PSYC314 (Health Psychology) Lecture Notes

PSYC314 – Health Psychology Lecture Notes
Unit 1
Module 1 - Introduction to Health Psychology
Health Psychology
- What is Health  World Health Organization definition of health (1948)
 Health is NOT merely the absence of disease. Health is state of complete well-being,
including the biomedical model
o Physical well-being
o Mental/Emotional well-being
o Social well-being
- What is psychology?
 The scientific study of behaviour & mind.
o Includes: cognition, emotion, motivation, and action
- Health psychology: the scientific study of how health and psychology intersect.
- Joseph Matarazzo (1980)
 Health psychology is the aggregate of the specific educational, scientific, and
professional contributions of the discipline of psychology to:
o Promotion and maintenance of health
o Prevention and treatment of illness
o Identification of etiologic and diagnostic correlates of health, illness and related
dysfunction
o Improvement of the health care system.

Biopsychosocial Model (Engel, 1977)
- George Engel (1913-1999)  Psychiatrist
- Health (including disease and illness) is best understood from a combination of biological,
psychological, and social perspectives rather than a purely biological perspective.
- Mind-body connection: assumption of complex mind-body interaction
 Inherent to biopsychosocial model
- Biology
 Sex, age, genetics, physiology, immune system, nutrition, medications, disease &
disorder
- Psychology
 Personality, self-efficacy, personal control, optimistic bias, stress perception, coping
skills, diet & exercise, risky behaviours, medical adherence
- Social
 Gender, socioeconomic status/income, ethnicity/race, culture, discrimination, health
disparities, caregiving, social support, social networks

System Interplay
- There is an interplay of systems  the person is affected by:
1. The world (social & environmental systems)
2. Their biology (genes & physiology)
3. Their psychology (experiences & behaviours)
- “Living systems have come to be seen as systems (of which mind and body are a unit) which are
integral parts of larger systems, in permanent interaction with their environment...”

,  (Neeta Mehta, PhD, 2011)
- The importance of context is large (to all things psychological and social, including health).
- Person-situation interaction
 Behaviour and experience are each a function of an interaction between the individual
and the situation or environment.

History of the Biopsychosocial Model
- The Medical Renaissance (1400-1700)
 Attempts were made to break away from superstitions of past centuries  paved the way
for modern medicine.
 Physicians were said to heal the body
 Physical evidence was the sole basis for diagnosis
- René Descartes (1596-1650)
 Cartesian Dualism: the mind and body are made of distinct substances and exist
independently.

Emerging Science and Technology
- Over time, medicine looked more to the laboratory and less to the mind.
- Emphasis shifted to biology as sole cause of disease.
- Key Developments:
 16th – 17th C: Compound microscope was invented/developed
 18th – 19th C: Germ theory developed  microorganisms identified as causes of disease
 20th Century: Penicillin (first true antibiotic) discovered by Alexander Fleming in 1928

Biomedical Reductionism
- Reductionism in medicine ensued
- Every disease process could be explained in terms of an underlying deviation from normal
function  pathogen, genetic or developmental abnormality, or injury

Changing Patterns of Illness
- With advances in technology and medicine, the development of antibiotics, and improved
sanitation and nutrition, the prevalent causes of death shifted from acute infectious diseases to
chronic conditions
 Acute infections: influenza virus, pneumonia, COVID-19
 Chronic conditions: heart disease, hypertension, high blood pressure, etc.
- Canada 1900 vs. 2001
 1900 Influenza (20,000,000 deaths) vs 2001 Influenza (2500000)
- Average life expectancy in 2019:
 84.2 for females
 80.0 for males

Leading Causes of Death in Canada (2019)
- Variations occur by age, region, class, ethnicity
 Variations occur by age group (e.g., in young people accidents are more likely but in
older cancer is).
- There were 284,082 deaths in Canada in 2019.

