Health psychology: understanding psychological influences on how people stay healthy, why they become ill,
and how they respond when they do get ill.
Health psychologists: Study these issues + promote interventions to help people stay well or get over illness.
eg: information about why people smoke helps a health psych researcher understand the habit and design
interventions to help people stop smoking.
1948 WHO’s definition of health: complete state of physical, mental and social wellbeing; not merely the
absence of disease or infirmity.
= balance among physical, mental and social well being
1. Focus on health promotion and maintenance:
how to get kids to develop good health habits
how to promote regular exercise
how to design a media campaign to get people to improve their diets
2. Study the psychological aspects of prevention and treatment of illness.
3. Focus on the etiology and correlates of health, illness and dysfunction
etiology: origins or causes of illness
behavioral and social factors that contribute to health/illness and dysfunction
4. Attempt to analyze + attempt to improve the health care system and the formulation of health policy.
study the impact of health institutions and health professionals on people’s behavior
and develop recommendations for improving health care.
=> Health psychology:
educational, scientific, professional contributions of psychology to the promotion and maintenance of health
identification of the causes and correlates of health, illness, and related dysfunction
improvement of the health care system
health policy formation
mind + body considered a single unit.
disease = evil spirits entering the body
treatment = exorcism
*trephination: drill holes in skull
earliest to identify role of bodily functioning in health and illness.
developed humoral theory of illness (Hippocrates, Galen) disease = when 4 circulating fluids of the body are out of balance:
treatment: restore balance among the humors.
specific personality types believed to be associated with the bodily temparaments in which 1 of the 4 humors
ascribed disease states to bodily factors + believed these factors can also have an impact on the mind.
supernatural explanations of illness
disease: god’s punishment for evildoing
driving out evil by torturing the body
church was the guardian of medical knowledge
medical practice = religious overtones, healing and practice of religion were indistinguishable
Renaissance to present day:
rejection of humoral theory of illness
scientific understanding of cellular pathology (Kaplan)
Descartes’ doctrine of mindbody dualism
medicine looked more to medical laboratory and bodily factors as a basis for medical progress.
physical evidence became the sole basis for diagnosis and treatment of illness.
Modern psychology: Freud’s work on conversion hysteria
specific unconscious conflicts can produce particular physical disturbances that symbolize the repressed
patient converts the conflict into a symptom via the voluntary nervous system; he/she then becomes relatively
free of the anxiety the conflict would otherwise produce
researchers linked patterns of personality to specific illnesses.
Dunbar, Alexander: conflicts produce anxiety, which takes a physical toll on the body via the automatic
nervous system, which eventually produces an actual organic disturbance.
now: onset of disease requires interaction of a variety of factors:
possible genetic weakness in the organism
presence of environmental stressors
early learning experiences and conflicts
individual cognitions and coping efforts
focus on objective and clinically relevant interventions that would demonstrate the connections between body and mind
interdisciplinary field concerned with integrating behavioral science and biomedical science for understanding
physical health and illness , and for developing and applying knowledge and techniques to prevent, diagnose,
treat, and rehabilitate.
Current views of the mindbody relationship
now known that physical health is inextricably interwoven with the psychological and social environment
all conditions of health and illness are influenced by psychological and social factors
treatment of illness and prognosis for recovery are affected by factors like
relationship between patient and practitioner
expectations about pain and discomfort
staying well is determined by good health habits; for the most part under one’s personal control, and factors
availability of health resources
Biopsychosocial model of health
fundamental assumption: health and illness are consequences of the interplay of biological, psychological, and
Biopsychosocial vs. biomedical model
Biomedical model: illness can be explained on the basis of aberrant somatic processes, eg: biochemical
imbalances or neurophysiological abnormalities.
assumes: psychological and social processes are largely independent of the disease process
*liabilities of biomedical model:
reductionistic: reduces illness to lowlevel processes
essentially a singlefactor model of illness: explains illness in terms of a biological malfunction
implicitly assumes a mindbody dualism: mind and body are separate entities
clearly emphasizes illness over health
difficulty accounting for why a particular set of somatic conditions need not inevitably lead to illness
Advantages of the biopsychosocial model
maintains that biological, psychological, and social factors are allimportant determinants of health and illness:
both macrolevel processes and microlevel processes interact to produce a state of health or illness
multiple causal factors considered
mind and body inseparable
emphasizes both health and illness
Systems theory: maintains that all levels of organization in any entity are linked to each other hierarchically and
that change in any one level will affect change in all the other levels. = microlevel processes are nested within the macrolevel processes and that changes on the microlevel can have
macrolevel effects and vice versa.
Clinical implications of the biopsychosocial model
process of diagnosis should always consider the interacting role of biological, psychological, and social factors
in assessing an individual’s health or illness: interdisciplinary approach
recommendations for treatment must also examine all 3 sets of factors: team approach
significance of the relationship between patient and practitioner
Factors that led to the development of health psychology
Changing Patterns of Illness
until the 20 century, acute disorders (tuberculosis, pneumonia) were major causes of illness and death
acute disorders: shortterm medical illness; often result of viral/bacterial invader, usually amenable to cure
now: chronic illnesses (esp. heart disease, cancer) are main causes of disability and death.
chronic illnesses: slowly developing diseases; often can’t be cured but can be managed
chronic illnesses are diseases in which psychological and social factors are implicated as causes.
because people may live with chronic diseases for many years, psychological issues arise in connection with
Advances in technology and research
health psychologists conduct research that identifies risk factors for disease and help people learn to change
their diet and stick to their resolution.
certain treatments that may prolong life severely compromise quality of life
patients are asked their preferences regarding lifesustaining measures and they may require counselling.
