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Samenvatting boek Health psychology eight editionNiet tot de leerstof behoren:
hoofdstuk 15 uit het tekstboek
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1. An overview of psychology and health
What is health?
Illness/wellness continuum = health as a continuum ranging from death to optimal wellness.
Health = positive state of physical, mental and social well-being, not simply the absence of disease,
that varies over time along a continuum.
During 17th, 18th, 19th centuries people suffered and died from two types of illness: dietary and
infectious.
Dietary diseases = malnutrition.
Infectious diseases = acute illness caused by harmful microorganisms such as bacteria or viruses.
Through 18th century people in America experienced periodic epidemics of infectious diseases such
as influenza, brought on by the Europeans. High death rate occurred for two reasons:
1. Native population lacked natural immunity
2. Native American’s immune functions were limited by low degree of genetic variation.
In 19th century most significant was tuberculosis or ‘consumption’.
Decline by the end of 19th century due to improved hygiene, better nutrition and public health
innovations such as water and sewers.
In 20th century life expectancy increased greatly. Lower death rate for children.
Chronic diseases = degenerative illnesses such as heart disease and cancer, that develop or persist
over a long period of time. Account for more than half of all deaths worldwide.
Deaths due to infectious disease is expected to decrease and due to chronic diseases is expected to
increase.
In childhood and adolescence main cause of death is accidents.
Viewpoints from history: physiology, disease processes and the mind
Early cultures believed illness was caused by mystical forces.
Ancient Greece and Rome
Earliest written ideas about health 500-300 B.C. Hippocrates ‘father of medicine’ recommended a
good diet and avoiding excesses to achieve a humoral balance.
Humoral theory = body contains 4 fluids called humors, health = when these are balanced.
Plato proposed that mind and the body are separate. Body = physical being. Mind = abstract process
that includes thoughts and feelings.
Mind/body problem = question of their relationship and if they function separately.
,Galen was a Greece physician who dissected animals to learn about the brain and kidneys. Became
accepted that illnesses can be localized and different diseases have different effects.
Middle ages
Influence of the Church in slowing the development of medical knowledge was enormous. Dissection
was prohibited, also for animals.
Belief in demons as cause of illness became strong. Sickness was God’s punishing.
St. Thomas Aquinas rejected the separation of mind and body in 13 th century and interest in the issue
was renewed.
Renaissance (rebirth) and after
More human-centered than God-centered, set the stage for scientific revolution after 1600.
Rene Descartes separated mind and body and stated 3 things:
1. Body = machine with action and sensation.
2. Body and mind communicate through the pineal gland.
3. Animals have no soul > dissection acceptable.
Scientist learned through dissection and microscope. Humoral theory rejected.
Biomedical model = all diseases or physical disorders can be explained by disturbances in
physiological processes which result from; injury, biochemical imbalances, bacterial infections etc.
Disease is separate from the psychological and social processes of the mind. Biomedical model
became widely accepted in 19th and 20th century and still dominant view in medicine today.
Sir William Osler in late 19th century mentioned stress and social factors as a potential health issue.
Seeing a need: psychology’s role in health
Problems in the health care system
Health care costs have increased rapidly. Main health problems are chronic.
The person in health and illness
Two factors: lifestyle and personality.
Lifestyle = everyday patterns of behavior.
Risk factors = characteristics associated with the development of a disease or injury. Can be
biological or behavioral.
Behavioral risk factors for leading causes of death:
1. Heart disease – smoking, cholesterol, obesity, lack of exercise
2. Cancer – smoking, alcohol, diet
3. Stroke – smoking, cholesterol, lack of exercise
4. COPD – smoking
5. Accidents – alcohol/drug use and not using seat belts.
Practicing healthful behavior can reduce risk of illness and early death.
Less healthful behavior gives short-term pleasure. Healthful behavior consequences seem remote.
People can feel pressured and/or develop habits.
,Personality = a person’s cognitive, affective or behavioral tendencies that are stable across time and
situations.
Low levels of conscientiousness = more likely to die at earlier ages.
High levels of positive emotions = live longer.
High levels of anxiety, depression or pessimism = risk for dying early.
More optimistic people also recover more quickly.
Not a one-way street; illness can affect personality too.
How the role of psychology emerged
Psychosomatic medicine = formed in 1930s, founders were trained in medicine and included
psychoanalysts and psychiatrists.
Psychosomatic means the mind and body are both involved.
Behavioral medicine = two defining characteristics: interdisciplinary (psychology, sociology, medicine
etc.) and grew out of behaviorism.
Behaviorism based on: classical (respondent) conditioning and operant conditioning.
Conditioning can help with overeating and emotions.
Biofeedback = a person’s physiological processes (ex. Blood pressure) are monitored by the person so
that he can gain voluntary control over them. Involves operant conditioning.
Health psychology = four goals of the field:
1. To promote and maintain health
2. To prevent and treat illness
3. To identify the causes and diagnostic correlates of health, illness and related dysfunction
4. To analyze and improve health care systems and health policy.
Integration
The three fields are basically the same. The difference is the organizations and the focus they have.
Psychosomatic medicine is interdisciplinary and includes physicians and behavioral scientists
but remains closely tied to medical disciplines including psychiatry.
Behavioral medicine is also interdisciplinary and focused on interventions without drugs or
surgery.
Health psychology is based in psychology and draws heavily on it.
All three share the view that health and illness result from the interplay of biological, psychological
and social forces.
Health psychology: the profession
Field is new, most work in hospitals, clinics and academics.
Health psychologists prove direct help (therapy in dealing with illness) and indirect help (designing
programs for better lifestyles).
, Current perspectives on health and illness
Biopsychosocial model adds biological factors to the psychological and social factors. All three
factors affect and are affected by the person’s health.
The biopsychosocial perspective
Biological factors includes genetic materials and processes by which we inherit from our parents.
Also includes function and structure of a person’s physiology. Organs, tissues and cells.
Psychological factors involve cognitive, emotion and motivation.
Cognition = mental activity, learning, remembering, thinking, believing etc.
Emotion = subjective feeling that affects and is affected by thoughts, behavior and physiology.
Motivation = process that gets someone to start some activity, choose direction and persist.
Social factors involve society, community and family/friends.
Society = values of our culture, mass media.
Community = individuals who live near one another, same town or organization.
Family = closest and most continuous relationships.
The concept of ‘systems’
System = dynamic entity with components that are continuously interrelated.
The social, psychological and biological systems are all interrelated.
Life-span and gender perspectives
Life-span perspective = characteristics of a person are considered with respect to their prior
development, current level and likely development in the future. The kind of illness people have
varies with age.
Pediatrics deal with children and geriatrics with the elder.
Biological, cognitive and social relationships change over the lifespan.
Gender perspective = males and females differ in biological functioning, health-related behavior,
social relationships, experience of stress and risk of illnesses.
Related scientific fields: foundations and connections for health
psychology
Medicine provides essential foundation and connection for health psychology. Health psychologists
must develop working knowledge of medical fields and work together with health care providers.
Epidemiology = scientific study of the distribution and frequency of disease and injury, provides
context. Occurrence of illness in a population.
Five terms in epidemiology:
Mortality = death, on a large scale
Morbidity = illness or injury/disability
Prevalence = number of cases at a given moment in time (60% of people)
Incidence = number of new cases, during a period of time (1000 new people in last month)
Epidemic = infectious disease that increased rapidly.
Rate = number per number of people. 5 per 100.
Epidemiologists help with identifying risk factors and health disparities.
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