Introduction to Health Psychology

Deidre B. Pereira, PhD, ABPP

Welcome!
Who Am I?
Let’s Get to Know Each Other!

• Pair up
• Get your peer’s name, home city, year in program, major, future
occupational aspirations
• Identify 3 things that you have in common
• Introduce your peer to the class!

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Review of Syllabus
Changes

• January 31, 2025

• No class
• Lecture recording
• Move Team Quiz #1 to 2/7/2025
• 2/14/2025
• No class
• Lecture recording

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Chapter One

What Is Health
Psychology?
Chapter Outline

• Definition of health psychology.

• The mind-body relationship: A brief history.
• The rise of the biopsychosocial method.
• The need for health psychology.
• Health psychology research.
• What is health psychology training for?

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Case Study

• 63 yo Black male.
• Lives in rural North Florida.
• Elevated prostate specific antigen (PSA).
• Declines to undergo digital rectal exam (DRE).

• What are some possible reasons why he is

declining DRE?
• How might this affect his health and well-being?
• How do we help?

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Health Psychology

Studies psychological influences on:

• How people stay healthy.

• Why they become ill.
• How they respond when they get ill.

Health: “Complete state of physical, mental, and social well being not
merely the absence of disease or infirmity” (World Health Organization,
1948).

Wellness: Optimum state of health.

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Focus of Health Psychologists

Health promotion and maintenance.

Prevention and treatment of illness.

Etiology and correlates of health, illness, and dysfunction.

• Etiology: Origins or causes of illness.

Improvement of the health care system and formulation of health policy.

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Health Service Psychology and Other Applied Services

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The Mind-Body Relationship: A Brief History 1

During prehistory:

• Mind and body intertwined.

• Diseases arise when evil spirits enter the body.

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The Mind-Body Relationship: A Brief History 2

Ancient Greeks: Humoral theory of illness.

• Diseases resulted when the four humors, or circulating fluids of the
body, were out of balance.
• Four humors associated with personality types.
• Blood: Passionate temperament.

• Black bile: Sadness.

• Yellow bile: Angry disposition.

• Phlegm: Laid-back approach to life.

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The Mind-Body Relationship: A Brief History 3

Middle Ages: Disease regarded as God’s punishment.

Renaissance to present day: Enhanced scientific knowledge and

assessment.
• Practice is dependent on laboratory findings and reported or observed
bodily factors.
• Diagnosis and treatment are based on organic and cellular pathology.

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The Biomedical Model 1

• All illness can be explained through aberrant somatic bodily

processes, such as biochemical imbalances or neurophysiological
abnormalities.
• Assumes that psychological and social processes are largely
irrelevant to the disease process.

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The Biomedical Model 2

Ill-suited to understanding illness:

• Reduces illness to low-level processes.

• Fails to recognize social and psychological processes as powerful
influences—assumes a mind-body dualism.
• Emphasizes illness rather than focusing on behaviors that enhance
health.
• Cannot address puzzles that face practitioners (for example, 6 people
are exposed to the flu and only 3 get it).

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Conversion Hysteria

• Specific unconscious conflicts produce physical disturbances

symbolizing repressed psychological conflicts.
• Conceptualized by Sigmund Freud.
• Gave rise to the field of psychosomatic medicine.

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Psychosomatic Medicine

Specific illnesses are produced by people’s internal conflicts.

Dunbar and Alexander linked patterns of personality to specific illnesses.

• Conflict produces anxiety which takes a physiological toll.

Criticism: Conflict or personality type is not sufficient to produce illness.

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Biopsychosocial Model

Health and illness are consequences of the interplay of biological,

psychological, and social factors.

Advantages.
• Maintains that the macrolevel and microlevel processes continually
interact to influence health and illness.
• Emphasizes both health and illness.

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Biopsychosocial-Cultural Model

Health and illness are consequences of the interplay of biological,

psychological, and social factors.

Advantages.
• Maintains that the macrolevel and microlevel processes continually
interact to influence health and illness.
• Emphasizes both health and illness.
• Incorporates culture and identity as factors that interact with
biopsychosocial relationships as they impact health and illness.
• (This is a term that I coined and use in my research and clinical
practice).

