Topic

Introduction
to Health
Psychology

LEARNING OUTCOMES
By the end of this topic, you should be able to:
1.

Describe the meaning of health;

2.

Describe the history of health psychology;

3.

Explain the importance of health psychology; and

4.

Explain the biopsychosocial model.

INTRODUCTION
Welcome to the world of health psychology. At the beginning of this topic you
will learn the definition of health and health psychology. Then we will discuss
the history of health psychology and its importance in our lives. Finally, we will
learn about some basic concepts in health psychology, with a special look at the
biopsychosocial model.

Copyright Open University Malaysia (OUM)

1.1

TOPIC 1

INTRODUCTION TO HEALTH PSYCHOLOGY

DEFINITION OF HEALTH

Take a few moments to read the conversation that is taking place in the cartoon
below (see Figure 1.1).

Figure 1.1: Health problems

In the scenario above, who do you think is not healthy? What is your definition
of health?
Health does not simply mean to be in good physical condition. You are said
to be healthy if your body is healthy, your mind is healthy, you have healthy
interaction with your environment and you can function appropriately.

Copyright Open University Malaysia (OUM)

TOPIC 1

INTRODUCTION TO HEALTH PSYCHOLOGY

The definition of health by the World Health Organization (1948) is:

A complete state of physical, mental, and social well-being and not merely
the absence of disease and infirmity.
Now, study Figure 1.2 to learn about what health is considered to be.

Figure 1.2: The concept of health

ACTIVITY 1.1
1.

Analyse your lifestyle. Which of your daily activities have

positive or negative effects on your physical fitness?

2.

How would you change those negative activities so that you will
stay healthy?

1.2

DEFINITION OF HEALTH PSYCHOLOGY

Health psychology is a branch of psychology that focuses on the understanding

of how you can stay healthy, why you become ill and how you and your
environment respond when you get ill.

Copyright Open University Malaysia (OUM)

TOPIC 1

INTRODUCTION TO HEALTH PSYCHOLOGY

Initially, Matarazzo (1980) defined health psychology as the comprehensive

study of:
the specific educational, scientific, and professional contributions of the
discipline of psychology to the promotion and maintenance of health, the
prevention and treatment of illness, and the identification of etiologic and
diagnostic correlates of health, illness and related dysfunction.
Recently, health psychologists have become involved in more important areas
of health, for example, formulating health care policies and contributing to
the management of health care systems. Therefore, the definition of health
psychology has incorporated these new roles as suggested by Brannon and Feist
(2000), who stated that health psychology is:
psychologys contributions to the enhancement of health, the prevention and
treatment of illness, the identification of health risk factors, the improvement
of the health care system, and shaping of public opinion with regard to
health
The above definition suggests that there must be some form of control. Control is
a key concept in the psychology of health. It has important applications in the
fields of stress, coping and adaptation, health promotion, health education,
rehabilitation and care in acute and chronic illness, disability and terminal illness.
It also has important implications for the management of the relationship
between patients or clients and carers and health care professionals in all health
care settings.

SELF-CHECK 1.1
1.

Define health in your own words.

2.

Define Health Psychology.

1.3

HISTORY OF HEALTH PSYCHOLOGY

To understand the history of health psychology you must first understand

the earlier concepts of mind and body, and then relate these with current
understanding.
Copyright Open University Malaysia (OUM)

TOPIC 1

1.3.1

INTRODUCTION TO HEALTH PSYCHOLOGY

Early Concepts of Mind and Body

Previous philosophers and researchers fluctuated in their views regarding the

relationship between mind and body.
Before modern times, manifestations of psychiatric disorders were believed to be
associated with supernatural phenomenon such as the belief that the body has
come into the possession of evil spirits.
Later, the Greeks believed that disturbances in our behaviour and emotions
could be due to an imbalance between elements in our body. Hippocrates
(460370 BC) described the ancient Humoral Theory. He believed that certain
human temperaments, i.e., moods, emotions and behaviours, were associated
with an imbalance of body fluids (called humors): blood, yellow bile, black bile
and phlegm.
In humoral theory, individual diseases did not exist in the way that we
understand them today. Diseases were not seen as forces or entities separate
from the body, but instead were understood as states of bodily imbalance.
Physicians trained in humoral theory relied not only on a knowledge of medical
texts, but also on personal understanding of the patient; on the inspection of
blood, urine and other fluids produced by the body; and on the patients
description of his or her symptoms.
Extensive physical examinations were rare. Prognosis was a finely honed skill,
and work published by physicians before the 20th century often contained
detailed observations of the stages and crisis periods in illness. Authors typically
refer to the eruption of lesions on the skin, the movement of fluids through the
body, and the problems caused by any blockages. Preventative treatment was
also of central importance, and public health practices developed in the early
19th century were based in part on basic humoral presuppositions especially on
the relationship between environment, individual lifestyle and health. These
ideas were often criticised, however, especially after mid-century.
Belief in the supernatural and religious influences were dominant in the Middle
Ages. It was believed that a cure for an illness could be achieved by driving out
evil through torturing the body.
During the Renaissance period, medicine placed more attention on technology,
laboratory results and bodily factors. Through autopsies, humoral theory was
put to rest and cellular changes and pathology of the body became the basis of
the diagnosis and treatment of diseases.
Copyright Open University Malaysia (OUM)

