Chapter 1

Question 1

Although this is frequently the case, the number of psychologists who work with people who are trying to adjust to and overcome medical conditions has shown explosive growth over the last how many years?

Answer 1

> 40 years

Question 2

It is now commonplace for psychologists to work with people who are trying to manage conditions such as:

CP,C, or O

Answer 2

> chronic pain, cancer, or obesity

Question 3

Psychologists who specialize in working with people who have physical health problems are known as:

Answer 3

> health psychologists.

Question 4

A survey of prac-tising psychologists conducted by the American Psychological Association (2016) showed what about clinical health psychology as a specialty

Answer 4

> was the fourth most common of 15 specialties of practising psychology

> 19 % of psychologists indicating that they considered health psychology to be either their primary or secondary practice specialty

Question 5

Health psychology can be thought of as what?

Answer 5

> a subspecialty of psychology, but also as a discipline-specific descriptor within the broad interdisciplinary field of behavioural medicine.

Question 6

The 1977 Yale Conference on Behavioural Medicine was organized to support what? What did it lead to?

Answer 6

> was organized to support the early stages of behavioural medicine

> the conference led to the following definition of “behavioural medicine”

Question 7

What was the definition of behavioural medicine as provided by the 1977 Yale Conference?

Answer 7

> is the field concerned with the development of behavioral-science knowledge and techniques relevant to the understanding of physical health and illness

> the application of this knowledge and these techniques to diagnosis, prevention, treatment and rehabilitation.

> Psychosis, neurosis and substance abuse are included only insofar as they contribute to physical disorders as an end point

Question 8

hree years after the Yale conference, a formal definition of health psychology was developed by who? What is noteable about this figure?

Answer 8

> by American psychologist J.D. Matarazzo

• (who was the first president of the Health Psychology Division (Division 38) of the American Psychological Association (APA))

Question 9

What is Matarazzo’s definition of health psychology?

Answer 9

> Health psychology is the aggregate of the specific educational, professional and scien-tific contributions to the discipline of psychology that deals with:

> promotion and maintenance of health,
the prevention and treatment of illness,
and the identification of etiologic and diagnostic correlates of health, illness and related dysfunction.

Question 10

What is the focus of clinical health psychologists?

Answer 10

> Clinical health psychologists help people diagnosed with health conditions manage the symptoms of their health condition and address the psychological consequences of these symptoms.

Question 11

What is the focus of Occupational Health Psychology?

Answer 11

> a subspecialty
focuses on the prevention + management of occupational stress, the prevention of injury, and the maintenance of health of workers

Question 12

What is the focus of community health psychology?

Answer 12

> Another subspecialty, community health psychology, concerns itself with community-wide health needs and health-care systems.

> aim to effect change and to promote access and cultural competence within health-care systems so that these systems can more effectively serve diversity within communities

Question 13

Psychologists have made tremendous contributions to the prevention of illness, the maintenance of good health, and the management of a variety of conditions including but not limited to:

Answer 13

> Asthma
Diabetes
Cardiovascular disease
Chronic pain

Question 14

Psychologists have also helped thousands of people cope with the psychological consequences of serious ill-nesses such as:

Answer 14

> Cancer and AIDS.

Question 15

Moreover, psychological interventions for patients with chronic illnesses can result in what?

Answer 15

> substantial medical cost savings

Question 16

The roots of health psychology can be traced back to early thinkers such as? What were their views?

Answer 16

> Hippocrates, who is considered by many to be the father of modern medicine, and Galen.

> These early Greek physicians held a holistic view of health and considered the mind and the body to be part of the same system

> They also believed that a balance between physical and emotional states was necessary to sustain overall health

Question 17

Over the years, the popularity of Hippocrates and Galen’s ideas varied. Describe what this means.

Answer 17

> During the Renaissance, Descartes (1596–1650) argued in favour of what is now referred to as Cartesian dualism or the idea that mind and body are separate entities and that explanations for illness can be found in the body alone. This idea formed the basis for much of physical medicine in Western societies

Question 18

Following Descartes, the role of psychological factors in illness was revived again when? What did this “give rise to?”

