Health Psychology
What Do Health
Psychologists Do?
Teachers, research scientists, clinicians
Applied health psychologists: licensed
practitioners who focus on health-promoting
interventions and helping people cope with
illnesses
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
Where Do Health
Psychologists Work?
Training to become a
Health Psychologist
General psychology training at the
undergraduate level
Special training at the doctoral (Ph.D.) level
Four- to six-year program
65 Ph.D. programs in health psychology in the
United States
Issues
Issues and historical trends that have
shaped the development of Health
Psychology
I. Increased Life
Expectancy
Average life expectancy —
Increased by more than 30 years since 1900
In the U.S. in 21st century
• Women: around 80
• Men: around 75
• Why is this increase important?
II. Changes over the last 100
years
The 10 Leading Causes of
Death in The U.S. in
1900
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Pneumonia
Tuberculosis
Diarrhea and enteritis
Heart disease
Stroke
Liver disease
Injuries
Cancer
Senility
Diphtheria
Source: Centers for Disease Control and Prevention
Leading causes of death
(today)
1.
2.
3.
4.
Heart disease
Cancer
Stroke
Lung disease
(COPD)
5. Accidents
6. Diabetes
These top six account for
80% of deaths
They are mostly lifestyle
diseases with preventable
causes
They are mostly chronic
disorders (rather than acute
disorders)
Source: U.S. National Center for Health Statistics
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
III.
Rising Health Care Costs
IV.
Trends in how illness has been viewed
Western view (traditional)
Biomedical model — illness is caused by
physical phenomena (e.g., germs, cell
abnormalities) -- reductionistic
Biopsychosocial
Perspective
The view that health is determined by the
interaction of biological mechanisms,
psychological processes, and social influences
Biological mechanisms: genes, evolutionary history,
anatomical/biological makeup, nutrition
Psychological processes: coping mechanisms, attitudes
toward treatment, personality/outlook on life
Social context: SES, social network, societal and cultural
norms (e.g., pervasive consumption of soda)
A Biopsychosocial Model
of Depression
The Biopsychosocial Model
in practice
 Somatic presentations of psychological
dysfunction
Chest pain in panic attack
Hypochondriasis
 Psychological conditions secondary to
illness
Post M.I. Depression
Psychological sequelae of stroke
Stress disorders associated with traumatic injuries
The Biopsychosocial Model
in practice
Physical symptoms responsive to
behavioral interventions
anticipatory nausea
enuresis
tension & migraine headache
early labor (clip from “The New Medicine”)
The Biopsychosocial Model
in practice
 Psychological presentations of organic
problems
hypothyroidism presenting as depression
steroid-induced psychosis
 Somatic complications associated with
behavioral factors
mismanagement of diabetes
noncompliance to medications
The Biopsychosocial Model
in practice
 Behavioral risk factors for disease or
disability
smoking
excessive weight
risk taking
sedentary lifestyle
 Problems of health care providers and
health care systems
Physician-patient relationships
Lack of access to health care
The Biopsychosocial Model
in practice (case studies)
Small group exercise – using the BPS
(then discuss assessment targets using
the BPS – next slide)
Biological Review
current status of illness / background of
illness (usually found in the medical
history chart)
medications
pain
family history
lifestyle habits (e.g., nutrition and
exercise)
Psychological Review
Affective/emotional
Cognitive (e.g., thinking, beliefs, memory,
attention, learning, interpreting, problemsolving)
Motivation
Social Review
Patient’s interaction with health care staff
Family / friends support
Socioeconomic status (SES)
Environment to which patient will return
(job?)
Cultural factors