1. Health Psychology

2. What Do Health Psychologists Do? yTeachers, research scientists, clinicians yApplied health psychologists: licensed practitioners who focus on health-promoting interventions and helping people cope with illnesses

3. 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

4. Where Do Health Psychologists Work?

5. Training to become a Health Psychologist yGeneral psychology training at the undergraduate level ySpecial training at the doctoral (Ph.D.) level xFour- to six-year program x65 Ph.D. programs in health psychology in the United States

6. Issues zIssues and historical trends that have shaped the development of Health Psychology

7. I. Increased Life Expectancy yAverage life expectancy — xIncreased by more than 30 years since 1900 xIn the U.S. in 21 st century Women: around 80 Men: around 75 Why is this increase important?

8. II. Changes over the last 100 years The 10 Leading Causes of Death in The U.S. in 1900 1.Pneumonia 2.Tuberculosis 3.Diarrhea and enteritis 4.Heart disease 5.Stroke 6.Liver disease 7.Injuries 8.Cancer 9.Senility 10.Diphtheria Source: Centers for Disease Control and Prevention

9. Leading causes of death (today) 1.Heart disease 2.Cancer 3.Stroke 4.Lung disease (COPD) 5.Accidents 6.Diabetes Source: U.S. National Center for Health Statistics xThese top six account for 80% of deaths xThey are mostly lifestyle diseases with preventable causes xThey are mostly chronic disorders (rather than acute disorders)

10. Behavior and health Actual Causes of Death in the U.S. 1. Tobacco 2. Diet /activity patterns 3. Alcohol 4. Microbial agents 5. Toxic agents 6. Firearms 7. Sexual behavior 8. Motor vehicles 9. Illicit use of drugs Source: Journal of the American Medical Association

11. III. Rising Health Care Costs

12. IV. Trends in how illness has been viewed

13. Western view (traditional) yBiomedical model — illness is caused by physical phenomena (e.g., germs, cell abnormalities) -- reductionistic

14. Biopsychosocial Perspective yThe view that health is determined by the interaction of biological mechanisms, psychological processes, and social influences xBiological mechanisms: genes, evolutionary history, anatomical/biological makeup, nutrition xPsychological processes: coping mechanisms, attitudes toward treatment, personality/outlook on life xSocial context: SES, social network, societal and cultural norms (e.g., pervasive consumption of soda)

15. A Biopsychosocial Model of Depression

16. The Biopsychosocial Model in practice z Somatic presentations of psychological dysfunction y Chest pain in panic attack yHypochondriasis z Psychological conditions secondary to illness y Post M.I. Depression y Psychological sequelae of stroke yStress disorders associated with traumatic injuries

17. The Biopsychosocial Model in practice zPhysical symptoms responsive to behavioral interventions y anticipatory nausea y enuresis y tension & migraine headache y early labor (clip from “The New Medicine”)

18. The Biopsychosocial Model in practice z Psychological presentations of organic problems y hypothyroidism presenting as depression y steroid-induced psychosis z Somatic complications associated with behavioral factors y mismanagement of diabetes ynoncompliance to medications

19. The Biopsychosocial Model in practice z Behavioral risk factors for disease or disability y smoking y excessive weight y risk taking y sedentary lifestyle z Problems of health care providers and health care systems y Physician-patient relationships yLack of access to health care

20. The Biopsychosocial Model in practice (case studies) Small group exercise – using the BPS (then discuss assessment targets using the BPS – next slide )

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

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

23. Social Review z Patient’s interaction with health care staff z Family / friends support z Socioeconomic status (SES) z Environment to which patient will return (job?) z Cultural factors