Samenvatting Health Psychology - Inleiding in de gezondheidspsychologie
Inleiding in de gezondheidspsychologie 9e editie
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Health Psychology: Biopsychosocial Interactions
Health Psychology: Biopsychosocial Interactions
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, CHAPTER 1
AN OVERVIEW OF PSYCHOLOGY AND HEALTH
CHAPTER OUTLINE
I. What is Health?
A. Section Introduction
1. Common definitions of health focus on lack of:
a. objective signs of illness - e.g., high blood pressure
b. subjective symptoms of illness - e.g., pain or nausea
B. An Illness/Wellness Continuum
1. The concepts of health and sickness overlap
2. Antonovsky proposes an illness/wellness continuum with polar ends of
death/illness/disability v. optimal wellness
a. need to change focus from what makes people sick to what
keeps people well
3. Health = the positive state of physical, mental and social well-being that
varies over time along a continuum
C. Illness Today and in the Past
1. In industrialized nations, people live longer than in past and suffer from
different patterns of illnesses
2. Until this century, people in North America died from mainly dietary and
infectious diseases
a. dietary illnesses: illnesses resulting from malnutrition such as
beriberi (lack of vitamin B1)
b. infectious diseases: acute illnesses caused by harmful matter or
microorganisms (bacteria or viruses); main cause of death in
most of world today
3. History of diseases in US
a. 18th century: epidemics of smallpox, diphtheria, yellow fever,
measles and influenza killed thousands, esp. children
i. infectious diseases such as malaria and dysentery
weakened victims and made them susceptible to other fatal
diseases
ii. such diseases were introduced to America by European
settlers
1) Native Americans died at high rates due to lack of
previous exposure and natural immunity; lack of
immunity probably due to low degree of genetic
variation
b. 19th century: new infectious disease beginning to emerge (e.g.,
tuberculosis)
i. decrease in deaths from infectious diseases by end of 19 th
century
ii. cause of decline
1
, 1) improved personal hygiene
2) better nutrition resulting in greater resistance to
disease
3) public health innovation (e.g., water purification and
sewage treatment facilities)
4) increased personal concern about health and
following advice of health reformers
th
c. 20 century: death rate due to infectious disease declined and
average life expectancy increased
i. increase in infant life expectancy from 48 years to 77 years
ii. chronic disease leading cause of health problems and half
of all deaths in developed countries
1) definition = degenerative illnesses that develop or
persist over long period of time
2) examples = heart disease, cancer, stroke
3) reasons = increase in industrialization increases
stress and exposure to harmful chemicals; longer
life span places people at higher risk for chronic
disease
4. Main causes of death across the life span
a. children – accidental injury, cancer, & congenital abnormalities
b. adolescents – accidental injury, homicide, suicide
II. Viewpoints from History: Physiology, Disease Processes, and the Mind
A. Early Cultures
1. Belief that physical and mental illness caused by mystical forces (e.g.,
evil spirits)
a. speculative evidence - use of trephination to allow spirits to
escape
B. Ancient Greece and Rome
1. Hippocrates’ humoral theory
a. health was due to harmony or balance of four humors whereas
illness was the result of an imbalance of bodily fluids
b. health recommendations included good diet, avoiding excesses
to keeps humors in balance
2. Introduction of the mind/body problem
a. Greek philosophers, including Plato, argued that the mind and
body are separate entities (mind has little impact on the body
and its state of health)
3. Influence of Galen
a. believed in humoral theory and mind-body split
b. innovations attributed to Galen - animal dissections to discover
how systems work, localization of illness, and belief that different
disease have different effects
C. The Middle Ages
1. With collapse of Roman Empire, advancement of knowledge and
culture slowed dramatically
2. Impact of the Church on slowing development of medical knowledge
2
, a. prohibition on human and animal dissection
b. belief that creatures with a soul were set apart from ordinary laws
of the universe
3. Illness was believed to be a punishment for sin
a. medical treatments involving use of torture to drive evil spirits out
of body were done by clergy under this belief
4. Influence of St. Thomas Aquinas
a. church scholar who saw the mind and body as interrelated unit
that forms whole person
D. The Renaissance and After
1. Period witnessed rebirth of inquiry, culture, politics, belief in “human-
centered” focus; set stage for changes in philosophy once scientific
revolution began
2. Influence of Descartes
a. advanced notion of "body as machine" and described mechanics
of body action and sensation
b. believed the mind and body, although separate entities,
communicated through pineal gland
c. argued soul left humans at death; therefore dissection on
humans acceptable
3. Changes in science & medicine
a. knowledge increased due to technological improvements (e.g.,
microscope) and use of dissection
b. rejection of humoral theory and development of new theories due
to increased knowledge of body functions and discovery of
microorganisms
c. surgical practice improved by antiseptics & anesthesia
d. status of hospital changed to "place of healing" along with more
respect for ability of doctors to heal
4. Biomedical model
a. new approach to conceptualizing health/illness that proposes
physiological problems cause afflictions of the body
b. health/illness of body separated from psychological/social
experience of the mind
c. dominant perspective in medicine since 19th century
III. Seeing a Need: Psychology’s Role in Health
A. Section Introduction
1. Biomedical model led to:
a. development of vaccines and reduction in infectious disease
b. development of antibiotics and cures to illnesses from bacterial
infection
2. Despite advances, biomedical model needs improvement
B. Problems in the Health Care System
1. Health care costs comprise an increasing percentage of the GDP
2. Chronic diseases are now the main health problems
a. improvements in treatments have been modest
3. People have changed
3
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