Health Psychology

General Overview of Health Psychology

Historical background
Stress & Reactions to stress
-What is it?
-GAS & the physiology of stress
-Coping with Stress
Personality and Stress
BioPsychoSocial Model

Other areas of Health Psychology

General overview of Health Psychology

Health psychology involves psychology's primary role in the science and profession of behavioural medicine and health care practices, disease development.

Behavioural Medicine is a broad and interdisciplinary field of study that involves: scientific investigation, clinical practice, and education that addresses health, illness, and related physiological functions.

Topics include: Stress & Coping, Coronary Heart Disease, Hypertension, Pain, Smoking, Food abuse/disorders, Ulcers, Migraines, Asthma, Diabetes, Compliance with Medical Intervention, Patient & Care Provider Behaviours.

Psychosomatic Medicine

Mind-Body Problem revisited
Cartesian Dualism
- Mind affects body & body affects minds

Psychoanalysis: Somatoform disorders (not same as psychosomatic)

Health Psychology has Formal beginnings as early as 1911 when APA had a symposium on "The Relations of Psychology and Medical Education"

Edward Alexander "Ned" Bott (1887-1974): University of Toronto

-WWI - Mechanotherapy: Veteran rehabilitation
-Treat the whole man, not just the wounded body.

-1928 Teaching of psychology in the medical course

-Need to study psychological aspects of disease status

Walter Cannon (1935) Stresses and strains of homeostasis

Wolff (1950) brought to bear the relationship between
stress and adaptation in health and disease states

Hans Selye (1956), The Stress of Life, interest grew on the
relationship between thoughts and physiology (akin to
placebo effects).

Schwartz & Weiss (1977) Behavioural Medicine is born out of psychosomatic medicine and Health Psychology is born.

Stress and Reactions to Stress

Stress, What is it? What do you do to alleviate it?

[review and short video]

Walter Cannon (1914, 1935) one of the first to use the term stress which involves both physiological and psychological aspects

-has an emotional aspect -arousal (Cannon-Bard Theory of emotion)

-may reach a critical level of stress that disrupts one's homeostasis


Hans Selye (1956) built upon Cannon's notion, providing the
General Adaptation Syndrome

Three stage syndrome that is a non-specific but idiosyncratic response. It has no single cause but differs 'in profile' from person to person

Stage 1. Alarm - mobilise response (sympathetic NS)

Stage 2. Resistance - coping and resistance

Stage 3. Exhaustion - vulnerability to disease and tissue damage
(Endocrine & ANS activity: adrenal cortex, spleen, thymus, lymph nodes, stomach, +..)

Extreme forms - Post Traumatic Stress Disorder: major anxiety and other symptoms including nightmares as the direct result of serious trauma such as war, rape, earthquake, working as public rescue (police, fire, ambulance), ....

What makes a Stressor?

Primary Appraisal
- Ask: is the event or 'stimulus' is stressful?

Secondary Appraisal - Ask: am I prepared to deal with it? (coping)

Viktor Frankl - Nazi death camps, some people "gave up hope" they were called "dead in three days" because that is what happened once hope's gone.

Common Stressors
SRRS Major Life Events Scales -
What's most stressful?

-Eustress pertains to physiological and psychological reactions of a positive nature that place some demand on the mind-body systems.

-Distress pertains to similar demands that are of a more negative or damaging nature. 

[Selye video]

There is a need for self-esteem and efficacy for survival. Self-discrepancy theory predicts less health when feeling incongruence to thoughts of self.


 Problem-focused coping involves the redefinition of a situation or alternatives.  This may be proactive, targeting the stressor and attempting to eliminate it before it has an impact. It may also involve combative coping where the adjustment is made to reduce the stressor or its effects after it has had an impact. 

Emotion-Focused coping involves an attempt to reduce emotional distress through controlling the event or reinterpreting the meaning of the stressor.

Common forms

Personality and Stress

Type A vs B
 Friedman & Rosenman (1975) found types of personality.

