Health Psychology, 6th edition
Shelley E. Taylor
Chapter One:
What Is Health Psychology?
Chapter One: An Introduction
Adam
Healthy Diet
Non-smoker
Exercises
Adequate sleep
Occasional beer
Greg
Doritos, Pepsi
Smoker
Inactive
Sleep deprived
Frequently drunk
Division 38 Mission Statement
In high school, Adam had learned about Health
Psychology
Division 38 of the APA
[Link]
was established to facilitate collaboration
among psychologists and other health science
and health care professionals interested in the
psychological and behavioral aspects of physical
and mental health
Definition of Health Psychology
Health Psychology is devoted to
understanding psychological
influences on
How people stay healthy
Why people become ill
How people respond when they do
become ill
World Health Organizations
Definition (1948)
Health is a complete state of well-being:
Physical well being
Mental well being
and Social well being
Health is NOT merely the absence of
disease or infirmity.
This state of optimum health is called
wellness
Four Areas of Focus in
Health Psychology
1. Health promotion and maintenance
How can we encourage children to
development health food habits?
What would be effective in promoting
regular exercise?
How can we design a media campaign that
gets people to improve their diets?
Four Areas of Focus in
Health Psychology
2. Prevention and treatment of illness
If individuals work in high-stress jobs, what
techniques might help them so stress
doesnt adversely influence their health?
What can be done to help those who are ill
to follow treatment regimens?
Four Areas of Focus in
Health Psychology
3. Etiology (cause) and correlations of
health, illness and dysfunction
How does smoking contribute to illness?
How does exercise promote health?
What impact do particular health habits,
such as wearing seat belts, have on health
and illness?
Four Areas of Focus in
Health Psychology
[Link] the health care system and
formulating health policy
What impact do health institutions have on
peoples behavior?
What recommendations can be developed
in order to improve health care?
The Mind-Body Relationship:
A Brief History
Are the mind and the body each part of the
same system?
Or, are the mind and the body two
separate systems?
We have come full circle in answering
these questions.
Mind and Body are part of the
same system
Earliest Times: Mind and Body are One
Stone age skulls and trephination
Shaman performs the treatment
Greeks note the role of the body in health
and illness
Hippocrates
Galen
Humoral Theory (4 circulating fluids)
Blood, black bile, yellow bile, phlegm
Middle Ages - Mind and Body
The same supernatural system
Middle Ages: Mysticism and demonology
Disease: Punishment from God
Cure: Torture evil out of the body
Do penance through prayer and good works
Healing is within the realm of the priest
The Renaissance - Mind and Body
are two separate systems.
Dualistic concept of mind and body
Attempts to break away from superstitions of
past centuries
Theologians, priests,
philosophers
treat the mind
Physicians heal the
body. Physical
evidence is the
sole basis for
diagnosis
The Mind-Body Relationship:
Technological Strides Separate
Mind and Body
Technological Basis of Medical Practice
Anton van Leeuwenhoek: microscopy
Giovanni Morgagni: autopsies
Medicine
Looked more to laboratory
Looked less to mind
The Mind-Body Relationship:
Psychoanalytic Contributions
Sigmund Freud conversion hysteria
In this theory, mind and body are linked
Specific unconscious conflicts can lead to
particular physical disturbances
Occurs through the voluntary nervous system.
The person is freed from anxiety because the
conflict has been converted into a physical
symptom
Many of these conversions are biologically
impossible (glove anesthesia)
The Mind-Body Relationship:
Psychosomatic Medicine (1930s-1940s)
Flanders Dunbar and Franz Alexander
Patterns of personality (not specific conflicts) are
linked to specific illnesses
Psychological conflicts produce anxiety which, in
turn, has a physiological effect through the
autonomic nervous system
Examples of the diseases studied:
asthma, ulcers, hypertension
The Mind-Body Relationship:
Contemporary Viewpoint
Despite criticisms of early views, it did lay
groundwork for current holistic view
Physical health is interwoven with
psychological and social environment
ALL conditions of health and disease are
interwoven in this way
The mind and the body cannot be
separated in matters of health and illness
The Rise of Health Psychology
Changing patterns of illness
Acute Disorders
Short-term medical illnesses
Examples: tuberculosis, pneumonia
Chronic Disorders
Slow-developing diseases.
Often these cannot be cured, only managed
Psychological/Social factors are often causes
Comparison: 1900 and 2001
How are chronic diseases linked to
health psychology?
Psychological/social factors cause chronic
diseases,
Psychologists develop ways to change healthcompromising factors (diet, smoking) for patients
and other family members
Living with a chronic illness means years of
treatment regimens that may affect family
functioning
Psychologists help ease problems in relationships
The Rise of Health Psychology :
Advances in Technology and Research
Ability to identify genes that contribute to
particular disorders.