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Clinical Implications of the Biopsychosocial Model

Understanding the interacting role of biological, psychological, and social

factors informs diagnosis.

Emphasis on the relationship between patient and their practitioner,

which improves:

• Patient’s use of services.

• Efficacy of treatment.
• Rapidity with which illness is resolved.

Importantly, it also emphasizes that there are individual-level

biopsychosocial factors that predispose, precipitate, and perpetuate
health and illness.

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The Biopsychosocial Model: The Case History of
Nightmare Deaths 1

Purpose: To show how the mind and body are intertwined in health.

Sudden nocturnal deaths among male refugees from Southeast Asia

after the Vietnam War.
• Occurred in the first few hours of sleep.
• Autopsies revealed no specific cause of death.

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The Biopsychosocial Model: The Case History of
Nightmare Deaths 2

Due to a combination of:

• Genetic susceptibility.
• Chronic strain of adjustment to life in the US.
• Immediate trigger (for example, family argument, violent television,
frightening dream).

Example of the interplay between biological, psychological, and social

factors.

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The Biopsychosocial Model: The Case History of Broken
Heart Syndrome 2

Stress-induced cardiomyopathy or Takotsubo cardiomyopathy.

• Tako-Tsubo are Japanese fishing pots used to catch octopi.
• Occurs in response to an intense emotional or physical experience.
• Usually temporary.
• May be due to release of stress hormones.

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Need for Health Psychology 1

Increase in chronic or lifestyle-

related illnesses.
• Until the 20th century, illness
primarily caused by acute
disorders (for example,
tuberculosis, influenza).
• Now, chronic illnesses are the
main contributor to disability
and death.
• Heart disease, cancer, and
respiratory diseases.

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Need for Health Psychology 2

• Advances in technology and research.

• Expanded health care services.
• Increased medical acceptance.

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Health Psychology Research 1

Theory: Set of analytic statements that explain a set of phenomena.

Advantages.
• Provides guidelines for how to do research and interventions.
• Generates specific predictions that can be tested and modified.
• Helps tie together loose ends.

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Health Psychology Research 2

Experiments: Two or more differing conditions are created to which

people are assigned randomly, and their reactions are measured.

Randomized clinical trials: Conducted to evaluate effectiveness of

treatments or interventions over time.
• Evidence-based medicine: Medical interventions go through rigorous
testing and evaluation of their benefits before they become the
standard of care.

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Health Psychology Research 3

Correlational research: Measures whether changes in one variable

correspond with changes in another variable.
• Advantage over experiments: More adaptable.
• Disadvantage: Difficult to determine the direction of causality
unambiguously.

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Health Psychology Research 4

Prospective Research.
• Looks forward in time to see.
• How groups of people change.

• How relationships between two variables change over time.

• Conducted to understand the risk factors that relate to health
conditions.

Longitudinal research: Same people are observed at multiple points in

time.

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Health Psychology Research 5

Retrospective Designs: Look backward in time in an attempt to

reconstruct the conditions that led to a current situation.
• Were critical in identifying the risk factors that led to the development
of AIDS.

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Role of Epidemiology in Health Psychology

Epidemiology: Study of the frequency, distribution, and causes of

infectious and noninfectious disease in a population.
• Morbidity: Number of cases of a disease that exist at some given
point in time.
• Mortality: Numbers of deaths due to particular causes.

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Methodological Tools 1

Tools of neuroscience.
• Functional magnetic resonance imaging (fMRI) permits glimpses into
the brain.
• Have helped improve the knowledge of the autonomic,
neuroendocrine, and immune systems.

Mobile and wireless technologies.

• Used to deliver interventions.
• Can be used to assess biological indicators (for example, blood
sugar).

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Methodological Tools 2

Meta-analysis.
• Combines results from different studies to identify how strong the
evidence is for particular research findings.

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What Is Health Psychology Training For?

• Health care practitioners.

• Social work.
• Occupational therapy.
• Dietetics.
• Physical therapy.
• Public health.
• Academic research.
• Private practice.
• Management of health care.
• Treatment settings.
• Occupational health settings.

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End of Main Content