Medical Psychology

1
Medical Psychology

• Introduction
• Medical Psychology
• and Border Areas

2
Themes of Medical Psychology

• ? Psychological factors influencing the
  development or progression of disease
• Etiology
• ? Patients response to illness and disease
• Outcomes
• ? Communication with patients and colleagues
• - Relational issues

3
Medical Psychologyand border areas
PRIMARY PREVENTION Health education
TREATMENT General practice Hospital
care Rehabilitation
Medical doctors and other health professionals
Individual behavior diet, exercise,
etc. supperted by health professionals
Health Psychology
Clinical Psychology and Psychiatry
Clinical psychologists and psychiatrists
Health psychologists
4
Historical views of diseases

• ? Anatomical pathology
• Belief that disease was localized in anatomy
  (16th to 18th Centuries)
• ? Cellular pathology
• Belief that cells must be the place to look for
  disease (19th century)
• ? Germ theory
• Discovery that particles that could not seen
  (e.g., bacteria) could cause disease.

5
Contemporary view

• Biopsychosocial model
• (George Engel, 1977)
• Mind, body, and environment
• interact
• in causing disease.

6
The biopsychosocial model of disease

• Biology
• Genetics
• Anatomy
• Physiology

• Pathogens
• Germs
• Toxins

• Social factors
• Family
• Society
• Friends, etc.

7
Psychological components of the biopsychosocial
model

• ? Behaviour (actions in relation to the
  environment)
• ? Emotions (feelings, subjective states)
• ? Cognition (thoughts, beliefs, and
  attitudes)
• ? Personality (characteristic ways of
  thinking and feeling)

8
Clinical relevance 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.

9
Examples for psychosocial factors influencing
the onset of illness or injury

• ? Many patients diagnosed with cancer having had
  some significant loss 12-18 months prior to
  diagnosis.
• ? Individuals with high stress, low resources and
  poor coping have greater risk for injury
  (accidents, etc.).

10
Major life events, stress, and illness outcome

• 2000 peoples life events and periods of illness
  in the previous 10 years (Rahe et al, 1967).
• ? Approximately 50 of those who reported higher
  life stress scores indicated varying degrees of
  illness the following year.
• ? Life stress scores at the very top end were
  positively correlated with the number of reported
  periods of illness.

11
The practical relevance of medical psychology

• ? An interdisciplinary effort to open
  communication and collaboration.
• ? A common language can be created in which
  different disciplines can benefit each other.

12
The use of psychological interventions

• Short-term behavioral interventions have been
  effective in helping patients to
• ?Manage pain
• ? Reduce anxiety prior and after surgery
• ? Improve communication with doctors
• ? Manage side effects and treatment effects when
  coping with chronic illness

13
Contributions of psychology to medical care

• ? Reliable and valid measures for assessing
  health-related factors.
• PSYCHOLOGICAL TESTS
• ? Techniques useful in changing behaviours that
  affect health and illness.
• BEHAVIOR MODIFICATON, SUPPORT
• AND PSYCHOTHERAPY

14
The clinical health psychologist

• ? A psychologist trained to work in collaboration
  with other health professionals
• ? Intervenes at the individual level
• to treat illness,
• slow or prevent disease progression, and
  reduce disability

15
The Practice of Medical Psychology
16
Pain management
17
Modification of illness beliefs
18
Communication with patients
19
Patient education