Answer 18

> in the nineteenth century.

> This eventually gave rise to the development of psychosomatic medicine, with the word “psychosomatic” having been coined by Johann Christian August Heinroth

Question 19

Psychosomatic medicine initially focused on what? What thinker was this idea consistent with?

Answer 19

> Psychosomatic medicine initially focused on illness behaviour that could be attributed to psychological causes.

> Consistent with this, Benjamin Rush argued that “actions of the mind could cause many illnesses.”

Question 20

Who is Benjamin Rush?

Answer 20

> Rush is considered to be the father of modern psychiatry

> and is credited with founding the American Medico-Psychological Association, which later became the American Psychiatric Association

Question 21

Development of the ideas that led to the emergence of health psychology are also linked to
more recent thinkers, including:

Answer 21

> Freud and other psychoanalysts who believed that certain symp-toms such as paralysis and blindness represented manifestations of unconscious conflicts.

Question 22

In the 1940s, who helped establish psychosomatic medicine, and what did it focus on?

Answer 22

> In the 1940s, Franz Alexander helped establish psychosomatic medicine, which focused on the idea that physical disease can be the result of “fundamental, nuclear, or psychological conflict.”

Question 23

These explora-tions concerning the multifactorial causation of disease have been more directly stimulated by what field?

Answer 23

> behavioural sciences

Question 24

What is behavioural medicine directly concerned with?

Answer 24

> with behavioural approaches (e.g., biofeedback, health-promoting behaviours) to the treatment and prevention of physical disease

Question 25

In contrast to behavioural medicine, what has psychosomatic medicine been concerned with?

Answer 25

> psychosomatic medicine has traditionally emphasized etiology and pathogenesis of physical disease.

Question 26

he American Psychosomatic Society was founded in what year and by whom?

Answer 26

> was founded in 1942 by an inter-disciplinary group that included psychiatrists, psychoanalysts, psychologists, physiologists, and internists, with neurologist Tracy Putnam as its first presi-dent

Question 27

As psychodynamic and psychoanalysis became less popular in North America due to insufficient scientific rigour, a variety of scholars and clinicians continued to explore the interdependence of psychological factors, such as stress and disease. What model did this lead to and who developed it?

Answer 27

> Guze, Matarazzo, and Saslow (1953) published an account of the biopsychosocial model as a foundation of comprehensive medicine, al-though later work by George Engel (1977) on the biopsych-osocial model became more widely cited

Question 28

In terms of the organized discipline of psychology, in 1973 the American Psychological Association appointed a task force to explore psychology’s role within behavioural medicine and in what year was there a division created for the health psychology department?

Answer 28

> in 1978 created a health psychology division (Division 38) (Straub, 2007).

> The Health Psychology Div-ision of APA is one of the five largest divisions within the organization

Question 29

When was health psychology added to the CPA?

Answer 29

> he Health Psychology Section (which has since been renamed as the Health Psychology and Behavioural Medicine Section) of the Canadian Psych-ological Association (CPA) was founded in the early 1980s

Question 30

Health psychologists are often trained to conduct what? Can they be trained to conduct only one type of research?

Answer 30

> both applied (e.g., clinical) work and research.

• However, health psychologists interested in academic or related research careers are sometimes trained exclusively as researchers.

Question 31

What is the Knowledge base?
The entry-level health psych-ologist researcher should have knowledge of:

Answer 31

1) The historical relationship of health psychology to the basic sciences, public health, and clinical investigation.

2) Scientific foundations and methods of psychology and exposure to allied health disciplines

3) Biobehavioural, social-environmental, and psychological factors associated with health behaviours, illness, and disease.

4) Mechanistic and mediational pathways between contextual, psychosocial, and biological phenomena as they relate to disease progression, health promotion, and illness prevention.

5) Biological, psychological, behavioural, and sociocultural tools relevant to individuals and systems

6) Dynamic interactions between populations and contextual variations on health be-haviour and health outcomes.

7) Pathophysiology of disease and the implications for development of biopsychosocial treatments

8) Appropriate methods and procedures to develop a program of research.

9) Strengths and potential pitfalls of role relationships that characterize interdisciplinary collaborative research.

