PSYC314 – Health Psychology Lecture Notes
Unit 1
Module 1 - Introduction to Health Psychology
Health Psychology
- What is Health World Health Organization definition of health (1948)
Health is NOT merely the absence of disease. Health is state of complete well-being,
including the biomedical model
o Physical well-being
o Mental/Emotional well-being
o Social well-being
- What is psychology?
The scientific study of behaviour & mind.
o Includes: cognition, emotion, motivation, and action
- Health psychology: the scientific study of how health and psychology intersect.
- Joseph Matarazzo (1980)
Health psychology is the aggregate of the specific educational, scientific, and
professional contributions of the discipline of psychology to:
o Promotion and maintenance of health
o Prevention and treatment of illness
o Identification of etiologic and diagnostic correlates of health, illness and related
dysfunction
o Improvement of the health care system.
Biopsychosocial Model (Engel, 1977)
- George Engel (1913-1999) Psychiatrist
- Health (including disease and illness) is best understood from a combination of biological,
psychological, and social perspectives rather than a purely biological perspective.
- Mind-body connection: assumption of complex mind-body interaction
Inherent to biopsychosocial model
- Biology
Sex, age, genetics, physiology, immune system, nutrition, medications, disease &
disorder
- Psychology
Personality, self-efficacy, personal control, optimistic bias, stress perception, coping
skills, diet & exercise, risky behaviours, medical adherence
- Social
Gender, socioeconomic status/income, ethnicity/race, culture, discrimination, health
disparities, caregiving, social support, social networks
System Interplay
- There is an interplay of systems the person is affected by:
1. The world (social & environmental systems)
2. Their biology (genes & physiology)
3. Their psychology (experiences & behaviours)
- “Living systems have come to be seen as systems (of which mind and body are a unit) which are
integral parts of larger systems, in permanent interaction with their environment...”
, (Neeta Mehta, PhD, 2011)
- The importance of context is large (to all things psychological and social, including health).
- Person-situation interaction
Behaviour and experience are each a function of an interaction between the individual
and the situation or environment.
History of the Biopsychosocial Model
- The Medical Renaissance (1400-1700)
Attempts were made to break away from superstitions of past centuries paved the way
for modern medicine.
Physicians were said to heal the body
Physical evidence was the sole basis for diagnosis
- René Descartes (1596-1650)
Cartesian Dualism: the mind and body are made of distinct substances and exist
independently.
Emerging Science and Technology
- Over time, medicine looked more to the laboratory and less to the mind.
- Emphasis shifted to biology as sole cause of disease.
- Key Developments:
16th – 17th C: Compound microscope was invented/developed
18th – 19th C: Germ theory developed microorganisms identified as causes of disease
20th Century: Penicillin (first true antibiotic) discovered by Alexander Fleming in 1928
Biomedical Reductionism
- Reductionism in medicine ensued
- Every disease process could be explained in terms of an underlying deviation from normal
function pathogen, genetic or developmental abnormality, or injury
Changing Patterns of Illness
- With advances in technology and medicine, the development of antibiotics, and improved
sanitation and nutrition, the prevalent causes of death shifted from acute infectious diseases to
chronic conditions
Acute infections: influenza virus, pneumonia, COVID-19
Chronic conditions: heart disease, hypertension, high blood pressure, etc.
- Canada 1900 vs. 2001
1900 Influenza (20,000,000 deaths) vs 2001 Influenza (2500000)
- Average life expectancy in 2019:
84.2 for females
80.0 for males
Leading Causes of Death in Canada (2019)
- Variations occur by age, region, class, ethnicity
Variations occur by age group (e.g., in young people accidents are more likely but in
older cancer is).
- There were 284,082 deaths in Canada in 2019.
