Health and Medical Psychology - Notes
Main Topics Notes
1. Explaining health - health psychology the study of health, illness and health-care practices
behavior professional and personal ; aim to understand, explain and predict health and illness
behavior to develop e ective interventions to reduce physical and emotional costs of
risky behavior and illness; approach: holistic, but basically psychological
- health psychologists: what advice to give to parents to in uence health behavior in
children/ teens; how to assist patients to quit unhealthy behavior, and advice medical
professionals to address it; knowledge of diseases and psychosocial consequences of
having them, how to break this vicious cycle; counselling patients to comply to
di cult medical treatments, cope with new health realities
- at municipal health services prevent overweight in children, loneliness in elderly ,
private practice, primary health care, organizations burn-out prevention , secondary
health care pain clinics, rehabilitation centers , med. psychol. department hospital
- knowledge in: body mind, chronic disease, stress disease, prevention health
promotion, capacity empowerment, eHealth self-management looking for
best way of overcoming problems
what is health - as not ill no symptoms or visits to doctor , as reserve/resource strong, quick
recovery , as behavior I look a er myself , as physical tness and vitality, as
psychological well-being balance, enjoyment , as function able to do what I want/
need to
- consists of the domains: "ha ing doing being" see below
- health can be de ned negati el absence of illness , functionall ability to cope with
everyday activities , positi el as tness and well-being
health is an idiosyncratic experience!! what is central to health shi s across
situations depending on the health of who answers, what feels healthy to them
- has many dimensions: physical, psychological, emotional, social, behavioral..
- WHO : health is a state of complete ph sical mental and social ell being and not
merel the absence of disease or in rmit !! but that is o en not the case
models of health illness - biomedical model: underlying pathology/ neural/ biochemical process , via
exposure to contagious agent, insu cient immune response
- but also other in uences: health behavior sleep, nutrition , stress/ emotions, social
relations support, con ict biopsychosocial model: body and mind interact to
determine health/ illness; it is the consequence of constant interplay of biological
genes, pathogens , psychological emotion, cognition, beh , and social norms, social
cultural context factors
prevention - to increase the factors that increase health; focus: to increase capacity and
empowerment, and develop e ective coping to life events and challenges, to
increase life span; in categories:
- primary prevention: target healthy people, full lifespan, promote healthy lifestyle;
prevention of the problem/ illness/ casualty; measures vaccination, promoting
healthy habits, banning unhealthy substances associated with disease
- secondary prevention: target healthy w/ early/ reversible/ high risk/
predisposition for disease; screening tracing illness in early phase and early
treatment, prevent more serious complaints; measures mammography, blood
pressure testing
- tertiary prevention: illness manifested, irreversible; prevention of complications
and worsening of symptoms; revalidation to reduce stress and fears, prolonging/
increase quality of life, adhering to treatment; measures self-regulation
interventions, lifestyle counselling, rehabilitation
encouraging a healthy - large longitudinal epidemiological study s started showing that behavior
lifestyle in uenced quality of life and lifespan
- Framingham Heart Study: longitudinal, large sample, showed high blood pressure,
, physical inactivity, high cholesterol, unhealthy eating pattern, unhealthy weight have
strong relationship with cardiac disease
- British Doctor Study: doctors provide data on lifestyle and health status; insights
into the relationship between behavior and health; smoking strongly related to
cancer, cardiovascular disease and chronic lung disease
- Alameda Study health habits are related w/ health status, chronic conditions
and mortality: having never smoked, less than drinks in one sitting, sleeping
- hours, exercising, maintaining desirable weight for height, avoid snacks,
eating breakfast; associated w/ cancer, heart disease, stroke, diabetes, high blood
pressure, lung problems, better happiness and health
- epidemiological studies where/ when disease is found or not; incidence
distribution
types of health behavior - health beh beh associated w/ health status; not necessarily performed with the
Matarazzo, explicit goal of protecting health; clearly associated with serious health outcomes
- behavioral pathogens are health compromising; e.g. smoking, alcohol abuse,
sharing needles, unsafe sex, drunk driving, no ear protection...
