1. Module:. Health Psychology Lecture:. Revision Session Date:
Module: Health Psychology Lecture: Revision Session Date: 27 April 2009
Chris Bridle, PhD, CPsychol
Associate Professor (Reader)
Warwick Medical School
University of Warwick
Tel: +44(24)

2. Aims and Objectives
To provide an overview of the module and to provide you with a framework within which you can organise your revision for the module
… in 12 or so slides!

3. Psychological Processes
Background Factors
Stable Factors
Social Factors
Situational
Factors
Stuff
Psychological
Processes
Physiological Reactivity
Biological
Systems
Biological
& other
Hereditary

4. Dual Pathway Model
Two broad ways in which psychological processes may influence physical health
Psychological
Processes
Physical
Health
Direct Path
Indirect Path
Indirect Path
Behaviour

5. Nervous System: Physiological Reactivity Psychological Appraisal
Nerves
Hormones
Response
Nervous System: Physiological
Reactivity
Psychological
Appraisal
Chronic
Stress
GI: IBS, ulcers
Psych: cognitive decline, morbidity
Sensitivity - more severe
RS: impotence, amenorrhea
ReS: asthma, hyperventilation
Salient
Event
Cardiovascular System
Endocrine System
Immune System
Essential
Hypertension
Metabolic
dysfunction
Lowered
immunity
Hypervigilance - more events
Physical and Psychological
Health Status

6. Framework
Background factors: the context in which individuals live, e.g. S-E-S
Stable factors: relatively enduring and resistant to change, e.g. negative affect
Social factors: resources available through social relations, e.g. social support
Situational factors: give meaning to salient events and respond to demands, e.g. appraisal and coping
Distal
Proximal
We bring with us, to any situation, the cumulative influence of background, stable and social factors, which we combine in various ways to form an understanding of our current situation. In most cases, our understanding of the situation determines our behaviour within it.

7. All of these behaviours are driven by beliefs ...
Behaviour and Beliefs
Health behaviour:
Smoking; alcohol misuse; excessive revision; sedentary lifestyle; neglect of preventive behaviours, etc.
Illness behaviour:
Seeking medical help; adherence; denial; service (over)use; Dr shopping, etc.
All of these behaviours are driven by beliefs ...
... that form our understanding, guide interpretation and give meaning to the behaviour in a particular situation

8. Situation-Specific Beliefs
Health beliefs
Many models describing the relationship between antecedent beliefs and health behaviour
Common, evidence-based beliefs: personal relevance, self-efficacy, intention/motivation, outcome evaluation
Illness beliefs
At least 5 dimensions of belief: Identity; Cause; Time; Consequence; Control-Cure
Illness beliefs predict not only illness behaviour, but also prognosis independently of illness severity
Understanding, predicting and changing behaviour is dependent upon identifying the beliefs that promote and maintain the particular behaviour

9. Stable Individual Differences
Explanatory styles: Psychological processes involved in explaining the causes of negative events - past
Emotional dispositions: Psychological processes involved in both the experience and expression of emotion - present
Generalised expectancies: Psychological processes involved in formulating expectations in relation to future outcomes - future
Stable, individual differences reflect our tendency to interpret things in a particular way. They influence / predict beliefs, behaviour and health-related outcomes.

10. Poor communication negatively affects patient health
Consultation
People judge adequacy of care by the manner in which it is delivered and not by its technical quality
Patients highlight the doctors use of blocking behaviours as main problem, e.g. interrupting; depersonalisation; use of jargon
Poor communication has numerous adverse effects for patient health: poor adherence, cancellation of follow-up/referral, low future use
Poor communication negatively affects patient health

11. Revision Approach: Concept driven
Biopsychosocial: Psychological processes and physical health outcomes; mechanisms of action; effects
Theory: Illness representations; Stages of change (TTM); transaction model of stress and coping
Processes: Stress; Coping; Behaviour change; Motivation; Illness perception
Practice: Communication; Screening; Motivating patients to change; Supporting change; Stepped care / pathways

12. Things you should know: Screening
Common psychological conditions, e.g. depression, alcohol abuse and smoking
For each condition:
Relevant signs, symptoms, effects
Screening questions to ask
Differential diagnosis - what and how
Options and opportunities for treatment - psychological v's pharmacological; generalist v's specialist?

13. Other Things to Know
Psychological intervention: Broad aims of psychological intervention (ABC); types of psychotherapy available
Stages of change: Name, description, order, e.g. pre-contemplation = not thinking of changing
Relapse: Factors influencing relapse and methods to prevent it, e.g. developing proactive coping skills
Coping: Brief description of coping dimensions, the effect of coping (what it does) and the determinants of coping
Somatisation/Chronic illness: Characteristics; principles of assessment, treatment and management

14. What now? In your tutor (sub-)groups, now or later:
Screening: Select ONE condition and answer questions / provide information
Select ONE topic from the list of 'Other Things to Know' and answer questions / provide relevant information
Complete ONE integrated question examples from module webpage
Formulate ONE question re: any of the above
Any Questions?