Personality Types and Heart Attack

Individuals can be classified into two on the basis of their personality types-Type A and Type B.
Type A personality includes a set of characteristics that includes being impatient, excessively time-conscious, insecure about one's status, highly competitive, hostile and aggressive, and incapable of relaxation. Type A individuals are often highly achieving workaholics who multi-task, drive themselves with deadlines, and are unhappy about the smallest of delays. Although they may exhibit some or all of these characteristics, it does not mean that people with the type A personality are incapable of showing love, affection or other types of non-pessimistic behavior. Many are also capable of "couching" some of these behavior attributes with proper treatment and medication. Those who do not seek treatment have been described as stress junkies, and often display some of the following characteristics:
1. An intrinsic insecurity or insufficient level of self-esteem, which is considered to be the root cause of the syndrome. This is believed to be covert and therefore less observable.
2. Time urgency and impatience, which causes irritation and exasperation.
3. Free floating hostility, which can be triggered even over little incidents.
The Type B personality, in contrast, is patient, relaxed, and easy-going.
An individual can work any number of hours provided he/she enjoys it. Otherwise it causes stress. Negative personalities like Type A trigger negative psycho-neuro-humoro-viscero-immune chain reaction. This increases the hormones of fright, fight and flight (adrenaline, noradrenaline and cortisol) resulting in a rise in heart rate, blood pressure, blood sugar, bad cholesterol (LDL) and decrease in good cholesterol (HDL). This leads to the narrowing of coronary arteries namely left and right (in turn endangering the blood supply to the heart muscle (myocardium), which in turn causes an imbalance between demand and supply of oxygen to the heart.
These individuals generally see their work as stressful, tend to over eat, lead a sedentary life, are obese and also smoke. This kind of a lifestyle leads to hypertension, diabetes mellitus and hypercholesterolemia, which culminates in coronary heart disease (CAD) and other health problems. There are three mechanisms of CAD: narrowing of the coronary arteries by the deposit of excess cholesterol or plaque; the erosion or rupture of plaque causing an instantaneous blood clot; acute coronary spasm. Obstructions up to 70 percent in the coronary arteries are sometimes compensated by coronary reserves, a gift of Nature. But beyond 70 percent, it manifests as effort angina or chest pain caused by exertion. Total or 100 percent block leads to a heart attack.
The increasing incidence of CAD among youngsters can be attributed to a combination of stress, insecurity and unhealthy lifestyle. A majority of the heart attacks occur between 5.00 a.m. and 8.00 a.m. due to over anxiety about work.
Type B personalities have a positive chain reaction that results in increased secretion of hormones like endorphins, melatonin and serotonin that help the organs including the heart to function normally.
A healthy work culture along with lifestyle modification not only helps in primary prevention of heart disease but also in reversing blocked coronary arteries. Intermittent breaks, mild stretching exercises, including more vegetables and fruits in diet and mental relaxation help improve one’s performance.
Globally about 30 percent of heart attack victims die within 2-3 minutes of the onset of pain. The only solution is primary prevention. Interventions like stenting and bypass surgery are temporary measures.
The only permanent cure is effective lifestyle changes. Three mantras for a healthy heart:
1. Positive Thought
2. Healthy food
3. Adequate exercise.
Reference:
Chockalingam, V (27/9/2009), Magazine, The Hindu Daily.
http://encyclopedia.thefreedictionary.com/

Modifying Our Own Behaviour: Research Findings

Can people modify their own behaviour?

The answer is yes.

The first thing to do is to decide what is the "target" behaviour.

Similar is the case if you want to get rid of some behaviour.

Behaviour modification sepecialists emphasize a positive approach called "ignoring". Much better results are achieved when the emphasis is on the new behaviour to be acquired rathre than on the behaviour to be eliminated. For example, instead of setting a target of being less shy, you migh define the target behaviour as becoming more outgoing or more sociable. Other possible target behaviours are behaving more assertively, studying more, and getting along better with your room-mates. In each case, you have focused on the behaviour that you want to acquire rather than on the behaviour that you want to reduce or eliminate.

The next step is to define the target behaviour precisely: What exactly do you mean by "assertive" or by "sociable"? One way to do this is to imagine situations in which the target behaviour could be performed. Then describe in writing these situations and the way in which you now respond to them. For example, in the case of shyness, you might write: "when I am sitting in the lecture hall, waiting for class to begin, I don't talk to the people around me. " Next, write down bow you would rather act in that situation: "Ask the people sitting next to me how they like the class or the professor; or ask if they have seen any particularly good films recently."

The next step is to monitor your present behaviour by keeping a daily log of activities related to the target behaviour in order to establish your present rate of behaviour. At the same time, try to figure out if your present, undesirable behavoiur is being reinforced in some way. For example, if you find yourself unable to study, record what you do instead and try to determine how that undesirable behaviour is being reinforced.

