PSYC6003 – Psychosocial Aspects of Illness and Disability

Module Profile

Click here for the module profile.

Module Outline

The module will cover a range of different illnesses and conditions and will examine the psychosocial predictors and sequelae of those illnesses. A variety of topics will be covered, including coping with chronic illness and associated emotional distress and disability, the impact of illness upon the family, psychological aspects of progressive diseases, and the role of psychoneuroimmunology in health and illness. Furthermore, a number of specific illnesses will be covered in depth, including chronic pain, cancer, diabetes, coronary heart disease, and traumatic brain injury. The lectures will consider a range of different models used to explain the coping and adjustment processes in health care, and will include current research literature along with a range of “real life” interviews with patients and their families who have experienced these conditions. These interviews are not role-plays or scripted in any way and despite the fact that some are emotional, they will be used to illustrate particular points related to the lectures.

In addition to reviewing current knowledge and theoretical perspectives, the lectures will also try to raise ideas for student research projects and will provide comprehensive reference lists of the material covered.

Seminar	Lecturer	Date
1. Causality	Dr Daniel Schoth	7th October 2020
2. Symptom Perception and Illness Representations	Dr Daniel Schoth	14th October 2020
3. Pain	Professor Christina Liossi	16th October 2019
4. Paediatrics	Professor Christina Liossi	23th October 2019
5. PNI (Psychoneuroimmunology)	Dr Daniel Powell	30st October 2019
6. Coping with chronic illness	Dr Simone Holley	6th November 2019
7. Coronary Heart Disease	Professor Paul Bennett	13th November 2019
8. Cancer	Professor Christina Liossi	20st November 2019
9. Diabetes	Dr Katie Greenfield	27th November 2019
10. Neurological Disability and the Family	Dr Katie Greenfield	4th December 2019
11. Placebo	Dr Felicity Bishop	11th December 2019
12. Tutorial	Professor Christina Liossi	8th January 2020

All seminars are scheduled for Wednesday mornings, 10am to 1pm in building 54 room 10037 – Seminar Room 10B.

Assessment

Informal in-class activities provide the opportunity for formative feedback.

The learning outcomes for this module are assessed through one exam and two pieces of coursework:

• Exam – 2 hours (40%)
• Marked assignment: 3,000 word essay (60%)
• Skills portfolio

Exam

Further details will be provided in class.

Essay

Essay titles: choose one of the following essay titles:

• Discuss how stress can affect health outcomes via psychoneuroimmunological or psychoneuroendocrinological pathways. Describe and critically evaluate evidence with regards to a specific chronic illness of your choice.
• Critically discuss how parental factors can influence children’s perception of acute and chronic pain.
• Critically discuss the effectiveness of psychological interventions in improving quality of life in cancer.
• With reference to chronic illness and disability, critically discuss the role of information in patient coping, considering the different sources of information available.

Skills Portfolio

In order to complete the Skills Portfolio PSYC6003, you will attend a number of specific sessions on the MSc Health Psychology Skills Training Programme. You will also upload specific documentation regarding these sessions, typically a short reflective log. A complete portfolio must be submitted in order to Pass this module.  For details about the portfolio, please see the MSc Health Psychology Skills Programme module on Blackboard.

Note on Referrals

Students who fail the exam will take a resit.  Students who fail the coursework will redo the coursework.

Lecture outlines

Causality – Dr Daniel Schoth

Debated for thousands of years, the notion of causality is considered central within the social sciences. Determining whether changes in one variable actually influence changes in another variable is not always easy however, or necessarily even the goal of empirical investigation. What is the nature of a causal claim? What criteria do scientists use when deciding whether a causal connection exists? What are the most appropriate research methods for exploring causal relationships? This seminar will address important questions such as these, and how they relate to contemporary issues in the field of health psychology.

Essential Readings

Hill, A. B. (1965). The environment and disease: association or causation? Proceedings of the Royal Society of Medicine, 58: 295 – 300.

Ford, E. S., Bergmann, M. M., Boeing, H., Li, C., & Capewell, S. (2012). Healthy lifestyle behaviours and all-cause mortality among adults in the United States. Preventive Medicine, 55: 23 – 37.

