Health Psychology – BPT Lecture Notes

Harshavardhan.S

Associate Prof. of Psychiatry

1. What is Health Psychology?

A branch of psychology that explores how mind and body work together in health and
illness.
It’s about why people fall sick, how they cope, and how psychology helps them recover.
Based on the Bio-Psycho-Social Model

Bio- Psycho-Social Model

George Engel first articulated the biopsychosocial model in 1977, proposing that
understanding a person’s medical condition requires assessing not only their biology but
also psychological and social influences.
A biopsychosocial model is a holistic approach to understanding health and illness
considering multiple influences. It recognizes the interplay between biological,
psychological, and social factors on health throughout a person’s lifespan (Bolton &
Gillett, 2019).
The biopsychosocial model encompasses three primary elements: physiological,
psychological, and sociocultural aspects.
For example, biological factors can include a person’s age, genetic makeup, health
history, and gender. Psychological influences can include the individual’s emotions,
thoughts, and behavior.
Finally, social aspects like economic status, family relationships, and access to healthcare
services can drastically alter one’s choices.
This method emphasizes that people possess unique well-being needs, recognizing the
interrelationship of these three components for optimal care.
By taking a comprehensive approach to patient healthcare, medical practitioners
can understand the root causes of illness, thus enabling them to craft individualized care
plans.
Through this model, practitioners can gain insight into how physical, psychological, and
social stressors can interact to affect an individual’s overall health.
Let’s look at each of these components:
1. Biological Component
This component refers to the physiological and genetic characteristics of the individual
that affect his health. It includes predisposition to certain diseases, immune system, age,
gender, and other biological factors.
For instance, hereditary factors may make a patient with a family history of type 2
diabetes more prone to developing the disorder.
2. Psychological Component
The psychological aspect covers the patient’s emotional and psychological state,
including stress, anxiety, mood, and consciousness.
Psychological factors can influence health through behavioral and cognitive processes.
As in the first case, in a patient with a chronic condition such as arthritis, increased stress
levels can increase pain and cause depression.
3. Social Component
This component affects the social environment and cultural factors that affect human
health.
For example, it may include health care availability and quality, family support, economic
status, and educational attainment.
A patient with low socioeconomic status may have limited access to quality health care or
a healthy diet, leading to chronic diseases.
Mind Body Relationship
The mind-body relationship is a central concept in health psychology, emphasizing the
interconnectedness of mental and physical health. By understanding and addressing this
connection, individuals can improve their overall well-being and achieve better health
outcomes.
In health psychology, the mind-body relationship refers to the intricate connection
between our mental processes (thoughts, feelings, beliefs) and our physical health. It
acknowledges that what we think, feel, and believe can directly affect our body's
functioning, both positively and negatively. Conversely, our physical state can also
influence our mental well-being. This interconnectedness highlights the importance of a
holistic approach to health, where mental and physical health are seen as inseparable.
Examples of the Mind-Body Connection:
 Stress and Illness:
Stress, a psychological state, can trigger physical responses like increased heart rate and
blood pressure, and even weaken the immune system.
 Emotions and Physical Symptoms:
Anxiety can cause physical symptoms like stomach aches, muscle tension, and
headaches.
 Diet and Mental Health:
A poor diet can negatively affect mood and cognitive function, while a balanced diet can
improve mental well-being.
 Exercise and Mental Health:
Physical activity can reduce stress, improve mood, and enhance cognitive function.
What is its importance in Health Psychology:
 Holistic Approach:
Health psychologists recognize the importance of addressing both mental and physical
health to improve overall well-being.
 Preventative Measures:
Understanding the mind-body connection helps develop strategies for preventing illness
and promoting healthy behaviors.
 Chronic Illness Management:
Mind-body interventions can play a role in managing chronic conditions like pain,
anxiety, and depression.
  Treatment Effectiveness:
By considering the mind-body connection, healthcare providers can tailor treatments to
better address the needs of individuals.
Examples of Mind-Body Interventions:
 Mindfulness and Meditation:
These practices can help individuals become more aware of their physical sensations and
emotional states, reducing stress and promoting emotional regulation.
 Stress Management Techniques:
Techniques like deep breathing, progressive muscle relaxation, and yoga can help reduce
stress and improve physical health.

