Health Psychology

1. Health Psychology Chapter 1: Introduction to Health Psychology August 22-24, 2007 Classes #2-3

2. Health psychology: “A field which integrates psychological knowledge relevant to the maintenance of health, the prevention of illness, and the adjustment to illness.” (Wolfgang Stroebe, 2000)

3. Course Goals To encourage thinking about health and illness from a number of perspectives, including: • scientist/researcher • patient • caregiver • health professional

4. Course Goals Health psychology is an integrative field – you will be encouraged to synthesize ideas from a number of approaches and perspectives, through evaluation of theories, studies, and personal experience.

5. How would you describe your general overall health? I am in excellent health. I am in good health. I am in average health. I am in poor health.

6. What is health? “The absence of disease, disorder and injury.” The Cornell Illustrated Encyclopedia of Health, 2002 "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” World Health Organization

7. Disease v. Illness • Disease is a diagnosable biological dysfunction or infection. • Illness is an individual’s unique experience of pain and suffering.

8. Etiology 1: CAUSE, ORIGIN; specifically: all of the causes of a disease or abnormal condition

9. Aggression? Social pressures: Group think? Etiology Example: A Broken Bone Sensation seeking? Alcohol abuse? Role models? Risk taking? Competition? Sleep deprivation?

10. Why do people get sick? Biomedical Model: • Exposure to infectious agents or pathogens • Immune response either sufficient or insufficient

11. Why elsedo people get sick? • Previous exposure to virus • Health behaviors (sleep, nutrition, etc.) • Stress/emotions • Social relationships (support, conflict)

12. Biopsychosocial Model • Recent advances in psychological, medical, and physiological research have led to a new way of thinking about health and illness • This conceptualization, labeled the Biopsychosocial Model, views health and illness as the product of a combination of factors including biological characteristics (e.g., genetic predisposition), behavioral factors (e.g., lifestyle, stress, health beliefs), and social conditions (e.g., cultural influences, family relationships, social support).

13. * The Biopsychosocial Model BIO PSYCHO HEALTH SOCIAL

14. The Biopsychosocial Model: Why do college students get sick? health behaviors previous exposure to virus BIO PSYCHO immune reaction to virus personality HEALTH emotions SOCIAL social support social conflict

15. The Biopsychosocial Model:Understanding Pain

16. Why does a broken hearthurt so much?!?!

17. Where is pain in the brain? The same part of the brain – the anterior cingulate cortex – responds to physical and emotional pain.

18. Studies of Chronic Pain • People with chronic pain are more likely to have an anxious personality. • People with chronic pain report low levels of social support.

19. Studies of Experimental Pain • Anxiety and fear increase pain. • Having a friend present reduces pain.

20. Psychological Consequences of Pain • Chronic back pain patients showed atrophy in the prefrontal cortex. and….. • impaired judgment in a risk-taking task.

21. Social Consequences of Pain • Think back to your pain memory…. • Did the pain influence your ability to fulfill social role obligations?

22. Social Consequences of Pain • Think back to your pain memory…. • Did the pain influence your ability to fulfill social role obligations? • Being a good student?

23. Social Consequences of Pain • Think back to your pain memory…. • Did the pain influence your ability to fulfill social role obligations? • Being a good team member?

24. Social Consequences of Pain • Think back to your pain memory…. • Did the pain influence your ability to fulfill social role obligations? • Being a good friend?

25. The Biopsychosocial Model: Understanding Pain neurological changes risk-taking BIO PSYCHO brain activation anxiety, fear HEALTH SOCIAL attachment role obligations rejection social support

26. What do health psychologists do? • Psychologists who strive to understand how biological, behavioral, and social factors influence health and illness are called health psychologists. • In contemporary research and medical settings, health psychologists work with many different health care professionals (e.g., physicians, dentists, nurses, physician's assistants, dietitians, social workers, pharmacists, physical and occupational therapists, and chaplains) to conduct research and provide clinical assessment and treatment services • Many health psychologists focus on prevention through research and clinical interventions designed to foster health and reduce the risk of disease • While more than half of health psychologists provide clinical services as part of their duties, many health psychologists function in non-clinical roles primarily involving teaching and research.