Recommended Readings

Kubzansky, L. D., & Kawachi, I. (2000). Going to the heart of the matter: do negative emotions cause coronary heart disease? Journal of Psychosomatic Research, 48: 323 – 337.

Dienes, Z. (2008). Understanding psychology as a science: an introduction to scientific and statistical inference. New York: Palgrave Mcmillan

Moses, J. W. & Knutsen, T. L. (2012). Ways of knowing: competing methodologies in social and political research. China: Palgrave Mcmillan. Chapters 3, 5.

Symptom Perception and Illness Representations – Dr Daniel Schoth

This session will address the role of patients’ perceptions in the interpretation of somatic experiences. The session examines some of the psychological, social and cultural factors that influence how people make sense of and respond to symptoms. We will look at various models of symptom perception, both generic and illness specific – with a focus on symptom perception in chronic fatigue syndrome. The common sense model of illness will be presented as a model for understanding patients’ beliefs about their illness and symptoms, and how these affect the way in which they respond and cope with their illness.

Essential class readings

Cioffi, D. (1991). Beyond attentional strategies: A Cognitive-Perceptual Model of somatic interpretation. Psychological Bulletin. 109(1):25-4.

Hagger, M. S., & Orbell, S. (2003). A meta-analytic review of the common-sense model of illness representations. Psychology & Health, 18(2), 141-184.

Moss-Morris, R. (2005). Symptom perceptions, illness beliefs and coping in chronic fatigue syndrome. Journal of Mental Health, 14(3), 223-235.

Recommended Readings

Kolk, A. M. et al.(2003). A symptom perception approach to common physical symptoms. Social Science and Medicine, 57: 2343-2354.

Petersen S, van den Berg RA, Janssens T, Van den Bergh O. (2011). Illness and symptom perception: a theoretical approach towards an integrative measurement model. Clinical Psychology Review, 31(3):428-39.

 

Pain – Professor Christina Liossi

This session will review the biopsychosocial literature relating to pain and its assessment and management. The session will outline the various models of acute and chronic pain, will review assessment and measurement tools in the area and will critically evaluate the literature relating to the efficacy of psychological interventions in pain management.

Essential Readings

Williams, A. C. de C. (2002). Facial expression of pain: an evolutionary account. Behavioral and Brain Sciences, 25(4), 439-455.

Gatchel R. J., Peng Y. B., Peters M.L., Fuchs P.N., Turk D.C. (2007). The biopsychosocial approach to chronic pain: scientific advances and future directions. Psychological Bulletin, 133(4): 581-624.

Eccleston, C., & Crombez, G. (1999). Pain demands attention: a cognitive-affective model of the interruptive function of pain. Psychological Bulletin, 125(3), 356 – 366.

Williams A. C. D. C, Eccleston C, Morley S. Psychological therapies for the management of chronic pain (excluding headache) in adults. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD007407. DOI: 10.1002/14651858.CD007407.pub3.

Lumley MA, Cohen JL, Borszcz GS, Cano A, Radcliffe AM, Porter LS, Schubiner H, Keefe FJ. (2011). Pain and emotion: a biopsychosocial review of recent research. J Clin Psychol. Sep;67(9):942-68.

 

Paediatrics – Professor Christina Liossi

This session will introduce you to the field of paediatric psychology. After providing a brief overview of conditions specific to the field of paediatric, the session will move onto to review the research in six key areas: assessment, adjustment, chronic illness, the family, interventions and prevention/promotion. Throughout, the session will focus on the evaluation of current theory.

Essential class readings

Koopman, H.M., Baars, R.M., Chaplin, J. & Zwinderman, K.H. (2004). Illness through the eyes of the child: the development of children’s understanding of the causes of illness Patient Education and Counseling, 55, 363-370.

Bogosian, A., Moss-Morris, R., & Hadwin, J. (2010). Psychosocial adjustment in children and adolescents with a parent with multiple sclerosis: a systematic review, Clinical Rehabilitation, 24(9), 789-801.

