Transcript Introduction to Health Psychology

The Biopsychosocial Model, Methodology,
and Systems of the Body 1
September 2, 2004
Overview
The Emergence of Health Psychology
The Biopsychosocial Model
Methodology
Systems of the Body
• Nervous System
• Endocrine System
• Cardiovascular System
• Respiratory System
The Emergence of Health Psychology
Foundations for Contemporary Health Psychology
In ancient times and the middle ages there was a belief that
spiritual disturbances caused disease.
The development of early Greek Medicine and the advent
of the Renaissance brought about a focus on physical
causes for disease.
Scientific advances in microscopy and human anatomy
further advanced medicine.
The Emergence of Health Psychology
Foundations for Contemporary Health Psychology
Psychoanalytic case studies revealed how anxiety and
unconscious personality conflicts can manifest as
physical symptoms.
The study of psychosomatic medicine focused on diseaseprone personality types.
The contemporary view focuses on the balance between
physical and mental well-being in the context of the
social environment.
U.S. Ten Leading Causes of Death
(NVSR, 50(16),2002)
Cause of Death
Deaths
Percent of Total Deaths
Diseases of the heart
710,760
29.6
Malignant Neoplasms
553,091
23.0
Cerebrovascular
Diseases
167,661
7.0
CLRD
122,009
5.1
Accidents (unintentional
injuries)
97,900
4.1
Diabetes
69,301
2.9
Influenza & Pneumonia
65,313
2.7
Alzheimer’s Disease
49,558
2.1
Kidney Disease
37,251
1.5
Septicemia
31,224
1.3
Total
2,403,351
100.0
The Emergence of Health Psychology
The Modern Problem
Patterns of illness are changing.
People are less likely to die from acute disorders and communicable disease
(with the exception of AIDS).
People are living longer with chronic diseases
Chronic diseases:
• Generally can be managed, not cured
• Related to health behaviors and compliance with medical regimen
• Living with chronic diseases has social and psychological consequences
The Emergence of Health Psychology
Technological Advances
Genetic counseling
• Coping with potential health risks
Patient counseling regarding life-sustaining measures
Research in health psychology identifies risk-factors
The Emergence of Health Psychology
Health Care Services
• Health care is the largest service industry in the
United States.
• Prevention can reduce health care costs.
• Most people in the U.S. are recipients of health care
services.
• Research on satisfaction with health care
• Health psychologists are becoming more integrated
into the medical context.
The Biopsychosocial Model
Health and illness are consequences of the interplay of
biological, psychological, and social factors.
Systems Theory
All levels of organization in any entity are linked
hierarchically.
Change at one level influences change in other levels
• Changes on the microlevel can have macrolevel
effects and vice versa.
The Biomedical Model
• Dominant model for the past 300 years
• All illness can be explained on the basis of aberrant somatic
processes.
Liabilities of the Biomedical Model
• Reductionism – Illness is reduced to microlevel processes i.e.
chemical imbalances.
• Single-factor model – Illness is due to one factor: a biological
malfunction.
• Mind-body dualism – The mind and the body are separate
entities.
• Emphasis on illness over health
Advantages of the Biopsychosocial Model
Health is determined by both microlevel and
macrolevel processes (psychological and social
factors).
Multiple factors – a variety of factors are involved in
health and illness.
The mind and body are not separated when
considering matters of health and illness.
Emphasis on both health and illness.
Clinical Applications of the Biopsychosocial
Model
The process of diagnosis must consider the
interaction of biological, psychological, and
social factors.
• Treatment recommendations must take these factors
into account.
The relationship between the patient and the
health care practitioner has an impact on the
effectiveness of care.
Areas of Focus In Health Psychology
Health Promotion and Maintenance
Prevention and Treatment of Illness
Etiology (causes) and Correlates of Health and
Illness
Health Policy and Health Care Service Delivery
Contributions of Health Psychology
Short-term behavioral interventions have been
effective in helping patients to:
•
•
•
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Manage pain
Modify bad health habits (such as smoking)
Manage side effects and treatment effects when coping with chronic
illness.
Psychologists help ease the adjustment process for
patients.
Methodology
Experiments
Randomized
Clinical Trials
Correlational
Studies
Comparing
changes in
variables
Looking
forward,
longitudinal
research
Looking
backward
Prospective
Designs
Retrospective
Research
Methodology
Experiment
A study where there is random assignment to treatment groups in an
intervention focused on exercise and weight loss
Correlation
A study of the relationship between cultural identity and physical
symptoms
Prospective
A study following the physical and mental health indicators outcomes of
cancer patients 6 months, 1 year, and 2 years after chemotherapy
Retrospective
A study examining the past coping strategies of cardiac patients
Methodology
Epidemiology
The study of the frequency, distribution, and
causes of infectious and noninfectious
disease in a population based on an
investigation of the physical and social
environment
Methodology
Morbidity refers to the number of cases of a
disease that exist at some given point in time.
