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Lectures Health and Medical Psychology
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Lectures Health and Medical Psychology, 10 EC course in Bachelor Psychology, Leiden University
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Health and Medical PsychologyHC 1: Explaining Health Behavior
What is health psychology?
1. Body & mind interaction (main thing!)
2. Self-management and coping
3. Prevention and health promotion
4. Stress and disease
5. Positive psychology and empowerment
→ No focus on the problem in itself, but more on coping with (chronic/everyday)
disease.
→ Focus on the healthy functioning of people.
→ Emphasis on prevention and adaptation during all phases from health to
illness.
Prevention
Three kinds:
6. Primary
o Prevention of the problem
o Target group = healthy people
7. Secondary (screening / early treatment)
o Tracing illness in early phase, for early treatment
o Target group = (healthy) people with an increased risk
8. Tertiary (revalidation)
o Prevention of complications and worsening of symptoms through
optimal care.
o Target group = ill people.
Healthy person → early symptoms (reversible) → later symptoms (irreversible) →
illness.
Primary Secondary
Tertiary
What is healthy functioning → very personal!
The psychological part of health is very important.
Why would we want to change health behavior? Are we allowed to do so?
WHO definition of Health (1948): Health is a state of complete physical, mental
and social well-being and not merely the absence of disease or infirmity.
→ Criticism: A complete physical, mental and social well-being? Is that possible?
Why influence health behavior?
→ Reason 1: Health behavior is related to mortality, morbidity (illness) and
quality of life.
→ Reason 2: Socio-demographical differences in health behavior increase social
economic differences. (Differences in health behavior between SES groups →
enhance social inequality).
→ Reason 3: Prevalence of risk behaviors is high.
→ Reason 4: Health behavior is not always an informed choice / frequenty not
based on an informed choice.
Adverse effects may occur! → Increase of SES differences, hardening (For
example; when people say ‘I dont trust this government anymore, they always
,try to influence my behavior, and because of
that I will not change my behavior’) and
stigmatising (For example; Judging obese
people for eating fries).
Models explaining health behavior
Biopsychosocial Model →
9. Body and mind interaction determine
health and illness
10.Consequences of interplay of biological, psychological and social factors.
11.The different systems influence each other continuously.
Motivation is the core motive of the following models.
1. Health Belief Model (Rosenstock et al., 1966)
12.Concerns 2 main elements:
o Perceived vulnerability (I can get this condition)
o Perceived severity (If I get this, it would be terrible!)
13.Perceived threat → motivator. (If I keep doing this, I will be at risk)
14.Preventive action is the consequence of perceived threat.
15.Fear is the key feature! → Fear determines together with respnose efficacy
the likelihood of occurrence of behavior.
2. Theory of reasoned action (Fishbein & Ajzen, 1975)
16.Not only fear, can also be positive and shows a lot of associations with
behavior.
17.Introduces a new thing: Norms.
o Descriptive
o Injunctive
o Group norms/social pressure
o Social support (positive and negative)
3. Social learning/cognitive theory (Bandura, 1977/1989)
18.Capability!
19.Outcome and self-efficacy expectancies determine behavior.
20.Involves:
o Performance accomplishments (past experiences)
o Vicarious experiences (modeling by others)
o Social persuasion (coaching and evaluative feedback)
o Physiological and emotional states
21.These all lead to self-efficacy judgements, which lead to
behavior/performance.
4. Theory of planned behavior (Azjen, 1988)
22.Self-efficacy is main element for behavior change.
23.Extention of theory of reasoned action. → perceived behavioral control was
added as extra element.
24.Perceived behavioral control = quite similar to self-efficacy.
SUMMARY social cognition models
People will change if they believe that:
25.They are susceptible to some disease.
, 26.Developing the disease will have severe consequences.
27.Adopting the health (preventive) behavior will make them less susceptible
or will reduce the severity.
28.The benefits outweigh the anticipated costs
29.They feel capable of doing so.
People will change if:
30.Their attitude/outcome expectancies towards behavior are positive.
31.Social norms are favorable/supportive of behavior.
32.Their self-efficacy/perceived behavioral control expectancies are high.
HC 2: Changing Health Behavior
Reasons to change health behavior:
1. Mortality
2. Morbidity/quality of life
3. Socio-economic health differences
4. High prevalence of unhealthy behaviors
5. Informed choice
However, only if determinants of behaviors are known! → these determinants are
changeable!
Behavioral (change) theories:
1. Early theories → It could happen to you!
2. Later theories → You can do it!
3. Newer theories → If only you want to!
4. Newest theories → Stick to your plans!
1) It could happen to you!
Health Belief Model & Protection Motivation Theory
33.Help, I can get this condition… → Perceived vulnerability.
34.And if so, that would be terrible! → Perceived severity.
→ How? Inducing fear!
Through information/persuasion or modeling.
From fear you get anticipated regret (I would feel regretful if I get this disease in
the future)
Parallel process model (Leventhal et al., 1983; Witte, 1992)
Fear →
1. Fear control, the need to reduce
the emotion of fear (denial,
avoidance, distraction)
2. Danger control, the need to
reduce the negative
consequences
But under which conditions?
Extended parallel process model (incl.
efficacy) →
SUMMARY FEAR
Only works in combination with:
35.Response efficacy (reduction of threat is possible)
36.Self-efficacy (able to perform behavior, perceived behavioral control)
If not, negative effects!
, 2) You can do it!
Social Cognitive Theory
Outcome expectancies and self-efficacy determine behavior.
Social Learning Theory
Linking new behavior to other behavior of the past (performance
accomplishments, vicarious experience, social persuasion, physiological and
emotional states)
How? → Increasing self-efficacy!
Performance accomplishments and social coaching/training
37.Goals (behavior and outcome)
38.Step-by-step mastery
39.Instruction (how)
40.Specific
41.Realistic
42.Practice
43.Evaluative feedback
Vicarious experience / modeling
44.Reliable
45.Identification
46.Attractive
SUMMARY SELF-EFFICACY
Effective when motivation is high, but motivation fluctuates (motivation state
rather than motivational stage). Ambivalence occurs continuously.
3) If only you want to!
Behavior should be connected to own values and/or identity.
Self-regulation
The ability to direct our behavior to meet standards, achieve goals or reach
ideals.
Involves goal-setting, monitoring behavior, evaluate outcomes and adjust
behavior accordingly, until goals are achieved.
People select goals that support definition of the self
47.Goals guide actions
48.Goals give meaning
Key assumption and key message: Behavior can be understood only by
identifying the underlying goals to which behavior is linked (contextualization).
Control theory
Refers to process of goal-setting and monitoring. Feedback and loops, so you go
back and start again.
Self-determination theory
Basic needs: 1. Autonomy
2. Competence
3. Relatedness
The more the goal fulfills the three needs,
the more intrinsic the goal is.
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