2. Why Should Physios Care? Because:

- Patient beliefs shape treatment response!
- Behaviour change = better recovery
- Stress, mindset & lifestyle = impact pain, healing, and participation

3. Key Questions in Health Psychology

- What causes illness?
- Who’s responsible for treatment?
- How do mind and body interact?
- How can psychology promote health?

4. Health Beliefs & Behaviours

Beliefs influence behaviour; behaviour affects health.
Examples:
- “I’m not at risk of lung cancer” → Keeps smoking
- “Exercise helps my heart” → Joins gym
5. Models to Know
A. Health Belief Model
Developed by Rosenstock and Becker.

✅ Explains why people do (or don’t) take preventive actions.

Key Concepts:
- Perceived Susceptibility: ‘Could I get this illness?’
- Perceived Severity: ‘Is it serious?’
- Perceived Benefits: ‘Will the action help?’ - Perceived Barriers: ‘What’s stopping me?’
- Cues to Action: Triggers (e.g., symptoms, advice)
- Health Motivation: ‘Do I care about staying healthy?’
Clinical Tip: Use this to explore what stops patients from following advice.

B. Theory of Planned Behaviour Developed

by Ajzen.

Predicts deliberate health behaviours.

Key Components:
- Attitudes: Personal view of the behaviour (‘I think exercise is good for me’)
- Subjective Norms: Social pressure (‘My friends want me to quit smoking’) -
Perceived Behavioural Control: Confidence in doing it (‘I can avoid junk food’)
These shape Intention → which influences Behaviour.
Useful in physiotherapy when promoting rehab adherence.

C. Stages of Change Model

Developed by Prochaska & DiClemente.

Behaviour change is a journey, not a jump.

Stages:
- Precontemplation: No intention to change (‘I won’t quit smoking’)
- Contemplation: Aware but ambivalent (‘Maybe I should quit’)
- Preparation: Getting ready (‘I’ll quit next month’)
- Action: Taking steps (‘I’ve started cutting down’)
- Maintenance: Sticking to change (‘3 months smoke-free!’)
- Relapse: Slip back to old behaviour (‘Had a cigarette last week’)

It's dynamic — people can move back and forth. Advice has to be appropriate to stage.

5. Illness Beliefs: What Patients Think

How people understand their illness affects how they cope and recover.
5 Dimensions:
- Identity (what is it?)
- Cause (what caused it?)
- Timeline (how long will it last?)
- Consequences (how bad is it?)
- Control/Cure (can it be managed?)

6. Stress & Illness: The Link

Stress isn’t just in your head—it’s in your hormones, heart rate, and immune system.
Models:
- Fight or Flight (Cannon)
- General Adaptation Syndrome (Selye)
- Transactional Model (Lazarus) Effects of Chronic Stress:
- Suppressed immunity
- Heart disease risk
- Poor sleep, bad habits

7. Chronic Illness: Psychology’s Role

Using Coronary Heart Disease (CHD) as example:
- Predicts risk behaviours (diet, smoking, stress)
- Shapes beliefs after illness (“It’s my genes” vs “I can change”)
- Improves rehab outcomes (more than just pills!)

8. Fun Fact – Placebo Effect

Patients who believed their pills (even if fake) would work → lived longer.
Belief = healing power!
Take-Home Message

"Health is not just about the body, but also about the mind."

What patients believe, how they feel, and what they do—all shape their journey
from illness to recovery.

As future physiotherapists, understanding health beliefs, behaviour

change models, and the psychology of stress and illness will help you
empower patients, improve outcomes, and become holistic healers.

Change begins with awareness. Support your patients at every step—from denial
to action—with empathy and evidence.