The next step--the basic principle of self-modification--is to provide yourself with a positive reinforcer that is contingent on specific improvements in the target behaviour. You may be able to use the same reinforcer that now maintains your undesirable behaviour, or you may want to pick a new reinforcer.

(Obligation: "Psychology: An Introduction" 7th ed. by Charles G. Morris)

Research Findings on Listening Techniques.

Teachers are of different type. Type 1 come down to the students during the lecture, through various live illustrations. There is a type 2, teachers who would never come down, but try to raise the students to their level through an elevated style. Most of the students would like to listen type 1. But some, this may be very little, really motivated students love the type 2. In other words, type 2 lectures will be a great success in a class of active listeners. Active listeners, indeed, used to motivate the type 1 teachers too. They know how to control their attention in the teachers explanations, avoiding unnecessary internal as well as external noises. Is there any common process which is followed by active listeners? Yes; the following can be taken as some tips to become an active listener in the class.

The important steps for active listening can be summarized as LISAN.

L = Lead. Don’t follow. Try to anticipate what the instructor is going to say. Try to set questions as guides. Questions can come from the instructor’s study guides or the reading assignments. Or it can be made from the text too. If so, there should be a prior reading on the topic.

I = Ideas. Every lecture is based on a core of important ideas. Usually, an idea is introduced and examples or explanations are given. Ask yourself and make clear, “What is the main idea now?” And “What ideas support it?”

S = Signal words. Listen for words that tell you the direction the instructor is taking. For instance, here are some groups of signal words:
There are three reasons why … - The idea will follow
Most important is… - Next will be the main ideas.
On the contrary… - Opposite idea to the main idea will follow
As an example… - Support for main idea will be delivered.
Therefore… - The speaker tends to conclude.

A = Actively listen. Sit where you can hear and where you can be seen if you need to ask a question. Look at the instructor when he or she talks. Bring question you want answered from the last lecture or from your reading. Raise your hand at the beginning of class or approach your instructor before the lecture begins. Do anything that helps you to be active.

N = Note taking. As you listen, write down only key points. Listen to everything, but be selective and don’t try to write everything down. If you are too busy writing, you may not grasp what is being said. Any gaps in your notes can be filled in immediately after class.

Findings suggest that most students take reasonably good notes, but never use them properly! They wait until just before exams to review their notes. By then the notes would have lost much of their meaning. Thus, notes those are taken should be reviewed regularly. LISAN will help to listen carefully as well as to motivate the teachers. After all, good teachers are made by good students. The main reason for the lack of class room performance by well eminent scholars may be that they would not have faced well motivated class of students.

Research Inquiries on Dwarfism

Being a dwarf is strangely bitter in reality than in fiction. Studies done in search of the factors behind dwarfism points out one of the prominent reasons - insufficient growth hormone. If this condition is not treated, a child may fall 6 to 12 inches behind age-mates in height. As adults, some will be hypo-pituitary dwarfs. Such individuals are perfectly proportioned, but tiny.
For many years, dwarfism could be treated only with injections of human growth hormone. It was a painstaking and expensive process. Now, a relatively cheap synthetic growth hormone is available. Regular injections of this hormone can raise a hypo-pituitary child’s height by several inches.
However, it has to be noted that synthetic growth hormone has side effects. If not carefully administered, it can cause giantism, acromegaly, diabetes, or other medical problems. Also, it has to be noted that normally short children are found to fail to increase their height even after the application of this hormone.

Most Recent Research Findings about the Chemicals that Keep the Brain Sharp

The brain, the nervous and vascular systems, and to a lesser extent, all cells in the body use a special kind of fat in their construction, known as essential fat (Richardson, 2006). The brain alone is comprised of three quarters of this fat, which has a different chemical composition to the visible fat the body uses as a way of storing energy. At a molecular level, fat is comprised of a string of carbons, saturated with hydrogen and with an acid group at one end. The carbon atoms are normally joined by single bonds (Walter et al 2003). With some fats, some of the hydrogens can be moved to form double bonds between adjacent carbons. Essential fatty acids have more than one double bond and are called polyunsaturated.

There are two different types of essential fatty acids:

• Linoleic acid and its derivatives, including arachidonic acid (AA), are known as the Omega-6 series of fatty acids;
• Alpha-linolenic acid and its derivatives are the Omega-3 series of essential fatty acids, which include EPA and DHA.
  

These essential fatty acids cannot be made in the body and must be eaten in the diet. Animals and fish eat the plants containing the shorter chain fatty acids, and their digestive systems change the fat, extending the length of the carbon chain. When people eat meat or fish they build on these building blocks again. It is the long chain fatty acid derivatives that are used in human brain construction, in particular in the construction of cell membranes. These different chemical structures give the fats different properties: saturated fats are hard and inflexible, while polyunsaturated fats are liquid. Essential fats are unstable, so they are stripped from foods by industrial processing where shelf life and stability are considered more important.

