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Psyche en Soma samenvatting
College 1: H1, H2 en H17 uit Ayers
H1 Psychology and Medicine
Health operates on many levels such as the physical, subjective, behavioural, functional and social.
Defining health is therefore difficult. For individuals, health and illness are subjective states of
wellbeing; does the person feel or think they are healthy or ill?
If we try to make a definition of health, then it depends on the sort definition we make; physical,
subjective, behavioural, functional, psychosocial, social and cultural.
WHO defines health really broadly as a state of complete physical, mental and social wellbeging an
not merely the absence of disease or infirmity.
The importance of treating the person and not just the disease is widely recognized. The value of
psychological research is:
It tests common sense views empirically to conform or disconfirm them
It goes beyond common sense
People don’t always act according to common sense
Understanding psychological and social processes will help us diagnose and treat people more
effectively. Evidence shows there is a strong link between psychical health and psychological health.
Biomedical approach
A lot of medical students are tought a mechanical view of the body and medicine. This stems from a
belief in dualism = according to which the mind and body are independent. The disadvantage of
dualism is that it provided the basis for the biomedical approach or model = which is baed on a
separation of body and mind that is unhelpful in many ways. This approach dominated medicine for
centuries.
The biomedical approach to healthcare is based on a dualistic approach to mind and body and is not
consistent with current science and evidence. It assumes that all disease can be explained in terms of
physiological processes: therefore the treatment acts on the disease and not on the person. The
person as a whole is not considered by the biomedical approach.
This model does not consider the influence of social or psychological factors on health. Social factors
are just as important today. One of the most consistent findings from public health research is the
influence on social class on health. People in lower social classes are more at risk of illness
(morbidity) and death (mortality). This increased risk is partly due to differences in lifestyles.
,Also important is the placebo effect because it illustrates the effect of our beliefs on health and
illness, whereby people recover because they think they are going to recover, as opposed to
recovering because of physical treatment.
The Biopsychosocial approach
The biopsychosocial approach is a framework that does incorporate biological, psychological and
social factors. This approach was later expanded to include factors as ethnicity and culture.
External factors: factors that include the sociocultural environment, such as poverty, access to
healthcare.
Internal factors: factors that include personal history, psychosocial processes and biochemical
mechanisms. Personal history involves multiple factors such as ethnicity, genetic make-up, learned
behavior and previous illnesses.
This biopsychosocial approach provides a clear framework that sums up what many healthcare
professionals already intuitively know: it links between psychological and social factors and health
explicit. It is a more person-centred approach to medicine.
This lead to the Holistic approach: that is the treatment of the whole person.
There has always been a tendency to focus on either biology or psychology: nature-nurture debate.
The problem is that health and wellbeing are determined by both.
There is emerging evidence that environmental influences such as a lack of nurturing can lead to
physiological changes that can then be passed from parents to children and grandchildren. This is
sometimes called the intergenerational transmission of vulnerability and is part of the evolving field
of epigenetics.
Social diversity and health
Health is also affected by much broader economic, social, cultural and environmental elements.
Socioeconomic status (SES) influences health behaviours and outcomes, including mortality.
Ethnicity is also an important influence; people from ethnic minorities tend to have poorer health.
Sex and gender also play a role; statistics reveal strong differences between women’s and men’s
health. Life expectancy is several years shorter for men than for women in nearly every country.
Important difference: sex and sex differences are biologically based: thery refor to comparisons
between people who are biologically female and people who are biologically male. Gender refers to
the social construction of femininities and masculinities through ‘feminine’ and ‘masculine’
behaviours. Health outcomes also vary along the lines of sexual identity. LGBT tend to have poorer
health and psychological wellbeing.
It is clear that health is shaped by a range of demographic varibales. Each of these may be important
in its own right and may also intersect with other variables. This is the concept of intersectionality.
Awareness of intersectionality draws attention to the ways in which age-, sex-, gender-, ethnicity-,
sexuality- or SES-based inequalities can influence health behaviors and outcomes.
,H2: Motivation, Emotion and Health
Beliefs, motivation and emotion influence how people respond to day-to-day stress. There is a
complex interaction between moetivation and emotion.
Motivation = essentially a drive to act. Some motives are biological (drive to eat, drink or reproduce).
Other motives are social motives (drive for achievement, status, play, autonomy or dominance).
