health psychology lecture 1

8/11/2019 Health Psychology Lecture 1

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Introduction to HealthPsychology


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Health PsychologyStudy of social, behavioural, cognitive,and emotional factors that influence the:

Maintenance of healthDevelopment of illness and disease

Course of illness or diseasePatients and familys response to illnessand disease


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What is health, illness, and

disease?


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World Health Definition of

Health (1948)

A complete state of physical, mental,and social well-being and not merelythe absence of disease and infirmity.


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Health ConceptPhysical Role - Physical SocialEmotional Role- Emot. Pain

Vitality General Health


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SF-36 (John Ware et al.,

1993) Social Functioning1. in past 4 weeks, to what extent have

physical/emotional problems interferedwith normal social activities with family,friends, neighbors, or groups.

2. in past 4 weeks, how much time hasyour physical/emotional problemsinterfered with your social activities (likevisiting with friends and relatives)?


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1993)Role limitations due to physical health Do youhave any of the following problems with workor other regular daily activity as a result of yourphysical health?

Cut down on time spent on work Accomplished less than you would likeLimited in the kind of work you could doHad difficulty performing work(took more effort)


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1993)Role limitation due to emotional problem Do you have any of the following problemswith work or other regular daily activity asa result of any emotional problems?

Cut down on time spent at work

Accomplished les than you would likeDidnt do work or other activities as carefullyas usual.


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What are your health risks?

For each item, answer YES or No.1. I believe if I feel well I must be healthy.

2. My weight is not within the range that thecharts say it should be.

3. I smoke cigarettes

4. My drinking would not qualify as moderate I either do not drink or I drink too muchto be considered a moderate drinker.

5. I rarely get 7 or 8 hours of sleep.


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What are your health risks?For each item, answer YES or No.

6. I do not follow a regular exercise program.

7. I believe that most disease have a geneticbase.

8. I believe that modern medicine will findcures for most diseases before I am oldenough to be affected by these diseases.

9. As long as I am not overweight, I believethat my diet will not affect my health.

10. I can wait until I am older to develop ahealthier lifestyle.


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Estimated contributions of different

factors to health status.

30%

20%

40%

Other Factors Genetic Behaviour Medical Care


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Health PsychologistScientists who research the areaHealth promotion intervene at the social

(e.g., government policy, community) orindividual level to promote health and prevent illness and disease.Clinical health psychologist intervene at theindividual level to treat illness, slow orprevent disease progression, and reducedisability.


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Health PsychologyDevelopment or progression of illnessand disease

Etiology

Individuals and familys response toillness and disease

Outcomes


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Relation of health psychology to

other health-related fieldsHealth

EducationNutrition

MedicinePsychosomatic

Cardiology

Oncology, etc.

Behaviouralhealth

Behaviouralmedicine

HealthPsychology

SociologyNutrition

Exercise Phys.

Physiology

Psychology


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History of Medicine


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History of Medicine1. Stone-age

Body____Mind

Spirit

2. Ancient Greeks

Body Mind

3. Middle-AgesBody____Mind

Spirit

4. Contemporary View

Body Mind

Socio-behavioural


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Supernatural or Magical Belief;

Disease resulted from:SorceryBreach of social tabooObject intrusionSupernatural possession

Losing ones sole


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TreatmentsConfession and appeasing of the gods.Magical sucking to remove the intrusiveobject.Drive out evil spirits by using vileconcoctions such as animal excrementor even torture.Trephination


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Greeks Hippocrates

(460-377 B.C.)Origin of the view that disease is anatural process.

Humoral theory View that disease occurs when the fourfluids of the body are out of balance

Four fluids are blood, black bile, yellowbile, and phlegm.Personality types


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Hippocrates - TreatmentsTemperament Humor Disease Treatment

Phlegmatic Phlegm Cold,headaches

Hot baths,warm food

Sanguine Blood Angina,epilepsy

Blood letting

Melancholic Black bile Hepatitis,ulcers

Hot baths

Choleric Yellowbile

Stomach, jaundice

Blood letting,liquid diet


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Evolving view of diseases Anatomical pathology

Belief that disease was localized in anatomy

(16th

to 18th

Centuries)Tissue pathology

Specific tissues could become diseased whileothers remain healthy (Late 1800s)

Cellular pathologyBelief that life resided in cells and so cells mustbe the place to look for disease (19 th century)


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Evolving view of diseasesGerm theory

Discovery that particles in the air that could not

seen (e.g., bacteria) could cause disease.Magic bullet

A specific cure could be found for every ailmentthat restore the person to perfect health.

Biopsychosocial modelMind, body, and environment interact incausing disease.


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History of MedicineStone-age

Body____Mind

Spirit

Ancient Greeks

Body Mind

Middle-AgesBody____Mind

Spirit

Contemporary View

Body Mind

Socio-behavioural


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Psychosomatic MedicineFreud (1856-1939)

Cannon (1932)

Dunbar (1930)

Alexander (1940s 1950s)


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Biopsychosocial Model of

DiseaseBiology

Genetic variability

AnatomyPhysiology

PathogensGerms

Toxins

Behavioural risk factorsDietExerciseSmokingSafe sexWearing seat belts in the car, etc.

SocialFamily

SocietyFriends, etc.