Role of Nutrition in Behaviour: Research Findings

Research evidence suggests that poor nutrition among children would lead to problems like anti-social behaviour, exclusions and poor literacy standards that beset schools. Bernard Gesch (2005), a senior research scientist in the Department of Physiology at Oxford University, in a research carried out in prisons found out that food supplements containing vitamins, minerals and essential fatty acids ensured a fall of over 35% in their anti-social behaviour and violence.
Another instance for this is an experiment conducted by Dr Alex Richardson of Oxford University (2005), involved young children (aged from six to 11) with specific difficulties in motor coordination, over 30% had Attention Deficit Hyperactivity Disorders (ADHD), and 40% had specific learning difficulties and were more than two years behind in reading and spelling, in Durham (Alex, 2004). The experiment provided the children with supplements containing Omega-3 and Omega-6 fatty acids and vitamin E. The recipients of the food supplements improved their reading ability at more than three times the normal rate, and more than twice the rate in spelling, over three months of treatment. There were also significant improvements in their ADHD symptoms (Lawrence, 2005). As far as India is considered, it is high time to provide nutritional education to improve both behaviour and academic standards.
World-class scientific research shows that diet can play an important role in dyslexia and related conditions such as dyspraxia, ADHD, and autistic spectrum disorders, as well as in many other aspects of behaviour, learning and mood (Alex, 2004). Dietary supplementation with omega-3 and omega-6 fatty acids is found to be helpful in treating dyslexic children. These fatty acids are essential to the brain, and must be provided by the diet. Everyone needs them - but some people appear to need more than others (Baker, 2005). Rigorous scientific research shows that the performance of underachieving children, some of whom were also disruptive, improved dramatically when their diets were supplemented with fish oils.
Low birth weight is associated with an increased risk of serious health problems, including respiratory disorders and diabetes (B.B.C. Website, 2005). Folate, also known as folic acid, or Vitamin B9, found in vegetables (broccoli, spinach), fruit (oranges, grapefruits) and whole-meal products like bread or cereals is found to have some link with birth weight. Recommended intake of folic acid regularly is 200 micrograms per day. Women are advised to take an additional 400 micrograms a day before conception and during the first 12 weeks of pregnancy (Harward Medical School, 2005). It is to reduce the risk of neural tube defects with spina bifida (a congenital defect or opening in the spinal column through which the spinal membranes or spinal cord may protrude, often resulting in hydrocephalus, paralysis etc). Medical evidence suggests that folic acid influences birth weight because it is an essential nutrient for growth and plays a role in gene expression in the foetus (Baker, 2005). Pregnant women who smoked were more likely to have lower levels of folate in their blood - which might explain why women who smoke often have lighter babies. However, it has to be noted that, increased amount of folic acid consumption could make it harder to spot a deficiency of vitamin B12, which can lead to neurological damage.

Delaying the introduction of cereal-based foods into a child's diet could help avoid later gut problems, say University of Colorado scientists (B.B.C. Website, 2005). Babies had a lower chance of developing the digestive disorder coeliac disease if they were not fed grains until aged four to six months, they found. This condition is caused by proteins in grains, which damage the gut and make it difficult to digest foods. The research appears in the Journal of the American Medical Association. Exposure to gluten - a protein found in wheat - in the first three months of life increased the risk of coeliac disease five-fold, the study of more than 1,500 children found. Children not exposed until they were older than seven months were also more likely to develop coeliac disease than infants exposed when they were aged between four and six months.
The researchers said there were possible explanations for the apparent "safe window" for gluten exposure during infancy. For gluten to evoke an allergic reaction it has to cross the gut barrier so that it can be recognized by the body's immune cells (B.B.C. Website, 2005). At very young ages, such as the first three months of life, this barrier may not be as complete as at older ages, thus allowing gliadin to pass even with small amounts of intake (Richardson, 2004). Conversely, when wheat products are introduced to an older child, such as those older than seven months, it tends to be in larger portion sizes, thus increasing the amount of gluten available to cross the gut. Even if a small proportion of the available gluten crosses the gut, it may be sufficient to initiate an adverse response.
Treatment for coeliac disease is a gluten-free diet, which essentially eliminates foods containing wheat, barley and rye from the diet. However, children with a parent or other first degree relative with coeliac disease had a one in 10 chance of developing the intolerance themselves.

Research Enquiries on Pain

Defining Pain
Pain is a uniquely personal human experience, which has been defined in many ways.
1. An aversive, personal, subjective experience, influenced by cultural learning, the meaning of the situation, attention and other psychological variables, which disrupts ongoing behaviour and motivates the individual to attempt to stop pain.
2. An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
These definitions highlight subjective emotional and multi-dimensional nature of pain experience.
Pain may be acute, like useful biological response provoked by injury or disease. Acute pain will respond to pharmacological treatment. For example, tooth aches, wounds etc. It may also be chronic, which may persist for six months or more. Chronic pain tends not to respond to pharmacological treatment.

