INSTRUCTORS MANUAL - CHAPTER 1 AN OVERVIEW OF PSYCHOLOGY AND HEALTH ...

INSTRUCTOR’S MANUAL

CHAPTER 1

AN OVERVIEW OF PSYCHOLOGY AND HEALTH

CHAPTER OUTLINE

• What is Health?

• Section Introduction

1. Common definitions of health focus on lack of:

• objective signs of illness - e.g., high blood pressure
• subjective symptoms of illness - e.g., pain or nausea

• An Illness/Wellness Continuum

• The concepts of health and sickness overlap

• Antonovsky proposes an illness/wellness continuum with polar ends of

death/illness/disability v. optimal wellness

• need to change focus from what makes people sick to what

keeps people well

• Health = the positive state of physical, mental and social well-being that

varies over time along a continuum

• Illness Today and in the Past

• In industrialized nations, people live longer than in past and suffer from

different patterns of illnesses

• Until this century, people in North America died from mainly dietary and

infectious diseases

a. dietary illnesses: illnesses resulting from malnutrition such as

beriberi (lack of vitamin B1)

b. infectious diseases: acute illnesses caused by harmful matter or

microorganisms (bacteria or viruses); main cause of death in most of world today; especially lower income developing countries

• History of diseases in Canada
• 18

th & 19 th

centuries: epidemics of smallpox, cholera, diphtheria,

measles and influenza killed thousands, esp. children 1 / 4

Sarafino, Health Psychology, Biopsychosocial Interactions, Canadian Edition © 2015 John Wiley & Sons Canada, Ltd

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• such diseases were introduced to America by European

settlers 1) Aboriginals died at high rates due to lack of previous exposure and natural immunity; lack of immunity probably due to low degree of genetic variation 2) exposure to infectious diseases resulted in famine, social unrest, and population depletion in aboriginal communities

• 19

th

century: infectious diseases were still the greatest threat to

early settlers and new diseases were emerging (e.g., tuberculosis)

• Smallpox epidemic in Montreal led to the formation of a

board of health in Quebec ii.Tuberculosis was the greatest cause of death in Canada in 1867; death rate declined sharply towards the end of the century with the introduction of vaccines iii. cause of decline in death rates for all infectious diseases

can be attributed to preventive measures including:

1) improved personal hygiene 2) better nutrition resulting in greater resistance to disease 3) public health innovation (e.g., water purification and sewage treatment facilities) 4) increased personal concern about health and following advice of health reformers 5) appointment of medical office to oversee health in Aboriginal communities

• 20

th

century: death rate due to infectious disease declined and

average life expectancy increased

• increase in life expectancy at birth from 59 years to 80

years for men and 61 years to 84 years for women 1) life expectancy varies according to region and ethnicity; lower for some Aboriginal groups ii. chronic disease leading cause of health problems and half of all deaths in developed countries 1) definition = degenerative illnesses that develop or persist over long period of time 2) examples = heart disease, cancer, stroke 3) reasons = increase in industrialization increases stress and exposure to harmful chemicals; longer life span places people at higher risk for chronic disease

• / 4

Sarafino, Health Psychology, Biopsychosocial Interactions, Canadian Edition © 2015 John Wiley & Sons Canada, Ltd

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• Main causes of death across the life span
• children – accidental injury, cancer, & congenital abnormalities
• adolescents – accidental injury, homicide, suicide

II. Viewpoints from History: Physiology, Disease Processes, and the Mind

• Early Cultures

• Belief that physical and mental illness caused by mystical forces (e.g.,

evil spirits)

• speculative evidence - use of trephination to allow spirits to

escape

• Ancient Greece and Rome

• Hippocrates’ humoral theory
• health was due to harmony or balance of four humors whereas

illness was the result of an imbalance of bodily fluids

• health recommendations included good diet, avoiding excesses

to keeps humors in balance

• Introduction of the mind/body problem
• Greek philosophers, including Plato, argued that the mind and

body are separate entities (mind has little impact on the body and its state of health)

• Influence of Galen
• believed in humoral theory and mind-body split
• innovations attributed to Galen - animal dissections to discover

how systems work, localization of illness, and belief that different disease have different effects

• The Middle Ages

• With collapse of Roman Empire, advancement of knowledge and

culture slowed dramatically

• Impact of the Church on slowing development of medical knowledge
• prohibition on human and animal dissection
• belief that creatures with a soul were set apart from ordinary laws

of the universe

• Illness was believed to be a punishment for sin 3 / 4

Sarafino, Health Psychology, Biopsychosocial Interactions, Canadian Edition © 2015 John Wiley & Sons Canada, Ltd

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• medical treatments involving use of torture to drive evil spirits out

of body were done by clergy under this belief

• Influence of St. Thomas Aquinas
• church scholar who saw the mind and body as interrelated unit

that forms whole person

• The Renaissance and After

• Period witnessed rebirth of inquiry, culture, politics, belief in “human-

centered” focus; set stage for changes in philosophy once scientific revolution began

• Influence of Descartes
• advanced notion of "body as machine" and described mechanics

of body action and sensation

• believed the mind and body, although separate entities,

communicated through pineal gland

• argued soul left humans at death; therefore dissection on

humans acceptable

• Changes in science & medicine
• knowledge increased due to technological improvements (e.g.,

microscope) and use of dissection

• rejection of humoral theory and development of new theories due

to increased knowledge of body functions and discovery of microorganisms

• surgical practice improved by antiseptics & anesthesia
• status of hospital changed to "place of healing" along with more

respect for ability of doctors to heal

• Biomedical model
• new approach to conceptualizing health/illness that proposes

physiological problems cause afflictions of the body

• health/illness of body separated from psychological/social

experience of the mind

• dominant perspective in medicine since 19

th century

III. Seeing a Need: Psychology’s Role in Health

• Section Introduction

1. Biomedical model led to:

• development of vaccines and reduction in infectious disease
• / 4