,  Other 29.4%
 Cancer 28.2 % (malignant neoplasms)
 Heart disease 18.5%
 Stroke 4.8%
 Accidents 4.8%
 Lower Respiratory 4.5%
 Diabetes 2.4%
 Influenza & Pneumonia 2.4%
 Alzheimer’s 2.2%
 Suicide 1.4%
 Kidney Disease 1.3%

Need for a New Model
- Common causes of death are now chronic conditions (heart disease, cancer, diabetes,
Alzheimer’s, etc.).
 No known cures or quick fixes.
 Can live with them, but quality of life is affected.
 Require expensive healthcare.
- The biomedical model has had limited success in these regards.

Module 1 Terms
- Disease: an abnormal condition affecting an organism or part of an organism
 Due to infection, injury/trauma, behaviour, etc.
 E.g., heart disease, influenza
- Illness: feelings that might come with having a disease.
 Feelings like pain, fatigue, weakness, etc. – the reasons people seek care.
- Disorder: an abnormality of function
 Due to genetic abnormalities, behaviours, stressors, etc.
 Similar to disease
 E.g., cystic fibrosis, deafness
- Syndrome: set of symptoms or conditions that occur together and suggest the presence of a
certain disease or increased risk.
 E.g., metabolic syndrome, AIDS
- Mortality: incidence of death in a population.
 In general or due to a specific cause (in a given period of time).
- Morbidity: occurrence of ill health (generally) or a specific disease (e.g., asthma) in a population.
 Incidence – Number of new cases (in a given period of time)
 Prevalence – Total number of existing cases.

Module 2 – Fight, Flight, or Frenzy: Understanding Stress Today
Stress as a Stimulus (The Bear)
- Stress: defined as a stimulus or change in the environment
 Something that causes stress is a “stressor”
 Acute stressors: limited stress, e.g. running late, fights, accidents
 Chronic stressors: prolonged and repeated stress, e.g. job strain, poverty
- Major life events and daily hassles can also cause stress

, - Major Life Events (Holmes & Rahe, 1967)
 Social Readjustment Rating Scale  major life events scale
 Change (+ or -) is assumed to be stressful.
 Items are assigned a life change unit score based on severity.
 Correlations have been shown with incidence of heart attacks, broken bones, diabetes,
multiple sclerosis, tuberculosis, complications of pregnancy, decline in academic
performance, etc.
- More stressful life events = increased likelihood of contracting cold virus
- Day-to-day unpleasant or potentially harmful events.
 Ideally measured as they unfold using daily process methods
 Hassles (and also uplifts) may be more strongly associated with health than life events.

Stress as a Response (The Runner)
- Stress: defined as a person’s physiological response and/or a person’s psychological response
(i.e. thoughts and emotions)
 Fight-or-flight
 Reactivity to situations
 Something that feels stress is a “strain”
- Fight-or-Flight Response (Cannon, 1932)
 Mobilization, increased energy, and increased focus leads to increased:
o Breathing, heart rate, blood pressure, muscle tension, blood glucose, pupil
dilation, tunnel vision, and sweating
o Slow digestion, dry mouth, relaxed bladder, hands/feet get cold
- Epinephrine / Norepinephrine
 Epinephrine (adrenaline) & norepinephrine (noradrenaline) are released by the adrenal
glands (part of SNS).
 Hormones/neurotransmitters (catecholamines) that regulate heart rate, metabolism,
respiration, oxygen to the brain and muscles, etc
- Cortisol “Stress Hormone” (Corticosteroid/Glucocorticoid)
 Cortisol complements the SNS
o Increases blood pressure and glucose  enhances brain’s use of glucose.
o Suppresses nonessential systems (e.g., digestive, reproductive, immune).
o Reduces inflammation.
 Assists return to homeostasis.
o Cortisol output automatically decreases over time (negative feedback loop)
- Measuring Cortisol
 Difficult to study
 Influenced by exercise, diet, mood, and other factors
 Individual differences in diurnal cycles, average output, etc.
 Inconsistent results across stressors

Stress as a Transaction (Bear + Runner)
- Stress: defined as a process involving continuous interactions and adjustments between a person
and the environment, each affecting and affected by the other.
- Transactional Model of Stress (Lazarus, 1984)