COM205 — Introduction to Medical Psychology: Lecture Note

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la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS Course code: COM 205 Course title: Introduction to Medical Psychology Course credit load: 1 Unit Series 1: Basic Concepts in Psychology • Part 1.1: Psychology as a Science o Sub Part 1.1.1: Definition, scope, and goals of psychology o Sub Part 1.1.2: Major schools of psychological thought o Sub Part 1.1.3: Psychology and medicine: the biopsychosocial model • Part 1.2: Behaviour, Stimulus, and Response o Sub Part 1.2.1: Defining behaviour and its determinants o Sub Part 1.2.2: Stimulus systems and perception o Sub Part 1.2.3: The nervous system as the basis of behaviour • Part 1.3: Motivation and Mood o Sub Part 1.3.1: Theories of motivation o Sub Part 1.3.2: Emotion: nature, components, and theories o Sub Part 1.3.3: Mood, affect, and their relevance to health Introduction Psychology is the scientific study of the mind and behaviour; it occupies a uniquely central position in the health sciences because every clinical encounter involves not just a body with a disease but a person with thoughts, feelings, motivations, fears, and social relationships that

la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS profoundly shape the course and outcome of illness and the effectiveness of treatment; the clinician who understands psychological principles is better equipped to communicate with patients, elicit accurate histories, promote treatment adherence, support patients through distressing diagnoses, and recognise when psychological factors are contributing to physical presentations. This Series introduces the foundational concepts of psychology that are most relevant to medical practice: the definition and scope of the discipline, its major schools of thought and their different ways of understanding behaviour, the biopsychosocial model that integrates psychology into clinical medicine, the concepts of behaviour and stimulus that form the basis of learning theory and behaviour modification, and the psychology of motivation and mood that determines why patients act as they do in relation to their health and how emotional states influence physical health outcomes. Series Learning Outcomes Upon completing this Series, you should be able to: • SLO 1.1 define psychology, describe its major schools of thought, and explain the biopsychosocial model and its relevance to clinical medicine, • SLO 1.2 define behaviour, explain the role of stimulus systems and the nervous system in determining behaviour, and • SLO 1.3 describe the major theories of motivation and emotion, and explain how mood and affect influence health outcomes.

la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS 1.1 Psychology as a Science 1.1.1 Definition, scope, and goals of psychology Psychology is defined as the scientific study of behaviour and mental processes; behaviour refers to any observable action or response made by an organism, from the reflexive withdrawal of a hand from a hot surface to the complex social behaviour of political negotiation; mental processes refer to the internal, subjective experiences that accompany and guide behaviour, including perception, thought, memory, emotion, motivation, and consciousness; the adjective scientific in the definition is important: psychology uses systematic methods of observation, measurement, and analysis to generate knowledge about behaviour and mental processes, rather than relying on intuition, common sense, or untested tradition. The goals of psychology are fourfold: description (accurately characterising behaviour and mental processes, answering the question of what is happening), explanation (identifying the causes and mechanisms of behaviour, answering why it happens), prediction (using knowledge of causes to anticipate how behaviour will occur in specified circumstances), and control or modification (applying psychological knowledge to change behaviour in beneficial directions, the goal most directly relevant to clinical medicine); the scope of psychology is extremely broad, encompassing areas as diverse as the neurochemical basis of emotion, the cognitive development of children, the social psychology of prejudice, the clinical assessment and treatment of mental disorders, and the psychological factors that influence physical health and healthcare behaviour. Fill in the blank: The four goals of psychology are description, ________ (identifying causes and mechanisms), prediction, and control or modification of behaviour. 1.1.2 Major schools of psychological thought The history of psychology as a scientific discipline has been shaped by a succession of schools of thought, each offering a different framework for understanding behaviour and mental processes; structuralism (Wilhelm Wundt, late nineteenth century) attempted to identify the basic elements of conscious experience through introspection; functionalism (William James, late nineteenth century) focused on the adaptive functions of mental processes rather than their structure;

la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS psychoanalysis (Sigmund Freud, early twentieth century) proposed that behaviour is driven by unconscious forces, particularly repressed sexual and aggressive drives, and that early childhood experiences shape adult personality; behaviourism (John Watson, B.F. Skinner, early to mid-twentieth century) rejected the study of unobservable mental processes and focused exclusively on observable behaviour and its environmental determinants, producing influential learning theories based on classical and operant conditioning. Humanistic psychology (Abraham Maslow, Carl Rogers, mid-twentieth century) reacted against both behaviourism and psychoanalysis by emphasising the inherent worth and growth potential of human beings, the importance of subjective experience, and the capacity for self-directed change; cognitive psychology (from the 1960s onward) restored the study of mental processes by examining information processing, memory, attention, and problem-solving using objective experimental methods; biological psychology (neuroscience) examines the brain and nervous system mechanisms underlying behaviour, linking psychological phenomena to neural structures and neurochemical processes; and evolutionary psychology applies Darwinian evolutionary theory to explain psychological mechanisms as adaptations shaped by natural selection; in contemporary psychological practice, these perspectives are increasingly integrated rather than treated as mutually exclusive, with most clinicians drawing on biological, psychological, and social explanations simultaneously. Fill in the blank: ________ psychology, associated with Maslow and Rogers, emphasises the inherent worth and growth potential of human beings, the importance of subjective experience, and the capacity for self-directed personal change. 1.1.3 Psychology and medicine: the biopsychosocial model The relevance of psychology to medicine is captured most comprehensively in the biopsychosocial model, introduced by George Engel in 1977, which holds that health and illness are best understood as the product of three interacting dimensions: the biological (genetic, neurochemical, physiological, and immunological factors), the psychological (thoughts, emotions, beliefs, personality, and behaviour), and the social (family relationships, cultural norms, socioeconomic status, social support, and healthcare systems); the model does not merely

la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS add psychology alongside biology as a separate consideration but argues that these three dimensions are continuously interacting and that a complete understanding of any illness requires attending to all three simultaneously. In clinical practice, the biopsychosocial model has several specific applications: it directs the clinician to assess not only the biological features of a presenting complaint but also the patient psychological responses (fear, beliefs about illness causation, coping style, and mood) and social context (family support, work demands, financial resources, and cultural illness narratives); it provides the framework for understanding how psychological states influence physical health (stress suppressing immune function, depression predisposing to cardiovascular disease, anxiety producing somatic symptoms); it supports the integration of psychological interventions (counselling, cognitive-behavioural therapy, relaxation training, and motivational interviewing) alongside medical treatments; and it underpins the importance of the therapeutic relationship as itself a healing instrument, since a trusting, empathic clinical relationship improves patient disclosure, adherence to treatment, and health outcomes independently of the specific treatments applied. Fill in the blank: The biopsychosocial model, proposed by George ________ in 1977, holds that health and illness are best understood as the product of three interacting dimensions: the biological, the psychological, and the social.

la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS Figure 1.1: Major schools of psychology and the biopsychosocial model Pilot questions 1.1 1. Define psychology and state its four goals. 2. Name six major schools of psychological thought and state the key focus of each. 3. Explain the biopsychosocial model and describe three of its clinical applications. 4. Explain why behaviourism rejected the study of mental processes and what its main contribution to psychology was. 1.2 Behaviour, Stimulus, and Response 1.2.1 Defining behaviour and its determinants Behaviour is any observable and measurable action or response of an organism; it ranges from simple reflexes (the knee jerk reflex in response to a tap on the patellar tendon) through routine

la-NET | ONLINE LEARNING VIDEO PLATFORM FOR POST-SECONDARY & HIGHER INSTITUTION STUDENTS motor actions (walking, speaking, and writing) to complex goal-directed activities (seeking healthcare, adhering to treatment, managing a chronic illness); in clinical medicine, health behaviour encompasses all actions related to health, including preventive behaviours (immunisation, screening, dietary habits, physical activity), treatment-seeking behaviours (when and where to seek care), treatment adherence behaviours (taking medications, attending follow-up appointments, completing rehabilitation), and risk behaviours (tobacco use, alcohol consumption, unsafe sexual practices). The determinants of behaviour are multiple and operate at different levels: at the biological level, genetic predispositions, neurochemical states, hormonal influences, and physiological drives (hunger, thirst, pain, and fatigue) shape behaviour directly; at the psychological level, learning

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