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Part One: Introduction to Health Psychology Chapter 1: What is Health Psychology?

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What is Health Psychology? <ul><li>Definition: </li></ul><ul><li>Health psychology is the field devoted to understanding psychological influences on how people stay healthy, why the become ill and how they respond to this. </li></ul><ul><li>Health psychologists focus on health promotion , maintenance , prevention and treatment of the illness. </li></ul><ul><li>-Example: reasons why people smoke. </li></ul><ul><li>They also focus on etiology (origins or causes of the illness) and correlates of health , illness and dysfunction , especially interested in behavioral and social factors such as exercise, alcohol consumption, smoking and ways of copying with stress. </li></ul><ul><li>Finally, they analyze and attempt to improve health care system . </li></ul>

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The Mind-Body Relationship: A Brief History <ul><li>There’s evidence of ancient cultures that suggests that mind and body were considered a unit . </li></ul><ul><li>Early cultures believed that disease arose when evil spirits entered the body and that these spirits could be exorcised through treatment process . </li></ul><ul><li>The Greeks : They were among the first to identify the role of bodily functioning in health and illness. They developed a humoral theory of illness , in which specific personalities were associated to four humors. </li></ul><ul><li>Middle Ages: Mysticism and demonology dominated the concepts of disease, which was “God’s punishment of evildoing”. Throughout this time, the Church was the guardian of medical knowledge. </li></ul>

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<ul><li>Renaissance : Great strides were made in the technological basis of medical practice, such as Leeuwenhoek’s microscopy and Morgagni’s contributions to autopsy. </li></ul><ul><li>For the next 300 years, physical evidence became the sole basis for diagnosis and treatment of the illness. </li></ul><ul><li>This view began with the rise of modern psychology, with Sigmund Freud’s early work on conversion hysteria . According to him, unconscious conflicts can produce physical disturbances that symbolize the repressed psychological conflicts. </li></ul><ul><li>In 1930, unlike Freud, Flanders Dunbar and Franz Alexander linked patterns of personality to a specific illness. </li></ul><ul><li>Their works helped the emerging field of psychosomatic medicine </li></ul>The Mind-Body Relationship: A Brief History

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<ul><li>Now, it is known that all conditions of health and illness are influenced bye psychological and social factors . </li></ul><ul><li>This current conception is one of the many factors that have spawned the rapidly growing field of health psychology . </li></ul>The Mind-Body Relationship: A Brief History

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Why is the field of health psychology needed? <ul><li>Health psychology is one of the most important developments wthin the field of psychology in the last 50 years. </li></ul><ul><li>Some of the factors that have contributed to its emergence </li></ul><ul><li>are the following . </li></ul>Chaging Patterns of Illness The major causes of illness and death in the United States were acute disorders. Acue disorders are short-term medical ilness often result of a viral or bacterial invader and usually amenable to cure. Now, however, chronic ilness are the main contributors to disability and death. Health psychology has evolved, in part, to help researchers and practitioners understand develop research for improving our understanding of the relation of behavioral and social factors to illness and how we may affect these factors. chronic ilness affect family functioning, including relationships with a partner and/or children, and health psychologists both elucidate these effects and help ease the

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Problems in family functioning that may result. Helping people make informed appropriate decsions is fundamentally a Psychological task. Patients play in fundamental decision regarding their health and illness and its management, and of the help health psychologists can provide in this process. Changing patterns of illness have been charted and followed by the field of epidemiology, this is a study of the frequency, distribution, and causes of infectious and non-infectious diseasein a population, based on an investigation of the physical and socil enviroment. In the context of epidemiologic statistics, we will see frequent use of two important terms: Morbidity: Number of cases of a disease that exist at some given point in time. Morality: Refers to numbers of deaths due to particular causes.

