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Chapter 1

Chapter 1 Notes

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University of Toronto Mississauga
Terry Borsook

Chapter 1: Introducing Health Psychology - Health psychology: the application of psychological principles and research to the enhancement of health, and the prevention and treatment of illness. o Concerns include; social conditions (availability of health care), biological factors (family longevity), personality traits (optimism). - A person may be free of disease but still not enjoy a satisfying life; health involves physical, psychological and social well-being. - “Average life expectancy of those born in the US is lower than in most other affluent countries.” Health and Illness: Lessons from the Past Ancient views: Prehistoric Medicine - When a person became sick there was no obvious physical reason for it, rather it was thought of as a possession by an evil spirit. - Treated through exorcism, rituals of sorcery or Trephination: an ancient medical intervention in which a hole was drilled into the human skull to presumably allow “evil spirits” to escape. o Wildly practiced form of treatment in India, Europe, Egypt, Central and South America. - About 4,000 years ago, people realized that hygiene also played a role in health and disease. o Egyptians engaged in cleansing rites. o Iraq, soap was manufactured, sewage systems constructed. o (bloodletting-opening a vein to remove blood). Greek and Roman medicine - Great drainage system, the Cloaca Maxima, built to drain a swamp that later became a modern sewage system. - Hippocrates (460 – 377 BCE) – father of modern medicine. o Was the first to argue that disease is a natural phenomenon and that the causes of disease (and their treatment and prevention) are worthy of study. o Humoral theory: (proposed by Hippocrates) a concept of health that considered wellness a state of perfect equilibrium among four basic body fluids, called humors. Sickness was believed to be the result of disturbances in the balance of humors. o Humors: blood, yellow bile, black bile and phlegm. o To maintain proper balance, person had to follow a healthy lifestyle (exercise), sufficient rest, good diet and the avoidance of excesses. o Conducted the first public health surveys of gout sufferers‟ habits, temperaments, heart rates, and other physical symptoms. o Gout: disease caused by disturbances in the body‟s metabolism of uric acid. o Was also interested in patient‟s emotions and thoughts regarding their health and treatment. - Claudius Galen (129-200 CE) – physician o Wrote a lot on hygiene, anatomy and diet. o Expanded the humoral theory of disease by developing system of pharmacology. o Blood for example was hot and moist, thus a disease caused by an excess of hot and moist could only be cured with drugs that were cold and dry. Non-Western Medicine - Traditional oriental medicine (TOM) – founded on the principle that internal harmony is essential for good health. o Fundamental to this is the concept of qi (chi) – a vital energy or life force that ebbs and flows with changes in each person‟s mental, physical, and emotional well-being. o Acupuncture, herbal therapy, tai chi, meditation and other interventions restore health by correcting blockages and imbalances in chi. - Ayurveda: based on the belief that the human body represents the entire universe in a microcosm and that the key to health is maintaining a balance between the microcosmic body and the macrocosmic world. o The key to this relationship is held in the balance of three bodily humors or doshas: vata, pitta, and kapha, or, collectively, the tridosha. o Oldest known medical system in the world, originated in India around sixth century. The middle ages and the Renaissance - Illness was viewed as God‟s punishment and epidemic disease such as the two plague‟s (a bacterial disease carried by rats and other rodents) were believed to be a sign of God‟s wrath. - Epidemic: literally, among the people; an epidemic disease is one that spreads rapidly among many individuals in a community at the same time. A pandemic disease affects people over a large geographical area. - Renaissance, a reemergence of scientific inquiry began. o Anatomist and artist Andres Vesalius published study of human internal organs, muscles, skeletal systems. - Renee Descartes – first innovation was the concept of the human body as a machine. (Described all the basic reflexes of the body). o Mind–body dualism: the philosophical viewpoint that mind and body are separate entities that do not interact. (Humans have two natures, mental and physical). o Rejected the notion that the brain influences the body. Post-Renaissance Rationality - Hippocrates humoral theory was finally discarded for: - Anatomical theory: the theory that the origins of specific diseases are found in the internal organs, musculature, and skeletal system of the human body. - Medicine changed rapidly in seventeenth and eighteenth centuries due to advances in technology, most important