APPLIED PSYCHOLOGY UNIT-5 PSYCHOLOGY AND MEDICINE

INTRODUCTION
Psychology as the science of behavior and mental processes emphasizes training and knowledge
about such aspects (e.g. development over the lifespan, learning, motivations, experiences,
emotions, cognition, social behavior and attitudes, personality etc). Moreover, it strives to
understand how biological, behavioral, and social factors influence health and illness.
Thus, psychologists as behavioral health providers play a major role in understanding how
biological, behavioral, and social factors influence health, and illness. They are equipped with
training, skills, and knowledge to understand how basic behavioral and cognitive processes (e.g.
cognition. emotion, motivation, development, personality, social and cultural interaction) prepare
the body to develop dysfunctions. They are trained, on the other hand, to perceive how these
behavioral and cognitive functions are altered, the factors that contribute to their alteration, and
how these dysfunctions are diagnosed and treated. In dealing with such problems, they are also
trained and skilled to use several psychological, psycho diagnostic and psychotherapeutic
techniques which help and affect the abilities of individuals to function in diverse settings and
roles. In addition, they help people to modify their behavior and lifestyle so as to prevent and
recover from health problems.
Consequently, demands for psychologists in hospitals and medical settings have dramatically
increased and clinical health psychology has become one of the most important disciplines in
health care. In the following section, an overview of the main clinical specialties of psychology
is given.
THE CLINICAL SUB-FIELDS OF PSYCHOLOGY
The development of Psychology as a health specialty and discipline has led to the emergence of
several sub-fields and subspecialties. These sub-fields include clinical psychology, health
psychology (also referred to as medical psychology or behavioral medicine), clinical neuro
psychology, counseling psychology, rehabilitation psychology, community psychology, and
pediatric psychology with subspecialties in each field.
Clinical Psychology
Clinical psychology is the application of psychological knowledge and skills, research and
intervention techniques to health and illness, particularly as related to mental health.
The American Psychological Association defines clinical psychology as “a clinical discipline
that involves the provision of diagnostic, assessment, treatment plan, treatment, prevention, and
consultative services to patients of emergency room, inpatient units, and clinics of
hospitals”Another definition given by the Canadian Psychological Association sees it as a broad
field of practice and research within the discipline of psychology applying psychological
principles to the assessment, prevention, amelioration, and rehabilitation of psychological
distress, disability, dysfunctional behavior, and health-risk behavior, and to the enhancement of
psychological and physical well-being.
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Overall, the field of clinical psychology integrates science, theory and practice to understand,
predict and alleviate maladjustment, disabilities, and discomfort as well as to promote human
adaptation, adjustment, and personal development. It, therefore, focuses on the intellectual,
emotional, biological, psychological, social, and behavioral aspects of human function in
different cultures and at all socioeconomic levels.
Clinical psychology has several subspecialties such as child and adolescent psychology, clinical
adult psychology, clinical gero-psychology, clinical psychology of learning disabilities, clinical
psychology of substance abuse and clinical forensic psychology
Gero psychology is a branch of psychology that seeks to address the concerns of older adults.
Mental Health Disorders, depression and aging, anxiety, and age-related illnesses all increase the
need for older adults to seek psychological care from gero psychologists.
Health Psychology/ Medical Psychology
Health psychology (sometimes referred to as medical psychology or behavioral medicine) can be
defined as the aggregate of the specific educational, scientific and professional contributions of
the discipline of psychology to the promotion and maintenance of health, the prevention and
treatment of illness, the identification of etiological and diagnostic correlates of health, illness
and related dysfunction, and the improvement of the health care system and health policy
formation.
Health Psychologists apply psychological research and methods to the prevention and
management of disease, the promotion and maintenance of health, the identification of
psychological factors that contribute to physical illness, the improvement of the health care
system, and the formulation of health policy.
The American Psychological Associations’ Division of Health Psychology outlined the
objectives of health psychology as understanding the etiology, promotion and maintenance of
health, prevention, diagnosis, treatment and rehabilitation of physical and mental illness; the
study of psychological, social, emotional and behavioral factors in physical and mental illness;
and the improvement of the health care system and formulation of health policy.
Thus, health psychologists are interested in how biological, psychological, and social factors
affect health and illness. Therefore, they are engaged in the promotion and maintenance of
health-related behavior, the prevention and treatment of illness and analysis and improvement of
the health care system.
Clinical Neuropsychology
Clinical neuropsychology focuses on the brain-behavior relationship and how behavior and
behavioral problems are affected by the way the brain functions. A clinical neuropsychologist
specializes in the diagnostic assessment and management of individuals with brain
impairment.13 Clinical neuropsychologists are usually located in the departments of clinical
psychology, neuroscience and neurosurgery.
