Health Psychology: Analysis of Theories of Placebo Effects

Task 1

The Health Belief Model (HBM) -The health behaviour model is classified as a psychological model which has been developed in order to provide a prediction and an explanation of the various behaviours which are health-related. In the year 1966, both Stanislav Kasl and Sidney Cobb specified that there are three main types when it comes to health-related behaviours. Firstly, that health behaviour meant a behaviour which seeks to prevent diseases - for example, maintaining a healthy diet in order to reduce the risk of developing diabetes. Secondly, that health behaviour was a behaviour which aimed to seek for remedy - for example, booking a GP appointment and seeing a doctor when feeling unwell. Thirdly that the sick role behaviour means any activity which has the intention of making the individual getting well - for example being given a medical prescription or being told by the doctor to take time off of work in order to gain some rest. Later on in 1984 Joseph for ‘behavioural pathogens’ which have a negative effect to health behaviours such as consuming high amounts of alcohol, smoking excessively on a daily basis and consuming high cholesterol diets regularly too. Behaviours with positive effects may include attending to check-ups on a regular basis and making sure that every night you have the right amount of sleep on a daily basis. Overall health behaviours are usually referred to as behaviours which will have a relation to the overall status of a human being.

A physician called Thomas Mckeown wrote a book called ‘The Role of Medicine’ which studies the effect of medicine within health ever since the beginning of the seventeenth century. Mckeown provided explanations on the many suggestions and assumptions which revolved around the benefits of medicine and its role when it came to reducing the chances of many individuals developing highly infectious diseases (e.g. measles, pneumonia, whooping cough and more). The physician also displayed how there was a decrease in illnesses before any type of medical development. Once he displayed this he claimed that the reduction of the development in infectious diseases which has been viewed over the last three centuries would be understood clearly in the role of behaviour and behaviour mortality. For example in the role of behaviour, Thomas Mckeown studied both illness and health during the twentieth century. He strongly believed that illness which is contemporary is usually determined by the many choices an individual decides to make (such as eating habits, exercise, and alcohol consumption). In conclusion, the physician looked at the causes of death within society and results showed that the majority of deaths were actually caused by illnesses that are dominant such as coronary heart disease and lung cancer.

Theories of Placebo Effects (TBE) – There are many different types of explanations and summaries of the definition of placebo. The most common definition would be a substance that is consumed and will cause some sort of relief towards the symptoms. A good example would be if I was given a sugar pill and said ‘due to the fact that I have taken this sugar pill, my headache has now disappeared’. As there are many types of definitions of placebos, this has caused some misunderstanding with what the word actually means. Non-active theories are theories which study one's characteristics, health professionals’ characteristics and characteristics of treatment too.

Firstly we have the characteristics of the health professional. This is when there are professionals who work in the health industry (e.g. a doctor) provide treatment of the placebo which can control the extent of the placebo effect. Studies have shown that the higher the status of the professional then the higher the worry – the reason for this is because of the increase within the placebo effect.

Secondly, there are the characteristics of an individual. Every individual carries many different types of traits which make them easily vulnerable to experiencing the effects of the placebo. Different types of characteristics have been classified as neurosis or emotional dependency- those who are seen as introverts have also shown a reaction toward the placebo effect. There is limited evidence which can provide support that traits which are consistent are predicted when responding to the placebo effect.

Lastly, there are the characteristics of treatment. Research in the past have solely focused on the characteristics of treatment and have provided suggestions that these characteristics of the placebo treatment may have a relation to how effective the placebo effect really is. A good example would be that if a treatment is viewed by one who takes it seriously, meaning that the effect of the placebo being high such as receiving an injection. Studies have also shown that the greater the pill (within size) then the greater the effect of the placebo in comparison to a smaller pill.

Within health psychology placebos have different types of factors such as pain, stress, health beliefs from health professionals, health beliefs, illness cognitions and health-related behaviours. The ‘health beliefs’ portray that in order for a placebo to be effective, a human being must have a strong belief for the mediation to have an effect. If I was given a placebo which is in a pill-like structure will have an impact if one applies to the model of medical illnesses and health and the tradition of medical beliefs when looking at alternative medicine.

Task 1 ii

There are a variety of factors which can have an impact on the way we behave and our beliefs in which we will have a response of illness and health, such as gender, socioeconomic class, culture, education, ethnicity and location geographically. The two factors which I’ll be focusing on is gender and culture.

Socioeconomic

Socioeconomic classes can also have an influence the way we behave and our beliefs in which we will have a response of illness and health. I strongly believe this because it can affect their life expectancy, health physically, the ability to gain the appropriate and the right care for nutrition and medicine. Studies in the United States display that an individual’s social and economic status can affect ones health. An individual who has a low socioeconomic level is more likely to experience a wide range of issues related to health whereas someone with a high socioeconomic level is less likely to have health problems. Having a low socioeconomic level this means that one will struggle to afford and use healthcare, if they’re able to use the healthcare with a low socioeconomic level then it’s more likely to have low quality. Many researchers think this maybe because of the different hazards of the environment. For example, if one lives in a poor and low-class neighbourhood then this means they’re not exposed to many grocery stores, healthy restaurants and are instead exposed to a variety of fast-food chains. This shall increase an issue in nutrition and the different health conditions related to nutrition (e.g. eating disorder).

