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PSY333H1 Lecture 1

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University of Toronto St. George
Lisa Lipschitz

PSY333H1F L1 Sept 12, 2013 o Bodily disorders caused by emotional, social, Health Psychology psychological conflicts  Don’t have to memorize statistics, name of expts or o Conflicts produce anxiety (takes a physiological toll on researchers the body via the autonomic NS)  Multiple choice from book & lectures o Ex. ulcers, hyperthyroidism, colitis, asthma  Anxiety associated w higher likeliness of disease,  Short Answer Qs from lectures can make it worse Over time the definition of health has changed o Today: the belief is that the onset of disease requires an interaction of a variety of factors  Health used to be thought of as evil from spirits or punishment from G-d  Behavioural  Native Americans – connection to nature, using substances as o Focus on objective & clinical relevant interventions that would demonstrate the mind-body connection cures  Freud 1800s: the mind has a role in health o Grounded in cognitive & behavioural modification  World Health Organization 1946: “State of complete physical, approaches to understanding, treating, and managing health & illness mental, and social well-being”  Ex. relationship btwn smoking & health, exercise Mind-Body Relationship & health  Working on cognitions can influence bhvr  Mind & body change (ex. get rid of denial that smoking won’t o 2 separate systems or the same system?  Early cultures: Mind & body 1 unit hurt you) o Illness caused by evil spirits Field of Health  The Greeks Hippocrates & Galen – Humoral theory of illness (400 BCE, 131-201 AD)  Changing patterns of illness  Life expectancy is much longer o An imbalance of blood, black bile, yellow bile, phlegm in o Acute disorders: short term illnesses, viral or bacterial the body  Sometimes blood would be let out for relief (due to unhealthy conditions)  Used to be major causes of illness & death o Disease & illness related to bodily factors but can also  Now have vaccines, cleaner water impact the mind  Middle Ages: Mysticism & demonology o Chronic illness: slow developing diseases, long-term, usually managed o Religiously based rather than scientifically based  Now the main contributors to disability & death  These approaches became less accepted w new evidence & understanding of cellular pathology  Psychological & social causes o Leeuwenhoek & Morgagni (late 1600s) work in  Psychological issues usually arise out of chronic disease – require indiv & family support and microscopy & autopsy – rejection of humoral theory adjustment  Thru advances in medicine, the mind & body became separate o Physicians looked after the body while philosophers &  Ex. how we cope w pain  Psychological changes after diagnosis – theologians looked after the mind change in outlook of life, change of roles of  The dualistic approach & reliance on physical evidence, became the only basis for diagnosis & treatment family members Chronic illness  Biomedical model of health & illness continued for nearly  In 2012 4 chronic diseases (heart disease, respiratory disease, 300yrs common cancers, type 2 diabetes) claimed more than 35 mil lives worldwide Biomedical Model  3 out of 5 deaths  Biomedical model o Illness can be explained in terms of abnormal bodily  Close to ½ of these death are premature (before age 70)  Nearly 80% of these deaths occur in low- & middle-incomes processes & diverging from normal processes countries o Ex. chemical imbalance, neurophysiological abnormalities, exposure to a pathogen (disease-causing o Less resources to cope  Can be considered diseases of poverty organism)  More than ½ can be avoided by increasing access to essential o This model of health & illness contends that psychological & social influences or factors are medications, reducing tobacco use, improving diet independent of the disease process Chronic illness in comparison  Thru Freud we get our 1 conceptualization of the mind o Conversion Hysteria: Unconscious conflicts can  Socially determined & therefore avoidable produce physical illness  Low diagnostic accuracy  Palliative treatment usually occurs o The conflict is converted into a physical symptom & the person is free of the conflict o Managing w meds or lifestyle changes long-term o Ex. person can suffer from numbness, blindness, or o Can’t necessarily cure, but can treat  Multivariate causation paralysis w/o a definable organic cause – could be a traumatic event instead o Can be different causes o The Talking Cure  Multiple therapeutic options o Ex. managing type 2 diabetes thru meds or lifestyle  Psychosomatic changes  Predicted to become main causes of death in 2030  Biological malfunction o Cardiovascular at the top o Mind-body dualism o Also increasing deaths by car accidents o Emphasis on illness  From 1921-25 to 2004: now chronic illnesses mainly cause  Does not focus on conditions that emphasize or death promote health Defining Health Today Biopsychosocial model  World Health Organization 1948  Macrolevel (societal values) processes & microlevel (cellular changes) processes interact to contribute to health or illness o “A complete state of physical, mental, and social well being and not merely the absence of disease...”  