, Other 29.4%
Cancer 28.2 % (malignant neoplasms)
Heart disease 18.5%
Stroke 4.8%
Accidents 4.8%
Lower Respiratory 4.5%
Diabetes 2.4%
Influenza & Pneumonia 2.4%
Alzheimer’s 2.2%
Suicide 1.4%
Kidney Disease 1.3%
Need for a New Model
- Common causes of death are now chronic conditions (heart disease, cancer, diabetes,
Alzheimer’s, etc.).
No known cures or quick fixes.
Can live with them, but quality of life is affected.
Require expensive healthcare.
- The biomedical model has had limited success in these regards.
Module 1 Terms
- Disease: an abnormal condition affecting an organism or part of an organism
Due to infection, injury/trauma, behaviour, etc.
E.g., heart disease, influenza
- Illness: feelings that might come with having a disease.
Feelings like pain, fatigue, weakness, etc. – the reasons people seek care.
- Disorder: an abnormality of function
Due to genetic abnormalities, behaviours, stressors, etc.
Similar to disease
E.g., cystic fibrosis, deafness
- Syndrome: set of symptoms or conditions that occur together and suggest the presence of a
certain disease or increased risk.
E.g., metabolic syndrome, AIDS
- Mortality: incidence of death in a population.
In general or due to a specific cause (in a given period of time).
- Morbidity: occurrence of ill health (generally) or a specific disease (e.g., asthma) in a population.
Incidence – Number of new cases (in a given period of time)
Prevalence – Total number of existing cases.
Module 2 – Fight, Flight, or Frenzy: Understanding Stress Today
Stress as a Stimulus (The Bear)
- Stress: defined as a stimulus or change in the environment
Something that causes stress is a “stressor”
Acute stressors: limited stress, e.g. running late, fights, accidents
Chronic stressors: prolonged and repeated stress, e.g. job strain, poverty
- Major life events and daily hassles can also cause stress
, - Major Life Events (Holmes & Rahe, 1967)
Social Readjustment Rating Scale major life events scale
Change (+ or -) is assumed to be stressful.
Items are assigned a life change unit score based on severity.
Correlations have been shown with incidence of heart attacks, broken bones, diabetes,
multiple sclerosis, tuberculosis, complications of pregnancy, decline in academic
performance, etc.
- More stressful life events = increased likelihood of contracting cold virus
- Day-to-day unpleasant or potentially harmful events.
Ideally measured as they unfold using daily process methods
Hassles (and also uplifts) may be more strongly associated with health than life events.
Stress as a Response (The Runner)
- Stress: defined as a person’s physiological response and/or a person’s psychological response
(i.e. thoughts and emotions)
Fight-or-flight
Reactivity to situations
Something that feels stress is a “strain”
- Fight-or-Flight Response (Cannon, 1932)
Mobilization, increased energy, and increased focus leads to increased:
o Breathing, heart rate, blood pressure, muscle tension, blood glucose, pupil
dilation, tunnel vision, and sweating
o Slow digestion, dry mouth, relaxed bladder, hands/feet get cold
- Epinephrine / Norepinephrine
Epinephrine (adrenaline) & norepinephrine (noradrenaline) are released by the adrenal
glands (part of SNS).
Hormones/neurotransmitters (catecholamines) that regulate heart rate, metabolism,
respiration, oxygen to the brain and muscles, etc
- Cortisol “Stress Hormone” (Corticosteroid/Glucocorticoid)
Cortisol complements the SNS
o Increases blood pressure and glucose enhances brain’s use of glucose.
o Suppresses nonessential systems (e.g., digestive, reproductive, immune).
o Reduces inflammation.
Assists return to homeostasis.
o Cortisol output automatically decreases over time (negative feedback loop)
- Measuring Cortisol
Difficult to study
Influenced by exercise, diet, mood, and other factors
Individual differences in diurnal cycles, average output, etc.
Inconsistent results across stressors
Stress as a Transaction (Bear + Runner)
- Stress: defined as a process involving continuous interactions and adjustments between a person
and the environment, each affecting and affected by the other.
- Transactional Model of Stress (Lazarus, 1984)
