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Chapter One: What Is Health Psychology? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. •Definition of health psychology •The mind-body relationship: a brief history •The rise of the biopsychosocial method •The need for health psychology •Health psychology research •What is health psychology training for? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 2 •Studies psychological influences on people • How they stay healthy • Why they become ill • How they respond when they get ill •Health: Complete state of physical, mental, and social well-being • Wellness: Optimum state of health Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 3 •Bio Factors: Virus, Bacteria, Genetics •Psych Factors: Behavior, Choices, Perception, Beliefs, Norms, Coping, Pain •Social: SES, Stress, Social Support, Available resources, Access to healthcare Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 4 •Health promotion and maintenance •Prevention and treatment of illness •Etiology and correlates of health, illness, and dysfunction • Etiology: Origins or causes of illness •Improvement of health care system and the formulation of health policy Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 5 •Disease during prehistory - Considered to arise when evil spirits entered the body •Humoral theory of illness - Diseases resulted when the humors or circulating fluids of the body were out of balance • Personality types associated with the humors • Blood - Passionate temperament • Black bile - Sadness Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 6 • Yellow bile - Angry disposition • Phlegm - Laid-back approach to life •Disease in Middle Ages - God’s punishment •Renaissance to present day - Technical bases of medicine are understood • Dependent on laboratory findings and looked to bodily factors • Diagnosis - Organic and cellular pathology Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 7 •16th/17th Century: Disease localized to body •Late 1800 – Tissue Pathology (microscope) •19th Century- cell biology, basic element •Gave Rise to: Magic Bullet Theory: There is a one shot cure for all illnesses Germ Theory: germs at cell level cause illness Created the Biomedical Model Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 8 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 9 •Specific unconscious conflicts produce physical disturbances symbolizing repressed psychological conflicts (sexual) • Conceptualized by Sigmund Freud • Belle’s Palsy: Symptoms without physical cause • Case: “Dora” lost her ability to speak • Symptoms symbolic of conflict involving unacceptable sexual desire • Gave rise to “psychosomatic” medicine Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 10 •Specific illnesses are produced by people’s internal conflicts • Criticism - Conflict or personality type is not sufficient to produce illness • Conflicts can not be objectively measured or verified (scientific principles) Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 11 •Freud’s observations helped to create •Health and illness are consequences of the interplay of biological, psychological, and social factors •Advantages • Individual and society continually interact to influence health and illness • Emphasizes both health and illness Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 12 •Process of diagnosis can benefit from understanding the interacting role of biological, psychological, and social factors •Significance of the relationship between patient and practitioner is made clear which improves: • Patient’s use of services • Efficacy of treatment • Rapidity with which illness is resolved Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 13 •Purpose - To see how completely the mind and body are intertwined in health •Sudden nocturnal deaths among male refugees from Southeast Asia after the Vietnam war • Occurred in the first few hours of sleep • Autopsies revealed no specific cause of death •Reasons • Genetic susceptibility Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 14 • Victims were overwhelmed by: • Cultural differences • Language barriers • Difficulties finding satisfactory jobs • Immediate trigger provided by: • Family argument • Violent television • Frightening dreams Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 15 •Increase in chronic or lifestyle-related illnesses • Acute disorders: Tuberculosis, pneumonia, and other infectious diseases • Chronic illnesses: Heart disease, cancer, and respiratory diseases •Advances in technology and research •Expanded health care services •Increased medical acceptance Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 16 •Acute- 1900s •Causes: •Influenza/Pneu •Tuberculosis •GI Infection •Chronic-now •Heart Disease:1 •Cancer:2 •Injuries/Accid:3 Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 17 •Drop in Deaths due to Infectious Disease: • Improved hygeine • Cleaner water • Antibiotics • Healthier behavior • Note: Acute conditions are now short-lived and curable, Chronic are incurable and lifelong Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 18 •Most Chronic Illness are Preventable: • Adherence to medication (insulin) • Diet • Stop smoking • Exercise • Limit alcohol (car accidents, self-inflicted gun shots) Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 19 •10% Medical care •20% Genetics •40% Behavior !!! •30% other factors •NOTE: Illness is multi-factorial, not caused by 1 factor alone! Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 20 • Biopsychosocial Model: • Instructions: Create a list of all possible psychological, biological and social/environmental factors that contribute to the onset of this college student’ winter cold. • Sherry is a 18 year old freshman living in the dorms and currently attending Cal Poly Pomona majoring in Business. She has family in Wisconsin and is feeling very lonely and isolated. Normally a successful student, Sherry received her first F in two classes in the Fall Q. Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 21 • Ryan is currently a senior in an IB program in high school. He is a vivacious and sociable student and enjoys his classes and has many friends. His favorite past-time is to play league of legends with his friends online. He was recently diagnosed with Lymphoma. He will be undergoing aggressive chemotherapy and will miss most of the rest of his senior year. • What are the biopsychosocial factors to consider when considering improving his quality of life and his response to treatment? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 22 •Explanation of a phenomena, Describes relationships between variables • Advantages • Guides Research investigations • Develop cohesive knowledge base • Avoid trial and error Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 23 • Evidence-based medicine: Medical interventions are based on empirical evidence; defines standard of care • Experimental Designs: • Causal : Ability to conclude A causes B • Exp: Mediterranean diet reduces heart disease • Correlational Designs: • Predict:Ability to predict B, if A is known • Exp: Income is related to increased well-being Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 24 •Definition: must have an independent variable and dependent variable(s) • Independent Variable: manipulated variable administered to the subjects • Exp: Drug treatment, Antidote, Therapy, New diet • Dependent Variable: what is measured • Exp.: # of anxiety symptoms, reduced cholesterol, # depressive symptoms, reduced risk of heart disease • Operational Definition: how you measure the constructs (exp. Measuring happiness) Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 25 •Potential Problems with Concluding Cause: Confounds • Solution: Randomized –Placebo Double-Blind Study (The Gold Standard) • Reduces: • Selection Effects: random assignment to groups • Placebo Effects : “Sugar pill” group • Hawthorne Effects: influence of the experimenter • Social Desirability Effect: Subjects biasing results Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 26 •Correlational research: whether one variable co-varies with another • Positive Correlation: As one increases, so does the other (meditation and wellbeing) • Negative Correlation: As one decreases, the other increases (exercise and heart disease) •Disadvantage – No causality can be inferred •Advantage over experiments - Easier Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 27 •Looks forward in time: explore health risks • Group of people change • Exp: Follow a cohort of Native-American children raised on a reservation and follow their health over time • Relationship between two variables over time • Exp: Examine dietary practices and health outcomes •Longitudinal research: Same people are observed at multiple points in time (exp. Longevity Project) Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 28 •Looks backward in time in an attempt to reconstruct the conditions that led to a current situation •Were critical in identifying the risk factors that led to the development of AIDS •Important in identifying infectious patterns: exp. Understanding the spread of SARS, Ebola Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 29 •Important to understand health trends •Epidemiology: Study of the frequency, distribution, and causes of infectious and noninfectious disease in a population • Morbidity: Number of cases of a disease that exist at some given point in time • Mortality: Total number of deaths due to particular cause Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 30 Tools of neuroscience • Functional magnetic resonance imaging (fMRI) - Permits glimpses into the brain • Has helped to improve the knowledge of the autonomic, neuroendocrine, and immune systems Mobile and wireless technologies • Ecological momentary interventions • Ambulatory blood pressure monitoring devices Meta-analysis • Combines results from different studies to identify how strong the evidence is for particular research findings Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 31 Health care practitioners Social work Occupational therapy Dietetics Physical therapy Public health Academic research Private practice Management of health care Treatment settings Occupational health settings Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 32 •Design a study to investigate the effects of lack of sleep on wellbeing. • What is your hypothesis? • 1. Operational Definition of Wellbeing • 2. What is the independent variable • 3. What is the dependent variable • Is the design Experimental or Correlational or Descriptive? Copyright © 2015 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of McGraw-Hill Education. 33