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Health psychologists are becoming more involved in the effort to improve quality of life among those diagnosed with chronic illnesses so that individuals may live out their remaining years as free from pain, disability and lifestyle compromise as possible. <ul><li>Another set of factors tha has contributed to the rise of health psychology </li></ul><ul><li>relates to the expansion of health care services. </li></ul><ul><li>Health care is the largest service industry in the United States. </li></ul><ul><li>Americans spend over $1000 billion annually on health. </li></ul><ul><li>Health psychology represents an important perspective on these issues </li></ul><ul><li>for several reasons: </li></ul><ul><li>Health psychology´s emphasis on prevention. </li></ul><ul><li>Research on what makes people satisfied or dissatisfied with their health care. </li></ul><ul><li>Design of health care systems. </li></ul><ul><li>Health care industry employs many millions of individuals in a variety of jobs. </li></ul>Expanded Health Care Services

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Psychologists have been involved in the development of behavior-change programs to teach people to practice better health habits, including not smoking, getting exercise, eating a balanced diet, practicing safe sex, reducing alcohol consumption avoiding accidents and managing stress. Psychologists learned many years ago that preparing patients to undergo unpleasant Medical procedures, such as surgery, improves their adjustment to those procedures. Increased Medical Acceptance Although health psychologists have been employed in health seetings for many years, their value is increasingly recognized by physicians and other health care professionals. Caregivers are increasingly recognizing that psychological and social factors are always important in health and illness. Demonstrated Contributions to Health

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The health psychologist can be a valuable member of the research team by providing the methodological and statistical expertise that is the hallmark of good training in psychology. Health psychology is important because the major health problems of the day, especialy the origin and treatment of chronic illness, can increasingly be understood substantially in of psychological and social factors; the field of health psychology terms addressesan issue of paramount economic and social importance, namely, Health Care. Methodological Contributions

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The Biopsychosocial Model in Health Psychology <ul><li>Its fundamental assumption is that any heath or illness outcome is a consequence of the interplay of biological, psychological and social factors. </li></ul>

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The Biopsychosocial Model vs The Biomedical Model <ul><li>Maintains that all illness can be explained on the basis of aberrant somatic processes ( biochemical imbalances or neuropsychological abnormalities) </li></ul><ul><li>Assumes that psychological and social processes are largely independent of the disease process. </li></ul>

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<ul><li>The biomedical model clearly incorporates the assumption of a mind-body dualism, maintaining that mind and body are separate entries. </li></ul><ul><li>The biomedical model clearly emphasizes illness over health. </li></ul><ul><li>This model has proven to be scientifically and clinically inadequate in explaining the disease process. </li></ul>

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Advantages of the Biopsychosocial Model <ul><li>Both, macrolevel processes (such as the existence of social support, the present of depression) and microlevel processes (such as cellular disorders or chemical imbalances) interact to produce a state of health or illness. </li></ul><ul><li>Maintains that the mind and body cannot be distinguished in matters of health and illness because both clearly influence an individual’s state of health </li></ul>

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<ul><li>Emphasizes both health and illness rather than regarding illness as a deviation from some steady state </li></ul>

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The Biopsychosocial Model as a Research Tool <ul><li>Research investigators must try to measure ALL three classes of variables. </li></ul><ul><li>Must also be conducted on the context of the state of art methodology on the relevant fields (psychology, biology, social) </li></ul>

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Clinical Implication of the Biopsychosocial Model <ul><li>The diagnosis should always consider the interacting role of biological, psychological, and social factors in assessing an individuals health or illness </li></ul><ul><li>Recommendation for treatment must also examine all three sets of factors </li></ul><ul><li>Makes explicit the significance of the relationship between patient and practitioner </li></ul>

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What do health psychologist do? <ul><li>Because of their experience in health psychology, they are often able to understand and manage the social an psychological aspects of the health problems they treat better that would be the case if their if their education had included only training in traditional medicine. </li></ul>

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Other health psychology students go into the allied health professional fields: <ul><li>Social work </li></ul><ul><li>Occupational therapy </li></ul><ul><li>Dietetics </li></ul><ul><li>Physical therapy </li></ul><ul><li>Public health </li></ul>

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<ul><li>Many undergraduates go on to graduate school in psychology, where they learn the research, teaching, and intervention skills necessary to practice health psychology in academic positions . </li></ul><ul><li>Many health psychologists become clinical and work with medical patients in a hospital or other treatment setting </li></ul>