By having a lower socioeconomic class this will result to lower chances of buying health insurance – leaving those in the lower socioeconomic class to be prone to getting many injuries and not receiving compensation for any injuries or illnesses. This can be easily explained due to the likelihood that those who are in the middle and higher class have an employer who will provide them with health insurance as a benefit for the employees – on the other hand, those who are in lower socioeconomic classes are less likely to work in jobs where they’re provided with health insurance and other health related benefits. Without having health insurance it can be incredibly expensive, due to the high expense this means that those who are uninsured are more likely to have poor quality treatment. Lower socioeconomic class people are more likely to be exposed to physical injuries which can lead them to being disabled, cancer and deaths within infants.

Gender

1. Males - Research shows that health risks which occur within male can be linked to behaviour. Overall men are known to take part in different types of activities and behaviours which can cause them to have more illnesses and injuries in comparison to women – these activities and behaviour can include rugby and fighting. Men are also known to consume diets which are considered as unhealthy – such as eating diets filled with high cholesterol on a daily basis e.g. KFC, McDonalds and more. The way the body works, genes and also hormones can have an impact on the high risk of the diseases which men develop such as cardiovascular disease. Cardiovascular disease is when the blood vessels are narrowed which can lead to a heart attack, various pains within the chest and strokes too. When studying males who are aged over 60, over 40% will be diagnosed with heart disease in comparison to females who are also aged over 60 as only 27% will be diagnosed. Researchers believe that the reason for this is because females are often known to have a slim figure in comparison to men who have a more heavy build – when a female gains weight, the weight will usually be transferred to their thighs or hips. Pamela Strauss (a doctor who specialises in medicine) has claimed that men are often put on weight ‘in the middle’ (referring to their bellies and stomach) –by having this type of body fat it makes men more prone to developing a heart disease called visceral which is a heart disease where fat is kept deep down in the abdomen, women don’t have this as they don’t share the same problem.
2. Females - Many doctors believe that the causes of the different types of health risks within women is due to their hormones and the way their body works too. Research displays that every year in the United States of America, roughly around 50,000 more women were more likely to have a stroke in comparison to men. The reason for this is because of oestrogen – which is a sex hormone primarily found in females. Mahtab Sohrevardi who is a doctor in medicine has stated that females may be unaware of the impact oestrogen can have in the development of a stroke, by taking pills such birth control can raise the chances of them being fertile however it can also change the levels of oestrogen too. Once the levels of oestrogen have changed this can have an impact on the substances within the bloodstream which will lead to blood clots being produced. The more blood clots that are produced the higher the risk of developing a stroke. In the United States, almost 80% of females out 10 million male and females are more likely to have osteoporosis. Osteoporosis is the weakening of bones which makes them incredibly fragile – one can get osteoporosis if they’ve had a sudden fall. This happens because females have bones which are both thinner and don’t have a lot of bone tissue in comparison to males. Oestrogen protect the bones of women however this can stop a substance which can instantly kill the cells within the bones. Once a woman begins menopause a lot of oestrogen will be lost which results to bone mass being lost. Almost 50% of women who are over the age of fifty are most likely to break a bone due to osteoporosis.

Task 2: Researching own case study

Task 2 (1)

In case study 1 the health implication that Paul consumes high amounts of alcohol. I can infer this because in the case study is states that he drinks a bottle of red wine after work, every single evening, has high levels of cholesterol and doesn’t take part in any forms of exercise. Another health implication is that Paul’s wife Anne is overweight and binge eats. There are a variety of symptoms when studying Paul's different health problems.

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Paul’s health implications (CASE STUDY 1)

Firstly alcoholism is a dangerous form of alcohol abuse which means when someone is unable to manage and control how much alcohol they drink. In males, it’s highly recommended that nothing more than four drinks should be consumed a day and no more than fourteen drinks should be consumed within a week. The symptoms of alcoholism is that it can raise ones blood pressure which can damage the heart and often cause heart attacks too - even by drinking around two average-sized drinks every single day can increase the chances of having bowel and stomach cancer. Mentally and emotionally it can have an impact on your daily moods (you could feel happy one minute and switch to angry the next) and that by drinking excessive amounts of alcohol can increase the chances of developing dementia. Fertility-wise, consuming high amounts of alcohol can have an affect and lower the males levels in their testosterone and lower their sperm count too.

