1. Health Psychology and Behavioral Medicine
By: Melba Finley

2. OUTLINE: History and perspectives Methods of intervention
Prevention of health problems
Other applications
Health psychology: Prospects for the future

3. History and perspectives
Health Psychology- specialty area within psychology that applies:
tools of the discipline to the prevention of illness
the enhancement and maintenance of health
the identification of the correlates of illness and health
the treatment of the individuals in health care system and the formulation of health care policy.
Behavioral medicine:
Integration of the behavioral sciences with the practice and science of medicine.

4. History and perspectives continued…
Psychosomatic medicine- assumption that certain illnesses and disease state are caused by psychological factors.
Biopsychosocial model- viewed as integration of the biomedical and psychosocial influences:
Genetic predisposition,
Nutritional deficiencies
Biochemical imbalances
Social influences: friends, family members, home environments, and life events.

5. History and perspectives
Linking stress, lifestyle and behavior, personality, social support, and health:
Stress and health
Definition: process that involves an environmental event, its appraisal by the individual, various responses of the organism, and reevaluation that occurs as a result of these responses and changes in the stressor.
Physiological effects of stress on the body: complex chain of events.
Severe Stress: adverse effects on body organs, mental functions, and the immune system.

6. History and perspectives
Behavior and Health
Bx, habits, and lifestyles can affect both health and disease.
Cognitive variable: self efficacy- people’s belief about their capabilities to exercise control over events that affect their lives.
Personality factors
Disease process
Unhealthy bx
Affect disease via physiological mechanisms
Underlying biological variable may relate to both personality and disease
Several causes and feedback loops may affect relationship between personality and disease.
example: Type A personality
Social Support and Health:
Social support- number and quality of social relationships. May depend on: race, gender, culture.
Gender differences in relationships

7. History and perspectives
Range of applications:
Smoking
Alcohol abuse
Obsesity
Arrhythmia
Alzheimer’s disease
Acquired Immune Deficiency (AIDS)
Cystic fibrosis
Anorexia nervosa
Asthma
diabetes

8. Methods of intervention
Extinction- emotional reaction is eliminated by creating a situation in which the conditioned stimuli are no longer associated with the environmental stimuli that generated the bx.
Used to eliminate children’s fears of the dentist
Systematic desensitization- techniques are designed to enable individuals to produce a state of lowered arousal through their own efforts.

9. Methods of intervention
Operant Methods:
Operant Conditioning- increase behaviors said to lead toward health or problems.
Contingency contracting- therapist and patient draw up a formal agreement or contract that specifies the behaviors that are expected as well as the consequences for certain behavior.
Cognitive Behavioral Methods:
Various techniques: rational restructuring, stress inoculation training.
Self monitoring record

10. Methods of intervention
Biofeedback
Some aspect of the patients physiological functioning is monitored by an apparatus that feeds the information back to the patient in auditory form:
Task = voluntarily reduce tone, signifying a reduction of muscular tension, and a corresponding reduction in the headache.

11. Prevention of health problems
Cigarette smoking
Differ according to gender, education, and income.
Risk of cardiovascular disease and cancer
Techniques to stop smoking:
Behavioral contracts, acupuncture, aversion therapy, educational programs, cognitive therapy, group support.

12. Prevention of health problems
Alcohol abuse and dependence-
57% men, 45% women = consume alcoholic beverages
Negative outcomes:
Liver or neurological damage, cardiovascular problems, physical aggression, suicide, motor vehicle accidents, and violence.
Treatment approaches:
TOTAL ABSTINENCE
Medical treatments
Medication
Group supportive strategies
Controlled drink- light to moderate drinking
Relapse prevention.

13. Prevention of health problems
Obesity
Behavioral treatments used aimed at:
restricting certain types of foods
Teaching when and under what conditions to eat
Encouraging regular exercise
Maintaining modified eating patterns after the program has ended.
Associated with medical disorders:
Hypertension, diabetes, cardiovascular disease
Traced to childhood
Genetic component

14. Other applications Coping with medial procedures
Procedural information vs. sensory information
Prepare the patient: relaxation techniques, basic information about the procedures to be used, information concerning the bodily sensations experienced during procedures, COGNITIVE COPING SKILLS
Compliance with regimens
Non compliance = 50%
Illness/disease characteristics
Cultural norm
Characteristics of patient
Practitioner-patient interaction

15. Health psychology: Prospects for the future
Health care trends
Health psychologists- well suited to provide intervention that will serve to cut the costs of medical care.
Surplus of mental health professionals
Incorporate concepts and issues of health and behavioral psychology
Training issues
Training- clinical psychology programs
Specialized research/practicum or two in a health-related topic
IN THE FUTURE: health psychologist must be trained so they can design and conduct studies to empirically evaluate health outcomes.

16. Health psychology: Prospects for the future
Other challenges:
Defining the roles of its members
Role ambiguity
Issues of status
Competing goals

17. The End
NO PAIN, NO GAIN!