Health, Illness, and Trends that Shaped Health Psychology



Health, Illness, and Trends that Shaped Health Psychology

September 9, 1999

Three Domains of Health

Health—a state of complete physical, mental, and social well-being (World Health Organization)

Physical Health

Psychological Health

Social Health

Ancient Views of Health & Illness

Prehistoric age (10,000 BC)

Evil spirits cause illness

Trephination

Ancient Egypt (2,000 BC)

Illness as demon possession or punishment by gods

Treatment consisted of sorcery, exorcism, primitive forms of surgery

Ancient Views of Health & Illness

Ancient Greece (500 BC)

Hippocrates—”father” of Western Medicine

Humoral theory

Health due to equilibrium among blood, yellow bile, black bile, phlegm

Poor health due to imbalance

Treatments consisted of use of diuretics, enemas, blood-letting, emetics

Ancient Views of Health & Illness

Claudius Galen

Dissection studies of animals and treating gladiator injuries led to great advances in knowledge of anatomy

Expanded Hippocratic foundation of rational explanation and careful description of symptoms

Elaborate pharmacology used for 1500 years

Ancient Views of Health & Illness

Ancient Rome (200 AD)

Early public health measures, including public bathrooms, sewage systems, and water supply systems

The Plague

bubonic/pneumonic

bacteria->rats->fleas->people

famine, draught, fire, flood bring rats closer

septicemia-caused death w/in 5 days

10,000 deaths/day

The Middle Ages (476- 1450)

Fall of Roman Empire ushers in non-scientific era in which there was little new learning

Traditions of Hippocrates and Galen fall into disfavor

Medieval Church dogma came to control medicine and treatment

Illness viewed as God’s punishment for evil doing

“treatment” involves torturing the sick to force evil spirits from their bodies

The Renaissance (15th-16th centuries)

Rene Descartes

Mind-body (Cartesian)Dualism

Andreas Vesalius

dissection studies lead to seven-volume study of human anatomy.

Giovanni Morgagni

hundreds of human autopsies lead to replaced of ancient humoral theory with the new anatomical theory of disease

Post-Renaissance Developments

Anton van Leeuwenhoek

First practical microscope (270 X). Unsurpassed until 19th century.

First to observe blood cells, muscle fibers, etc.

Led to cellular theory of disease

Nineteenth Century Developments

Louis Pasteur

Isolates bacterium that causes silk worm disease

Proved that a microorganism caused rabies

Developed first effective rabies vaccine

Conducted critical experiments disproving spontaneous generation

Helped shape germ theory of disease

Nineteenth Century Developments

By end of century, researchers had isolated the microbes for malaria, pneumonia, diphtheria, leprosy, syphilis, bubonic plague, and typhoid

1846 ether introduced as first general anesthetic allowing painless surgeries

1896 x-rays allow observation of internal organs

Twentieth Century Western Medicine

The biomedical model

Disease is the result of a biological pathogen

Mind and body do not interact

Health is nothing more than freedom from disease

Led to great improvements in health care

Challenges to Biomedicine

Disorders that have no observable physical cause

Sigmund Freud (1856-1939)

Case histories of conversion disorders, include “glove anesthesia,” loss of speech, deafness

Development of psychoanalysis and psychosomatic medicine

“Fatal Flaws” in Psychoanalysis and Psychosomatic Medicine

Emphasis on unconscious, irrational processes in personality fell into disfavor in American psychology

Limited generalizability of case study research

Reductionism is too simplistic

Health Psychology

Recognized as Division 38 of APA in 1978

Four Goals

To study psychological, behavioral, and social factors in disease

To promote health

To prevent and treat illness

To improve public health policy and health care

Trends that Shaped the New Field

Increased Life Expectancy

Rising Health Care Costs

Trends that Shaped the New Field

Increased Life Expectancy

A Shift in the Leading Causes of Death

Rising Health Care Costs

A shift away from the biomedical model

Health Psychology’s Perspectives

Biopsychosocial Perspective (BPS)

Biological mechanisms: genes, hormones, evolution, physical environment

Psychological processes: motivation, attention, expectations, beliefs and attitudes, personality traits, emotions

Social influences: socioeconomic status, socialization processes, culture, ethnicity, peer pressure, social support, role models

Health Psychology’s Perspectives

The BPS Perspective

The Life-Course Perspective

Cohort effects

The Sociocultural perspective

The Gender perspective

Under representation of women in medical trials

Career Issues

3 roles

Teachers

Research scientists

Applied clinicians

Training

Multiple routes depending on role

Allied health professions

Ph.D. or Psy.D. programs

Where Do Health Psychologists Work?

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