Theories of Pain

Early Theories of Pain
In 1900s, there had been a tendency to consider body as a machine. During then, sensation of pain was explained in a mechanistic view. According to the mechanistic view, if an appropriate stimulus activates a receptor, the signal travels to the spinal cord and then to the brain, and thus sensation results. Specificity theory had been on the basis of this. Specificity theory propounds that body has a separate sensory system for perceiving pain, just as it does for hearing and vision. The system has special receptors for the purpose.
But, according to Pattern theory, there is no separate system. The receptors for pain are shared with other senses, such as touch. The receptors for pain are shared with other senses, such as touch. People feel pain when certain patterns of neural activity occur. These patterns occur only with intense stimulation. Strong and mild stimuli of the same sense modality produce different patterns of neural activity. Therefore being hit hard feels pain, but being caressed does not.
None of these theories adequately explained pain perception. Perhaps the most serious problem with the early theories is that they don't attempt to refer about psychological factors behind it. Research findings indicate that people who are suggested not to feel pain actually do feel less pain when deeply hypnotized than when in normal waking state.
Sensory Decision Theory relied heavily on the psychology of perception. Cognitive processes like perceptual habits, beliefs, expectations, costs and rewards and memory control have influence on how any sensory input is perceived. According to this theory, the experience of pain is increased by attention that is drawn to a specific, painful area of the body or by a conscious decision to focus attention on it. The focusing of attentions may cause even weak or transient sensations to become more noticeable, heightening the experience of pain. However, the theory sticked too much on psychology and neglects biological functions.
Gate Control Theory
In 1965, Ronald Melzack and Peter Wall formulated a new theory of pain, which suggests that pain is not the result of a linear process that begins with sensory stimulation of pain pathways and ends with the experience of pain. Rather pain perception is subject to a number of modulations that can influence the experience of pain. These modulations begin in the spinal cord. The researchers hypothesized that structures in the spinal cord acts as a gate for the sensory input that is interpreted as pain, thus it is called the 'Gate Control Theory'.
Gate control theory views pain as a multidimensional perspective experience.
In pain, ascending psychological inputs and descending psychological inputs are equally involved. The gating mechanism is existed in the dorsal horn of spinal cord that permits or inhibits the transmission of pain impulses.
The dorsal horn receives inputs from nociceptors which it transmits to the brain via neural gate. The dorsal horn also receives information from brain about the psychological and emotional state of the individual. This information can acts as an inhibitory control that closes the neural gate preventing the transmission of nociceptive impulses and thus modifying the perceptions of pain. The mechanism operates based on the relative activity of the peripheral nociceptor fibers and the descending cortical fibers. Pain impulses must reach conscious awareness before pain is experienced. If awareness can be prevented, the experience of the pain is decreased, eliminated or differed.
The gating mechanism is located in the spinal cord, more specifically in substantia gelatinosa of the dorsal horns, which are parts of gray matter that runs the length of the core of the spinal cord. Signal of noxious stimulation enter the gating mechanism (substantia gelatinosa) from the pain fibers. After these signals pass through the gating mechanism, they activate transmission cells, which send impulses to the brain. When the output of signals pass from the transmission cells reaches a critical level, the person perceives pain. The greater the output beyond the level, the greater the pain intensity.
Sensory input is subject to modulation depending on the activity of the large A-beta fibers, the small A-delta fibers and the small C fibers that enter the spinal cord and synapse in the dorsal horns. Certain neurons located in the gray matter of the spinal cord (the gate) have the ability to block or facilitate the transmission of pain impulses passed by A-delta and C fibers. The C fibers are inhibitory to the gate neurons, so impulses traveling along them tend to open the gate, whereas the A-beta fibers are excitatory to the gate neurons, so impulses traveling along them tend to close the gate. If impulses in the C fibers are stronger than those in A beta fibers, the gate opens.
The gateway neurons produce the pain-blocking neurotransmitter enkephalin (an endorphin), which is similar to opiates and can block substance "P" (sharp pain substance). Enkephalins can also be released through electrical stimulation of the brain and in acupuncture, which may be the cause of the reduction in pain.
Gate control theory further emphasizes the importance of specialized nerve impulses that arise in the brain itself and travel down the spinal cord to influence the gate. The central control trigger transmits impulses through large, rapidly conducting efferent fibers to the gate in the spinal cord. (Actually there are many gates located along the spinal cord). The central control trigger can send either inhibitory or excitatory impulses to the gate and sensitized it to either C fibre or A-beta fibre inputs. If the brain sensitizes the gate to C fibre impulses, then it is more likely to open. If it sensitizes the gate to A-beta fibre inputs, then it is more likely to close.
To conclude three factors are involved in GCT.
1. The amount of the activity of the pain fibers: The stronger the noxious stimulation, the more active the pain fibers.
2. The amount of activity in other perpheral fibers (A-beta fibers): ...carries information about harmless stimuli or mild irritation as touching or lightly scratching. Activity in A-beta fibers tends to close the gate inhibiting the perceptions of pain when noxious stimulation exists.
3. Messages that descend from the brain: Efferent pathways to the spinal cord and the impulses they send can opne or close the gate.

