Chapter One: What is Health Psychology?

Identify the health-related problems addressed by health psychologists.

1. Managing side effects of treatments 2. Modifying bad health habits such as smoking 3. Managing pain

health psychology:

The area within psychology devoted to understanding psychological influences on health, illness, and responses to those states, as well as the psychological origins and impacts of health policy and health interventions.

morbidity:

The number of cases of a disease that exist at a given point in time; it may be expressed as the number of new cases (incidence) or as the total number of existing cases (prevalence).

Etiology:

The origins and causes of illness.

chronic illnesses:

Illnesses that are long-lasting and usually irreversible. (Are the main contributors to disability and death, particularly in industrialized countries.)

In summary, health psychology...

In summary, health psychology examines the psychological and social factors that lead to the enhancement of health, the prevention and treatment of illness, and the evaluation and modification of health policies that influence health care.

Why is meta-analysis considered a powerful methodological tool in health psychology research?

It uses a broad array of diverse evidence to reach conclusions.

biopsychosocial model:

The view that biological, psychological, and social factors are all involved in any given state of health or illness.

biomedical model:

The viewpoint that illness can be explained on the basis of aberrant somatic processes and that psychological and social processes are largely independent of the disease process; the dominant model in medical practice until recently.

Identify a true statement about an experiment.

People are randomly assigned to different conditions and their reactions are measured.

conversion hysteria:

The viewpoint, originally advanced by Freud, that specific unconscious conflicts can produce physical disturbances symbolic of the repressed conflict; no longer a dominant viewpoint in health psychology.

mortality:

The number of deaths due to particular causes.

epidemiology:

The study of the frequency, distribution, and causes of infectious and noninfectious disease in a population, based on an investigation of the physical and social environment. Thus, for example, epidemiologists not only study who has what kind of cancer but also address questions such as why certain cancers are more prevalent in particular geographic areas than other cancers are.

True or false: Morbidity and mortality statistics are essential to health psychologists where charting the major causes of disease can lead to steps to reduce their occurrence.

True

Slowly developing diseases with which people live for many years and that cannot be cured but rather are managed by patient and health care providers are known as _____.

chronic illnesses

Renaissance

dualistic • body caused illness (natural) • cellular pathology/germs

What factors led to the development of health psychology?

the inception of the field of psychology in the early 20th century, psychologists have made important contributions to health, exploring how and why some people get ill and others do not, how people adjust to their health conditions, and what factors lead people to practice health behaviors.

Stone Age

unified • mind caused illness (supernatural) • spirits

Health psychologist study...

Psychological aspects of the prevention and treatment of illness. They study the impact of health institutions and health professionals on people's behavior to develop recommendations for improving health care.

Identify the experimental method that is usually used for evidence-based medicine.

Randomized clinical trials

Which of the following is the main contributor to disability and death of people, particularly in industrialized countries?

Chronic illnesses

meta-analysis:

Combines and contrasts results from multiple studies to identify consistencies in patterns of research findings.

health:

Defined by the World Health Organization (1948). The absence of disease or infirmity, coupled with a complete state of physical, mental, and social well-being; health psychologists recognize health to be a state that is actively achieved rather than the mere absence of illness.

clinical implications of the biopsychosocial model

Diagnosis should consider all (i.e., biopsychosocial) interacting roles and may require and interdisciplinary team. Treatment should consider all (i.e., biopsychosocial) interacting roles and may require an interdisciplinary team. Patient-provider relationships are important.

_____ has contributed to the rise of health psychology.

Expansion of health care services

Identify the research method that provides more definitive answers than other research methods.

Experiments

Identify the gold standard methods of health psychology research.

Experiments and Randomized clinical trials

randomized clinical trials:

Experiments to evaluate the effectiveness of treatments or interventions over time. An experimental study of the effects of a variable (such as a drug or treatment) administered to human participants who are randomly selected from a broad population and assigned on a random basis to either an experimental group or a control group. The goal is to determine the clinical efficacy and pharmacologic effects of the drug or procedure.

True or false: The biopsychosocial model does not place a significance on an effective patient-practitioner relationship in clinical settings.

