Health PsychologyHealth Psychology

Division 38 (Health Psychology)Division 38 (Health Psychology)

Education & Training CommitteeEducation & Training CommitteeRegan A. R. Gurung (Chair)Regan A. R. Gurung (Chair)

Created 2008Created 2008

Sample Research Findings in Sample Research Findings in Health PsychologyHealth Psychology

One of the strongest predictors of who is likely to have a One of the strongest predictors of who is likely to have a heart attack among American adults is a hostile personality heart attack among American adults is a hostile personality trait and a tendency towards hostile interactions with trait and a tendency towards hostile interactions with others.others.

After surgery, patients in a hospital room with a pleasant After surgery, patients in a hospital room with a pleasant view go home sooner and with fewer complications that view go home sooner and with fewer complications that those looking at a blank wall.those looking at a blank wall.

Premature infants in the hospital given 15 minutes of light Premature infants in the hospital given 15 minutes of light massage per day gain weight faster and go home soonermassage per day gain weight faster and go home sooner

Keeping a diary where one writes about important thoughts Keeping a diary where one writes about important thoughts and events boosts the body’s immune system and and events boosts the body’s immune system and improves physical health. improves physical health.

Hostile and conflictual interactions with one’s spouse or Hostile and conflictual interactions with one’s spouse or partner can suppress the immune system and increase the partner can suppress the immune system and increase the risk of developing colds.risk of developing colds.

Laughter is a powerful painkiller.Laughter is a powerful painkiller.

Sample Research Findings in Sample Research Findings in Health Psychology (cont.)Health Psychology (cont.)

Some people with asthma can suffer full-blown attacks after Some people with asthma can suffer full-blown attacks after looking at artificial flowers.looking at artificial flowers.

People with few friends and who lead isolated lives are twice as People with few friends and who lead isolated lives are twice as likely to die during a given time period. likely to die during a given time period.

After a heart attack, patients who owned pets were significantly After a heart attack, patients who owned pets were significantly less likely to die in the following year. less likely to die in the following year.

Blood pressure decreases when pet owners talk to their pets or Blood pressure decreases when pet owners talk to their pets or are in the presence of their pets during stressful events.are in the presence of their pets during stressful events.

Men who performed volunteer work once a week lived longer and Men who performed volunteer work once a week lived longer and were healthier than men who volunteered less than once a week.were healthier than men who volunteered less than once a week.

Depression is a stronger predictor of heart attacks and poor Depression is a stronger predictor of heart attacks and poor recovery from a heart attack than high cholesterol or cigarette recovery from a heart attack than high cholesterol or cigarette smoking.smoking.

When people watch tropical fish in an aquarium with their full When people watch tropical fish in an aquarium with their full attention, they lower their blood pressure and heart rate attention, they lower their blood pressure and heart rate significantly.significantly.

People taught relaxation and meditation techniques showed lower People taught relaxation and meditation techniques showed lower blood pressure and less complications during surgery.blood pressure and less complications during surgery.

The AreaThe Area Psychologists who strive to understand Psychologists who strive to understand

how biological, behavioral, and social how biological, behavioral, and social factors influence health and illness are factors influence health and illness are called health psychologists.called health psychologists.

The term "health psychology" is often The term "health psychology" is often interchanged with the terms "behavioral interchanged with the terms "behavioral medicine" or "medical psychology". medicine" or "medical psychology".

Illnesses related to Psychological/Behavioral factors:

Heart disease and stroke

Cancer

HIV/AIDS

COPD

Type II diabetes

Poor birth outcomes

Chronic pain conditions

Infectious illnesses

Actual causes of death in the US *:1. Smoking / tobacco2. Sedentary lifestyle and poor diet3. Alcohol 4. Microbial agents5. Toxic agents6. Motor vehicle accidents7. Firearms8. Sexual behavior9. Drug abuse

*Mokdad et al. Actual causes of death in the US 2000. JAMA 2004:291:1238-46

Half of all deaths that occurred in the United States in 2000 can be attributed to a limited number of largely preventable behaviors and exposures (Mokdad et al., 2000). This is where Health Psychologists are particularly effective.

