
 1960s - degenerative diseases main cause of
death (chronic conditions)
 1990s - new infectious disease main cause of
premature death (chronic condition)
The Emergence of Health Psychology
Foundations for Contemporary Health Psychology
 In ancient times and the middle ages there

was a belief that spiritual disturbances
caused disease.
 The development of early Greek Medicine -

focus on physical causes for disease.
 Scientific advances in microscopy and human

anatomy further advanced medicine.
Foundations for Contemporary Health Psychology
 Psychoanalytic case studies revealed how anxiety

and unconscious personality conflicts can manifest
as physical symptoms.
 The study of psychosomatic medicine focused on

disease- prone personality types.
 The contemporary view focuses on the balance

between physical and mental well-being in the
context of the social environment.
The Modern Problem
 Patterns of illness are changing.
 People are less likely to die from acute disorders and

communicable disease (with the exception of AIDS).
 People are living longer with chronic diseases
 Chronic diseases:
• Generally can be managed, not cured
• Related to health behaviors and compliance with medical regimen
• Living with chronic diseases has social and psychological consequences
Technological Advances
Genetic counseling
• Coping with potential health risks
Patient counseling regarding life-sustaining measures
Research in health psychology identifies risk-factors
Health Care Services

• Health care is the largest service industry in the
world.
• Prevention can reduce health care costs.
• Most people are recipients of health care services.
• Research on satisfaction with health care
• Health psychologists are becoming more

integrated into the medical context.
The Biomedical Model
• Dominant model for the past 300 years

• All illness can be explained on the basis of aberrant somatic
processes.
Liabilities of the Biomedical Model
• Reductionism – Illness is reduced to microlevel processes

i.e. chemical imbalances.
• Single-factor model – Illness is due to one factor: a biological
malfunction.
• Mind-body dualism – The mind and the body are separate
entities.
• Emphasis on illness over health
The Biopsychosocial Model
 Health and illness are consequences of the

interplay of biological, psychological, and social
factors.
Systems Theory
 All levels of organization in any entity are linked
hierarchically.
 Change at one level influences change in other
levels
• Changes on the microlevel can have macrolevel
effects and vice versa.
Advantages of the Biopsychosocial Model
 Health is determined by both microlevel and

macrolevel processes (psychological and social
factors).
 Multiple factors – a variety of factors are involved
in health and illness.
 The mind and body are not separated when
considering matters of health and illness.
 Emphasis on both health and illness.
Clinical Applications of the Biopsychosocial
Model
 The process of diagnosis must consider the

interaction of biological, psychological, and
social factors.
• Treatment recommendations must take these
factors into account.
 The relationship between the patient and the

health care practitioner has an impact on the
effectiveness of care.
Areas of Focus In Health
Psychology
Health Promotion and Maintenance
Prevention and Treatment of Illness
Etiology (causes) and Correlates of Health and

Illness
Health Policy and Health Care Service Delivery

Contributions of Health Psychology
Short-term behavioral interventions have been

effective in helping patients to:
• Manage pain
• Modify bad health habits (such as smoking)
• Manage side effects and treatment effects when coping with
chronic
• illness.
Psychologists help ease the adjustment process for

patients.
Methodology
Epidemiology
 The study of the frequency, distribution,

and causes of infectious and
noninfectious disease in a population
based on an investigation of the
physical and social environment
Methodology
 Morbidity refers to the number of cases

of a disease that exist at some given
point in time.
• Incidence: the number of new cases
• Prevalence: the total number of existing
cases
 Mortality refers to the number of deaths
due to a particular cause.
Health Psychology
Health Psychology:
- Exciting and relatively new field devoted to

understanding psychological influences on
how people stay healthy, why people
become ill and how they respond when
they do get ill
Health Psychology
 The social, behavioural, cognitive, and
emotional factors that influence the:
 Maintenance of health
 Development of illness and disease
 Course of illness or disease
 Patient’s and family’s response to illness

and disease
What is health, illness, and
disease?
 Illness is symptoms of something wrong

in the body
 Disease is the underlying condition that
can give rise to illness
 Health is not simply the absence of

illness or sickness
WHO
“A complete state of physical, mental, and social

well-being and not merely the absence of
disease and infirmity.”
Estimated contributions of different
factors to health status.
10%
30%
40%
20%
Other Factors Genetic Behaviour Medical Care
Change 5 behaviors
According to the US
Public Health Service, of 1. Adherence to medical
the 10 leading causes recommendations
of death in the US, at (eg use of hypertensive
least 7 could be medication)
reduced substantially if 2. Diet
people at risk would
change just 5 3. Smoking
behaviors! 4. Lack of exercise
5. Alcohol and drug use
Health Psychologist
 Scientists who research the area
 Health promotion – intervene at the social
(e.g., government policy, community) or
individual level to promote health and prevent
illness and disease.
 Clinical health psychologist – intervene at the
individual level to treat illness, slow or
prevent disease progression, and reduce
disability.
History of Medicine
History of Medicine
 Stone age
 Middle age
 Contemporary age
History of Medicine
 Stone-age beliefs – evil spirits entered the body and
caused illness.
 They could be removed through religious rituals that were performed
by the physician or shaman.
 Greeks – Hippocrates and later Galen proposed that diseases arose
from imbalances in the bodily fluids (blood, black bile, yellow bile, and
phlegm).
 Middle ages the pendulum had swung back toward
mental or spiritual explanations of illness.
 Contemporary view is that most illness and disease are
caused by disorder at the cellular level.
 Also, there is a growing acceptance that the cause or source of
problem can stem for physical, mental, or socio-behavioural factors.
 Moreover, that these factors can interact, causing further health
Greeks – Hippocrates
(460-377 B.C.)
 Origin of the view that disease is a
natural process.
 Humoral theory
 View that disease occurs when the four
fluids of the body are out of balance
 Four fluids are blood, black bile, yellow
bile, and phlegm.
 Personality types
Hippocrates - Treatments
Temperament Humor Disease Treatment
Phlegmatic Phlegm Cold, Hot baths, warm

