Health Psychology

           

What Do Health Psychologists Do?

Teachers, research scientists, clinicians Applied health psychologists: licensed

practitioners who focus on health-promoting interventions and helping people cope with illnesses

Goals in Health Psych

• Pinpoint Psychological, Behavioral, and Social Factors in Disease and Health

• Promote and Maintain Health

• Prevent and Treat Illness

• Improve the Health Care System and Health Care Policy

Where Do Health Psychologists Work?

Training to become a Health Psychologist

General psychology training at the undergraduate level

Special training at the doctoral (Ph.D.) levelFour- to six-year program65 Ph.D. programs in health psychology in

the United States

Issues

Issues and historical trends that have shaped the development of Health Psychology

I. Increased Life Expectancy

Average life expectancy — Increased by more than 30 years since

1900In the U.S. in 21st century

• Women: around 80• Men: around 75 • Why is this increase important?

II. Changes over the last 100 years

The 10 Leading Causes of Death in The U.S. in

1900

1. Pneumonia2. Tuberculosis3. Diarrhea and enteritis4. Heart disease5. Stroke6. Liver disease7. Injuries8. Cancer9. Senility10. Diphtheria

Source: Centers for Disease Control and Prevention

Leading causes of death (today)

1. Heart disease2. Cancer3. Stroke4. Lung disease

(COPD)5. Accidents6. Diabetes

Source: U.S. National Center for Health Statistics

These top six account for 80% of deathsThey are mostly lifestyle diseases with preventable causesThey are mostly chronic disorders (rather than acute disorders)

Behavior and healthActual Causes of Death in the U.S.

1. Tobacco

2. Diet /activity patterns

3. Alcohol

4. Microbial agents

5. Toxic agents

6. Firearms

7. Sexual behavior

8. Motor vehicles

9. Illicit use of drugsSource: Journal of the American Medical Association

III. Rising Health Care Costs

IV. Trends in how illness has been viewed

Western view (traditional)

Biomedical model — illness is caused by physical phenomena (e.g., germs, cell abnormalities) -- reductionistic

Biopsychosocial Perspective

The view that health is determined by the interaction of biological mechanisms, psychological processes, and social influences

Biological mechanisms: genes, evolutionary history, anatomical/biological makeup, nutrition

Psychological processes: coping mechanisms, attitudes toward treatment, personality/outlook on life

Social context: SES, social network, societal and cultural norms (e.g., pervasive consumption of soda)

A Biopsychosocial Model of Depression

The Biopsychosocial Model in practice

Somatic presentations of psychological dysfunction Chest pain in panic attack Hypochondriasis

Psychological conditions secondary to illness Post M.I. Depression Psychological sequelae of stroke Stress disorders associated with traumatic

injuries

The Biopsychosocial Model in practice

Physical symptoms responsive to behavioral interventions anticipatory nausea enuresis tension & migraine headache early labor (clip from “The New Medicine”)

The Biopsychosocial Model in practice

Psychological presentations of organic problems hypothyroidism presenting as

depression steroid-induced psychosis

Somatic complications associated with behavioral factors mismanagement of diabetes noncompliance to medications

The Biopsychosocial Model in practice

Behavioral risk factors for disease or disability smoking excessive weight risk taking sedentary lifestyle

Problems of health care providers and health care systems Physician-patient relationships Lack of access to health care

The Biopsychosocial Model in practice (case studies)

Small group exercise – using the BPS

(then discuss assessment targets using the BPS – next slide)

Biological Review

current status of illness / background of illness (usually found in the medical history chart)

medicationspainfamily historylifestyle habits (e.g., nutrition and

exercise)

Psychological Review

Affective/emotionalCognitive (e.g., thinking, beliefs,

memory, attention, learning, interpreting, problem-solving)

Motivation

Social Review

Patient’s interaction with health care staff

Family / friends supportSocioeconomic status (SES)Environment to which patient will

return (job?)Cultural factors