HEALTH

A complete state of physical, mental, and social well-being and not merely the absence of
disease (WHO, 1948 as cited in Taylor, 2003).
HEALTH PSYCHOLOGY

Is devoted to understanding psychological influences on how people stay healthy, why they
become ill, and how they respond when they do get ill (Taylor, 2003).
Health psychology study how the mind and behavior influence physical health and illness and
vice versa (Bernard & Krupat, 1994).
Brief History and Mind Body Relationship

 In the earliest the mind and body were considered a unit.

 Philosophers were divided in two sides’ debates one known as dualists and others known
as holists.
 Disease arises when evil spirits enter the body.
 Archeologists found Stone Age skull and signs of trephination
 Greeks were the first to identify the role of bodily functioning in health and illness
 Development of humoral theory by Hippocrates (ca. 460-ca. 377 B.C).
 The biomedical model: Rene Descartes (1596-1650) a Renaissance called body as
“extended substance” and mind as “unextended substance”. It is responsible for the belief
that the physical and mental aspects of our health are separate and subject to only limited
interaction (as cited in Bernard & Krupat, 1993). This model has 4 characteristics:
1. Dualistic
2. Mechanistic
3. Reductionistic
4. Disease oriented
 This theory expanded by Galen (A.D 129-ca.199) by providing The Germ Theory of
Disease that proposed, disease is caused by a pathogen (Bernard & Krupat, 1993).
 In middle ages, supernatural explanation of illness swung back. (Disease is God’s
punishment for evil doing). Cure consisted of driving out evil by torturing the body.
 Medical practice took on religious overtones
  Most notable medical practice in these days was by Anton van Leeuwenhoek’s (1632-
1723) work in microscopy and Giovanni Morgagni’s (1682-1771) contribution to
autopsy. Groundwork for the rejection of humoral theory (Taylor, 2003).
 Rudolf Virchow (1821-1902) founded microscopic organisms.
 Each pathogen causes a specific disease (Stone, 1970 as cited in Bernard & Krupat,
1993).
 Primary focus on organic, cellular changes and physical evidence became the sole basis
for diagnosis and treatment.
 During 19th century modern medicine established. “The origin of species” (1856) a
Darwin’s thesis explain the theory of evolution which explains human beings as part of
biological beings. The theory in accordance with Biomedical model (Ogden, 2007).
The pattern of illness has changed dramatically during 20th century.

 Psychosomatic Medicine: View change with the work of Sigmund Freud (1856-1939)
on conversion (hysteria) that is caused by repressed impulses (hysterical paralysis). The
combination of “psyche” and “soma”(Taylor, 2003).
 Behavioral health: Late 1800- how behavior is learned through conditioning. First
proponent was John Watson believe that psychologists should only study observable
behavior. Maintenance of health, and prevention of illness in currently healthy
individuals through the use of educational inputs to change behavior and lifestyle.
 In 1930 Flanders Dunbar and in 1940 Franz Alexander linked patterns of personality
rather than single specific conflict of specific illness.
 1950- incidences of noncontagious diseases linked to behavior or lifestyle was rising.
Behavioral Medicine: 1970- Neal Miller applied the principles of behaviorism to basic
physiological processes.
o Method derived from the experimental analysis of behavior,
o Elements from the behavioral science disciplines (Psychology, sociology,
health education).
o Focus on health care, treatment and illness prevention
 Health Psychology:
o specific to the discipline of psychology
o role of mind in both the treatment and cause of illness
o 1974- Directly involved health psychologists were identified by APA
 o 1977- George Engel (psychiatrist) proposed this The biopsychosocial model
“medical model must take into account the patient, the social context in which he
lives and the complementary system devised by society to deal with the disruptive
effects of illness”
o The mind and body are not separate entities rather they are two aspects of a whole
person. The traditional biomedical model of illness is dualistic while newer
biopsychosocial model is holistic.
o 1978- Division of health psychology was formed in APA
o 1987- Division has 3000 members.

Biopsychosocial Model

Psycho

Bio Social

(Engel, 1977, 1980)

Differences between biomedical model and health psychology (Ogden, 2007)

Biomedical Model Health Psychology

Causes of illness Disease either come from outside Combination of biological,
the body or originate as internal psychological and social factors.
involuntary physical changes. Biopsychosocial model of health and
Disease caused by chemical illness
imbalance, bacteria, viruses and
genetic predisposition.
Responsibility Individual are not seen as Combination of factors
for illness responsible for illness. Individuals Individual is not seen as passive but
are victims responsible
Treatment of Vaccination, surgery, chemotherapy Whole person will be treated
illness and radiotherapy. Behavior change, Beliefs change,
Change in the physical state of the improvement in coping strategy and
body. compliance with medical
recommendations
Responsibility of Medical professionals are Patient is responsible for taking
treatment responsible medication, adherence towards
treatment, changing beliefs and
behavior.
Relationship Individual is either healthy or ill, no Health and illness exist on a continuum.
between health continuum between the two Individual progress along with being
and illness healthy or ill .
Relationship Mind and body functions Interaction between mind and body.
between mind independently. Two entities influencing each other
and body Mind as abstract and body as
physical matter
Role of Illness may have psychological Direct and indirect association between
Psychology in consequences not psychological psychology and health.
health and illness causes. Impact of stress on illness
Thinking pattern influence behavior
direct
Psy. factors Health
status

