Part 2 Historical Introduction of Health Psychology

www.psych.yorku.ca/.../health_psychology.../health_psychology_lecture_1.ppt

Don’t Worry Only Some – ** Choose: • Summary History : •Psychological Concepts & Models related tour society & to Part 1 Introductory mainly definition & models : mainly:

•Modified Health Concepts with Moral & Spiritual

Don’t Worry Only Some – ** Choose: • Summary History : •Psychological Concepts & Models related tour society & to Part 1 Introductory mainly definition & models : mainly:

•Modified Health Concepts with Moral & Spiritual

Brief History of Medicine & Psychology

**History of Medicine

1. Stone-age

Body____Mind

Spirit

2. Ancient Greeks

Body Mind

3. Middle-Ages

Body____Mind

Spirit

4. Contemporary View

Body Mind

Socio-behavioural

Supernatural or Magical Belief;Disease resulted from:

Sorcery شعوذة Breach of social taboo اللعنة

االجتماعية Object intrusion Supernatural possession Losing one’s sole

Treatments Confession and appeasing of the

gods. Magical sucking to remove the

intrusive object. Drive out evil spirits by using vile

concoctions such as animal excrement or even torture.

Trephination

Greeks – Hippocrates (460-377 B.C.) Origin of the view that disease is a

natural process. Humoral theory

View that disease occurs when the four fluids of the body are out of balance

Four fluids are blood, black bile, yellow bile, and phlegm.

Personality types

Hippocrates - Treatments

Temperament Humor Disease Treatment

Phlegmatic Phlegm Cold, headaches

Hot baths, warm food

Sanguine Blood Angina, epilepsy

Blood letting

Melancholic Black bile Hepatitis, ulcers

Hot baths

Choleric Yellow bile

Stomach, jaundice

Blood letting, liquid diet

Evolving view of diseases Anatomical pathology

Belief that disease was localized in anatomy (16th to 18th Centuries)

Tissue pathology Specific tissues could become diseased

while others remain healthy (Late 1800s) Cellular pathology

Belief that life resided in cells and so cells must be the place to look for disease (19th century)

Evolving view of diseases Germ theory

Discovery that particles in the air that could not seen (e.g., bacteria) could cause disease.

Magic bullet A specific cure could be found for every

ailment that restore the person to perfect health.

Biopsychosocial model Mind, body, and environment interact in

causing disease.

History of MedicineStone-age

Body____Mind

Spirit

Ancient Greeks

Body Mind

Middle-Ages

Body____Mind

Spirit

Contemporary View

Body Mind

Socio-behavioural

**Psychosomatic Medicine

Freud (1856-1939)

Cannon (1932)

Dunbar (1930)

Alexander (1940s – 1950s)

Freud born 1939 and dead 1856 (T\F) Correct …..

**Biopsychosocial Model

Psychological component Behaviour (adoption and maintenance) Emotional (feelings) Cognition (thoughts, beliefs, and

attitudes) Personality – characteristic ways of

thinking and feeling

(Use these components to develop the Bioosychosocial Model”

Biopsychosocial Model of Disease

Biology•Genetic variability• Anatomy• Physiology

Pathogens•Germs•Toxins

Behavioral risk factors•Diet•Exercise•Smoking• Marriage•Wearing seat belts in the car, etc.

Social•Family•Society•Friends, etc.

Medical (Traditional) Psychology Model

(Draw)

Important Contributions of Psychology to Health

Has provided techniques useful in changing behaviors that affect health and illness.

Is committed to keeping people healthy rather than waiting to only treat them when they become ill.

Long history of developing reliable and valid measures for assessing health-related factors.

Has contributed a solid foundation of scientific methods for studying such behaviors.

**Please respond to each of these items with YES or NO.

1. Personal testimonials are a good way to decide about treatment effectiveness.

2. Newspaper reports of scientific research give an accurate picture of the importance of the research.

3. The personal information from case studies usually provides more valid data than information from longitudinal studies.

