The root of all health is in the brain. The trunk of it is in emotion. The branches and leaves are the body. The flower of health blooms when all parts work together. ~Kurdish Saying

1. Health Psychology
What is health psychology?
What questions does it address?
Seta A. Wicaksana, Psychologist

3. 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?

4. 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.

5. 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.

6. 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

7. 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.

8. 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.

9. 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 health.

10. 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.

11. 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.

12. 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.

13. 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.
• Today’s major killers are cardiovascular diseases-heart
disease and strokes and cancers.
• Cardiovascular diseases account for about 40% of all
deaths in industrialised countries.

14. 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,

15. 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 people’s
health beliefs, attitudes and
behaviour.
• The biomedical model has a reactive
attitude towards illness. Traditional
medicine is more focused on disease
than on health.

16. 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.

17. 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 someone’s health status.

18. 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.

19. Role of Health
Psychology
• 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.

20. 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.

21. 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.

22. 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.

23. 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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