Health, Illness, and Trends that Shaped
Health Psychology
September 9, 1999
Three Domains of Health




Health—a state of complete physical, mental, and social
well-being (World Health Organization)
Physical Health
Psychological Health
Social Health
Ancient Views of Health & Illness

Prehistoric age (10,000 BC)



Evil spirits cause illness
Trephination
Ancient Egypt (2,000 BC)


Illness as demon possession or punishment by gods
Treatment consisted of sorcery, exorcism, primitive forms of
surgery
Ancient Views of Health & Illness

Ancient Greece (500 BC)


Hippocrates—”father” of Western Medicine
Humoral theory
Health due to equilibrium among blood, yellow bile, black bile, phlegm
 Poor health due to imbalance
 Treatments consisted of use of diuretics, enemas, blood-letting, emetics

Ancient Views of Health & Illness

Claudius Galen



Dissection studies of animals and treating gladiator injuries led to
great advances in knowledge of anatomy
Expanded Hippocratic foundation of rational explanation and
careful description of symptoms
Elaborate pharmacology used for 1500 years
Ancient Views of Health & Illness

Ancient Rome (200 AD)

Early public health measures, including public bathrooms,
sewage systems, and water supply systems
The Plague





bubonic/pneumonic
bacteria->rats->fleas->people
famine, draught, fire, flood bring rats closer
septicemia-caused death w/in 5 days
10,000 deaths/day
The Middle Ages (476- 1450)





Fall of Roman Empire ushers in non-scientific era in which there
was little new learning
Traditions of Hippocrates and Galen fall into disfavor
Medieval Church dogma came to control medicine and treatment
Illness viewed as God’s punishment for evil doing
“treatment” involves torturing the sick to force evil spirits from their
bodies
th
th
The Renaissance (15 -16 centuries)

Rene Descartes


Andreas Vesalius


Mind-body (Cartesian)Dualism
dissection studies lead to seven-volume study of human anatomy.
Giovanni Morgagni

hundreds of human autopsies lead to replaced of ancient humoral theory
with the new anatomical theory of disease
Post-Renaissance Developments

Anton van Leeuwenhoek



First practical microscope (270 X). Unsurpassed until 19th
century.
First to observe blood cells, muscle fibers, etc.
Led to cellular theory of disease
Nineteenth Century Developments

Louis Pasteur




Isolates bacterium that causes silk worm disease
Proved that a microorganism caused rabies
Developed first effective rabies vaccine
Conducted critical experiments disproving spontaneous

generation
Helped shape germ theory of disease
Nineteenth Century Developments



By end of century, researchers had isolated the microbes
for malaria, pneumonia, diphtheria, leprosy, syphilis,
bubonic plague, and typhoid
1846 ether introduced as first general anesthetic allowing
painless surgeries
1896 x-rays allow observation of internal organs
Twentieth Century Western Medicine

The biomedical model




Disease is the result of a biological pathogen
Mind and body do not interact
Health is nothing more than freedom from disease
Led to great improvements in health care
Challenges to Biomedicine


Disorders that have no observable physical cause
Sigmund Freud (1856-1939)


Case histories of conversion disorders, include “glove
anesthesia,” loss of speech, deafness
Development of psychoanalysis and psychosomatic medicine
“Fatal Flaws” in Psychoanalysis and
Psychosomatic Medicine



Emphasis on unconscious, irrational processes in
personality fell into disfavor in American psychology
Limited generalizability of case study research
Reductionism is too simplistic
Health Psychology


Recognized as Division 38 of APA in 1978
Four Goals




To study psychological, behavioral, and social factors in disease
To promote health
To prevent and treat illness
To improve public health policy and health care
Trends that Shaped the New Field
Increased Life Expectancy
Rising Health Care Costs
Trends that Shaped the New Field




Increased Life Expectancy
A Shift in the Leading Causes of Death
Rising Health Care Costs
A shift away from the biomedical model
Health Psychology’s Perspectives

Biopsychosocial Perspective (BPS)



Biological mechanisms: genes, hormones, evolution, physical
environment
Psychological processes: motivation, attention, expectations,
beliefs and attitudes, personality traits, emotions
Social influences: socioeconomic status, socialization processes,
culture, ethnicity, peer pressure, social support, role models
Health Psychology’s Perspectives


The BPS Perspective
The Life-Course Perspective



Cohort effects
The Sociocultural perspective
The Gender perspective

Under representation of women in medical trials
Career Issues

3 roles




Teachers
Research scientists
Applied clinicians
Training

Multiple routes depending on role
Allied health professions
 Ph.D. or Psy.D. programs

Where Do Health Psychologists Work?