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Psych 365 Ch 1.docx

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PSYC 365
David Cox

Psych 365- Ch1: The development of the field • In 1970s psychologists realized that there were many ways psychological principles applied to health care, then health psychology emerged (after behavioural medicine) • Behavioural medicine= branch of medicine concerned with the rlnshp b/w health and behaviour o Focus usually on remediation o Dev behavioural and biomedical knowledge and techniques relevant to illness and apply this knowledge/techniques to prevention, diagnosis and tx/rehab • Health psychology= the compilation of all that psychology has to offer to the diagnosis and tx of illness as well as to ppl’s attempts to maintain health and wellbeing o Health means more than just absence of illness • Psychosomatic medicine= approach in which particular medical complaint is viewed as being th result of an underlying chornic emotional conflict that ultimately surfaces in the form of physiological symptoms o Specific symptoms linked to particular kinds of conflict (ie hypertension connected to inability to express feelings of anger in appropriate way) o Psychotherapy to provide insight into impact of unresolved conflicts in hopes of reducing symptoms o Vs behavioural medicine which concentrates on addressing indiv’s current behaviour (which is influenced by learning) • The development of Health Psychology as a Discipline: o Neal Miller’s 1983 article on behavioural medicine marks arrival of health psychology o The early stages of health psychology’s dev (applying behaviourism principles to health)  Germ theory= based on discovery that many illnesses were caused by activity of mico-organisms (ie bacteria) • Then got antibiotics to tx • These 2 resulted in changing profile of previously life threatening diseases (Germs replaced by lifestyle as number one killer) and emphasis on technical aspects of medicine to replace consideration of emotional factors in health • Technical medicine was so successful at treating germ based conditions, but useless against problems caused by lifestyle and other psychosocial factors o Behavioural medicine emerged to deal with 2 previously mentioned factors o See health as being affected by what we DO rather than what we THINK • Big problems of adherence to tx (non-compliance as identified by Miller) o Gradient of reinforcement= lag time b/w behaviour and a reinforce; the greater the lag time the weaker the behaviour  Noncompliance b/c reinforcement for following medical regimen often delayed (ie exercise don’t suddenly get fit)  Delayed gratification= to describe lag time b/w behaviour and reinforce o Asymptomatic= conditions not accompanied by palpable symptoms/sensations  Lowest compliance rates for tx  Type A behaviour pattern linked to heart disease thru attributes such as time urgency, achievement orientation and hostility o Health psychology expands to include cognition and other personality factors:  Increase in ideas of therapy such as Cognitive restructuring (change stress inducing interpretation tendencies)  90% of articles published today emphasize cognitive processes in health psychology  Krantz- Study of compliance important b/c led to more in depth study of patient- physician rlnshp • Term compliance criticized b/c assumes unidirectional rlnshp (doctor gives orders, patient follows them) o More attention is paid to the ways ppl cope:  Rodin and Salovey looked at personality variables and rnlshp b/w thinking and health • Coping styles= patterns in the way ppl deal w/difficult situations o Monitors= ppl who seek info in attempt to cope with illness and accompanying challenges o Blunters= avoid info in attempt to cope w/illness o The introduction of Psychneuroimmunology: Finding links b/w psychological and biological processes  Psychoneuroimmunology (PNI)= study of rlnshp b/w psychological state and immune system functioning (initially alluded to by Miller)  Immunocompetence= extent to which our immune system is functioning properly to ward off micro-organisms • Good areas for showing hypothesized links b/w mind and body  Janice Kiecolt-Glaser in PNI area looking at situations such as marital conflict and caregiving for patients w/Alzheimers and effects on immune system o Summary= today health psychologists use interventions that combine behavioural and cognitive theories • Why has health psychology come into such prominence? o Health psychology section of Canadian Psychological Association (CPA) is one of the larger sections o Changing the profiles of Illness and Health in Canada  At turn of century most common cause of death was acute infectious disease (mainly respiratory disease like flu and pneumonia) nd • By 1950 was circulatory disease and cancer 2 • Infectious diseases fallen as major cause of death but still garner intense media attn (ie SARS, H1N1, etc...)  More active adults, less active children (more worrisome) • 39% more obesity in kids that buy lunch at school vs bring pack lunch • Activity very relevant to health, also cigarette smoking o Definite psychological barriers to making lifestyle changes (need to unlearn old behaviours and learn new good ones) and have to believe you’re capable of making change o Multiple perspectives are needed to understand health and health statistics  Another reason for growing of health psych is that it provides helpful ways to understand statistics describing our health  Malignant neoplasms= cancerous growths that may be treated by radiation and chemical therapy • Biomedical perspective for this and biology • Linkage of lifestyle factors to types of cancer (and their related mortality rates, ie lung cancer highest and mostly caused by smoking)  Carcinogenic=cancer causing  Medical geography= study of health related impact of differences in environments • Some environments healthier than others • So there’s biomedical, psychological and geographical perspectives to understanding (ie) cancer deaths o Also demographic differences= relating ot personal variables  “healthy immigrant effect”= newly arrived immigrants gave self reports of health status that were higher than those of non immigrants tho w/time self reports converged and immigrants self reported health status lowered to non immigrant level • Ppl w/serious illness less likely to immigrate,
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