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Biopsychosocial ModelPsychological component

Behaviour (adoption and maintenance)Emotional (feelings)Cognition (thoughts, beliefs, and attitudes)Personality characteristic ways of

thinking and feeling


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Important Contributions of

Psychology to HealthHas provided techniques useful in changingbehaviours that affect health and illness.Is committed to keeping people healthyrather than waiting to only treat them whenthey become ill.

Long history of developing reliable and validmeasures for assessing health-related factors.Has contributed a solid foundation ofscientific methods for studying such

behaviours.


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Please respond to each of

these items with YES or NO.1. Personal testimonials are a good way to decide

about treatment effectiveness.

2. Newspaper reports of scientific research give anaccurate picture of the importance of the research.

3. The personal information from case studies usuallyprovides more valid data than information fromlongitudinal studies.

4. Placebo effects apply only to suggestible peopleand are not an important factor in the treatment ofmost people.


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Please respond to each of

these items with YES or NO.5. Placebo effects can influence psychological but not

physical disorders.

6. Different research methods are not important indetermining the validity of research because allscientific methods yield equally valuable results.

7. The number of participants in a research study is notimportant to the validity of the study.

8. Studies with nonhuman subjects can be just asimportant as those with human participants in

determining important health information.


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Please respond to each of theseitems with YES or NO.

9. Experimental rather than observational research isrequired to learn about patterns of disease.

10. Valuable research is done by people outside thescientific community, but scientists try to discountthe importance of such research.

11. Scientific breakthroughs happen everyday.

12. Each new report of health research seems tocontradict previous findings, so there is no way touse this information to make good personaldecisions about health.


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Research Methods

Case StudiesIn depth analysis of one individualType of single-subject research design

Advantage is a more complete analysis ofthe individualDisadvantage is that it can magnify

sampling errors


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Correlational Studies Yield degree of relationship betweentwo variablesType of descriptive research design

Advantage is that it can examine variablesthat cannot be experimentally manipulated

(e.g., IQ and occupational status).Disadvantage is that it cannot determinecausality.


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Cross-Sectional Study DesignsCompares groups at one point in time(e.g., age groups, ethnic groups,disease groups)

Advantage is that it is an efficient way toidentify possible group differences because

you can study them at one point in time.Disadvantage is that you cannot rule outcohort effects.

P li d H i


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Personality and Hypertension,The effect of Hypertension

Awareness (Irvine et al. 1989)Hypertension Study

PersonalityStudy

2nd BPScreen

MatchedNormotensive

Mean DBP>= 90 mmHgHypertensive

5th BP Screen5 months

4th BP Screen4 months

DBP < 105

3rd BP Screen3 months

PersonalityStudy

2nd BP Screen2-3 weeks later

DBP >= 90 but< 115 mmHg

1st BP Screen

P li d H i


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Personality and Hypertension:Effect of Hypertension Awareness

Variable Group 1 AwareHyper-tensive

Group 2

Normo-tensive

Group 3UnawareHyper-tensive

Group 4

Normo-tensive

% Male 75 75 89 89

AgeMean*(SD)

46.2(9.2)

46.2(8.2)

46.4(8.3)

45.8(8.0)

SBP/DBPMean*(SD)

135.1/93.9

(9.2/5.1)

118.7/76.3

(11.5/5.5)

135.8/93.8

(8.2/3.4)

118.5/75.7

(10.3/4.8)


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Personality and Hypertension:Effect of Hypertension Awareness

Variable Group 1 AwareHyper-tensive

Group 2

Normo-tensive

Group 3UnawareHyper-tensive

Group 4

Normo-tensive

Neuro-ticismMean*(SD)

12.0(5.3)

9.3(5.3)

9.7(4.8)

9.5(4.6)

Type AMean*(SD)

0.79(8.5)

-3.0(9.4)

-2.0(9.4)

-2.6(8.2)

* Group 1 > Group 2 & Group 3 (p < 0.01)


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Personality and Hypertension:

Effect of Hypertension Awareness

012345678910

11121314

Neuroticism

Aware HyperNormotUnaware HyperNormot

Aware hypertensive > normotensive & unaware hypertensive,

P < 0.001


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ConclusionDo hypertensives have a differentpersonality than those with normal bloodpressure?

No, because the unaware hypertensives didnot differ from the normotensives.

Why did the aware and unawarehypertensives differ?

Possible explanations?


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Conclusion Awareness of hypertension statusconfounds assessment of theassociation between personalitycharacteristics and hypertension.

Due to hypertension labeling effect; orDue to self-selection bias


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Longitudinal DesignTo gather data on the course of healthor disease over time (e.g., progression

of multiple sclerosis). Advantage is that you can see the timecourse of the disease or behaviour (e.g.,

smoking cessation over time).Disadvantage is it is costly and still subjectto bias


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Experimental DesignsExamines differences betweenexperimentally manipulated groups

(e.g., one group gets a certain drug andthe other gets a placebo). Advantage is that you can determinecausality.

Disadvantage is cost and many variablescannot be experimentally manipulated(e.g., smoke exposure over time).


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Please answer anonymouslythese questions

1. What is the main thing you learned from thislecture?

2. What is the main question you have that wasntanswered?3. The things the instructor did best OR the best

things about the lecture that were?4. The things the instructor did worst OR the

worst things about the lecture that were?

health psychology lecture 1

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