Inleiding psychologie, medische en
gezondheidspsychologie
Inhoudsopgave
Inleiding ......................................................................................................................................................... 7
Wat is psychologie? ............................................................................................................................................ 7
Voorlopers vd psychologie .................................................................................................................................. 7
De eerste scholen vd psychologie ....................................................................................................................... 8
Europa............................................................................................................................................................ 8
Psychologie vandaag ........................................................................................................................................ 10
Onderzoeksmethoden in de psychologie .......................................................................................................... 11
Beschrijvend onderzoek............................................................................................................................... 11
Correlatie-onderzoek ................................................................................................................................... 11
Experimenteel onderzoek ............................................................................................................................ 11
Psychotherapeutische oriëntaties: Therapeutic Orientations (tekst) ............................................................... 12
Ontwikkelingspsychologie ............................................................................................................................ 15
Eriksons model van ontwikkeling...................................................................................................................... 15
Kindertijd .......................................................................................................................................................... 16
Ontwikkeling van gehechtheid .................................................................................................................... 16
Cognitieve ontwikkeling volgens Jean Piaget (1896-1980) .......................................................................... 18
Taalontwikkeling .......................................................................................................................................... 20
Adolescentie ..................................................................................................................................................... 22
Volwassenheid .................................................................................................................................................. 22
Oudere leeftijd .................................................................................................................................................. 23
Emoties ........................................................................................................................................................ 24
Wat is emotie? .................................................................................................................................................. 24
Theorieën .......................................................................................................................................................... 24
Brandende vragen ............................................................................................................................................ 25
Zijn emoties universeel/aangeboren? ......................................................................................................... 25
Hebben emoties een unieke fysiologische signatuur?................................................................................. 26
Waarom hebben we emoties?..................................................................................................................... 26
Geheugen ..................................................................................................................................................... 27
Geheugenmodel van Atkinson & Shiffrin (1968)............................................................................................... 27
Werkgeheugen (Baddely & Hitch) .................................................................................................................... 30
Soorten geheugen en betrokken hersenstructuren .......................................................................................... 31
1
, Het feilbare LGT ................................................................................................................................................ 32
Distinctieve oproepingsaanwijzingen .......................................................................................................... 32
Geheugensteuntjes ...................................................................................................................................... 33
Herinnering is reconstructie ........................................................................................................................ 33
Amnesie ....................................................................................................................................................... 34
Emotionele herinneringen ........................................................................................................................... 34
Leren ............................................................................................................................................................ 35
Klassieke conditionering (KC) (Pavlov) ............................................................................................................. 35
Verwachtings- vs. evaluatief leren (Belangrijk onderscheid) ....................................................................... 36
Generalisatie, blokkeren, latente inhibitie .................................................................................................. 36
Extinctieleren ............................................................................................................................................... 36
Relevantie van klassieke reacties (CR) in medische setting ......................................................................... 37
Introceptieve angst ...................................................................................................................................... 37
Operante conditionering (OC)........................................................................................................................... 38
Belangrijke fenomenen met betrekking tot operante conditionering......................................................... 39
Observationeel leren (OBS) ............................................................................................................................... 41
Artikel: Learned fear of Gastrointestinal sensations in healthy adult............................................................... 42
Persoonlijkheidstrekken (‘personality traits’) ............................................................................................... 43
Sociale psychologie....................................................................................................................................... 47
Sociale beïnvloeding ......................................................................................................................................... 47
Persoonsperceptie ............................................................................................................................................ 48
Groepsperceptie ............................................................................................................................................... 51
Stress ........................................................................................................................................................... 53
Terugvalpreventie ............................................................................................................................................. 53
Stress: basics ..................................................................................................................................................... 53
Transactioneel model Stress & Coping (Lazarus & Folkman, 1984) ............................................................. 53
Stress meten ................................................................................................................................................ 54
Fysiologie van stress .................................................................................................................................... 55
Dimensies van stress .................................................................................................................................... 60
Stress en gezondheid ........................................................................................................................................ 62
Gezond gedrag en stress (tekst van Steptoe) .............................................................................................. 62
Algemene modellen ..................................................................................................................................... 63
3 Routes: hoe heeft stress effect op de gezondheid ................................................................................... 64
Stressen over stress (Tekst) ......................................................................................................................... 65
Buffers.......................................................................................................................................................... 65
Stress & gezondheid VERVOLG (Dr. Vandenberghe) ...................................................................................... 67
ALGEMEEN id psychologie: Veranderingen in de gezondheidszorg .................................................................. 67
Stress ................................................................................................................................................................ 68
3 Integratieve modellen die aansluiten bij biopsychosociaal model ........................................................... 69
Maladaptieve stress ..................................................................................................................................... 69
2
