Health Psychology

1. Introduction to Health
Psychology
Jain University

2. The Emergence of Health Psychology
The BioMedical Model v/s Bio-psycho-social model
Methodology
Systems of the Body
• Nervous System
• Endocrine System
• Cardiovascular System
• Respiratory System
Overview

3. What is Health Psychology?

4. • WHO(1948): “A complete state of physical,
mental, and social wellbeing” not merely
absence of disease as earlier said.
• Wellness came into picture at a later stage
• Current focus is on body-mind relationship and
quality of life.

5. Concept of Health Behaviour
• Health behavior refers to a person's beliefs
and actions regarding their health and well-
being.
• As a good example of this, some
people's health behaviors jive well with
promoting and maintaining a healthy lifestyle.
People on their best health behavior:
• Do not smoke or use any other tobacco
products.

6. • Preventive health behavior:
• "any activity undertaken by an individual who
believes himself to be healthy for the purpose of
preventing or detecting illness in an
asymptomatic state"

7. What Factors Led to the Development of Health
Psychology?
• APA Division in 1978
• Health Psychology journal in 1982
• Nature of illnesses has changed
• Infectious diseases – 1900
• Life style choices – 21st Century
• Behavioral choices

8. Health Psychology
• Personality traits, physiological responses and health related
behaviors – optimism, hostility, and extraversion
• Social factors – especially social support, like BP and immune
system, dealing with minor and major illnesses
• Treatments and psychological factors – attitudes towards AIDS –
behavior: safe sex
• Pain influence on psychological well-being, especially with chronic
diseases – new study using MDMA effects on anxiety in terminally
ill cancer patients – www.maps.org
• Primary prevention, secondary prevention, tertiary prevention –
Table 14.1 , p. 564
• Taylor (1990) – 93% failed to follow recommended treatment

9. Foundations for Contemporary Health Psychology
In ancient times and the middle ages there was a belief
that spiritual disturbances caused disease.
The development of early Greek Medicine and the advent
of the Renaissance brought about a focus on physical
causes for disease.
Scientific advances in microscopy and human anatomy
further advanced medicine.
The Emergence of Health Psychology

10. Foundations for Contemporary Health Psychology
Psychoanalytic case studies revealed how anxiety and
unconscious personality conflicts can manifest as
physical symptoms.
The study of psychosomatic medicine focused on disease-
prone personality types.
The contemporary view focuses on the balance between
physical and mental well-being in the context of the social
environment.
The Emergence of Health Psychology

11. The Modern Problem
Patterns of illness are changing.
People are less likely to die from acute disorders and communicable disease
(with the exception of AIDS).
People are living longer with chronic diseases
Chronic diseases:
• Generally can be managed, not cured
• Related to health behaviors and compliance with medical regimen
• Living with chronic diseases has social and psychological consequences
The Emergence of Health Psychology

12. Technological Advances
Genetic counseling
• Coping with potential health risks
Patient counseling regarding life-sustaining
measures
Research in health psychology identifies risk-
factors
The Emergence of Health Psychology

13. Health Care Services
• Health care is the largest service industry in the
United States.
• Prevention can reduce health care costs.
• Most people in the U.S. are recipients of health
care services.
• Research on satisfaction with health care
• Health psychologists are becoming more integrated
into the medical context.
The Emergence of Health Psychology

14. The challenge of caring for a billion
India is the second most populous
country in the world
The death rate has declined but birth rates
continue to be high in most of the states.
Health care structure in the country is over-
burdened by increasing population
Family planning programs need to be (re)activated

15. Challenge: Burden of Disease
in the new millenium
India faces the twin epidemic of
continuing/emerging infectious diseases
as well as chronic degenerative diseases.
The former is related to poor implementation
of the public health programs, and the latter
to demographic transition with increase in life
expectancy.

16. •Economic deprivation in a large segment of
population results in poor access to health care.
•Poor educational status leads to non-utilization of
scanty health services and increase in
avoidable risk factors.
•Both are closely related to life expectancy and
IMR.
•Advances in medicine are responsible for no more
than half of the observed improvement in health
indices.
Economic development, Education
and Health

17. Human Development Indicators: A
challenge for all
Longevity, literacy and GDP per capita are
the main indicators of human development
Longevity is a measure of state of health, and
is linked to income and education
Weakness in health sector has an adverse
effect on longevity
India ranks low (115th) amongst world nations
judged by HDI

