Health Psychology: Understanding the Mind-Body Connection

Hello future Health Psychologists! Welcome to one of the most fascinating options in the IB Psychology course. This chapter is all about taking the theories you learned in the core (Biological, Cognitive, Sociocultural) and applying them to real-life issues like stress, illness, pain, and how we stick to healthy habits.

Why study this? Because health is not just about biology. It’s about how you think and how society influences your well-being. Understanding this complex relationship is key to promoting positive change globally and personally. Let's dive in!


Section 1: The Foundations – Moving Beyond the Biomedical Model

The Shift in Perspective

For a long time, the medical world relied on the Biomedical Model. This model suggests that illness is purely a result of biological factors—like viruses, bacteria, or genetic damage—and should be treated by medical intervention (drugs, surgery).

The problem? It ignores the influence of the patient's thoughts, emotions, and environment.

Health Psychology stepped in to bridge this gap. It is the application of psychological principles to the promotion of health, the prevention and treatment of illness, and the improvement of the healthcare system.

The Biopsychosocial Model (BPS)

This is the cornerstone of Health Psychology. It states that health and illness are determined by an interaction of biological, psychological (cognitive), and social factors.

Analogy: Think of the BPS model like a three-legged stool. If one leg is weak (e.g., high stress, poor diet, lack of friends), the whole system (your health) becomes unstable.

Factors within the BPS Model:
  • Biological: Genetics, physiological reactions (e.g., hormones, immune system function), viruses, injuries.
  • Psychological (Cognitive): Personality, stress appraisal, coping styles, health beliefs, self-efficacy.
  • Social: Social support, culture, socioeconomic status (SES), living conditions, access to healthcare.

Key Takeaway: We must analyze health problems through the BPS lens, recognizing that a headache might be caused by tight neck muscles (B), worrying about exams (P), and financial pressure (S).


Section 2: The Biological Approach and Stress

The Biological Approach focuses on the physiological mechanisms linking our body and mind, especially in response to stress.

What is Stress?

Stress can be defined in two ways:

  1. As a stimulus (stressor): An external event or demand (e.g., a deadline, a noisy environment).
  2. As a response: The physiological and psychological reactions to a stressor.
The Physiology of Stress: Fight or Flight (Acute Stress)

When you face an immediate threat (like narrowly avoiding a car crash), your body releases adrenaline and noradrenaline. This triggers the Sympathetic Nervous System (SNS) and the Adrenal-Medullary System, leading to:

  • Increased heart rate and blood pressure.
  • Faster breathing.
  • Pupil dilation.
  • Energy diverted away from digestion and immune function.
The HPA Axis (Chronic Stress)

For prolonged (chronic) stressors, a different system takes over: the Hypothalamic-Pituitary-Adrenal (HPA) Axis. This axis releases cortisol, the main stress hormone.

  • Hypothalamus releases CRH.
  • Pituitary gland releases ACTH.
  • Adrenal cortex releases Cortisol.

While cortisol helps regulate energy during prolonged resistance, chronic high levels are highly damaging to the body (e.g., memory impairment, reduced immunity).

Selye's General Adaptation Syndrome (GAS)

Hans Selye proposed that the body responds to chronic stress in a predictable sequence, regardless of the stressor.

  1. Alarm Stage: The initial shock. The "fight or flight" response kicks in (adrenaline/HPA activation).
  2. Resistance Stage: The body attempts to cope and adapt to the stressor. Cortisol levels remain high, trying to repair any damage and maintain alertness. If the stressor is manageable, the body stays in this stage.
  3. Exhaustion Stage: If the stressor continues indefinitely, the body's resources are depleted. Physiological wear and tear occurs, leading to vulnerability to illness, burnout, and even death.

Quick Review: Biological Effects of Chronic Stress
Chronic exposure to cortisol causes immunosuppression (weakened immune system), making you more vulnerable to infections and potentially contributing to heart disease (due to chronic high blood pressure).

Key Takeaway: The biological response to stress is universal (GAS), but chronic activation (HPA Axis) can seriously damage physical health.


Section 3: The Cognitive Approach and Health

The Cognitive Approach focuses on mental processes—how we perceive, interpret, and appraise stressful situations and health threats.

Lazarus and Folkman: Stress Appraisal

The key idea here is that stress is not just the event itself; it is our cognitive appraisal (how we think about) the event. What one person finds stressful, another might find exciting.

This is captured by the Transactional Model of Stress and Coping (Lazarus & Folkman):

Step 1: Primary Appraisal

The individual evaluates whether the event is:

  • Irrelevant: It doesn't matter to me.
  • Benign-positive: It is positive (e.g., a holiday).
  • Stressful: It involves harm/loss, threat, or challenge.
If it's stressful, we move to Secondary Appraisal.

Step 2: Secondary Appraisal

The individual evaluates their resources and ability to cope with the threat. They ask: "What can I do about this?"

  • Do I have the necessary skills/resources?
  • What coping options are available?

The outcome of this appraisal determines the level of stress experienced.

Example: You get a surprise pop quiz. Primary Appraisal: "This is a threat!" Secondary Appraisal: "I studied yesterday; I can probably pass." (Low stress.) OR "I haven't opened the book all week!" (High stress.)

Coping Strategies

Lazarus and Folkman also distinguish between two main types of coping:

  1. Problem-Focused Coping: Aimed at changing or eliminating the source of stress (e.g., studying harder for the quiz, asking for an extension on a deadline).
  2. Emotion-Focused Coping: Aimed at managing the emotional reaction to the stressor (e.g., venting to a friend, meditating, distracting yourself with TV).

