I. Why Behavioral Medicine

A. It’s a response to changes in healthcare. 1. Acute infectious diseases are no longer the

major killer or cripplers. 2. The profile of today’s illness is marked by

chronic stress related multifactorial diseases.

I. Why Behavioral Medicine

Health Today

Mortality rates indicate people are living longer

Morbidity rates indicate fewer people suffer from infectious disease

I. Why Behavioral Medicine

3. These are diseases of “choice” not chance because of life style and unhealthy behaviors.

a) With the chronicity of disease, behavioral and psychological factors become more crucial to prognosis and to effective therapy (i.e. consider passive patients that become active as they are given a diagnosis).

I. Why Behavioral Medicine

Health: Yesterday and Today 1800’s

Health = absence of illness. Common illnesses: bubonic plague, pneumonic

plague, tuberculosis Poor health often associated with poor hygiene

Late 1800’s and 1900’s Suspicion of the environment as a cause of

I. Why Behavioral Medicine

World Health Organization 1947 conference on global health “Health is the state of complete physical,

mental, and social well-being, not just the absence of disease or infirmity.”

The first time health meant more than an absence of illness

I. Why Behavioral Medicine

B. As such, Interdisciplinary communication begins. 1. Consequently, a school of medical

thought is challenged – mind-body dualism (Descartes)

2. Simultaneously, another school of medical thought is challenged and reinforced – reductionistic vs integrative

I. Why Behavioral Medicine

C. A unique conference is held at Yale University in 1997 defines 1. Behavioral Medicine is defined 2. At this conference different disciplines

open communication between researchers and clinicians.

II. Definition

A. Behavioral Medicine is an interdisciplinary effort involving research and clinical practice.

B. It studies the interactions of the physical, psychological, social environment, cognition, behavior and biology in health and illness.

II Definition

C. It then, focuses on the applications of these findings or techniques based on the knowledge of these interactions in the promotion of health and rehabilitation as well as providing prevention, diagnosis, and treatment of illness

III. Events involved in the creation of Behavioral Medicine A. Success of behavior

modification/behavioral analysis B. Success of biofeedback C. Emergence of Chronic illness as the

major issue in healthcare

III. Events involved in the creation of Behavioral Medicine D. Escalation of healthcare costs ( due to

the above)

III. Events involved in the creation of Behavioral Medicine E. Failure of psychosomatic medicine CHANGES IN MODELS OF HEALTH

Biomedical Biopsychosocial Acceptance of the Biopsychosocial by lay

public Currently, Biopsychosocialspiritual

1960s definition of health included: Physical Social Mental Elements of life Environmental Spiritual Emotional Intellectual dimensions

The 6 Dimensions of the Health and Wellness Continuum Physical

Includes body functioning, physical fitness, Activities of Daily Living (ADL)

Intellectual “brain power” Ability to think clearly, reason objectively

Social Ability to have satisfying relationships

The 6 Dimensions of the Health and Wellness Continuum (continued) Emotional

Self-esteem, self-efficacy Environmental

Appreciation of the external environment and one’s role

Spiritual Feeling as if part of a greater spectrum of

existence

IV. How is it relevant?

A. It is an interdisciplinary effort to open communication and collaboration.

B. It demonstrates that a common language can be created in which different discipline can benefit each other.

C. It Challenges us and our field to demonstrate effectiveness 1. Sometimes require common language 2. Similar to acculturation (dominant vs

minority culture)

V. History of Western Medical Knowledge which leads up to current A. First epoch-between 15th and 12th

centuries BC Hygeia (Greek Goddess of Health) 1. Patients are entitled to health if they via

moderation in order to not elicit illnesses. 2. Toward of the end of Era, first Western

Greek physician conceptualizes illness as organic and treats them with herbs.

V. History of Western Medical

B. Second Epoch 12th- 5th centuries BC 1. The first disease specialist evolves. 2. Illness treated with surgery and

medication but also with music and massage.

V. History of Western Medical

C. Third Epoch –5th BC – Dark Ages - Hippocrates’s era 1. Promotes the use of more of a scientific

approach and systematic methods. 2. Aristotle also contributes to this era and

creates the foundation for the future birth of psychology.

V. History of Western Medical

D. Fourth Epoch- Dark Ages – the Catholic church becomes a powerful political and social force 1. The mind-body question becomes a

religious one. 2. The church creates an institutionalized

view of a separation of the body and behavior/mind.

3. The church allows for scientist to dissect bodies if they agree to limit their studies to the body.

V. History of Western Medical

E. 17th Century – Rene Descartes formalizes the dualistic views of the church into the reductionistic approach.

F. Industrial Revolution leads to a return to the Hippocratic approach in order to address environmental health problems

V. History of Western Medical

G. 19th -20th Centuries – scientific research experience gains in fighting acute illnesses