Intro to Beh Med and Research Methods Flashcards
What is Behavioural Medicine?
Described as:
the development and integration of behavioural, psychosocial and biomedical science knowledge and techniques relevant to the understanding of health and illness, and the application of this knowledge and these techniques to prevention, diagnosis, treatment and rehabilitation.
What did Hippocrates and Galen propose?
Ancient Greeks: Hippocrates – Founder of medicine – attributed disease to environmental factors and life style rather than supernatural causes. Proposed humoral theory of health.
Galen - early Roman Physician BC200-129 developed theory – four bodily humours: blood, phlegm, black bile and yellow bile. Health depended on maintaining balance – treatments involved sweating, purging, blood letting etc.
Also promoted lifestyle modification.
How did Ibn-Sina contribute to medicine?
Ibn-Sina (Avicenna, 980 to 1037) Arab scientist and doctor wrote the first medical text book “Al Qanun of Medicine” used throughout Europe for seven centuries, also advocated the use of reason and logic as the way to gain knowledge pre-European Renaissance.
- found that music and physical activity had a definite effect on patients
- etiology of disease must be understood. only then is it possible to begin treatment
Describe health in the Middle Ages.
Beliefs about illness dominated by superstition
Poor hygiene, lack of sanitation, lack of medical knowledge.
Life expectancy from birth was 30-40 years. High infant mortality.
Unpredictability - wars, famines, infectious diseases. Black Death killed nearly one third of the population of England in1348-1350
Disease seen as God’s punishment for evil doing (behavior) in this life or previous life. Cured by driving out the evil forces by torturing the body or accepting fate.
Treatment becomes penance through prayer and good works, the function of the physician is absorbed by the priest.
Describe the theory of miasma. What was it replaced by?
Proposed that diseases were caused by the presence in the air of a miasma, a poisonous foul smelling vapour in which articles of decaying matter were suspended
This theory originated in the Middle Ages and endured until 1800s
Replaced by Germ Theory - proposed diseases are caused by microscopic organisms invisible to the naked eye (Louis Pasteur, Robert Koch and John Snow in mid 1800s)
Describe the periods of Renaissance and Enlightenment.
14th to 17th century: Renaissance
- Mind and body separation
- The growth of physical medicine reinforced
- dualistic viewpoint-popularised by Descartes
Enlightenment: 1650 – 1800
- Scientific method developed
- Theory of evolution - Origin of Species 1856
- Invention of microscope
- New sciences (autopsy and cellular pathology)
- Focus on organic and cellular pathology for diagnosis
- Biomedical model dominant
What is the Biomedical Model?
What causes illness? External factors – invasion by bacteria, viruses. Internal involuntary changes such as chemical imbalance, genetic predisposition etc
Who is responsible for illness? External force. Individuals have no control over illness and seen as victims. Illness arises from biological changes beyond control.
How should illness be treated? Treatment should aim to change the physical state of the body – vaccine, surgery, medication
Who is responsible for treatment? The medical profession. Experts.
What is the relationship between health and illness? These are two independent states – you are either healthy or ill – no continuum between the two.
What is the relationship between the mind and the body? The mind is abstract. Thoughts and feelings are not capable of influencing the body. The body is physical matter and functions independently of the mind.
What is the role of psychology in health and illness? Illness may cause unhappiness and anxiety, but psychology does not cause physical illness.
Describe the challenges made to the assumptions of the biomedical model?
19th century - Renowned French physiologist Claude Bernard established use of scientific method in medicine. Highly respected scientist. Emphasised that psychological factors influenced physical illness.
20th century - The psychoanalytic contribution: Sigmund Freud stressed the importance of unconscious mental processes in shaping feelings, thoughts, and behaviour.
Psychosomatic medicine: Dunbar and Alexander proposed that bodily disorders were caused by emotional conflicts, examples: Ulcers; arthritis; essential hypertension; asthma etc.
1950-60s Watson and Skinner develop behavioural psychology – classical and operant conditioning
1960s Cognitive psychology expands understanding of memory, thought, perception, attention, language (Broadbent, Miller)
What is the biopsychosocial model?
Health and illness as the product of a combination of factors including:
Biological characteristics (genetic predisposition) Behavioural factors (lifestyle, stress, health beliefs) Social conditions & environmental (cultural influences, family relationships, social support).
Mind and body are not distinguishable in matters of health and illness
How did WHO describe health in 1946? What are the limitations to this?
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
Limitations -
Definition is important in defining how health, illness and disease are measured.
Health as ‘the absence of disease’ – medicalises health
Time dependent – diagnosis may change tomorrow
Experience of symptoms variable
Impact of the genome ? Genetic screening – predisposition to disease not yet symptomatic? Impact on concept of risk?
Is an individual’s identity defined by the presence or absence of disease e.g. “the diabetic” “the schizophrenic”
Does absence of physical illness imply psychological health?
Is a community where ‘disease’ is absent also healthy? What if a disease is simply not recognised as a health issue , such as mental health problems.
Health promotion – how does managing risk factors fit into this model? Health in the digital age
How was health redefined by WHO in 1984?
Health is now understood as a continuum and as a process rather than a state of being
Redefined by WHO in 1984:
- Health is the extent to which an individual or group is able to realize aspirations and satisfy needs and to change or cope with the environment.
- Health is a resource for everyday life, not the objective of living; it is a positive concept, emphasizing social and personal resources, as well as physical capacities.
What is the life expectancy at birth of different places?
Global - overall avergae 73.2 years (women - 75.6, men - 70.8)
UK - male 80.2, female 83.3 years - average 80.8 years
Scotland - 76 years
Wales - 78 years
Variation by country - Highest Hong Kong 85.29, Lowest Central African Republic 54.36
UK ranks 29th out of 191 countries
Variation within countries - boys born in Blackpool live 8 years less than Richmond-upon-Thames
What are the top 10 causes of death worldwide?
Ischaemic heart disease stroke COPD Lower resp infections Alzheimer's and other dementias Trachea, bronchus and lung cancers Diabetes Mellitus Road injury Diarrhoeal diseases Tuberculosis
What are health behaviours?
Any actions or inactions undertaken by
individuals or populations that affect their health
or the health of others.
What is a health habit?
- A health related behaviour that is firmly established and often performed automatically, without awareness.
- Cue - behaviour - reward
- Usually developed in childhood – i.e. tooth brushing
- Stabilises around age 11 or 12yrs – likely to be maintained.
- Initial develops due to specific positive outcomes i.e. parental approval, social acceptance.
- Eventually becomes independent of the reinforcement process and is maintained by the associated environmental factors
- It can be highly resistant to change
- 66 days to establish a habit?
