4 th Edition Copyright 2004 - Prentice Hall14-1 Health Psychology Chapter 14.

Copyright 2004 - Prentice Hall 14-1

4th Edition

Health Psychology

Chapter 14


Mind-Body Relationship

• From earliest times – mind and body generally thought of as one unit

• Disease understood as resulting from some type of divine (supernatural) cause -

possession, punishment from god(s), etc.



• Greeks and Arabs were among the first to suggest natural causes of illness

• Ex – Hippocrates’ Humoral theory• Galen – the first to attribute disease to a

specific pathogen• This emphasis on natural causation was

lost with the fall of the Roman Empire and the subsequent rise in power of the Church.



• In the Middle Ages the Church was the guardian of medical knowledge – the functions of the priest and physician merged.

• This began to change during the Renaissance, however, especially due to the influence of René Descarte


Cartesian Dualism

• Descartes proposed that mind and body be considered as two separate entities

• Body – works mechanistically – thus, can be understood scientifically

• Mind – also, the soul – to be studied by priests

• This “split” laid the foundation for study and experimentation that led to modern medicine



• For the next 200 years, physicians looked exclusively at organic and cellular changes and pathology to understand and treat illness, until physical evidence became the only basis for diagnosis and treatment of disease

• Example – Krafft-Ebbing and General Paresis



• This view became less tenable, however, with the contributions of Sigmund Freud – hysterical patients had obvious, profound physical symptoms, with no apparent organic cause

• Psychosomatic Medicine in the 1920’s– Led to an emphasis on the autonomic

nervous system


Biomedical Model

• Still the dominant model in medicine• Maintains that all illness can be explained

on the basis of problems with bodily processes (biochemical imbalances, neurophysiological abnormalities, etc.)

• Is reductionistic• Implicitly incorporates the assumption of

mind/body dualism• Emphasizes illness over health


Biopsychosocial Model

• Assumes biological, psychological and social factors are all important determinants of both illness and health

• Health and illness both caused by multiple factors and produce multiple effects

• Mind and body cannot be distinguished in matters of health and illness

• Emphasizes both health and illness – health is to be achieved, not taken for granted


Health Psychology

• Health psychology is a subfield that is concerned with the social and psychological factors that Influence health and illness.


Why Health Psychology?

1. Changing Nature of Illness – traditional medicine has been very successful treating acute illnesses – tuberculosis, pneumonia, influenza, etc. –

* are short term

* have identifiable causes

* can be treated



• However, most of the major health problems today are chronic, not acute

• Cancer, heart disease, AIDS, accidents

* cannot be cured, only managed

* causes?

* people must live with these diseases for years, leading to a number of issues

of coping



• Rapidly expanding cost of health care

• Increased medical acceptance

• Methodological and statistical contributions to research


The Nervous System

• Major division - Central vs. Peripheral

• Central or CNS- brain and spinal cord

• Peripheral- nerves connecting CNS to muscles and organs

Central Nervous System

Peripheral Nervous System



Skeletal(Somatic)

Sympathetic Parasympathetic

Autonomic



Sympathetic

• “ Fight or flight” response

• Release adrenaline and noradrenaline

• Increases heart rate and blood pressure

• Increases blood flow to skeletal muscles

• Inhibits digestive functions

CENTRAL NERVOUS SYSTEMBrain

Spinalcord

SYMPATHETIC

Dilates pupil

Stimulates salivation

Relaxes bronchi

Accelerates heartbeat

Inhibits activity

Stimulates glucose

Secretion of adrenaline,nonadrenaline

Relaxes bladder

Stimulates ejaculationin male

Sympatheticganglia

Salivaryglands

Lungs

Heart

Stomach

Pancreas

Liver

Adrenalgland

Kidney


Parasympathetic

• “ Rest and digest ” system

• Calms body to conserve and maintain energy

• Lowers heartbeat, breathing rate, blood pressure

CENTRAL NERVOUS SYSTEMBrain

PARASYMPATHETIC

Spinalcord

Stimulates salivation

Constricts bronchi

Slows heartbeat

Stimulates activity

Contracts bladder

Stimulates erectionof sex organs

Stimulates gallbladder

Gallbladder

Contracts pupil


Summary of autonomic differences

Autonomic nervous system controls physiological arousal

Sympatheticdivision (arousing)

Parasympatheticdivision (calming)

Pupils dilate EYES Pupils contract

Decreases SALVATION Increases

Perspires SKIN Dries

Increases RESPIRATION Decreases

Accelerates HEART Slows

Inhibits DIGESTION Activates

Secrete stresshormones

ADRENALGLANDS

Decrease secretionof stress hormones


Stress and Illness

• Hans Selye developed the concept of stress as the nonspecific response of the body to demands to adjust to a wide range of changes.


