Chapter One: What Is Health Psychology ?

1. Chapter One:What Is Health Psychology?

2. Chapter Outline • Definition of health psychology • The mind-body relationship: a brief history • The rise of the biopsychosocial method • The need for health psychology • Health psychology research • What is health psychology training for?

3. Health Psychology • Studies psychological influences on people • How they stay healthy • Why they become ill • How they respond when they get ill • Health: Complete state of physical, mental, and social well-being • Wellness: Optimum state of health

4. Focus of Health Psychologists • Health promotion and maintenance • Prevention and treatment of illness • Etiology and correlates of health, illness, and dysfunction • Etiology: Origins or causes of illness • Improvement of health care system and the formulation of health policy

5. The Mind-Body Relationship: A Brief History • Disease during prehistory - Considered to arise when evil spirits entered the body • Humoral theory of illness - Diseases resulted when the humors or circulating fluids of the body were out of balance • Personality types associated with the humors • Blood - Passionate temperament • Black bile - Sadness

6. The Mind-Body Relationship: A Brief History • Yellow bile - Angry disposition • Phlegm - Laid-back approach to life • Disease in Middle Ages - God’s punishment • Renaissance to present day - Technical bases of medicine are understood • Dependent on laboratory findings and looked to bodily factors • Diagnosis - Organic and cellular pathology

7. Table 1.1 - The Biomedical model: Why is It Ill-suited to Understanding Illness?

8. Conversion Hysteria • Specific unconscious conflicts produce physical disturbances symbolizing repressed psychological conflicts • Conceptualized by Sigmund Freud • Gave rise to psychosomatic medicine

9. Psychosomatic Medicine • Specific illnesses are produced by people’s internal conflicts • Perpetuated in the work of Dunbar and Alexander • Linked patterns of personality to specific illnesses • Criticism - Conflict or personality type is not sufficient to produce illness

10. Biopsychosocial Model • Health and illness are consequences of the interplay of biological, psychological, and social factors • Advantages • Maintains the macrolevel and microlevel processes continually interact to influence health and illness • Emphasizes both health and illness

11. Clinical Implications of the Biopsychosocial Model • Process of diagnosis can benefit from understanding the interacting role of biological, psychological, and social factors • Significance of the relationship between patient and practitioner is made clear which improves: • Patient’s use of services • Efficacy of treatment • Rapidity with which illness is resolved

12. The Biopsychosocial Model: The Case History of Nightmare Deaths • Purpose - To see how completely the mind and body are intertwined in health • Sudden nocturnal deaths among male refugees from Southeast Asia after the Vietnam war • Occurred in the first few hours of sleep • Autopsies revealed no specific cause of death • Reasons • Genetic susceptibility

13. The Biopsychosocial Model: The Case History of Nightmare Deaths • Victims were overwhelmed by: • Cultural differences • Language barriers • Difficulties finding satisfactory jobs • Immediate trigger provided by: • Family argument • Violent television • Frightening dreams

14. Need for Health Psychology • Increase in chronic or lifestyle-related illnesses • Acute disorders: Tuberculosis, pneumonia, and other infectious diseases • Chronic illnesses: Heart disease, cancer, and respiratory diseases • Advances in technology and research • Expanded health care services • Increased medical acceptance

15. Theory  • Set of analytic statements that explain a set of phenomena • Advantages • Provide guidelines for how to do research and interventions • Generate specific predictions that can be tested and modified • Help tie together loose ends

16. Experiment • Two or more different conditions are created to which people are assigned randomly and their reactions are measured • Randomized clinical trials: Conducted to evaluate treatments or interventions and their effectiveness over time • Evidence-based medicine: Medical interventions go through rigorous testing and evaluation of their benefits before they become the standard of care

17. Correlational Studies  • Correlational research: Measures whether a change in one variable corresponds with changes in another variable • Disadvantage - Difficult to determine the direction of causality unambiguously • Advantage over experiments - More adaptable

18. Prospective Research • Looks forward in time to see how: • Group of people change • Relationship between two variables changes over time • Conducted to understand the risk factors that relate to health conditions • Longitudinal research: Same people are observed at multiple points in time

19. Retrospective Designs • Looks backward in time in an attempt to reconstruct the conditions that led to a current situation • Were critical in identifying the risk factors that led to the development of AIDS

20. Role of Epidemiology in Health Psychology • Epidemiology: Study of the frequency, distribution, and causes of infectious and noninfectious disease in a population • Morbidity: Number of cases of a disease that exist at some given point in time • Mortality: Numbers of deaths due to particular causes

21. Methodological Tools Tools of neuroscience • Functional magnetic resonance imaging (fMRI) - Permits glimpses into the brain • Has helped to improve the knowledge of the autonomic, neuroendocrine, and immune systems Mobile and wireless technologies • Ecological momentary interventions • Ambulatory blood pressure monitoring devices Meta-analysis • Combines results from different studies to identify how strong the evidence is for particular research findings

22. What is Health Psychology Training For? Health care practitioners Social work Occupational therapy Dietetics Physical therapy Public health Academic research Private practice Management of health care Treatment settings Occupational health settings