Health Psychology and Behavioral Medicine

By: Melba Finley

OUTLINE:

• History and perspectives

• Methods of intervention

• Prevention of health problems

• Other applications

• Health psychology: Prospects for the future

History and perspectives

• Health Psychology- specialty area within psychology that applies:

– tools of the discipline to the prevention of illness– the enhancement and maintenance of health– the identification of the correlates of illness and health– the treatment of the individuals in health care system and

the formulation of health care policy.

• Behavioral medicine:– Integration of the behavioral sciences with the practice and

science of medicine.

History and perspectives

continued…

• History: – Psychosomatic medicine- assumption that certain

illnesses and disease state are caused by psychological factors.

– Biopsychosocial model- viewed as integration of the biomedical and psychosocial influences:

» Genetic predisposition,

» Nutritional deficiencies

» Biochemical imbalances

» Social influences: friends, family members, home environments, and life events.

History and perspectives

• Linking stress, lifestyle and behavior, personality, social support, and health: – Stress and health

» Definition: process that involves an environmental event, its appraisal by the individual, various responses of the organism, and reevaluation that occurs as a result of these responses and changes in the stressor.

» Physiological effects of stress on the body: complex chain of events.

» Severe Stress: adverse effects on body organs, mental functions, and the immune system.

History and perspectives

– Behavior and Health» Bx, habits, and lifestyles can affect both health and disease.» Cognitive variable: self efficacy- people’s belief about their

capabilities to exercise control over events that affect their lives.– Personality factors

» Disease process» Unhealthy bx» Affect disease via physiological mechanisms» Underlying biological variable may relate to both personality and

disease » Several causes and feedback loops may affect relationship

between personality and disease.example: Type A

personality– Social Support and Health:

• Social support- number and quality of social relationships. May depend on: race, gender, culture.

• Gender differences in relationships

History and perspectives

• Range of applications:– Smoking– Alcohol abuse– Obsesity– Arrhythmia– Alzheimer’s disease– Acquired Immune Deficiency (AIDS)– Cystic fibrosis– Anorexia nervosa– Asthma– diabetes

Methods of intervention

• Extinction- emotional reaction is eliminated by creating a situation in which the conditioned stimuli are no longer associated with the environmental stimuli that generated the bx.

– Used to eliminate children’s fears of the dentist

• Systematic desensitization- techniques are designed to enable individuals to produce a state of lowered arousal through their own efforts.

Methods of intervention

– Operant Methods:• Operant Conditioning- increase behaviors said

to lead toward health or problems.• Contingency contracting- therapist and patient

draw up a formal agreement or contract that specifies the behaviors that are expected as well as the consequences for certain behavior.

– Cognitive Behavioral Methods:• Various techniques: rational restructuring, stress

inoculation training.– Self monitoring record

Methods of intervention

– Biofeedback• Some aspect of the patients physiological

functioning is monitored by an apparatus that feeds the information back to the patient in auditory form:

• Task = voluntarily reduce tone, signifying a reduction of muscular tension, and a corresponding reduction in the headache.

Prevention of health problems

• Cigarette smoking– Differ according to gender, education, and

income.– Risk of cardiovascular disease and cancer– Techniques to stop smoking:

• Behavioral contracts, acupuncture, aversion therapy, educational programs, cognitive therapy, group support.

Prevention of health problems

• Alcohol abuse and dependence-– 57% men, 45% women = consume alcoholic

beverages– Negative outcomes:

• Liver or neurological damage, cardiovascular problems, physical aggression, suicide, motor vehicle accidents, and violence.

– Treatment approaches:• TOTAL ABSTINENCE• Medical treatments• Medication• Group supportive strategies• Controlled drink- light to moderate drinking• Relapse prevention.

Prevention of health problems

• Obesity– Behavioral treatments used aimed at:

• restricting certain types of foods• Teaching when and under what conditions to eat • Encouraging regular exercise• Maintaining modified eating patterns after the program has

ended.

– Associated with medical disorders: • Hypertension, diabetes, cardiovascular disease

– Traced to childhood– Genetic component

Other applications

• Coping with medial procedures– Procedural information vs. sensory information– Prepare the patient: relaxation techniques, basic

information about the procedures to be used, information concerning the bodily sensations experienced during procedures, COGNITIVE COPING SKILLS

• Compliance with regimens– Non compliance = 50%

1. Illness/disease characteristics2. Cultural norm3. Characteristics of patient4. Practitioner-patient interaction

Health psychology: Prospects for the future

• Health care trends• Health psychologists- well suited to provide intervention

that will serve to cut the costs of medical care.• Surplus of mental health professionals• Incorporate concepts and issues of health and behavioral

psychology

• Training issues • Training- clinical psychology programs• Specialized research/practicum or two in a health-related

topic• IN THE FUTURE: health psychologist must be trained

so they can design and conduct studies to empirically evaluate health outcomes.

Health psychology: Prospects for the future

• Other challenges:• Defining the roles of its members• Role ambiguity• Issues of status• Competing goals

The EndNO PAIN, NO GAIN!