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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

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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