Training and Career Prospects in Health Psychology

As the field of health psychology is so new, the profession is developing. Most health psychologists work in hospitals, clinics and academic departments of colleges and universities. In these positions, they either provide direct help to patients or give indirect help through research, teaching and consulting activities. The direct help includes the management of the patient's psychological adjustment and health problems. The indirect help is through research and theory formation. The qualification for becoming health psychologist includes completion of the doctoral degree in Psychology.

Most Health Psychologists follow one of two career categories:
1. Those who work mainly in clinical capacities with patients
2. Those who work mainly in academic or research capacities.
Some combine these areas and some do administrative work such as in governmental agencies or programs to promote health.
In United States, the number of psychologists working on health care exceeds 45,000. Laws enabling psychologists to obtain full staff status in hospitals giving them same privileges as physicians have been passed. In India, however, career prospects of health psychologists are yet to improve. The society is still blind in understanding the importance of psychology in the field of health and illness.
Besides hospitals, health psychologists have opportunities in colleges and universities, medical schools, health maintenance organizations, rehabilitation centers, pain centers and private practice and consultancy offices. Sometimes job descriptions for these setting s are broad, making eligible even professionals from non-psychology fields, such as nursing, public health and social work. However, broad job descriptions can increase the scope for psychologists also.
Training programs
Training in health psychology is offered at three educational levels. Undergraduate courses in health psychology or behavioural medicine, graduate programmes and postdoctoral programmes. Post-doctoral programmes are available particularly for people with doctoral degrees that did not focus on the relationship between health and psychology. However, in India, health psychology is not so grown up as in US and other western countries. In US, dozens of graduate programs now exist, specifically for training.

Health Psychology and Related Fields

Health Psychology is an interdisciplinary field concerned with the application of psychological knowledge and techniques of health, illness and health care. Various disciplines including Psychology and Medicine have done sufficient contributions to Health Psychology. Some of the follows.
Epidemiology, the scientific study of the distribution and frequency of disease and injury, has close relationship with Health Psychology. Epidemiologists determine the occurrence of illness in a given population and organize the data in terms of when and where the disease or injury occurred, and to which gender, age and racial or cultural groups. Some terms used in epidemiology are
a) Mortality: death, on a large scale.
b) Morbidity: illness, injury or disability.
c) Prevalence: the number of cases (previously reported or new) of a disease or of persons infected at risk.
d) Incidence: number of new cases.
e) Epidemic: The incidence, generally of an infection disease has increased rapidly.
Public Health is a field concerned with protecting, maintaining, and improving health through organized efforts in the community. They examine and give orientation about immunization, sanitation, health education and awareness and ways to provide community health services.
Sociology focuses on human social life. It examines groups or communities of people and elevates the impact of various social factors, such as the mass, media, population, growth, epidemics and institution. Medical sociology is a sub-field of sociology, studies a wide range of issues related to health.
Anthropology is the study of human cultures. Medical Anthropology examines differences in health and health care across cultures.
The combined information health psychologist obtain from Epidemiology, public health, sociology and anthropology describes the social systems in which health, illness and person exist and develop. Health Psychology is also related to some non-psychology careers also, such as nursing, physician assistants, dietitians, physical therapists, occupational therapists and social workers.

