INTRODUCTION TO HEALTH PSYCHOLOGY:THE LIFE-SPAN PERSPECTIVE

<< INTRODUCTION TO HEALTH PSYCHOLOGY:The Background to Biomedical Model

HEALTH RELATED CAREERS:Nurses and Physician Assistants, Physical Therapists >>

Health Psychology PSY408

LESSON 05

INTRODUCTION TO HEALTH PSYCHOLOGY

The Concept of "Systems"

The whole person--as in the sentence, we need to understand the whole person--is a phrase we often hear. It

reflects our recognition that people and the reasons for their behavior are very complex. Many health

professionals strive to consider the impact of all aspects of a person's life as a total entity in understanding

health and illness. This approach uses the Biopsychosocial model and is sometimes called holistic.

This term is derived from the Greek word hoIs, which means whole. But many people today use the term

holistic to include a broad range of alternative approaches to promote health, such as treatments that use

aromas and herbs to heal.

How can we conceptualize the whole person? George Engel (1980) has proposed that we can do this by

applying the biological concept of `Systems". A system is a dynamic entity with components that are

continuously interrelated. By this definition, your body qualifies as a system-- and it includes the immune

and nervous systems, which consist of tissues and cells. Your family is a system too, and so are your

community and society. As systems, they are entities that are dynamic--or constantly changing--and they

have components that interrelate, such as by exchanging energy, substances, and information.

The systems concept places smaller, simpler systems within larger, more complex ones. There are levels of

systems. Cells are within the person who is within a society, for instance. Earlier we saw that a system at one

level, such as a person, is affected by and can affect a system at another level, such as the family. Similarly, if

we look at levels within the person, illness in one part of the body can have far reaching effects. If you fell

and seriously injured your leg, your internal systems would be automatically mobilized to help protect the

body from further damage.

In addition, the discomfort and disability you might experience for days or weeks might affect your social

relations with your family and community.

To illustrate how the systems concept can be useful, let's use it to explain how Sara's weight problem might

have come about. Let's assume that she did inherit some factor that affects her weight. The nature of this

factor might involve a preference for sweet foods, for instance (Rozi, 1989). When she was a toddler, her

parents quieted her tantrums by giving her candy, which almost always calmed her. Sara's parents were not

concerned that she was getting heavy because they believed a popular misconception: "A chubby baby is a

healthy baby.' The meals the family ate usually contained lots of high-fat, high-calorie foods and a sweet

dessert. Because Sara was heavy, she was less agile and tired more easily than children who were not

overweight. So she usually preferred to engage in sedentary activities, such as playing with dolls or watching

television, rather than sports. She and her friends snacked on cookies while watching television. The

commercials on most children's television shows made her weight problem worse, promoting high-fat,

sweet breakfast and snack foods, which she got her parents to buy. This hypothetical account shows how

different but interacting Biopsychosocial systems can contribute to a person's weight problem.

Using the Biopsychosocial model as a guide, researchers have discovered new and important findings and

ways to promote people's health and recovery from illness. For example, consider the following discoveries:

· Using psychological methods to reduce anxiety of patients who are awaiting surgery enables them to

recover more quickly and leave the hospital sooner.

· Programs that teach safer sex practices have dramatically reduced risky sexual behavior and the spread of

HIV infection.

Health Psychology PSY408

· People who have a high degree of social support from family and Friends are healthier and live longer

than people who do not.

· Stress impairs the functioning of the immune system.

· Applying psychological and educational programs for cancer patients reduces their feelings of depression,

improves their immune system functioning, and enables them to live longer.

· Biofeedback and other psychological techniques can reduce the pain of people who suffer from chronic,

severe headaches.

THE LIFE-SPAN PERSPECTIVE

People change over time through the process called development. As people develop, each portion of the

life span is affected by happenings in earlier years. And each affects the happenings in years that will come.

Throughout people's lives, health, illness, and the role of different biopsychosocial systems change. This is

why it is important to keep the life-span perspective in mind when we examine health psychology.

In the life-span perspective, characteristics of a person are considered with respect to their prior

development, current level, and likely development in the future. How do characteristics relating to health

and illness vary with development? One way is that the kinds of illnesses people have tend to change with

age. Compared with older individuals, children suffer from relatively few chronic diseases (USBC. 1999).

Illnesses that keep children out of school tend to be short-term infectious diseases, such as colds or the flu.

In contrast, many people in late adulthood and old age suffer from heart disease, cancer, and stroke.

How do the roles of different bio-psychosocial systems change as we develop?

Biological systems change in many ways. Virtually all systems of the body grow in size, strength, and

efficiency during childhood and decline in old age. The decline can be seen in the slowing down that older

people notice in their physical abilities. They have less stamina because the heart and lungs function less

efficiently and the muscles are weaker. They also recover from illness and injury more slowly.

Changes occur in psychological systems, too-- for example, in cognitive processes. Children's knowledge

and ability to think are limited during the preschool years but grow rapidly during later childhood. Before

children can assume responsibility for their health, they need to understand how their behavior can affect it.

As children get older and their cognitive skills improve, they are more likely to engage in behaviors that

promote their health and safety. They also become better able to understand the implications of their own

illness when they are sick.