The most effective strategy depends on the situation. If you can change it, use problem-focused; if you can't (e.g., grieving a loss), use emotion-focused.

Self-Efficacy (Bandura)

Self-efficacy is a crucial cognitive concept in health. It is the belief in one's own ability to successfully execute the behavior required to produce desired outcomes.

If a person has high self-efficacy regarding a task (e.g., quitting smoking), they are much more likely to attempt it, persist through challenges, and succeed. Low self-efficacy is a major barrier to adopting healthy behaviors.

Key Takeaway: Stress is largely dependent on subjective cognitive appraisal (Lazarus). Interventions should focus on changing how people interpret threats and boosting their belief in their ability to cope (Self-Efficacy).


Section 4: The Sociocultural Approach and Health

The Sociocultural Approach examines how social, cultural, and environmental factors influence health behaviors and outcomes.

Social Support

Having a network of caring people (family, friends, community) is a powerful buffer against stress and illness.

  • Buffering Hypothesis: Social support acts as a protective layer, cushioning the negative effects of stress when a person is experiencing high demands.
  • Direct Effects Hypothesis: Social support is beneficial regardless of stress levels, providing consistent stability, self-esteem, and health resources (e.g., people remind you to exercise).

Did You Know? Studies on bereaved spouses have shown that those with stronger social networks have less immunosuppression than those who face the loss alone.

Socioeconomic Status (SES)

SES (determined by income, education, and occupation) is one of the strongest predictors of health outcomes.

  • Lower SES is often linked to higher rates of chronic illness, poor diet, smoking, and sedentary lifestyles.
  • Reasons: Lack of access to quality healthcare, chronic exposure to stressors (financial worry, unsafe neighborhoods), and limited educational resources regarding health.

Cultural Factors and Health

Culture influences how we define, experience, and express illness.

  • Health Beliefs: Culture shapes what people believe causes illness (e.g., fate, karma, imbalance of energies) which dictates the treatment they seek (e.g., traditional healers vs. Western doctors).
  • Somatization: Some cultures express psychological distress physically (as headaches, stomach problems) rather than verbally expressing emotions like sadness or anxiety. This can complicate diagnosis in a Western medical context.

Key Takeaway: Our environment and social ties profoundly affect our ability to manage stress and adhere to medical advice. Health interventions must be culturally sensitive and address social barriers like poverty and isolation.


Section 5: Application – Understanding Adherence

One critical application of Health Psychology is studying adherence, which means following the recommendations of a healthcare professional (e.g., taking medicine as prescribed, completing physical therapy, changing diet).

Why is Non-Adherence a Problem?

Non-adherence is common (estimates suggest up to 50% of people with chronic diseases do not adhere fully) and leads to wasted resources, increased illness severity, and potential drug resistance.

Explaining Adherence (Using the BPS Framework)

1. Biological Factors (Barriers to Adherence)
  • Side Effects: Unpleasant side effects of medication (e.g., nausea, fatigue) are the most common biological reason for discontinuing treatment.
  • Severity of Illness: If symptoms disappear quickly (e.g., antibiotics for an infection), patients may stop taking the full course, believing they are cured. Conversely, if symptoms are very painful, adherence may be difficult to maintain.
2. Cognitive Factors (Beliefs and Understanding)
  • Perceived Susceptibility and Severity: If a patient believes their condition is mild or that they are unlikely to suffer severe consequences (low cognitive appraisal of threat), they are less motivated to adhere.
  • Complexity of Regime: Patients are more likely to forget or ignore instructions if the treatment plan is too complicated (e.g., taking multiple pills at different times).
  • Low Self-Efficacy: If the patient does not believe they are capable of making the necessary long-term changes (e.g., maintaining a new exercise regime), they will likely fail.
3. Sociocultural Factors (Contextual Barriers)
  • Cost: High cost of medication or treatment sessions (especially relevant in healthcare systems without universal coverage).
  • Social Stigma: Fear of judgment (e.g., hiding mental health medication or HIV treatment).
  • Relationship with Practitioner: If the patient distrusts the doctor or feels the communication was poor, adherence decreases significantly.
  • Cultural Conflict: If the prescribed treatment conflicts with traditional cultural practices or beliefs.

Interventions to Improve Adherence

Interventions must target all three levels:

  1. Biological: Simplify drug regimes (e.g., once-daily dosage) or address side effects promptly.
  2. Cognitive: Improve communication (clear instructions), use positive reinforcement, and boost self-efficacy through skills training and goal setting.
  3. Sociocultural: Utilize family/friend networks for support, reduce costs, and ensure culturally appropriate delivery of advice (e.g., using bilingual materials).

Important Tip for Exams: When asked to "Discuss factors affecting adherence," structure your answer using the BPS model for clear organization and comprehensive coverage!


Final Review: Health Psychology Checkpoint

Encouragement Corner!

Remember, Health Psychology is highly applied. When studying, always link the theory back to a real-life health issue (like stress, addiction, or non-adherence). This makes the content easier to remember and helps you apply it brilliantly in your essays!

Key Terms to Master:
  • Biopsychosocial Model (BPS)
  • HPA Axis and Cortisol
  • General Adaptation Syndrome (GAS)
  • Cognitive Appraisal (Primary vs. Secondary)
  • Self-Efficacy
  • Buffering Hypothesis
  • Adherence

You have successfully mastered the application of the core approaches to health and well-being. Good luck!