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Clinical Health Psy. in Medical Science - Summary, Tilburg University $6.06   Add to cart

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Clinical Health Psy. in Medical Science - Summary, Tilburg University

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A summary of the course Clinical Health Psy. in Medical Science. The summary consists of the lectures given and the chapter of the book. If you have any questions, you can message me :)

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  • June 10, 2024
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  • 2023/2024
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Lecture 1
Brief history
 The mind-body relationship
o During prehistory
 Mind and body intertwined
 Diseases arise when evil spirits enter the body
 Treatment consisted primarily of attempts to exorcise these spirits
o Ancient Greeks: humoral theory of illness
 Diseases resulted when the four humors, or circulating fluids of the body,
were out of balance
 Treatment: to restore balance between the humors
 Four humors
 Blood – passionate temperament
 Black bile – sadness
 Yellow bile – angry disposition
 Phlegm – laid-back approach to life
o Middle ages
 Disease regarded as God’s punishment
 Treatment: driving out evil forces by torturing the body. Later, it was replaced
by prayer and doing good
o Renaissance to present day
 Enhanced scientific knowledge and assessment
 Practice is dependent on laboratory findings and reported or observed bodily
factors
 Diagnosis and treatment are based on organic and cellular pathology
 The result: biomedical model emerged
 The biomedical model
o All illness can be explained through aberrant somatic bodily processes
o Health is seen as biochemical or physical in nature
o Assumes that psychological and social processes are largely irrelevant to the disease
process
o Ill-suited to understanding illness
 Reduces illness to low-level processes
 Fails to recognize social and psychological processes as powerful influences –
assumes a mind-body dualism
 Emphasizes illness rather than focusing on behaviors that enhance health
 Cannot address puzzles that face practitioners
 Conversion hysteria
o The biomedical viewpoint started to change with the rise of modern psychology
o Specific unconscious conflicts produce physical disturbances symbolizing repressed
psychological conflicts
o Conceptualized by Sigmund Freud
o Gave rise to the field of psychosomatic medicine
 Psychosomatic medicine
o Idea that specific illnesses are produced by people’s internal conflicts
o Dunbar and Alexander linked patterns of personality to specific illnesses
 Ulcer-prone personality: someone with excessive needs for dependency and
love
 Secretion of acid in the stomach  eroding the lining of the stomach
 Conflict produces anxiety which takes a physiological toll
o Criticism: conflict or personality type is not sufficient to produce illness

,  Biopsychosocial model
o Health and illness are consequences of the interplay of biological, psychological and
social factors
o Advantages
 Maintains that the macrolevel and microlevel processes continually interact
to influence health and illness
 Emphasizes both health and illness
o Also received criticism
 Social aspect not well captured in research
 To be studied over time, explore complex interaction systems
 Biomedical vs biopsychosocial




 Clinical implications of the biopsychosocial model
o Understanding the interacting role of biological, psychological, and social factors
informs diagnosis
o Emphasis on the relationship between patient and their practitioner, which improves
 Patient’s use of services
 Efficacy of treatment
 Rapidity with which illness is resolved

Epidemiology




Different disciplines
 Mental problems and physical illness
o What is the relationship between mental problems and illness/disease?
o Which major fields contribute to our knowledge on mental problems and/or
illness/disease and what is the role of these fields in a medical setting?
 Psychology and medicine

, Psychology is different from medicine
o Mono-causal explanation of disease in medicine
o Emphasis on biological pathways
o Clear distinction between body and mind
o Disease vs illness
 Disease is something an organ has, illness is something a man has
 Disease is something that needs to be cured. Illness is something that needs
to be managed.
 They are not mutually exclusive, and often occur together
 Psychiatry
o Focus on mental health problems
o Treatment of abnormal emotions and behavior
o Largely driven by DSM classification
o Psychiatrist is physician
o Use of psychotropic drugs to treat mental conditions
 Clinical psychology
o Diagnostics of mental problems
o Provision of psychotherapeutic treatment
 Health psychology
o Part of psychology that mainly concerns prevention of disease and promotion of
health
o Promotion of certain health behaviors in order to prevent illness
o Health-compromising behaviors
o Health-enhancing behaviors
 Medical psychology
o Focus on patients in medical situations and their psychological problems
o Psychologists work in hospitals or rehabilitation center
o Patient categories in a medical setting
 Adult patients with chronic diseases
 Patients with functional complaints who present somatic complaints, in the
absence of a clear medical cause
 Adult patients with brain damage, who need neuropsychological assessment
and treatment
 Children up to 18 years of age, with a variety of diseases and symptoms
 Adult psychiatric patients with primary psychiatric conditions
o Medical psychology in hospitals
 In 2022, there are about 71 hospitals
 Patients can only consult a medical specialist after being referred by the GP
 However, the GP can not refer patients to a medical psychologist in
the hospital directly
 The following disciplines are working in departments of medical psychology
 Psychologists
 Health psychologists
 Clinical psychologists
 And psychological assistants, psychological workers, secretaries and
trainees
o Tasks of a psychologist in a medical setting
 Direct interaction with the patient
 Assessment of the patient and his complaints by interviewing,
observation and testing
 Psychological treatment, which generally is short-term intervention

,  Indirect patient related tasks
 Team coaching, consultation of other professionals
 Participating in staff committees
 Management tasks
 Training of master students and post-graduate students
 In general, research is not a structural task

Recognition of symptoms
 Individual differences
o Hypochondriacs believe that normal bodily symptoms are indicators of illness
o Neurotic people often exaggerate their symptoms
 Attentional differences
o People who are focused on themselves are quicker to notice symptoms
o People with more distractions and who attend less to themselves experience fewer
symptoms
 Situational factors
o Boring situations make people more attentive to symptoms
o Medical students’ disease: students believe they are ill with the same illness about
which they are studying
 Stress
o Stress-related physiological changes are interpreted as symptoms of illness
 Mood and emotions
o Affects perceptions of symptoms and perceived vulnerability to illness
 Interpretation of symptoms
o Prior experience
 Common disorders are regarded as less serious than rare disorders
o Expectations
 Unexpected symptoms are ignored, and expected symptoms are amplified
o Seriousness of the symptoms
 Treatment is sought only when the symptoms affects a highly valued organ
and/or limits mobility
 Common sense model of illness (Leventhal)
o People hold implicit commonsense beliefs about their symptoms and illnesses
o Result in organized illness representations
o Includes basic information about an illness
 Identity = name
 Causes = factors that led to illness
 Consequences = symptoms, treatment, and implication of QoL
 Timeline = length of time illness is expected to last
 Control or cure = belief that illness can be managed or cured
 Coherence = how well these beliefs represent the disorder
o Models of illness
 Acute illness
 Believed to be caused by viral or bacterial agents
 Short in duration, with no long-term consequences
 Chronic illness
 Believed to be caused by multiple factors
 Long in duration, with severe consequences
 Cyclic illness
 Alternating period of either no symptoms or many symptoms

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