Secondly, there’s high cholesterol which is when one has an excessive amount of cholesterol (a substance which consists of fat) in your bloodstream. You can gain high cholesterol by eating ‘fatty foods on a daily basis whilst not doing enough exercise, consuming lots of alcohol and smoking too. The main symptoms of high cholesterol are heart disease, high blood pressure, stroke, sudden chest pains (which is caused by heart disease), extra growth in the screen which is usually yellow/green. For men in particular with high cholesterol, they’re more likely to develop impotence which is caused by the arteries, this can cause an impact on high amounts of cholesterol within the blood.

Lastly, by doing no exercise this means that decline of movement in the body which requires energy. Examples of different types of exercise/physical activity would be walking, playing football, swimming, climbing up the stairs, dancing and more - exercise can have high vigorous-intensity or they can be moderate. There are a range of symptoms when an individual barely does any exercise such as sharp pains in the lower back, constantly hungry, high levels of fatigue and a higher chance of developing cardiovascular disease.

Anne’s health implications (CASE STUDY 1)

Being overweight means when one has more body fat than what is usually seen as healthy on a human being. A body which is healthy needs the minimum amount of fat in order for the body to gain energy, thermal uses and so that the body can function properly including the reproductive system, our hormones and immune system. If the body has too much storage of body fat then this can cause an impact on how quickly the body moves, its flexibility and it will also alter the body’s appearance. The symptoms of being overweight include being breathless quite often, high levels of sweating, often feeling isolated and depressed, high fatigue and many more.

Patient’s health implication (CASE STUDY 2)

The patient in case study 2 is a heroin addict, which means that he has a physical addiction to the drug heroin. Heroin is a drug made from morphine, a substance which is extracted from the seeds of poppy plants. Consuming heroin can have both its short-term and long-term effects. Short term is you may often have the feeling of a dry mouth, vomiting and nausea, experience a warm flush within the skin and mentally you may feel hazy or unclear thinking. On the other hand, the long-term effects is that you can get insomnia, the tissues that are located in the nose will become severely damaged (as they use their noses to snort and sniff the drug), can have lung and kidney disease, can experience complications within the lungs and more.

Task 2 (2)

There are a range of demographic, genetic, psychological, social and medical factors which can have an impact on Paul’s problem behaviour. The three main factors which are linked to Paul’s drinking problem are genetics, social and psychological.

There are many genetic factors which can impact one’s drinking behaviour. For example, case study one states how Paul’s mother is an alcoholic and died from chronic liver disease. Chronic liver disease is when there’s a scar within the tissue which replaces the healthy liver tissue. The scarred tissue will stop the healthy liver from functioning properly. It’s a long-term disease which can cause damage to the lungs over a long period of time. Chronic liver disease is a genetic cause which can be inherited, it’s known that fifteen out of 100 newborns can inherit the disease – as they grow older the more the disease will develop. Although in the case study it hasn’t stated whether Paul inherited the disease from his mother, we can infer that there’s a chance he may have which has led him to drink excessively and be at a high risk of having the disease.

Paul’s drinking problem can have its social factors. For example, it states how in the weekend both Anne and Paul go out with friends and family which is when Paul will always go past the limit of the advised levels of drinking. Social often means an informal gathering which has been organised by an individual or a group of people. Going out with friends and family is a social event and in many cultures it is normal to have a drink when in the company of others. Although it doesn’t specify whether it’s every weekend or if it’s once every few weekends – we know that he exceeds the recommended drinking levels which has an impact on Paul’s drinking behaviour.

Lastly, there’s psychological factor which can affect Paul’s drinking behaviour. In the case study it says ‘But Paul says that unlike her, he can stop drinking anytime.’ This means that mentally Paul strongly believes that he can restrict himself from consuming the same habits which is mother had. However, in reality, it seems like he can’t as he’s constantly drinking high amounts of alcohol on a regular basis. This has an impact on Paul’s drinking behaviour as he is in denial of how he isn’t following his mother’s footsteps and that he hasn’t got an addiction.

Task 2 (3)

There are any different types of psychological and social interventions which can address Paul’s drinking problem. The first idea would be for Paul to attend cognitive behavioural therapy which is considered as both a psychological and social intervention. Its therapy where the individual (who has the addiction or ‘problem’ where one will focus on their many thoughts, beliefs and attitudes to different aspects of their lives, their feelings and how they behave – during this treatment an individual will be taught on the different coping mechanisms which they can apply to when having to deal with difficult problems throughout their lives. If Paul was to attend a cognitive behavioural therapy then I strongly believe that this would benefit him because he will be able to talk freely about any issues he may have and may find that it’s easier to talk about these issues in front of a group of strangers rather than those who are closer to him. Paul can also be taught the coping mechanism when it comes to how much alcohol he consumes.

An example of a social intervention would be family therapy. Family therapy is when an individual gains emotional support from family members towards the member who is trying to restrain themselves from consuming alcohol. when studying the health behaviour model.