PSY6009 Health Psychology Introduction PDF

PSY6009 Health Psychology Malika Guruge BSc in Psychology and Counselling MSc in Clinical and Health Psychology  TABLE OF CONTENTS Introduction The 01 to health psychology Biomedical Model...

PSY6009 Health Psychology Malika Guruge BSc in Psychology and Counselling MSc in Clinical and Health Psychology  TABLE OF CONTENTS Introduction The 01 to health psychology Biomedical Model 02 Views in The 03 Health Psychology Biopsychosocial Model 04 Learning Outcomes of the Module 1. Evaluate the contribution of psychology to the understanding and management of health and illnesses. 2. Critically appraise theories of health behaviour and the efficacy of interventions for changing behaviour. 3. Critically discuss the role of psychosocial factors in health and illness and the importance of these factors in the therapeutic relationship.  Introduction 01  INTRODUCTION Health psychology is a specialized field of psychology that focuses on understanding how psychological factors impact physical health and well-being. According to Matarazzo (1980: 815), health psychology is defined as, “the aggregate of the specific educational, scientific and professional contribution of the discipline of psychology to the promotion and maintenance of health, the promotion and treatment of illness and related dysfunction”.  Development of Health Psychology Health psychology gained formal recognition as a subfield within psychology in 1978 when the American Psychological Association established Division 38, known as the Division of Health Psychology. With the formal recognition of the APA division of the health Psychology which occured in 1978, which was involved with the role of psychology on health issues other than “mental health”. The discipline of psychology in health is primarily concerned with matters related to “mental health”. This alignment with the prevailing trends in medical specialization was in line with the mechanistic approach adopted to address issues pertaining to physical health, illness, and disorders. The work of division 38 involves enhancing understanding of health and illness through basic and clinical research, education and service activities and also seeks to integrate biomedical information about health and illness with current psychological knowledge. Refer- https://youtu.be/qink-sq-f60 The British Psychology Society (BPS) Definition The goal of health psychology is to study scientifically the psychological processes of health, illness and health care. The aim is to apply health psychology to the promotion and maintenance of health, the analysis and improvement of the healthcare system and health policy formation, the prevention of illness and disability and the enhancement of outcomes of those who are ill or disabled (Division of Health Psychology | BPS, n.d.). Its objective is to utilize these discoveries to advance and sustain good health, analyze and enhance the healthcare system, contribute to the development of health policies, prevent illnesses and disabilities, and improve the well-being of individuals dealing with illness or disability. Refer- https://youtu.be/D0KY4JdsAbE The Mind-Body Relationship During ancient times, most cultures associated the mind and body to be intertwined with each other. Hence disease was thought to arise when evil spirits entered the body (Taylor, 2018). The ancient Greeks described and developed the theory of the four humors, which was a foundational concept in early medicine [human body was governed by four primary fluids or humors: blood, phlegm, black bile, and yellow bile] (Taylor, 2018). During Middle ages, the perception of illness was swung towards supernatural explanations with diseases being regarded as “God’s Punishment for evildoing”. During the renaissance and continuing to this day, the medical practices lead to the development of the biomedical model (Mehta, 2011). “Mind and body dualism represents the metaphysical stance that mind and body are two distinct substances, each with a different essential nature” (Mehta, 2011).  02 The Biomedical Model  What is the Biomedical Model? It is the traditional approach to healthcare that Primarily focuses on the physical and biological aspects of illness and disease (Taylor, 2018). The biomedical model being the prominently practiced model for the past 300 years, depicts that all illnesses can be explained on the basis of abnormal bodily processes, such as biochemical imbalances or neurophysiological abnormalities (Taylor, 2018). The biomedical model assumes that psychological and social processes are largely irrelevant to the disease process (Mehta, 2011). The biomedical model looks into these questions; ○ What causes an illness? E.g. For instance, a bacterial infection, a malfunctioning organ, or a genetic predisposition can be seen as the direct causes of illness. ○ Who is responsible for illness? E.g. Responsibility is often attributed to factors like microbes, genetics, or environmental toxins. ○ How should illness be treated? In the biomedical model, illness is treated through medical interventions such as medications, surgeries, and other procedures. ○ Who is responsible for treatment? Medical professionals like doctors and specialists, primarily responsible for treatment. What is the Biomedical Model Cont? The biomedical model looks into these questions; ○ What is the relationship between health and illness? In the biomedical model, health is often seen as the absence of illness or disease. ○ Who is the relationship between the mind and the body? Psychological factors may be acknowledged but are typically secondary to the biological factors in understanding and treating illness. ○ What is the role of psychology in health and illness? In the biomedical model, psychology's role in health and illness is limited to addressing mental health conditions that have clear biological components, such as depression or anxiety. Doesn’t look into the psychosocial aspects of the illness. 