Chapter 1
Brannon, L., Feist, J., & Updegraff, J. (2014). Health Psychology; An Introduction to Behavior and Health.
(8th Ed.). United States: Wadsworth Cengage Learning.
Foundations of Health Psychology
Introducing Health Psychology
The Changing Field of Health
• The field of health psychology developed in 1970's
• Life expectancy used to be 50 years old, a century ago; mostly from pneumonia, tuberculosis,
diarrhea, and enteritis from drinking water, contaminated food or sick people; people died fast
from these, usually in weeks
o Life expectancy is 8- years old now a days
• New century killers: chronic diseases; heart disease, cancer and stroke are now the
leading causes and account for a greater proportion of deaths than infectious diseases
ever did
▪ These develop, persist and recur
▪ 2 million die a year
▪ 1/2 adults live with at least 1 chronic disease
• Most deaths are attributable to diseases associated with individual behaviour and life style
o Most due to smoking, alcohol abuse, unwise eating, stress and sedentary lifestyle
• Patterns of Disease and Death
o During the last few years, deaths from chronic diseases began to decrease, including heart
disease, cancer and stroke
• Major reason why; fewer people smoke now
o Death rates from unintentional injuries, suicide and homicide have increased in recent years
o Alzheimer's disease, septicaemia and Parkinson's have increased
• Major reason why; increasingly older population
o Behaviour is a less important component here for those that have decreased
o Age
• Cardiovascular disease and cancer account for about 60% of all deaths in the US
▪ Not the leading cause for young people
▪ People aged 1-44 years, unintentional injuries are the leading cause of death,
along with violent deaths from suicide and homicide
• For those aged 45-64, cardiovascular and cancer become leading deaths
• Older people are more likely to die however young people show different patterns of
mortality
o Ethnicity, Income and Disease
• Europeans have a longer life expectancy than African Americans; neither live longer
than people in Japan, Canada, Iceland, Australia, UK, Italy, France, Hong Kong, Israel
• Hispanics have SE disadvantages similar to African Americans
▪ Include poverty and low educational levels; both relate to health problems and
lower life expectancy
▪ 32% of African Americans and 26% of Hispanics live under the poverty line
• Poor mothers are more likely to deliver low-birth-weight babies; more likely to die
• Poor mothers are more likely to be abused and thus babies suffer prenatal child abuse
• Association between income level and health is very strong
, ▪ Very wealthy people= very healthy, wealthy people= healthy, etc.
• Higher the education, the less likely to engage in unhealthy behaviours
• Peoples perception of their social standing impacts health
o Changes in Life Expectancy
• Life expectancy today is more than 77; more likely to live more than a generation
longer than great-great-grandparents
▪ 30 year increase from before
• Medical care is NOT responsible for this increase
• Most important is lowering of infant mortality
• Infant death rates affect average life expectancy percentages much
more than older peoples
▪ Prevention of disease contributed to increase in life expectancy
• Widespread vaccinations
• Safer drinking water and milk supplies
• Efficient disposal of sewage and better nutrition
▪ Minor role: new surgical technology, antibiotics, paramedic teams, skilled
intensive care personnel
• Escalating Cost of Medical Care
o Jump of 600% in medical care costs
o Early detection and limiting services could cut costs
• What is Health?