, Fysiologie van stress .................................................................................................................................... 70
Acute stressrespons ..................................................................................................................................... 70
Chronische stress ......................................................................................................................................... 70
Maladaptieve stress: effecten op hersenen ................................................................................................ 71
Maladaptieve stress: Cardiovasculaire effecten .......................................................................................... 71
Sociale en gedragsmatige determinatie van gezondheid ............................................................................... 74
Gezondheid ....................................................................................................................................................... 74
Levensverwachting: sociale determinanten en evolutie ................................................................................... 74
Doodsoorzaken, vermijdbare ziektes en sterfte ................................................................................................ 75
Rol van gedrag .................................................................................................................................................. 76
Bio-psycho-sociaal model van gezondheid ....................................................................................................... 77
Verschillende bio-psycho-sociale modellen................................................................................................. 78
Symptoomperceptie & ziektegedrag ............................................................................................................. 80
Onverklaarde klachten – Prevalentie – Ziekte Vs. Klachtenmodel .............................................................. 80
Ziektemodel ................................................................................................................................................. 80
Kenmerken die samenhangen met negatieve affectiviteit .......................................................................... 81
Klachten begrijpen vanuit ziektemodel → gevolgen ................................................................................... 82
Nood aan klachtenmodel ipv disease-model (ziektemodel) ........................................................................ 83
=> Klachtenmodel (ipv ziektemodel) ........................................................................................................... 83
Experimenteel onderzoek onverklaarde klachten ............................................................................................. 83
Hyperventilatie en NA.................................................................................................................................. 83
Experimentele inductie van onverklaarde klachten .................................................................................... 84
Perceptuele effecten van interoceptieve vreesconditionering ................................................................... 87
Placebo en Nocebo ........................................................................................................................................... 89
Ziekte–opvattingen ........................................................................................................................................... 90
Pijn ............................................................................................................................................................... 92
Pijn: biologische aspecten................................................................................................................................. 92
Traditioneel ziektemodel ............................................................................................................................. 92
Rugpijn .............................................................................................................................................................. 93
Oorzaken rugpijn ......................................................................................................................................... 93
Pijn als mentale representatie .......................................................................................................................... 93
Gedragsprocessen ............................................................................................................................................ 94
Associatieve leerprocessen .......................................................................................................................... 94
Cognitieve processen ........................................................................................................................................ 95
Klinische toepassing.......................................................................................................................................... 96
Conclusie ........................................................................................................................................................... 97
Preventie en gezondheidspromotie .............................................................................................................. 98
Doel(groepen), middelen en evolutie ................................................................................................................ 98
3
, Beleid en actoren ............................................................................................................................................ 100
Evidence based practice voor preventie ......................................................................................................... 101
Belang en betekenis van evidence-based werken ..................................................................................... 101
Theoretische modellen gedragsverandering ............................................................................................. 102
Planmatig werken ........................................................................................................................................... 109
Roken en drinken ....................................................................................................................................... 114
Inleiding .......................................................................................................................................................... 114
Tekst ‘nicotine addiction’ ........................................................................................................................... 114
Gedragsepidemiologie .................................................................................................................................... 116
Beginnen .................................................................................................................................................... 118
Roken ......................................................................................................................................................... 118
Drinken ...................................................................................................................................................... 119
Continueren .................................................................................................................................................... 119
Stoppen ........................................................................................................................................................... 121
Terugvalpreventie ...................................................................................................................................... 122
Chronische ziekte, dood en sterven ............................................................................................................ 124
Chronische ziekte ............................................................................................................................................ 124
Ziekte en dood ................................................................................................................................................ 127
Psychosomatiek: functionele klachten ........................................................................................................ 130
Biopsychosociaal model .................................................................................................................................. 130
Psychologische verklaringsmodellen .............................................................................................................. 130
Sociale verklaringsmodellen ........................................................................................................................... 132
Biologische verklaringsmodellen .................................................................................................................... 132
Emoties en pijnmodulatie .......................................................................................................................... 134
Psychologische factoren in geneeskunde ....................................................................................................... 135
Diagnose en behandeling van functionele aandoeningen .............................................................................. 136
Immuniteit, bescherming en afweer ........................................................................................................... 138
Psycho-neuro-immunologie ............................................................................................................................ 138
Invloed psychologische (gedachten & gevoelens) toestand op immuunsyst., afweer & immuunfunctie . 138
Respiratoire gezondheid ............................................................................................................................. 140
Ademhaling en emoties .................................................................................................................................. 140
Gastro-intestinaal systeem ......................................................................................................................... 141
Alcoholgebruik ........................................................................................................................................... 143
Aanvaardbaar alcoholgebruik vanuit gezondheidsperspectief....................................................................... 143
Problematisch alcoholgebruik en alcohol gerelateerde stoornissen .............................................................. 143
