INTRODUCTION TO

BEHAVIOURAL
SCIENCES
DR.ATIA JABEEN
DPT,SLP/T
• Behavioral sciences are a term that encompasses all
the disciplines that explore the behavior and strategies
within and between organisms in the natural world.
• Behavioral Sciences is a holistic and integrative
approach in all disciplines of education and Medical
practice
HOLISTIC MEDICINE

• Whole is greater than its parts

• Integration of mind-body and spirit
• The holistic medicine aims at restoring health and
wellness to the person as a whole
• Person, environment and health
• Patients are most likely to comply with
medical advice for which of the following
reasons?
a. The illness has few symptoms
b. The patient likes the physician
c. The physician is young
d. The illness is chronic
e. The treatment schedule is complex
How would you describe your general
overall health?

I am in excellent health.

I am in good health.

I am in average health.

I am in poor health.
What is health?

"Health is a state of complete physical,

mental and social well-being and not merely
the absence of disease or infirmity.”
World Health Organization
Health Psychology v. Biomedicine

X
Health Psychology v. Biomedicine
Health Psychology

• Study of social, behavioral, cognitive, and

emotional factors that influence the:
• Maintenance of health
• Development of illness and disease
• Course of illness or disease
• Patient’s and family’s response to illness and disease
 Health Psychology
“The educational, scientific, and professional
contributions of psychology to
• the promotion and maintenance of health,
• The prevention and treatment of illness,
• The identification of etiologic correlates of
health and illness, and
• The improvement of the health care system and
health policy formation.” Matarazzo, 1980
Disease v. Illness

• Disease is a diagnosable biological dysfunction

or infection.

• Illness is an individual’s unique experience of

pain and suffering.
Etiology

1 : CAUSE, ORIGIN; specifically : all of the causes of a

disease or abnormal condition
Why do people get sick?

Biomedical Model:
• Exposure to infectious agents or pathogens
• Immune response either sufficient or insufficient
Why else do people get sick?

• Previous exposure to virus

• Health behaviors (sleep, nutrition, etc.)
• Stress/emotions
• Social relationships (support, conflict)
 *
The Biopsychosocial Model

BIO PSYCHO

HEALTH

SOCIAL
 *
The Biopsychosocial Model

BIO PSYCHO

HEALTH

SOCIAL
 *
The Biopsychosocial Model

BIO PSYCHO

HEALTH

SOCIAL
 The Biopsychosocial Model:
Why do college students get sick?
health
previous exposure behaviors
to virus BIO PSYCHO
immune reaction
to virus HEALTH personality
emotions

SOCIAL
social support
social conflict
Biopsychosocial Model of Disease

Biology Pathogens
•Genetic variability •Germs
•Anatomy •Toxins
•Physiology
Social
Behavioral risk factors •Family
•Diet •Society
•Exercise •Friends, etc.
•Smoking
•Safe sex
•Wearing seat belts in the car, etc.
The Biopsychosocial Model:
Understanding Pain
Studies of Chronic Pain

• People with chronic pain are more likely to have an

anxious personality.
• People with chronic pain report low levels of social
support.
Studies of Experimental Pain

• Anxiety and fear increase pain.

 
• Having a friend present reduces pain.

                                     

            
 Psychological Consequences of
Pain

• Chronic back pain

patients showed atrophy
in the prefrontal cortex.
 Psychological Consequences of Pain

• Chronic back pain patients

showed atrophy in the
prefrontal cortex.
and…..
• impaired judgment
in a risk-taking task.
Social Consequences of Pain

• Think back to your pain memory….

• Did the pain influence your ability to fulfill social
role obligations?
Social Consequences of Pain

• Think back to your pain memory….

• Did the pain influence your ability to fulfill social
role obligations?
• Being a good student?
Social Consequences of Pain

• Think back to your pain memory….

• Did the pain influence your ability to fulfill social
role obligations?
• Being a good team member?
Social Consequences of Pain

• Think back to your pain memory….

• Did the pain influence your ability to fulfill social
role obligations?
• Being a good friend?
The Biopsychosocial Model:
Understanding Pain

neurological risk-taking
changes BIO PSYCHO
brain activation
HEALTH anxiety, fear

SOCIAL
attachment
rejection role obligations
social support
BIO PSYCHO

HEALTH

SOCIAL
Stress due to Illness
• Change of role
• Financial loss
• Stigmatization
• Loss of self esteem
• Fear of being handicapped or of disfigurement
• Uncertain prognosis
Stress of Hospitalization
• Anatomy and Physiology of hospitals
• Loss of privacy
• Loss of autonomy
• Separation from the dear ones
• Need of seeking approval of doctors
• Threat of social dysfunction of the family
• Unsatisfactory information
 Daily Stress

• Some stressors are chronic:

