Samenvatting Health Psychology
Chapter 1 An overview of psychology and health
What is Health?
Illness/Wellness continuum:
Health means a positive state of physical, mental and social well-being, not simply the absence
of injury or disease – that varies over time along a continuum. Health and sickness are two ends
of a continuum, with death on the one end and optimal wellness on the other.
Illness today and in the past:
17th, 18th, 19th century: major cause of death dietary (due to malnutrition) and infectious
diseases (due to bacteria and viruses).
o In America the settlers brought the diseases and death rate among natives skyrocketed
as they lacked natural immunity and had a weakened immunity due low genetic
variations
19 century: death rates of infectious diseases drop due to preventive measures as better
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hygiene, sewage treatment facilities and water purification as well as vaccination and medical
treatment
20th century: life expectancy increases and major cause of death is chronic diseases (cancer,
heart disease, stroke)
o Reason is that people are older giving chronic diseases time to develop, people
experience more stress and are exposed to chemicals.
o Main cause of death among children is accidental injury
Viewpoints from history: physiology, disease, processes and the mind
Early cultures: Thousands of years ago: physical and mental illness are caused by mystical forces
(trephination procedure of drilling holes in the skull to release demons from the head)
Ancient Greece and Rome:
o Hippocrates: humoral theory of illness, a balanced mixture of fluids
o Plato: mind and body are separate entities, mind/body problem
o Galen: due to dissection awareness came that illnesses can be localized in the body and
that different diseases have different effects.
Middle ages: Influence of the church limits development of science, prohibits dissection.
Sickness is seen as a punishment of God, church takes over practice of medicine and priests have
a role in medical treatments.
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, Renaissance and after: Rebirth of science, human centered approach instead of god centered.
o Rene Descartes, body as a machine, communication between body and soul via pineal
gland, animals have no soul. Therefore dissection was acceptable.
o Many innovations, use of dissection, microscope, microorganism as cause of disease,
surgery after introduction of anesthesia and antiseptic techniques
o Biomedical model dominates: diseases or physical disorders can be explained by
disturbances in physiological processes, which result from injury, biochemical
imbalances, bacterial or viral infection and the like.
o Some physicians already took the view that the mind can influence health (Sir William
Osler for example)
Seeing a need: Psychology’s role in health
Problems in the healthcare system. Biomedical model was helpful in conquering infectious
diseases, development of vaccines and antibiotics. But it needs improvement, because:
o Health care costs are increasing rapidly
o Main cause of death is chronic diseases and no longer infectious diseases
o People are more aware of the signs and symptoms of illness, more motivated to take
action. Therefore the person is also important, but not included in the biomedical model
The ‘person’ in health and illness
o Lifestyle: everyday patterns of behavior
o Risk factors: characteristics or conditions associated with the development (not
necessarily cause it). Risk factors can be biological or behavioral.
o Five leading causes of death in US: heart disease, cancer, stroke, COPD and accidents
o Research indicates that practicing healthful behavior reduces the risk of illness and early
death. Conclusion of years of research is that behavior matters.
o Why don’t people do what’s good for them?
Less healthful behavior brings immediate pleasure
People feel social pressure to engage in unhealthful behavior and behavior can
be strong habits, making quitting difficult
People aren’t always aware of the dangers or don’t know how to change their
behavior
o Personality is a person’s cognitive, affective or behavioral tendency and is fairly stable
over time. Research indicates a link between personality and health. The link is two-way.
Some personality traits lead to a better health (like low levels of hostility), but when
people are ill the personality traits can help them in overcoming the illnesses faster or
coping better with the disease.
o As a consequence it’s important to consider psychological and social factors in health
and illness and not just biological one.
How the role of psychology emerged. The connection between medicine and psychology dates
back to ancient Greece, but got more formalized in 20th century via the work of Freud
(psychoanalysis).
o Psychosomatic medicine
Psychosomatic doesn’t mean symptoms are imaginary, but that body and mind
are involved
Field developed in 1930 mostly via psychoanalytic interpretations for specific
health issues like, ulcers, asthma, migraine etc.
