Introductory Lecture Behav Sci - Thu 14 May '15

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Transcript of Introductory Lecture Behav Sci - Thu 14 May '15

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BEHAVIORAL SCIENCE

IzBen C. Williams, MD, MPH

Lecturer

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INTRO

 

OVERVIEW OF

BEHAVIORAL SCIENCE

COURSE

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Defnii!n " S#!$e

BEHAVIORAL SCIENCE%A branch of science dealing broadly with

human actions (behaviors). It usuallyincludes elements from all social sciencerelated elds including:

psychology, psychiatry,

ociology, cultural anthropology!iology

"conomics, political science

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In Me&i#al C'((i#'l'm )A *asi# s#ien#e

BEHAVIORAL SCIENCE%In medical schools it is generally classied

as one of the basic (pre#clinical) sciencesalong with standards such as : !iochemistry

$harmacology

$hysiology Anatomy

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In Me&i#al C'((i#'l'm )A *asi# s#ien#e

BEHAVIORAL SCIENCE%%owever because of the breath of disciplines it

straddles and under which it is taught, it is

inherently di&erent from the other basic clinicalsciences.

As a sub discipline it is of core relevance to theeducation of the modern day physician and the

clinical practice of medicine.It has come to include everything that cannot

be categori'ed in one of the traditional basicsciences

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Me&i#al E+amsBEHAVIORAL SCIENCE%Te USMLE standards are fully cogni'ant

of the signicance and importance of

students appreciating the correlationbetween physical health and mental health.

 herefore on all three Steps of theeamination the substantial power of mind#body relationship is thoroughly tested

 

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Te Bi!Ps-#!S!#ial Pa(a&im

BEHAVIORAL SCIENCE%

Te Bi!/Ps-#!/S!#ial m!&el $!sis a *i!l!i#al,$s-#!l!i#al, an& s!#ial 0a#!(s a(e in1!l1e& in e

mainenan#e !0 eal an& in e #a'sai!ns an&mani0esai!ns !0 &isease.

It is important to appreciate why the biopsychosocial modelenlightens our understanding the interaction betweenbiology, psychology, culture and society, and how this

in*uences our health.A biopsychosocial frame of reference is conceptuallyboundless

 

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Heal/(elae& 2'ali- !0 li0e

Heal/(elae& 2'ali- !0 li0e (%+oL) is amulti#dimensional concept that includes domainsrelated to

physical,mental,

emotional and

social functioning.

It goes beyond direct measures of populationhealth, life epectancy and causes of death, andfocuses on the impact health status has on-uality of life

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Well/*ein is (elae& ! 3!L

A concept associated wiyh %+oL is 4ell/*ein,which assesses the positive aspects of a persons

life, such as positive emotions and lifesatisfaction.

+ecall /%0s denition of health:A sae !0 #!m$lee $-si#al, menal an&

s!#ial 4ell/*ein an& n! me(el- e a*sen#e!0 &isease !( inf(mi-.

1eeping in mind the big picture of !lisi#eal

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Bi!Ps-#!S!#ialS#ema

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Te Bi!Ps-#!S!#ial Pa(a&im

According to the biopsychosocial model, it isthe interaction between one3s genetic ma4eup(i.e., biology), mental health

and personality (i.e., psychology),and sociocultural environment (i.e., social) thatcontribute to health or illness. he biological in*uences on mental health and

mental illness are varied, and include genetics,infections, physical trauma, nutrition, hormones,toins etc.

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Te Bi!Ps-#!S!#ial Pa(a&im

BEHAVIORAL SCIENCE% he psychological component loo4s for

potential psychological causes for a health

problem such as lac4 of self#control, emotionalturmoil, and negative thin4ing.

ocial and cultural factors are conceptuali'edas a particular set of stressful life events

(stressors), such as losses (e.g., losing one3s 5obor partner) that can di&erentially impact mentalhealth depending on the individual and thesocial contet in which they live and function.

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B!'n&less 0(ame !0(e0e(en#e

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A&&i#i!n as ane+am$le

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Te Bi!Ps-#!S!#ial Pa(a&im

Ine($la- !0 Fa#!(s% he biopsychosocial theory posits that any one

of these factors, even if not by itself su6cient

to bring about physical or mental illness, mayinteract with other factors to determines thecourse of one3s health and development.

7espite its usefulness, there are issues with the

biopsychosocial model including the degree ofin*uence that each factor has, the degree ofinteraction between factors, and variationacross individuals and life spans.

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Meas'(in HealSel0/(ae& eal s#ales%8lobal health, as assessed by self#rated

health (+%), incorporates several healthdomains that dynamically and bi#directionally interact. 9or simplicity, vemain domains are shown: biologicalclinical,psychological, social, behavioral, and

spiritual.

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Sel0/Rae& Heal

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S!me n!a*le 3!L S#ales

Menal% Internet Mental Health Quality of Life Scale

-

http://www.mentalhealth.com/qol/IMHQOLScale.pdf

Mental state inentory !e" MMS#$

%epression inentory !&un"' (ec)'$

  *n+iety inentory 

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S!me n!a*le 3!L S#ales

 

S!#ial%ocial health is how you get along with

other people, how other people react toyou, and how you interact with society. 

Holmes and ,ahe: social readustmentscale 

 

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S!me n!a*le 3!L SR S#ales

 

P-si#al%%ealth +elated uality of Life cales,

(particularly with cardiac and pulmonarypatients)

7AL; (7isability Ad5usted Life ;ears) Ameasure of overall disease burden,epressed as the number of years lost dueto ill#health, disability or early death

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Bea1i!(al S#ien#e

COURSE MATERIAL

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C!'(se Mae(ial he recommended tet is:

Behavioral Science by Barbara Fadem, 6th Edition; Li$$in#!. 

 he tetboo4 will be supplemented with: power point lectures'

handouts and

ideo i"nettes

tudents are as4ed to preview the relevantmaterial in advance of attending eachlectures.

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O i 0 L

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O1e(1ie4 !0 Le#'(eT!$i#s

<)  he life cycle

=)  he biology of behavior

>) Assessment of patients with psychiatricsymptoms

?) @odels of the mind

) $sychometric evaluation: 0linicalassessment of intelli"ence' personalityetc

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O i 0 L

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O1e(1ie4 !0 Le#'(eT!$i#s

B) Cegetative symptomatology (distur1ance

of functions necessary to maintain life)D) @a5or clinical syndromes ( psychosis'

mood' an+iety etc$

E) ome other psychiatric disorders 

F) $ersonality and its disorders

<G)ubstance abuse !includin" alcoholism$

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O1e(1ie4 !0 Le#'(eT!$i#s

<<)$sychiatric disorders of children

<=) he therapies !1iolo"ical and psycholo"ical$

<>)$sychosomatic @edicine (bodymind)

<?)%uman seuality

<)Aggression and abuse

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O i 0 L

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O1e(1ie4 !0 Le#'(eT!$i#s

<B)9amily, culture and illness

<D) he $hysician#patient relationship<E)!asic epidemiology

<F)ome legal and ethical issues in medicine

=G)%ealthcare in the Hnited tates

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