Medical Psychology

Introduction:

Medical Psychology

and Border Areas

Themes of Medical Psychology

► Psychological factors influencing the development or progression of disease– Etiology

► Patient’s response to illness and disease– Outcomes

► Communication with patients and colleagues

- Relational issues

Medical Psychologyand border areas

BehaviouralHealth

Medical Psychology(Behavioural

Medicine)Individual behaviordiet,exercise, etc.supperted byhealth professionals

Medical doctorsand other healthprofessionals

Health psychologists

TREATMENTGeneral practiceHospital careRehabilitation

PRIMARY PREVENTION

Health education

Clinical Psychology

andPsychiatry

Clinicalpsychologistsandpsychiatrists

HealthPsychology

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.

Contemporary view

Biopsychosocial model (George Engel, 1977)

Mind, body, and environment

interact in causing disease.

The biopsychosocial model of disease

Biology•Genetics•Anatomy•Physiology

Pathogens•Germs•Toxins

Psychology

Behavioural factors•Diet, exercise, smoking, coping with illness

Other psych. factors•Stress, anxiety, depression, illness

beliefs, etc.

Social factors•Family•Society•Friends, etc.

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)

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.

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.).

Major life events, stress, and illness outcome

2000 people’s 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.

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.

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

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

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

The Practice of Medical Psychology

Painmanagement

Modification of

illness beliefs

Communicationwith

patients

Patienteducation