False

The idea that specific illnesses are produced by people's internal conflicts was perpetuated in the work of...

Flanders Dunbar in the 1930s and Franz Alexander in the 1940s For example, Alexander developed a profile of the ulcer-prone personality as someone with excessive needs for dependency and love.

factors involved in the rise of Health Psychology

Health Psychology was "established" in the late 1970s into the early 1980s (roughly 40 years), spurred by: 1. changes in patterns of illness (morbidity and mortality) 2. advances in technology and research 3. expansion of healthcare services 4.increased medical acceptance and understanding

Epidemiological studies frequently use what two important terms?

"morbidity" and "mortality."

definition of Health Psychology:

"the aggregate of the specific educational, scientific, and professional contributions of the discipline of psychology to the promotion and maintenance of health, the prevention and treatment of illness, and the identification of etiologic and diagnostic correlates of health, illness, and related dysfunctions" (Matarazzo, 1980, p. 815)

Behavioral Medicine:

"the interdisciplinary field concerned with the development and integration of behavioral and biomedical science, knowledge, and technique relevant to health and illness and the application of this knowledge and these techniques to prevention, diagnosis, treatment, and rehabilitation" (Schwartz & Weiss, 1978, p. 250)

Identify the factors that fueled efforts for reforming the health care system in the United States in order to provide a basic health care package for all.

1. Basic preventive care and treatment for common illnesses were out of financial reach. 2. Some individuals received the best of health care while others received less.

How can chronic illnesses be treated?

1. By medication 2. By altering diet 3. By self-monitoring of symptoms

What other factors have fueled the growing field of health psychology?

1. Change in illness patterns in the United States including the increase in chronic or lifestyle-related illnesses 2. New medical technologies and scientific advances create issues that can be addressed by health psychologists. 3. The expansion of health care services and the expanding role of health care in the economy 4. An increasing acceptance of health psychologists within the medical community and the rigorous methodological contributions of health psychology researchers. 5. the realization that psychological and social factors contribute to health and illness 6. The demonstrated importance of psychological interventions to improving people's health.

Identify true statements about research in health psychology.

1. Much research in health psychology is experimental. 2. In a health psychology experiment, people are randomly assigned to different conditions and their reactions are measured.

The Biomedical Model: Why Is It Ill-suited to Understanding Illness?

1. Reduces illness to low-level processes such as disordered cells and chemical imbalances 2. Fails to recognize social and psychological processes as powerful influences over bodily states—assumes a mind-body dualism 3. Emphasizes illness over health rather than focusing on behaviors that promote health 4. Cannot address many puzzles that face practitioners: why, for example, if six people are exposed to a flu virus, do only three develop the flu?

How does the biopsychosocial model of health and illness overcome the disadvantages of the biomedical model?

1. The biopsychosocial model emphasizes both health and illness. From this viewpoint, health becomes something that one achieves through attention to biological, psychological, and social needs, rather than something that is taken for granted. 2. The biopsychosocial model maintains that biological, psychological, and social factors are all important determinants of health and illness. Both macrolevel processes (such as the existence of social support or the presence of depression) and microlevel processes (such as cellular disorders or chemical imbalances) continually interact

Health psychologists analyze and attempt to improve...

Health psychologists analyze and attempt to improve the health care system and the formulation of health policy.

What are the advantages of theory for guiding research and treatment?

1. Theories provide guidelines for how to do research and interventions. (For example, the general principles of cognitive-behavioral therapy can tell one investigator what components should go into an intervention with cancer patients and these same principles can help a different investigator develop a weight loss intervention) 2. Theories generate specific predictions, so they can be tested and modified as the evidence comes in. (For example, testing theories of health behavior change revealed that people need to believe that they can change their behavior, and so the importance of self-efficacy has been incorporated into theories of health behaviors.) 3. Theories help tie together loose ends. (Example, Everyone knows that smokers relapse, people go off their diets, and alcoholics have trouble remaining abstinent. A theory of relapse unites these scattered observations into general principles of relapse prevention that can be incorporated into diverse interventions.)