Background readings

Sawyer, S.M., Drew, S., Yeo, M.S., & Britto, M.T. (2007) Adolescents with a chronic condition: challenges living, challenges treating. Lancet, 369, 1481-1489.

Myant, K.A., & Williams, J.M. (2005). Children’s concepts of health and illness: Understanding of contagious illnesses, non-contagious illnesses and injuries. Journal of Health Psychology, 10(6), 805-819.

Zimmermann Tansella C. (1995). Psychosocial factors and chronic illness in childhood. Eur Psychiatry, 10(6):297-305.

Kibby, M. Y., Tyc, V. L., & Mulhern, R. K. (1998). Effectiveness of psychological interventions for children and adolescents with chronic medical illness: A meta-analysis. Clinical Psychology Review, 18(1), 103-117.

Drotar, D. (1997). Relating parent and family functioning to the psychological adjustment of children with chronic health conditions: What have we learned? What do we need to know? Journal of Pediatric Psychology, 22(2), 149-166.

Evans, C. A., Stevens, M., Cushway, D., & Houghton, J. (1992). Sibling response to childhood cancer: A new approach. Child: Care, Health and Development, 18, 229-244.

 

PNI – Dr Daniel Powell

In this session we will explore the topical field of psychoneuroimmunology (PNI): the influence of psychological factors on endocrine and immune function. This increasingly popular field has numerous applications within the physical health domain, for both acute and chronic illness. A number of review articles are included in the readings, together with articles that focus on more specific illnesses studied within this field. In particular the relationship between emotions, stress and illness will be explored together with current models for understanding their consequences for health and illness. Moderators of stress such as social support, coping and nutrition will also be considered.

Preparation: give some thought to what makes you feel stressed, what coping mechanisms you employ to deal with stress, and your personal or observed experience of the effects of stress.

Essential Readings

Kiecolt Glaser, J. K., McGuire, L., Robles, T. F., & Glaser, R. (2002). Psychoneuroimmunology: Psychological influences on immune function and health. Journal of Consulting and Clinical Psychology, 70(3), 537-547.

Lutgendorf, S. K., & Costanzo, E. S. (2003). Psychoneuroimmunology and health psychology: An integrative model. Brain, Behavior, and Immunity, 17(4), 225-232.

McEwen, B. S. (1998). Protective and damaging effects of stress mediators. The New England Journal of Medicine, 338(3), 171-179.

Background Readings

Further to the above, choose one of the following that is of interest to you.

Antoni, M. H., Lechner, S., Diaz, A., Vargas, S., Holley, H., Phillips, K., et al. (2009). Cognitive behavioral stress management effects on psychosocial and physiological adaptation in women undergoing treatment for breast cancer. Brain, Behavior, and Immunity, 23(5), 580-591.

Cohen, S., Frank, E., Doyle, W.J., Skoner, D.P., Rabin, B.S., Gwaltney, J.M. (1998). Types of stressors that increase susceptibility to the common cold. Health Psychology, 17 (3), 214-223.

Dube, S. R., Fairweather, D., Pearson, W. S., Felitti, V. J., Anda, R. F., & Croft, J. B. (2009). Cumulative childhood stress and autoimmune diseases in adults. Psychosom Med, 71(2), 243-250.

Garssen, B., & Goodkin, K. (1999). On the role of immunological factors as mediators between psychosocial factors and cancer progression. Psychiatry Research, 85, 51-61.

Ironson, G., & Hayward, H. (2008). Do positive psychosocial factors predict disease progression in HIV-1? A review of the evidence. Psychosom Med, 70(5), 546-554.

Klumb, P., Hoppman, C., & Staats, M. (2006). Work hours affect spouse’s cortisol secretion – for better and for worse. Psychosomatic Medicine, 68, 742-746.

Kiecolt Glaser, J. K. (2010). Stress, food, and inflammation: Psychoneuroimmunology and nutrition at the cutting edge. Psychosomatic Medicine, 72, 365-369.