Stress and Illness

• Stressors are demands that give rise to the general adaptation syndrome (GAS), which consists of three stages: alarm, resistance, and exhaustion.


Stress and Illness

• Among the circumstances that could lead to stress are catastrophes, major life changes such as divorce, acculturative stress, traumatic events such as criminal victimization, and hassles.

• They have been associated with physiological responses such as increased levels of stress hormones,


Stress and Illness

• Researchers found that high levels of life change were associated with Illness.

• Subsequent Investigation showed that the relation between major life events and illness is not as strong as originally reported.

• One explanation is that a person's interpretation of events is an important determinant of the event's impact.


Stress and Illness

• Everyday minor annoyances can accumulate and become associated with subsequent health problems.


Stress and Illness

• Interpretation or appraisal of an event often determines whether that event is stressful.


Stress and Illness

• Primary appraisal occurs when we determine whether an event is a threat

• Secondary appraisal occurs when we decide how to deal with the threat.


Factors the Influence Reactions to Stress

• I. The Stressor Itself– Importance– Duration– Cumulative effect– Imminence– Anticipated vs. Unanticipated



• 2. The Individual– Perception of threat– Presence of a plan– Voluntary vs. involuntary– Control and predictability– Stress tolerance (EA on Rorschach)



• 3. External Resources & Social Support– Positive social and family relationships– Cultural rituals (funerals, confession,

atonement)


Coping with Stress

• Ineffective Coping Strategies– Withdrawal (avoidance)– Aggression– Overreliance on primitive defense

mechanisms (distort reality)


Coping with Stress

• Effective Coping Strategies– Removing stressors– Cognitive coping – changing the way we think

about an event– Managing stress reactions – sometimes, if we

can’t change the reality, we have to deal with the response

• schedule relaxing activities• relaxation training


Stress and Illness

• The immune system is the body's major defense against bacteria and viruses.

• Psychoneuroimmunology is the study of how psychological and physiological factors interact to influence the immune system.

• A wide variety of stressful events can affect immune system functioning.


Lifestyle Influences on Disease Risk

• Smoking-related illnesses are the most preventable cause of death in the United States.

• The number of smokers is declining, but people with less education are more likely to smoke than people with more education.

• Most smokers tried their first cigarette before age 18.

• Peer pressure is a major factor leading individuals to start smoking.



• Although there are many programs to help people stop smoking, most people who quit do so on their own, usually after several unsuccessful attempts.

• Anticipated weight gain after quitting is often cited as a reason for continuing to smoke.



• The number one cause of death in the United States is heart disease.

• There is a strong association between men and heart disease.



• Heart disease also varies with race.



• Type A behavior has been considered a risk factor in the development of heart disease.

• Type A individuals tend to be aggressive, competitive, impatient, and have difficulty relaxing.



• The Western Collaborative Group Study indicated that a Type A individual was twice as likely to develop heart disease as the more relaxed and easygoing Type B person.

• Subsequent studies did not replicate this finding, and it became apparent that not all the components of Type A impart risk.

• Current research focuses on hostility as the toxic component of Type A behavior.



• Efforts to change type A behavior reduced the rate of recurrent heart attacks as compared with the rate among victims who received typical heart patient counseling



• AIDS is the 10th leading cause of death in the United States.

• Aids cases among men is substantially higher than the number of cases among women.



• Men and women differ in their likelihood of being exposed to infection with HIV.


• HIV is actually a fragile virus that does not survive well outside the body.

• When HIV infects the body, however, it sets up a struggle between the immune system and the virus.




• The immune system fights well for 8 to 10 years until HIV replicates so rapidly that it destroys too many T-cells.

• A combination with stress hastens the onset of AIDS.


Coping With Stress

• A number of psychological factors have been shown to modify stress reactions.

• Hardiness is a psychological characteristic composed of commitment, a sense of control, and a tendency to view change as a challenge.

• Hardy individuals react differently to stressful events and experience fewer illnesses than less hardy individuals.


Coping With Stress

• Social support is the availability of approval, advice, money, or encouragement from others.


Coping With Stress

• Social support may reduce the negative effects of stressful events.


Coping With Stress

• There is growing support for the notion that humor and laughter can reduce mood disturbances, buffer the effects of life events, and aid in dealing with pain.


Coping With Stress

• Many people have never developed the skill of relaxing.

• Among the techniques used to produce relaxation are progressive relaxation , the relaxation response, and biofeedback.

• Relaxation activates the parasympathetic nervous system and is helpful in reducing stress reactions.


Coping With Stress

• Physical activity is associated with increased longevity and positive benefits on physical and psychological health.


Coping With Stress

• Current recommendations call for at least 30 minutes of physical activity per day, which can be accumulated in short bouts throughout the day.

4 th Edition Copyright 2004 - Prentice Hall14-1 Health Psychology Chapter 14.

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