This document provides an introduction and overview of key concepts in health psychology. It discusses the goals of studying health from multiple perspectives and integrating different approaches. Key terms are defined, including health psychology, health, disease, and illness. The document outlines the historical development of health psychology as a field and how it began to integrate biological, behavioral, and social factors influencing health. Major causes of death are discussed, noting the increasing role of lifestyle behaviors. Theories of attribution, health locus of control, and unrealistic optimism related to health beliefs and behaviors are also introduced. Culture is discussed as an important macro-level influence on concepts of health and disease.

1. Introduction to Health
Psychology
Chapter 1

2. Course Goals
To encourage thinking about health and illness
from a number of perspectives, including:
• scientist/researcher
• patient
• caregiver
• health professional

3. Course Goals
Health psychology is an integrative field – you
will be encouraged to synthesize ideas from a
number of approaches and perspectives,
through evaluation of theories, studies, and
personal experience.

4. How would you describe your
general overall health?
I am in excellent health.
I am in good health.
I am in average health.
I am in poor health.

5. Chapter outline
• Concerned with the ways in which we, as individuals,
behave and interact with others in sickness and in
health.
• Definitions of Health, Illness and Disease
• How do they relate to health and illness?
• Can certain behaviors predispose us to particular
illnesses?
• Historical background of Health Psychology
• Past and modern concepts of Health & Illness
• Health is a perception issue?

6. Key terms
Health psychology:
“A field which integrates psychological knowledge relevant to
the maintenance of health, the prevention of illness, and
the adjustment to illness.” (Wolfgang Stroebe, 2000)
• Health: "Health is a state of complete physical, mental and
social well-being and not merely the absence of disease or
infirmity.”(World Health Organization, 1946)
• Disease is a diagnosable biological dysfunction or infection.
• Illness is an individual’s unique experience of pain and
suffering.
• Etiology: the cause, set of causes, or manner of causation of a
disease or condition.

7. Two distinct concepts: disease and illness
• Social scientists argue that disease and illness
are usually used in different ways and can
often be considered as two distinct concepts.
You can have a disease without being ill, for
example:
• A person with heart disease may not know
that they have heart disease until they suffer a
heart attack, or
• A person who has contracted HIV, may not
know until becomes seriously ill with AIDS in
the future.

8. What do health psychologists do?
• Psychologists who strive to understand how biological, behavioral, and
social factors influence health and illness are called health
psychologists.
• In contemporary research and medical settings, health psychologists
work with many different health care professionals (e.g., physicians,
dentists, nurses, physician's assistants, dietitians, social workers,
pharmacists, physical and occupational therapists, and chaplains) to
conduct research and provide clinical assessment and treatment
services
• Health psychologists participate in health care in a multitude of
settings including:
– primary care programs
– inpatient medical units
– specialized health care programs
• such as pain management, rehabilitation, women's health,
oncology, smoking cessation, and various other programs
– They also work in colleges and universities, corporations, and for
governmental agencies

9. When & How did Health Psychology
begin?
• 1978 USA Conference in which all medical health care
providers as well as psychologists were there and they
found a need of an interconnecting decipline
• 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.

10. Matarazzo’s 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.

11. Changing Patterns of Illness & Disease
• Over the last century health behaviours have
played an increasingly important role in health and
illness.
• McKeown’s book, The Role of Medicine (1979),
discusses the decline of infectious diseases in the
nineteenth century, which forms the focus for
medical sociology.
• It also highlights the increasing role of behaviour in
illness in the twentieth century; this represents the
focus for health psychology.

12. • McKeown also examined health and illness throughout
the twentieth century.
• He argued that contemporary illness is caused by an
individual’s own behaviours, such as whether they
smoke, what they eat and how much exercise they take
– and he suggested that good health was dependent on
tackling these habits.
• McKeown’s emphasis on behaviour is supported by
evidence of the relationship between behaviour and
mortality. It has been suggested that 50 per cent of
mortality from the ten leading causes of death is due to
behaviour.
• For example, Doll and Peto (1981) estimated that
tobacco consumption accounts for 30 per cent of all
cancer deaths, alcohol 3 per cent, diet 35 per cent, and
reproductive and sexual behaviour 7 per cent.

13. The past and Modern Concept of Health & Illness
• In particular, based on the premise that people behave in line
with the way they think, health psychologists have turned to the
study of health beliefs as potential predictors of behaviour.
• Contagious diseases and infections now contributed
minimally to illness and death in the Western World till 2019.
• 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.

14. Major Causes of Death in (21st
• Those in which behavioral 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.
• However this changed immensely after the onset of
COVID-19.
• YOUR PERCPECTIVE ABOUT PREVELANCE OF COVID-19.
• Was/IS it a life style disease?
• Completely depended on biological causes?
• Has Social/ Environmental reasoning as well?

15. The role of health beliefs
• Attribution theory
• Health Locus of Control
• Unrealistic optimism

16. Attribution theory
• The origins of attribution theory lie in the work of
Heider (1944, 1958), who argued that individuals are
motivated to understand the causes of events as a
means to make the world seem more predictable and
controllable.
• Attribution theory has been applied to the study of
health and health behaviour; for example, Bradley
(1985) examined diabetic patients’ daily injections –
the results indicated that the patients who chose an
insulin injections showed increased control over their
diabetes and decreased control attributed to doctors.
• Three dimensions of casual attribution

17. A further study by King (1982) examined the relationship
between attributions for an illness and attendance at a
screening clinic for hypertension.
• The results demonstrated that if the hypertension was
seen as external but controllable, the individual was
more likely to attend the screening clinic (‘I am not
responsible for my hypertension but I can control it’).

18. Health locus of control
• The issue of controllability emphasized in attribution
theory has been specifically applied to health in terms
of the health locus of control.
• Individuals differ in their tendency to regard events as
controllable by them (an internal locus of control) or
uncontrollable by them (an external locus of control).
• It has been suggested that health locus of control
relates to whether we change our behaviour (by giving
up smoking or changing our diet, for instance), and also
to our adherence to recommendations by a health
professional

19. Unrealistic optimism
• Weinstein (1983, 1984) suggested that one of the
reasons we continue to practice unhealthy behaviours is
our inaccurate perceptions of risk and susceptibility.
• He gave participants a list of health problems to examine
and then asked: ‘Compared to other people of your age
and sex, are your chances of getting [the problem]
greater than, about the same as, or less than theirs?’
• Most participants believed that they were less likely to
experience the health problem.
• Clearly, this would not be true of everyone, so Weinstein
called this phenomenon unrealistic optimism.

20. • Weinstein (1987) described four cognitive factors
that contribute to unrealistic optimism:
1. lack of personal experience with the
problem;
2. the belief that the problem is preventable by
individual action;
3. the belief that if the problem has not yet
appeared, it will not appear in the future;
and
4. the belief that the problem is infrequent.
• These factors suggest that our perception of our
own risk is not a rational process.

21. 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.

22. 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.