Health Psychology Ch.1 What is Health Psychology?

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

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 to influence health and illness and their course. 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

Clinical Implications of the Biopsychosocial Model

The biopsychosocial model makes explicit the significance of the relationship between patient and practitioner. An effective patient-practitioner relationship can improve a patient's use of services, the efficacy of treatment, and the rapidity with which illness is resolved.

Psychosomatic Medicine

The idea that specific illnesses are produced by people's internal conflicts was perpetuated in the work of Flanders Dunbar in the 1930s (Dunbar, 1943) and Franz Alexander in the 1940s (Alexander, 1950). Dunbar and Alexander maintained that conflicts produce anxiety, which becomes unconscious and takes a physiological toll on the body via the autonomic nervous system. The continuous physiological changes eventually produce an organic disturbance.

The Biopsychosocial Model: The Case History of Nightmare Deaths

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

Prospective Designs

Prospective research looks forward in time to see how a group of people change, or how a relationship between two variables changes over time. 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. A particular type of prospective study is longitudinal research, in which the same people are observed at multiple points in time.

the etiology and correlates of health, illness, and dysfunction.

Etiology refers to the origins or causes of illness. Health psychologists especially address the behavioral and social factors that contribute to health, illness, and dysfunction, such as alcohol consumption, smoking, exercise, the wearing of seat belts, and ways of coping with stress.

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

First - 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, and sexual activity is critical to the likelihood of developing AIDS. Second, because people may live with chronic diseases for many years, psychological issues arise in their management. Health psychologists help chronically ill people adjust psychologically and socially to their changing health state and treatment regimens, many of which involve self-care. Chronic illnesses affect family functioning, including relationships with a partner or children, and health psychologists help ease the problems in family functioning that may result.

Health

"a complete state of physical, mental, and social well-being and not merely the absence of disease or infirmity." Rather than defining health as the absence of illness, health is recognized to be an achievement involving balance among physical, mental, and social well-being. Many use the term wellness to refer to this optimum state of health.

psychosomatic medicine

(Dunbar and Alexander's work influenced psychosomatic medicine). Offers profiles of particular disorders believed to be psychosomatic in origin, that is, caused by emotional conflicts. These disorders include ulcers, hyperthyroidism, rheumatoid arthritis, essential hypertension, neurodermatitis (a skin disorder), colitis, and bronchial asthma. We now know that all illnesses raise psychological issues. Moreover, researchers now believe that a particular conflict or personality type is not sufficient to produce illness. Rather, the onset of disease is usually due to several factors working together, which may include a biological pathogen (such as a viral or bacterial infection) coupled with social and psychological factors, such as high stress, low social support, and low socioeconomic status.

Division of Health Psychology

1978 - Was formed within the APA

Health Psychology

A field devoted to understanding psychological influences on how people stay healthy, why they become ill, and how they respond when they do get ill. Health psychologists study issues but also come up with interventions to help people. 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. health psychologists work to improve quality of life so that people with chronic disorders can live their lives as free from pain, disability, and lifestyle compromise as possible.

prevention and treatment of illness

A health psychologist might teach people in a high stress occupation how to manage stress effectively to avoid health risks. A health psychologist might work with people who are already ill to help them follow their treatment regimen.

the health care system and the formulation of health policy.

Health psychologists study the impact of health institutions and health professionals on people's behavior to develop recommendations for improving health care.

Retrospective Design

Investigators also use retrospective designs, which look backward in time in an attempt to reconstruct the conditions that led to a current situation. Retrospective methods, for example, were critical in identifying the risk factors that led to the development of AIDS. Initially, researchers saw an abrupt increase in a rare cancer called Kaposi's sarcoma and observed that the men who developed this cancer often eventually died of general failure of the immune system. By taking extensive histories of the men who developed this disease, researchers were able to determine that the practice of analreceptive sex without a condom is related to the development of the disorder. Because of retrospective studies, researchers knew some of the risk factors for AIDS even before they had identified the retrovirus.

