The first is the importance of behavioral science in health. In all of these and more I could have listed, behavior is a critical, if not the critical, factor. And if we encourage behavioral science, with all the sub- and cross- and inter-disciplinary perspectives that implies, we will be addressing many of the daunting health concerns facing our nation. For all the conditions I just listed, there is a basic science of behavior:. Before you address how to change attitudes and behaviors around AIDS, you need to know how attitudes develop and change in the first place; Before you can change decisions about any risky behavior, you need to know how judgments and decisions are made on a range of topics; Before you address memory decline in the elderly, you need to know the basics of learning and memory and how that changes with age; And before you address the complexity of the interactions among genetics, the brain, and, say, schizophrenia, you need to know the basics of cognition, emotion, culture, you need to know behavioral and cognitive neuroscience, and behavioral genetics.
Not to simplify too much, but when NIH higher-ups think of behavioral research, with few exceptions, they think of applications, such as the following:. A vaccine is ready and now the behavioral question is how to convince parents to bring their children in for inoculation.
But, just as the development of that vaccine was built on basic research in virology and molecular and cellular biology, a persuasive message to parents builds on basic research in cognitive, developmental, and social psychology. The same is true for questions such as: How do you get TB patients to stay on their course of treatment? What are the behavioral aspects of controlling blood pressure?
How are minorities disadvantaged in access to health care? Or, even more cross-disciplinary questions like, what about combined behavioral and pharmacological treatments for depression or anxiety disorders? Let me make this NIH disconnect between basic behavioral science and health even more concrete. His research on judgment and decision-making has enormous implications for health. Or, on an even more direct clinical course, when I talk to parents of those with schizophrenia, they often tell me that among the many serious problems their adult children have, one of the most troubling is that they just plain make bad decisions — on everything from whether to take their medications; to not telling the truth about their symptoms; to self-medicating with illegal drugs and alcohol.
To me, this all means that basic research on judgment and decision-making should have been encouraged at NIH all along. I maintain that such a view would never occur in any other area of non-behavioral research that is so directly related to health. Okay, end of rant about the range of behavioral science being a dividing line, except to say that we are seeing more and more pressure on NIH to do less and less basic behavioral science.
Behavioral sciences in clinical practice
And there is no doubt in my mind that this appreciation is sorely lacking at many institutes. Behavioral medicine is concerned with the integration of knowledge in the biological , behavioral, psychological , and social sciences relevant to health and illness. These sciences include epidemiology , anthropology , sociology , psychology , physiology , pharmacology , nutrition , neuroanatomy , endocrinology , and immunology.
The practice of behavioral medicine encompasses health psychology, but also includes applied psychophysiological therapies such as biofeedback , hypnosis , and bio-behavioral therapy of physical disorders, aspects of occupational therapy , rehabilitation medicine , and physiatry , as well as preventive medicine. In contrast, health psychology represents a stronger emphasis specifically on psychology's role in both behavioral medicine and behavioral health.
Behavioral medicine is especially relevant in recent days, where many of the health problems are primarily viewed as behavioral in nature, as opposed to medical.
For example, smoking, leading a sedentary lifestyle , and alcohol abuse or other substance abuse are all factors in the leading causes of death in the modern society. Practitioners of behavioral medicine include appropriately qualified nurses , social workers , psychologists , and physicians including medical students and residents , and these professionals often act as behavioral change agents, even in their medical roles. Behavioral medicine uses the biopsychosocial model of illness instead of the medical model.
Writings from the earliest civilizations have alluded to the relationship between mind and body, the fundamental concept underlying behavioral medicine. In the form in which it is generally understood today, the field dates back to the s. The earliest uses of the term were in the title of a book by Lee Birk Biofeedback: Behavioral Medicine , published in ; and in the names of two clinical research units, the Center for Behavioral Medicine, founded by Ovide F. Subsequently the field burgeoned, and inquiry into behavioral, physiological, and biochemical interactions with health and illness gained prominence under the rubric of behavioral medicine.
In , in recognition of this trend, the National Institutes of Health created the Behavioral Medicine Study Section to encourage and facilitate collaborative research across disciplines. The Yale Conference on Behavioral Medicine and a meeting of the National Academy of Sciences were explicitly aimed at defining and delineating the field in the hopes of helping to guide future research. Additional developments during this period of growth and ferment included the establishment of learned societies the Society of Behavioral Medicine and the Academy of Behavioral Medicine Research, both in and of journals the Journal of Behavioral Medicine in and the Annals of Behavioral Medicine in In , at the International Congress of Behavioral Medicine in Sweden, the International Society of Behavioral Medicine was founded to provide, through its many daughter societies and through its own peer-reviewed journal the International Journal of Behavioral Medicine , an international focus for professional and academic development.
Behavioral Science Course
Many chronic diseases have a behavioral component, but the following illnesses can be significantly and directly modified by behavior, as opposed to using pharmacological treatment alone:. Medications work best for controlling chronic illness when the patients use them as prescribed and do not deviate from the physician's instructions.
This is true for both physiological and mental illnesses. However, in order for the patient to adhere to a treatment regimen, the physician must provide accurate information about the regimen, an adequate explanation of what the patient must do, and should also offer more frequent reinforcement of appropriate compliance.
It is important for doctors to make meaningful connections and relationships with their patients, instead of simply having interactions with them, which often occurs in a system that relies heavily on specialist care. For this reason, behavioral medicine emphasizes honest and clear communication between the doctor and the patient in the successful treatment of any illness, and also in the maintenance of an optimal level of physical and mental health. The study of anthropology is concerned both with the biological features that make us human such as physiology, genetic makeup, nutritional history and evolution and with social aspects such as language, culture, politics, family and religion.
Topic domains for the behaviour science in medical teaching: 1. Mind body interaction 2. Patient behavior 3. Physician role and behavior 4. Physician patient interaction 5. Social and cultural issues in health care 6. Health policy and economics Categories of Behavioral Sciences Decision Sciences: Decision sciences deals with the decision processes. It concentrate mainly on Psychology. Communication Sciences: Communication Sciences deals with communication strategies used by human. It concentrate mainly on Sociology and Anthropology.
Concepts of Psychology Concepts of Anthropology Concepts of Sociology Decision process Communication strategies The scope of behavioral science encompasses linking the concepts of psychology, sociology and anthropology with decision process and communication strategies. Scope In other words, sick role is behavior and obligations expected from a sick person. Health related Behaviors It is possible to have a disease and not feel ill, e.
Also possible to feel ill without any detectable disease, e.
Behavior causing ill-health Behavior related to Chronic Illness Five key health-related behaviors for chronic disease prevention are: -Never smoking, -Getting regular physical activity, -Consuming no alcohol or only moderate amounts, -Maintaining a normal body weight, and -Obtaining daily sufficient sleep. How to change a behavior Technology also changes behavior.
The Health Belief Model HBM is a psychological health behavior change model developed to explain and predict health-related behaviors, particularly in regard to the uptake of health services. The health belief model suggests that people's beliefs about health problems, perceived benefits of action and barriers to action, and self-efficacy explain engagement or lack of engagement in health-promoting behavior. A stimulus, or cue to action, must also be present in order to trigger the health- promoting behavior.
Yellow marked boxes are the target for educational intervention, to ensure healthy practices. Components of HBM -Perceived susceptibility: This refers to a person's subjective perception of the risk of acquiring an illness or disease. There is wide variation in a person's feelings of severity, and often a person considers the medical consequences e.
The person weighs the effectiveness of the actions against the perceptions that it may be expensive, dangerous e.
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