Current Perspectives of Health and Illness

As WHO defines, in the current perspective, health is a state of well being with physical, cultural, psychosocial, economic and spiritual attributes, not simply the absence of illness. The term Health Promotion was first coined in 1974 by the Canadian Minister of National Health and Welfare, Max Lalonde. According to him, health and illness are not dependent only on medical conditions, but also on the environment and living conditions. WHO (1986) defined Health Promotion as the process of enabling people to increase control over, and to improve their health. To reach a state of complete physical, mental and social well-being an individual or group must be able to identify and to realize aspiration to satisfy needs, to change or cope with the environment. Biopsychosocial model expands the Biomedical view by adding to biological factors the influence of psychological and social factors. It proposes that all three factors affect and are affected by the person’s health.
The role of biological factors in health
Biological factors include the genetic materials and processes by which we inherit characteristics from our parents. It also includes aspects of the person's physiological functioning. The body is made of enormously complex physical systems. The efficient, effective and healthful functioning of these systems depends on the way these components operate and interact with each other.
The role of psychological factors in health
Psychological factors include the behaviour and mental processes of the individual. Cognition, emotion and motivation play a major role in health and illness. Cognition is a mental activity that encompasses perceiving, learning, remembering, thinking, interpreting, behaving and problem solving. Emotion is a subjective feeling that affects our thoughts, behaviour and physiology. Some emotions are positive or pleasant (eg: joy and affection) and others are negative (eg: anger, fear and sadness). Motivation is the force which acts behind a particular behaviour. For instance, a person who is motivated to feel and look better might begin an exercise programme.
The role of social factors in health
Individuals are units of society. Each individual interacts with others and influence as well as gets influenced by others. Society also affects the health of individuals by promoting certain values of our culture. The values can be influenced by different other aspects such as medias and books. Sometimes Medias may encourage unhealthy behaviour. However, as a part of the society, one can write opinions to the mass media, and thus influence it back. Like society, community and family would influence the members they include.
The role of biological, psychological and social factors in health and illness is not hard to see. What is more difficult to understand is how health is affected by this interplay. Health professionals consider the impact of a person's life as a total (holistic) entity in understanding health and illness. According to Engel, this can be achieved by applying the biological concept of system. A system is a dynamic activity with components that are continuously inter-related. Thus body is a system, which includes immune and nervous system, family is a system, and therefore, community and society. These systems have components that inter-relate, such as exchanging energy, substances and information.
While examining Health Psychology, it is important to keep the life span perspective in reference. As people develop, each portion of the life-span is affected by happenings in earlier years, and each affects the happenings in years that will come. In life span perspective, characteristics of a person are considered with respect to their prior development, current level and likely development in future. Life span perspective adds an important dimension to the biopsychosocial perspective in the effort to understand how people deal with issues of health and illness.

Health, Disease and Mind: Research Findings

The word health is derived from Old High German and Anglo-Saxon words meaning whole, hale and holy. Galen, the early Greek Physician, followed the Hippocratic tradition in believing that hygieia (health) and euxia (soundness) occur when there is a balance between the hot, cold, dry and wet components of the body. The four bodily fluids were believed to be blood, phlegm, yellow bile and black bile that were hot and wet, cold and wet, hot and dry and cold and dry respectively. Diseases were thought to be caused by external pathogens that disturbed the balance of the body's four elements. Galen believed that the body's constitution, temperament or state could be put out of equilibrium by excessive heat, cold, dryness or wetness. Such imbalances might be caused by fatigue, insomnia, distress, anxiety, or by the residues of food resulting from the wrong quantity or quality.

In Nineteenth Century, Rudolf Virchow, a German Pathologist, found microscopic organisms that disrupt normal operation of the body and cause disease. This resulted in the bout of Germ theory. The Germ Theory, along with Descartes' dualistic interactionism dominated Medicine and Physiology for 300 years. Both provided an important foundation for the Bio-Medical Model of illness. Hitherto, this model dominated medicine. The Bio-Medical Model has four characteristics.

1. Dualistic: Physical and psycho-social process are separate, and disease is not influenced by the latter.

2. Mechanistic: The body is like a machine. Disease occurs when the normal operation of the body-machine is disrupted by a foreign agent.

3. Deductionistic: Ignores the complexity of factors-some psychological and some physical-that are involved in the health of the whole person by focusing solely on one disease or physical system.

4. Disease oriented: Health is defined as the absence of disease and efforts rarely go beyond the elimination of the disease.

The Germ Theory and Bio-Medical Model led to the development of specific aggressive physical treatments, for diseases, such as;
a) Medication that destroy pathogens or ease pain and suffering were discovered in nature or created synthetically.
b) Vaccines to protect against viral diseases were discovered. (Eg. Polio)
c) Medical technology to diagnose disease was advanced (Eg: x-ray)
d) New surgical procedures (antiseptics and anesthetics) to reduce complication and save lives were discovered.

These resulted in greatest health advancement in human history. Many diseases like Hepatitis B, Influenza, Malaria, Mumps, Measles, Pneumonia, Rabies, Tetanus, Tuberculosis etc. which are found to be the results of pathogenic attack began to get treated. The three Ds of Bio-Medical Model is Diagnosis, Disease and Drugs

However, Bio-Medical Model has been challenged by two recent trends.
1) Changing patterns of illness
2) Escalating cost of health care.
The changing pattern of illness is the result of several factors.
1) The decline of contagious diseases, due partly to success of Bio-Medical Model.
2) The decline in the rate of infant mortality.
The increase in the non-contagious diseases is largely the result of people living longer and engaging in health compromising behaviour.

Psychiatrist George Engel (1977) was the first to propose a Bio-Psycho-Social Model of illness. He said that health and illness are a consequence of physical, psychological, and cultural variables. The three Ps of Bio-Psycho-Social Model - People, Prevention, Psychology - can be contrasted with the three Ds of Bio-Medical Model. By stating that a model of disease must take the patient into account, Engel repudiated the Bio-Medical Model and Dualism. Bio-Psycho-Social model stands for the idea; people are "individual mind-body complexes ceaselessly interacting with the social and physical environment in which they are embodied".
Bio-Psycho-Social Model is actually a return to holism, which existed at the time of Hippocrates - the Father of Medicine. According to Bio-Psycho-Social Model, health and illness are states of being that result from multiple factors and have multiple effects. These multiple factors include biological and physiological processes, pathogens and chemical imbalances, as well as psychosocial processes, personality and behaviour. The mind and body are not separate independent entities. They are two aspects of the whole person.