Theories of motivation can be separated into three broad categories:
Drive theories use the concept of homeostasis to explain motivation. This is a state of
physiological stability that organisms strive to maintain. A lack of stability between our
current state and our needs creates an internal tension which we are motivated to reduce.
Drive theory would for example predict that once we have eaten we are no longer motivated
to continue eating. Drive theories therefore can account for some of biological drives, but is
limited in its application to a lot of human behavior.
Evolutionary theories the argue that social characteristics are shaped by processes of
natural selection in the same way as physical characteristics: desirable social characteristics
maximise the chances of reproductive success. Thus social motives, such as the need for
achievement or dominance, are thought to occur because they increase our chances of
survival and reproduction.
Incentive theories these emphasise the role of external factors that trigger and regulate
motivation and take into account expectations and values.
The theories are not incompatible: drive theories emphasise internal states as motivating us whereas
incentive theories emphasise external stimuli and rewards. The two can be though of as push and
pull theories of motivation: internal states push us to act and external stimuli pull us.
Motivation and health
Example = the motivation to drink alcohol involves both biological and social factors.
Health optimism bias means that most people will consistently underestimate their own risk of
disease compared to others. Understanding motivation can help us treat abnormal extremes of
biological drives, such as obesity, eating disorders, smoking, addiction, risky sexual behavior and
insomnia.
Emotion
In psychology the term affect is generally used to include emotions, moods and impulses. Our
emotions have a huge impact on our lives and the quality of our lives. Most theories of emotions
start with the premise that emotion has three components:
Cognitive component the conscious experience of emotion, including the meaning we
attach to it. The meaning of a situation is critical to how a person responds to it emotionally.
There are 3 elements:
o Appraisal: how people appraise a situation when it occurs, or what immediate
meaning they make of it
o Labeling: how people label their emotional state when it occurs
o Evaluation: whether we evaluate our respons as positive or negative.
For example: the meaning that people attach to their experience of panic can result in them
becoming anxious about being anxious, which becomes a self-fulfilling cycle.
The physiological component of emotion is complex and involves the central nervous
system, autonomic nervous system and endocrine system. It is thought that the limbic
system provides a fast initial response and the cortex then provides a slower, secondary
response that regulates the initial response.
, The behavioural component of emotion this can be further separated into the nonverbal
expression of emotions and behavioural responses. They can be divided into:
o Action tendencies: the potential or drive to act
o Nonverbal responses: like posture and gestures
o Facial expressions
The current consensus is that appraisal processes initiate our physiological, behavioural and
conscious experience of emotion. Theories of emotion vary in focus. One theory divides it into
positive and negative affect. It is quite reasonable to assume that emotion at a low level of intensity
will have different physiological effect and influence on health than a high-intensity emotion
(extreme anger).
The nature of the relationship between emotions and health is considered in three main ways:
1. The association between normal emotions and health: any strong or extreme emotion is
associated with increased physiological arousal regardless of whether that emotion is
positive or negative. Studies also show that generally positive mood is associated with better
health. Theories of positive affect and health outline a number of pathways through which
positive affect might lead to better health:
a. These include the Broaden and Build model, which proposes that positive affect
results in: (1) more healthful thought processes by broadening attention and (2)
more resilience by enhancing resources, such as coping and social relationships.
In summary, there is evidence that positive emotions are associated with good health and
that specific negative emotions are associated with certain illnesses, but there are many
ways in which one may influence the other.
2. The influence of emotional dispositions on health: emotional dispositions are personality-like
tendencies toward experiencing certain emotions. Five main personality traits:
a. Openness to new experience
b. Conscientiousness
c. Extraversion
d. Agreeableness
e. Neuroticism
3. The effect of how people regulate and express their emotions on health: Emotion regulation
is critical in how we respond to stress and control our emotions. Regulation may take two
forms:
a. Intrinsic regulation: we attempt to regulate our own emotions through strategies like
cognitive reappraisal, talking to others and seeking help from others.
b. Extrinsic regulation: we attempt to regulate someone else’s emotion through
strategies like providing empathy, comfort or support.
Important:
How people respond to illness is initially determined by how they appraise it
Helping people appraise things more positively can reduce negative emotions and help
people cope.
Positive emotions have the potential to have positive influence on health and negative
emotions are associated with chronic illnesses such as heart disease.
Encouraging optimism can help people if they are facing an essentially controllable illness.
Getting people to write about stressful or traumatic events has the potential to improve
health in some people.
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