Health Psychology The Science and the Field

1
Health PsychologyThe Science and the Field

• Notes from Taylor, S.E. (1990),
• The American Psychologist, 45(1), 40-50

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Defining Health Psychology

• Educational, scientific and professional
  contributions of the discipline of psychology to
  the promotion and maintenance of health, illness,
  and related dysfunction, and the improvement of
  health care system and health policy formation
  (Matarazzo, 1980)

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contributions

• Understanding healthy behaviors
• Understanding multiple factors that undermine
  health and can lead to illness
• Development of conceptual frameworks that
  elucidate
• the (non) practice of health behaviors ,
• the role of stress,
• how people think about health and illness
• How people cope
• What determines how people adjust

4
contributions

• Medicine traditionally lacks these
  conceptualizations
• Theory helps make sense out of isolated and
  confusing data (i.e., noncompliance)
• Theory suggests new directions for research

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Health Promotion and Health Habit Formation

• Increase in preventable disorders
• Smoking 25 of all cancer deaths and 350,000
  premature deaths from heart attack
• 10 weight reduction in men (35-55) with diet and
  exercise would cut coronary artery disease by 20
• 400 billion annually on health and illness

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Health Promotion and Health Habit Formation

• Research on mass media appeals
• Sometimes change attitudes but not behaviors
• Focused , tailored interventions aim at
  particular groups seem to be most effective

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Psychological States and Illness

• In 1930s-40s Franz Alexanders work on specific
  personality profiles for different illnesses.
  Primitive methodology.
• Recent general negative affective style
  (depression, anxiety and hostility) may be
  associated with development of many conditions
• Repression as coping style?

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Psychological States and Illness

• General disease-prone personality??
• May be circular causality
• Type A personality and hostility
• Personality type and onset and progression of
  cancer?
• Difficult to study due in part to longitudinal
  nature of cancer

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Psychological States and Illness

• Compromised immune system functioning
• Bereavement, depression and stressful events with
  perceived lack of control
• Psychosocial factors in the development of AIDS

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Psychological States and Illness

• Can positive emotional states be protective?
• In some cases optimists recover faster
• Importance of self-efficacy
• Are these predisposing characteristics or do they
  develop in relation to stress?

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Cognitive factors in health and illness

• Conceptions of illness, what it is and what one
  can do about it
• Coping with chronic disease and disability
• Those who have a sense of control over day to day
  symptoms tend to do better

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Stress and illness

• Lazarus psychological appraisal key factor in
  stress response
• Events judged positive, negative or neutral
• If negative
• Harmful, threatening , challenging
• Early stress research amount of stress
• (Holmes and Rahe Scale)
• Later, daily hassles
• Events labeled negative, uncontrollable,
  ambiguous are experienced as the most stressful

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Psychological States and Illness

• How stressful events erode good health habits
• Selye General Adaptation Syndrome
• There may be some physiological specificity in
  reactions to stress

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Coping

• Managing internal and external demands that are
  perceived as taxing or exceeding resources.
• Great need for commonality in research language
• Ways of Coping Scale and other instruments

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Coping Strategies

• Problem solving
• Regulation of emotions
• Problem solving particularly useful in
  controllable situations
• Regulation of emotions particularly useful in
  uncontrollable situations
• Usually use both in good coping
• Active and avoidant coping
• Matching coping strategies to events

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Social Support

• Impact of social support on coping
• Psychological and physical benefits of social
  support
• Direct effects positive effects whether or not
  person is stressed
• Buffering effects under stressful conditions.

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Interventions to improve coping

• Psychological control has been the conceptual
  focus
• People who believe they can exert some control
  tend to do better
• Coping benefits of understanding beforehand what
  happens in medical procedures

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Relaxation and Guided Imagery

• Regulation of emotional and physiological states
  without expensive equipment
• Modifying health habits (smoking and eating)
• Pain management
• Coping with chronic disease and treatment

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Other areas of focus

• Substance abuse
• Non-adherence to treatment
• Ethnic, sociocultural, racial and gender patterns
  in health and illness

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Trends

• Increasing diversity, complexity and acceptance
  of discipline of health psychology
• Cost containment
• Better health behaviors
• Inexpensive ways to provide services
• Cirrhosis, lung cancer and automobile deaths
  still increasing early intervention??
• Problems related to aging