PSYC 3170 Chapter Notes - Chapter 1: Rheumatoid Arthritis, Autonomic Nervous System, Cerebrovascular Disease

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ď‚·Health psychology is devoted to understanding psychological influences on how people stay healthy, why
they become ill, and how they respond when they do get ill. Health psychologists both study such issues and
promote interventions to help people stay well or get over illness.
In 1948, the World Health Organization defined health as “a complete state of physical, mental, and social wellbeing
and not merely the absence of disease or infirmity”. This definition, which was very forward looking for its time, is
at the core of health psychologists’ conception of health. Rather than defining health as the absence of illness, health
is recognized to be an achievement involving balance among physical, mental, and social wellbeing. Many use the
term “wellness” to refer to this optimum state of health.
Health psychologists focus on health promotion and maintenance, which includes such issues as how to get children
to develop good health habits, how to promote regular exercise, and how to design a media campaign to get people
to improve their diets.
Health psychologists also study the psychological aspects of the prevention and treatment of illness. A health
psychologist might teach people in a high stress occupation how to manage stress effectively so that it will not
adversely affect their health. A health psychologist might be involved in the design of programs to encourage uptake
of cancer screening behaviours, and might work with people who are already ill to help them adjust more
successfully to their illness or to learn to follow their treatment regimen.
Health psychologists also focus on the etiology and correlates of health, illness, and dysfunction. Etiology refers to
the origins or causes of illness, and health psychologists are especially interested in the behavioural and social
factors that contribute to health or illness and dysfunction, factors that can include health habits such as alcohol
consumption, smoking, exercise, the wearing of seat belts, and ways of coping with stress.
Finally, health psychologists study the impact of health institutions and health professionals on people’s behaviour
and develop recommendations for improving health care.
Putting it all together, health psychology represents (1) the educational, scientific, and professional contributions of
psychology to the promotion and maintenance of health; (2) the prevention and treatment of illness; (3) the
identification of the causes and correlates of health and illness; and (4) the improvement of the health care system
and the formulation of health policy
ď‚·Historically, philosophers have vacillated between the view that the mind and body are part of the same
system and the idea that they are two separate ones. When we look at ancient history, it becomes clear that we
have come full circle in our beliefs about the mind body relationship.
In the earliest times, the mind and body were considered a unit. Early cultures believed that disease arose when evil
spirits entered the body and that these spirits could be exorcised through the treatment process. Archaeologists have
found Stone Age skulls with small holes in them that are believed to have been made intentionally with sharp stone
tools. This procedure, called trephination, allowed the evil spirits to leave the body while the “physician,” or
shaman, performed the treatment ritual
The Greeks were among the earliest civilizations to identify the role of bodily functioning in health and illness.
Rather than ascribing illness to evil spirits, they developed a humoral theory of illness, which was first proposed by
Hippocrates and later expanded by Galen. According to this view, disease arises when the four circulating fluids of
the body— blood, black bile, yellow bile, and phlegm—are out of balance. The function of treatment is to restore
balance among the humours. Specific personality types were believed to be associated with bodily temperaments in
which one of the four humours predominated. In essence, then, the Greeks ascribed disease states to bodily factors
but believed that these factors can also have an impact on the mind.
This view began to change with the rise of modern psychology, particularly with Sigmund Freud’s early work
on conversion hysteria. According to Freud, specific unconscious conflicts can produce particular physical
disturbances that symbolize the repressed psychological conflicts. In conversion hysteria, the patient converts the
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conflict into a symptom via the voluntary nervous system; he or she then becomes relatively free of the anxiety the
conflict would otherwise produce
Psychosomatic Medicine
Although true conversion hysteria responses are now rarely seen, the idea that specific illnesses are produced by
individuals’ internal conflicts was perpetuated in the work of Flanders Dunbar in the 1930s and Franz Alexander in
the 1940s . Unlike Freud, these researchers linked patterns of personality rather than a single specific conflict to
specific illnesses.
Whereas Freud believed that conversion reactions occur via the voluntary nervous system with no necessary
physiological changes, Dunbar and Alexander argued that conflicts produce anxiety, which becomes unconscious
and takes a physiological toll on the body via the autonomic nervous system, which eventually produces an actual
organic disturbance. For example, repressed emotions resulting from frustrated dependency and love-seeking
needs were said to increase the secretion of acid in the stomach, eventually eroding the stomach lining and
producing ulcers
Dunbar’s and Alexander’s works helped shape the emerging field of psychosomatic medicine by offering profiles of
particular disorders believed to be psychosomatic in origin—that is, bodily disorders caused by emotional conflicts:
ulcers, hyperthyroidism, rheumatoid arthritis, essential hypertension, colitis, and bronchial asthma
Nonetheless, researchers now believe that a particular conflict or personality type is not sufficient to produce
illness. Rather, the onset of disease requires the interaction of a variety of factors; these factors include a possible
genetic weakness in the organism, the presence of environmental stressors, early and current ongoing learning
experiences and conflicts, and individual cognitions and coping efforts.
Behavioural Medicine
Although psychosomatic medicine did much to bridge the mind-body gap, it relied on subjective, verbal
interventions based on psychodynamic perspectives that did not provide testable hypotheses.
Behavioural medicine developed, in part, to address this need by focusing on objective and clinically relevant
interventions that would demonstrate the connections between body and mind suggested by psychosomatic
medicine ; Behavioural medicine is considered the interdisciplinary field concerned with integrating behavioural
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 Mind-Body Relationship
It is now known that physical health is inextricably interwoven with the psychological and social environment: All
conditions of health and illness, not just the diseases identified by the early psychosomatic theorists, are
influenced by psychological and social factors. The treatment of illness and prognosis for recovery are substantially
affected by such factors as the relationship between patient and practitioner, and expectations about pain and
discomfort. Staying well is heavily determined by good health habits, which are for the most part under one’s
personal control, and by such socially determined factors as culture, socioeconomic status, place, stress,
availability of health resources, and social support.
WHAT IS THE BIOPSYCHOSOCIAL MODEL OF HEALTH?
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Document Summary

In 1948, the world health organization defined health as a complete state of physical, mental, and social wellbeing and not merely the absence of disease or infirmity . This definition, which was very forward looking for its time, is at the core of health psychologists" conception of health. Rather than defining health as the absence of illness, health is recognized to be an achievement involving balance among physical, mental, and social wellbeing. Many use the term wellness to refer to this optimum state of health. Health psychologists also study the psychological aspects of the prevention and treatment of illness. A health psychologist might teach people in a high stress occupation how to manage stress effectively so that it will not adversely affect their health. Health psychologists also focus on the etiology and correlates of health, illness, and dysfunction. Finally, health psychologists study the impact of health institutions and health professionals on people"s behaviour and develop recommendations for improving health care.

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