Miller, G. E., Chen, E., & Zhou, E. S. (2007). If it goes up, must it come down? Chronic stress and the hypothalamic-pituitary-adrenocortical axis in humans. Psychologicl Bulletin, 133(1), 25-45.

Schedlowski, M. & Pacheco-López, G. (2010). The learned immune response: Pavlov and beyond. Brain, Behavior and Immunity, 24, 176-185.

Sephton, S. E., Dhabhar, F. S., Keuroghlian, A. S., Giese-Davis, J., McEwen, B. Ionan, A. C., & Spiegel, D. (2009). Depression, cortisol, and suppressed cell-mediated immunity in metastatic breast cancer. Brain, Behavior and Immunity, 23, 1148-1155.

Steptoe, A., & Marmot, M. (2006). Psychosocial, hemostatic, and inflammatory correlates of delayed poststress blood pressure recovery. Psychosomatic Medicine, 68, 531-537.

Tsigos, C. & Chrousos, G. P. (2002). Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. Journal of Psychosomatic Research, 53, 865-971.

 

Coping with chronic illness – Dr Simone Holley

This session will review the literature relating to the development of coping skills in chronic illness. It will consider various models of coping, and critically evaluate their application to a variety of chronic medical conditions including pain and cancer. This seminar will also review the role of information in the development and implementation of coping strategies, along with individual difference variables including age and gender.

Essential class readings

(will be discussed in class)

McCracken, L. M., & Samuel, V. M. (2007). The role of avoidance, pacing, and other activity patterns in chronic pain. PAIN, 130(1), 119-125.

Berger, M., Wagner, T. H., & Baker, L. C. (2005). Internet use and stigmatized illness. Social science & medicine, 61(8), 1821-1827.

Tamres, L. K., Janicki, D., & Helgeson, V. S. (2002). Sex differences in coping behavior: A meta-analytic review and an examination of relative coping. Personality and social psychology review, 6: 2-30.

Recommended readings

Greenlagh, T. (2009). Chronic Illness: Beyond the expert patient, British Medical Journal, 338: 629-631

Endler, N. S., Kocovski, N. L., & Macrodimitris, S. D. (2001). Coping, efficacy, and perceived control in acute vs chronic illnesses. Personality and Individual Differences, 30: 617-625.

McCabe, M.P., McKern, S., & McDonald (2004). Coping and psychological adjustment among people with multiple sclerosis. Journal of Psychosomatic Research, 56: 355-361.

Compas, B.E., Jaser, S.S., Dunn, M.J., & Rodriguez, E.M. (2012). Coping with chronic illness in childhood and adolescence, Annual Review of Clinical Psychology, 8: 455-480.

Coronary heart disease: Professor Paul Bennett

You will learn about the underlying pathophysiology of CHD, and empirical evidence linking psychological and social factors with CHD. You will also examine some models of cardiac rehabilitation and consider their effectiveness, before a workshop in which you will develop your own model cardiac rehabilitation programme.

Essential Readings

Richards, S.H., Anderson, L., Jenkinson, C.E…..Bennett, P. et al. (2017). Psychological interventions for coronary heart disease. The Cochrane Library, Issue 4. Art. No.: CD002902.

Jolly K, Taylor RS, Lip GY, Stevens A. (2006). Home-based cardiac rehabilitation compared with centre-based rehabilitation and usual care: a systematic review and meta-analysis. Int J Cardiol.  Aug 28;111(3):343-51.

Background Readings

Bennett P. (2017) Cardiovascular rehabilitation. In, J. Niebauer (ed.) Cardiac rehabilitation manual.  2^nd edition. Berlin: Springer.

Orth-Gomér K. (2007) Psychosocial and behavioral aspects of cardiovascular disease prevention in men and women. Curr Opin Psychiatry. Mar;20(2):147-51.

Bennett P. (2007). Cardiac rehabilitation. In P Kennedy (ed.) Psychological care of patients with chronic disease.