11 Why is the Biomedical Model Flawed? Reductionist viewpoint- The biomedical model has a tendency to simplify complicated health occurrences to their simply biological causes. The impact of psychological, social, and environmental factors on health and illness is frequently ignored (Taylor, 2018). Seperation of the Mind-body- It does not take into account the connection between mental and physical health and instead treats them as separate things. Focus of disease and illnesses- The biomedical model is mostly focused on diseases. Though it may not fully address preventive measures or general well-being, it lays a high emphasis on identifying and treating ailments. Lack of emphasis on preventive measures- The model responds reactively to illnesses once they occur, overlooking and advocating the prevention measures that are available. Disregard of the psychosocial factors- The influence of psychosocial elements on health outcomes, such as stress, social support, and mental health, is frequently undervalued by the biological model. Incomplete Well-Being: While biomedicine is concerned with the absence of disease or infirmity, it may not fully address an individual's overall well-being (Taylor, 2018). Overemphasis on Pharmaceuticals: The biomedical model often relies heavily on pharmaceutical interventions for the treatment of illnesses (Taylor, 2018). Refer-https://youtu.be/sDrXyneTIzM Different Aspects in the Field of Health Psychology Health psychology encompasses various aspects related to the psychological and behavioral dimensions of health and illness. Health Behavior: Examining how individuals' behaviors, such as diet, physical activity, smoking, and substance use, impact their overall health. Psychosocial Factors: Investigating the role of psychosocial factors like stress, social support, coping strategies, and personality traits in health outcomes (Taylor, 2018). Chronic Illness: Studying the psychological aspects of chronic conditions such as diabetes, heart disease, cancer, and chronic pain. Health Promotion: Developing and evaluating health promotion and disease prevention programs aimed at encouraging healthy behaviors and reducing the risk of illness. Psychological Interventions: Developing and implementing psychological interventions to improve health outcomes. Public Health: Contributing to public health initiatives by studying population-level health trends, risk factors, and interventions.  WHO View During the late 1940s, the World Health Organization introduced a more comprehensive understanding of health, defining it as "a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity." This definition represented a shift away from the earlier biomedical model, which primarily focused on the absence of disease, to a more holistic approach that encompassed not only physical health but also mental and social aspects, recognizing the interconnectedness of these dimensions in overall well-being.  Illnesses that Health Psychologists Deal with Health psychologists play a vital role in understanding, managing, and preventing various health conditions. 1. Chronic illness- chronic conditions like diabetes, heart disease, arthritis, cancer, and autoimmune disorders. Health psychologist assist in the, management, adherence to the treatment plans. 2. Mental Health Disorders- mental health conditions like depression, anxiety disorders, bipolar affective disorder (BAD), and schizophrenia. Psychotherapy, counselling and other psychological interventions are provided. 3. Addictions- Health psychologists assists in individuals struggling with substance abuse and addiction by assisting in relapse prevention. 4. Obesity and Weight Management- assists individuals adopt healthier lifestyles, manage weight, and overcome issues related to overeating, emotional eating, and body image concerns. 5. Cardiovascular disorders- sticking to lifestyle changes changes which could reduce the risk of cardiovascular disorders. 6. HIV/AIDS- Offering support and counselling to individuals living with HIV/AIDS by addressing the emotional challenges associated with the condition by promoting adherence to treatment. 7. Rehabilitation- assists in the recovery processes from injuries, surgeries, adn disabilities, helping in adjustment for physical limitations and psychological changes. Global Health Statistics 17  Group Activity In the realm of health psychology, select an illness that has been previously discussed and undertake an exploration of the multifaceted influences encompassing psychological, biological, and social factors. Evaluate how these factors may contribute to both the prevalence and maintenance of the chosen illness. 