4
gezondheidspsychologie
Inhoudsopgave
Inleiding ......................................................................................................................................................... 7
Wat is psychologie? ............................................................................................................................................ 7
Voorlopers vd psychologie .................................................................................................................................. 7
De eerste scholen vd psychologie ....................................................................................................................... 8
Europa............................................................................................................................................................ 8
Psychologie vandaag ........................................................................................................................................ 10
Onderzoeksmethoden in de psychologie .......................................................................................................... 11
Beschrijvend onderzoek............................................................................................................................... 11
Correlatie-onderzoek ................................................................................................................................... 11
Experimenteel onderzoek ............................................................................................................................ 11
Psychotherapeutische oriëntaties: Therapeutic Orientations (tekst) ............................................................... 12
Ontwikkelingspsychologie ............................................................................................................................ 15
Eriksons model van ontwikkeling...................................................................................................................... 15
Kindertijd .......................................................................................................................................................... 16
Ontwikkeling van gehechtheid .................................................................................................................... 16
Cognitieve ontwikkeling volgens Jean Piaget (1896-1980) .......................................................................... 18
Taalontwikkeling .......................................................................................................................................... 20
Adolescentie ..................................................................................................................................................... 22
Volwassenheid .................................................................................................................................................. 22
Oudere leeftijd .................................................................................................................................................. 23
Emoties ........................................................................................................................................................ 24
Wat is emotie? .................................................................................................................................................. 24
Theorieën .......................................................................................................................................................... 24
Brandende vragen ............................................................................................................................................ 25
Zijn emoties universeel/aangeboren? ......................................................................................................... 25
Hebben emoties een unieke fysiologische signatuur?................................................................................. 26
Waarom hebben we emoties?..................................................................................................................... 26
Geheugen ..................................................................................................................................................... 27
Geheugenmodel van Atkinson & Shiffrin (1968)............................................................................................... 27
Werkgeheugen (Baddely & Hitch) .................................................................................................................... 30
Soorten geheugen en betrokken hersenstructuren .......................................................................................... 31
1
, Het feilbare LGT ................................................................................................................................................ 32
Distinctieve oproepingsaanwijzingen .......................................................................................................... 32
Geheugensteuntjes ...................................................................................................................................... 33
Herinnering is reconstructie ........................................................................................................................ 33
Amnesie ....................................................................................................................................................... 34
Emotionele herinneringen ........................................................................................................................... 34
Leren ............................................................................................................................................................ 35
Klassieke conditionering (KC) (Pavlov) ............................................................................................................. 35
Verwachtings- vs. evaluatief leren (Belangrijk onderscheid) ....................................................................... 36
Generalisatie, blokkeren, latente inhibitie .................................................................................................. 36
Extinctieleren ............................................................................................................................................... 36
Relevantie van klassieke reacties (CR) in medische setting ......................................................................... 37
Introceptieve angst ...................................................................................................................................... 37
Operante conditionering (OC)........................................................................................................................... 38
Belangrijke fenomenen met betrekking tot operante conditionering......................................................... 39
Observationeel leren (OBS) ............................................................................................................................... 41
Artikel: Learned fear of Gastrointestinal sensations in healthy adult............................................................... 42
Persoonlijkheidstrekken (‘personality traits’) ............................................................................................... 43
Sociale psychologie....................................................................................................................................... 47
Sociale beïnvloeding ......................................................................................................................................... 47
Persoonsperceptie ............................................................................................................................................ 48
Groepsperceptie ............................................................................................................................................... 51
Stress ........................................................................................................................................................... 53
Terugvalpreventie ............................................................................................................................................. 53
Stress: basics ..................................................................................................................................................... 53
Transactioneel model Stress & Coping (Lazarus & Folkman, 1984) ............................................................. 53
Stress meten ................................................................................................................................................ 54
Fysiologie van stress .................................................................................................................................... 55
Dimensies van stress .................................................................................................................................... 60
Stress en gezondheid ........................................................................................................................................ 62
Gezond gedrag en stress (tekst van Steptoe) .............................................................................................. 62
Algemene modellen ..................................................................................................................................... 63
3 Routes: hoe heeft stress effect op de gezondheid ................................................................................... 64
Stressen over stress (Tekst) ......................................................................................................................... 65
Buffers.......................................................................................................................................................... 65
Stress & gezondheid VERVOLG (Dr. Vandenberghe) ...................................................................................... 67
ALGEMEEN id psychologie: Veranderingen in de gezondheidszorg .................................................................. 67
Stress ................................................................................................................................................................ 68
3 Integratieve modellen die aansluiten bij biopsychosociaal model ........................................................... 69
Maladaptieve stress ..................................................................................................................................... 69
2