Health over TimeHealth over Time

3000 years ago3000 years ago::• Spirits, Mind, and body seen as oneSpirits, Mind, and body seen as one

Greeks onwardGreeks onward (e.g., Descartes): (e.g., Descartes): • Mind and body separateMind and body separate

Age of Scientific DiscoveryAge of Scientific Discovery (17-19 (17-19thth century): century):• Rise of the biomedical model of diseaseRise of the biomedical model of disease• Inventions drive health care (e.g., 1668 Microscope)Inventions drive health care (e.g., 1668 Microscope)

Beginnings of Health Psychology as we know itBeginnings of Health Psychology as we know it• 1930s Society for 1930s Society for Psychosomatic MedicinePsychosomatic Medicine formed formed• 1970s Society for 1970s Society for Behavioral Medicine Behavioral Medicine formed formed• 1970s 1970s Health Psychology Health Psychology formed formed• Mind and body are seen as one againMind and body are seen as one again

Historical moments in health psychology-Walter Cannon (1932) - stomach movements affected by emotional state. Stress increases blood sugar, epinephrine, BP, respiration rate (“Fight or flight”)-Framingham study (1948 - ) - lifestyle factors are significant risk factors for cardiovascular disease-Hans Selye (1956) – physiological arousal from stress leads to disease if prolonged or chronic-Lazarus (1960’s+) – appraisals of events are critical for understanding health outcomes-Neal Miller (1970’s) – can learn to control bodily functions like BP, intestinal contractions, muscle tension-Robert Ader (1970’s) – classical conditioning of immune system responses to immune-suppressant drugs

Health Psychology’s Main GoalsHealth Psychology’s Main Goals

Understanding psychological Understanding psychological influences:-influences:-

- on how we stay healthy,- on how we stay healthy,- why we become sick, and - why we become sick, and - how we respond when we do.- how we respond when we do.

GOALS of FieldGOALS of Field1. Promote and maintain health (e.g., stop 1. Promote and maintain health (e.g., stop

smoking, buckle belts).smoking, buckle belts).

2. Prevent and treat illness (e.g. reduce High 2. Prevent and treat illness (e.g. reduce High Blood pressure).Blood pressure).

  3. Focus on cause and detection of illness: 3. Focus on cause and detection of illness:

influence of personality, cognitive processes.influence of personality, cognitive processes.

4. Improve the health care system/health policy.4. Improve the health care system/health policy.

The Main Approach UsedThe Main Approach Used

The Biopsychosocial ModelThe Biopsychosocial Model• views health and illness as the product of a views health and illness as the product of a

combination of factors includingcombination of factors including Biological factors (e.g., genetic predisposition),Biological factors (e.g., genetic predisposition), Psychological factors (e.g., personality, lifestyle, Psychological factors (e.g., personality, lifestyle,

stress, health beliefs), andstress, health beliefs), and Social factors (e.g., cultural influences, family Social factors (e.g., cultural influences, family

relationships, social support). relationships, social support).

Biopsychosocial Approach to Health and Illness Traditional biomedical model has limited usefulness with current patterns of illness and the health challenges of the 21st century.

Integrates biological, psychological, and social influences in order to understand health and vulnerability to illness and successfully treat disorders.

Addresses limitations of a traditional medical model that attempts to cure disease. We are not healthy until we become sick. Mental problems are not clearly distinguishable from physical problems.

Sample Major TheoriesSample Major Theories

BEHAVIOR CHANGEBEHAVIOR CHANGE• Health Belief ModelHealth Belief Model• Theory of Planned BehaviorTheory of Planned Behavior• Transtheoretical ModelTranstheoretical Model

STRESSSTRESS• Fight and Flight responseFight and Flight response• General Adaptation SyndromeGeneral Adaptation Syndrome• Cognitive Appraisal ModelCognitive Appraisal Model

Current IssuesCurrent Issues

Interactions between health Interactions between health psychologists and medical doctors.psychologists and medical doctors.

Cultural differences in health.Cultural differences in health. Technology and health.Technology and health. Reducing Obesity.Reducing Obesity.

Where Do Health Psychologists Where Do Health Psychologists Work?Work?

Health psychologists participate in health Health psychologists participate in health care in a multitude of settings including:care in a multitude of settings including:• primary care programs,primary care programs,• inpatient medical units, andinpatient medical units, and• specialized health care programs such asspecialized health care programs such as

pain management,pain management, rehabilitation,rehabilitation, women's health,women's health, oncology,oncology, smoking cessation, andsmoking cessation, and headache managementheadache management

• They also work in colleges and universities, They also work in colleges and universities, corporations, and for governmental agencies. corporations, and for governmental agencies.