o The biomedical model is the traditional view of medicine, which defines health as the
absence of disease
• Result of exposure to a specific pathogen, a disease-causing organism
• Uses drugs and medical technology toward removing pathogens and curing disease
• Once chronic illnesses began to replace infectious diseases as leading causes of death,
this model became inadequate
o The biopsychosocial model considers the social, psychological, physiological and spiritual
aspects of a persons health
• Approach to health that includes biological, psychological and social influences
• Diseases result from a combination of genetics, physiology, social support, personal
control, stress, compliance, personality, poverty, ethnic background, cultural beliefs
• Two advantages over the biomedical model:
▪ It incorporates not only biological conditions but also psychological and social
factors
▪ It views health as a positive condition
• Health is much more than the absence of disease
▪ Health is multidimensional, thus all aspects need to be considered
▪ World Health Organization (WHO) believes health is a state of complex physical,
mental and social well-being and not just the absence of disease
• Feeling good is more than not feeling bad
• In Summary
o Four major trends in health care
1. Changing pattern of disease and death; chronic diseases now replace infectionous
diseases as the leading cause of death and disability, including heart disease, stroke,
cancer, emphysema, adult onset diabetes
2. Escalating medical care costs; due to increases ageing population, innovative but
expensive medical technology and inflation
, 3. Changing definition of health; health is a state of positive well-being using the
biopsychosocial model
4. Emergence of biopsychosocial model
Psychology's Relevance for Health
• The Contributions of Psychosomatic Medicine
o Biopsychosocial model compatible with the views of Socrates, Hippocrates and Freud
o Walter Cannon observed that psychological changes accompany emotion; emotions can
change psychological changes that are capable of causing disease
• Developed the notion that habitual responses which people exhibit as part of their
personalities, relate to specific diseases
▪ Relationship between personality type and disease
▪ Many of these views led others to see a range of illnesses as psychosomatic
▪ Psychosomatic medicine laid the foundation for the transition to the
biopsychosocial model of health and disease
• The Emergence of Behavioural Medicine
o Two new disciplines emerged from psychosomatic medicine movement: behavioural
medicine and health psychology
• Behavioural Medicine: the interdisciplinary field concerned with the development
and integration of behavioural and biomedical science knowledge and techniques
relevant to health and illness and the application of the knowledge and these
techniques to prevention, diagnosis, treatment and rehabilitation
▪ Goals are improved prevention, diagnosis, treatment, and rehabilitation
• The Emergence of Health Psychology
o Health Psychology: branch of psychology that concerns individual behaviours and lifestyles
affecting a persons physical health
• Includes psychology's contributions to enhancements of health, the prevention and
treatment of disease, the identification of health risk actors, the improvement of
health care systems, shaping the publics opinion of health
▪ Application of psychological principles to physical health areas such as managing
stress
▪ Helps identify conditions that affect health, diagnose and treat diseases, and
modify behavioural factors including physiological and psychological rehab
▪ Promotes biopsychosocial model
, Chapter 2
Brannon, L., Feist, J., & Updegraff, J. (2014). Health Psychology; An Introduction to Behavior and Health.
(8th Ed.). United States: Wadsworth Cengage Learning.
Conducting Health Research
• A placebo is an inactive substance or condition that has the appearance of an active treatment
and that may cause participants to improve or change because of their belief in the placebos
efficacy
o Ex. Moseley's knee surgery experiment; those who received fake surgery reported the same
level of knee pain and functioning as those who received the real treatment
• Therefore, a belief in the effectiveness of a treatment boosts the treatments
effectiveness
The Placebo in Treatment and Research
• Can have treatment benefits but research drawbacks
• Treatment and the Placebos
o Can lead to noticeable improvements in health outcomes, especially for pain and nausea
o The more a placebo resembles an effective treatment, the stronger the placebo effect
• Big pills are more effective than little ones, and coloured are more effective then
white; capsules work better than tablets, and placebos labelled with brand names
work better
• Two doses provoke a larger response
• An injection is more powerful than a pill, and surgery even more so
• More expensive pills work better as well
o Dependant on physician and patient expectations
• Responses relate to their reputation, attention, interest, concern, confidence
projection
▪ When person knows there is a possibility of being given a placebo, placebo
effects end to weaken because the participant is less confident about receiving
an effective treatment
▪ When a person choses a treatment, placebo effects are stronger
o How and why does this work?
• Most believe its psychologically based, but research suggests that they have both a
physical and psychological basis
▪ The underlying physiological mechanisms for placebo responses are the same as
for drug treatments
▪ Placebos can alter neurotransmitters, hormones, endorphins, producing
perceptual, behavioural and physical effects
o Placebos can produce adverse effects called the nocebo effect
• Negative side effects; presence of negative effects demonstrates that the placebo
effect is not merely improvement but includes any change resulting from an inert
treatment
• Activates certain areas of the brain and acts on neurotransmitters
o Expectancy is a major component of the placebo effect
• People act in ways that they think they should act
• Those who receive treatment without their knowledge do not benefit as much as
those who know what to expect
Brannon, L., Feist, J., & Updegraff, J. (2014). Health Psychology; An Introduction to Behavior and Health.