Multiple factors produce multiple effects  An indiv’s health is a combo of physical, mental, and social  Mind & body not separate well-being – Wellness  This model assumes that health is “achieved”  Systems Theory approach to health & illness Current Views o All levels of organization in any entity are linked &  Changes in health care (ex. vaccinations) change in any one level will effect change in all other  Health & illness arre influenced by psychological, social, and levels biological factors or predispositions o Interdisciplinary collaboration & thinking outside of one’s discipline  Treatment & prognosis is related to the patient-practioner relationship & expectations o Individual (knowledge, attitude, skills)  Interpersonal o More medical attention, more time together (social network)  Organizational (envt, ethos)   Personal control (ex. health habits) & socially determined Community (cultural values, norms)  Public Policy factors (ex. culture, socioeconomic status, stress, accessible & available health resources, social support) are taken into Clinical Implications account  Diagnosis & treatment must consider the indiv in terms of  An holistic approach to health biological, psychological, and social factors when considering o Lifestyle, surroundings, resources, ppl around them health or illness o Ex. cultural background Biopsychosocial Model  Patient-practitioner relationship extremely important  “Health & illness are conseqs of the interplay btwn biological, psychological, and social factors” Case Study  Disease may result from a combo of factors:  Consider the case of a high-powered business owner in her o Genetics, physiology, social support, personal control, early 50s who has a heart attack stress, compliance, personality, poverty, ethnic  Traditional medical approach would emphasize possible family history of heart disease & treatment using drugs background, cultural beliefs  The prominent model in Health Psychology practice &  BPS approach would also consider the social, cultural, ad research bhvr’al factors o Recent immigrant trying to adjust to Canadian life Examples of: o Struggling to balance work & family demands  Biological factors:  BPS treatment recommendations: o Exercise, stress management, program to quit smoking, o Virus, bacteria, injury, accidents, genetics o *Genetics, gender, age, ethnicity, immune system, goal to increase positive social interaction w family and nutrition, medication friends, etc.  Psychological factors: o Reaction to traumatic event, anxiety, coping Determinants of Health mechanisms, emotions & reactions, personality type  Similar to BPS approach, population health research has o *Personality, self-efficacy, optimistic bias, social identified 12 main factors affecting population health support, stress, coping skills, risky bhvrs, adherence (to o These have been focus of much research treatment regimens)  Social factors: 1. Income & social status o Socioeconomic status, social support, risky bhvr o Most important determinant influenced by others, religious beliefs, race or o High social & economic status associated w better experiencing racism, education health o Low-income Canadians are more likely to die earlier & o *Socio-economic status, ethnic background, racism, cultural beliefs suffer from illnesses  All factors affect each other 2. Social support   Outcomes  Health & Illness o More social contacts  lower premature death rate Biomedical Model 3. Education  Criticisms o A reductionist model o Low educated are more likely to by unemployed, poor,  Low level processes, does not recognize the role and die earlier o Can be related to socio-economic status of social & psychological processes o A single factor model of illness 4. Employment/Working conditions o Can affect health & emotional well-being o Publishes research articles on issues in health psychology 5. Social envt  Quite a new field o High levels of trust & grp membership leads to reduced mortality rates The 4 Cornerstones o Family violence reduces health 1. Health Promotion & Maintenance o Promote health & well-being 6. Physical envt o Examining health bhvrs & habits o Increased rates of childhood asthma due to increased o Ex. how to get children to develop good health habits airborne contaminants (regular teeth brushing) o Increased exposure to UV-B radiation ue to reduced o Promote regular exercise ozone layer o Design effective media campaigns to get ppl to improve their diets 7. Personal Health/Coping Skills o Smoking, risk-taking, diet 2. Prevention & Treatment of Illness o Effective problem solving & self-efficacy (believing that o Prevent illness & comply w treatment you can make changes) can lead to healthy choices o Changing health habits to prevent illness & accidents (ex. anti-smoking campaigns, wear seatbelts) 8. Healthy child development o Help those who are ill adjust more effectively o Conception to age 6 most important time for brain o Stress management development o Rehabilitation o Ex. mother’s habits while pregnant (ex. fetal alcohol o Take medications as directed syndrome), attachment style o Vaccinations 9. Biology & genetic endowment 3. Etiology & Correlates of Health, Illness, and Dysfunction o Predispositions to diseases o Etiology: origins or causes of illness o Bhvr’al & social factors that contribute to disease 10. Health Services o Health habits such as alcohol consumption, smoking, o Available resources, tools, insuran
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