, Fysiologie van stress .................................................................................................................................... 70
Acute stressrespons ..................................................................................................................................... 70
Chronische stress ......................................................................................................................................... 70
Maladaptieve stress: effecten op hersenen ................................................................................................ 71
Maladaptieve stress: Cardiovasculaire effecten .......................................................................................... 71
Sociale en gedragsmatige determinatie van gezondheid ............................................................................... 74
Gezondheid ....................................................................................................................................................... 74
Levensverwachting: sociale determinanten en evolutie ................................................................................... 74
Doodsoorzaken, vermijdbare ziektes en sterfte ................................................................................................ 75
Rol van gedrag .................................................................................................................................................. 76
Bio-psycho-sociaal model van gezondheid ....................................................................................................... 77
Verschillende bio-psycho-sociale modellen................................................................................................. 78
Symptoomperceptie & ziektegedrag ............................................................................................................. 80
Onverklaarde klachten – Prevalentie – Ziekte Vs. Klachtenmodel .............................................................. 80
Ziektemodel ................................................................................................................................................. 80
Kenmerken die samenhangen met negatieve affectiviteit .......................................................................... 81
Klachten begrijpen vanuit ziektemodel → gevolgen ................................................................................... 82
Nood aan klachtenmodel ipv disease-model (ziektemodel) ........................................................................ 83
=> Klachtenmodel (ipv ziektemodel) ........................................................................................................... 83
Experimenteel onderzoek onverklaarde klachten ............................................................................................. 83
Hyperventilatie en NA.................................................................................................................................. 83
Experimentele inductie van onverklaarde klachten .................................................................................... 84
Perceptuele effecten van interoceptieve vreesconditionering ................................................................... 87
Placebo en Nocebo ........................................................................................................................................... 89
Ziekte–opvattingen ........................................................................................................................................... 90
Pijn ............................................................................................................................................................... 92
Pijn: biologische aspecten................................................................................................................................. 92
Traditioneel ziektemodel ............................................................................................................................. 92
Rugpijn .............................................................................................................................................................. 93
Oorzaken rugpijn ......................................................................................................................................... 93
Pijn als mentale representatie .......................................................................................................................... 93
Gedragsprocessen ............................................................................................................................................ 94
Associatieve leerprocessen .......................................................................................................................... 94
Cognitieve processen ........................................................................................................................................ 95
Klinische toepassing.......................................................................................................................................... 96
Conclusie ........................................................................................................................................................... 97
Preventie en gezondheidspromotie .............................................................................................................. 98
Doel(groepen), middelen en evolutie ................................................................................................................ 98
3
, Beleid en actoren ............................................................................................................................................ 100
Evidence based practice voor preventie ......................................................................................................... 101
Belang en betekenis van evidence-based werken ..................................................................................... 101
Theoretische modellen gedragsverandering ............................................................................................. 102
Planmatig werken ........................................................................................................................................... 109
Roken en drinken ....................................................................................................................................... 114
Inleiding .......................................................................................................................................................... 114
Tekst ‘nicotine addiction’ ........................................................................................................................... 114
Gedragsepidemiologie .................................................................................................................................... 116
Beginnen .................................................................................................................................................... 118
Roken ......................................................................................................................................................... 118
Drinken ...................................................................................................................................................... 119
Continueren .................................................................................................................................................... 119
Stoppen ........................................................................................................................................................... 121
Terugvalpreventie ...................................................................................................................................... 122
Chronische ziekte, dood en sterven ............................................................................................................ 124
Chronische ziekte ............................................................................................................................................ 124
Ziekte en dood ................................................................................................................................................ 127
Psychosomatiek: functionele klachten ........................................................................................................ 130
Biopsychosociaal model .................................................................................................................................. 130
Psychologische verklaringsmodellen .............................................................................................................. 130
Sociale verklaringsmodellen ........................................................................................................................... 132
Biologische verklaringsmodellen .................................................................................................................... 132
Emoties en pijnmodulatie .......................................................................................................................... 134
Psychologische factoren in geneeskunde ....................................................................................................... 135
Diagnose en behandeling van functionele aandoeningen .............................................................................. 136
Immuniteit, bescherming en afweer ........................................................................................................... 138
Psycho-neuro-immunologie ............................................................................................................................ 138
Invloed psychologische (gedachten & gevoelens) toestand op immuunsyst., afweer & immuunfunctie . 138
Respiratoire gezondheid ............................................................................................................................. 140
Ademhaling en emoties .................................................................................................................................. 140
Gastro-intestinaal systeem ......................................................................................................................... 141
Alcoholgebruik ........................................................................................................................................... 143
Aanvaardbaar alcoholgebruik vanuit gezondheidsperspectief....................................................................... 143
Problematisch alcoholgebruik en alcohol gerelateerde stoornissen .............................................................. 143
4