18. Health Care in India
Private practitioners and hospitals major
providers of health care in India
Practitioners of alternate systems of medicine
also play a major role
Concerns regarding ethics, medical negligence,
commercialization of medicine, and
incompetence
Increasing cost of medical care and threat to
healthy doctor patient relationship

19. Levels of Prevention
Primary Prevention
•Prevent disease
•Identify causes
•Promote health behaviors
Secondary Prevention
•Catch disease in early stages
•Prevent further deterioration
Tertiary Prevention
•Manage illnesses w/ no
•cure

20. Microscopic
Macroscopic
Biological
Psychological
Sociological
Biopsychosocial Health Model

21. Biological Factors
• Genetics
• Physiology
• Gender
• Age
• Vulnerability to stress
• Immune system
• Nutrition
• Medications

22. Psychological factors
Personality
Self-efficacy
Personal control
Optimistic bias
Social support
Stress
Coping skills
Diet
Risky behaviors
Adherence to medical advice
Addiction

23. Sociological factors
• Poverty
• Ethnic background
• Cultural beliefs
• Racism
• Living with chronic illness

25. • Dominant model for the past 300 years
• All illness can be explained on the basis of aberrant somatic
processes.
Liabilities of the Biomedical Model
• Reductionism – Illness is reduced to microlevel processes i.e.
chemical imbalances.
• Single-factor model – Illness is due to one factor: a biological
malfunction.
• Mind-body dualism – The mind and the body are separate entities.
• Emphasis on illness over health
The Biomedical Model

26. What Factors Led to the Development of Health
Psychology?
• The Biomedical Model is unable to fully account
for health
• Mind-body question
• Biomedical treatments only
• Failures to account for many psychological
factors and health
• Placebo effects – how to explain

27. Health is determined by both microlevel and
macrolevel processes (psychological and social factors).
Multiple factors – a variety of factors are involved in
health and illness.
The mind and body are not separated when
considering matters of health and illness.
Emphasis on both health and illness.
Advantages of the Biopsychosocial Model

28. The process of diagnosis must consider the
interaction of biological, psychological, and social
factors.
• Treatment recommendations must take these factors
into account.
The relationship between the patient and the health
care practitioner has an impact on the
effectiveness of care.
Clinical Applications of the Biopsychosocial
Model

29. Areas of Focus In Health Psychology
Health Promotion and Maintenance
Prevention and Treatment of Illness
Etiology (causes) and Correlates of Health and
Illness
Health Policy and Health Care Service Delivery

30. Short-term behavioral interventions have been
effective in helping patients to:
• Manage pain
• Modify bad health habits (such as smoking)
• Manage side effects and treatment effects when coping with chronic
• illness.
Psychologists help ease the adjustment process for
patients.
Contributions of Health Psychology

31. What Factors Led to the Development of Health
Psychology?
• Health care costs have risen dramatically. In
2003 1.3 trillion dollars spent
• Increase life expectancy – 1900: 47 years 2000:
76 years
• The development of new technology
• The meaning of health has changed – positive
psychology, includes well-being (WHO)
• College students and health issues – health
related behaviors
• Cultural definitions of health

32. How is Health Psychology Related to
Other Disciplines?
• Freud and the unconscious
• Psychosomatic medicine
• medical psychology
• behavioral medicine
• behavioral health
• medical sociology and anthropology

33. Experiments Randomized
Clinical Trials
Correlational
Studies
Comparing
changes in
variables
Prospective
Designs
Looking
forward,
longitudinal
research
Retrospective
Research
Looking
backward
Methodology
Methods to study Health Psychology

34. Experimental & Correlation
• An experiment is an investigation in
which a hypothesis is scientifically tested.
In an experiment, an independent variable
(the cause) is manipulated and the
dependent variable (the effect) is
measured; any extraneous variables are
controlled.
• An advantage is that experiments should
be objective. The views and opinions of
the researcher should not affect the results
of a study. This is good as it makes the
data more valid, and less bias
• Limitation: The artificiality of the
setting may produce unnatural
behaviour that does not reflect real
life, i.e. low ecological validity. This
means it would not be possible to
generalize the findings to a real life
setting.
• Demand characteristics or
experimenter effects may bias the
• Correlation research is a type of non
experimental research in which the
researcher measures two variables and
assesses the statistical relationship (i.e.,
the correlation) between them with little
or no effort to control extraneous
variables.
• Correlational research allows researchers
to collect much more data than
experiments. ... Correlation research only
uncovers a relationship; it cannot provide
a conclusive reason for why there's a
relationship.

