Health Psychology

1. Health Psychology • Psychologists who strive to understand how biological, behavioral, and social factors influence health and illness are called health psychologists. • The term "health psychology" is often interchanged with the terms "behavioral medicine" or "medical psychology".

2. Illnesses related to Psychological/Behavioral factors: • Heart disease and stroke • Cancer • HIV/AIDS • COPD • Type II diabetes • Poor birth outcomes • Chronic pain conditions • Infectious illnesses

3. Actual causes of death in the US *: • Smoking / tobacco • Sedentary lifestyle and poor diet • Alcohol • Microbial agents • Toxic agents • Motor vehicle accidents • Firearms • Sexual behavior • Drug abuse Half of all deaths that occurred in the United States in 2000 can be attributed to a limited number of largely preventable behaviors and exposures (Mokdad et al., 2000). This is where Health Psychologists are particularly effective. *Mokdad et al. Actual causes of death in the US 2000. JAMA 2004:291:1238-46

4. Health over Time • 3000 years ago: • Spirits, Mind, and body seen as one • Greeks onward (e.g., Descartes): • Mind and body separate • Age of Scientific Discovery (17-19th century): • Rise of the biomedical model of disease • Inventions drive health care (e.g., 1668 Microscope) • Beginnings of Health Psychology as we know it • 1930s Society for Psychosomatic Medicine formed • 1970s Society for Behavioral Medicine formed • 1970s Health Psychology formed • Mind and body are seen as one again

5. Historical moments in health psychology • Walter Cannon (1932) - stomach movements affected by emotional state. Stress increases blood sugar, epinephrine, BP, respiration rate (“Fight or flight”) • Framingham study (1948 - ) - lifestyle factors are significant risk factors for cardiovascular disease • Hans Selye (1956) – physiological arousal from stress leads to disease if prolonged or chronic • Lazarus (1960’s+) – appraisals of events are critical for understanding health outcomes • Neal Miller (1970’s) – can learn to control bodily functions like BP, intestinal contractions, muscle tension • Robert Ader (1970’s) – classical conditioning of immune system responses to immune-suppressant drugs

6. Health Psychology’s Main Goals Understanding psychological influences:- - on how we stay healthy, - why we become sick, and - how we respond when we do.

7. GOALS of Field 1. Promote and maintain health (e.g., stop smoking, buckle belts). 2. Prevent and treat illness (e.g. reduce High Blood pressure). 3. Focus on cause and detection of illness: influence of personality, cognitive processes. 4. Improve the health care system/health policy.

8. The Main Approach Used • The Biopsychosocial Model • views health and illness as the product of a combination of factors including • Biological factors (e.g., genetic predisposition), • Psychological factors (e.g., personality, lifestyle, stress, health beliefs), and • Social factors (e.g., cultural influences, family relationships, social support).

9. Biopsychosocial Approach to Health and Illness • Traditional biomedical model has limited usefulness with current patterns of illness and the health challenges of the 21st century. •  Integrates biological, psychological, and social influences in order to understand health and vulnerability to illness and successfully treat disorders. • Addresses limitations of a traditional medical model that attempts to cure disease. We are not healthy until we become sick. Mental problems are not clearly distinguishable from physical problems.

10. Current Issues • Interactions between health psychologists and medical doctors. • Cultural differences in health. • Technology and health. • Reducing Obesity.

11. Where Do Health Psychologists Work? • 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, and • headache management • They also work in colleges and universities, corporations, and for governmental agencies.

12. Clinical Activities • Health Psychologists: • Help measure/assess for mental and behavioral problems, • Conduct clinical interviews • Administer surveys and personality tests. • Design interventions to help: • With stress management, • Educate about disease and illness, • Ways to cope with disease, • Perform more health behaviors such as physical activity.

13. Health psychology research 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. • The effect of psychological, social, and cultural factors on numerous specific diseases

14. Sample Research Findings in Health Psychology • One of the strongest predictors of who is likely to have a heart attack among American adults is a hostile personality trait and a tendency towards hostile interactions with others. • After surgery, patients in a hospital room with a pleasant view go home sooner and with fewer complications that those looking at a blank wall. • Premature infants in the hospital given 15 minutes of light massage per day gain weight faster and go home sooner • Keeping a diary where one writes about important thoughts and events boosts the body’s immune system and improves physical health. • Hostile and conflictual interactions with one’s spouse or partner can suppress the immune system and increase the risk of developing colds. • Laughter is a powerful painkiller.

15. Sample Research Findings in Health Psychology (cont.) • Some people with asthma can suffer full-blown attacks after looking at artificial flowers. • People with few friends and who lead isolated lives are twice as likely to die during a given time period. • After a heart attack, patients who owned pets were significantly less likely to die in the following year. • Blood pressure decreases when pet owners talk to their pets or are in the presence of their pets during stressful events. • Men who performed volunteer work once a week lived longer and were healthier than men who volunteered less than once a week. • Depression is a stronger predictor of heart attacks and poor recovery from a heart attack than high cholesterol or cigarette smoking. • When people watch tropical fish in an aquarium with their full attention, they lower their blood pressure and heart rate significantly. • People taught relaxation and meditation techniques showed lower blood pressure and less complications during surgery.

16. Training for Health Psychology Careers: • 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 • Board certification is available in health psychology through the American Board of Professional Psychology.

17. Preparing for a career in health psychology • Obtain general psychology training at the undergraduate and doctoral levels, • Receive specialty training at the postdoctoral or internship level. • Predoctoral Internships: Clinical and counseling psychologists are required to complete a one-year internship/residency before obtaining their doctorates. • 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.

18. Resources • APA Division 38 (Health Psychology) Webpage: www.health-psych.org/ • Major Journal in Field • Health Psychology: www.apa.org/journals/hea/ • Careers Page: • www.sbm.org/careers/