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Introduction to Health Psychology

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Title: Introduction to Health Psychology


1
Introduction to Health Psychology
  • What is health psychology?
  • What questions does it address?

2
What is Health Psychology?
  • Concerned with the ways in which we, as
    individuals, behave and interact with others in
    sickness and in health.
  • What are the physiological bases of emotion?
  • How do they relate to health and illness?
  • What is stress?
  • Can certain behaviours predispose us to
    particular illnesses?
  • Can educational interventions prevent illnesses?

3
When How did Health Psychology begin?
  • Conference in USA in 1978
  • Creation of a section devoted to health
    psychology in the American Psychological
    Association (APA) in 1979
  • British Psychological Association (BPA) only set
    up a section in 1986, which was formerly
    recognised in 1997.
  • Health is a state of complete physical, mental
    and social well-being and not merely the absence
    of disease and infirmity. WHO 1946. The holistic
    nature of health was thus emphasized.

4
Matarazzos 1980 definition
  • Health psychology is 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, the
    identification of aetiologic and diagnostic
    correlates of health, illness and related
    dysfunction and the analysis and improvement of
    the health care system and health policy
    formation. This definition has become widely
    accepted.

5
Historical and Cultural Origins
  • Basic ideas and concepts have been around for a
    long time
  • Relationship between mind and body
  • Study of psychosomatic disorders owes much to
    Freud.
  • Attempts to relate distinct personality types to
    particular diseases with a causation hypothesis
    have largely been abandoned in favour of a more
    behavioural or biological approach, which seeks
    to employ interventions derived from behavioural
    medicine.
  • Changing patterns of illness and disease

6
Changing Patterns of Illness Disease
  • Contageous diseases and infections now contribute
    minimally to illness and death in the Western
    World.
  • Major breakthroughs in science have reduced
    prevalence of smallpox, rubella, influenza and
    polio.
  • Most deaths now caused by heart disease, cancer
    and strokes.
  • These diseases, studies suggest, are a by-product
    of life-style.
  • By 1970s health spending in Western countries was
    getting out of control. Governments began to
    explore disease prevention and health promotion.

7
Major Causes of Death in (21st
  • Those in which behavioural pathogens are the
    single most important factor. These are personal
    habits such as smoking, excessive drinking,
    over-eating and not exercising which can
    influence the onset and course of a disease.
  • Fighting diseases endemic in different parts of
    the world can be affected by behaviour and
    attitude e.g. malaria.

8
The Biomedical Model
  • Diseases come from outside the body and invade
    it, causing internal physical changes or
  • Diseases originate in the body as internal,
    involuntary physical changes.
  • Diseases are caused by chemical imbalances,
    bacteria, viruses or genetic pre-disposition.
  • Individuals are not responsible for their
    illnesses, which are from biological changes
    beyond their control. People who are ill are
    victims.
  • Treatment should consist of vaccination, surgery,
    chemotherapy or radio therapy, all of which aim
    to change the

9
The Biomedical Model continued
  • Physical state of the body.
  • Responsibility for treatment lies with the
    medical profession,
  • Health and illness are qualitatively different.
    You are either healthy or ill there is no
    continuum between them.
  • Mind and body function independently of each
    other. The abstract mind relates to feelings and
    thoughts and is incapable of influencing physical
    matter.
  • Illness may have psychological consequences, but
    not psychological causes.

10
The Biopsychosocial Model
  • In opposition to these ideas, Health Psychology
    argues that human beings should be seen as
    complex systems. Illness is often caused by a
    combination of biological ( e.g. viruses) and
    psychological (e.g. behaviour and beliefs) and
    social (e.g. poor housing, unemployment) factors.
  • These assumptions reflect the biopsychosocial
    model of health and illness, reflecting the
    changes in the nature of illness, causes of death
    and life expectancy of the (20th.
  • Health Psychologists are interested in normal
    everyday behaviour and normal psychological
    processes in relation to health and illness,
    rather than in psychopathology or abnormal
    behaviour.

11
(20th Changes in the nature of Illness
  • The biopsychosocial model reflects fundamental
    changes in the nature of illness, causes of death
    and overall life expectancy during the (20th.
  • Average life expectancy in the the USA has
    increased from 48 in 1900 to 76 today. There is
    the same rate of increase for most Western,
    industrialised nations. This is due mainly to the
    virtual elimination of infectious diseases such
    as pneumonia, flu, TB, diptheria, scarlet
    fever, measles, typhoid and polio as causes of
    death.

12
Major Killers of the (20th and (21st
  • HIV/AIDS increased the number of
    infection-related deaths in the West in the 1980s
    and 1990s. It is a major killer in Africa,
    reducing life expectancy to the 30s in some
    nations.
  • Poverty and poor nutrition has reduced life
    expectancy in Burma, for example, to 48.
  • Todays major killers are cardiovascular
    diseases-heart disease and strokes and cancers.
  • Cardiovascular diseases account for about 40 of
    all deaths in industrialised countries.

13
Why the Biomedical Model is no longer adequate
  • There has been a small, but steady decline in
    deaths due to cardiovascular diseases since the
    1960s. This is due to
  • Improvement in medical treatment.
  • Changes in lifestyle reduction in cholesterol
    levels and cigarette smoking.
  • Rise in cancers in industrialised nations due
    almost entirely to rises in lung cancer,

14
Why the Biomedical Model no longer applies
  • The influence of lifestyle factors is
    incompatible with the biomedical model. (Stroebe
    2000).
  • Conceptualisation of disease in purely biological
    terms means that the model has little to offer
    the prevention of chronic diseases through
    efforts to change peoples health beliefs,
    attitudes and behaviour.
  • The biomedical model has a reactive attitude
    towards illness. Traditional medicine is more
    focused on disease than on health.

