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Health psychology is concerned with understanding how biology, behavior, and social context influence health and illness.APA, Division 38. What a Health Psychologist Does and How to Become One. Retrieved 03-04-2007. Health psychologists generally work alongside other medical professionals in clinical settings, although many also teach and conduct research. Although its early beginnings can be traced to the kindred field of clinical psychology, four different approaches to health psychology have been defined: clinical, public health, community and critical health psychologyMarks, D.F., Murray, M. et al. (2005). "Health Psychology: Theory, Research & Practice." London, England : Sage Publications. ISBN 141290336X
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Recent advances in psychological, medical, and physiological research have led to a new way of thinking about health and illness. This conceptualization, labeled the Biopsychosocial Model, views health and illness as the product of a combination of factors including biological characteristics (e.g., genetic predisposition), behavioral factors (e.g., lifestyle, stress, health beliefs), and social conditions (e.g., cultural influences, family relationships, social support).
Psychologists who strive to understand how biological, behavioral, and social factors influence health and illness are called health psychologists. The term "health psychology" is often interchanged with the terms "behavioral medicine" or "medical psychology". In contemporary research and medical settings, health psychologists work with many different health care professionals (e.g., physicians, dentists, nurses, physician\'s assistants, dietitians, social workers, pharmacists, physical and occupational therapists, and chaplains) to conduct research and provide clinical assessment and treatment services. Many health psychologists focus on prevention through research and clinical interventions designed to foster health and reduce the risk of disease. While more than half of health psychologists provide clinical services as part of their duties, many health psychologists function in non-clinical roles primarily involving teaching and research.
Health psychology is both a theoretical and applied field. Many different methods are employed including questionnaires, interviews, controlled studies, and actions designed to bring about change using "action research". Health psychologists conduct health interviews with clients that aim to construct a more holistic picture of each person’s health, one that includes their genes, religious beliefs, social supports, living conditions, emotional state, and beliefs of health, etc. They use this information to work alongside a person’s physicians and therapists to develop a treatment tailored for individual needs or to develop greater empowerment among the community\'s members so that the community is able to strengthen and sustain its own quality of life.
Health psychologists seek to identify the behaviors and experiences that promote health, lead to illness, influence the effectiveness of health care, and recommend improvements to health policy in their life. There are many examples of this. For instance, smoking, diet, and regular exercise are all factors in the contribution or prevention in physical and mental disease. There are some minor associations between illness and individual characteristics such as personality. For example, it is claimed that individuals with thrill seeking personalities are more likely to drive fast, making them more likely to injure themselves in car accidents. And also that people distrustful of physicians will not get regular checkups. However there are contextual factors in the form of political, economic, cultural, community, social and lifestyle factors that have a more major influence on the health of particular individuals, although they will not generally recognize these.
Factors that lead to the behaviors that cause illness are of interest because they help psychologists to predict who is most susceptible to illness and why. There are many contributing factors that help determine our behaviors, and all of the dimensions of the biopsychosocial model can be applied to understand these inter-connections. Biologically, physical addiction plays an important role in smoking cessation. As does the psychological dependency on tobacco brought about largely by seductive advertising and other forms of tobacco promotion. Psychologically, people with high stress jobs are more likely to develop cardiovascular disease. Socially, people with low incomes have less access to health resources and screening processes. They also are exposed to greater environmental toxins, lower levels of education, poorer housing, less healthy foods, higher smoking prevalence, and many other toxic socially determined living conditions.
Health psychologists also aim to change health behaviors for the dual purpose of helping people stay healthy and helping patients adhere to disease treatment regimens. Cognitive behavioral therapy and behavior modification are techniques often used for this purpose.
Psychologists work towards promoting health through behavioral change, as mentioned above, but they prevent illness in other ways as well. Practitioners emphasize education as a large part of illness prevention, as many people do not recognize the risk to illness present in their lives. Or they are unable to implement the knowledge that they have owing to the pressures of their everyday existence. A common example of this is anti-smoking campaigns. Those least able to afford tobacco products consume them the most. It is a method for controlling emotional states, the daily experiences of stress that characterize the lives of deprived and vulnerable people. Health psychologists also aim at educating health professionals like physicians and nurses in communicating with patients in a way that highlights the psychosocial barriers to understanding, memorizing and implementing effective strategies for reducing risk factors and making behavior changes and that will help them to develop appropriate means for communicating information relevant to diagnosis, treatment and prognosis (Ogden, 2004).
