Week 1: Intro to Health Psychology, Models of Health and Research Methods Flashcards
What is Health Psychology?
- Health psychology is sub-field of psychology that links psychological theory and practice to physical health.
-It aims to understand the reciprocal influences between the mind and body (between mental and physical health).
-Thus health psychology research questions combine some aspect of psychology with some aspect of the physical body.
-Health psychology is both interdisciplinary and multidisciplinary in nature.
How did health psychology come about?
-Health psychology is a relatively new sub-field of psychology and came about due to a shift in what people began dying from.
-Historically infectious diseases were responsible for a large portion of mortality. As time went on knowledge around safe hygiene practises increased, and the advent of medications to treat such illness occurred. This meant less people died from infectious disease ‘freeing’ them up to live longer and die from other causes.
-Death rates as measured in 2001 show diseases of the heart and cancers to be hugely influential in mortality while similar trends are shown in a study looking at US deaths in 2020.
-The exception to infectious diseases no longer being a primary cause of death is COVID (likely because we didn’t/ don’t know much about it- so don’t have effective medications etc.).
-In other words, people mostly die from chronic diseases in today’s society. -These diseases are generally of slow duration and progression resulting from an accumulation of health behaviours/ environment during an individual’s life span. Examples of chronic diseases include heart disease, stroke, cancer, chronic respiratory diseases and diabetes.
-This shift therefore puts pressure on individuals to make the right decisions for their health and so health psychology arose to address this.
-While early psychologists were trained in medicine in the 1970s a growing epidemic of chronic diseases resulted in more and more psychologists beginning to work in medical settings conducting research to address the behaviour factors in chronic disease- there was also a shift in funding to support this.
-In 1978 the American Psychological association officially started a society for health psychology (division 38).
-Countries like the US and UK have been dominant in developing the field of health psychology but the discipline has now also filtered down to Australia and New Zealand.
What are chronic diseases + examples?
These diseases are generally of slow duration and progression resulting from an accumulation of health behaviours/ environment during an individual’s life span. Examples of chronic diseases include heart disease, stroke, cancer, chronic respiratory diseases and diabetes.
What are the implications for the role of psychology in maintaining health now that the majority of people in industrialised countries are dying from chronic disease (aside from the recent Covid-19 spike)?
Chronic diseases result from the accumulation of an individual’s health behaviours across the lifespan i.e. cardiovascular disease, type 2 diabetes. Psychology at its core is about influencing and understanding behaviour. Therefore psychology is essential in maintaining health - through psychology we can change the health behaviours of individuals and resulting in better outcomes.
Countries with biggest impact in developing health psychology as discipline?
-Countries like the US and UK have been dominant in developing the field of health psychology but the discipline has now also filtered down to Australia and New Zealand.
World health definition of health in 1948:
“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
“The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”
In what ways is the WHO (1948) definition of health ahead of it’s time?
- Recognise three factors important in health: physical, mental and social well-being. This is a biopsychosocial model of health that aligns with Engel, 1977 i.e. ahead of time as the WHO definition came about in 1948!
- Health as a right and one that is should be equally accessible to all regardless of race, religion, political belief, economic or social condition. This is remarkable when you consider the unjust climate of the 1940s: certain groups of society were deemed by most as beneath others so WHO coming out and saying all should have equal access to health is a statement.
- “Health is not merely the absence of disease or infirmity” - links to idea of health as an illness wellness continuum. At one end you have death and the at the other high level of wellness. In the middle is a neutral point where there is no discernible illness or wellness (i.e. absence of disease but not thriving). This continuum can be paralleled with one for mental health whereby at one end there is mental illness and the other complete mental health & flourishing. In both we see that it is not simply the absence of illness (either physical or mental) that defines optimum health but the presence of wellness (physical health continuum) and flourishing (mental health continuum). The WHO definition is therefore ahead of its time as it encompasses the ideas of positive psychology (a much more recent psychology subfield.
Health as a continuum? Mental health as a continuum?
- Health can be conceptualized on a continuum: at one end you have death and the at the other high level of wellness. In the middle is a neutral point where there is no discernible illness or wellness (i.e. absence of disease but not thriving).
-This continuum can be paralleled with one for mental health whereby at one end there is mental illness and the other complete mental health & flourishing.
-In both we see that it is not simply the absence of illness (either physical or mental) that defines optimum health but the presence of wellness (physical health continuum) and flourishing (mental health continuum).
-links to positive psychology
What is positive psychology?
mental health is not just the absence of mental illness but also requires the presence of ‘flourishing’. Relates to the WHO definition of health and the illness- wellness continuum whereby health is not merely the absence of physical illness but also the presence of ‘wellness’.
Biomedical model of health: what is it? In what ways does it fall down?
- Primary model up to the 20th century
- Biological or physiological processes were studied separately from psychological processes
- Highly western approach: individualistic, medicalized, mind-body dualism
- Health has been understood within the biomedical model since the advent of modern science (e.g. anatomy)
PROBLEM: does not always follow that understand the physical state of an individual results in complete understanding of illness i.e. can have those with physical ‘markers’ of illness but don’t have illness symptoms or the reverse: can still be unwell with no physical abnormality to show for it (e.g. discogenic chronic lower back pain persisting after disc injury has ‘healed’).
Biopsychosocial model: What is it?
- Three elements of health that interact:
Biological (genes, cellular functioning, immune system), Psychological (behaviours and mental processes, cognition, emotion, motivation), Social (relationships with friends, family, society, community)
-Proposed by Engel, 1977 although also aligns with the WHO definition (1948)
Biopsychosocial model: in what ways does it challenge the biomedical model?
- Engel challenged the separation of medicine from psychiatry, and criticized physicians who did not consider psycho-social contributors to illness.
- Additionally, he claimed that the biomedical model is too reductionistic. In other words it assumed that the language of chemistry and physics suffices to explain biological phenomena ignoring the fact that there is often not a 1:1 correspondence between biochemical deficit and disease. Illness instead results from a complex interaction of factors.
- The biomedical model also does not explain placebo effects (if illness is health is purely a result of biological/ physiological processes then how do beliefs like expectancy influence physical health.
List the two Māori health models:
-Te Whare Tapa Wha
-The Meihana model
Te Whare Tapa Wha
- Māori model of health proposed by sir Mason Durie (1985)
- Durie proposed that a “full appreciation of health requires understanding of culture”
- The WHO definition i.e. a biopsychosocial model lacks a spiritual aspect so this models adds it to create four elements in total
- Additionally the “social well-being definition” from WHO/ biopsychosocial models prioritised structural inequalities rather than key interpersonal aspects of family (whanau, hapu, and iwi and thus is too individualistic for a Māori context.
- Depicts health as a house with four sides: all four sides (spiritual wellbeing = te taha Wairau, mental and emotional wellbeing= te taha Hinengaro, physical well-being = te taha Tinana , family and social wellbeing = ta taha Whanau) holistically represent health and wellbeing without one the house will fall down. Note: whenua (land/ roots) is the foundation of this ‘house’.
The Meihana model
- Developed in 2007 by Professor Suzanne Pitama (Ngāti Kahungunu)
-Framework and assessment tool for translating Te Whare Tapa Whā model into better serving Māori people within mental health service delivery.
-Contains the four aspects of Durie’s model (physical, emotional, spiritual, social) plus two more (physical environment & health services), and winds and currents (marinization, colonisation, racism, migration).
-Depicts health with an image of two wakas
-Patient is one waka and the family is the other: Recognises both as having equal importance for health
-Bridges between the waka (factors influencing health, note: spiritual represented elsewhere in image?)