indirect Behaviors
AIMS OF HEALTH PSYCHOLOGY

Aims of Health
Psychology

1) Understanding, 2) Putting this

explaining, theory into
developing and practice.
testing theory

a) Evaluating the b) b) Preventing

role of behavior in a) Promoting
the eatiology of Predicting unhealthy healthy behavior illness.
illness behaviors

c) Evaluating the e) Evaluating the

interaction b/w d) Understanding role of psychology
psychology & the role of
in the treatment of
physiology psychology in the
illness
experience of
illness
FOCUS OF HEALTH PSYCHOLOGIST
• Health promotion and maintenance

• Prevention and treatment of illness

• Etiology and correlates of health, illness and dysfunction

• The health care system and the formulation of health policy (Taylor, 2003).

THE CLINICAL HEALTH PSYCHOLOGIST

 Is someone who merges clinical psychology with its focus on the assessment and
treatment of individuals in distress
 Is someone who first gain training as a clinical psychologist and then later acquire an
expertise in health psychology
 Who tends to work within the field of physical health, including stress and pain
management, rehabilitation of the patients with chronic illnesses or the development of
interventions for problems such as spinal cord injury and disfiguring surgery

A PROFESSIONAL HEALTH PSYCHOLOGIST

 Is someone who is trained to an acceptable standard in health psychology and works as a
health psychologist
 Health psychologist have competence in three areas:
1) Research
2) Teaching
3) Consultancy
 They complete a higher degree in health psychology
 have suitable knowledge base of academic health psychology
 Their work includes research, teaching, and the development and evaluation of
interventions to reduce risk-related behavior.

BASIC CONCEPTS IN HEALTH PSYCHOLOGY

FACTORS INFLUENCING HEALTH: biological, psychological and social

HEALTH PROMOTING BEHAVIORS: physical activity, nutritional habits, interpersonal

growth, spiritual growth, stress management

HEALTH COMPROISING BEHAVIORS: behaviors that make individuals vulnerable for

disease.
HEALTH RESTORATION BEHAVIORS: behaviors that help to restore, regain the previous
or closer level of health.

HEALTH BELIEF: beliefs about health status

ILLNESS COGNITION: patients own common sense beliefs about their illness, causes, time
line, consequences, curability and controllability.

LOCUS OF CONTROL: Extent to which individuals believe they can control events affecting
them. Understanding of the concept was developed by Julian B. Rotter in 1954, and has since
become an aspect of personality studies. (internal and external).

SELF EFFICACY: person’s judgment about being able to perform a particular activity.
Individual’s belief about one’s ability to achieve or complete a goal/task.

SOCIAL SUPPORT: Perception and actuality that one is cared for, has assistance available
from other people, and that one is part of a supportive social network.

QUALITY OF LIFE (QOL): General wellbeing of an individual.

 Health related QOL: is an assessment of how the individual’s well being may be
affected over time by a disease, disability or disorders.
 Perceived QOL: individual’s own perception, understanding or subjective interpretation
about wellbeing.

LONGEVITY: THE WORK OF BELLOC AND BRESLOW (1972)

Belloc and Breslow (1972) , Belloc (1973) and Breslow and Enstrom (1980) examined the
relationship between mortality rates and behavior among 7000 people. Seven behaviors were
related to health status. These behaviors were:

1) Sleeping 7-8 hours a day

2) Having breakfast every day
3) Not smoking
4) Rarely eating between meals
5) Being near or at prescribed weight
6) Having moderate or no use of alcohol
7) Taking regular exercise

PATIENT REPOSTRT OUTCOME (PRO): Report coming directly from patient about how
he/she feels or function in relation to a health condition and its therapy.
Humoral Theory

Humors Elements Season Organ Qualities Ancient Personality

characteristics
Blood/ Air Spring Heart Warm & Courageous, Extravert
Sanguine/ moist hopeful,
childhood playful,
carefree,
sociable,
outgoing,
talkative,
responsive,
lively,
leadership Emoti.
Yellow Fire Summer Liver Warm & Ambitious, Extravert stable
Bile/ dry leader-like,
Choleric/ restless, easily
youth angry, touchy,
aggressive, Emoti.
impulsive, unstable
optimistic,
active
Black Earth Autumn Spleen Cold & Quiet, Introvert
Bile/ dry analytical,
Melancho serious, moody,
lic/ anxious, rigid,
maturity sober,
pessimistic,
reserved,
unsociable
Phlegm/ Water Winter Brain Cold & Calm, Introvert
Phlegmat moist thoughtful,
ic/ patient, passive,
twilight peaceful,
careful,
controlled,
reliable