This is the Chapter 1 of the book Introduction to Health Psychology (Val Morrison_ Paul Bennett) 4th Edition. Which is content for the exam of the component Health Psychology of Module 5 (Health Psychology & Applied Technology) of the University of Twente, in the Netherlands. 

Ch.1 : What is health?

• Health is wholeness, including mental and physical aspects.

Mind/body:

• Humoral theory: Health is viewed as 4 circulating fluids, which are balanced (yellow bile, phlegm, blood and black bile)
  • Hippocrates, considered body and mind as one unit --> and stated that specific bodily humours were related to particular personalities.
  • This theory explains that the mind and the body are interrelated. But then, physical and mental disturbances both were said to have an underlying physical cause. The mind itself was not thought to play a role  
• Illness aetiology: the cause of illness
• Dualism: body and mind are separate entities
  • Material: body
  • Non-material: not objective or visible, such as thoughts and feelings
• Anatomical research: Body of research that determined that diseases were located in human cells, and not in ill-balanced humours.
  • Mechanistic: an approach that reduces behaviour to organs and physical function.
  • Biomedical model: human behaviour reduced to and explained at, the level of cells, neural activity or biochemical activity.

Biomedical model:

• Health = absence of symptoms
• Illness results outside the body or in involuntary internal changes
• Reductionism: it ignores evidence that different people respond in different ways to the same underlying disease pathology

Challenges to dualism:

• Placebo effect: an inactive substance that leads to the report of reductions in pain
• Sigmund Freud: talked about consciousness and unconsciousness, and he reported physical disturbances where no underlying physical explanation was present. Meaning that it was curable through accessing the unconscious.
• Biopsychosocial: diseases and symptoms explained by a combination of physical, social, cultural and psychological factors.

The biopsychosocial model of illness:

• The model draws emphasis on the interaction of body and mind + biological processes + psychological and social influences
• Mortality: it represents the number of deaths in a given population and/or in a given year ascribed to a given condition
• Incidence: it represents the number of new cases of a disease occurring in a defined time interval.
• Prevalence: it represents the number of established cases of a disease in a population at any one time.
• Health psychologists: try to demonstrate that one’s own behaviour contributes to their health and mortality --> understanding why we behave and how to change behaviour
• Mid-twentieth century --> health was either seen as “fitness to work” or “sick role”.

Theories of health:

• Health is related to feelings, symptoms, and performance --> relative state of being
• Health behaviour: the behaviour that protects, promotes or maintains health
• Categories of health:
  • Health as not ill
  • Health as a reserve (biological predispositions)
  • Health as behaviour
  • Health as physical fitness and vitality
  • Health as psychosocial (approach merges psychological and social aspects to health)
  • Health as function
• WHO definition (1947): defined health as a state of complete physical, mental, and social well-being and [. . .] not merely the absence of disease or infirmity

Cross-cultural perspectives:

• Holistic: concern with the whole being and its wellbeing
• Collectivist: individual as part of wider a unit. Emphasis on duties above rights, with actions motivated by interconnectedness, reciprocity and group membership.
• Individualist: responsibility at the individual level, and they draw emphasises on rights above duties; thus behaviour is often driven by individual needs
• Religion: belief that the likelihood of becoming ill was uncontrollable

Developmental theories:

• Development process:

1. Learning: relatively permanent change in knowledge, skill or ability result of experience
2. Experience: do/see/hear/feel/think
3. Maturation: thought/behaviour/physical growth

• Erik Erikson 8 life stages, across different dimensions:
  • Cognitive
  • Language/communication skills
  • Understanding illness
  • Maintenance behaviour
• Piaget staged structure:

1. Sensorimotor: [birth-2 years] understanding of the world of sensations and movement --> they lack symbolic thought, and they move from reflexive to voluntary action
2. Preoperational: [2-7 years] symbolic thought is developing --> development of simple logical thinking and language. And they are self-centred.
3. Concrete operational: [7-11 years] Beginning of abstract thought logic, the performance of mental operations, and manipulation of objects
4. Formal operational: [12-adulthood] stage of imagination and deductive reasoning

Sensorimotor and preoperational stage:

• Illness concept: (with examples of thoughts that individuals at those stages would have)
  • Incomprehension: “sun causes heart attack”
  • Phenomenonism: “cold is when you sniff a lot”
  • Contagion: they attribute illness to activity  that occurred before the illness

Concrete operational stage:

• Illness concept:
  • Contamination: when an illness has symptoms, they recognise them as the cause of the illness
  • Internalisation: Illness is partially understood, and the medical staff is seen as absolute authority

Adolescence and formal operational thought:

• Illness concept:
  • Physiological: define illness in terms of specific body organs and functions, that are damaged.
  • Psychophysiological: seeing that the mind and the body interact, and understanding and accepting the role of stress
• Good health:

1. Functional
2. Mental Health
3. Health behaviour

Ageing and health:

• 1^st age: [3-13years] dependency/education.
  • what is learned is ideally applied to achieving future life goals
• 2^nd age: [adolescence-adulthood] develop independence/maturity/responsibility
• Middle age: [40-60years] doubts/anxiety --> triggered from the uncertainty of roles parents are supposed to take when their children leave home
• Elderly: expect poor health care, since it's inevitable --> may not respond to symptoms as they should
• Epidemiology: a study of patterns of disease, associated factors such as lifestyle
• Self-concept: knowledge, conscious thoughts and beliefs about yourself that allow you to feel you are distinct from others and that you exist as a separate person. Relatively stable through ageing

Successful ageing:

• Identify successful ageing:
  • Biomedical model: diagnoses and functional ability
  • Broader biomedical model: includes social engagement
  • Social functioning model: social support accessed
  • Psychological resources model: personal characteristics optimism/self-efficacy/ sense of purpose/coping and problem-solving/self-confidence/self-worth
  • Lay model: plus socioeconomic variables of income and “perceived social capital”
• Health: is a continuum, not simply a dichotomy of sick versus healthy

Health psychology:

• Empiricism: all knowledge is obtained through experience à scientific study mental/behavioural functioning à describe/explain/predict/intervene to control/modify behaviour/mental processes
• Goals:
  • Promote/maintain health
  • Healthcare systems/health policy
  • Prevention/treatment of illness
  • Illness risk factors
• Psychosomatic medicine: mind/body involved illness. Organic causes not easily identified
• Behavioural medicine: behavioural science in relation to medicine/medical conditions --> behavioural principles applied to evaluate techniques of prevention/rehabilitation (not solely treatment)
  • Behavioural health: health enhancement/disease prevention, rather than focus on illness
• Medical psychology: More of a profession, instead of a specific discipline
  • UK --> work with a holistic model (not only account or biological basis of health)
  • Netherlands --> work medical setting, with psychology degree and master trainning
  • USA --> (physical) medicine considered. Sometimes prescribe medicines
• Medical sociology: between psychology/sociology
• Health/illness à social factors that influence individual, their cognitive/beliefs and responses to external worlds
• Boundaries medical sociology/health psychology blurred

• Clinical psychology: diagnosis + treatment mental health problems. Interventions derived from behavioural/cognitive principles
• Health psychology:
  • Behavioural medicine: discipline where health psychology falls within
  • Biological/social/psychological factors involved prevention/treatment of physical illness, promote maintenance health