Health Psychology Module
Health Psychology Module
PSYCHOLOGY
Hassan A. Dahie
PhD (Cand), MPH, MED EDUBScN
Table of Contents
UNIT ONE: .............................................................. 1
INTRODUCTION TO PSYCHOLOGY ........................... 1
1.1 Definition and general remark ............................. 1
1.2 What is science? ................................................ 2
1.3 What is behavior? .............................................. 2
1.4 Contributions of Psychology ................................ 3
1.5 Psychology Vs Sociology ..................................... 4
1.6 Psychology and Health ....................................... 5
1.7 Branches of Psychology ...................................... 5
1.7.1 Pure branches: ............................................ 6
1.7.2 Applied branches ......................................... 8
UNIT TWO: ............................................................ 11
HEALTH PSYCHOLOGY ........................................... 11
2.1 Introduction .................................................... 11
2.2 Scope of Health Psychology .............................. 12
2.3 Divisions of Health Psychology .......................... 14
2.4 The purpose of health psychology ...................... 14
2.5 Need and significance of health psychology ......... 14
2.6 What does a health psychologist do? .................. 16
UNIT THREE: ......................................................... 17
DEVELOPMENTAL PSYCHOLOGY ............................ 17
3.1 Introduction .................................................... 17
3.2 Developmental psychology as a science.............. 17
3.3 Causes of change ............................................ 18
3.4 Major controversies in developmental psychology 19
3.5 Key concepts in developmental psychology ......... 20
3.6 Stages of Pre Natal Development....................... 21
3.6.1 Environmental influences on the unborn baby 21
3.7 Post-natal Development (after birth) .................. 22
UNIT FOUR: .......................................................... 27
I
PERSONALITY PSYCHOLOGY ................................. 27
4.1 Introduction .................................................... 27
4.2 Factors affecting personality ............................. 27
4.3 Theories of Personality ..................................... 29
4.4 Structure of Mind: Freud's Id, Ego, & Superego 31
4.5 Erik Erikson’s Psycho-Social Stages of
Development ........................................................ 34
4.6 Psychosexual development ............................... 36
Frustration, Overindulgence and Fixation ................. 37
UNIT FIVE: ............................................................ 41
SENSATION, PERCEPTION & MEMORY .................. 41
5.1 Introduction .................................................... 41
5.2 Sensation ....................................................... 41
5.2.1 Types of Sensation ..................................... 41
5.3. Perception ..................................................... 42
5.3.1 Nature of Perception ................................... 42
5.3.2 The Perceptual Process ............................... 43
5.3.3 Factor of perception: .................................. 44
5.3.4 Perceptual Errors: ...................................... 44
5.4 Memory .......................................................... 47
5.4.1 The Memory Process .................................. 47
5.4.2 Types of Memories ..................................... 48
UNIT SIX: ............................................................. 53
DEFENCE MECHANISMS......................................... 53
6.1 Introduction .................................................... 53
6.2 Types of Defence Mechanism ............................ 54
Denial ............................................................... 54
Displacement ..................................................... 54
Projection .......................................................... 55
Rationalization ................................................... 55
Reaction Formation ............................................ 56
Regression ........................................................ 56
II
Sublimation ....................................................... 57
UNIT SEVEN: ......................................................... 59
MOTIVATION ........................................................ 59
77.1 Introduction .................................................. 59
7.2 Nature of Motivation: ....................................... 59
7.3 Components of Motivation ................................ 59
7.4 Theories of motivation: .................................... 60
7.5 Maslow's hierarchy of needs.............................. 62
UNIT EIGHT: ........................................................... 65
STRESS & STRESS COPING MECHANISMS .................. 65
8.1 Introduction .................................................... 65
8.2 Stressors ........................................................ 65
8.3 Relationship between Stressors and Stress ......... 66
8.4 Causes of Stress.............................................. 66
8.5 Warning Signs of Stress ................................... 67
8.5.1 Physical Signs ............................................ 68
8.5.2 Mental Signs ............................................. 68
8.5.3 Emotional Signs ......................................... 68
8.5.4 Behavioral Signs ........................................ 68
8.6 Coping ........................................................... 69
8.6.1 Problem focused coping .............................. 69
8.6.2 Emotion focused coping .............................. 69
III
PREFACE
This Health Psychology Module is designed for Public
Health Student who are tasked to educate, inform,
and enable patients to mitigate physical health
problems. It consists of eight core units which will
enable the learners to equip themselves with the basic
concepts of the subject.