Should children be tested if a parent is
diagnosed with a genetic disorder?
What changes will this lead to in the lives of
the children?
What coping skills and behavioral changes will
be likely to occur?
The Rise of Health Psychology:
Decisions regarding Health
Making informed decisions is a psychological
task
Technology has led to the need to make
these kinds of decisions
Example: Do I want to know if I have the breast
cancer gene?
Psychologists conduct research to identify
different risk factors.
Will a certain type of treatment lead to
adverse changes in regard to quality of life?
Impact of Epidemiology
The field of epidemiology is closely related to
health psychology.
Epidemiology is the study of the
frequency
distribution
causes
of infectious and noninfectious disease in a
population, based on an investigation of the
physical and social environment.
Morbidity and Mortality Statistics
Morbidity
number of cases of a disease that exist at some
given point in time
Incidence
number of new cases at a given time
Prevalence
total number of existing cases at a given time
Mortality
number of deaths due to a particular cause
The Rise of Health Psychology:
Expanded Health Care Services
Health care
Largest service industry in the United States
Health psychologys main emphasis on prevention
has the potential of reducing health care costs
Health psychologists
Conduct research on how satisfied people are with
their health care
Design user-friendly systems
Most people in the U.S. have direct contact with
health care services.
The Rise of Health Psychology:
Acceptance of Psychologists
Health psychologists, in the past,
saw problem patients
administered/interpreted tests
Growing recognition
Psychological/social factors are ALWAYS important
The role of the health psychologist in changing
health habits and in contributing to treatment is
increasingly acknowledged
The Rise of Health Psychology:
Demonstrated Contributions
Short-term behavioral interventions
have been effective in helping patients:
Manage pain
Modify bad health habits (such as
smoking)
Manage side effects and treatment effects
when coping with chronic illness.
The Rise of Health Psychology:
Demonstrated Contributions
Adjustment to
unpleasant medical
procedures to the
patient are helped
by providing full
information
beforehand.
OK. I know
what Im in for
now
"Being a Grandfather" 2003, by McGraw-Hill
The Rise of Health Psychology:
Methodological Contributions
Psychologists have methodological and
statistical expertise that is required for
rigorous research investigations
Experiments
Randomized
clinical trials
Two or more conditions differ from
each other in exact and
predetermined ways; Random
assignment
Experiments to evaluate
treatments/interventions and
effectiveness over time
The Rise of Health Psychology:
Methodological Contributions
Correlational Studies
Comparing changes
in variables (cannot
determine causality
Prospective Designs
(longitudinal)
Looking forward
Retrospective Research
Looking backward
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Models of Health Care:
Biopsychosocial Model
Focuses on the system
Fundamental assumption:
Health and illness are consequences
of the interplay of
Biological
Psychological
Social factors
Models of Health Care:
Biomedical Model
Focus on illness
Dominant model for the past 300 years
All illness can be explained on the basis
of aberrant somatic processes.
Psychological/Social processes
Independent of disease
Biomedical Model Limitations
Single-factor model
Illness due to one factor, biological
malfunction.
Mind-body dualism
Emphasis on illness over health
Reductionism
Illness reduced to microlevel (low- level)
processes, such as chemical imbalances.
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Advantages of the Biopsychosocial
Model
Macrolevel processes
psychological and social factors (social support,
depression) are determinants of health, just as
microlevel processes are.
Multiple factors
involved in health and illness.
Mind and body cannot be distinguished in
matters of health and illness.
Emphasis on both health and illness
Systems Theory
All levels of organization in any entity are
linked to each other hierarchically
Changes in one level influence change at
all other levels
Microlevel processes are nested within
macrolevel processes
Changes on the microlevel can have
macrolevel effects and vice versa
Clinical Implications of the
Biopsychosocial Model
The process of diagnosis must consider the
interaction of (1) biological, (2) psychological, and
(3) social factors.
Recommendations for treatment must also
consider these three factors.
This means that therapy is targeted to an individual
The relationship between the patient and the
health care practitioner is important in the
effectiveness of care.
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Summary of the Biopsychosocial
Model
Health habits can be understood only within the
patients psychological and social context.
Biological, psychological, and social factors all
contribute to recovery when a person is ill.
Example: High-powered 40-year-old executive
has a heat attack. How would both models
approach this problem?
What is Health Psychology Training
for? Careers in practice
health psychologists
physicians
physical therapists
social workers
occupational therapists
dietitians
nurses
public health workers
What is Health Psychology
Training for? Careers in research
Public health researchers
May develop educational interventions to
promote the practice of better health
behaviors.
May formally evaluate programs for improving
health-related practices.
May be administrators for health agencies.
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What is Health Psychology
Training for? Careers in research
Health Psychologists
Work settings include
Universities
Hospitals
Industrial/occupational health settings
Independent practices
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