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Lecture 1.docx

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Nevena Simic

September 21, 2011 Lecture 1 Introduction: What is Health Psychology? The Systems of the Body What is Health Psychology? - Health psychology is devoted to understanding the psychological influences on how people stay healthy, why they become ill, and how they respond when they do get ill - In 1948, the WHO defined health as a complete state of physical, mental, and social well-being and not merely the absence of disease or infirmity Four Main Points in Health Psych: 1. Focus on health promotion and maintenance o Promoting could include changes in behaviour i.e. brushing their teeth, how to properly wash your hands o Maintaining get active, exercising o How to get children to develop good health habits,, promote regular exercise, promote better diets 2. Prevention and treatment of illness o Teach how to better cope with stress so that it doesnt adversely affect the person, how to cope with an illness i.e. meditation, yoga = reduce stress, seeing someone to help with mental health (psychiatrist etc) 3. Etiology and correlates of health, illness, and dysfunction o Etiology refers to the causes of illness and HP are interested in behavioural and social factors that contribute to health or illness/dysfunction 4. Analyze and improve the health care system and the formulation of health policy o Improving the system to help the society the individual is a part of o Develop health policies to govern and guide our health system Putting it ALL together... - HEALTH PSYCHOLOGY represents the educational, scientific, and professional contributions of psychology to the 4 points discussed above The Mind-Body Relationships: - In the earliest times... o The mind and body were seen as a unit o Disease = evil spirits entering the body o Treatment = spirits could be exorcised - Stone ages o Trephination the thought that evil demons were in the mind of the ill and to cure this we need to drill a hole in their head to let the evil spirits out Small hole or various holes were dug into the skull of the patient which allowed the evil spirit to exit the body The person conducting this procedure (physician/shaman) was seen as having complete power over the spirit and therefore having control over the persons well-being Oldest known surgical procedure Cave painting suggest that it was used to treat epileptic seizures, migraines, mental disorders How did this go on for so long? It actually WORKED! September 21, 2011 They were able to remove the correct part of the brain that was involved with the actual disease Migraines = pressure in the head, so drilling a hole relieved the pressure Pictures of skulls show that holes were drilled in different parts of the skill showing that different methods were used for different illnesses Sophisticated system different sizes and holes to represent different illnesses (maybe based on severity?) Also shows multiple holes for multiple surgeries or attacking of various site at one time - Greeks were first to realize the role of bodily functions in health and illness o Developed a Humoral theory of illness (proposed by Hippocrates, expanded by Galen) Disease arises when the four circulating fluids of the body (blood, black bile, yellow bile, and phlegm) are out of balance When these fluids are out of balance, disease will arise Balance of humours determined health, well-being and personality Function of treatment = restore balance to these humours Humoral theory: - Personality theory certain personalities coincide with a dominance in one of the fluids o High in blood = high in optimism and sanguine o High in phlegm = more apathetic o High in black bile = prone to sadness and depression o High in yellow bile = easily angered or irritable Middle Ages - Back to supernatural explanations of illness - Moving away from a bodily explanation of illness - Mysticism and demonology o gods punishment of evildoing o Illness is a result of a gods will - Cure typically consisted of driving the evil out by torturing the body - Later this therapy was replaced by penance through prayer and good works o In order to cast gods good will on them - Church = guardian of medical knowledge o They are the therapists and shaman and have all consuming power over an individuals well-being Dualistic Theory of Mind and Body: - Renaissance - Trying to break with the superstitions of the past, physicians strongly reinforced the dualistic concept of mind and body o Physicians = guardians of the body o Theologians and philosophers = caretakers of the mind (more limited in the scope of guardianship) - For the next 300 years physicians focused on organic and cellular changes and pathology as a basis for their medical inferences o Physical evidence = sole basis for diagnosis and treatment (the only basis on which treatment is introduced) September 21, 2011 As the years go by, Rise of Modern Psychology - Freud psychoanalysis o Early work on conversion hysteria: idea that specific illnesses are produced by individuals internal conflicts o Conversion occurs via voluntary nervous system: enables humans to react consciously to environmental changes o Includes 31 pairs of spinal nerves and 12 pairs of cranial nerves This system controls movements of skeletal (voluntary) movements Conversion Hysteria - Unconscious conflicts that can produce particular physical disturbances that represented psychological conflicts - Rather than a single specific conflict, Dunbar (1930s) and Alexander (1940s) linked patterns of personality to specific illnesses - Helped shape emerging field of psychosomatic medicine: bodily disorders can be caused by emotional conflict (ulcers, etc) - Physiological mechanism: conflicts anxiety physiological toll on body via ANS organic disturbance (organ failure) o Ex. Repressed emotions increased acid in stomach ulcer o Linking psychological processes to physiological changes in the body Criticisms: 1. Work on which many of the formulations were based were methodologically problematic o Different methods to diagnosis the same illness in the same patient 2. Researchers now believe that a particular conflict or personality type is not sufficient enough to produce illness o Requires an interaction like geentics, environmental stressors, learning experiences, individual cognitions/coping strategies 3. Restricts that range of medical problems to which psychological and social factors were deemed to apply (i.e. treating ulcers, but nothing on treating cancer or diabetes) - But, it is now know that physical health is inextricably interwoven with psychological and social well-being Biopsychosocial Model in Health psychology - The idea that the mind and the body work together to determine health and illness o Interplay of biological, psychological and social factors - Contrasts with BIOMEDICAL model o Governed thinking for the last 300 years o All illness can be explained exclusively on the basis of aberrant somatic processes such as biochemical imbalances or neurophysiological abnormalities o Assumes psychological and social processes are independent of the disease process Problems with the Biomedical model: 1. Reductionist model focus illness at a cellular level 2. Single-factor model of illness biological malfunction, not recognizing other important factors 3. Implicitly assumes a mind-body dualism implies mind and body are separate entities 4. Emphasizes illness over health does not promote conditions that may lead to health September 21, 2011 5. Difficulty accounting for somatic conditions that dont lead to a particular illness because the social and psychosocial factors important in health behaviour Advantages of the Biopsychosocial Model: - Maintains that biological, psychological and social factors ALL affect health/illness - Macro level and micro level processes interact o High SES recovery better then low SES o The environment that the body is put in, determines the level of repair the body is able to obtain - Health and illness are caused by multiple factors and produce multiple effects - Emphasizes both health AND illness (rather tha
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