Health Psychology
Mind-Body Relationship
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From earliest times – mind and body
generally thought of as one unit
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Disease understood as resulting from
some type of divine (supernatural) cause possession, punishment from god(s), etc.
Mind-Body Relationship
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Greeks and Arabs were among the first to
suggest natural causes of illness
Ex – Hippocrates’ Humoral theory
Galen – the first to attribute disease to a specific
pathogen
This emphasis on natural causation was lost
with the fall of the Roman Empire and the
subsequent rise in power of the Church.
Mind-Body Relationship
In the Middle Ages the Church was the
guardian of medical knowledge – the
functions of the priest and physician
merged.
 This began to change during the
Renaissance, however, especially due to
the influence of René Descartes
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Cartesian Dualism
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Descartes proposed that mind and body be
considered as two separate entities
Body – works mechanistically – thus, can be
understood scientifically
Mind – also, the soul – to be studied by priests
This “split” laid the foundation for study and
experimentation that led to modern medicine
Mind-Body Relationship
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For the next 200 years, physicians looked
exclusively at organic and cellular changes and
pathology to understand and treat illness, until
physical evidence became the only basis for
diagnosis and treatment of disease
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Example – Krafft-Ebbing and General Paresis
Mind-Body Relationship
This view became less tenable, however,
with the contributions of Sigmund Freud –
hysterical patients had obvious, profound
physical symptoms, with no apparent
organic cause
 Psychosomatic Medicine in the 1920’s
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 Led
to an emphasis on the autonomic
nervous system
Biomedical Model
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Still the dominant model in medicine
Maintains that all illness can be explained on the
basis of problems with bodily processes
(biochemical imbalances, neurophysiological
abnormalities, etc.)
Is reductionistic
Implicitly incorporates the assumption of
mind/body dualism
Emphasizes illness over health
Biopsychosocial Model
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Assumes biological, psychological and social
factors are all important determinants of both
illness and health
Health and illness both caused by multiple
factors and produce multiple effects
Mind and body cannot be distinguished in
matters of health and illness
Emphasizes both health and illness – health is
to be achieved, not taken for granted
Health Psychology
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Health psychology is a subfield that is
concerned with the social and
psychological factors that Influence health
and illness.
Why Health Psychology?
1.
Changing Nature of Illness – traditional
medicine has been very successful
treating acute illnesses – tuberculosis,
pneumonia, influenza, etc. –
* are short term
* have identifiable causes
* can be treated
Why Health Psychology?
However, most of the major health
problems today are chronic, not acute
 Cancer, heart disease, AIDS, accidents
* cannot be cured, only managed
* causes?
* people must live with these diseases for
years, leading to a number of issues of
coping
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Why Health Psychology?
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Rapidly expanding cost of health care
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Increased medical acceptance
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Methodological and statistical
contributions to research
Research Methods in Health
Psychology
Case Studies
 Correlational Studies
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 May
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be univariate or multivariate
Note: example of MacDougall, Dembroski,
Drusdale and Hackett (1985)
Controlled Experimental Studies
 To
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assess causality
Problem – limited generalizability
Training for Health Psychology
Careers
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Health psychologists typically hold a doctoral
degree (Ph.D. or Psy.D.) in psychology. Applied
health psychologists are licensed for the
independent practice of psychology in areas
such as clinical and counseling psychology, and
board certification is available in health
psychology through the American Board of
Professional Psychology.
Training for Health Psychology
Careers
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Undergraduate: Health psychology courses are
available at about a third of North American
colleges and universities. Because of the field's
biopsychosocial orientation, students are also
encouraged to take courses focusing on
abnormal and social psychology, learning
processes and behavior therapies,
psychophysiology, anatomy and physiology,
psychopharmacology, community psychology,
and public health.
Training for Health Psychology
Careers
 Graduate: Many doctoral programs in clinical,
counseling, social, or experimental psychology
have specialized tracks or preceptorships in
health psychology. A number of programs now
exist in the United States and other countries
specifically for doctoral training in health
psychology. These programs are quite diverse:
some specialize in training students either for
research careers or for direct clinical service to
patients. Division 38 has a directory of doctoral
programs offering training in health psychology,
available from the Office of Division Services of
the American Psychological Association.
Training for Health Psychology
Careers
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Predoctoral Internships: Clinical and counseling
psychologists are required to complete a oneyear internship/residency before obtaining their
doctorates. Many of these programs offer some
training in health psychology. A number of
internship programs provide specialized training
in health psychology in which at least half of the
trainee's time is spent in supervised health
psychology activities. Division 38 distributes a
directory of health psychology internships, which
is linked to its web site, including programs
offering major rotations (at least half time health
psychology) and minor rotations (less than half
time) in health psychology.
Training for Health Psychology
Careers
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Postdoctoral Fellowships: Many university
medical centers, universities, health
centers, and health psychology programs
offer specialized research and/or clinical
training in different areas of health
psychology. Division 38 has a directory of
postdoctoral opportunities in health
psychology, linked to its web site.
The Work Setting of a Health
Psychologist
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Health psychologists participate in health care in
a multitude of settings including primary care
programs, inpatient medical units, and
specialized health care programs such as pain
management, rehabilitation, women's health,
oncology, smoking cessation, headache
management, and various other programs. They
also work in colleges and universities,
corporations, and for governmental agencies.
Clinical Activities
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Assessment approaches often include cognitive and behavioral
assessment, psychophysiological assessment, clinical
interviews, demographic surveys, objective and projective
personality assessment, and various other clinical and
research-oriented protocols. Interventions often include stress
management, relaxation therapies, biofeedback,
psychoeducation about normal and patho-physiological
processes, ways to cope with disease, and cognitive-behavioral
and other psychotherapeutic interventions. Healthy people are
taught preventive health behaviors. Both individual and group
interventions are utilized. Frequently, health psychology
interventions focus upon buffering the effect of stress on health
by promoting enhanced coping or improved social support
utilization.
Research
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Health psychologists are on the leading edge of research
focusing on the biopsychosocial model in areas such as HIV,
oncology, psychosomatic illness, compliance with medical
regimens, health promotion, and the effect of psychological,
social, and cultural factors on numerous specific disease
processes (e.g., diabetes, cancer, hypertension and coronary
artery disease, chronic pain, and sleep disorders). Research in
health psychology examines: the causes and development of
illness, methods to help individuals develop healthy lifestyles to
promote good health and prevent illness, the treatment people
get for their medical problems, the effectiveness with which
people cope with and reduce stress and pain, biopsychosocial
connections with immune functioning, and factors in the
recovery, rehabilitation, and psychosocial adjustment of
patients with serious health problems.
Career Opportunities
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The opportunities for careers in health psychology in the United
States are quite good. Medical settings, particularly medical
centers, have greatly expanded their employment of
psychologists. Aside from medical centers, health psychologists
often work in colleges and universities, medical schools, health
maintenance organizations, rehabilitation centers, pain
management centers, public health agencies, hospitals, and
private consultation/practice offices. In addition to the specific
content skills which psychologists offer to patients and staff in
the medical community, psychologists' unique training often
makes the health psychologist an asset to the medical team
with regard to quality assurance methods (making certain that
health care is helpful and cost-effective), research, writing,
grant-writing, statistical, communication, and team development
skills.