Notes on Human Behaviour in Medicine and Health

Learning Outcomes

  • What is human behaviour?
  • Relevance to Medicine and Health
  • Determinants of human behaviour
  • Theories of learning and personality
  • Definitions of normal behaviour
  • Influence of human behaviour on health

What is Human Behaviour?

  • Refers to the potential and capacity for physical, mental, and social activity throughout all phases of human life.
  • Studied through various lenses: psychology, sociology, biology, anthropology, archaeology.
  • Encompasses all human actions, thoughts, and feelings.

Human Behaviour Over the Life Course

  • Typical life course consists of phases:
    • Prenatal life
    • Infancy
    • Childhood
    • Adolescence
    • Adulthood
    • Old age
  • Life-course approaches in developmental psychology explain changes in cognitive, emotional, and behavioural functioning over time.
  • Behaviour at each life stage affects health and medical care.

Maslow’s Hierarchy of Needs (1954)

  • Basic human drives include:
    • Eating, drinking, sleeping, reproducing.
    • Seeking homeostasis in physical and psychological functioning.

Relevance of Human Behaviour to Health

  • Psychological, social, and behavioural factors can lead to physical disease (e.g., loneliness, trauma, poverty).
  • Individual differences affect disease acceptance and health management.

Intersectionality and Health Equity

  • Intersectionality: Understanding that identity markers (gender, race, religion, sexuality) intersect and influence health experiences.
  • Unique stressors can affect individuals based on their identity markers, creating different challenges to health care.

Determinants of Human Behaviour

  • Genetics: Inherited genetic sequences and epigenetics influenced by life events.
  • Environment: Social context, cultural exposure, life experiences shaping development.
  • Interaction between genes and environment results in individual differences in biochemistry, behaviour, emotional tendencies.

Human Genetics

  • Genetic sequence variation includes nucleotides and is studied in the Human Genome Project.
  • Common variations seen as single nucleotide polymorphisms (SNPs); rare variations can lead to diseases.

Genetics and Epigenetics

  • Genetics: Fixed for life; not altered by experience.
  • Epigenetics: Reversible changes influencing gene expression without altering DNA itself; persist across generations.

Neuroplasticity

  • Definition: Nervous system's ability to reorganize its structure and functions in response to experiences and stimuli.
  • Evidence shows brain continuously adapts and reorganizes based on external inputs.

Neurodevelopment

  • Behaviour changes occur from physical maturation (e.g., skills like sitting up).
  • Infant brain development: 2,500 synapses per neuron increasing to 15,000 by age 2-3. Synaptic pruning reduces this by half into adulthood.

Theories of Learning and Personality

Bandura's Observational Learning
  • Learning through observing others and reinforcement; demonstrated through children mimicking aggressive behaviour witnessed in adults.
Ecological Systems Theory (Bronfenbrenner)
  • Focuses on social context and child’s environment; complexity increases with child’s growth and development.

Theories of Temperament and Personality

  • Temperament: Biological disposition observed in early childhood; influences behaviours like sociability and compliance.
  • Personality: More complex; influenced by experiences and time, involving traits, behaviours, and beliefs.

Cloninger’s Psychosocial Theory of Personality

  1. Novelty Seeking: Reacting excitedly to new experiences.
  2. Harm Avoidance: Sensitivity to negative stimuli.
  3. Reward Dependence: Reacting for social approval.
  4. Persistence: Continuing behaviour despite frustration.
  5. Self-directedness: Ability to adapt behaviour for goals.
  6. Cooperativeness: Identifying and working well with others.
  7. Self-transcendence: Feeling connected to a larger whole.

Psychodynamic Models of Personality/Behaviour

  • Three parts to personality: Id (basic survival needs), Ego (realistic decision-making), Superego (social norms and morality).
  • Development occurs through the ego’s interaction with the world.

Eysenck’s Personality Theory

  • Proposes three inherited dimensions of personality affecting learning and adaptation.

Big Five Personality Traits

  • Traits are dimensions rather than distinct types.
  • Major dimensions include openness, conscientiousness, extraversion, agreeableness, and neuroticism, each with subtraits.

Understanding Normal Behaviour

  • Deviance: Assessment from statistical norms or cultural acceptability.
  • Personal Distress: Subjective feelings of inability to cope.
  • Maladaptive Behaviour: Disturbances in social or occupational functioning.

Influence of Personality on Health Behaviour

  • Personality traits affect:
    • Eating habits and exercise.
    • Engagement in risky behaviours (linked to neuroticism and conscientiousness).
    • Compliance with treatment (optimistic individuals tend to adhere better).

Possible Mechanisms Linking Health and Personality

  • Direct relationships between personality types and illness risk.
  • Shared genetic variance between psychological traits and physical health.
  • Causal links from personality to health behaviours and outcomes.

Practitioner Goals

  • Respect for the uniqueness of patients and colleagues.
  • Effective communication, responsiveness, teamwork, kindness.

Summary

  • Human behaviour is complex and develops across the life course through genetic and experiential interactions.
  • Multiple identity markers like gender and race intersect, shaping healthcare experiences.
  • Understanding behaviour helps assess health responses and quality of life.