IV
UNIT ONE:
INTRODUCTION TO
PSYCHOLOGY
1
1.2 What is science?
Science is a group of related facts and principles of a
particular subject.
2
Motor activities (Walking, speaking)
Cognitive activities (perceiving, remembering,
thinking, reasoning)
Emotional activities (feeling happy, sad, angry,
afraid)
Behavior is both mental and bodily:
Mental behaviors are thinking, reasoning,
imagination and other mental experiences or
processes.
Bodily behavior refers to the movements and
actions of the body in response to a situation.
In general there are four major facts proposed in
relation to the nature of behavior. These are:
Behavior has a bodily basis
Behavior is dynamic
Behavior varies from person to person
Behavior is social
3
The health professional works with patients,
families, other nurses, doctors and
administrative staffs.
Equipped with the knowledge of psychology, the
health professional will achieve greater success
in interpersonal relationships.
Psychology helps the health professional to
learn why others differ from him/her in their
preferences, customs and beliefs or cultural
patterns.
3. It enlightens to appreciate the necessity of
changing the environment and how to bring it
about
By changing the environment, the health
professional can bring about change in the
patient’s life.
4
1.6 Psychology and Health
The relationship is well articulated in so many health
related books. It is also clearly stated in the WHO’s
preamble as follows:
“Health is a state of complete physical, mental
and social well-being, and not merely the
absence of disease or infirmity.”
5
Branches of Psychology are broadly divided into
two categories: pure and applied.
General psychology:
Physiological psychology:
6
Developmental psychology:
Child psychology:
Animal psychology:
Abnormal psychology:
7
deals with various kinds of mental disorders, their
symptoms and causes.
Social psychology:
Educational psychology:
8
Clinical psychology:
Industrial psychology:
Counselling psychology:
Health psychology
9
This is the study of psychological and behavioral
processes in health, illness, and healthcare.
10
UNIT TWO:
HEALTH PSYCHOLOGY
2.1 Introduction
Health psychology is an exciting and relatively new
field devoted to understanding psychological
influences on how people stay healthy, why they
become ill, and how they respond when they do get
ill. Health psychologists both study such issues and
promote interventions to help people stay well or get
over illness.
11
the promotion and maintenance of health and
health policy formation, illness prevention
and treatment.
E.g.: why people continue to smoke although
they know it is unhealthy for them.
12
The influence of culture on health is vast. For
example, it affects perceptions of health, illness
and death, beliefs about causes of disease,
approaches to health promotion, how illness and
pain are experienced and expressed, where
patients seek help, and the types of treatment
patients prefer.
13
2.3 Divisions of Health Psychology
14
Advances in Technology and Research
15
2.6 What does a health psychologist do?
16
UNIT THREE:
DEVELOPMENTAL PSYCHOLOGY
3.1 Introduction
Developmental psychology examines the influences of
nature and nurture on the process of human
development, and processes of change in context and
across time. Many researchers are interested in the
interaction between personal characteristics, the
individual's behavior and environmental factors,
including social context and the built environment.
17
This field examines change across a broad range of
topics including: motor skills, cognitive development,
Maturation
Fetal development
Developmental biology
Psychological
development.
18
Learning
Critical Periods
1. Nature-Nurture
a. How much of an individual's development is due
to nature and how much to nurture? For
instance, the development of twins are
sometimes different
19
b. Typically, developmental psychologists are
interested in looking at how these factors
interact, rather than trying to decide which is
more important.
2. Continuity-Discontinuity
a. Whether human development occurs gradually,
or occurs in a series of breakthroughs.
b. The people who believe that development is a
series of stages belong to the continuity camp,
while the people who believe that a child would
have to work through would be in the
discontinuity camp.
3. Universality-Particularity
a. Does everyone go through the same
developmental processes/stages/aspects or
does development vary across people, and
cultures?
b. Although people seem to develop abilities at
approximately the same age this view has been
called too simplistic.
c. Cultural differences, as well as family
differences, may influence development.
Development may be much more multifaceted.
20
competence of a function. Growth is differentiation
and refinement of parts and/or functions.
21
Drugs adversely affect fetal development. During
pregnancy, it is advised to take as little medication
as possible.
22
environment changes as a function of age and
experience.
3. Late Childhood
At about the time children begin school, they enter
the stage of concrete operational stage (7 to 12
years).
