4 th Edition Copyright Prentice Hall14-1 Health Psychology Chapter 14
Copyright Prentice Hall14-2 Mind-Body Relationship From earliest times – mind and body generally thought of as one unit Disease understood as resulting from some type of divine (supernatural) cause - possession, punishment from god(s), etc.
Copyright Prentice Hall14-3 Mind-Body Relationship Greeks and Arabs were among the first to suggest natural causes of illness Ex – Hippocrates’ Humoral theory Galen – the first to attribute disease to a specific pathogen This emphasis on natural causation was lost with the fall of the Roman Empire and the subsequent rise in power of the Church.
Copyright Prentice Hall14-4 Mind-Body Relationship In the Middle Ages the Church was the guardian of medical knowledge – the functions of the priest and physician merged. This began to change during the Renaissance, however, especially due to the influence of René Descarte
Copyright Prentice Hall14-5 Cartesian Dualism Descartes proposed that mind and body be considered as two separate entities Body – works mechanistically – thus, can be understood scientifically Mind – also, the soul – to be studied by priests This “split” laid the foundation for study and experimentation that led to modern medicine
Copyright Prentice Hall14-6 Mind-Body Relationship For the next 200 years, physicians looked exclusively at organic and cellular changes and pathology to understand and treat illness, until physical evidence became the only basis for diagnosis and treatment of disease Example – Krafft-Ebbing and General Paresis
Copyright Prentice Hall14-7 Mind-Body Relationship This view became less tenable, however, with the contributions of Sigmund Freud – hysterical patients had obvious, profound physical symptoms, with no apparent organic cause Psychosomatic Medicine in the 1920’s –Led to an emphasis on the autonomic nervous system
Copyright Prentice Hall14-8 Biomedical Model Still the dominant model in medicine Maintains that all illness can be explained on the basis of problems with bodily processes (biochemical imbalances, neurophysiological abnormalities, etc.) Is reductionistic Implicitly incorporates the assumption of mind/body dualism Emphasizes illness over health
Copyright Prentice Hall14-9 Biopsychosocial Model Assumes biological, psychological and social factors are all important determinants of both illness and health Health and illness both caused by multiple factors and produce multiple effects Mind and body cannot be distinguished in matters of health and illness Emphasizes both health and illness – health is to be achieved, not taken for granted
Copyright Prentice Hall14-10 Health Psychology Health psychology is a subfield that is concerned with the social and psychological factors that Influence health and illness.
Copyright Prentice Hall14-11 Why Health Psychology? 1.Changing Nature of Illness – traditional medicine has been very successful treating acute illnesses – tuberculosis, pneumonia, influenza, etc. – * are short term * have identifiable causes * can be treated
Copyright Prentice Hall14-12 Why Health Psychology? However, most of the major health problems today are chronic, not acute Cancer, heart disease, AIDS, accidents * cannot be cured, only managed * causes? * people must live with these diseases for years, leading to a number of issues of coping
Copyright Prentice Hall14-13 Why Health Psychology? Rapidly expanding cost of health care Increased medical acceptance Methodological and statistical contributions to research
Copyright Prentice Hall14-14 The Nervous System Major division - Central vs. Peripheral Central or CNS- brain and spinal cord Peripheral- nerves connecting CNS to muscles and organs Central Nervous System Peripheral Nervous System
Copyright Prentice Hall14-15 Peripheral Nervous System Skeletal (Somatic) SympatheticParasympathetic Autonomic Peripheral Nervous System
Copyright Prentice Hall14-16 Sympathetic “ Fight or flight” response Release adrenaline and noradrenaline Increases heart rate and blood pressure Increases blood flow to skeletal muscles Inhibits digestive functions CENTRAL NERVOUS SYSTEM Brain Spinal cord SYMPATHETIC Dilates pupil Stimulates salivation Relaxes bronchi Accelerates heartbeat Inhibits activity Stimulates glucose Secretion of adrenaline, nonadrenaline Relaxes bladder Stimulates ejaculation in male Sympathetic ganglia Salivary glands Lungs Heart Stomach Pancreas Liver Adrenal gland Kidney
Copyright Prentice Hall14-17 Parasympathetic “ Rest and digest ” system Calms body to conserve and maintain energy Lowers heartbeat, breathing rate, blood pressure CENTRAL NERVOUS SYSTEM Brain PARASYMPATHETIC Spinal cord Stimulates salivation Constricts bronchi Slows heartbeat Stimulates activity Contracts bladder Stimulates erection of sex organs Stimulates gallbladder Gallbladder Contracts pupil
Copyright Prentice Hall14-18 Summary of autonomic differences Autonomic nervous system controls physiological arousal Sympathetic division (arousing) Parasympathetic division (calming) Pupils dilate EYES Pupils contract Decreases SALVATION Increases Perspires SKIN Dries Increases RESPIRATION Decreases Accelerates HEART Slows Inhibits DIGESTION Activates Secrete stress hormones ADRENAL GLANDS Decrease secretion of stress hormones
Copyright Prentice Hall14-19 Stress and Illness Hans Selye developed the concept of stress as the nonspecific response of the body to demands to adjust to a wide range of changes.
Copyright Prentice Hall14-20 Stress and Illness Stressors are demands that give rise to the general adaptation syndrome (GAS), which consists of three stages: alarm, resistance, and exhaustion.
Copyright Prentice Hall14-21 Stress and Illness Among the circumstances that could lead to stress are catastrophes, major life changes such as divorce, acculturative stress, traumatic events such as criminal victimization, and hassles. They have been associated with physiological responses such as increased levels of stress hormones,
Copyright Prentice Hall14-22 Stress and Illness Researchers found that high levels of life change were associated with Illness. Subsequent Investigation showed that the relation between major life events and illness is not as strong as originally reported. One explanation is that a person's interpretation of events is an important determinant of the event's impact.
