Health Psychology 8th edition Shelley E. Taylor Chapter One: What Is Health Psychology?

Health Psychology Health Psychology: - exciting and relatively new field devoted to understanding psychological influences on how people stay healthy, why people become ill and how they respond when they do get ill At the current time, scientists warn of a threat regarding avian flu epidemics. (Altman, Lawrence K. (March 8, 2005). 4 New Cases of Avian Flu are Reported in Vietnam. New York Times, March 8, 2005.) In this above article, Altman reports that a Vietnamese man had died of the avian flu. His death brings the number of fatalities in Vietnam reported to the World Health Organization as having human avian flu to 31 of 42 individuals infected. Scientists have known about these types of avian flu epidemics for over a century. But the epidemics were usually confined to birds and pigs. The World Health Organizations reports that, “The first documented infection of humans with an avian influenza virus occurred in Hong Kong in 1997, when the H5N1 strain caused severe respiratory disease in 18 humans, of whom 6 died.” URL: http://www.who.int/csr/don/2004_01_15/en/ The World Health Organization notes that it is believed that an influenza pandemic is inevitable. How will people respond? It is impossible to predict the future. But we can look at health care crises that have occurred in this century and study how people have responded. Think back to the fears that spread across the globe in regard to SARS. The fears over SARS (severe acute respiratory syndrome) can be used as an example of how people may respond when they become ill or when they are concerned about becoming ill. ►A physician from Taiwan traveled through several cities in western Japan in the Spring of 2003. ►When it was revealed to the public that he was infected with SARS, there was immediate concern. ►The names of the hotels in which the doctor stayed were made public on May 18, 2003 and on that day there were 2,300 cancellations at the Miyako Hotel Osaka; there were an additional 20 cancellations at the hotel the following day. ►How did the physician respond when he became ill? Was he unaware of his symptoms? Was he aware of the symptoms, but in denial regarding their significance? Was he unwilling to interrupt his vacation since he felt well enough to tour the country? This example illustrates the importance of considering psychological influences. In addition, it can be seen that far-reaching consequences occur as other members of society respond. How do people behave when they are concerned about becoming ill? ►Many hotels in Japan decided that they would not accept any guests from either Taiwan or China. ►There is a concern that by refusing guests from particular countries lodging, it will have a detrimental effect on their businesses. ►By accepting Chinese and Taiwanese guests, will the hotels experience a detrimental effect because other tourists feel uncomfortable? Source: www.japantoday.com May 20, 2003 “Hotels refusing China, Taiwan guests over SARS fear”

Health Psychology (cont.) Health Psychologists focus on: - health promotion and maintenance - prevention and treatment of illness - etiology and correlates of health, illness and dysfunction - the health care system and the formulation of health policy

The Mind-Body Relationship: A Brief History Disease was believed to be: - evil spirits entering the body - the result of the imbalance of blood, black bile, yellow bile and phlegm - God’s punishment for evil-doing Advances in science looked to bodily factors rather than the mind as bases for health and illness

The Mind-Body Relationship: A Brief History (cont.) Psychoanalytic Contributions: - Freud’s early work on conversion hysteria: - unconscious conflicts produce physical disturbances such as “glove anesthesia” (sudden loss of speech, hearing, or sight), tremors, muscular paralysis, possible eating disorders

The Mind-Body Relationship: A Brief History (cont.) Psychosomatic Medicine: - Dunbar and Alexander: - linked patterns of personality to specific illnesses - helped shape belief that bodily disorders are caused by emotional conflicts - criticisms: - methodological problems - conflict and personality not sufficient to produce illness - restricted the range of medical problems caused by psychological and social factors

The Mind-Body Relationship: Current Perspectives - Increased attention to traditional East Asian medical philosophies and practices The field of neuroscience has developed powerful new practices that help answer questions like: - How do placebos work? - Why are many people felled by functional disorders that seem to have no underlying biological causes? - Why is chronic pain so intractable to treatment?

The Biopsychosocial Model in Health Psychology - health and illness are consequences of the interplay of biological, psychological and social factors Biomedical model: - all illness can be explained on the basis of aberrant somatic bodily processes; psychological and social processes are irrelevant to disease process

The Biopsychosocial Model in Health Psychology (cont.) Advantages of the Biopsychosocial Model: - macrolevel processes and microlevel processes interact to produce a state of health or illness - the mind and body cannot be distinguished in matters of health and illness - researchers have adopted a systems theory approach to health and illness

The Biopsychosocial Model in Health Psychology (cont). Clinical implications: - diagnosis should always consider biological, psychological and social factors in assessing an individual’s health or illness - recommendations for treatment must examine all three sets of factors - the relationship between the patient and the practitioner is significant

The Biopsychosocial Model in Health Psychology (cont.) Nightmare Deaths: - unexpected nocturnal deaths to Southeast Asian refugee males - rare, genetically-based malfunction in the heart’s pacemaker - men who were successfully resuscitated said they had been having severe night terror - biological, psychological and cultural factors were involved in the deaths

Why is the Field of Health Psychology Needed? - changing patterns of illness - advances in technology and research: - role of Epidemiology in Health Psychology - morbidity and mortality - expanded health care services - health care is the largest service industry in the U.S.

Why is the Field of Health Psychology Needed (cont.)? - increased medical acceptance - health psychology research: - the role of theory - experiments - correlational studies - prospective designs - retrospective research

Why train in Health Psychology? Careers in practice: - physicians, nurses and allied health professionals Careers in research: - conduct research in public health, psychology and medicine