1.3.2

TOPIC 1

INTRODUCTION TO HEALTH PSYCHOLOGY

Contemporary Psychology

Modern psychology began when neurologist Sigmund Freud (18561939) failed

to find the innervations that were responsible for hysterical phenomena. In order
to explain the phenomenon, he proposed a theory that specific unconscious
conflicts can produce physical disturbances that symbolise the repressed
psychological conflicts without specific physiological changes.
The relationship between body and mind was also explored through
physiological studies. In 1928, Walter Cannon and Phillip Bard proposed the
Cannon Bard Theory which emphasised the importance of the autonomic
nervous system in the physiology of stress.
In the 1950s, Wolff further reinforced the association between stress and illness
by introducing a relationship between stress and adaptation in health and
disease states. Hans Selye introduced the General Adaptation Syndrome, which
emphasised the stages of stress and their association with hormonal,
immunological and other physiological changes in our body.
Other researchers, namely Flanders Dunbar (1930s) and Franz Alexander (1940s),
were more interested in the link between personality and certain illnesses, i.e.,
they posited that people who have excessive needs for dependence and love
were prone to developing ulcers. Dunbar and Alexander introduced the field of
Psychosomatic Medicine.
Two new interrelated disciplines emerged from psychosomatic medicine:
behavioural medicine and behavioural health.

In 1977, Behavioural Medicine was born out of psychosomatic medicine by

Schwartz & Weiss. It was defined as:
... the field concerned with the development of behavioural science
knowledge and techniques relevant to the understanding of physical
health and illness and the application of this knowledge and these
techniques to prevention, diagnosis, treatment and rehabilitation.
Psychosis and neurosis and substance abuse are included only so far as
they contribute to physical disorders as an endpoint.

Copyright Open University Malaysia (OUM)

TOPIC 1

INTRODUCTION TO HEALTH PSYCHOLOGY

Behavioural Health focused more on the prevention of diseases in healthy

people rather than the treatment of sick people. This field covered research
and activities related to promoting a healthy lifestyle, e.g., a healthy diet, no
smoking, and regular exercise. Later , in 1978, this discipline became
recognised as Health Psychology, Division 38 of the American Psychological
Association (APA).

SELF-CHECK 1.2
Write a short paragraph on the history of psychology.

1.4

HEALTH PSYCHOLOGY VERSUS OTHER

DISCIPLINES

There is no clear demarcation between health psychology, clinical psychology,

behavioural medicine and psychiatry. However, health psychology focuses
more on medical diseases than mental disorders, when compared to clinical
psychology and psychiatry. Often, the roles of professionals in the respective
disciplines overlap. Figure 1.3 illustrates where health psychology stands in
relation to other related disciplines.

Figure 1.3: Health psychology and other related disciplines

Source: Albery and Munaf (2007)

Copyright Open University Malaysia (OUM)

TOPIC 1

INTRODUCTION TO HEALTH PSYCHOLOGY

SELF-CHECK 1.3
Fill in the blanks below:

I work with psychiatrists at a psychiatric clinic. I help those with

schizophrenia, depression and others mental disorders. My discipline
is ..................................................................................................
I help to promote a healthy lifestyle. I motivate those who are obese to
love themselves, to exercise and to get a balanced diet. My discipline
is................................................................

1.5

IMPORTANCE OF HEALTH PSYCHOLOGY

Health psychology is important because of several factors, as discussed below:

(a)

Changing Pattern of Illness

Nowadays, illness patterns are changing. More non-communicable
diseases, such as heart disease, cancer and diabetes, contribute to death and
disability compared to communicable diseases, such as tuberculosis and
pneumonia. Table 1.1 below shows the percentage of deaths worldwide in
2008 by illness, according to the World Health Organization.
The main factors that contribute to these non-communicable diseases are
lifestyle and social factors, both of which are modifiable.
Health psychologists who are experts in patterns of coping style,
personality and stress management may contribute to the prevention and
identification of health risk factors, as well as to the improvement of the
health care system to reduce the risk of such diseases.

Copyright Open University Malaysia (OUM)

TOPIC 1

INTRODUCTION TO HEALTH PSYCHOLOGY

Table 1.1: Percentage of Deaths Worldwide in 2008 (World Health Organization)

World
Ischaemic heart disease
Stroke and other cerebrovascular disease
Lower respiratory infections
Chronic obstructive pulmonary disease
Diarrhoeal diseases
HIV/AIDS
Trachea, bronchus, lung cancers
Tuberculosis
Diabetes mellitus
Road traffic accidents

Deaths in
millions

% of deaths

7.25
6.15
3.46
3.28
2.46
1.78
1.39
1.34
1.26
1.21

12.8%
10.8%
6.1%
5.8%
4.3%
3.1%
2.4%
2.4%
2.2%
2.