-Type A
is time urgent, impatient, hard driving, and hostile
-Type B
is easygoing, relaxed and less rushed

--Type A is twice as likely to suffer heart attacks
(Other risk factors: hypertension, smoking, high cholesterol,

family history, obesity, lack of exercise).

Self Healing Personality
Hardiness - characterized by a trilogy of traits

- 1) commitment-
a sense of purpose with respect to family, career, religion
- 2) challenge - an interest in taking on new experiences that may be difficult

- 3) control - confidence in one's own power to be an important influence

Optimism and Hope -Cousins (1989) 'hope' & positive expectations can release endorphins .    

Social Support & dogs -having people around you to offer conversation and emotional support is greatly beneficial, as is having a dog or pet to care for & have social experience

Alameda County Study: social support 27% vs 58% deaths after 1 year

-Control and information for heart patients.


  • Stress has a weakening effect on the immune system
    Immune system contains special white blood cells-lymphocytes that develop from B cells (bone marrow) and T cells (thymus gland) to fight invaders.

    - also have macrophages and NK (natural Killer) cells that fight viruses and cancerous cells

Cancer and AIDS
Breast cancer longevity increased with positive confronting attitude vs. passive or negative attitude (Burgess et al., 1988).

Repression/inhibition of thoughts & feelings for prolonged time leads to immune suppression (Pennebaker, 1995).

Write about your experiences/stress 20 min daily showed stronger immune system (blood samples) than non-writers (Pennebaker et al.,1988).

Bio-Psycho-Social Model of Stress
Considers primary and secondary appraisal, etiology and alleviation of stress to be in the biological, psychological and social sphere of living.

  • Biological (Behavioural) - Genetic, Environmental and Behavioural influences: temperament, personality, habits, learned responses, ...
  • Psychological - Cognition, interpretations, thought, mindset; Conation, perceived and actual control; Affect, emotional response.
  • Social - Relationships (family, friends, community), cultural
    practices and values, institutional support and use.

Application to Culture: Acculturative Stress among
Immigrant Youth & International students Metropolis Project:

Take-Home Activity on Stress

Other Prominent Areas of Health Psychology

  • Pain Management
  • Chronic Back Pain, Migraine, Phantom Pain

Theories of Pain

          Pain   The Gate Control Theory commonly assessed through McGill Pain Questionnaire

Biofeedback (Miller, 1969, 1978) - monitoring devices track the bodily processes in question and deliver a signal (light or tone) whenever a person makes the desired response - e.g., headaches, blood pressure, heart rate, brain waves, ....[See  demo]

Health Promotion & Behavioural Change

  • Smoking, Eating & Drinking disorders

Regimens for quitting smoking, multifaceted involving behavioural reinforcement, aversion therapy, stimulus substitution. Social support and perhaps biochemical support too (the patch or gum). Go Smoke Free

Promoting physical activity and healthy diet

ParticipAction is a program first developed in the 1970s and then became Body Break and now is back - "don't go to their website" Take Action ! Do It!

Canadian Food Guide - Health Canada


Medical Settings and Health Behaviour

Psychologists can be involved in a number of areas in the medical field, including: health provider behaviour, sick-role syndrome, regimen maintenance, programme evaluation, community action research . . .

Health Psychology in the International field
Aboud (1998) has extended the general model of health psychology to an international perspective which covers such topics as:

Genetic and biological factors (sickle cell anemia, age, gender)
Physical environment (viruses, parasites, food availability)

Health Services (skills, motivation, habits, attitude, of staff)

Health Behaviours (infant care, eating, hygiene, family planning)

Political, Economic, & Social Institutions (education, family, religion, commerce, entertainment) E.g. Lubec at al.




Aboud, F. E. (1998). Health Psychology in Global Perspective: Thousand Oaks: Sage. 

Gatchel, R.J., A. Baum, & D. S. Krantz (1989). An introduction to health psychology (second edition). New York: Random House.

Poole, G. , Hunt-Matheson, D. & Cox, D. (2012). The Psychology of Health and health Care: A Canadian Perspective (4th Edition). Pearson, Toronto, ON.

See Psychology 228 - Health Psychology