4. Placebo effects apply only to suggestible people and are not an important factor in the treatment of most people.

5. Placebo effects can influence psychological but not physical disorders.

6. Different research methods are not important in determining the validity of research because all scientific methods yield equally valuable results.

Please respond to each of these items with YES or NO.

9. Experimental rather than observational research is required to learn about patterns of disease.

10. Valuable research is done by people outside the scientific community, but scientists try to discount the importance of such research.

11. Scientific breakthroughs happen everyday.

12. Each new report of health research seems to contradict previous findings, so there is no way to use this information to make good personal decisions about health.

7. The number of participants in a research study is not important to the validity of the study.

8. Studies with nonhuman subjects can be just as important as those with human participants in determining important health information.

Health Psychology Study of social, behavioural,

cognitive, and emotional factors that influence the: Maintenance of health Development of illness and disease Course of illness or disease Patient’s and family’s response to

illness and disease

What is health, illness, and disease?

World Health Definition of Health (1948)

“A complete state of physical, mental, and social well-being and not merely the absence of disease and infirmity.”

(With all Psychological Contemporary Vies, Redefine WHO for Health Psychology:

Health Psychology is a complete state of Physical, Social, Moral, Spiritual, Emotional, Psychological, and Behavioral well-being and not merely the absence of disease and infirmity

Health ConceptPhysical Role - Physical SocialEmotional Role- Emot. PainVitality General Health

Physical Role - Physical SocialEmotional Role- Emot. PainVitality General Health

SF-36 (John Ware et al., 1993) – Social Functioning

1. …in past 4 weeks, to what extent have …physical/emotional problems interfered with normal social activities with family, friends, neighbors, or groups.

2. …in past 4 weeks, how much time has your physical/emotional problems interfered with your social activities (like visiting with friends and relatives)?

SF-36 (John Ware et al., 1993)

Role limitations due to physical health – Do you have any of the following problems with work or other regular daily activity as a result of your physical health? Cut down on …time spent on work… Accomplished less than you would like Limited in the kind of work you could do Had difficulty performing work…(took more

effort)

SF-36 (John Ware et al., 1993)

Role limitation due to emotional problem –Do you have any of the following problems with work or other regular daily activity as a result of any emotional problems? Cut down on time spent at work… Accomplished les than you would like Didn’t do work or other activities as

carefully as usual.

**What are your health risks?For each item, answer YES or No.

1. I believe if I feel well I must be healthy.

2. My weight is not within the range that the charts say it should be.

3. I smoke cigarettes

4. My drinking would not qualify as moderate – I either do not drink or I drink too much to be considered a moderate drinker.

5. I rarely get 7 or 8 hours of sleep.

6. I do not follow a regular exercise program.

** What are your health risks?For each item, answer YES or No.

7. I believe that most disease have a genetic base.

8. I believe that modern medicine will find cures for most diseases before I am old enough to be affected by these diseases.

9. As long as I am not overweight, I believe that my diet will not affect my health.

10. I can wait until I am older to develop a healthier lifestyle.

Additional (Religious based Psycho-behavourl )

11 I believe that all\most psychological problems have a religious base

12

13

Estimated contributions of different factors to health status.

30%

20%

40%

10%

Other Factors Genetic Behaviour Medical Care

30%

20%

40%

10%

Other Factors GeneticBehaviour Medical Care

Psychology = Behavioral + Other = … % + ….%

Health Psychologist

Scientists who research the area Health promotion – intervene at the social

(e.g., government policy, community) or individual level to promote health and prevent illness and disease.

Clinical health psychologist – intervene at the individual level to treat illness, slow or prevent disease progression, and reduce disability.

Health Psychology

Development or progression of illness and disease Etiology

Individual’s and family’s response to illness and disease Outcomes

**Relation of health psychology to other health-related fields

HealthEducationNutrition

MedicinePsychosomatic

CardiologyOncology, etc.