Why have chronic illnesses helped spawn the field of health psychology?

1. These are diseases in which psychological and social factors are implicated as causes. For example, personal health habits, such as diet and smoking, contribute to the development of heart disease and cancer. 2. People may live with chronic diseases for many years, psychological issues arise in their management. 3. Chronic illnesses may require medication use and self-monitoring of symptoms, as well as changes in behavior, such as altering diet and getting exercise. Health psychologists develop interventions to help people learn these regimens and promote adherence to them.

Identify the kind of questions that the methods and knowledge of neuroscience can address.

1. Why is chronic pain so intractable to treatment? 2. How do placebos work?

Methodological tools that have proven valuable in health psychology research...

1. functional magnetic resonance imaging (fMRI) that permit glimpses into the brain. 2. Web-based programs for managing distress in response to illness or treatment now exist for many disorders. Interventions make use of cell phones, pagers, palm pilots, tablets, and other mobile technologies to deliver interventions and assess health-related events in the natural environment like telemedicine. 3. Meta-analysis is a particularly powerful methodological tool, because it uses a broad array of diverse evidence to reach conclusions.

Health Psychology is the area of psychology that focuses on:

1. how we stay/become healthy: >health promotion >health maintenance >illness prevention 2. why we become ill: >etiology (origins) of health, illness, dysfunction correlates of health, illness, dysfunction 3. how we respond to illness: >treatment of illness >coping with illness >healthcare systems and policy

Health psychologist focus on...

1. how we stay/become healthy: health promotion, health maintenance, illness prevention 2. why we become ill: etiology (origins) of health, illness, dysfunction correlates of health, illness, dysfunction 3. how we respond to illness: treatment of illness, coping with illness, healthcare systems and policy Health promotion and maintenance. The etiology and correlates of health, illness, and dysfunction. Health psychologists especially address the behavioral and social factors that contribute to health, illness, and dysfunction

systems theory

> All levels of organization in any entity are linked hierarchically (from micro to macro levels). > Change in one level will influence all others. GENES> CELL> ORGAN> ORGAN SYSTEM> INDIVIDUAL> IMMIDIATE SOCIAL NETWORK> BROADER SOCIAL NETWORK

psychosomatic medicine:

A field within psychiatry, related to health psychology, that developed in the early 1900s to study and treat particular diseases believed to be caused by emotional conflicts, such as ulcers, hypertension, and asthma. The term is now used more broadly to mean an approach to health-related problems and diseases that examine psychological as well as somatic origins.

longitudinal research:

A particular type of prospective study. The repeated observation and measurement of the same individuals over a period of time.

prospective research

A research strategy in which people are followed forward in time to examine the relationship between one set of variables and later occurrences. (For example, if we were to find that hostility develops relatively early in life, but heart disease develops later, we would be more confident that hostility is a risk factor for heart disease and recognize that the reverse direction of causality—namely, that heart disease causes hostility—is less likely.)

prospective research:

A research strategy in which people are followed forward in time to examine the relationship between one set of variables and later occurrences. For example, prospective research can enable researchers to identify risk factors for diseases that develop at a later time.

retrospective designs:

A research strategy whereby people are studied for the relationship of past variables or conditions to current ones. Interviewing people with a particular disease and asking them about their childhood health behaviors or exposure to risks can identify conditions leading to an adult disease, for example.

theory:

A set of interrelated analytic statements that explain a set of phenomena, such as why people practice poor health behaviors. (The best theories are simple and useful.) (one-third of health psychology investigations are guided by theory.)

experiment:

A type of research in which a researcher randomly assigns people to two or more conditions, varies the treatments that people in each condition are given, and then measures the effect on some response.

A. early 20th century VS. B. 1900 early 21st century/2015

A. early 20th century 1. acute diseases 2 infectious diseases 3. germ theory/cellular causes 4. "single causes" 5. curable/preventable 6. e.g., vaccines, antibiotics, antibacterial B. 1900 early 21st century/2015 1. chronic illnesses 2. progressive, non-infectious diseases 3. psychological/social causes 4. "multiple causes" 5. chronic, incurable 6. e.g., diet, smoking, alcohol, exercise, sex

A. biopsychosocial model vs. B. biomedical model

A. multiple levels of determination, from micro to macro level A. holistic, unified A. emphasis on health as well as illness A. greater explanatory power B. single level of determination (e.g., germ theory) B. reductionistic, dualistic B. emphasis on illness over health B. incomplete explanatory power

Retrospective methods were critical in identifying some risk factors for _____ even before the causative agent was discovered.

AIDS

acute disorders:

Illnesses or other medical problems that occur over a short time, that are usually the result of an infectious process, and that are reversible. (Until the 20th century, the major causes of illness and death in the United States)

wellness:

An optimum state of health achieved through balance among physical, mental, and social well-being.

What is the advantage of using correlational studies over experiments in health psychology research?

It can study issues when variables cannot be manipulated experimentally.

correlational research:

Measuring two variables and determining whether they are associated with each other. Studies relating smoking to lung cancer are correlational, for example. (The disadvantage of correlational studies is that it is difficult to determine the direction of causality unambiguously.) (correlational studies often have advantages over experiments because they are more adaptable, enabling us to study issues when variables cannot be manipulated experimentally.)

correlational research

Measuring two variables and determining whether they are associated with each other. Studies relating smoking to lung cancer are correlational, for example. (The disadvantage of correlational studies is that it is difficult to determine the direction of causality unambiguously.) (Correlational studies often have advantages over experiments because they are more adaptable, enabling us to study issues when variables cannot be manipulated experimentally.)

_______ ________ combines results from different studies to identify how strong the evidence is for particular research findings.

Meta-analysis

Identify a psychosomatic disorder caused by emotional conflicts.

Neurodermatitis

evidence-based medicine:

Uses the scientific method to determine the best available treatments for disorders. Typically drawing on double-blind placebo-controlled clinical trials, evidence-based medicine is increasingly the standard for clinical decision making in health care.

Until the 20th century, the major causes of illness and death in the United States were _____.

acute disorders

The type of model that maintains that all illnesses can be explained on the basis of aberrant somatic bodily processes, such as biochemical imbalances or neurophysiological abnormalities, is known as the ________ model.

biomedical

Health Psychology was "established" in the late 1970s into the early 1980s (roughly 40 years) spurred by:

changes in patterns of illness (morbidity and mortality) advances in technology and research expansion of healthcare services increased medical acceptance and understanding

In randomized clinical trials, researchers _____.

compare a target treatment against the existing standard of care or a placebo control

Mid-1900s

connected • most disease caused by physical factors, some diseases caused by mental factors (mental factors affect body) •personality/stress• unconscious conflicts

According to Freud, specific unconscious conflicts can produce physical disturbances that symbolize repressed psychological conflicts. This is known as _______ ________.

conversion hysteria

The type of research where health psychologists measure whether changes in one variable correspond to changes in another variable is called

correlational research

Most of the research in health psychology is based on _____.

correlational research

The type of research where health psychologists measure whether changes in one variable correspond to changes in another variable is called...

correlational research

American Psychological Association (APA)...

created a task force in 1973 to focus on psychology's potential role in health research. These groups joined forces, and in 1978, the Division of Health Psychology was formed within the APA. It is safe to say that health psychology is one of the most important developments within the field of psychology in the past 50 years.

Turn of Century

dualistic • body caused real illness • mind caused conversion illness • cellular pathology/germs • unconscious conflicts

The study of the frequency, distribution, and causes of infectious and noninfectious diseases in a population is called _____.

epidemiology

Medical interventions go through rigorous testing and evaluation of their benefits before they become the standard of care in

evidence based medicine

A researcher creates two or more conditions that differ from each other in exact and predetermined ways in a

experiment

What are the gold standards used in health psychology research?

experiments and randomized clinical trials. Experiments have been the mainstay of science, because they typically provide more definitive answers to problems than other research methods.

