Module:
Health Psychology
Lecture:
Revision Session
Date:
27 April 2009
Chris Bridle, PhD, CPsychol
Associate Professor (Reader)
Warwick Medical School
University of Warwick
Tel: +44(24) 761 50222
Email: [email protected]
www.warwick.ac.uk/go/hpsych
Aims and Objectives
To provide an overview of the module and to
provide you with a framework within which you
can organise your revision for the module
… in 12 or so slides!
Psychological
Processes
Dual Pathway Model

Two broad ways in which psychological processes
may influence physical health
Psychological
Processes
Direct Path
Behaviour
Physical
Health
Nerves
Nervous System:
Physiological
Reactivity
Hormones
Response
GI: IBS,
ulcers
Psychological
Appraisal
Psych: cognitive
decline, morbidity
RS: impotence,
amenorrhea
Endocrine System
ReS: asthma,
hyperventilation
Cardiovascular
System
Essential
Hypertension
Physical and
Psychological
Health Status
Immune System
Sensitivity more severe
Salient
Event
Framework
 Background factors: the context in which individuals live,
Distal
e.g. S-E-S
 Stable factors: relatively enduring and resistant to change,
e.g. negative affect
 Social factors: resources available through social
relations, e.g. social support
 Situational factors: give meaning to salient events and
respond to demands, e.g. appraisal and coping
Proximal
We bring with us, to any situation, the cumulative influence of
background, stable and social factors, which we combine in various
ways to form an understanding of our current situation. In most cases,
our understanding of the situation determines our behaviour within it.
Behaviour and Beliefs

Health behaviour:


Smoking; alcohol misuse; excessive revision; sedentary
lifestyle; neglect of preventive behaviours, etc.
Illness behaviour:

Seeking medical help; adherence; denial; service
(over)use; Dr shopping, etc.
All of these behaviours are driven by beliefs ...
... that form our understanding, guide interpretation and
give meaning to the behaviour in a particular situation
Situation-Specific Beliefs

Health beliefs



Many models describing the relationship between antecedent
beliefs and health behaviour
Common, evidence-based beliefs: personal relevance, selfefficacy, intention/motivation, outcome evaluation
Illness beliefs


At least 5 dimensions of belief: Identity; Cause; Time;
Consequence; Control-Cure
Illness beliefs predict not only illness behaviour, but also
prognosis independently of illness severity
Understanding, predicting and changing behaviour is
dependent upon identifying the beliefs that promote and
maintain the particular behaviour
Stable Individual Differences

Explanatory styles: Psychological processes involved in
explaining the causes of negative events - past

Emotional dispositions: Psychological processes
involved in both the experience and expression of
emotion - present

Generalised expectancies: Psychological processes
involved in formulating expectations in relation to future
outcomes - future
Stable, individual differences reflect our tendency to
interpret things in a particular way. They influence / predict
beliefs, behaviour and health-related outcomes.
Consultation



People judge adequacy of care by the manner in
which it is delivered and not by its technical quality
Patients highlight the doctors use of blocking
behaviours as main problem, e.g. interrupting;
depersonalisation; use of jargon
Poor communication has numerous adverse effects for
patient health: poor adherence, cancellation of followup/referral, low future use
Poor communication negatively affects patient health
Revision Approach: Concept driven




Biopsychosocial: Psychological processes and physical
health outcomes; mechanisms of action; effects
Theory: Illness representations; Stages of change (TTM);
transaction model of stress and coping
Processes: Stress; Coping; Behaviour change; Motivation;
Illness perception
Practice: Communication; Screening; Motivating patients to
change; Supporting change; Stepped care / pathways
Things you should know: Screening

Common psychological conditions, e.g. depression,
alcohol abuse and smoking

For each condition:

Relevant signs, symptoms, effects

Screening questions to ask

Differential diagnosis - what and how

Options and opportunities for treatment - psychological v's
pharmacological; generalist v's specialist?
Other Things to Know





Psychological intervention: Broad aims of psychological
intervention (ABC); types of psychotherapy available
Stages of change: Name, description, order, e.g. precontemplation = not thinking of changing
Relapse: Factors influencing relapse and methods to
prevent it, e.g. developing proactive coping skills
Coping: Brief description of coping dimensions, the effect of
coping (what it does) and the determinants of coping
Somatisation/Chronic illness: Characteristics; principles of
assessment, treatment and management
What now?

In your tutor (sub-)groups, now or later:




Screening: Select ONE condition and answer questions /
provide information
Select ONE topic from the list of 'Other Things to Know'
and answer questions / provide relevant information
Complete ONE integrated question examples from
module webpage
Formulate ONE question re: any of the above
Any Questions?