Behaviouralhealth

Behaviouralmedicine

HealthPsychology

SociologyNutritionExercise Phys.

Physiology

Psychology

Research Methods Case Studies In depth analysis of one individual Type of single-subject research

design Advantage is a more complete

analysis of the individual Disadvantage is that it can magnify

sampling errors

Correlational Studies Yield degree of relationship between

two variables Type of descriptive research design

Advantage is that it can examine variables that cannot be experimentally manipulated (e.g., IQ and occupational status).

Disadvantage is that it cannot determine causality.

Cross-Sectional Study Designs Compares groups at one point in

time (e.g., age groups, ethnic groups, disease groups) Advantage is that it is an efficient way

to identify possible group differences because you can study them at one point in time.

Disadvantage is that you cannot rule out cohort effects.

Personality and Hypertension,The effect of Hypertension Awareness (Irvine et al. 1989)

H yp erten s ion S tu d y

P erson a lityS tu d y

2 n d B PS creen

M atch edN orm oten s ive

M ean D B P > = 9 0 m m H gH yp erten s ive

5 th B P S c reen5 m on th s

4 th B P S c reen4 m on th s

D B P < 1 0 5

3 rd B P S c reen3 m on th s

P erson a lityS tu d y

2 n d B P S c reen2 -3 weeks la te r

D B P > = 9 0 b u t< 1 1 5 m m H g

1 s t B P S c reen

Personality and Hypertension: Effect of Hypertension Awareness

Variable

Group 1AwareHyper-tensive

Group 2

Normo-tensive

Group 3UnawareHyper-tensive

Group 4

Normo-tensive

% Male 75 75 89 89

AgeMean* (SD)

46.2(9.2)

46.2(8.2)

46.4(8.3)

45.8(8.0)

SBP/DBPMean* (SD)

135.1/93.9

(9.2/5.1)

118.7/76.3

(11.5/5.5)

135.8/93.8

(8.2/3.4)

118.5/75.7

(10.3/4.8)

Personality and Hypertension: Effect of Hypertension Awareness

Variable Group 1AwareHyper-tensive

Group 2

Normo-tensive

Group 3UnawareHyper-tensive

Group 4

Normo-tensive

Neuro-ticismMean* (SD)

12.0(5.3)

9.3(5.3)

9.7(4.8)

9.5(4.6)

Type AMean* (SD)

0.79(8.5)

-3.0(9.4)

-2.0(9.4)

-2.6(8.2)* Group 1 > Group 2 & Group 3 (p < 0.01)

Personality and Hypertension:Effect of Hypertension Awareness

0123456789

1011121314

Neuroticism

Aware HyperNormotUnaware HyperNormot

Aware hypertensive > normotensive & unaware hypertensive,P < 0.001

Personality and Hypertension:

Conclusion

Do hypertensives have a different personality than those with normal blood pressure? No, because the unaware hypertensives

did not differ from the normotensives. Why did the aware and unaware

hypertensives differ? Possible explanations?

Personality and Hypertension:

Conclusion

Awareness of hypertension status confounds assessment of the association between personality characteristics and hypertension.

Due to hypertension labeling effect; or

Due to self-selection bias

Longitudinal Design To gather data on the course of

health or disease over time (e.g., progression of multiple sclerosis). Advantage is that you can see the time

course of the disease or behaviour (e.g., smoking cessation over time).

Disadvantage is it is costly and still subject to bias

Experimental Designs Examines differences between

experimentally manipulated groups (e.g., one group gets a certain drug and the other gets a placebo). Advantage is that you can determine

causality. Disadvantage is cost and many

variables cannot be experimentally manipulated (e.g., smoke exposure over time).

Please answer anonymously these questions

1. What is the main thing you learned from this lecture?

2. What is the main question you have that wasn’t answered?

3. The things the instructor did best …OR the best things about the lecture that were?

4. The things the instructor did worst …OR the worst things about the lecture that were?