Clinical ActivitiesClinical Activities

Health Psychologists:Health Psychologists:• Help measure/assess for mental and behavioral Help measure/assess for mental and behavioral

problems,problems,• Conduct clinical interviewsConduct clinical interviews• Administer surveys and personality tests.Administer surveys and personality tests.• Design interventions to help:Design interventions to help:

With stress management,With stress management, Educate about disease and illness,Educate about disease and illness, Ways to cope with disease,Ways to cope with disease, Perform more health behaviors such as physical Perform more health behaviors such as physical

activity.activity.

Research ActivitiesResearch Activities Health psychologists are on the leading edge of Health psychologists are on the leading edge of

research focusing on the biopsychosocial model research focusing on the biopsychosocial model in areas such as:in areas such as:• HIV,HIV,• CancerCancer• Compliance with medical regimens,Compliance with medical regimens,• Health promotion, andHealth promotion, and• the effect of psychological, social, and cultural factors on the effect of psychological, social, and cultural factors on

numerous specific diseasesnumerous specific diseases diabetes,diabetes, cancer,cancer, hypertension and coronary artery disease,hypertension and coronary artery disease, chronic pain, andchronic pain, and sleep disorders.sleep disorders.

Health psychology research examines:Health psychology research examines:• The causes and development of illness,The causes and development of illness,• Methods to help individuals develop healthy lifestyles Methods to help individuals develop healthy lifestyles

to promote good health and prevent illness,to promote good health and prevent illness,• The treatment people get for their medical problems,The treatment people get for their medical problems,• The effectiveness with which people cope with and The effectiveness with which people cope with and

reduce stress and pain,reduce stress and pain,• Biopsychosocial connections with immune Biopsychosocial connections with immune

functioning, andfunctioning, and• Factors in the recovery, rehabilitation, and Factors in the recovery, rehabilitation, and

psychosocial adjustment of patients with serious psychosocial adjustment of patients with serious health problems. health problems.

CareersCareers

Elaborate on career opportunities in Elaborate on career opportunities in this areathis area

Describe potential intrinsic and Describe potential intrinsic and extrinsic benefitsextrinsic benefits

Describe working conditionsDescribe working conditions Describe training requiredDescribe training required Potential for upward career Potential for upward career

movementmovement Other professional opportunitiesOther professional opportunities

Training for Health Psychology Training for Health Psychology Careers:Careers:

Health psychologists typically hold a Health psychologists typically hold a doctoral degree (Ph.D. or Psy.D.) in doctoral degree (Ph.D. or Psy.D.) in psychology.psychology.

Applied health psychologists are licensed Applied health psychologists are licensed for the independent practice of psychology for the independent practice of psychology in areas such as clinical and counseling in areas such as clinical and counseling psychologypsychology

Board certification is available in health Board certification is available in health psychology through the American Board of psychology through the American Board of Professional Psychology. Professional Psychology.

Preparing for a career in health Preparing for a career in health psychologypsychology

Obtain general psychology training at the Obtain general psychology training at the undergraduate and doctoral levels,undergraduate and doctoral levels,

Receive specialty training at the postdoctoral Receive specialty training at the postdoctoral or internship level.or internship level.• Predoctoral Internships:Predoctoral Internships: Clinical and counseling Clinical and counseling

psychologists are required to complete a one-year psychologists are required to complete a one-year internship/residency before obtaining their internship/residency before obtaining their doctorates. doctorates.

• Postdoctoral Fellowships:Postdoctoral Fellowships: Many university medical Many university medical centers, universities, health centers, and health centers, universities, health centers, and health psychology programs offer specialized research psychology programs offer specialized research and/or clinical training in different areas of health and/or clinical training in different areas of health psychology. psychology.

ResourcesResources

APA Division 38 (Health Psychology) APA Division 38 (Health Psychology) Webpage: Webpage: www.health-psych.org/www.health-psych.org/

Major Journal in FieldMajor Journal in Field• Health Psychology: Health Psychology:

www.apa.org/journals/hea/www.apa.org/journals/hea/ Careers Page:Careers Page:

• www.sbm.org/careers/www.sbm.org/careers/