15
The Biopsychosocial Model
  • It would be more appropriate to call our
    healthcare systems disease care systems, as the
    primary aim is to treat or cure people, rather
    than promote health or prevent diseases. Maes
    Van Elderen 1998.
  • The biopsychosocial model underlying health
    psychology adopts a more proactive attitude
    towards health.
  • Bio genetic, viruses, bacterial, lesions,
    structural defects, gender
  • Psycho cognitions (e.g. expectations of health),
    emotions (e.g. fear of treatment), behaviour (e.g
    smoking, exercise, diet, alcohol consumption,
    stress, pain.

16
The Social aspect of the Biopsychosocial Model
  • Social Norms of behaviour e.g. smoking/not
    smoking.
  • Pressures to change e.g. peer pressure,
    expectations, parental pressures.
  • Social values placed on health.Social class
  • Ethnicity
  • Employment
  • Gender expectations
  • The Biopsychosocial model offers a holistic
    approach. The person as a whole has to be looked
    after. Both at micro-level e.g.causes, such as
    chemical imbalance and at macro-level, such as
    the extent of social support need to be taken
    into account. These processes interact to
    determine someones health status.

17
Key Beliefs that inform the Biopsychosocial Model
  • Individuals are not just passive victims, but are
    responsible for taking their medication and
    changing their beliefs and behaviour.
  • Health and illness exist on a continuum-people
    are not either healthy or ill, but progress along
    a continuum in both directions.
  • Psychological factors contribute to the aetiology
    (causes) of illness. They are not just
    consequences of illness.
  • According to Ogden (2002) health psychology aims
    to
  • Evaluate the role of behaviour in the aetiology
    of illness, such as the links between smoking,
    coronary heart disease, cholesterol level, high
    blood pressure.
  • Predict unhealthy behaviours- for example,
    smoking, alcohol consumption and high fat diets
    are related to beliefs and belief about health
    and illness can be used can be used to predict
    behaviour.

18
Role of Health Psychology cont.
  • Understand the role of psychological factors in
    the experience of illness. For example,
    understanding the psychological consequences of
    illness could help alleviate pain, nausea,
    vomiting ,anxiety and depression.
  • Evaluate the role of psychological factors in the
    treatment of illness.
  • These aims are put into practice by
  • Promoting health behaviour, such as changing
    beliefs and behaviour
  • Preventing illness, for example by training
    health professionals to improve communication
    skills and to carry out interventions that may
    prevent illness.
  • Why do people adopt, or fail to adopt
    health-related behaviour?
  • Models of health behaviour try to answer this
    question.

19
Culture Health
  • One of the macro-level processes.
  • 1) How cultural factors influence various aspects
    of health. Stemming from an earlier, more
    established study.
  • 2) The more recent and active study of the health
    of individuals and groups as they settle into and
    adapt to new cultural circumstances through
    migration and their persistence over generations
    as ethnic groups.
  • Health Disease as Cultural Concepts
  • Concepts of health and disease are are defined
    differently across cultures.
  • Disease is rooted in pathological, biological
    processes common to all.
  • Illness now widely recognised as a culturally
    influenced, subjective experience of suffering
    and discomfort.

20
Culture Health
  • Recognising certain conditions as either healthy
    or a disease is also linked to culture e.g.
    trances are health-seeking mechanisms in some
    cultures. In others it is seen as a psychiatric
    disorder.
  • How a condition is expressed is also linked to
    cultural norms. In some cultures, psychological
    problems are expressed somatically- in the form
    of bodily symptoms e.g. in Chinese culture.
  • Disease and disability are highly variable.
    Cultural factors such as diet, substance abuse
    and social relationships within the family also
    contribute to the prevalence of disease,
    including heart disease, cancer and schizophrenia.

21
Acculturation
  • The process of adaptation to a new host culture
    is called acculturation.
  • Cross-cultural psychologists believe that there
    is complex pattern of continuity and change in
    how people who have developed in one cultural
    context adapt when they move to and live in a new
    cultural context.
  • The longer immigrants live in the host country
    (increasing acculturation) their health status
    migrates to the national norm of that country.
  • For immigrants to Canada from 26 out of 29
    countries, their coronary heart disease rates
    shifted to the Canadian norm. Similar patterns
    have been found for stomach and intestinal cancer
    among immigrants to the USA.
  • One possible explanation is exposure to widely
    shared risk factors in the physical environment,
    such as climate, pollution, pathogens.

22
Pursuit of Assimilation or Integration
  • Pursuing assimilation or integration as a way to
    acculturation may expose immigrants to cultural
    risk factors, such as diet, lifestyle and
    substance abuse..
  • This behavioural shift interpretation would be
    supported if health status both improved and
    declined relative to national norms.
  • Main evidence points to a decline. This supports
    the acculturation stress interpretation that
    the very stress of acculturation may involve risk
    factors that can reduce health status.
  • This is supported by evidence that stress can
    reduce resistance to diseases such as
    hypertension and diabetes. Berry 1998.
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