This stage of cognitive development is marked by
mastery of the principle of conservation. They can
think logically though their thought process is
limited to the concrete.
They can understand simple transformation, like
for example, reversing a ball of clay into a sausage
shape and back to a ball shape.
4. Adolescence
Adolescence is the development stage between
childhood and adult hood during which many
physical, cognitive, and social changes take place.
Most dramatic biological changes occur during this
stage. Major physical and sexual changes and their
corresponding average range of ages for both
sexes are shown below.
The psycho- social development stage during
adolescence is named as the identity versus
confusion stage.
23
Major physical and biological changes during
adolescence
Males Females
Major-sexual Average Major-sexual Average
Changes range of age Changes range of
age
High spurt 12-16 Height spurt 11-14
5. Puberty
It is the period during which maturation of the
sexual organs occur.
For girls 11 or 12 years
For boys 13 or 14 years
However, there are wide cultural variations
depending on quality of nutrition and access to
health services.
Early maturation has an advantage and
disadvantage for both sexes.
Early maturing boys may do better in athletics
and are generally more popular with peers. This
enhances self-concept.
Early maturation in girls may expose them to
untimely sexual practices and sexually
transmitted diseases.
24
In general, the impact of early and late maturation
is related to the specific reactions and attitudes of
the society.
6. Adulthood
It includes the years from 20-60 but usually 20-40.
Physical changes during this period are less
apparent and occur more gradually than the
preceding stages.
Although physical strength and status of health are
great at early adulthood period, gradually they
decrease. The body begins to operate less
efficiently and immune system decreases.
At about late forties and early fifties, women stop
menstruating (Menopause). Except in decline in
the amount of sperm production and frequency of
orgasm, men remain fertile up to old age.
In general adulthood is a time of peak intellectual
accomplishment. An increase in IQ is observed at
this stage.
They perform better on any learning or memory
task. They find it easy to accept new ideas and they
can readily shift their strategies for solving
different problems.
According to Erickson the stage of social
development during early adult hood is termed as
intimacy versus isolation stage.
7. Old age
Physical changes brought about by the aging
process include skin wrinkling and folding, slight
25
loss of height due to decrease in the size of disks
between vertebrates in the spines.
Sensory activities i.e. Vision, hearing, smell and
taste decrease.
26
UNIT FOUR:
PERSONALITY PSYCHOLOGY
4.1 Introduction
Personality psychology is a branch of psychology
that studies personality and its variation among
individuals. It looks at the patterns of thoughts,
feelings, and behavior that make a person unique.
27
3. The reactions or behavior: they are results from
the interaction of the individual and the stimuli
from the environment.
28
Repressive home atmosphere will result in
rebellious or dependence as personality traits;
Personality of the teacher, richness of the
curriculum, the presence or absence of co
curricula activities, methods of teaching affect
the child’s personality.
1. Theory
2. Structure
29
3. Development
4. Dynamics
General remark
Example:
Question:
30
Question 1: Why don’t all people react in the same
way to the same encounter?
31
Id too strong = bound up in self-gratification
and uncaring to others
32
It stores and enforces rules. It constantly strives
for perfection, even though this perfection ideal
may be quite far from reality or possibility.
Superego too strong = feels guilty all the time,
may even have an insufferably saintly
personality
The ego - "I could ask my father Ali to buy it for me,
but he might say no.
33
4.5 Erik Erikson’s Psycho-Social
Stages of Development
34
6. Does not share self or possessions
Autonomy vs. Shame and Doubt
Toddler (2nd year)
Toddler strives to learn independence and self-confidence
Expressions of autonomy Expressions of shame and doubt
1. Independent 1. Procrastinates frequently
2. Not easily led 2. Has trouble working alone
3. Resists being dominate 3. Need structure and directions
4. Able to stand on own two feet 4. Has trouble making decisions
5. Works well alone or with others 5. Is easily influenced
6. Assertive when necessary 6. Embarrassed when complimented
35
3. Participation in games, groups 2. Avoidance, defensive
4. Open, willing to interact 3. Self-defeating behavior
5. Able to make and keep commitments 4. Maintaining isolation
5. Questions job performance
Generativity vs. Stagnation
Middle Adulthood (40-60 years)
Middle-aged person seeks a sense of contributing to the world, through, for
example family and work.
