Health, Illness, and Trends that Shaped Health Psychology
September 9, 1999
Three Domains of Health
Health—a state of complete physical, mental, and social well-being (World Health Organization)
Physical Health
Psychological Health
Social Health
Ancient Views of Health & Illness
Prehistoric age (10,000 BC)
Evil spirits cause illness
Trephination
Ancient Egypt (2,000 BC)
Illness as demon possession or punishment by gods
Treatment consisted of sorcery, exorcism, primitive forms of surgery
Ancient Views of Health & Illness
Ancient Greece (500 BC)
Hippocrates—”father” of Western Medicine
Humoral theory
Health due to equilibrium among blood, yellow bile, black bile, phlegm
Poor health due to imbalance
Treatments consisted of use of diuretics, enemas, blood-letting, emetics
Ancient Views of Health & Illness
Claudius Galen
Dissection studies of animals and treating gladiator injuries led to great advances in knowledge of anatomy
Expanded Hippocratic foundation of rational explanation and careful description of symptoms
Elaborate pharmacology used for 1500 years
Ancient Views of Health & Illness
Ancient Rome (200 AD)
Early public health measures, including public bathrooms, sewage systems, and water supply systems
The Plague
bubonic/pneumonic
bacteria->rats->fleas->people
famine, draught, fire, flood bring rats closer
septicemia-caused death w/in 5 days
10,000 deaths/day
The Middle Ages (476- 1450)
Fall of Roman Empire ushers in non-scientific era in which there was little new learning
Traditions of Hippocrates and Galen fall into disfavor
Medieval Church dogma came to control medicine and treatment
Illness viewed as God’s punishment for evil doing
“treatment” involves torturing the sick to force evil spirits from their bodies
The Renaissance (15th-16th centuries)
Rene Descartes
Mind-body (Cartesian)Dualism
Andreas Vesalius
dissection studies lead to seven-volume study of human anatomy.
Giovanni Morgagni
hundreds of human autopsies lead to replaced of ancient humoral theory with the new anatomical theory of disease
Post-Renaissance Developments
Anton van Leeuwenhoek
First practical microscope (270 X). Unsurpassed until 19th century.
First to observe blood cells, muscle fibers, etc.
Led to cellular theory of disease
Nineteenth Century Developments
Louis Pasteur
Isolates bacterium that causes silk worm disease
Proved that a microorganism caused rabies
Developed first effective rabies vaccine
Conducted critical experiments disproving spontaneous generation
Helped shape germ theory of disease
Nineteenth Century Developments
By end of century, researchers had isolated the microbes for malaria, pneumonia, diphtheria, leprosy, syphilis, bubonic plague, and typhoid
1846 ether introduced as first general anesthetic allowing painless surgeries
1896 x-rays allow observation of internal organs
Twentieth Century Western Medicine
The biomedical model
Disease is the result of a biological pathogen
Mind and body do not interact
Health is nothing more than freedom from disease
Led to great improvements in health care
Challenges to Biomedicine
Disorders that have no observable physical cause
Sigmund Freud (1856-1939)
Case histories of conversion disorders, include “glove anesthesia,” loss of speech, deafness
Development of psychoanalysis and psychosomatic medicine
“Fatal Flaws” in Psychoanalysis and Psychosomatic Medicine
Emphasis on unconscious, irrational processes in personality fell into disfavor in American psychology
Limited generalizability of case study research
Reductionism is too simplistic
Health Psychology
Recognized as Division 38 of APA in 1978
Four Goals
To study psychological, behavioral, and social factors in disease
To promote health
To prevent and treat illness
To improve public health policy and health care
Trends that Shaped the New Field
Increased Life Expectancy
Rising Health Care Costs
Trends that Shaped the New Field
Increased Life Expectancy
A Shift in the Leading Causes of Death
Rising Health Care Costs
A shift away from the biomedical model
Health Psychology’s Perspectives
Biopsychosocial Perspective (BPS)
Biological mechanisms: genes, hormones, evolution, physical environment
Psychological processes: motivation, attention, expectations, beliefs and attitudes, personality traits, emotions
Social influences: socioeconomic status, socialization processes, culture, ethnicity, peer pressure, social support, role models
Health Psychology’s Perspectives
The BPS Perspective
The Life-Course Perspective
Cohort effects
The Sociocultural perspective
The Gender perspective
Under representation of women in medical trials
Career Issues
3 roles
Teachers
Research scientists
Applied clinicians
Training
Multiple routes depending on role
Allied health professions
Ph.D. or Psy.D. programs
Where Do Health Psychologists Work?