LECTURE 2: SEPTEMBER 14TH, 2012
TOPIC: CONTINUANCE OF LECTURE 1AND LECTURE 2 INTERVENTIONSAND
REFER TO PPT.
THE BIOPSYCHOSOCIAL MODEL
➔ Visual representation of the biopsychosocial model. Refer to ppt.
➔ Example: Social factor as to why someone smokes → friends smoke. Psychological factor →
makes you happier to smoke or feel less stressed (cognition aspects), perceived stress, feeling
guilty (decrease smoking behavior –negative relation), or people who claim their father smoked
for so long and nothing happened so therefore nothing will happen to me. Biological factors →
addicted to a chemical compound (nicotine), over active nicotine receptors (some people are
more prone to getting addicted → individual differences), those with schizophrenia get a hyper
reaction from smoking which motivates them to continue and therefore get hooked.
CLINICAL IMPLICATIONS OF THE BIOPSCYHOSOCIAL MODEL
➔ The teams have to work together to assess and diagnose. They cannot work separately.
Example : psychologists doing their own research and health practitioners do theirs.
➔ Relationship between patient and doctor → if you have a doctor you do not like they will be
less effective because you are not going to want to listen or follow what they say, treatment will
feel worse and your perception will change causing you to not feel confident in the process.
➔ Medical schools are paying more attention to the key to communication, verbal reasoning and
soft clinical skills. Doctors need this element to be effective and successful.
➔ REFER TO PPT
IMPORTANT CONTRIBUTIONS OF PSYCHOLOGY TO HEALTH
➔ Psychologists are playing more of a role in medical settings → sign of change
➔ Psychologists have been consulting with medical teams. They provide the accuracy of reliable
and valid measures. Example: you have a treatment that involves an intervention you must
demonstrate the treatment works before any one will listen. Research must be done which is
where the psychologists play a role.
➔ What do you want to measure and how?
➔ They can also help to develop techniques and have a commitment to keep people healthy.
➔ Need research methods to test effectiveness of interventions. Cannot say something is useful or
helpful without research.
HEALTH PSYCHOLOGY RESEARCH
➔ REFER TO PPT.
➔ Examples: of the type of research we will be studying in the course.
➔ (1) Stress and Immune Function → natural killer cell activity went down and then rebounded
after periods of stress. They took medical students under lots of pressure and measured their
normal natural killer cell activity. It went down before the exam they had and rebounded back
in place after the exam ended. Affects the social, psychological and biological individual
differences of an individual ~Glaser et al. ➔ (2) Psoriasis → It is a chronic skin condition (hyper cells) → patches on skin, visually obvious.
Patients get flare ups when they are emotionally stressed. Ultra violet light either kills off or
slows the growth of the skin cells (this therapy is dangerous). Some did standard therapy
without meditation others did the standard therapy and meditation. These groups were
compared. After 12 weeks, those who meditated had healthier skin than those who had not.
10/12 → clear skin 2/12 → no meditation and therefore only helped 2 people. Should we even
use UV rays? → sometimes people get better without treatment ~Kabat-Zin et al.
➔ (3) Breast Cancer → serious breast cancer, women were terminal and said to die in 6 months.
Treatment → chemotherapy and radiation. Half of them were in a psychotherapy group →
provided emotional support. Group therapy condition → better quality of life, calmer, happier,
less fearful. These women lived longer (18-24 months longer) ~Spiegel.
LECTURE 2 BEGINS
→ Aperson's behavior and lifestyle affects their health now a days not infectious agents. How can
psychologists motivate people to change their bad habits even when they know their habits are
→ The Case of Katharine → family doctor referred her to a psychologist, she was married had 3 kids
and her husband was a busy physician and she was enrolled in a graduate program in University. She
had good grades and ran the child care facilities. She did all the grocery shopping and cooking. She was
a multi-tasker. She suffered from crippling headaches. She would close the lights and sleep in bad for
the whole day and she would need a babysitter. Psychologist asked about her relationships → she felt
close to her husband but guilty to ask him to help out and she felt she would inconvenience him (he is
too good for that according to her). Ahealth psychologist would use a biopsychosocial model to help
understand who she is and what is going on. They sent her to a neurologist to make sure she did not
have an aneurism and such. They ruled that out.
ASSESSMENT OF HEALTH-RELATED PROBLEM BEHAVIOURS
➔ Cognitive behavioral assessment → cognition, behaviors and emotions.
➔ Psycho-dynamic theories → childhood past, Electra complex, unconsciousness (This is what
Freud would have asked in the past). Today, psychologists focus on the here and now in terms
of cognition, behaviors and emotions.
➔ Psychological factors → psychologists
➔ Social factors → social workers → decisions about going back to work and such
➔ Biological factors
➔ (1)Self-report → what brings you here. Example: Katharine said she had migraines, time stress,
trouble falling asleep, guilt etc.
➔ (2)Psychologist would gather info on all of the problems the patients wants to improve.
Psychologist prioritizes what is most important to work on first and then continue on to the next
most pressing issue.
➔ (3) Target problems when there is a long list. Pick the top 3. Use priority order. Then make sure
the client agrees to the top 3 chosen.
➔ (4) Measure and analyze the issues specifically. Be clear about what is happening, how often
and what happens after it occurs.
➔ REFER TO PPT FOR THE REST MEASUREAND ANALYZE THE PROBLEM
➔ You use a clinical interview for step 4 above to do a good assessment
➔ You want info from the client that will help you to analyze and measure the problem. We need
the dimensions of the problems (what does it consist of?) In her case it was throbbing on one
side of the head to the other, threw up, and felt confused etc.
➔ She reported that she experienced an aura → visual disturbance proceeds the migraine →
maybe they see lines, tunnel vision, things are blurry. It is believed that there is a biological
foundation for this aura. Signals get crossed during a migraine for example.
➔ How often does she get migraines? Once every 1-2 months. They lasted for 24 hours on
➔ Want to know when the problem start → relevant historic events → she did not get these
migraines when she was on maternity leave, her mother and sister also suffer from this
➔ What takes place right before a migraine? → situational determinants example: people who
get panic attacks do not know what triggered it. They just say oh it happened out of the blue. In
this case, common situational determinants for migraines are: certain foods and drinks, red
wine, cheeses, nuts, fatigue, noise, anything that overwhel