 

Cancer – Professor Christina Liossi

This session aims to provide you with an introduction to psychosocial oncology.  Amongst the topics covered will be aetiology and incidence of cancer, symptom detection and management, psychological consequences, population-specific issues and research.  It will view the cancer journey and consider the psychological sequelae at different points of this trajectory. The session will also review models of coping and adjustment and clinically relevant interventions for both patients and carers.

Essential Readings

Breitbart, W.S., & Alici, Y. (2009). Psycho-Oncology. Harvard Review of Psychiatry, 17, 361-76.

Osborn RL, Demoncada AC, Feuerstein M. (2006). Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. International Journal of Psychiatry in Medicine, 36 (1), 13-34.

Stephen, J.E., Rahn, M., Verhoef, M., Leis, A. (2007). What is the state of the evidence on the mind-cancer survival question, and where do we go from here? A point of view. Supportive Care in Cancer, 15, 923-30.

 

Diabetes – Dr Katie Greenfield

This session will introduce the literature on diabetes mellitus and briefly describe its key features and prevalence. The session will outline the psychosocial burden of living with diabetes, including effects both on the patient and their families. We will discuss relevant theoretical models and examine the relationship between the beliefs that diabetic patients have and their management outcomes. Finally, we will evaluate the recent research in this area and the success of psychosocial interventions with this population.

Essential class readings

Harvey, J. N., & Lawson, V. L. (2009). The importance of health belief models in determining self-care behaviour in diabetes. Diabetic Medicine, 26: 5-13.

Peyrot M., Rubin R. R. (2007). Behavioral and psychosocial interventions in diabetes: a conceptual review. Diabetes Care, 30: 2433–2440.

Background readings

Ismail, K., Winkley, K., & Rabe-Hesketh, S. (2004). Systematic review and meta-analysis of randomised controlled trials of psychological interventions to improve glycaemic control in patients with type 2 diabetes. The Lancet, 363: 1589-1597.

Winkley, K. ,Ismail,k., Landau, S. &Eisler, I. (2006). Psychological interventions to improve glycaemic control in patients with type 1 diabetes: systematic review and meta-analysis of randomised controlled trials, BMJ, 333 (2006), 65-70.

Peyrot, M., Rubin, R. R., Lauritzen, T., Snoek, F. J., Matthews, D. R., Skovlun, S. E. (2005). Psychosocial problems and barriers to improved diabetes management: results of the Cross-National Diabetes Attitudes, Wishes and Needs (DAWN) Study. Diabetic Medicine, 22: 1379-1385.

White, P., Smith, S.M., Hevey, D., O’ Dowd, T. (2009). Understanding type 2 diabetes: including the family member’s perspective. Diabetes Educator, 35: 810-817.

 

Neurological Disability and the Family – Dr Katie Greenfield

This session will review the psychological literature regarding coping and adaptation to neurological disability. The literature reviewed will be concerned with the adaptation of an individual with neurological disability as well as their family. The role of psychosocial support will be considered and a review of the literature relating to this sphere will be provided. Specific neurological entities such as brain injury and dementia will be used as a vehicle on which to attach the relevant psychological literature.

Essential Readings

Harmell AL, Chattillion EA, Roepke SK, Mausbach BT. (2011). A review of the psychobiology of dementia caregiving: a focus on resilience factors. Curr Psychiatry Rep, 13(3):219-24.

Backhaus, S. L., Ibarra, S. L., Klyce, D., Trexler, L. E., & Malec, J. F. (2010). Brain injury coping skills group: A preventative intervention for patients with brain injury and their caregivers. Archives of physical medicine and rehabilitation, 91(6), 840-848.

Background Readings

Chien LY, Chu H, Guo JL, Liao YM, Chang LI, Chen CH, Chou KR. (2011). Caregiver support groups in patients with dementia: a meta-analysis. Int J Geriatr Psychiatry, 26(10):1089-98.

Chu, Y., Brown, P., Harniss, M., Kautz, H., & Johnson, K. (2013). Cognitive support technologies for people with TBI: current usage and challenges experienced. Disability and Rehabilitation: Assistive Technology, (0), 1-7.

van Vliet D, de Vugt ME, Bakker C, Koopmans RT, Verhey FR. (2010). Impact of early onset dementia on caregivers: a review. Int J Geriatr Psychiatry, 25(11):1091-100.