(8th Ed.). United States: Wadsworth Cengage Learning.
Foundations of Health Psychology
Introducing Health Psychology
The Changing Field of Health
• The field of health psychology developed in 1970's
• Life expectancy used to be 50 years old, a century ago; mostly from pneumonia, tuberculosis,
diarrhea, and enteritis from drinking water, contaminated food or sick people; people died fast
from these, usually in weeks
o Life expectancy is 8- years old now a days
• New century killers: chronic diseases; heart disease, cancer and stroke are now the
leading causes and account for a greater proportion of deaths than infectious diseases
ever did
▪ These develop, persist and recur
▪ 2 million die a year
▪ 1/2 adults live with at least 1 chronic disease
• Most deaths are attributable to diseases associated with individual behaviour and life style
o Most due to smoking, alcohol abuse, unwise eating, stress and sedentary lifestyle
• Patterns of Disease and Death
o During the last few years, deaths from chronic diseases began to decrease, including heart
disease, cancer and stroke
• Major reason why; fewer people smoke now
o Death rates from unintentional injuries, suicide and homicide have increased in recent years
o Alzheimer's disease, septicaemia and Parkinson's have increased
• Major reason why; increasingly older population
o Behaviour is a less important component here for those that have decreased
o Age
• Cardiovascular disease and cancer account for about 60% of all deaths in the US
▪ Not the leading cause for young people
▪ People aged 1-44 years, unintentional injuries are the leading cause of death,
along with violent deaths from suicide and homicide
• For those aged 45-64, cardiovascular and cancer become leading deaths
• Older people are more likely to die however young people show different patterns of
mortality
o Ethnicity, Income and Disease
• Europeans have a longer life expectancy than African Americans; neither live longer
than people in Japan, Canada, Iceland, Australia, UK, Italy, France, Hong Kong, Israel
• Hispanics have SE disadvantages similar to African Americans
▪ Include poverty and low educational levels; both relate to health problems and
lower life expectancy
▪ 32% of African Americans and 26% of Hispanics live under the poverty line
• Poor mothers are more likely to deliver low-birth-weight babies; more likely to die
• Poor mothers are more likely to be abused and thus babies suffer prenatal child abuse
• Association between income level and health is very strong
, ▪ Very wealthy people= very healthy, wealthy people= healthy, etc.
• Higher the education, the less likely to engage in unhealthy behaviours
• Peoples perception of their social standing impacts health
o Changes in Life Expectancy
• Life expectancy today is more than 77; more likely to live more than a generation
longer than great-great-grandparents
▪ 30 year increase from before
• Medical care is NOT responsible for this increase
• Most important is lowering of infant mortality
• Infant death rates affect average life expectancy percentages much
more than older peoples
▪ Prevention of disease contributed to increase in life expectancy
• Widespread vaccinations
• Safer drinking water and milk supplies
• Efficient disposal of sewage and better nutrition
▪ Minor role: new surgical technology, antibiotics, paramedic teams, skilled
intensive care personnel
• Escalating Cost of Medical Care
o Jump of 600% in medical care costs
o Early detection and limiting services could cut costs
• What is Health?