There is much to know about how disease affects our mental well being. When illness or accidents befall a person, their entire life is affected. A psychologically healthy individual who gets severely injured, say, now has many different practical issues to contend with that will in turn affect their psychological wellbeing. Who will take care of them while they recover? If they can’t work, how will they pay for bills or care for dependents? If this person sees themselves as being self-reliant, how do they handle this new identity? What if they cannot pursue their usual hobbies and interests? All of these possibilities can affect a person’s relationships, self-esteem, stress level, happiness and belief system. Many of these issues are economic and social in nature rather than psychological but they have a direct impact on psychological wellbeing.
This important field of study considers how those with terminal illnesses can lead a better life. When there is little hope of recovery, health psychology therapists can improve the quality of life of the patient by helping them to recover their mental well-being.
Critical health psychologists are exploring how health policy can impact on inequities, inequalities and social injustice. This expands the scope of health psychology beyond the level of individual health to an examination of the social and economic determinants of health experience both within and between regions and nations. The individualism of mainstream health psychology has been critiqued and deconstructed by critical health psychologists and newer qualitative methods and frameworks for investigating health experience and behavior are advocated (Marks, Murray et al., 2005).
Health psychologists attempt to aid the process of communication between doctors and patients during medical consultations. There are many problems in this process, particularly the use of jargon by doctors (using long, complex, usually medicine-specific words often not understood by the patient). Researchers such as Boyle and McKinlay have investigated this process and discovered not only that patient understanding is low (40% of women on a maternity ward understood 13 medical terms that they were given), but that even doctors do not expect their patients to understand their jargon! One main area of research on this topic involves \'doctor centered\' or \'patient centered\' consultations. Doctor centered consultations are generally directive, with the patient answering questions and taking little part in decision-making. Although this style is preferred by elderly people and others, many people dislike the sense of hierarchy or ignorance that it inspires. They prefer the patient centered consultations, which focus on the patient\'s needs, involve the doctor listening to the patient completely before making a decision, and involving the patient in the process of choosing treatment and finding a diagnosis.Banyard, Philip, Psychology in Practice, (Hodder and Stoughton, 2002), pg 19-38.
Getting people to obey medical advice and adhere to their treatment regimens is a difficult task for health psychologists. Mostly, people forget to take their pills or find their side effects too difficult to cope with (rational non-adherence), but failing to take prescribed medication costs the Health Service millions of pounds per year, as well as wasting millions of usable, viable medicines that could otherwise be used to help other people. Estimated adherence rates are very hard to measure due to the issues raised by the various techniques available (see below). Sarafino estimates adherence to be very low, however, he judges adherence to be following every part of the treatment program, whereas Taylor encourages the tailoring of the program to one\'s personal routine. Banyard, Philip, Psychology in Practice (Hodder and Stoughton, 2002) pg 39-54
Health psychology attempts to find treatments to reduce and eliminate pain, as well as understanding pain anomalies such as episodic analgesia, causalgia, neuralgia and phantom limb pain. Problems of measuring and describing pain are prominent, although have been reduced by the McGill Pain Questionnaire. Treatments for pain involve patient-administered analgesia, acupuncture (found by Berman to be effective in reducing pain for osteo-arthritis of the knee), biofeedback and cognitive behavioral therapy.
Stress is a common problem in modern life, but extreme levels of stress can cause fatigue, irritability, burnout and even illness. Health psychology attempts to define, measure and treat stress. One effective treatment is the Stress Inoculation program pioneered by Meichenbaum. Another empirically-supported treatment is the Mindfulness-Based Stress Reduction (MBSR)program by Kabat-Zinn.
The longitudinal Life Cycle Study began in 1921 with 1500 children of average age 11. Class and ethnicity variables were removed by only using white children from middle-class families. The children had an IQ of 150+ and had been identified as "gifted" by their teachers. In 1950, the participants were asked to rate their religiosity on a scale of 1 to 4. In 1990, researchers compared this score with mortality of the sample and concluded that religious people live longer. However, it is not clear why this is - it may be related to happiness and feelings of fulfillment.
In a study by Fraser, it was found that affluent people were more likely to seek medical help earlier than the less affluent, who had less access to a car.
Freidman and Rosenman found that Type A personalities were twice as likely to develop coronary heart disease. They studied 2500 men over a period of 12 years.
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