Expressions of Generativity Expressions of Stagnation
1. Generativity 1. Stagnation
2. Confident 2. Watching
3. Productive work 3. Complaining, blaming
4. Willingness to invest in the next 4. Obesity
5. Generation 5. Fatalist attitude
6. Achievement goals 6. Dissatisfaction with self, job, life,
7. Willing to risk, explore, produce, mate
take charge attitude. 7. Resentful
Integrity vs. Despair
Late Adulthood (65 years and up)
Reflecting on life, the elderly person may experience satisfaction or a sense of
failure.
Expressions of Integrity Expressions of Despair and
1. Proud, content with self and life Distrust
2. Still actively thinking about the future 1. Despair
3. Healthy interaction with self 2. Deep resentment
4. Self-approving 3. Nothing left, uselessness
5. Comfortable giving and sharing with 4. Low self esteem
others 5. Anger at self, other, world, society
6. Likes being an example to others 6. Closed to others
7. Accepts aging process gracefully and 7. Complaints, irritable and anger at
death as part of life cycle aging.
36
Freud (1905) proposed that psychological
development in childhood takes place in a series of
fixed stages.
37
psychoanalysts call fixation at a particular
psychosexual stage.
38
In terms of personality, after effects of an anal
fixation during this stage can result in an obsession
with cleanliness, perfection, and control (anal
retentive).
On the opposite end of the spectrum, they may
become messy and disorganized (anal expulsive).
39
and play becomes largely confined to other children
of the same gender.
40
UNIT FIVE:
5.2 Sensation
41
1. Visual Sensation
2. Auditory Sensation
3. Olfactory Sensation
4. Taste Sensation
5. Tactual Sensation
5.3. Perception
42
5.3.2 The Perceptual Process
1. Sensation
2. Selection
3. Organization
4. Translation
43
5.3.3 Factor of perception:
There are 3 factors of perception, namely:
Subjective Factor
Fitness
Interest
Past experience and Knowledge
Mental Capacity
Objective factor
Social F actor
Social value
Attitudes
Stereotype
Suggestion
44
Illusion
Hallucination
Halo Effect
Stereotyping
Similarity
Horn Effect
Contrast
Illusion
Hallucination
Selective Perception
45
Halo Effect
Stereotyping
Similarity
Horn Effect
Contrast
46
The tendency to rate people relative to other people rather
than to the individual performance he or she is doing. Rather
will evaluate an employee by comparing that employee’s
performance with other employees.
5.4 Memory
Definition
47
might not be stored properly, or might not move from
short-term to long-term storage; and/or we might not be
able to retrieve the information once it’s stored.
Sensory Memory
Short-Term Memory
48
Long-Term Memory
Explicit Memory
49
A third way of measuring memory is known as relearning.
Measures of relearning (or savings) assess how much
more quickly information is processed or learned when it is
studied again after it has already been learned but then
forgotten.
Implicit Memory
50
There are three general types of implicit memory:
procedural memory, classical conditioning effects, and
priming.
51
fragment test, in which a person is asked to fill in missing
letters to make words.
52
UNIT SIX:
DEFENCE MECHANISMS
6.1 Introduction
In order to deal with conflict and problems in life,
Freud stated that the ego employs a range of defense
mechanisms that handle conflict between the Id, Ego
and Superego. Defense mechanisms operate at an
unconscious level and help ward off unpleasant
feelings (i.e. anxiety) or make good things feel better
for the individual.
53
6.2 Types of Defence Mechanism
Denial
Denial is simply refusing to acknowledge that an
event has occurred.
The person affected simply acts as if nothing has
happened, behaving in ways that others may see
as strange.
Examples
A man hears that his wife has been killed, and yet
refuses to believe it, still setting the table for her
and keeping her clothes and other accoutrements
in the bedroom.
A person having an affair does not think about
pregnancy or sexually transmitted diseases.
Displacement
Displacement is the shifting of actions from a
desired target to a substitute target when there is
some reason why the first target is not permitted
or not available.
Displacement may involve retaining the action and
simply shifting the target of that action.
Examples
54
A woman, rejected by her boyfriend, goes out with
another man 'on the rebound'.
Projection
When a person has uncomfortable thoughts or
feelings, they may project these onto other people,
assigning the thoughts or feelings that they need
to repress to a convenient alternative target.
Projection may also happen to obliterate attributes
of other people with which we are uncomfortable.
Examples
Rationalization
When something happens that we find difficult to
accept, then we will make up a logical reason why
it has happened.
