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

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