The relation between Medicine and Psychology can be traced back at least to the period of ancient Greece. This relationship is more formalized by the works of Sigmund Freud in Twentieth Century. He noticed that some patients showed symptoms of physical illness without any organic disorders. He attributed these illnesses to unconscious mental conflicts and called the disorder conversion hysteria. He believed that mental conflicts were being converted into physical symptoms.

Today, conversion hysteria is among a category of psychological disorders called somatoform. Under dualistic tradition, physicians have been involved only when there is a verifiable organic pathology. Somatoform disorders was regarded as a domain of psychiatrists or psychologists.
The ancient Greek Holists, Hippocrates among them, believed that mind and body should not be separated and studied independently. In Twentieth Century, Freud's psychiatric contemporaries showed interest in researches combining psyche (mind) and soma (body), which came to be known as psycho-somatic medicine. The term psychosomatic does not mean a person's symptoms are imaginary. It means that mind and body are both involved. Until 1960s or so, research in psychosomatic medicine focused on psycho-analytic interpretation for specific, real health problems including ulcer, high blood pressure, asthma, migraine headaches, and rheumatoid arthritis. After 1960s, it focused on new approaches. Currently, it is a broader field concerned with the inter-relationships among psychological and social factors, biological and physiological functions and the development and course of illness.

Two new fields emerged in 1970s to study the role of Psychology in illness. One is Behavioural Medicine and the second one, Health Psychology.

The field of Behavioural Medicine was launched in association with the National Academy of Sciences. This field has two defining characteristics.

1. Its membership is inter-disciplinary, including Psychology, Sociology and various areas of Medicine.

2. It grew out of the perspective of behaviourism, which proposed that people's behaviour results from learning (conditioning).

Conditioning methods has shown a good deal of success as therapeutic approaches in helping people modify problem behaviours such as over eating and emotions such as anxiety and fear.
Behaviourism served as an important foundation for Health Psychology - a field that is principally within the discipline of Psychology. In APA, the division of Health Psychology was introduced in 1978. The Journal "Health Psychology" began publication four years later.

Matarazzo, the First President of the division in APA, outlined four goals of Health Psychology.

1. To promote and maintain health: Psychologists study such topics as why people do and don't smoke cigarettes, use safety belts in cars, drink alcohol and eat particular diets. Health Psychologists can help in the design of school health education programmes and media campaigns to encourage healthful lifestyles and behaviour.

2. To prevent and treat illness: Psychological principles have been applied effectively in preventing illness, such as in reducing high blood pressure and therefore, the risk of heart disease and stroke. For those people who become seriously ill, psychologists with clinical training can help them adjust to their current condition, rehabilitation programme and future prospects, such as reduced work or sexual activity.

3. To identify the causes and diagnostic correlates of health, illness and related dysfunction: Psychologists study the causes of disease. Psychologists also study physiological and perceptual processes which affect people's experience of physical symptoms.

4. To analyze and improve health care systems and health policy: Psychologists contribute toward this goal by studying how characteristics or functions of hospitals, nursing homes, medical personnel and medical costs affect patients. The resulting knowledge enables them to make recommendations of improvement, suggesting ways to help physicians and nurses become more sensitive and responsive to the needs of patients and to make the system more accessible to individuals who fail to seek treatment.

According to Matarazzo (1982), Health Psychology is the aggregate of the specific educational, scientific, and professional contribution of the discipline of psychology to the promotion and maintenance of health, the prevention and treatment of illness, the identification of etiologic and diagnostic correlates of health, illness, and related dysfunction and to the analysis and improvement of the health care system and health policy formation. Matarazzo's definition has been adopted by the American Psychological Association (APA), the British Psychological Society and other organizations. It serves as Health Psychology's official definition.