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. Some skulls from the Stone Age have small, symmetrical holes that are believed to have been made intentionally with sharp tools to allow the evil spirit to leave the body while the shaman performed the treatment ritual.

ancient Greeks

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. According to this viewpoint, disease resulted when the four humors or circulating fluids of the body—blood, black bile, yellow bile, and phlegm—were out of balance. The goal of treatment was to restore balance among the humors. The Greeks also believed that the mind was important. They described personality types associated with each of the four humors, with blood being associated with a passionate temperament, black bile with sadness, yellow bile with an angry disposition, and phlegm with a laid back approach to life. Although these theories are now known not to be true, the emphasis on mind and body in health and illness was a breakthrough at that time.

THE RISE OF THE BIOPSYCHOSOCIAL MODEL

biomedical viewpoint began to change with the rise of modern psychology, particularly with Sigmund Freud's (1856-1939) early work on conversion hysteria. According to Freud, specific unconscious conflicts can produce physical disturbances that symbolize repressed psychological conflicts. Although this viewpoint is no longer central to health psychology, it gave rise to the field of psychosomatic medicine.

biomedical model

has governed the thinking of most health practitioners for the past 300 years, maintains that all illness can be explained on the basis of aberrant somatic bodily processes, such as biochemical imbalances or neurophysiological abnormalities. The biomedical model assumes that psychological and social processes are largely irrelevant to the disease process.

health promotion and maintenance

includes issues such as how to get children to develop good health habits, how to promote regular exercise, and how to design a media campaign to get people to improve their diets.

the biopsychosocial mode

it's fundamental assumption is that health and illness are consequences of the interplay of biological, psychological, and social factors

Mortality

refers to numbers of deaths due to particular causes.

Morbidity

refers to the number of cases of a disease that exist at some given point in time. Morbidity may be expressed as the number of new cases (incidence) or as the total number of existing cases (prevalence).

the Middle Ages

supernatural explanations for illness. Disease was regarded as God's punishment for evildoing, and cure often consisted of driving out the evil forces by torturing the body. Later, this form of "therapy" was replaced by penance through prayer and good works. During this time, the Church was the guardian of medical knowledge, and as a result, medical practice assumed religious overtones. The functions of the physician were typically absorbed by priests, and so healing and the practice of religion became virtually indistinguishable.

factors contributing to the rise of health psychology

the expansion of health care services. ∙ Because containing health care costs is so important, health psychology's main emphasis on prevention—namely, modifying people's risky health behaviors before they become ill—can reduce the dollars devoted to the management of illness. ∙ Health psychologists know what makes people satisfied or dissatisfied with their health care (see Chapters 8 and 9) and can help in the design of a user-friendly health care system. ∙ The health care industry employs millions of people. Nearly every person in the country has direct contact with the health care system as a recipient of services.

the Renaissance and continuing into the present day.

the invention of the microscope in the 1600s and the development of the science of autopsy, which allowed medical practitioners to see the organs that were implicated in different diseases. As the science of cellular pathology progressed, the humoral theory of illness was put to rest. Medical practice drew increasingly on laboratory findings and looked to bodily factors rather than to the mind as bases for health and illness. 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.

Epidemiology

the study of the frequency, distribution, and causes of infectious and noninfectious disease in a population. For example, epidemiologists study not only who has what kind of cancer but also why some cancers are more prevalent than others in particular geographic areas or among particular groups of people.

Changing Patterns of Illness

until the 20th century, the major causes of illness and death in the United States were acute disorders. Acute disorders are short-term illnesses, often result of a viral or bacterial invader and usually amenable to cure. The prevalence of acute infectious disorders, such as tuberculosis, influenza, measles, and poliomyelitis, has declined because of treatment innovations and changes in public health standards, such as improvements in waste control and sewage. Now, chronic illnesses—especially heart disease, cancer, and respiratory diseases—are the main contributors to disability and death, particularly in industrialized countries. Chronic illnesses are slowly developing diseases with which people live for many years and that typically cannot be cured but rather are managed by patient and health care providers.

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

•Reduces illness to low-level processes such as disordered cells and chemical imbalances • Fails to recognize social and psychological processes as powerful influences over bodily estates—assumes a mind-body dualism • Emphasizes illness over health rather than focusing on behaviors that promote health • Model 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?