10) Regulatory and ethics competence in relation to interdisciplinary research

Question 32

Health psychologists are employed by:

Answer 32

> general and specialized (e.g., cancer, physical rehabili-tation) hospitals and private clinics treating patients with complex problems (e.g., chronic pain), as well as in private practice.

Question 33

Health psychology operates within the biopsychosocial model of health that considers the interplay and integration of what factors?

Answer 33

> of biological, psychological, and social factors on health

Question 34

What area of psychology does the biopsychosocial model of health forms what basis for health psychology?

Answer 34

> forms the conceptual basis of health psychology

Question 35

What is the contrasting model to the biopsychosocial model of health?

Answer 35

> The traditional medical model of disease that separates the physical and psychosocial

Question 36

Many health problems can be conceptualized through the biopsychosocial model such as what two conditions?

Answer 36

> (e.g., obesity, drug addiction).

Question 37

Under the biopsychosocial, how would obesity be broken down?

Answer 37

> biological factors (e.g., some people may inherit a tendency to gain more weight or a slower metabolic rate),

> psychological factors (e.g., depression and low self-esteem may lead a person to eat more calorie-dense foods such as in desserts and/or to become physically inactive),

> social factors (e.g., socio-economic factors such as in ability to afford healthier foods that may be more expensive than “junk food”;

> absence of social support can contribute to the problem as well as play an important role in one’s ability to lose weight and maintain the weight loss.

Question 38

What is the health belief model?

Answer 38

> The model postulates that readiness to take action in relation to health problems is a function of people’s beliefs and of their perception of the benefits of taking action to prevent health problem

> The model, therefore, facilitates an understand-ing of possible reasons for non-compliance with health-care recommendations

Question 39

What are individual perceptions in the health belief model?

PS-PS-PBOPA-PBOPA

Answer 39

> Perceived susceptibility

> Perceived severity

> Perceived benefits of preventive action

> Perceived barriers to prevent action

Question 40

What are modifying factors in the health belief model?

Answer 40

> Demographic variables

> Sociopsychological variables

> Perceived threat

> Cues to action: Information Reminders
Persuasive communication Experience

Question 41

What affects the likelihood of action in the health belief model?

Answer 41

The perceived threat increases the likelihood of taking recommended preventive health action

Question 42

What is one downside of the health belief model?

Answer 42

> the model does not fully explain the full range of reasons (e.g., economic factors) that affect decisions to engage in health behaviours

Question 43

What is the social cognitive theory?

Answer 43

> Social cognitive theory is based on the work of Albert Bandura (1986, 1991a, 1991b) and considers human behaviour as being reflected in a three-way model in which personal factors, environmental influences, and behaviour commonly interact

Question 44

What are the central constructs in the social cognitive theory model?

R, OL, SC, SE

Answer 44

> Reinforcement,
observational learning,
self-control, and
self-efficacy

Question 45

According to Bandura, self-efficacy develops through what kind of experiences?

Answer 45

> through social experiences, observing others, and personal experiences, including any internal experiences that provide the person with informa-tion about his or her personal strengths and weaknesses.

Question 46

Overall, what does the social cognitive theory model explain and what model does it closely relate to?

Answer 46

> Social cognitive theory helps explain the socio-cultural and personal determinants of health (Bandura, 1998) and is largely consistent with the biopsychosocial model of health, with the greatest emphasis, however, placed on describing social variables involved in health

Question 47

Under the social cognitive model, how does self efficacy improve health?

Answer 47

> it influences our health behaviours, which then affect health outcomes.

Question 48

What is the theory of planned behaviour?

Answer 48

> is an expansion of a pre-existing formulation known as the theory of reasoned action

> The theory also gives consideration to the extent to which the individual has actual (as opposed to just perceived) control over the behaviour,

Question 49

According to Ajzen (1991; n.d.), our behaviour is determined by three types of beliefs [theory of planned behaviour]

Answer 49

(1) behavioural beliefs (i.e., beliefs about the likely consequences of behaviour),

(2) normative beliefs (i.e., beliefs about others’ ex-pectations), and

(3) control beliefs (i.e., beliefs about factors that facilitate or prevent performance of behaviour).