o The biomedical model is the traditional view of medicine, which defines health as the
absence of disease
• Result of exposure to a specific pathogen, a disease-causing organism
• Uses drugs and medical technology toward removing pathogens and curing disease
• Once chronic illnesses began to replace infectious diseases as leading causes of death,
this model became inadequate
o The biopsychosocial model considers the social, psychological, physiological and spiritual
aspects of a persons health
• Approach to health that includes biological, psychological and social influences
• Diseases result from a combination of genetics, physiology, social support, personal
control, stress, compliance, personality, poverty, ethnic background, cultural beliefs
• Two advantages over the biomedical model:
▪ It incorporates not only biological conditions but also psychological and social
factors
▪ It views health as a positive condition
• Health is much more than the absence of disease
▪ Health is multidimensional, thus all aspects need to be considered
▪ World Health Organization (WHO) believes health is a state of complex physical,
mental and social well-being and not just the absence of disease
• Feeling good is more than not feeling bad
• In Summary
o Four major trends in health care
1. Changing pattern of disease and death; chronic diseases now replace infectionous
diseases as the leading cause of death and disability, including heart disease, stroke,
cancer, emphysema, adult onset diabetes
2. Escalating medical care costs; due to increases ageing population, innovative but
expensive medical technology and inflation
, 3. Changing definition of health; health is a state of positive well-being using the
biopsychosocial model
4. Emergence of biopsychosocial model
Psychology's Relevance for Health
• The Contributions of Psychosomatic Medicine
o Biopsychosocial model compatible with the views of Socrates, Hippocrates and Freud
o Walter Cannon observed that psychological changes accompany emotion; emotions can
change psychological changes that are capable of causing disease
• Developed the notion that habitual responses which people exhibit as part of their
personalities, relate to specific diseases
▪ Relationship between personality type and disease
▪ Many of these views led others to see a range of illnesses as psychosomatic
▪ Psychosomatic medicine laid the foundation for the transition to the
biopsychosocial model of health and disease
• The Emergence of Behavioural Medicine
o Two new disciplines emerged from psychosomatic medicine movement: behavioural
medicine and health psychology
• Behavioural Medicine: the interdisciplinary field concerned with the development
and integration of behavioural and biomedical science knowledge and techniques
relevant to health and illness and the application of the knowledge and these
techniques to prevention, diagnosis, treatment and rehabilitation
▪ Goals are improved prevention, diagnosis, treatment, and rehabilitation
• The Emergence of Health Psychology
o Health Psychology: branch of psychology that concerns individual behaviours and lifestyles
affecting a persons physical health
• Includes psychology's contributions to enhancements of health, the prevention and
treatment of disease, the identification of health risk actors, the improvement of
health care systems, shaping the publics opinion of health
▪ Application of psychological principles to physical health areas such as managing
stress
▪ Helps identify conditions that affect health, diagnose and treat diseases, and
modify behavioural factors including physiological and psychological rehab
▪ Promotes biopsychosocial model
, Chapter 2
Brannon, L., Feist, J., & Updegraff, J. (2014). Health Psychology; An Introduction to Behavior and Health.
(8th Ed.). United States: Wadsworth Cengage Learning.
Conducting Health Research
• A placebo is an inactive substance or condition that has the appearance of an active treatment
and that may cause participants to improve or change because of their belief in the placebos
efficacy
o Ex. Moseley's knee surgery experiment; those who received fake surgery reported the same
level of knee pain and functioning as those who received the real treatment
• Therefore, a belief in the effectiveness of a treatment boosts the treatments
effectiveness
The Placebo in Treatment and Research
• Can have treatment benefits but research drawbacks
• Treatment and the Placebos
o Can lead to noticeable improvements in health outcomes, especially for pain and nausea
o The more a placebo resembles an effective treatment, the stronger the placebo effect
• Big pills are more effective than little ones, and coloured are more effective then
white; capsules work better than tablets, and placebos labelled with brand names
work better
• Two doses provoke a larger response
• An injection is more powerful than a pill, and surgery even more so
• More expensive pills work better as well
o Dependant on physician and patient expectations
• Responses relate to their reputation, attention, interest, concern, confidence
projection
▪ When person knows there is a possibility of being given a placebo, placebo
effects end to weaken because the participant is less confident about receiving
an effective treatment
▪ When a person choses a treatment, placebo effects are stronger
o How and why does this work?
• Most believe its psychologically based, but research suggests that they have both a
physical and psychological basis
▪ The underlying physiological mechanisms for placebo responses are the same as
for drug treatments
▪ Placebos can alter neurotransmitters, hormones, endorphins, producing
perceptual, behavioural and physical effects
o Placebos can produce adverse effects called the nocebo effect
• Negative side effects; presence of negative effects demonstrates that the placebo
effect is not merely improvement but includes any change resulting from an inert
treatment
• Activates certain areas of the brain and acts on neurotransmitters
o Expectancy is a major component of the placebo effect
• People act in ways that they think they should act
• Those who receive treatment without their knowledge do not benefit as much as
those who know what to expect