03 Views in Health Psychology Three Major Views in Health Psychology 1. The Traditional Medical Concept ○ This refers to the biomedical model of health, which primarily focuses on the absence of disease as a marker of health. It investigates the biological and the physiological aspects of health & illness. Biomedical focus (looks into the physiological processes, genetics & pathology in determining health status). Reductionism into isolated biological factors. Disease-centered (centered around diagnosing & treatment). Biological Determinism (health is determined by genetic makeup & physiological processes). 2. The WHO Concept ○ The WHO defined health as “ a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”. Complete Well-being (emphasizes more than just the absence of illness) Holistic Approach (physical, social & mental aspects) Patient Centered Care (collaboration with patients to address Biopsychosocial needs) Prevention and Promotion (encouraging the efforts to preventing illness, and improving health behaviors) Three Major Views in Health Psychology Cont. 3. The Ecological Concept ○ The ecological concept looks into the individual in the context of the environment. Includes the system approach which acknowledges that health is influenced by a complex integrated interplay of biological, social, psychological, and environmental factors (Mallee, 2017). Holistic perspective (takes the biopsychosocial aspects along with the environmental factors into consideration) Community and Cultural Context (considering the cultural & communal aspects, like; cultural beliefs & practices etc). Social determinants (acknowledgement of the social factors like, socioeconomic status, education, and access to resources play a significant role) Resilience & Adaptation (inclusion of the ability to adapt & maintain well-being in the face of environmental change and challenges)  Criticisms of the Models 1. Traditional Medical Model ○ Reductionistic- the model reduces health to the absence of disease or the presence of biological dysfunction. ○ Overemphasis medical interventions- neglecting the preventive measures while emphasising on medical and pharmaceutical interventions. E.g. In the case of mental health, this model may primarily focus on neurotransmitter imbalances while overlooking the influence of psychosocial factors like stress and social support. ○ Fragmented care- exclusion of the social, environmental, psychological determinants and overall well-being. 2. WHO Concept ○ Idealized Definition- unrealistic expectations in order to achieve complete well-being is idealistic and not always achievable. E.g Designing a healthcare program that addresses both physical and mental well-being, while also considering social factors, can be logistically complex and resource-intensive. ○ Neglect of Disease- Downplays the importance of addressing health conditions & medical treatments and mentioning diseases. ○ Downplays Human Capacity- undermines the capacity for coping with the dynamic physical, emotional, and social challenges while maintaining wellbeing with a chronic disease or disability.  Criticisms of the Models Cont. 3. The Ecological Concept ○ Complexity- The ecological concept of achieving holistic wellbeing is complex and challenging to implement in practice (Mallee, 2017). For instance, in addressing obesity, it may be unclear whether the focus should be on improving access to healthy foods, promoting physical activity, or addressing psychological factors. ○ Practicality- it doesn’t provide clear guidance on specific interventions or treatments. ○ Difficulty in Identifying Causality- often involves studying associations and correlations between various factors. E.g. Determining whether poor air quality directly causes respiratory illnesses can be challenging due to the presence of confounding variables and the need for long-term studies. ○ Resource intensive- healthcare systems require significant funding, resources, time and personnel to make it feasible. E.g. Addressing social determinants of health, such as poverty and education, often requires extensive collaboration with various community organizations and government agencies, demanding significant time and funding resources.  Understanding Health Psychology Understanding health psychology involves recognizing that it offers a more comprehensive perspective on health and illness compared to the traditional biomedical model. While the biomedical model often seeks a single causal factor for illness, health psychology acknowledges that human health is influenced by a multitude of interconnected factors. These factors encompass biological aspects, such as viral infections, but also extend to psychological elements, such as behaviors and beliefs, as well as social determinants like employment status. This perspective helps to move away from simplistic, linear models of health causality towards a more nuanced understanding of the complexity of human health and well-being. 