Nowadays, a number of institutions and health care specialists are able to incorporate into their practice a holistic view on human health as a complex construct. In fact, health depends on overall wellness, composed of multiple factors, including psychological, sociocultural, socioeconomic, environmental, biological and many other determinants. Therefore, health imbalance, or illness, is associated with the deviation of variables composing certain factor from the standard, or quality of life, which refers to the maintenance of good health. The present paper is intended to discuss the multi-factorial model of health and address the contribution of psychology to explaining the problems of migraine headache and coronary heart disease.
According to the textbook, multi-factorial model is “the belief that health and illness are a function of multiple factors involving biological, psychological, and cultural domains, and their interactions”. As one can assume, this approach is quite broad and takes into consideration a number of characteristics in order to define the illness, understand its causes and find an appropriate remedy. Biological factors of health and illness include age, gender, race and ethnicity, genetic predisposition, disability, health and medication history, family history and many other determinants. Environmental aspects, normally considered by physicians, are dwelling safety, vehicular safety, exposure to various chemicals, radiation, water quality and many others. The groups of behavioral factors consists of habits, safety practices and adherence to health care checks. Personality factors include extroversion, neuroticism, optimism and many other traits. Stressors include significant life changes like divorce, birth of a child and minor daily routines, which might cause irritation, like preparing meals. Among sociocultural determinants, sicoeconomic status, family situation and employment are normally considered. For instance, a certain health imbalance might be associated with psychological traumas, negative ecological situation in the area, family upbringing, genetic predisposition, lack of coping abilities and high vulnerability to minor stressors. Certainly, this model requires a holistic assessment of the patient including physical examination, analysis of the social situation and environment, psychological testing and interviewing and so forth. However, as a result, the physician receives a comprehensive picture of the roots of the client’s current problems and has an opportunity to anticipate future risks and successfully prevent them. The intervention is likely to involve not merely the physical mitigation of negative symptoms, but also preventative measures which allow ensuring the ailment will not recur.
Migraine headaches refer to a type of headaches that “usually have a sudden onset and are identified by severe throbbing pain on one side of the head”. Neuropsychologists made a substantial contribution to explaining the causes of migraine, having proven that stress is amongst the most important causes of this persisting pain. Psychology has a rich legacy of stress research, especially in terms of “social” stressors like family life change or job –related stressors, so psychologists offer specific tools of preventing migraine like avoiding work overloads, time management, relationship management and conscientious approach to radical life changes.
As for the relationship between personality and depression, “investigators in one study found that women who experienced regular migraines, as opposed to those who did not, tended to be more self-critical, more likely to catastrophize stress and pain and less likely to seek social support when under stress”. Therefore the way the person responds to stress and headache as an important stressor is also a determinant of the frequency and intensity of migraine. It also needs to be noted that migraines are physically associated with the intake of tobacco, chocolate and alcohol, and psychologists thus draw an interrelation between addition to these products and migraine. In this sense, the health problem persists due to the fact that the individual is not able and often not willing to quickly eliminate those behavioral patterns which result in the emergence or intensification of headache. Therefore, psychologists offer a unique toolkit of migraine treatment including behavioral techniques like relaxation, psychological education.
Psychology also played an important role in the development of a comprehensive approach to coronary heart disease. In particular, neuropsychologists proved that this health problem is partly caused by stress and given the abundance of stress studies, psychologists created stress management techniques that decrease the probability of the disease. In addition, “Most studies suggest that there is at least a modest relationship between Type A behavior and CHD. Evidence also shows that reducing Type A behavior patterns can lower the risk of recurrent heart attacks”. Type A behavior is well-explained in psychology and refers to impatience, aggressiveness, striving for recognition and perceived time urgency. Similar studies that people with higher levels of hostility and irritable individuals, who easily fall in anger, are more prone to CHD. Therefore, purely psychological approach to CHD therapy is associated with emotion management and development of more constructive ways of emotion expression.
As one can conclude, the multi-factorial model implies taking into consideration various groups of factors in clinical settings. Psychology plays an important role in understanding the nature of disease, explaining its causes and defining appropriate intervention and further prevention. The present paper has demonstrated that health psychology considers mostly behavioral patterns like habits, coping practices, patterns of response to stressors and emphasizes the development of self-control and stress management skills in illness prevention and treatment.
References
Psychological factors and health, Chapter 4.