• Job-related (shift work, co-workers)
• Environmental stressors (aircraft noise)
• Hassles are small problems that accumulate to
induce major stress
• Time pressures to get things done
• Financial concerns
• Problems with family and coworkers
• Frustration is a negative emotional state associated
with a blocked goal
• Conflicts arise when choosing between 2
incompatible alternatives
 Effects of Stress

• The sympathetic portion of the autonomic nervous

system is activated during stress
• Increased heart rate and blood pressure
• Release of adrenaline and cortisol
• These physiological changes use up energy and can be sustained
for only a period of time
• Prolonged stressor exposure leads to exhaustion and death:
Stress and the Immune System
• Immune system functioning is impaired by
exposure to stress
• This immune response leaves a person susceptible to
disease
• Psychological events such as caring for a loved
one who has Alzheimer’s disease activates the
sympathetic system and impairs immune
response
• Hormone release during stress suppresses the
immune system and this increases the likelihood of
becoming ill
 Stress and Serious Illness

• Cancer is affected by psychological factors

• Exposure to chemicals that cause cancer can be
modified by behavior
• Sleep deprivation can reduce immune function
• Personality traits can alter stress response
• Heart disease is associated with the buildup of
fats in blood vessels, stress increases this effect
• Type A personalities (ambitious, time urgent) are
more likely to suffer heart disease
• Reducing stress alters blood cholesterol so as to
reduce chance of blood vessel blockage
Personality and Stress

• Type A personality traits include time

pressure, anger, and hostility
• Behavior modification is used to encourage Type A
persons to slow down, follow a diet, to exercise,
and to avoid cynical hostility
• Hardiness is a personality type that is
resistant to stress
• Hardiness involves
• Commitment to personal goals
• Personal view of being in control
• Viewing change as a welcome challenge
 Risk Factors Protective Factors
• A condition, behavior, • Personal, social, and
or experience that institutional resources
increases the likelihood that promote a positive
of a negative outcome. outcome.
• Smoking • Social Support
• Diet
• Optimism vs.
• Exercise
Pessimism
• Alcohol
• Exercise
What are some psychosocial
protective factors?

Buffers reduce the negative effects of a risk

factor (i.e. stress).

social support self-efficacy optimism

 How do different risk factors and
protective factors interact to influence health?
 *
Risk factors/protective factors can be related to each
other in a causal chain.

A B C Cardiovascular
disease
Unemployment is a risk factor for
cardiovascular disease.
 *

Unemployment Stress

Cardiovascular Cardiovascular
Reactivity Disease
 Loss of
Income & Cardiovascular
Unemployment Health Care Disease
 *

Loss of
Income &
Unemployment Health Care

Unable to
Cardiovascular
pay for blood
Disease
pressure
meds
 *

Unemployment X Cardiovascular
Disease
+
Social
Support
Unemployment Cardiovascular
Disease
+
Type A
Personality
 *

Unemployment Cardiovascular
Disease
+
Type A
Personality
 Coping with Stress

• Stressors are pervasive in our lives

• Reducing stress can be accomplished by either avoiding
stressors or by reducing our response to stressors
• Coping: managing stress in some effective way
• Emotion-focused forms of coping change how we view a
situation (our reaction)
• Problem-focused forms of coping deal directly with the
stressor to eliminate it
Resources to Manage Stress

• Health and energy are key aspects to minimize the

damage produced by stress
• Positive beliefs are important for reducing stress
impact
• Social skills lead to social support
• Social support (network of friends, family) reduces
stress impact
• Material resources can help to minimize the sources
and types of stress
• Personal control allows people to buffer the
negative reactions to stress
Active Coping Strategies
• Relaxation during stress exposure minimizes the
impact of the exposure
• Exercise leads to physical fitness and good health
• Reduces likelihood of illness
• Reduces negative impact of stress
ROLE OF PT IN PSYCHOLOGY

• Therapists must also become aware of “yellow flags,”

or thoughts, feelings, or behaviors that may present
additional challenges to therapy and may delay
recovery.  
• The cycle of chronic pain can quickly become
debilitating.
•  This cycle includes factors such as reduced activity,
negative thoughts and beliefs, and prior treatment
failures.  It also includes physical deterioration from
decreased activity, along with feelings of depression
and hopelessness.  These all combine, resulting in
overall suffering and disability.
• Graded exercise and graded exposure both involve the
patient first identifying activities they are fearful of
performing due to their pain.
•  The physical therapist then works directly with the
patient to set realistic goals and expectations for
treatment.
• Physical therapists can help patients feel a greater
sense of control over their pain and can enable them to
return to a more normal life, despite the presence of
pain.
• This is only achieved through the integration both
physical and psychological components of pain care
Applying What You Learned

• Next time you go to health services, try talking

to the healthcare provider from a
biopsychosocial perspective.
• Next time you get sick, examine all aspects of
your life – are there personal, social, or
institutional factors that undermine your health?
• If you’re trying to make a positive change in a
health behavior, find social support.
• Recognize the complexity of health and illness in
your interactions with others.