25  The Biopsychosocial 04 Model The Biopsychosocial Model The biopsychosocial model of health and illness was introduced by Dr. George L. Engel, an American Psychiatrist, in the late 20th century, 1977-1980. Dr. Engel proposed this model as an alternative to the traditional biomedical model. The biopsychosocial model takes into account three interconnected dimension; ○ Biological factors- These encompass the physical aspects of health and illness, such as genetics, physiology, and the presence of pathogens (e.g., viruses or bacteria). ○ Psychological Factors- Psychological factors refer to an individual's mental and emotional well-being. This dimension considers how thoughts, emotions, behaviors, and beliefs can influence health. ○ Social Factors- Social factors encompass the broader societal and environmental influences on health [socioeconomic status, access to healthcare, cultural norms, social support systems, and lifestyle choices]. The Biopsychosocial Model Importance of the Biopsychosocial Holistic perspective- aims to understand how psychological factors influence health and illness determined by both the biological and social influence. Prevention and Influence- the psychological and social determinants of health is used to develop strategies and interventions aimed at preventing health issues and improving overall well-being. Person-Centered Care- the model recognises each person as unique and that their health outcomes are influenced by a combination of factors. Health Promotion- aids health psychologists in designing effective health promotion programs to improve a healthy lifestyle. Cultural Sensitivity- the model also recognizes that cultural and social determinants of health are essential considerations in healthcare. Research Evidence- the model has initiated extensive research into the relationships between biological, psychological, and social factors in health and illnesses and their impact on health outcomes.  Aims to Understand in Health Psychology 1. Understanding, Explaining, Developing, and Testing Theory:- health psychology seeks to advance our comprehension of the complex relationship between psychological factors and health outcomes. ○ Understanding: Health psychologists strive to gain insights into the psychological, social, and behavioral determinants of health and illness. E.g. Exploring how thoughts emotions, behaviours and social influences impact an individual’s well-being. ○ Explaining: Health psychologists aim to provide explanations and theories that shed light on the mechanisms through which psychological factors influence health. E.g. Explaining how the Diathesis-Stress Model, which posits that chronic stress can lead to adverse health outcomes through various physiological and behavioral mechanisms. ○ Developing and Testing Theory: Health psychology involves the development of theoretical frameworks and models that can help us understand health-related phenomena better. E.g. Creation and refinement of theories which are subjected to empirical testing to evaluate their validity and applicability. 30  Aims to Understand in Health Psychology 2. Putting Theory into Practice: Application of the knowledge and theories derived from research to improve health outcomes and enhance well-being. ○ Interventions and Health Promotion: Health psychologists design and implement interventions aimed at promoting healthier behaviors, preventing illness, and enhancing overall well-being. ○ Patient Care and Support: Health psychologists work within healthcare settings to assist individuals in coping with illness, managing pain, adhering to treatment plans, and making informed healthcare decisions. ○ Policy and Public Health: Health psychology also has a role in shaping public health policies and initiatives that promote health, reduce health disparities, and create environments conducive to well-being. ○ Education and Training: Health psychologists educate healthcare professionals, policymakers, and the public about the psychological aspects of health and illness.  Group Activity Explore how the biological and psychological aspects of the individual is affected due to the alcohol use. Incorporate the biopsychosocial model to gain an in-depth analysis of the case study. Come up with some treatment modes which you could utilise for this case study.  References History of health psychology - iresearchnet. Psychology. (2017, November 16). https://psychology.iresearchnet.com/papers/history-of-health-psychology/ Division of Health Psychology | BPS. (n.d.-b). BPS. https://www.bps.org.uk/member-networks/division-health-psychology Pickren, W., & Degni, S. (2012). A history of the development of Health Psychology. The Oxford Handbook of Health Psychology, 16–41. https://doi.org/10.1093/oxfordhb/9780195342819.013.0002 Mallee, H. (2017). The evolution of health as an ecological concept. Current Opinion in Environmental Sustainability, 25, 28-32. https://doi.org/10.1016/j.cosust.2017.04.009 Mehta, N. (2011). Mind-body Dualism: A critique from a Health Perspective. Mens Sana Monographs, 9(1), 202-209. https://doi.org/10.4103/0973-1229.77436 Taylor, S. E. (2018). Health psychology. McGraw-Hill Education. World Health Organization. (n.d.). Health and well-being. World Health Organization. https://www.who.int/data/gho/data/major-themes/health-and-well-being 33 THANKS! DO YOU HAVE ANY QUESTIONS? [email protected]