Chevalier, Z., Kennedy, P., & Sherlock, O. (2009). Spinal cord injury, coping and psychological adjustment: a literature review. Spinal Cord., 11: 778 – 782
Levack WM, Kayes NM, Fadyl JK. (2010). Experience of recovery and outcome following traumatic brain injury: a metasynthesis of qualitative research. Disabil Rehabil, 32(12):986-99.

Liossi, C., & Wood, R. L. (2009). Gender as a moderator of cognitive and affective outcome after traumatic brain injury. J Neuropsychiatry Clin Neurosci, 21(1), 43-51.

Wood, R. L., & Liossi, C. (2007). The relationship between general intellectual ability and performance on ecologically valid executive tests in a severe brain injury sample. J Int Neuropsychol Soc, 13(1), 90-98.

The Placebo Effect: Theory and Practice-  Dr Felicity Bishop

The placebo effect is a term that has been widely used in health literature and its nature has been the focus of increasing research in recent years. A key conclusion of recent research is that there is not one placebo effect, but many, and that these effects are mediated by different psychological and neurobiological mechanisms. In the case of placebo analgesia, several placebo effects have been identified and some have argued that clinicians could ethically augment treatment effects in routine clinical practice. The first part of this session will explore neurobiological, cognitive and conditioning processes involved in placebo mechanisms with a particular focus on placebo analgesia. In the second part of the session we will explore practical applications of the placebo effect, discussing the evidence and ethics of prescribing placebos in the context of patient-centred care.  By the end of this session you will be able to explain key mechanisms underpinning the placebo effect and debate the ethics of prescribing placebos.

Essential Readings

Colloca L (2019). The Placebo Effect in Pain Therapies. Annual Review of Pharmacology and Toxicology, 59, 16.1–16.21. https://doi.org/10.1146/annurev-pharmtox-010818-021542

Kaptchuk TJ, Friedlander E, Kelley JM, Sanchez MN, Kokkotou E, et al. (2010) Placebos without Deception: A Randomized Controlled Trial in Irritable Bowel Syndrome. PLoS ONE 5(12): e15591. doi:10.1371/journal.pone.0015591

Background Readings

Bishop FL, Jacobson EE, Shaw J, Kaptchuk TJ. (2012) Participants’ Experiences of Being Debriefed to Placebo Allocation in a Clinical Trial. Qualitative Health Research, 22(8), 1138-1149. PMID: 22673094

Bishop FL, Jacobson EE, Shaw J, Kaptchuk TJ. (2012) Scientific tools, fake treatments, or triggers for psychological healing: How RCT participants conceptualise placebos. Social Science & Medicine, 74, 767-774. PMID: 22285289

Charlesworth JEG et al. (2017). Effects of placebos without deception compared with no treatment: A systematic review and meta-analysis. Journal of Evidence-Based Medicine, 10, 97–107. DOI:10.1111/jebm.12251

Hardman, D. I., Geraghty, A. W., Lewith, G., Lown, M., Viecelli, C., & Bishop, F. L. (2018). From substance to process: A meta-ethnographic review of how healthcare professionals and patients understand placebos and their effects in primary care. Health. https://doi.org/10.1177/1363459318800169 (Available on Blackboard)

Linde K, Atmann O, Meissner K, Schneider A, Meister R, Kriston L, et al. (2018)
How often do general practitioners use placebos and non-specific interventions? Systematic review and meta-analysis of surveys. PLoS ONE, 13(8), e0202211. https://doi.org/10.1371/journal.pone.0202211

Stewart-Williams, S., & Podd, J. (2004). The placebo effect: Dissolving the expectancy versus conditioning debate. Psychological Bulletin, 130, 324-340.

 

Tutorial – Professor Christina Liossi

This session focuses on feedback on your assignment and exam preparation. During the session you will have the opportunity to discuss feedback on your assignment and you will also be given details about the exam. You will have the opportunity to ask questions about the exam and work through example exam questions in class.