Ψ
UNIVERSITY OF MEDICINE AND PHARMACY
“CAROL DAVILA” – BUCHAREST
FACULTY OF MEDICINE
DEPARTMENT OF MEDICAL PSYCHOLOGY
MEDICAL PSYCHOLOGY
Course instructor:
Ovidiu Popa – Velea
MD, PhD, MA Psychology, Fulbright Alumnus
ovidiu.popa-velea@umf.ro
SYLLABUS
Purpose: To acquaint students with methods and issues relevant to the application of psychology
to health-related intervention, the way people are affected psychologically by illness and disease,
various behaviors and cognitions affecting health and illness.
Format: The course is designed as an introductory undergraduate course, and is structured as a
series of lectures and practical applications. Students are expected to have a minimal background
in medicine and psychology, which would facilitate the assimilation of key Health Psychology
concepts. The professor will prepare presentations and demonstrations, distribute background
reading material, and lead group discussions. Learning will be an interactive process, so all
students are encouraged to ask and to comment on any possible issues of interest concerning the
course.
Objectives: To enable students to:
1. Understand the disease in its triple dimension, biological, psychological and social, and
become familiar with the modern approach of some frequent psychosomatic diseases (e.g.
cardiovascular, pulmonary, allergic).
2. Understand the role of clinical and health psychologists in daily clinical practice;
3. Be able to identify the contribution of psychosocial factors in pathology and the possibility to
address them, via psychotherapy or counseling.
4. Become familiar with the concept and theories of stress, to instruments designed to evaluate
stress and to modalities of intervention, centered upon behavioral and coping style changes.
5. Be able to identify various psychological disorders and key personality traits related to health /
disease.
6. Learn about doctor-patient communication and its importance in improving adherence to
recommended health behaviors.
7. Learn about various difficult and / or critical patients and some psychological strategies of
approaching them.
8. Become familiar with ethical issues in health psychology.
9. Encourage own student learning about health psychology issues, and their application in
clinical settings.
Requirements: Students are expected to attend regularly the course and to participate actively in
group discussions. They will also have to attend Health Psychology seminars, their participation
being monitored by the teaching assistants. A number of two or more missed seminars will
prevent the respective student from being admitted at the exam.
References will be assigned by the instructor and need to be read before each class.
Evaluation: Grades will be based mainly on student’s performances at the final written exam.
Regular course and seminar attendance and a good grade obtained at the final seminar evaluation
will be considered a plus.
PROGRAM OF COURSES
Lecture 1
Medical psychology: an interference domain between medicine and psychosocial sciences
1. Health psychology and clinical psychology: commonalities and differences. Roles of health
and clinical psychologists: attitudes regarding diverse behavioral disturbances.
2. Orientation of the clinician in confronting patient behavioral disturbances (an algorithm of
differential diagnosis between neurosis, psychoses and personality disorders). Subsequent actions.
3. (seminar) Particularities and challenges of behavioral disturbances for the doctor-patient
relationship. Influences on adherence.
4. (+ seminar) Main research methods in health psychology: observation, experiments,
interviews, psychological tests.
5. (+ seminar) Specific of questionnaires and projective tests. Advantages and disadvantages.
6. (seminar) Examples of working with a questionnaire or performing an interview.
Lecture 2
Stress and illness
1. Stress: definition, various types of stressors.
2. Theoretical models of stress (traditional vs.modern).
3. (+ seminar) Stressful events: types, particularities compared to other stressors.
4. (+ seminar) The life events scale of Holmes and Rahe: an attempt to quantify the relative
weight of various stressors.
5. The relativity of perception and appraisal of stressful events.
6. (+ seminar) Personality traits related to different kinds of stress appraisal (A, C, D).
7. Cognitive traits which are protective or risky for the appraisal of stressful events.
8. (+ seminar) Hormonal correlates of stress. The difference between eustress and distress.
The positive role of endorphins.
9. Allostatic load.
10. The helplessness-hopelessness syndrome (Seligman).
11. (+ seminar) Coping strategies.
12. (seminar) Anti-stress strategies and programs.
Lecture 3
Disease (1). The multi-faceted approach of Medical Psychology
1. Conceptualization of disease: the triple factorial model (disease, illness, sickness).
2. Social and cultural aspects of the disease. The role of social support.
3. (+ seminar) Psychosomatic diseases and psychosomatic disorders: commonalities and
differences.
4. (seminar) Various models explaining the pathogenesis of psychosomatic diseases
(Alexander, Cannon, Pavlov; modern approaches).
5. (seminar) Various chronic conditions and the contribution of psychological factors in
ulcer, asthma, cardiovascular diseases, tuberculosis. The emergence of new
interdisciplinary fields (psychoneuroimmunology, psychoneuroallergology, psychooncology).
Lecture 4
Doctor-patient relationship (1)
1. Patient role and status (Parsons). Dynamics of assuming the patient role.
2. (seminar) Cognitive representations of illness (HBM, TRA, TPB, Leventhal).The clinical
utility of these models in the relationship with problematic / difficult patients.