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HEALTH PSYCHOLOGY: AN OVERWIEW <ul><li>We will now see how health psychologists address different problems </li></ul><ul><li>In part 1 : we provide an overview of the field of health psychology, covering its history and the reasons for its development. </li></ul><ul><li>°Chapter 2 : provides a brief look at human physiology </li></ul><ul><li>°Part 2 : ackownledges the role that psychological and social factors play, in the health habits and in the environmetal context. </li></ul><ul><li>-The two major causes of death in the U:S: heart disease and cancer, are now known to be affected by behavioral factors. </li></ul><ul><li>-25% of all cancer deaths could be avoided simply by getting people to stop smoking. </li></ul><ul><li>-Dietary factors and stress are implicated in both the onset and management of diabetes. </li></ul><ul><li>-Breast cancer, the main cause of death amongst American women, can be successfully trated if it is detected early. Breast self-examination is one of the best methods currently available for doing this. </li></ul>

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<ul><li>°Chapter 3 : focuses on the general issue of health promotion and determinants of the practice of health habits. </li></ul><ul><li>°Chapter 4 : examines attitudinal and cognitive-behavioral approaches to the modification of poor health habits. </li></ul><ul><li>°Chapter 5 : considers Health-Enhacing Behaviors such as: exercise, accident prevention, breast and testicular self-examination. </li></ul><ul><li>°Chapter 6 : considers Health Compromising Behaviors such as: alcoholism and smoking. </li></ul><ul><li>-In Part 3: we examine the role that stress plays in good health </li></ul><ul><li>°Chapter 7 : points out that stress is an important contributing factor in illnesses </li></ul><ul><li>-An example: President Lyndon Johnson. During each of his of his major election battles, he developed a serious illness. The most dramatic event came when President Richard Nixon disbaned the Great Society, which Johnson thought to be his greatest success. Johnson died that same day. </li></ul>

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<ul><li>°Chapter 8 : considers factors that moderate the stress-illness relationship </li></ul><ul><li>-Example: the most intriguing discovery would be the finding that people with strong personal relationships are less likely to become ill and tend to recover more quickly. </li></ul><ul><li>-Part 4: examines the psychological and social factors that prompt people to seek tratment. </li></ul><ul><li>°Chapter 9 : looks at how people detect and appraise their symptons and what leads them to seek or neglect treatment. </li></ul><ul><li>-The processes of interpreting disorders and seeking treatment are substantially guided by cultural and social factors. </li></ul><ul><li>°Chapter 10 : discusses communication problems. As many as two-thirds of all patients are unable to repeat simple facts about their illness and its treatment. The consequence can be severe. </li></ul><ul><li>-Including nonadherence to treatment or malpractice suits. </li></ul>

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<ul><li>°Chapter 11 : examines the elusive nature of pain. </li></ul><ul><li>-in this context we examine developments in the physiology of pain, especially the existence of natural pain combating substances, called endorphins. </li></ul><ul><li>-We also consider the control of pain and examine the many technologies that have been used to cambat it, including biofeedback, relaxation, acupuncture, and hypnosis. </li></ul><ul><li>-In particular this chapter will consider the problems of the patient with chronic pain. </li></ul><ul><li>-Part 5: discusses the management of chronic and terminal illnesses. </li></ul><ul><li>-Chronic illnesses raise more issues of phychological interest. </li></ul><ul><li>-Some os these issues areise because chronic illnesses are often caused at least partly by behavioral factors that can be modified. </li></ul><ul><li>°Chapter 12: examines that chronic ilnesses are a condition with which people may live for years. </li></ul><ul><li>-Example: a male adolescent who learns at age 13 that he has a chronic illness: diabetes. </li></ul>

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<ul><li>°Chapter 13 : presents a strong challenge to health psychologists. </li></ul><ul><li>-Here we deal with terminal illnesses. </li></ul><ul><li>-One of the most promising developments in this area is the creation of hospices. </li></ul><ul><li>*Institutions designed especially to care for the terminally ill. </li></ul><ul><li>°Chapter 14 : considers factors that predict the development of coronary heart disease, hypertension, diabetes and strokes. </li></ul><ul><li>°Chapter 15 : addresses psychoimmunology, AIDS, cancer, and arthritis </li></ul><ul><li>°Chapter 16 : examines anticipated trends in the field of health psychology. </li></ul><ul><li>-Example: new techniques for the control of pain and discomfort will be developed and psychologists will have a role in their implementation. </li></ul>