The target of rationalization is usually something
that we have done, such as being unkind to
another person. It may also be used when
something happens independent of us which
causes us discomfort, such as when a friend is
unkind to us.
55
Examples
Reaction Formation
Reaction Formation is the converting of unwanted
or dangerous thoughts, feelings or impulses into
their opposites.
For instance, a woman who is very angry with her
boss and would like to quit her job may instead be
overly kind and generous toward her boss and
express a desire to keep working there forever.
She is incapable of expressing the negative
emotions of anger and unhappiness with her job,
and instead becomes overly kind to publicly
demonstrate her lack of anger and unhappiness.
Regression
Regression involves taking the position of a child in
some problematic situation, rather than acting in a
more adult way.
This is usually in response to stressful situations,
with greater levels of stress potentially leading to
more overt regressive acts.
Regressive behavior can be simple and harmless,
such as a person who is sucking a pen or may be
56
more dysfunctional, such as crying or using
petulant arguments.
Example
Sublimation
Sublimation is simply the channeling of
unacceptable impulses, thoughts and emotions
into more acceptable ones.
For instance, when a person has sexual impulses
they would like not to act upon, they may instead
focus on rigorous exercise.
Refocusing such unacceptable or harmful impulses
into productive use helps person channel energy
that otherwise would be lost or used in a manner
that might cause the person more anxiety.
Sublimation is probably the most useful and
constructive of the defense mechanisms as it takes
the energy of something that is potentially harmful
and turns it to doing something good and useful.
Example
57
A person with strong sexual urges becomes an
artist.
A man who has extra-marital desires takes up
household repairs when his wife is out of town.
58
UNIT SEVEN:
MOTIVATION
7 7.1 Introduction
Motivation is defined as the process that initiates,
guides, and maintains goal-oriented behaviors.
Motivation is what causes us to act, whether it is
getting a glass of water to reduce thirst or reading a
book to gain knowledge.
Affected by motivating
Related to satisfaction
Complex process
59
Achieving such a goal requires the ability to persist
through obstacles and endurance to keep going in
spite of difficulties.
Incentive theories
60
Drive theory
Incentive theories
61
This approach attempts to explain motivation in terms
of the nature of the external stimuli; incentives that
direct and energize behavior.
62
1. Physiological needs: These include things
and well.
girlfriends, or boyfriends.
63
opportunity to use their talent, and a chance to
go where those talents might lead.
64
UNIT EIGHT:
8.2 Stressors
While stress is the feeling we have when we are under
pressure, stressors are the things in our environment
65
that we are responding to. Stressors can be as simple
as background noise in our environment or as
complex as a social situation such as going out on a
date. Stressors can involve physical threat such as a
car speeding toward you or an emotional threat such
as being rejected by your boyfriend or girlfriend.
66
causes stress depends, at least in part, on our
perception of it. Something that's stressful to us may
not faze someone else; they may even enjoy it.
For example, exam may be stressful for some but
few may enjoy facing the challenge given by exams.
For some individuals journey may be tiring and
irritating others may find the trip relaxing because
they allow more than enough time and enjoy listening
to music while they drive.
67
are likely to develop health problems like heart
disease. We could also worsen an existing illness.
68
8.6 Coping
Coping can be defined as the actual effort that is made
in the attempt to render a perceived stressor more
tolerable and to minimize the distress induced by the
situation.
69
a) Social supports for emotional reasons -
Seeking social support for emotional reasons
is getting moral support, sympathy or
understanding.
b) Denial or avoidance – Denial here means
refusal to believe that the stressor exists.
c) Venting of emotions- Here the individual has
the tendency to focus on whatever distress or
upset one is experiencing and to ventilate those
feelings.
d) Turning to religion- One might turn to
religion when under stress for widely varying
reasons. Religion might serve as a source of
emotional support.
e) Mental disengagement- This includes using
alternative activities to take one’s mind off a
problem a tendency opposite to suppression
of competing activities), day dreaming,
escaping through sleep or escape by immersion
in T.V etc.
f) Behavioral disengagement: In behavioural
disengagement one reduces one’s effort to deal
with the stressor even giving up the attempt to
attain goals with in which the stressor is
interfering.
g) Alcohol disengagement – Here one reduces
their effort to deal with a stressor by using
alcohol as a means to forget their stress
70
element. Individuals who use alcohol and drugs
are high on using this strategy.
71