Copyright Prentice Hall14-23 Stress and Illness Everyday minor annoyances can accumulate and become associated with subsequent health problems.
Copyright Prentice Hall14-24 Stress and Illness Interpretation or appraisal of an event often determines whether that event is stressful.
Copyright Prentice Hall14-25 Stress and Illness Primary appraisal occurs when we determine whether an event is a threat Secondary appraisal occurs when we decide how to deal with the threat.
Copyright Prentice Hall14-26 Factors the Influence Reactions to Stress I. The Stressor Itself –Importance –Duration –Cumulative effect –Imminence –Anticipated vs. Unanticipated
Copyright Prentice Hall14-27 Factors the Influence Reactions to Stress 2. The Individual –Perception of threat –Presence of a plan –Voluntary vs. involuntary –Control and predictability –Stress tolerance (EA on Rorschach)
Copyright Prentice Hall14-28 Factors the Influence Reactions to Stress 3. External Resources & Social Support –Positive social and family relationships –Cultural rituals (funerals, confession, atonement)
Copyright Prentice Hall14-29 Coping with Stress Ineffective Coping Strategies –Withdrawal (avoidance) –Aggression –Overreliance on primitive defense mechanisms (distort reality)
Copyright Prentice Hall14-30 Coping with Stress Effective Coping Strategies –Removing stressors –Cognitive coping – changing the way we think about an event –Managing stress reactions – sometimes, if we can’t change the reality, we have to deal with the response schedule relaxing activities relaxation training
Copyright Prentice Hall14-31 Stress and Illness The immune system is the body's major defense against bacteria and viruses. Psychoneuroimmunology is the study of how psychological and physiological factors interact to influence the immune system. A wide variety of stressful events can affect immune system functioning.
Copyright Prentice Hall14-32 Lifestyle Influences on Disease Risk Smoking-related illnesses are the most preventable cause of death in the United States. The number of smokers is declining, but people with less education are more likely to smoke than people with more education. Most smokers tried their first cigarette before age 18. Peer pressure is a major factor leading individuals to start smoking.
Copyright Prentice Hall14-33 Lifestyle Influences on Disease Risk Although there are many programs to help people stop smoking, most people who quit do so on their own, usually after several unsuccessful attempts. Anticipated weight gain after quitting is often cited as a reason for continuing to smoke.
Copyright Prentice Hall14-34 Lifestyle Influences on Disease Risk The number one cause of death in the United States is heart disease. There is a strong association between men and heart disease.
Copyright Prentice Hall14-35 Lifestyle Influences on Disease Risk Heart disease also varies with race.
Copyright Prentice Hall14-36 Lifestyle Influences on Disease Risk Type A behavior has been considered a risk factor in the development of heart disease. Type A individuals tend to be aggressive, competitive, impatient, and have difficulty relaxing.
Copyright Prentice Hall14-37 Lifestyle Influences on Disease Risk The Western Collaborative Group Study indicated that a Type A individual was twice as likely to develop heart disease as the more relaxed and easygoing Type B person. Subsequent studies did not replicate this finding, and it became apparent that not all the components of Type A impart risk. Current research focuses on hostility as the toxic component of Type A behavior.
Copyright Prentice Hall14-38 Lifestyle Influences on Disease Risk Efforts to change type A behavior reduced the rate of recurrent heart attacks as compared with the rate among victims who received typical heart patient counseling
Copyright Prentice Hall14-39 Lifestyle Influences on Disease Risk AIDS is the 10 th leading cause of death in the United States. Aids cases among men is substantially higher than the number of cases among women.
Copyright Prentice Hall14-40 Lifestyle Influences on Disease Risk Men and women differ in their likelihood of being exposed to infection with HIV.
Copyright Prentice Hall14-41 HIV is actually a fragile virus that does not survive well outside the body. When HIV infects the body, however, it sets up a struggle between the immune system and the virus. Lifestyle Influences on Disease Risk
Copyright Prentice Hall14-42 Lifestyle Influences on Disease Risk The immune system fights well for 8 to 10 years until HIV replicates so rapidly that it destroys too many T-cells. A combination with stress hastens the onset of AIDS.
Copyright Prentice Hall14-43 Coping With Stress A number of psychological factors have been shown to modify stress reactions. Hardiness is a psychological characteristic composed of commitment, a sense of control, and a tendency to view change as a challenge. Hardy individuals react differently to stressful events and experience fewer illnesses than less hardy individuals.
Copyright Prentice Hall14-44 Coping With Stress Social support is the availability of approval, advice, money, or encouragement from others.
Copyright Prentice Hall14-45 Coping With Stress Social support may reduce the negative effects of stressful events.
Copyright Prentice Hall14-46 Coping With Stress There is growing support for the notion that humor and laughter can reduce mood disturbances, buffer the effects of life events, and aid in dealing with pain.
Copyright Prentice Hall14-47 Coping With Stress Many people have never developed the skill of relaxing. Among the techniques used to produce relaxation are progressive relaxation, the relaxation response, and biofeedback. Relaxation activates the parasympathetic nervous system and is helpful in reducing stress reactions.
Copyright Prentice Hall14-48 Coping With Stress Physical activity is associated with increased longevity and positive benefits on physical and psychological health.
Copyright Prentice Hall14-49 Coping With Stress Current recommendations call for at least 30 minutes of physical activity per day, which can be accumulated in short bouts throughout the day.