Need for Health Psychology: Research Findings

Observing the current environment, one can see that some people are ill more frequently than most people do. This difference between the people can result from medical sources, such as variation in physiological processes and exposure to harmful micro-organisms. Psychological and social factors also play roles in it. Two of them, which have to be given more attention are life style and personality of a person.
Nineteenth Century was absolutely revolutionary in the case of health and illness. Infectious diseases declined sharply. Nutrition and personal hygiene improved. This brought changes in the life style of the individuals.
Today, the chief health problems in the technological societies are chronic diseases. The risk factors behind these may be biological, or it may be behavioural. For example, people who smoke cigarettes have higher risk of developing cancer and other illnesses than non-smokers do. Any risk factor is associated with a health problem. It does not necessarily cause the problem. For instance, poverty is a risk factor for cancer, but it does not cause the disease.
Life Style and Illness
Many risk factors result from the way people live or behave. Some behavioural risk factors associated with five leading causes of death are
1) Heart disease: Smoking, high dietary cholesterol and lack of exercise.
2) Cancer: Smoking, high alcohol use, and diet.
3) Stroke: Smoking, high dietary cholesterol and lack of exercise.
4) COPD (Chronic lung diseases, eg: emphysema): Smoking.
5) Accidents (including motor vehicle): alcoholic drug use driving vehicles too fast, and not using seat belts.
Many of the people who are the victims of these illness and accidents live for at least a short while and either recover or eventually succumb. Part of today's high medical costs result from people's life styles that contribute to their health problems. Most health care efforts and funds are directed towards treating illness, not preventing it.
One reason of people behaving in unhealthy way is due to the cravings for immediate pleasure. Another reason is social pressure. Some such behaviours may become strong habits. Quitting them becomes very difficult. These people need information about the way to protect their health.
Personality and Illness
The term personality refers to a person's cognitive, affective and behavioural tendencies that are fairly stable across time and situation. Researchers have found evidence linking personality traits and health. For example, people whose personalities include high levels of anxiety, depression, anger/hostility or pessimism seem to be at risk for developing a variety of illnesses, particularly heart disease. These four emotions are reactions that often occur when people experience stress.
People differ in the way they deal with stressful situation. Many people approach these situations with relatively positive emotions. Their outlook is more optimistic than pessimistic. The link between personality and illness is not a one way route. Illness can affect one's personality, too. People who suffer from serious illness and disability often experience feelings of anxiety, depression, anger and hopelessness.
Optimum Health
As WHO defines, health is a state of complete physical, mental and social well-being and not merely the absence of disease and illness. This definition points out that health requires not just optimal physical functioning, but optimal mental and social functioning as well. Thus health is broadly related to the overall quality of life. It involves the internal state and the external community.
Psychology and Health
The definition of optimum health clearly implies a role of psychologists in health. Psychologists have been interested in physical health for a long time, but health psychology has taken a while to develop to its current state.

Mind-Body Relationship: Research Findings

Ancient philosophers like St.Augustine and St.Thomas believed that there was a complete division between mind and body. It was the philosophers from Seventeenth Century, for the first time pointed out that mind and body were related in significant way.

Descartes (1596-1650) was well aware of the physiological knowledge of the actions of muscles, nerves and other biological structures, the circulation of blood (discovered by Harvey) and of digestion correctly. He knew that muscles operate in opposing pairs. He speculated the functioning of nerves to be important for sensation and for movement. He also speculated that nerves are hollow tubes which carry animal spirits in different direction. Animal spirits are the material substances which could move quickly. Descartes said that human body is just like a machine, when it is considered without its soul. He pointed out that animals are only machines with various kinds of reflexes, instincts and other automatic actions. Animals have no souls, and therefore, they are automata. This is a mechanical view about the nature of the body. The view assumes that body refers to all that is unanimate. There is a soul or mind in every person. It is a thinking substance, which has the power to direct and alter the mechanical activities of the body. Soul refers to all that is in us.

For Descartes, mind and body consists of two different substances. Body consists of extended matter, but soul consists of unextended matter. However, they are connected in some activities such as sensation, emotions and perceptions. Thus the relationship between the mind and body is one of the interactions. Pineal gland is the point of interaction, because it is the only one which has no pairs. For instance, the images from the two eyes set up action in animal spirits, which stimulates pineal gland making an impression on it. Through mind, one would sense the impression. If the mind wishes to remember something, the pineal gland gets activated, set up animal in pores of brain to find out traces left by the objects or events encountered previously. Descartes' psychological interactionism served as a model for several modern psychological schools like psychoanalysis and functionalism.

Gotfried Leibnitz (1646-1716), a great mathematician, wrote in his Nouveaux Essais about psychological parallelism, which relates spirit or mind monads to body monads, an alternative theory to Descartes' interactionism. The monad is an element of all being and a point of force. It is indestructible, uncreatable and inimitable, but it is not static. For Leibnitz, world is an infinite pluralism of independent monads. A human individual is made up of many monads. Some monads have higher degree of consciousness and some have lower degree of consciousness (unconsciousness). Leibnitz called lower degree of consciousness as petiles perception (little perception). For example, the sound of single falling drop of water may be regarded as petiles perception. These monads will not interact. Each monad is self contained. Thus, mind monads and body monads are not usually related. They follow a parallel course (Parallelism). Leibnitz concepts of degree of consciousness and unconsciousness were the major source for Freud and Jung. It was not Freud, but Leibnitz, who used the term conscious first.

Benedict Spinoza (1632-1677), pointed out that mind and body could not be separated from each other. They are different aspects of same substances. As they are different aspects, bodily activities do not affect or cause changes in mental activities and mental activities do not affect bodily activities (Psychological double aspecticism).

Recent approaches denied the existence of mind. It is called Monism. The first support in modern period for monism was given by J.B.Watson.