35. Prospective and Retrospective
research
• A prospective study watches for
outcomes, such as the development of a
disease, during the study period and
relates this to other factors such as
suspected risk or protection factor(s).
• It can be inferred that opium use causes an
increased risk of death
• he results may be biased if a substantial
number of cohort members were lost to
follow-up
• A cohort of individuals that share a
common exposure factor is compared to
another group of equivalent individuals
not exposed to that factor, to determine
the factor's influence on the incidence of a
condition such as disease or death.

36. Experiment
A study where there is random assignment to treatment groups in an
intervention focused on exercise and weight loss
Correlation
A study of the relationship between cultural identity and physical symptoms
Prospective
A study following the physical and mental health indicators outcomes of cancer
patients 6 months, 1 year, and 2 years after chemotherapy
Retrospective
A study examining the past coping strategies of cardiac patients
Methods to study Health Psychology

37. 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
Methodology
Methods to study Health Psychology

38. ILLNESS COGNITION

39. • The terms illness perceptions and illness
cognitions are used to describe a range of
cognitive processes underlying attention,
interpretation, and behavior in response to
illness-related information.
• Although often studied in the context of various
disease populations (e.g., diabetes, cancer),
illness cognitions and perceptions are also
relevant in the absence of a diagnosed health
condition and have important implications for
subsequent illness behavior (e.g., self-care,
healthcare utilization, treatment adherence).

40. Dimensions of illness (Lau, 1995):
• not feeling normal → ‘I don’t feel right’
• specific symptoms →
physiological/psychological
• specific illnesses → cancer, cold, depression
consequences of illness →‘I can’t do what I
usually do’
• time line → how long the symptoms last
• the absence of health → not being healthy

41. Illness cognitions (Leventhal, 1997)
• Definition: a patient’s own implicit common
sense beliefs about their illness.
• Illness cognitions provide patients with a
framework for:
• coping with their illness
• understanding their illness
• what to look out for if they are becoming ill

42. Illness cognitions
• 5 cognitive dimensions of illness cognitions:
• 1) Identitiy → label given to the illness (the
medical diagnosis) and the symptoms
experienced
• 2) The perceived cause of the illness → biological
(virus) or psychosocial (stress)
• 3) Time line → how long the illness will last
(acute, chronic)
• 4) Consequences → the possible effects of the
illness on life (physical, emotional)

43. • 5) Curability and controllability → the illness
can be treated and cured and the outcome of
illness is controllable

44. Self-regulatory model of illness
cognitions
• The model:
• is based on approaches to problem solving
• suggests that illnesses are dealt with in the
same way as other problems Problem/change in
the status quo → individual is motivated to solve
the problem → re-establish their state of
normality

45. Self-regulatory model of illness
cognitions
• Stage 1: Interpretation Confronting with the
problem of a potential illness through two
channels:
• 1) symptom perception (‘I have a pain in my
chest’)
• 2) social messages (‘the doctor has diagnosed
this pain as angina’)

46. • symptom perception (‘I have a pain in my
chest’):
• individual differences: internally/externally
focused
• influenced by mood, cognitions, environment

47. • 2) social messages (‘the doctor has diagnosed
this pain as angina’) Information about illness
also comes from other people:
• health professional →formal diagnosis or a
positive test result
• lay individuals → advices from colleagues,
friends or family Symptom perception Formal
diagnosis Formal diagnosis (in asymptomatic
stage) Symptom perception

48. • Representation of health threat Illness
cognitions are constructed according to 5
dimensions:
• identity
• cause
• consequences
• time line
• cure/control
Give the problem
meaning and
enable the
individual to
develop coping
strategies.

49. • Emotional response to health threat
Identification of the problem of illness will also
result in changes in emotional state:
• fear
• anxiety
• depression
Coping
strategies also
relate to the
emotional state
of the
individual.

50. Stage 2: Coping
Approaches to coping
with illness:
(1) coping with a
diagnosis
(2) coping with the crisis
of illness
(3) adjustment to
physical illness.
Broad categories of
coping strategies:
approach coping
(e.g. taking pills,
going to the doctor)
avoidance coping
(e.g. denial, wishful
thinking)

51. • Stage 3:
• Appraisal Individuals evaluating:
• the effectiveness of the coping strategy
• determining whether to continue with this
strategy or whether to opt for an alternative one

52. Why is the model called self-
regulatory?
• the 3 components of the model (interpretation,
coping, appraisal) interrelate in order to
maintain the status quo (i.e. they regulate the
self)
• if the individual’s health is disrupted by
illness the individual is motivated to return the
balance back to normality
• self-regulation involves the 3 processes
interrelating in an ongoing and dynamic fashion