Health Psychology: Introduction

Health Psychology

  • Health promoting behaviors

  • Preventive rather than reactive

  • How do people stay healthy? (emphasis on HOW)

  • HEALTH: 
      * Complete state of physical, mental, and social well-being; not merely the absence of illness or disease, infirmity (WHO, 1948)
      * WELL-BEING: optimum state of health

  • Foci of Health Psychology
      * Health promotion and maintenance
      * ^^Prevention^^ and treatment of illness
        * Treatment: more cognitive behavioral therapy
      * Etiology and correlates of Health, Illness, and Dysfunction
        * Causes and factors
      * Improvement of the Healthcare System and formulation of Healthcare Policy

  • Development of Health Psychology
      * Mind-Body Relationship
        * Human prehistory 
          * superstitious
          * Evil Spirits = illness
          * Treatment = exorcism (trephination) 
            * Exorcism: physical corporal punishment; rationalizing torture
            * Trephination: drilling into skull to remove evil spirit; treatment for head injuries
        * Ancient Greeks: Humoral Theory of Illness
          * 4 humors
            * blood (passionate personality)
            * black bile (sadness/melancholy personality)
            * yellow bile (angry disposition)
            * phlegm (laid-back personality)
              * Phlegmatic personality
          * Excess of a particular fluid = personality
        * Middle Ages 
          * Divine punishment = illness
          * Treatment/Cure = physical/corporal punishment => penance (prayers and good works)
          * Continued exorcism but illness is divine punishment
          * Penance: undoing (defense mechanism)
          * Extended superstition
        * Renaissance
          * advancement of the technical basis of medicine
          * Invention of the microscope in the 1600s
          * Increased dependence on laboratory/physical findings as basis for health and illness
          * Clinical Eye: can use labs to confirm diagnosis but should not be too dependent on it
        * Modern Times
          * Psychodynamic Contributions
            * Sigmund Freud: Conversion Hysteria
            * Unconscious Conflict = physical disturbances that represent ^^repressed psychological conflicts^^
            * Anna O. = diagnosed as having hysteria
              * Physical manifestation of a psychological conflict
              * Best treated with hypnosis
          * Psychosomatic Medicine
            * Flanders Dunbar (1930s) and Franz Alexander (1940s)
            * Conflicts led to anxiety and anxiety show up as physiological symptoms and sometime actual organic disease

 

  • Current Perspectives
      * Traditional East Asian medical philosophies and practices
        * Acupuncture or acupressure
      * Advancement of Neuroscience
      * Development of Psychoneuroimmunology (PNI)
        * Link between brain, physical symptoms and immunity
  • Biopsychosocial Model
      * Consider biological, psychological, and social factors
      * Help in planning treatment

   

  • Biomedical Model
      * ALL illness can be explained on the basis of aberrant somatic/physical bodily processes.
      * Psychological and social processes are IRRELEVANT to the disease process.
      * Potential Liabilities of the Biomedical Model:
        * Reductionistic single-factor model: reduces illness to simplistic cause
        * Implicitly assumes a MIND-BODY DUALISM: mind is separate from body; psyche cannot influence physical body
        * Emphasizes illness over health
        * Fails to address certain puzzles related to health (e.g., Given 6 people exposed to measles, why do only 3 develop it?)
          * Are there psychological and social factors that influence their health?
  • Advantages of the Biopsychosocial Model
      * Biological, psychological, and social processes are ALL important determinants of health and illness.
      * Mind and body cannot be distinguished in matters of health and illness.
      * Mind influences body, what we feel physically can influence our mind as well
  • How do biological, psychological, and social processes interact if biological processes are micro-level processes and psychological and social processes are macro-level processes?
      * Systems Theory Approach
        * All levels of organization are linked to EACH OTHER hierarchically. A change in one level results in change in all the other levels.
        * One would affect another based on their level

 

  • Clinical Implications of the Biopsychosocial Model
      * Diagnoses and recommendations for treatment should consider interactions between and among all 3 factors (Bio, Psych, and Social factors)
      * Makes explicit the Patient-Practitioner relationship as well as its significance
      * The achievement and practice of health habits involve the interaction of all 3 factors as well.
      * Ex social factor: support of family of them getting treatment

  • Current trends in medicine, psychology, and the health care system

  • Cases in Health Psychology: The Case of “Nightmare Deaths”
      * 1970s: influx of refugees to the United States from Laos, Cambodia, and Vietnam
      * Increase in sudden, unexpected, nocturnal deaths among males refugees from these countries.
      * INITIAL CLUES: Deaths occurred within the first few hours of sleep; victim was noted to gurgle (like drowning) and move restlessly in bed; most victims had a rare, genetically-based malfunction in the heart’s pacemaker (have irregular heartbeat); autopsies showed NO SPECIFIC CAUSE OF DEATH

  • “Nightmare Deaths”: Bangungot?
      * Psychosocial Clues:
        * ONLY MEN from particular ethnic backgrounds were affected
        * Deaths were clustered in certain families
        * Survivors and victims’ relatives seemed to recall a dream that foretold the death
        * Survivors said they experienced a severe night terror
        * Many victims were noted to have either: watched a violent TV show prior to retiring to bed, or had a family argument, or were exhausted from working 2 jobs or from having full-time work AND learning English.
      * Bangungot: 
        * acute pancreatitis (pancreas releases hormones and goes to shock and organ failure)
          * Pancreas release hormones to digest the food
          * Sudden flood of hormones = inflammation in the pancreas
          * Cardiac arrest: part of multiple organ failure; heart dilates; cannot handle pumping blood efficiently
        * “Asian Death Syndrome” : genetics may play in the occurrence
        * Sleep paralysis: paradoxical sleep (you know you’re awake but you cannot move)
          * Parasomnia, abnormal sleep features
        * Death certificates = acute pancreatitis, multiple organ failures, septic shocks

  • The Need for Health Psychology
      * Changing patterns of illness: Acute vs. Chronic Illness
        * Examples of chronic illness: Lifestyle illness (hypertension, diabetes, high blood pressure), dementia
      * Advances in technology and research: Genetic research & PNI
      * Role of Epidemiology in Health Psychology: Morbidity and Mortality statistics
        * What health behaviors can help prevent COVID-19
      * Expanded Health Services: How can health psychologists help?
      * Increased medical acceptance of health psychologists
        * US, health psychologists work in clinics and hospitals; practice in tandem with psychiatrists, cardiologists
          * Teaching medical doctors how to encourage patients

  • Career Paths in Health Psychology
      * Practical Application: Medicine, Applied Medical Field
        * Therapies (speech, physical)
      * Research: public health, industrial/occupational health settings
        * Types of Research: correlational studies, prospective and retrospective studies, longitudinal research, case studies
      * Issues: promote health behaviors, prevent illness and accidents, control health care costs