1. Introduction: Medical Psychology and Border Areas

2. Themes of Medical Psychology
► Psychological factors influencing the development or progression of disease
Etiology
► Patient’s response to illness and disease
Outcomes
► Communication with patients and colleagues
- Relational issues

3. Medical Psychology and border areas
PRIMARY PREVENTION
Health education
TREATMENT
General practice
Hospital care
Rehabilitation
Behavioural
Health
Medical
Psychology
(Behavioural
Medicine)
Medical doctors
and other health
professionals
Individual behavior
diet,
exercise, etc.
supperted by
health professionals
Health
Psychology
Clinical
Psychology
and
Psychiatry
Clinical
psychologists
and
psychiatrists
Health psychologists

4. Historical views of diseases
► Anatomical pathology
Belief that disease was localized in anatomy (16th to 18th Centuries)
► Cellular pathology
Belief that cells must be the place to look for disease (19th century)
► Germ theory
Discovery that particles that could not seen (e.g., bacteria) could cause disease.

5. Biopsychosocial model Mind, body, and environment
Contemporary view
Biopsychosocial model
(George Engel, 1977)
Mind, body, and environment
interact
in causing disease.

6. The biopsychosocial model of disease
Biology
Genetics
Anatomy
Physiology
Pathogens
Germs
Toxins
Psychology
Behavioural factors
Diet, exercise, smoking, coping with illness
Other psych. factors
Stress, anxiety, depression, illness
beliefs, etc.
Social factors
Family
Society
Friends, etc.

7. Psychological components of the biopsychosocial model
► Behaviour (actions in relation to the environment)
► Emotions (feelings, subjective states)
► Cognition (thoughts, beliefs, and attitudes)
► Personality (characteristic ways of thinking and feeling)

8. Clinical relevance of the biopsychosocial model
The process of diagnosis must consider the interaction of biological, psychological, and social factors.
Treatment recommendations must take these factors into account.
The relationship between the patient and the health care practitioner has an impact on the effectiveness of care.

9. Examples for psychosocial factors influencing the onset of illness or injury
► Many patients diagnosed with cancer having had some significant loss months prior to diagnosis.
► Individuals with high stress, low resources and poor coping have greater risk for injury (accidents, etc.).

10. Major life events, stress, and illness outcome
2000 people’s life events and periods of illness in the previous 10 years (Rahe et al, 1967).
► Approximately 50% of those who reported higher life stress scores indicated varying degrees of illness the following year.
► Life stress scores at the very top end were positively correlated with the number of reported periods of illness.

11. The practical relevance of medical psychology
► An interdisciplinary effort to open communication and collaboration.
► A common language can be created in which different disciplines can benefit each other.

12. The use of psychological interventions
Short-term behavioral interventions have been effective in helping patients to:
►Manage pain
► Reduce anxiety prior and after surgery
► Improve communication with doctors
► Manage side effects and treatment effects when coping with chronic illness

13. Contributions of psychology to medical care
► Reliable and valid measures for assessing health-related factors.
PSYCHOLOGICAL TESTS
► Techniques useful in changing behaviours that affect health and illness.
BEHAVIOR MODIFICATON, SUPPORT
AND PSYCHOTHERAPY

14. The clinical health psychologist
► A psychologist trained to work in collaboration with other health professionals
► Intervenes at the individual level
to treat illness,
slow or prevent disease progression, and reduce disability

15. The Practice of Medical Psychology

16. Pain
management

17. Modification of
illness beliefs

18. Communication
with
patients

19. Patient
education