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, o Behavioral medicine (medische psychologie) and health psychology
Two new fields developed around 1970
Behavioral medicine: 1) membership is interdisciplinary, 2) it grew out of the
field of behaviorism, stating the behavior results from 2 types of learning:
classical and operant conditioning
Conditioning has success as a therapeutic approach in modifying
problem behavior, such as overeating or emotions as anxiety.
Conditioning is also used in a technique called biofeedback, where a
person’s physiological processes are monitored to give a person
voluntary control over them.
Health psychology has four goals:
Promote and maintain health
Prevent and treat illnesses (adjusting to current condition, rehabilitation
and future prospect)
Identify causes and diagnostic correlates of health, illness and related
dysfunction (importance of personality in developing an illness)
Analyze and improve health care systems and health policy
o An integration
Psychosomatic medicine, behavioral medicine and health psychology are very
interrelated but there is a difference in focus
Psychosomatic medicine is closely tied to medical disciplines / psychiatry
Behavioral medicine has a focus on interventions promoting a healthy
lifestyle without drugs or surgery
Health psychology draws heavily on other psychological and
physiological fields to identify and alter lifestyle and emotional
processes that lead to illness and improve recovery.
Health psychology: the profession. Either giving help to patients directly via therapy,
biofeedback, emotional and social adjustment, behavioral changes or indirectly via research,
teaching or consulting.
Verschil tussen klinische en gezondheidspsychologie: eerste richt zich vooral op psychische
gezondheid en twee vooral op lichamelijke gezondheid en ziekte
Verschil tussen medische en gezondheidspsychologie: eerste richt zich vooral op ziektegedrag,
tweede ook op bevorderen en bewaken van gezondheid
Gezondheidspsychologie is zowel in US als in Nederland een volwassen academische discipline
met wetenschappelijke tijdschriften. Nederlandse universiteiten geven het ook als vak.
Current perspectives on health and illness
The new biopsychosocial model replaces and expands the biomedical model by taking
psychological and social factors into account that also affect or are affected by a person’s health.
o Biological factors: genetic material, function and structure of physiology etc.
o Psychological factors:
Cognition: learning, remembering, thinking, believing, problem solving
Emotion: subjective feelings affecting and being affected by our thoughts,
behavior and physiology
Motivation: start an activity, choose its direction and persist in it
o Social factors: influence of society, community, family
o The biopsychosocial model means that you have to see a person as a system, consisting
of biological, psychological and social factors that are all interrelated.
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, o New findings about people’s health and recovery. E.g. reducing anxiety for surgery,
results in quicker recovery / stress impairs the immune system
Life-span and gender perspectives.
o Life-span perspective: consider characteristics of a person with respect to their prior
development, current level and likely development in the future.
Biological: physical abilities, recovery etc. change during your life
Psychological: cognitive abilities change during your life
Social: school-work-pension, family, friends. Giving or receiving care
o Gender-perspective: males and females differ in health related behavior, social
relationships and risks for specific illnesses
Related scientific fields: foundations and connection for health psychology
Related fields:
o Medicine: basic understanding of body’s healthy and unhealthy functioning. Health
psychology is helping patients that are under care of physicians as well, but also help
care givers with tooling and knowledge
o Epidemiology: scientific study of the distribution and frequency of disease and injury.
Having a pivotal role in identifying risk factors. Definitions:
Mortality: numbers of deaths
Morbidity: illness, injury or disability or any departure from wellness
Prevalence: number of all cases of a disease, infected or at risk
Incidence: number of new cases in a reported period
Epidemic: situation in which incidence has increased rapidly
o Public health: protecting, maintaining, and improving health through organized effort in
the community.
o Sociology: study of human social life
o Anthropology: study of human cultures
o Health economics: study of demand and supply for health resources, health care
expenditures, cost and benefits of health care
o Health policy: examine decisions, plans and actions taken by governments /
organizations regarding health care and health related behavior
Sociocultural differences in health: different countries and cultures have different patterns of
health behavior and illnesses
o Causes: heredity, environmental pollution, economic barriers to health care,
discrimination- based negative emotions, different diets, health-related beliefs
o Across cultures and history there are different ideas about the causes of illness
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