Health Psychology

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Health Psychology
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What Do Health Psychologists Do?

• Teachers, research scientists, clinicians
• Applied health psychologists licensed
  practitioners who focus on health-promoting
  interventions and helping people cope with
  illnesses

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Goals in Health Psych

• Pinpoint Psychological, Behavioral, and Social
  Factors in Disease and Health
• Promote and Maintain Health
• Prevent and Treat Illness
• Improve the Health Care System and Health Care
  Policy

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Where Do Health Psychologists Work?
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Training to become a Health Psychologist

• General psychology training at the undergraduate
  level
• Special training at the doctoral (Ph.D.) level
• Four- to six-year program
• 65 Ph.D. programs in health psychology in the
  United States

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Issues

• Issues and historical trends that have shaped the
  development of Health Psychology

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I. Increased Life Expectancy

• Average life expectancy
• Increased by more than 30 years since 1900
• In the U.S. in 21st century
• Women around 80
• Men around 75
• Why is this increase important?

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II. Changes over the last 100 years

• The 10 Leading Causes of Death in The U.S. in
  1900
• Pneumonia
• Tuberculosis
• Diarrhea and enteritis
• Heart disease
• Stroke
• Liver disease
• Injuries
• Cancer
• Senility
• Diphtheria

Source Centers for Disease Control and
Prevention
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Leading causes of death (today)

• Heart disease
• Cancer
• Stroke
• Lung disease (COPD)
• Accidents
• Diabetes

• These top six account for 80 of deaths
• They are mostly lifestyle diseases with
  preventable causes
• They are mostly chronic disorders (rather than
  acute disorders)

Source U.S. National Center for Health Statistics
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Behavior and health

• Actual Causes of Death in the U.S.
• Tobacco
• Diet /activity patterns
• Alcohol
• Microbial agents
• Toxic agents
• Firearms
• Sexual behavior
• Motor vehicles
• Illicit use of drugs
• Source Journal of the American Medical
  Association

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III. Rising Health Care Costs
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IV. Trends in how illness has been viewed
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Western view (traditional)

• Biomedical model illness is caused by physical
  phenomena (e.g., germs, cell abnormalities) --
  reductionistic

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Biopsychosocial Perspective

• The view that health is determined by the
  interaction of biological mechanisms,
  psychological processes, and social influences
• Biological mechanisms genes, evolutionary
  history, anatomical/biological makeup, nutrition
• Psychological processes coping mechanisms,
  attitudes toward treatment, personality/outlook
  on life
• Social context SES, social network, societal and
  cultural norms (e.g., pervasive consumption of
  soda)

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A Biopsychosocial Model of Depression
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The Biopsychosocial Model in practice

• Somatic presentations of psychological
  dysfunction
• Chest pain in panic attack
• Hypochondriasis
• Psychological conditions secondary to illness
• Post M.I. Depression
• Psychological sequelae of stroke
• Stress disorders associated with traumatic
  injuries

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The Biopsychosocial Model in practice

• Physical symptoms responsive to behavioral
  interventions
• anticipatory nausea
• enuresis
• tension migraine headache
• early labor (clip from The New Medicine)

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The Biopsychosocial Model in practice

• Psychological presentations of organic problems
• hypothyroidism presenting as depression
• steroid-induced psychosis
• Somatic complications associated with behavioral
  factors
• mismanagement of diabetes
• noncompliance to medications

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The Biopsychosocial Model in practice

• Behavioral risk factors for disease or disability
• smoking
• excessive weight
• risk taking
• sedentary lifestyle
• Problems of health care providers and health care
  systems
• Physician-patient relationships
• Lack of access to health care

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The Biopsychosocial Model in practice (case
studies)

• Small group exercise using the BPS
• (then discuss assessment targets using the BPS
  next slide)

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Biological Review

• current status of illness / background of illness
  (usually found in the medical history chart)
• medications
• pain
• family history
• lifestyle habits (e.g., nutrition and exercise)

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Psychological Review

• Affective/emotional
• Cognitive (e.g., thinking, beliefs, memory,
  attention, learning, interpreting,
  problem-solving)
• Motivation

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Social Review

• Patients interaction with health care staff
• Family / friends support
• Socioeconomic status (SES)
• Environment to which patient will return (job?)
• Cultural factors