27. The Work Setting of a Health Psychologist… • Health psychologists participate in health care in a multitude of settings including: • primary care programs • inpatient medical units • specialized health care programs • such as pain management, rehabilitation, women's health, oncology, smoking cessation, headache management, and various other programs • They also work in colleges and universities, corporations, and for governmental agencies

28. Clinical Activities… • Assessment approaches often include cognitive and behavioral assessment, psychophysiological assessment, clinical interviews, demographic surveys, objective and projective personality assessment, and various other clinical and research-oriented protocols • Interventions often include stress management, relaxation therapies, biofeedback, psychoeducation about normal and patho-physiological processes, ways to cope with disease, and cognitive-behavioral and other psychotherapeutic interventions • Healthy people are taught preventive health behaviors. Both individual and group interventions are utilized

29. Research… • Health psychologists are on the leading edge of research focusing on the biopsychosocial model in areas such as HIV, oncology, psychosomatic illness, compliance with medical regimens, health promotion, and the effect of psychological, social, and cultural factors on numerous specific disease processes (e.g., diabetes, cancer, hypertension and coronary artery disease, chronic pain, and sleep disorders) • Research in health psychology examines: the causes and development of illness, methods to help individuals develop healthy lifestyles to promote good health and prevent illness, the treatment people get for their medical problems, the effectiveness with which people cope with and reduce stress and pain, biopsychosocial connections with immune functioning, and factors in the recovery, rehabilitation, and psychosocial adjustment of patients with serious health problems

30. Career Opportunities… • The opportunities for careers in health psychology in the United States are quite good. Medical settings, particularly medical centers, have greatly expanded their employment of psychologists • Aside from medical centers, health psychologists often work in colleges and universities, medical schools, health maintenance organizations, rehabilitation centers, pain management centers, public health agencies, hospitals, and private consultation/practice offices

31. Training for Health Psychology Careers… • Health psychologists typically hold a doctoral degree (Ph.D. or Psy.D.) in psychology. Applied health psychologists are licensed for the independent practice of psychology in areas such as clinical and counseling psychology, and board certification is available in health psychology through the American Board of Professional Psychology • Often, psychologists preparing for a career in health psychology obtain general psychology training at the undergraduate and doctoral levels, but then receive specialty training at the postdoctoral or internship level. Some programs have been developed which offer specialized training in health psychology at undergraduate and graduate levels

32. Undergraduate programs… • Health psychology courses are available at about a third of North American colleges and universities • Because of the field's biopsychosocial orientation, students are also encouraged to take courses focusing on abnormal and social psychology, learning processes and behavior therapies, psychophysiology, anatomy and physiology, psychopharmacology, community psychology, and public health

33. Graduate Programs • Many doctoral programs in clinical, counseling, social, or experimental psychology have specialized tracks in health psychology • A number of programs now exist in the United States and other countries specifically for doctoral training in health psychology • These programs are diverse: some specialize in training students either for research careers or for direct clinical service to patients

34. Predoctoral Internships… • Clinical and counseling psychologists are required to complete a one-year internship/residency before obtaining their doctorates • Many of these programs offer some training in health psychology. A number of internship programs provide specialized training in health psychology in which at least half of the trainee's time is spent in supervised health psychology activities

35. Postdoctoral Fellowships… • Many university medical centers, universities, health centers, and health psychology programs offer specialized research and/or clinical training in different areas of health psychology

36. Credits • stanford.edu/~kmcg/portfolio/documents/finalwinterlP1healthpsych.ppt • http://wwwpsych.stanford.edu/~kmcg/portfolio/documents/HealthPsychologyintrotopics.ppt#3