Question 50

What do the three types of beliefs lead to?

Answer 50

> behavioural beliefs lead to favourable or unfavourable attitudes about the behaviour;

> normative beliefs lead to perceived social pressure related to the subjective norm;

> and control beliefs lead to a perception of behavioural control.

Question 51

Since the three types of beliefs lead to attitudes, subjective norms, and perceived behavioural control, what does this affect?

Answer 51

> affect the strength of the intention to perform the behaviour and, ultimately, the actual performance (or lack thereof) of the behaviour.

Question 52

Considerable body of research has supported the use of the theory of planned behaviour in the prediction of intention and behaviour, although the prediction of what is stronger?

Answer 52

> self-reported behaviour ap-pears to be stronger than the prediction of actual behaviour

Question 53

What is the theory of planned behaviour criticized for?

Answer 53

> > Nonetheless, the theory has been criticized for neglecting the important role of emotion, as well as cultural factors, in the determin-ation of behaviour

Question 54

In health psychology, what has the theory of planned health behaviour been used for?

Answer 54

> used to study a wide range of health-related behaviours: such as adherence to diet and physical activity, in diverse clinical populations

Question 55

What is the the common-sense model (CSM) of self-regulation/the CSM of illness representations

Answer 55

> is a theoretical framework within health psychology that describes the way people process and cope with health threats.

> The model specifically suggests that individuals form a lay view of their health based on various sources of information and this lay view guides their coping responses

> The model suggests that there is continuous feedback between the efficacy of how people cope with health threats and their perceptions of the health threat.

> The model has been used to develop interventions to assist people in coping with illness.

Question 56

The cognitive behavioural perspective is often employed within the field of health psychology; however, what is it most commonly used for?

Answer 56

> used to assist clinicians in understanding how individuals respond to physical symptoms or medical conditions

Question 57

The cognitive behavioural perspective was originally developed to understand what? Has it expanded?

Answer 57

> developed to understand depression, but has been extended to other mental health conditions as well as in explanations of the way in which people respond to health problems

> The cognitive behavioural perspective also emphasizes that thoughts, be-haviour, and emotions are interconnected and thus our behaviours and emotions also influence our thoughts.

Question 58

What is CBT?

Answer 58

> Cognitive behavioural therapy (CBT), based on the cognitive behavioural perspective,

> gold standard treatment for psychologists working with patients

> The treatment is typically short-term, goal-oriented, and present-day focused, with the therapist helping the patient identify and challenge unhelpful thoughts and learn individual skills that will assist with or improve her or his health condition

Question 59

What is the transtheoretical model of behaviour change?

Answer 59

> specifically focuses on five stages of change people may experience when modifying health behaviours

Question 60

What are the stages in the transtheoretical model of behaviour change?

Answer 60

> The stages include precontemplation, contemplation, preparation, action, maintenance, and termination.

• Along with stages of change, this model also discusses various processes of change (i.e., behavioural and experiential actions that people use to make changes) and the way in which decisions about change are made.

Question 61

The most significant challenge that remains for future research involves what?

Answer 61

> the need for a better understanding of the biological processes mediating this relationship.

Question 62

Miller and colleagues also identified a series of advanced methodologies that are becoming increasingly influential and have the potential to help resolve the puzzle of how psycho-logical variables impact health. These methodologies include, but are not limited to:

Answer 62

> sophisticated statistical approaches for testing complex relationships among variables,

> use of non-invasive im-aging systems (e.g., magnetic resonance imaging [MRI]),
use of biomarkers such as C-reactive protein

> and use of laboratory analyses that permit the capture of a wide range of basic scientific information, in-cluding patterns of gene activity.

Question 63

With respect to applied areas, future research is expected to em-phasize questions about what?

Answer 63

> the cost-effectiveness of health psychology,
translate knowledge into practice,
how to improve delivery of health psychology services through the use of technology

Question 64

Health psychology must also pay greater attention to what?

Answer 64

> non-industrialized parts of the world, where it is estimated that 90 per cent of the global burden of disease exists, but where only 10 per cent of the world’s health-care resources are found