during this period was the microscope. - Dutch cloth merchant Anton van Leeuwenhoek (1632-1723) who made the first practical microscope. o Was the first to observe blood cells and structure of skeletal muscles. Discoveries of the Nineteenth century - Cellular theory: the theory that disease is the result of abnormalities in body cells. - French Scientist Louis Pasteur (1822-1895) truly rocked the medical world by showing that life can only come from existing life. - Before the nineteenth century scholars believed in spontaneous generation – the idea that living organisms can be formed from nonliving matter (ex. flies and maggots were believed to emerge spontaneously from rotting meat). - Through Pasteur‟s work in isolating bacteria in the laboratory, he paved the way for aseptic (germ-free) surgical procedures. - His discovery helped shape the germ theory: disease is caused by viruses, bacteria, and other microorganisms that invade body cells. - In 1846, American dentist William Morton introduced gas ether as an anesthetic. - Fifty years later, German physicist William Roentgen discovered x-rays. The Twentieth century and the Dawn of a New Era - Biomedical model: the dominant view of twentieth-century medicine that maintains that illness always has a physical cause. o Has three distinguishing features: first it assumes that disease is a result of a pathogen. It embraces reductionism the view that complex phenomenon (health and disease) come from a single primary factor. o Second it is based on the mind-body dualism. Finally, health is nothing more than the absence of disease. - Pathogen: a virus, bacterium, or some other microorganism that causes a particular disease. Psychosomatic Medicine - Biomedical model advanced health care significantly but it was unable to explain disorders that had no observable physical cause, like those by Sigmund Freud. - Freud‟s patients exhibited symptoms such as loss of speech, deafness, and even paralysis. Freud believed these maladies were caused by unconscious emotional conflicts that had been “converted” into a physical form. Freud labeled such illnesses conversion disorders, and the medical community was forced to accept a new category of disease. - In the 1940s, Franz Alexander advanced the idea that an individual‟s psychological conflicts could cause specific diseases. - According to his nuclear conflict model, each physical disease is the outcome of a fundamental, or nuclear, psychological conflict. For example, individuals with a “rheumatoid personality,” who tended to repress anger and were unable to express emotion, were believed to be prone to developing arthritis. o Alexander helped establish psychosomatic medicine: an outdated branch of medicine that focused on the diagnosis and treatment of physical diseases caused by faulty psychological processes. o Fell out of favor because it was grounded in the Freudian theory. And it was also based on reductionism – idea that a single psychological problem or personality flaw is enough to trigger disease. - This was the start to viewing health as multifactorial. o That is, many diseases are caused by the interaction of several factors, rather than by a single, invading bacterial or viral agent. Among these are host factors (such as genetic vulnerability or resiliency), environmental factors (such as exposure to pollutants and hazardous chemicals), behavioral factors (such as diet, exercise, and smoking), and psychological factors (such as optimism and overall “hardiness”). Behavioral Medicine - Behaviorists‟ defined psychology as the scientific study of observable behavior. - Behavioral medicine: an interdisciplinary field that integrates behavioral and biomedical science in promoting health and treating disease. o Neal Miller (1909–2002), who used operant conditioning techniques to teach laboratory animals (and later humans) to gain control over certain bodily functions. Miller demonstrated, for example, that people could gain some control over their blood pressure and resting heart rate when they were made aware of these physiological states. Miller‟s technique called biofeedback. The Emergence of Health Psychology - In 1978, the APA created the division of health psychology. 1) To study scientifically the causes or origins of specific diseases: a. That is their etiology: the scientific study of the causes or origins of specific diseases. They investigate why people engage in health-compromising behaviors. 2) To promote health: consider ways to get people to engage in health-enhancing behaviors. 3) To prevent and treat illness 4) To promote public health policy and the improvement of the health care system Chapter 2: Research in health Psychology - At the heart of all scientific inquiry is a skeptical attitude that encourages us to evaluate evidence and scrutinize conclusions. – called critical thinking. The dangers of unscientific thinking - Belief Bias: a form of faulty reasoning in which our expectations prevent us from seeing
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