Sluggish, dull headaches food
Sanguine Blood Angina, Blood letting

Cheerfulness, epilepsy
optimism
Melancholic Black bile Hepatitis, Hot baths
Sad and depressed ulcers
Choleric Yellow bile Stomach, Blood letting,

Fiery, excitable jaundice liquid diet
Evolving view of diseases
 Anatomical pathology
 Belief that disease was localized in
anatomy (16th to 18th Centuries)
 Tissue pathology
 Specific tissues could become diseased
while others remain healthy (Late 1800s)
 Cellular pathology
 Belief that life resided in cells and so cells
must be the place to look for disease
(19th century)
Evolving view of diseases
 Germ theory
 Discovery that particles in the air that could not
seen (e.g., bacteria) could cause disease.
 Magic bullet
 A specific cure could be found for every ailment
that restore the person to perfect health.
 Biopsychosocial model
 Mind, body, and environment interact in
causing disease.
Psychosomatic Medicine
 Freud (1856-1939) - psychosomatic
 Walter Cannon - psychophysiological
 Franz Alexander - personality
 Main assumptions:
 Psychological disorders are illnesses or
diseases affecting the nervous system
 Abnormal behaviour, thinking and emotion
are caused by biological dysfunctions
 Understanding mental illness involves
understanding what went wrong with the
brain
 Possible causes of abnormal behaviour:
 Biochemistry – an imbalance of certain
neurotransmitters or hormones might
cause parts of the brain to malfunction
 Structural damage or abnormality – if
the structure of the brain is damaged or
improperly formed then thinking, emotion
and behaviour may change
 Factors that may affect NS functioning:
 Genetics – inherited developmental
abnormality
 Toxicity – chemical poisoning from e.g.
drugs or environmental toxins
 Infection/disease – causing chemical or
structural damage to the brain
 Stress – causing abnormal hormonal
effects in the long term
Brain Abnormality (Structure)
Brain Abnormality (Structure)
Brain Abnormality
(Functioning)
Biopsychosocial Model
 Integration of:
 Biological
 Social
 Psychological (Esp. cognitive & behavioral)
 Abnormality caused by:

 Interaction of these factors – no one cause
 Relative importance of each factor depends
on individual and environment

Biopsychosocial Model
Feedback Loops
Psychological
Biological Emphasis on
Emphasis on psychological
biological factors, such as early
processes (e.g., childhood
genetics) experience and self-
concept
Feedback Loops Feedback Loops

Social
Emphasis on
interpersonal
relationships and
social environment
The Biopsychosocial Model
Systems Theory
 All levels of organization in any entity are linked
hierarchically.
 Change at one level influences change in other
levels
• Changes on the microlevel can have macrolevel
effects and vice versa.
Differences

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Introduction to Health

Foundations for Contemporary Health Psychology

 In ancient times and the middle ages there

 The development of early Greek Medicine -

 Scientific advances in microscopy and human

Foundations for Contemporary Health Psychology

 Psychoanalytic case studies revealed how anxiety

 The study of psychosomatic medicine focused on

 The contemporary view focuses on the balance

The Modern Problem

 Patterns of illness are changing.

 People are less likely to die from acute disorders and

 People are living longer with chronic diseases

Health Care Services

• Health psychologists are becoming more

• Dominant model for the past 300 years

• Reductionism – Illness is reduced to microlevel processes

 Health and illness are consequences of the

 Health is determined by both microlevel and

 The process of diagnosis must consider the

 The relationship between the patient and the

Prevention and Treatment of Illness

Etiology (causes) and Correlates of Health and

Health Policy and Health Care Service Delivery

Short-term behavioral interventions have been

Psychologists help ease the adjustment process for

 The study of the frequency, distribution,

 Morbidity refers to the number of cases

- Exciting and relatively new field devoted to

 Patient’s and family’s response to illness

 Illness is symptoms of something wrong

 Health is not simply the absence of

“A complete state of physical, mental, and social

Phlegmatic Phlegm Cold, Hot baths, warm

Sanguine Blood Angina, Blood letting

Choleric Yellow bile Stomach, Blood letting,

 Psychological (Esp. cognitive & behavioral)

 Abnormality caused by:

 Relative importance of each factor depends

on individual and environment

Feedback Loops Feedback Loops

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