- beh immunogens are health enhancing; physical activity, nutrition low fat and
salt, vegetables and fruit , sun protection, bicycle helmet, vaccination, wash hands...
why in uence behavior? health beh is related to health outcomes, and is perhaps the most important factor
to mortality, morbidity quality of life! see top causes of death nowadays: underlay
by unhealthy behaviors
di erences in prevalence of health beh btw SES groups enhance social inequality
levels of stress, lifestyle - knowledge, education, social norms, nancial accessibility
prevalence of risk behaviors is high sometimes di in low SES
health behavior is frequently not based on an informed choice, combined w/
environ in uences stir beh where is the stair, location of food in supermarket,
portion size provided…
- but.. adverse e ects may occur increases SES di erences high SES responds
better to interventions , hardening may occur reactivity, more resistant ,
stigmatization blaming ill people for their illness, e.g. being overweight, cancer
morbidity medical problems associated w/ illness e.g. disability, injury
2. Health behavior change - covid- : cough in elbows, touch face as little as possible, meet others less, wear
facial mask, keep , m distance…
- a new formal rule , m distance enforced by laws, not natural to follow: what
in uences whether we comply to them or not, when, how o en
- theories address: understanding beh change becoming moti ated, preparing action
and starting change, sta ing on track and in uencing beh increasing moti ation, helping
get started o ercoming barriers and lapses
- a discrepancy between believing rule is valid and actual compliance to rule
UNDERSTANDING BEH - social cognition models of behavior: outline the stages of getting moti ated to
CHANGE change; focus on cognitions people form based on social interactions that in uence
beh; social cognition beliefs people form and adopt based on experiences acquired
in life in interaction with others provides info, shapes our judgement, attitudes,
expectancies of outcome of beh determines beh;
- social cognitive approach assumes people are for large extent economically oriented
choose what will give best outcomes
getting moti ated stage Health - perceived threat perceived susceptibility to neg health outcome severity of
Belief Model Becker consequence of obtaining neg health outcome , and beh evaluations perceived
bene ts of reducing risk or severity of disease and perceived barriers, costs of beh ;
a ected by unrealistic optimism bias! bc lack experience and info of health
problems ; model assumes that the perceived threat and beh evaluations response
e cacy perceived e ectiveness of beh to avoid threat are in uenced by
demographic and psychological variables, and determine motivation to change;
, - critical factor is health motivation personal importance to being healthy , and cues
to action a ect action by reminding of it environ in uences ; fear based!!
Bandura's Social Cognitive Social Learning Theory; self-e cacy expectation expect to be able to? it's critical!
Theory bidirectional to beh initiation and maintenance behavior positive outcome
expectation of the beh, can be physical, emotional or self-evaluative in nature,
a ects beh initiation and maintenance outcome
- self-e cacy is in uenced by: performance accomplishments past experiences ,
vicarious experience modeling by others , social persuasion coaching or evaluative
feedback , and physiological and emotional states
Protection Motivation Theory - adaptation of Health Belief Model : fear in bidirectional relationship w/ severity
Rogers vulnerability, need to experience it!; fear based!!
- for maladaptive response, intrinsic extrinsic rewards - perceived severity and
vulnerability threat appraisal; for adaptive response, response e cacy for
reducing risks self-e cacy - response costs coping appraisal; threat and
coping appraisal protection motivation; fear in bidirectional relationship w/
severity vulnerability, need to experience it!
new to the model
Reasoned Action Approach/ - intention is the most proximal determinant of beh; in uenced by
Theory of Planned Behavior behavioral beliefs strength of belief outcome evaluation/ value: importance to
TPB goal form attitude towards beh instrumental: beh helps achieve goal?
experiential: how will experience outcome? -oriented
normative beliefs, on perceived norms strength of belief motivation to comply
w/ others' expectations form perceived/subjective norm injunctive: what people
consider desirable descriptive: what people actually do
control beliefs strength of belief power of control form perceived beh control
capacity autonomy ;
