Introduction to Clinical Psychology: Science, Practice and Ethics Chapter 15 Clinical Health...
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Transcript of Introduction to Clinical Psychology: Science, Practice and Ethics Chapter 15 Clinical Health...
Introduction to
Clinical Psychology:Science, Practice and Ethics
Chapter 15
Clinical Health PsychologyThis multimedia product and its contents are protected under copyright law. The following are prohibited by law:•Any public performance or display, including transmission of any image over a network;•Preparation of any derivative work, including the extraction, in whole or in part, of any images;•Any rental, lease, or lending of the program
Copyright ©Allyn & Bacon 2005
Copyright ©Allyn & Bacon 2005
Health Psychology: Definition
• “Health psychology is the aggregate of the specific educational, scientific, and professional contributions of the discipline of psychology to the promotion and maintenance of health, the prevention and treatment of illness, the identification of etiologic and diagnostic correlates of health, illness, and related dysfunction, and to the analysis and improvement of health care system and health policy formation” (Matarazzo, 1982).
Copyright ©Allyn & Bacon 2005
Copyright ©Allyn & Bacon 2005
Clinical Health Psychology• Subdiscipline of health psychology
and clinical psychology
• Approaches general health and illness with methods, models and assumptions of clinical psychology
• Aim “to translate research into practical applications that can help people lead healthier lives”
Copyright ©Allyn & Bacon 2005
Biopsychosocial model• Health and illness a product of
biological, psychological and social factors
Copyright ©Allyn & Bacon 2005
Health Psychology: Content Areas1. Health risk behaviour
2. Health protective and enhancing behaviours
3. Health-related cognitions
4. Processes influencing health-care delivery
5. Psychological aspects of illness
Copyright ©Allyn & Bacon 2005
Health Risk Behaviour• Smoking
• Media more impact than education (Flynn, 1992)• Gender differences: Males nicotine
Females situational• Cravings: 8 – 15 minutes
• Alcohol Abuse• Tension-reduction theory• Social Learning Theory• Cognitive: Alcohol Myopia• Personality: harm avoidance control • Genetic
Copyright ©Allyn & Bacon 2005
Health Risk Behaviour
• Obesity• Internal-External Hypothesis (Schacter,1968)• Mood regulation: more for females• Restraint Theory: dieter’s “Oh Well”• Lifestyle & Culture
• STD/HIV
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Health Belief Model
Susceptibility
Severity
Benefits
Costs
Behaviour
Rosenstock, 1960
Who will undertake preventative action:
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Reasoned Action/ Planned Behaviour
Perceived Behavioural
Control
IntentionsSubjective Norms
Attitudes
Behaviour
Ajzen, 1985
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Social Cognitive Theory (Bandura)
• Direct Modeling
• Symbolic Modeling
• Self- efficacy
• Outcome Expectancies
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Social cognitive theory (cont.)• What does it predict?
• smoking cessation• eating nutritious food• lowering cholesterol• brushing and flossing teeth• using condoms• exercising regularly
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Prevention and Health Promotion• Stress and illness
• Managing stress
• Behaviour and Health• Promoting healthy behaviour• Decreasing negative health behaviours
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Stress and Illness• Measurement:
• self-report• physiological
• Life Events vs Daily Hassles/Uplifts
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Stress and Illness• Fight or Flight Response (Cannon)
• General Adaptation Syndrome (Selye)
• Cognitive Appraisal (Lazarus & Folkman)
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General Adaptation Syndrome (Selye)StressorStressor
Alarm:
Initial mobilization to
fend off threat
Alarm:
Initial mobilization to
fend off threat
Resistance:
Continued fight against
stressor
Resistance:
Continued fight against
stressor
Exhaustion:
Depletion of bodily
resources
Exhaustion:
Depletion of bodily
resources
Illness & DiseaseIllness & Disease
Copyright ©Allyn & Bacon 2005
General Adaptation Syndrome (Selye)
StressStress
Endocrine
System
Endocrine
System
HypothalamusHypothalamus
Sympathetic
Nervous System
Sympathetic
Nervous System
Adrenal gland releases
catecholamines
(epinephrine,
norepinephrine)
Adrenal gland releases
catecholamines
(epinephrine,
norepinephrine)
Increases in production of
energy, inhibition of
swelling
Increases in production of
energy, inhibition of
swelling
Pituitary gland releases
adrenalcorticotropic
hormone (ACTH)
Pituitary gland releases
adrenalcorticotropic
hormone (ACTH)
Adrenal gland releases
corticosteroids
(cortisol)
Adrenal gland releases
corticosteroids
(cortisol)
Increases in Heart rate,
blood pressure, &
breathing
Increases in Heart rate,
blood pressure, &
breathing
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Cognitive Appraisal (Lazarus & Folkman)
EventEvent
Primary Appraisal:
“Am I in danger?”
Primary Appraisal:
“Am I in danger?”
Secondary Appraisal:
“What can I do about it?”
Secondary Appraisal:
“What can I do about it?”
StressStress
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Negative Impact of Prolonged Stress Response
• Negative impact on body organs, mental functioning & Immune system
• Affect immune system so cannot destroy viruses, bacteria, tumors, & irregular cells
• Still not clear total impact of stress on immunosuppression –in any case it is important influence on health and illness
Copyright ©Allyn & Bacon 2005
Illness
• Diabetes mellitus• Psychological Factors:
• Increase in depression & anxiety disorders• Stress impacts blood glucose levels
• Psychological Intervention• Blood Glucose Awareness Training (Cox, 1992)• Stress management: progressive muscle relaxation/
biofeedback
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Illness
• Headache: Migraine & Tension • Psychological Factors: (Martin, 1998)
• Hassles vs Life-events• Headache sufferers tend to evaluate stressful events
more –v’ly• Perceive less social support• Type-A personality (Friedman & Rosenman, 1974)
• Psychological intervention• Biofeedback:
• Migraine – thermal
• Tension – EMG
• Relaxation Training
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Illness
• Cancer• Psychological Factors:
• Depressed mood
• Psychological Intervention:• Treatment support: guided imagery• Palliative support
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Self-Healing Personalities
• Control: in facing challenge feel power to influence outcome
• Commitment: to something important or meaningful-work, communities & family
• Challenge: energy & excitement for life change & innovation
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Self-Healing Personalities
• Trust & Devotion:
• (Rotter, 1980) people who trust others are less likely to be unhappy, conflicted, or maladjusted-dependable & have more friends-healthier
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Learned Optimism: Martin Seligman (1991)
• Adversity• Belief (personal control / explanatory
style)
• Consequence (depression, anger, embarrassment, hurt, worry . . .)
• Disputation (questioning & disputing your demoralizing thoughts )
• Energy