How do people's social relationships and social systems change with development? For one thing, there are

some usual progressions: children usually become parents of their own families in adulthood and

grandparents in old age. As people develop, they progress through levels of education and employment, and

retire in old age. Changes in social relationships also relate to health and illness. Children's health is largely

the responsibility of adult caregivers--parents and teachers. During the teenage years, adolescents take on

more and more of these responsibilities. At the same time, social relationships with age-mates in the

community start to have a very powerful influence on adolescents. The strong need to be accepted by peers

sometimes leads teens toward unhealthful or unsafe behavior. For example, an adolescent who has a

chronic illness that can be controlled--as diabetes can--may neglect his or her medical care to avoid

looking and feeling different from other adolescents.

The life-span perspective adds an important dimension to the biopsychosocial perspective in our effort to

understand how people deal with issues of health and illness.

Health Psychology PSY408

Definition of Health psychology:

Matarazzo, in 1980, defined health psychology as "the aggregate of the specific educational, scientific, and

professional contribution of the discipline of psychology to the promotion and maintenance of health, the

promotion and treatment of illness and related dysfunction".

The Aims of Health Psychology

Health psychology emphasizes the role of psychological factors in the cause, progression and consequences

of health and illness. The aims of health psychology can be divided into (1) understanding, explaining,

developing and testing theory; and (2) putting this theory into practice.

1. Health psychology aims to understand, explain, develop and test theory by:

(a) Evaluating the role of behavior in the etiology of illness. For example:

Coronary heart disease is related to behaviors such as smoking, cholesterol level, lack of exercise, high

blood pressure and stress.

Many cancers are related to behaviors such as diet, smoking, alcohol and failure to attend for screening or

health check-ups.

A stroke is related to smoking, cholesterol and high blood pressure.

An often overlooked cause of death is accidents. These may be related to alcohol consumption, drugs and

careless driving.

(b) Predicting unhealthy behaviors. For example:

Smoking, alcohol consumption and high fat diets are related to beliefs.

Beliefs about health and illness can be used to predict behavior.

symptoms such as pain, nausea and vomiting.

Understanding the psychological consequences of illness could help to alleviate psychological symptoms

such as anxiety and depression.

(d) Evaluating the role of psychology in the treatment of illness. For example:

If psychological factors are important in the cause of illness, they may have a role in its treatment.

Treatment of the psychological consequences of illness may have an impact on longevity.

2. Health psychology also aims to put theory into practice. This can be implemented by:

(a) Promoting healthy behavior. For example:

Health Psychology PSY408

Understanding the role of behavior in illness can allow unhealthy behaviors to be targeted.

Understanding the beliefs that predict behaviors can allow these beliefs to be targeted.

Understanding the beliefs can help these beliefs to be changed.

(b) Preventing illness. For example:

Changing beliefs and behavior could prevent illness onset.

Behavioral interventions during illness (e.g., stopping smoking after a heart attack) may prevent future

illness.

Training health professionals to improve their communication skills and to carry out interventions may help

to prevent illness.

RELATING HEALTH PSYCHOLOGY TO OTHER SCIENCE FIELDS

Knowledge in health psychology is greatly enriched by information from many other disciplines, including

some disciplines within psychology, such as the clinical and social areas; medicine, including psychiatry and

pediatrics; and allied fields, such as nursing, nutrition, pharmacology, biology, and social work. We will look at

four fields that are especially important because they provide both information and a context for health

psychology.

Related Fields

To understand health psychology fully, we need to know the context in which health and illness exist. The

field of epidemiology--the scientific study of the distribution and frequency of disease and injury--

provides part of this context. Researchers in this field determine the occurrence of illness in a given

population and organize these data in terms of when the disease or injury occurred, where, and to which

age, gender, and racial or cultural groups. Then they attempt to discover why specific illnesses are

distributed as they are. You have probably seen the results of epidemiologists' work in the mass media. For

example, news reports have described areas of the United States where Lyme disease, a tick-borne illness,

occurs at high levels and where certain forms of cancer are linked to high levels of toxic substances in the

environment.

Another discipline of importance to health psychology is public health, the field concerned with

protecting, maintaining, and improving health through organized effort in the community. People who

work in public health do research and set up programs dealing with immunizations, sanitation, health

education and awareness, and ways to provide community health services. This field studies health and

illness in the context of the community as a social system. The success of public health programs and the

way individual people react to them are of interest to health psychologists.

Two other related fields are sociology and anthropology. Sociology focuses on human social life; it

examines groups or communities of people and evaluates the impact of various social factors, such as the

mass media, population growth, epidemics, and institutions. Medical sociology is a subfield that studies a wide

range of issues related to health, including the impact of social relationships on the distribution of illness,

social reactions to illness, socioeconomic factors of health care use, and the way hospital services and

medical practices are organized.

Anthropology includes the study of human cultures. Its subfield, medical anthropology, examines differences

in health and health care across cultures: How do the nature and definition of illness vary across different

cultures? How do people in these cultures react to illness, and what methods do they use to treat disease or

Health Psychology PSY408

injury? How do they structure health care systems? Without the knowledge from sociology and

anthropology, health psychologists would have a very narrow view. Knowledge from sociology and

anthropology gives us a broad social and cultural view of medical Issues and allows us to consider different

ways to interpret and treat illness.

The combined information health psychologists obtain from epidemiology, public health, sociology, and

anthropology paints a broad picture for us. It describes the social systems in which health, Illness, and the

person exist and develop.

Table of Contents: