Syllabus, references list - Medical Psychology

MEDICAL PSYCHOLOGY
2017-2018

Course instructor:
Ovidiu Popa – Velea
MD, PhD, MA Psychology, Fulbright Alumnus
ovidiu.popa-velea@umfcd.ro

Teaching assistants:
Liliana Diaconescu, MD, PhD, MA Psychology idiac2002@yahoo.com
Alexandra Mihailescu, MD, PhD andrast79@yahoo.com
Mihaela Pana, PhD cutovmihaela2005@yahoo.com

SYLLABUS

Purpose: To acquaint students with methods and issues relevant to the application of psychology to health-related intervention, the way people are affected psychologically by illness and disease, various behaviors and cognitions affecting health and illness.

Format: The course is designed as an introductory undergraduate course, and is structured as a series of lectures and practical applications. Students are expected to have a minimal background in medicine and psychology, which would facilitate the assimilation of key Health Psychology concepts. The professor will prepare presentations and demonstrations, distribute background reading material, and lead group discussions. Learning will be an interactive process, so all students are encouraged to ask and to comment on any possible issues of interest concerning the course.

Objectives: To enable students to:
1. Understand the disease in its triple dimension, biological, psychological and social, and become familiar with the modern approach of some frequent psychosomatic diseases (e.g. cardiovascular, pulmonary, allergic).
2. Understand the role of clinical and health psychologists in daily clinical practice;
3. Be able to identify the contribution of psychosocial factors in pathology and the possibility to address them, via psychotherapy or counseling.
4. Become familiar with the concept and theories of stress, to instruments designed to evaluate stress and to modalities of intervention, centered upon behavioral and coping style changes.
5. Be able to identify various psychological disorders and key personality traits related to health / disease.
6. Learn about doctor-patient communication and its importance in improving adherence to recommended health behaviors.
7. Learn about various difficult and / or critical patients and some psychological strategies of approaching them.
8. Become familiar with ethical issues in health psychology.
9. Encourage own student learning about health psychology issues, and their application in clinical settings.

Requirements: Students are expected to attend regularly the course and to participate actively in group discussions. They will also have to attend Health Psychology seminars, their participation being monitored by the teaching assistants. A number of two or more missed seminars will prevent the respective student from being admitted at the exam.
References will be assigned by the instructor and need to be read before each class.

Evaluation: Grades will be based mainly on student’s performances at the final written exam. Regular course and seminar attendance and a good grade obtained at the final seminar evaluation will be considered a plus.


PROGRAM OF COURSES

Lecture 1
Medical psychology: an interference domain between medicine and psychosocial sciences
1. Health psychology and clinical psychology: commonalities and differences. Roles of health and clinical psychologists: attitudes regarding diverse behavioral disturbances.
2. Orientation of the clinician in confronting patient behavioral disturbances (an algorithm of differential diagnosis between neurosis, psychoses and personality disorders). Subsequent actions.
3. (practical class) Particularities and challenges of behavioral disturbances for the doctor-patient relationship. Influences on adherence.
4. (+ practical class) Main research methods in health psychology: observation, experiments, interviews, psychological tests.
5. (+ practical class) Specific of questionnaires and projective tests. Advantages and disadvantages.
6. (practical class) Examples of working with a questionnaire or performing an interview.

Lecture 2
Stress and illness
1. Stress: definition, various types of stressors.
2. Theoretical models of stress (traditional vs.modern).
3. (+ practical class) Stressful events: types, particularities compared to other stressors.
4. (+ practical class) The life events scale of Holmes and Rahe: an attempt to quantify the relative weight of various stressors.
5. The relativity of perception and appraisal of stressful events.
6. (+ practical class) Personality traits related to different kinds of stress appraisal (A, C, D).
7. Cognitive traits which are protective or risky for the appraisal of stressful events.
8. (+ practical class) Hormonal correlates of stress. The difference between eustress and distress. The positive role of endorphins.
9. Allostatic load.
10. The helplessness-hopelessness syndrome (Seligman).
11. (+ practical class) Coping strategies.
12. (practical class) Anti-stress strategies and programs.

Lecture 3
Disease (1). The multi-faceted approach of Medical Psychology
1.Conceptualization of disease: the triple factorial model (disease, illness, sickness).
2.Social and cultural aspects of the disease. The role of social support.
3.(+ practical class) Psychosomatic diseases and psychosomatic disorders: commonalities and differences.
4. (practical class) Various models explaining the pathogenesis of psychosomatic diseases (Alexander, Cannon, Pavlov; modern approaches).
5. (practical class) Various chronic conditions and the contribution of psychological factors in ulcer, asthma, cardiovascular diseases, tuberculosis. The emergence of new interdisciplinary fields (psychoneuroimmunology, psychoneuroallergology, psycho-oncology).

Lecture 4
Doctor-patient relationship (1)
1. Patient role and status (Parsons). Dynamics of assuming the patient role.
2. (practical class) Cognitive representations of illness (HBM, TRA, TPB, Leventhal).The clinical utility of these models in the relationship with problematic / difficult patients.
3. (+ practical class) Typical patients’ reactions to illness: regression, evasion, informational contagion, (non)productive usage of illness. Clinical application: adjustment to incurable illness.
4. (practical class) Particularities of chronic patients.
5. (+ practical class) Individual variables that influence the risk of getting ill and the behavior vs. the disease.
6. (+ practical class) Buffer factors that increase the efficiency of defense mechanisms within illness.

Lecture 5
Doctor-patient relationship (2)
1. (+ practical class) Communication: verbal and non-verbal elements. The importance of the concordance between verbal and non-verbal behavior.
2. (+ practical class) The specific of the communication between doctor and the patient: the interaction to doctor’s presumed roles, various kinds of anamnesis and their utility.
3. (practical class) Difficult patients. Identification of problematic behavior within the interview and/or psychological testing. Application: MMPI test.
4. (+ practical class) Description of main personality disorders and their attitude towards doctors and medical institutions.
5. (+ practical class) Communication with difficult patients.
6. (+ practical class) Burnout syndrome at doctors.

Lecture 6
Psychological correlates of pain
1. General aspects of pain (types of pain, causes of pain).
2. (+ practical class) The role of psychological factors in producing and enhancing pain (e.g., depression, anxiety).
3. (+ practical class) Incurable / chronic illness and pain.
4. (+ practical class) Psychological interventions for pain suppression (hypnosis, relaxation, guided imagery). Application in a clinical case.

Lecture 7
Psychotherapy (1). (second part = Behavioral Sciences class, 2nd year of study)
1. (+ practical class) Definitions, classification, indications of psychotherapy.
2. (practical class) Modeling of one’s behavior: from theoretical principles to counseling and psychotherapy.
3. (+ practical class) Psychoanalysis (definition, theoretical background, indications, efficiency).
4. (+ practical class) Cognitive – behavioral therapy (definition, theoretical background, indications, efficiency).
5. (+ practical class) Relaxation techniques and hypnosis (definition, theoretical background, indications, efficiency).
6. (+ practical class) Rogersian therapy (definition, theoretical background, indications, efficiency).

REFERENCES

A. mandatory for exam preparation

1. Popa-Velea, O. (2015). "Behavioral Sciences in Medicine", Ed.Universitara Carol Davila - Bucharest
- (volume 1) 11-35, 43-56, 145-154, 160-167, 170-184, 189-202, 206-213, 236-247;
- (volume 2) 422-471, 474-485, 487-499, 533-542, 544-562.

B. additional references (not mandatory for the exam)

2. Marks, D., Murray, M., Evans, B., Willig, C., Woodall, C., Sykes, C. (2005). "Health Psychology: Theory, research and practice" (2nd Ed.), SAGE Publications Ltd., London Thousand Oaks, New Delhi: chapters 4 ("Culture and health") (pages 69-89), 12 ("Illness and personality") (pages 235-252).

3. Noble, L. "Doctor-patient communication and adherence to treatment" (chapter 3), in Myers, L., Midence, K. (Eds.) (1998). "Adherence to treatment in medical conditions", Harwood Academic Publishers, London (pages 51-73).

4. Ogden, J. (2005). "Health Psychology - a textbook" (3rd Ed.), McGraw-Hill Education, New York, London; chapters 10 ("Stress") (pages 233-250), 11 ("Stress and illness") (pages 251-283), 12 ("Pain") (pages 285-305), 13 ("Placebos and the interrelationship between belief, behavior and health") (pages 309-326).

5. American Psychological Association (2000). "Diagnostic and Statistic Manual of Psychiatric Disorders - Terms Revised" (DSM-IV TR) (4th Ed.): description of the most common personality disorders: paranoid (pages 690-694), schizoid (pages 694-697), histrionic (pages 711-714), obsessive-compulsive (pages 725-729).