Source: http://www.who.int/mediacentre/factsheets/fs310/en/index.html

(b)

Expanded Health Care Services

Prevention is better than cure. Health care costs for the treatment of
diseases are increasing. Therefore, preventive care for common diseases must
be the main emphasis in the management of any disease. Health
psychologists who are experts in modifying peoples risky health behaviours
are important professionals in implementing any health care system.

(c)

Increased Medical Acceptance

In other countries, health psychologists are well accepted as part of the
medical profession. In Malaysia, however, the contribution of health
psychologists to mainstream medical care services is still limited.

(d)

Advances in Research
More psychological research is needed to contribute to the comprehensive
management of medical diseases.

ACTIVITY 1.2
Research the contribution of health psychologists to the health care
system in Malaysia. Discuss your findings during your tutorial.

Copyright Open University Malaysia (OUM)

10

TOPIC 1

INTRODUCTION TO HEALTH PSYCHOLOGY

SELF-CHECK 1.4
State the importance of health psychology.

1.6

BASIC CONCEPTS IN HEALTH

PSYCHOLOGY

The most important concept in health psychology is the biopsychosocial model.

This model was introduced by G.L. Engel in 1977. This model shows the
interplay among psychological factors, biological factors and social factors in the
development of certain diseases. Figure 1.4 shows some aspects in the respective
biopsychosocial factors that contribute to health and disease.

Figure 1.4: Biopsychosocial factors that contribute to health and disease

Source: Brannon and Feist (2007)

Copyright Open University Malaysia (OUM)

TOPIC 1

INTRODUCTION TO HEALTH PSYCHOLOGY

11

Read about Mr Ali in Figure 1.5 to understand better the bio-psychosocial

concept in health psychology.

Figure 1.5: Mr Ali and his problems

Copyright Open University Malaysia (OUM)

12

TOPIC 1

INTRODUCTION TO HEALTH PSYCHOLOGY

Table 1.2 shows examples of the biopsychosocial factors that contribute to Mr Alis
disease. The table shows how there is an interplay among psychological factors,
biological factors and social factors in the development of certain diseases.
Table 1.2: Biopsychosocial Factors of Mr Ali's Disease
Psychology

Biology

1.

Poor stress
management

1.

Family history of
cardiovascular disease

2.

Poor impulse control;

unable to control eating

2.

Obesity

Social
1.

Financial crisis

2.

Poor working
environment

Outcome:

Heart disease

You will learn more about the biopsychosocial model in relation to other
concepts in health psychology in future topics.

SELF-CHECK 1.4
1.

Describe the importance of health psychology.

2.

What is the role of a health psychologist?

Copyright Open University Malaysia (OUM)

TOPIC 1

INTRODUCTION TO HEALTH PSYCHOLOGY

13

Being healthy means you are in good physical condition, your mind is
healthy, you have good interaction with your environment and you can
function appropriately.

Health psychology focuses more on the understanding of how you can stay
healthy, why you become ill and how you and your environment respond
when you get ill.

Health psychology helps in the improvement of the health care system and
the shaping of public opinion with regard to health.

The relationship between mind and body has been described since ancient
times. It was further elaborated by Sigmund Freud, Walter Cannon, Phillip
Bard, Hans Selye, Flanders Dunbar, Franz Alexander and other researchers.

Health psychology is important in present times because: there have been

changes in the pattern of illness; there has been an expansion of health care
services; there have been advances in research; and there is now an increased
acceptance among medical professionals on the role of psychologists in
managing various diseases.

The biopsychosocial model describes the interplay among psychological

factors, biological factors and social factors in the development of certain
diseases.

Behavioural medicine and behavioural health

Health psychology

Biopsychosocial model

Humoral theory

Contemporary psychology

Physiology of stress

General Adaptation Syndrome

Psychosomatic medicine

Copyright Open University Malaysia (OUM)

14

TOPIC 1

INTRODUCTION TO HEALTH PSYCHOLOGY

Albery, I. P., & Munaf, M. (2007). Key concepts in health psychology. London:
Sage Publications Ltd.
Brannon, L., & Feist, J. (2007). Health psychology An introduction to behavior
and health (6th ed.). Belmont, CA: Wadsworth Publishing.
Matarazzo, J. D. (1980). Behavioral health and behavioral medicine: Frontiers for
a new health psychology. American Psychologist, 35(9), Sep 1980, 807817.
doi: 10.1037/0003-066X.35.9.807
Percentage of Deaths Worldwide in 2008 by World Health Organization (2008).
Retrieved from
http://www.who.int/mediacentre/factsheets/fs310/en/index.html.
Schwartz, G. E., & Weiss, S. M. (1977). Behavioural Medicine revisited: An
amended definition. Journal of behavioral medicine, 1(3), 249251,
doi:10.1007/BF00846677
Taylor, S. E. (2006). Health psychology (6th ed.). Boston: Mc Graw Hill Higher
Education.

Copyright Open University Malaysia (OUM)