Role of epidemiology
study of the frequency, distribution, and causes of infectious and noninfectious disease in a population, based
on an investigation of the physical and social environment
morbidity: number of cases of a disease that exist at some given point in time.
incidence: number of new cases
prevalence: total number of existing cases
mortality: number of deaths due to particular causes
health psych is concerned with biological outcomes and also with healthrelated quality of life and
Changing perspectives on health and health care
Lalonde Report: framework of health that rested on 4 main cornerstones
health care organization
Epp Report: need to view health in nonmedical terms + give greater consideration to the social factors that
public health health promotion perspective: health is a capacity/resource linked to the ability to achieve one’s
goals, to learn, and to grow.
health: capacity of people to adapt to, respond to, or control life’s challenges and changes. * health psych’s main emphasis on prevention has the potential to reduce the number of $$ devoted to the
management of illness
* health psychologists have done substantial research on what makes people satisfied/not with their health care
* health care industry employs 100s of individuals, its impact is huge.
Increased Medical Acceptance
value of health psychologists is increasingly recognized
Demonstrated Contributions to Health
developed a variety of shortterm behavioral interventions to address a wide variety of healthrelated problems
modifying bad health habits
managing side effects or treatment effects associated with a range of chronic diseases
many have contributed to the actual decline in the incidence of some diseases, esp. coronary heart disease.
2 or more conditions that differ from each other in exact and predetermined ways
people are randomly assigned to experience these different conditions
their reactions measured
randomized clinical trials: experiments to evaluate treatments/interventions and their effectiveness over time
health psychologist measures whether a change in 1 variable corresponds with changes in another variable
* impossible to determine the direction of causality unambiguously
more adaptable than experiments
can study variables that can’t be manipulated experimentally
looks forward in time to see how a group of individuals changes, or how a relationship between 2 variables
changes over time
longitudinal research: observe the same people over a long period of time
looks backward in time, attempts to reconstruct the conditions that led to a current situation
open ended questions on surveys
include individual’s voice + perspective to gain a richer understanding of the experiences and factors related to
a particular health issue
Purpose of health psychology training
Careers in practice
go into medicine: physicians, nurses
clinical research setting
allied health professional fields:
social work occupational therapy
Careers in research
public health, psychology, medicine
public health researchers: broad goal of improving the health of the general population
typically work in academic settings
family planning clinics
Canadian Health Network and its constituent organizations and agencies
other health care agencies
inform policymakers about changes that would benefit communities
formally evaluate programs for improving healthrelated practices
chart the progress of particular diseases
monitor health threats in the workplace
develop interventions to reduce threats
conduct research on health issues Chapter 2
Function of the nervous system
Nervous system: complex network of interconnected nerve fibres that functions to regulate many important
bodily functions, including the response to and recovery from stress.
made up of:
central nervous system (CNS): brain + spinal cord
peripheral nervous system (PNS): rest of the nerves in the body, including those that connect to the
brain and spinal cord
PNS made up of:
> somatic (voluntary) nervous system: connects nerve fibres to voluntary muscles and provides
the brain with feedback in the form of sensory info about voluntary movement
> autonomic (involuntary) nervous system: connects the CNS with all internal organs over
which people do not customarily have control
Regulation of the autonomic nervous system occurs via:
sympathetic nervous system: prepares the body to respond to emergencies, to strong emotions
(anger/fear), and to strenuous activity. Its concerned with the mobilization and exertion of energy, called a
parasympathetic nervous system: controls the activities of organs under normal circumstances and acts
antagonistically to the sympathetic nervous system. Restores the body to normal state after an emergency.
Activation common during processes like digestion, can be experiences as a feeling of relaxation/drowsiness
after a large meal. Its concerned with conservation of body energy, called an anabolic system
command centre of the body
receives: afferent (sensory) impulses from the peripheral nerve endings
sends: efferent (motor) impulses to the extremities and to internal organs to carry out necessary movement
Hindbrain: 3 main parts
medulla: located just above the point where the spinal cord enters the skull
heavily responsible for regulation of heart rate, respiration, blood pressure
receives info about the rate at which the heart is contracting, and speeds up/slows down the heart rate as
receives sensory info about blood pressure and the levels of CO2 and O2 in the body to regulate blood
vessel constriction and the rate of breathing
pons: link between the hindbrain and the midbrain
helps control respiration
cerebellum: coordinates voluntary muscle movement maintenance of balance and equilibrium
maintenance of muscle tone and posture
Midbrain: major pathway for sensory and motor impulses moving between the forebrain and the hindbrain
responsible for the coordination of visual and auditory reflexes
Forebrain: 2 main sections
thalamus: involved in the recognition of sensory stimuli
relay of sensory impulses to the cerebral cortex
hypothalamus: regulates the centres in the medulla that control cardiac functioning, blood pressure,
responsible for regulating water balance in the body
regulating appetites, including hunger and sexual desire
important transition centre between the thoughts generated in the cerebral cortex of the brain and their
impact on internal organs
eg: embarassment ▯blushing via the hypothalamus ▯vasomotor centre in the medulla ▯blood vessels
anxiety: secretion of HCl in the stomach via signals from the hypothalamus
together with the pituitary gland, hypothalamus helps regulate the endocrine system which releases
hormones, influencing functioning in target organs throughout the body
*telencephalon: composed of the 2 hemispheres (left, right) of the cerebral cortex
cerebral cortex: largest portion of the brain
involved in higher order intelligence, memory, personality
sensory impulses that come from the peripheral areas of the body, up the spinal cord, and through the
hindbrain and midbrain are received and interpreted here
motor impulses pass down from the cortex to lower portions of the brain and then to other parts of the
consists of 4 lobes: frontal, parietal, temporal, occipital
each lobe has its own memory storage area or areas of association, through them the brain is able to
relate current situations to past ones
border the midline of the brain