3. (+ seminar) Typical patients’ reactions to illness: regression, evasion, informational
contagion, (non)productive usage of illness. Clinical application: adjustment to incurable illness.
4. (seminar) Particularities of chronic patients.
5. (+ seminar) Individual variables that influence the risk of getting ill and the behavior vs.
the disease.
6.
(+ seminar) Buffer factors that increase the efficiency of defense mechanisms within
illness.
Lecture 5
Doctor-patient relationship (2)
1. (+ seminar) Communication: verbal and non-verbal elements. The importance of the
concordance between verbal and non-verbal behavior.
2. (+ seminar) The specific of the communication between doctor and the patient: the
interaction to doctor’s presumed roles, various kinds of anamnesis and their utility.
3. (seminar) Difficult patients. Identification of problematic behavior within the interview
and/or psychological testing. Application: MMPI test.
4. (+ seminar) Description of main personality disorders and their attitude towards doctors
and medical institutions.
5. (+ seminar) Communication with difficult patients.
6. (+ seminar) Burnout syndrome at doctors.
Lecture 6
Psychological correlates of pain
1. General aspects of pain (types of pain, causes of pain).
2. (+ seminar) The role of psychological factors in producing and enhancing pain (e.g.,
depression, anxiety).
3. (+ seminar) Incurable / chronic illness and pain.
4. (+ seminar) Psychological interventions for pain suppression (hypnosis, relaxation,
guided imagery). Application in a clinical case.
Lecture 7
Important additional constructs of Medical Psychology: therapeutic compliance, placebo
effect, drug dependence, quality of life.
1. (+ seminar) Therapeutic adherence: psychological factors that influence patient’s
adherence to treatment.
2. (seminar) Example of low adherence in some chronic conditions (tuberculosis, asthma,
arterial hypertension).
3. (+ seminar) Placebo effect: ways of using Placebo effect in therapy, varieties of Placebo
effect, factors that influence the occurrence of Placebo effect.
4. (seminar) Psychological drug dependence: examples, reasons and consequences.
5. (+ seminar) Quality of life and its relation to drug profile: the balance between gains and
losses.
Lecture 8
Psychotherapy (1). (second part = Behavioral Sciences class, 2nd year of study)
1. (+ seminar) Definitions, classification, indications of psychotherapy.
2. (seminar) Modeling of one’s behavior: from theoretical principles to counseling and
psychotherapy.
3. (+ seminar) Psychoanalysis (definition, theoretical background, indications, efficiency).
4. (+ seminar) Cognitive – behavioral therapy (definition, theoretical background,
indications, efficiency).
5. (+ seminar) Relaxation techniques and hypnosis (definition, theoretical background,
indications, efficiency).
6. (+ seminar) Rogersian therapy (definition, theoretical background, indications,
efficiency).
REFERENCES
A. mandatory for exam preparation
Popa-Velea, O. (2015). "Behavioral Sciences in Medicine" (2nd Edition), Ed.Universitara Carol Davila –
Bucharest
Pages – (volume 1) 11-35, 43-56, 145-154, 160-167, 170-184, 189-202, 206-213, 236-247;
(volume 2) 422-471, 474-485, 487-499, 533-542, 544-562
OR
Popa-Velea, O. (2013). "Behavioral Sciences in Medicine", Ed.Universitara Carol Davila - Bucharest
(pages 15-39, 47-60, 141-149, 156-163, 166-180, 185-198, 201-208, 231-242, 411-460, 463-474, 476-489,
524-533, 535-554).
B. additional references (not mandatory for exam preparation)
2. Marks, D., Murray, M., Evans, B., Willig, C., Woodall, C., Sykes, C. (2005). "Health Psychology:
Theory, research and practice" (2nd Ed.), SAGE Publications Ltd., London Thousand Oaks, New Delhi:
chapters 4 ("Culture and health") (pages 69-89), 12 ("Illness and personality") (pages 235-252).
3. Noble, L. "Doctor-patient communication and adherence to treatment" (chapter 3), in Myers, L.,
Midence, K. (Eds.) (1998). "Adherence to treatment in medical conditions", Harwood Academic
Publishers, London (pages 51-73).
4. Ogden, J. (2005). "Health Psychology - a textbook" (3rd Ed.), McGraw-Hill Education, New York,
London; chapters 10 ("Stress") (pages 233-250), 11 ("Stress and illness") (pages 251-283), 12 ("Pain")
(pages 285-305), 13 ("Placebos and the interrelationship between belief, behavior and health") (pages 309326).
5. American Psychological Association (2013). "Diagnostic and Statistic Manual of Psychiatric Disorders Terms Revised" (DSM-V) (5th Ed.): description of the most common personality disorders: paranoid
(pages 649-652), schizoid (pages 652-655), histrionic (pages 667-669), obsessive-compulsive (pages 678682).