• Incidence: the number of new cases
• Prevalence: the total number of existing cases
Mortality refers to the number of deaths due to
a particular cause.
The Nervous System
Central Nervous System
• Brain and Spinal Cord
•
The brain is the command center
Peripheral Nervous System
• Somatic Nervous System
• Autonomic Nervous System
•
Sympathetic Nervous System
• Prepares the body to respond to emergencies
• Plays an important role in reactions to stress
• Is concerned with the mobilization of energy. A catabolic system
•
Parasympathetic Nervous System
• Acts antagonistically with the sympathetic nervous system.
• Restores the body to a normal state.
The Nervous System
Neurotransmitters
Chemicals that regulate nervous system
functioning.
• Catecholamines - the neurotransmitters,
epinephrine and norepinephrine, that
promote sympathetic nervous system activity.
• The catecholamines are released in
substantial quantities during stressful times.
The Nervous System
Disorders of the Nervous System
• Affect 25 million Americans
• 12% of deaths are from nervous system disorders.
• Epilepsy
• Cerebral Palsy
• Parkinson's Disease
• Multiple Sclerosis
• Huntington’s disease
• Polio
• Paraplegia, quadriplegia
The Endocrine System
• Complements the nervous system in
controlling bodily activities.
• Make up of ductless glands which secrete
hormones into the blood.
• Governs slow-acting responses of long
duration
• Regulated by the hypothalamus and the
pituitary gland
The Endocrine System
Disorders
Diabetes
• Third most common chronic disorder in the U.S.
• Body cannot manufacture and properly use insulin.
• Primary forms of diabetes:
• Type I (juvenile diabetes) – insulin dependent, partly genetic
• Type II – lifestyle, especially obesity and stress, plays a major role,
onset after age 40.
The Endocrine System
• Diabetes is associated with:
• Thickening of the arteries, leading to high rates of coronary heart
disease.
• Blindness, and is the leading cause of blindness in adults.
• Kidney failure
• Nervous system damage leading to pain and loss of sensation.
The Cardiovascular System
• System consists of the heart, blood vessels
and blood.
• Arteries carry blood from the heart to other
organs and tissues.
• Veins return the blood to the heart after the
oxygen has been used up.
The Cardiovascular System
The Heart
• Cardiac Cycle - Rhythmic phases of contraction and
relaxation.
• Systole Cycle - Blood is pumped out of the heart
and so blood pressure inside the vessels increases.
• Diastole Cycle - Blood pressure drops as the heart
muscle relaxes and blood is taken into the heart.
The Cardiovascular System
Disorders
• Congenital Defects (present at birth)
• Disorders Due to Infections
• Lifestyle
•
•
•
•
Diet
Exercise
Smoking
Stress Exposure
The Cardiovascular System
Disorders
• Atherosclerosis – deposits of plaque in the
arteries
• Angina Pectoris (chest pain)
• Myocardial infarction (heart attack)
• Hypertension – chronically high blood
pressure
The Cardiovascular System
• Disorders Related to White Cell Production
• Leukemia, leukopenia, leukocytosis
• Disorders Related to Red Cell Production
• Anemia, erythrocytosis, sickle-cell anemia
• Clotting Disorders
• Hemophilia, Clots (Thromboses) in blood vessels
• Coronary thromboses, cerebral thromboses
• Embolus (A clot that becomes detached)
The Respiratory System
Functions of Respiration
1. To take in oxygen
2. To excrete carbon dioxide
3. To regulate the composition of the blood
Organs Involved
• Nose, mouth, pharynx, trachea, diaphragm,
abdominal muscles, and lungs.
• Inspiration is active; expiration is passive.
The Respiratory System
Disorders
• Asphyxia –lack of O2, excess of CO2
• Anoxia – lack of O2
• Hyperventilation – excess of O2 , lack of excess of CO2
• Hay Fever – seasonal allergic reaction in which irritants
enter the lungs prompting the body to produce
histamines.
• Asthma – more severe allergic reaction that may
produce bronchial spasms and hyperventilation.
The Respiratory System
Disorders
• Viral Infections – Common cold, influenza
• Bacterial Infections – Strep throat, whooping cough,
diphtheria.
• Pneumonia and Emphysema
• Tuberculosis and Pleurisy
• Lung Cancer