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Morrison, Bennett: Summary Health Psychology, Ch 1 to 17
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Summary Health Psychology subtest 1
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Summary Health PsychologyChapter 1: What is Health?
What is Health? Changing Perspectives
Models of Health and Illness
Mind-Body Relationships
Hippocrates thought that balance of the humours (four bodily fluids) was
influenced by eating healthily, which shows a relationship between the body and
mind. Galen (129-299) thought that there was a pathological basis for all ill
health (physical and mental) and he believed that the humours were linked to the
four temperaments (sorts of moods). In the Middle Ages, disease was thought to
be a punishment by god. Around 1600 (Renaissance), the scientific revolution
influenced the field of health to a great extent. Descartes (1596-1650) proposed
that the mind and body were two different things, and that interaction between
the two was possible (dualism, the mind is non-material). Dualists look at the
body from a mechanistic viewpoint: the body is only understandable as the sum
of its parts, in occurrence with the biomedical model: diseases have a
physiological explanation.
Biomedical Model of Illness
This view is reductionist: The mind/body can all be explained at the level of cells,
neurons, etc. This view ignores different responses of people to diseases and
such.
Biopsychosocial Model of Illness
= Holistic model that believes that diseases can be explained by a combination of
physical, social, cultural and psychological factors. This is the dual-aspect monist
view: The mind/body is made of one type of stuff but can be viewed subjectively
and objectively.
Challenging Dualism: Psychosocial Models of Health and Illness
Descartes dualist view has now lost a little bit of its power.
Behaviour and Health
Cancer is more prevalent these days because people grow older, the incidence
is greater. Also, people’s behaviour plays a major role.
Individual, Cultural and Lifespan Perspectives on Health
Lay Theories of Health
Many people’s explanations of “health” include: Feeling, symptom orientation
and/or performance.
,Social Representations of Health
According to another survey, health also includes psychosocial wellbeing. Factors
defined as health included: Health as not ill, health as a reserve, as behaviour, as
physical fitness and vitality, as psychosocial well-being, and as function.
Cross-cultural Perspectives on Health
In the westernised world, health is looked upon from a medical viewpoint
(medicalised), but in developing regions it is more naturalised and more spiritual.
In some countries, there is a more collectivist approach to health: the community
has to work together to preserve it. It is often also more holistic.
Lifespan, Ageing and Beliefs about Health
Developmental Theories
Learning, experience and maturation are parts of the developmental process. Erik
Erikson defined eight major life stages including cognitive functioning, language
skills, understanding of illness, etc.
Piaget’s maturational framework for cognitive development:
1. Sensorimotor stage (-2 years): Infant lacks symbolic thought. Reflexive
> voluntary action;
2. Preoperational stage (2-7 years): Egocentric stage, symbolic thought
develops and simple logical thinking and language develop;
a. Hard to find out about illnesses because of speech limitations;
b. Illness concept based on association:
i. Incomprehension;
ii. Phenomenism;
iii. Contagion;
3. Concrete operational stage (7-11 years): Abstract thought and logic,
mental operations and manipulations of objects;
a. Illness concept based on a causal sequence:
i. Contamination;
ii. Internalisation;
4. Formal operational stage (12-adulthood): Abstract thought, imagination
ad deductive reasoning;
a. Illness concept based on interactions between person-environment:
i. Physiological;
ii. Psychophysiological.
Subjective Health Status
= how people regard their own health. But people rate their health differently
when they just look at themselves as when they compare their health to other
people’s health.
What is Health Psychology?
Main goals:
The promotion and maintenance of health;
Improving health-care systems and health policy;
, The prevention and treatment of illness;
The causes of illness: e.g. vulnerability/risk factors.
Four approaches to health psychology: Clinical health psychology (treatment),
Public health psychology (immunisation/epidemics/etc), Community health
psychology (promotion), Critical health psychology (arose from criticism).
Chapter 2: Health Inequalities
Health Differentials
Evidence of Health Differentials
Health differentials: A term used to denote differences in health status and life
expectancy across different groups.
Health life expectancy: WHO: The number of years that a person can expect to
live in “full health”.
In developing countries, 1/3 of deaths occurs before the age of 5, another 1/3
before the age of 65; in higher income countries, 2/3 of deaths occurs after the
age of 65.
Even the “Haves” Experience Health Differentials
Even within a country (of higher income), health life expectancy can differ.
Explanations of Socio-Economic Health Inequalities (in Industrialised
Countries):
Social Causation vs. Social Drift
Social causation model: low SES causes health problems.
Social drift model: Health problems lead to low SES.
There is more support for the social causation model.
Different Health Behaviours
Premature mortality: Death before the age that is normally expected (usually
before 65).
People with a lower SES engage in less health protective and more health
destructive behaviours, but this is not the only factor. The reason why people
engage in the healthy behaviours, is to cope with stress and improve other
aspects of (family) well-being.
Access to Health Care
In the US, higher SES was associated with less care; in the UK; the reverse was
true, though, people with a lower SES remained deprived of health care. In
Australia, the people with a lower SES were less likely to be prescribed satins
, (drugs to reduce cholesterol levels), and were less likely to seek appropriate
medical care.
Environmental Factors
People with a lower SES are more exposed to health-damaging environments
(work, state of house, whether the house is rented or owned).
The Stress Hypothesis
People with a lower SES:
Experience more stress;
Have less personal resources to cope with the stress;
Stress can inversely impact health.
Social Capital and Stress
The higher the income disparity of a country, the worse is its overall health.
According to Wilkinson, this occurred because the wider the wealth disparities
within society, the lower the levels of social cohesion and social capital
(feelings of social cohesion, solidarity and trust in one’s neighbours) within
society. This could be caused by more conflicting relationships (lower perceived
social support) in societies with low social capital.
Work Status and Stress
Three key factors that contribute to work stress (Karasek, Theorell):
1. The demands of the job;
2. The degree of freedom to make decisions about how best to cope with
these demands;
3. The degree of available support.
When all of these factors are present, then: work stress is high.
Siegrist et al. proposed another model: Work stress is the result of an imbalance
between efforts and rewards.
Work Life Balance and Stress
People with low SES/high stress jobs have an increased risk to develop CHD than
people with high SES/high stress jobs, probably because they also have more
stress at home (work-home spillover, especially present for women).
Unemployment
Can also influence health negatively, and so can the threat to be unemployed.
Minority Status and Health
There are differences between ethnicities, but to find out about these differences,
one needs to control for SES. Reasons for the differences:
Differential Health Behaviours
Culturally different health behaviours (diets) result in differences.
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