An advantage of the biopsychosocial model over the biomedical model is that the biopsychosocial model _____.

focuses on biological, psychological, and social factors that act as determinants of health and illness

Renaissance and continuing into the present day...

great strides were made in understanding the technical bases of medicine. The invention of the microscope in the 1600s and the development of the science of autopsy. In an effort to break with the superstitions of the past, practitioners resisted acknowledging any role for the mind in disease processes. Instead, they focused primarily on organic and cellular pathology as a basis for their diagnoses and treatment recommendations. Resulting in the biomedical model.

In comparison to earlier methods, people with diabetes now monitor their blood glucose levels multiple times a day using technology that is far _____.

less invasive

A type of research where the same people are observed at multiple points in time is known as _____.

longitudinal research

The number of cases of a disease that exist at some given point of time is referred to as _____.

morbidity

The number of deaths due to particular causes is called _____.

mortality

Prehistoric times...

most cultures regarded the mind and body as intertwined. Disease was thought to arise when evil spirits entered the body, and treatment consisted primarily of attempts to exorcise these spirits.

Morbidity may be expressed as incidence which refers to the ____.

number of new cases

"wellness" =

optimum state of health as defined above for health.

The continuous physiological changes that occur in people as a result of conflict can produce an actual _____.

organic disturbance

Teaching people in high-stress occupations to manage stress effectively so that it will not adversely affect their health is an example that focuses on _____.

prevention and treatment of illness

Some of the problems faced by researchers in correlational studies can be remedied using _____.

prospective research

The type of research that looks forward in time to see how a group of people change, or how a relationship between two variables changes over time is known as _____.

prospective research

Longitudinal research is a type of _____.

prospective study

Dunbar's and Alexander's work helped shape the emerging field of...

psychosomatic medicine

Sigmund Freud's work on conversion hysteria gave rise to the field of _____.

psychosomatic medicine

Experiments that are conducted by health care practitioners to evaluate treatments or interventions and their effectiveness over time are called:

randomized clinical trials.

The type of research design that looks backward in time in an attempt to reconstruct the conditions that led to a current situation is known as a

retrospective design

The Case History of Nightmare Deaths; biopsychosocial model :

strange phenomenon: sudden, unexpected nocturnal deaths among male refugees from Southeast Asia, especially Laos, Vietnam, and Cambodia. The combination of this chronic strain, a genetic susceptibility, and an immediate trigger provided by a family argument, violent television, or a frightening dream culminated in nightmare death. Clearly, the biopsychosocial model unraveled this puzzle.

Mobile health-based interventions and assessments have improved health psychologists' abilities to _____.

study health-related phenomena in real time

In recent years, the health care industry in the United States has come under increasing scrutiny because _____.

substantial increases in health care costs have not brought improvements in basic indicators of health

Middle Ages...

swung to supernatural explanations for illness. Disease was regarded as God's punishment. Church was the guardian of medical knowledge.

According to the humoral theory of illness, a disease arises when _____.

the four circulating fluids of a body are out of balance

During prehistoric times, most cultures believed that _____.

the mind and body were intertwined

In the context of using theory for guiding research in health psychology, testing _____ incorporated the importance of self-efficacy and revealed that people need to believe they can actually change their behavior.

theories of health behavior change

A set of analytic statements that explain a set of phenomena, such as why people practice poor health behaviors is known as a(n) _____.

theory

About one-third of health psychology investigations are guided by _____.

theory

Ancient Greeks

unified • body caused illness (natural) • balance of humors BOOD>PASSION BLACK BILE> SADDNESS DEPRESSION YELLOW BILE> ANGRY PERSONALITY PHLEGM> LAID BACK

Middle Ages

unified • mind caused illness (supernatural) • God, devil/evil spirits

Present

unified • physical health is inextricably woven with psychological and social environment • biological, psychological, and social factors

An optimum state of health is termed by many as _____.

wellness

Ancient Greeks...

were among the earliest civilizations to identify the role of bodily factors in health and illness. Rather than ascribing illness to evil spirits, they developed a humoral theory of illness. Disease resulted when the four humors or circulating fluids of the body—blood, black bile, yellow bile, and phlegm—were out of balance. The emphasis on mind and body in health and illness was a breakthrough for that time.