Reading: Anisman Chapter 1 Flashcards
The Tyranny of Illness
- The cause, nature and trajectories of illnesses differ appreciably
- As do the needs of the affected person (support required, whether coping strategies will be effective) which will change across the course of the illness.
-All illnesses effect quality of life and can be influenced by psychological factors.
Dealing with Coordinated Systems: A Holistic Perspective
- When it comes to health we need to consider the interconnected nature of the body i.e. a given function can never purely be isolated to one organ alone each has the ability to influence one another.
- This holistic nature means that treatment strategies need to take a broader perspective and treat multiple dimensions of the individual.
- Link between physical and psychological state. Psychological state has the power to influence compliance and success of a given treatment even if the condition would generally be considered as ‘physical’.
Multiple Concurrent and Sequential Influences
- Illness can be a result of accumulated poor-health related behaviours e.g. diabetes + heart disease related to dietary influence over decades.
- Even those where there is a genetic factor/ some characteristic that means specific vulnerability lifestyle choices can still have a profound effect on the outcomes and life course of a given illness/ condition.
- Wellbeing influenced by events that happened years earlier (e.g. early postnatal experiences) and can have a flow on effect to illness susceptibility across generations.
- We can all benefit from community actions geared towards healthy living.
Evidence based practice
- “The enhancement of decision making and treatment stemming from rigorous research that meets the criteria for valid and reliable methodological consideration, and interpretation of findings based on equally rigorous criteria”.
- Typically involves quantitative analyses (numerical) or qualitative analyses (narrative).
- A place for both study types i.e. qualitative can provide more in depth information than what is given through pure numbers or in some cases it is simply not possible to obtain hard data.
- Importance of knowing when it is appropriate to generalize findings and when it is not
What do we mean when we say Health Psychology : Health Psychology Defined
- Psychological + environmental factors (e.g. early life exposure, psychosocial processes) can influence physical illness
-These factors have been overlooked in the past and so were not a focus of previous health interventions. Today it has been shown that psychological techniques and behavioural interventions can go a long way to diminishing physical illnesses and in some cases precluding them from even appearing (substantiating the above claims).
-Attempts made to integrate the disciplines of psychiatry and neurology (between the behavioural and brain sciences).
-Health psychology is inherently multidisciplinary: focuses on the conjoint influences of psychosocial, neurobiological and genetic factors in relation to varied physical illnesses.
Clinical Health Psychology
- Health psychology research contributes the knowledge
- Clinical health psychologists might apply this knowledge to the development of therapeutic strategies in order to diminish physical illness or delay the occurrence of pathological conditions for an individual.
- Information is also of use to policy makers/government + educators & public health agencies who are concerned with the influence of psychosocial factors on health outcomes at the population/ community level —> can target campaigns to address either the whole population or a subset.
Behavioural Medicine
- Health psychology and behavioural medicine often thought of as interchangeable only subtle differences (potentially behavioural medicine more closely linked to medical disciplines).
- Behavioural medicine = focus on treatments of illness using techniques that involve a biological and psychosocial approach (e.g. hypnosis, biofeedback, OT, rehabilitation medicine).
- Behavioural medicine moves away from a strict medical model recognising the influence that behavioural adjustments can have on health.
Psychosomatic Illness: Development (3 catergories)
1) A mental illness and a medical illness are both present and each negatively effects the other
2) A psychiatric problem (e.g. depression, anxiety, post-traumatic stress disorder (PTSD)) develops as a result of a medical illness (e.g. cancer) or its treatment.
3) A psychiatric disturbance is expressed through physical problems (e.g. pain), as in the case of bullied children and adolescents who might exhibit varied physical disturbances
Somatoform Disorders
- Physical illnesses solely provoked by psychological factors e.g. body dysmorphia
- Psychological treatments alone could be effective in complete symptom removal.
-Sometimes it is unknown whether an illness is psychosomatic (i.e. physical illness influenced by psychological factors) or somatoform (e.g. physical illness purely caused by psychological factors alone) and the ‘category’ of an illness can change as knowledge progresses.
-This labelling has had a huge impact in the past i.e. diseases thought less legitimate if lack of biological cause was demonstrated. As knowledge is progressing more previously ‘sketch’ illnesses are gaining validity in the eyes of science and the public (e.g. chronic fatigue).
A Continuum Between Wellness and Illness
It is isn’t necessarily true that there is a gradual continuum from illness to wellness at least at a conscious level e.g. despite constant tumour growth a patient with cancer might suddenly jump from an impression of wellness/ health to sickness once the tumour has grown enough to effect daily functioning.
Effects that illness can have
- Becoming ill can effect self-reliance, sense of independence, shatters illusion of invulnerability, forces life-style chances, diminish ability to work, take care of dependents, cause finical strain, produce pain etc.
-Can form a new identity as a ‘sick person’
What is Vulnerability
- Vulnerability = “the susceptibility of an individual to develop certain psychological or physical disturbances in response to external or internal triggers e.g. more vulnerable to getting a cold when tired.”
- Ordinarily our biological systems might act well and the risk of illness may be low/ moderate but when excessive load is placed (either psychological or physical in nature) our weakness is exposed and we are more likely to become ill. What specific illness this is depends on what ‘weaknesses’ the individual possesses.
- If we know in what ways someone is vulnerable might be able to come up with interventions/ behavioural strategies to prevent illness on set.
What is Resilience?
-An individual’s propensity to overcome an illness, although it can also be used to refer to the ability of an individual to withstand the effects of stressful events that would ordinarily lead to a pathological condition.”
- What makes someone resilient is complex (may be a combination of factors that need to come together).
- Examples: personality dimensions, strong social identify, effective support network, presence of neuronal processes that favour positive feelings).
Difference between Vulnerability and Resilience
- Resilience and vulnerability are not necessarily at opposite ends of the spectrum i.e. the absence of vulnerability does not necessarily mean that illness resilience reigns. Likewise the presence of vulnerability doesn’t mean there is zero resilience (may be able to overcome obstacles that would otherwise lead to illness).
Illness Comorbidities + mechanisms by which this occurs
- Many illnesses are linked (e.g. depression and numerous physical illnesses such as heart disease)
-Multiple mechanisms by which this could occur:
1) Depression causes heart disease (precedes)
2) Both depression and heart disease are caused by some other common factor
3) Could be that there are common neurobiological mechanisms that contribute to both.
Mechanism has influence over where the focus for treatment should be.