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Counseling Psychology
Counseling psychology is a specialty in the field of psychology in which the practitioners help
people as individuals and groups, to improve their well-being, alleviate their distress, resolve
their crises, and increase their ability to solve problems and make decisions. Most of those who
seek help from a counseling psychologist are clients who do not have major psychological
disorders. Counseling psychologists, however, work in a variety of settings such as, hospitals and
medical centers, academic institutions, prisons, schools, business/industry, community health,
etc. and with people of all ages e.g. children and adolescents, adult, and the elderly. Counseling
psychologists then help people to adjust to change or make changes in their lifestyle. They assist
individuals and groups in areas related to personal wellbeing, interpersonal relationships, work,
recreation, health, and crisis management. They may practice independently or work with
clinical psychologists, child psychologists, and health psychologists or as academic counselors.
Rehabilitation Psychology
Rehabilitation psychology is an applied clinical specialty in professional psychology concerned
with the treatment and science of disabling and chronic health condition. Rehabilitation
psychologists deal with stroke and accident victims, people with mental retardation, and those
with developmental disabilities caused by such conditions as cerebral palsy, epilepsy, and
autism. They help disabled individuals adapt to their situation, frequently they work with other
health care professionals. They deal with such issues as pain management, personal adjustment,
interpersonal relations at home and the work place. They have become more involved in public
health programs to prevent disabilities. They also testify in the courts as expert witnesses on the
causes and effects of the disabilities and rehabilitation required to improve the quality of life.
Pediatric Psychology
Pediatric psychology is an interdisciplinary field that addresses the full range of physical and
mental development, health and illness issues affecting children, adolescents and families.16
Pediatric psychologists, therefore, diagnose, assess, and treat the psychological problems
affecting the physical health of children and adolescents or resulting from dysfunction of the
physical health. Moreover, they are involved in the improvement of the mental health services,
the promotion of health and development, and the prevention of illness and injury to children and
adolescents.
Psychology Community
Community psychology moves beyond individuals to deal with problems of mental health and
human relationships in communities. Community psychologists assist people to achieve their
goals in areas such as health welfare and community projects.
PSYCHOLOGISTS AND THE HEALTH CARE
The services of the health care psychologist would be required in the following areas.
Primary care
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To provide important diagnostic interventions, and preventive services for the psychological
problems in primary health care, illness prevention, and behavioral health promotion.
Secondary care
To give psychological assessments and diagnoses, psychological treatments, and rehabilitation.
These services are provided to a variety of age groups and special groups of patients. These
would include children, adolescents, adults, the elderly, and people with special needs such as
those with learning disabilities, the brain-damaged, and the mentally retarded.
Tertiary care
A psychologist is a member of the treatment team caring for the psychological aspects of patients
suffering from acute and chronic life-threatening diseases such as cancer, respiratory and renal
disease. In addition, the role of clinical neuropsychologist in the identification, assessment,
patient care and cognitive rehabilitation of brain-damaged patients is increasing.
PSYCHOLOGISTS’ ROLES IN HOSPITALS AND OTHER MEDICAL CENTERS
Psychologists in hospitals and other health care facilities may work independently, or as a part of
a team. First as clinical psychologists, they are mental health providers and usually render
service through mental health units and psychiatric hospitals. Second, as health or medical
psychologists, they are behavioral health providers and deal with the behavioral dimensions of
the physical health and illness. They provide the clinical and health services to both inpatient and
outpatient units as well as to patients who function independently and to those new patients who
need evaluation.21 The American Board of Clinical Psychology as a training body states that the
services provided by psychologists typically include: diagnosis and assessment, intervention and
treatment, consultation with professionals and others, program development, supervision,
administration, psychological services and evaluation and planning of these services and
teaching and research and contributing to the knowledge of all of these areas.
Assessment
One of the core roles of psychologists in hospitals and primary health care is clinical assessment.
They use psychological tests and measurements for specific purposes. For instance, to assess
current functioning in order to make diagnoses (e.g., confirmation or refutation the clinical
impression and differential diagnosis of the abnormal behavior such as depression, psychosis,
personality disorders, dementia etc. and non-psychiatric issues e.g. relationship conflicts,
compliance, learning differences, educational potential, career interest etc); identify the treatment
needs, assign appropriate treatment and give prognosis, monitor treatment over time, and
ascertain risk management.
To achieve these purposes, psychologists use psychometric tests, which are standardized and
validated tools to assess a wide range of functions including intelligence, personality, cognitive
neuropsychology, motivations, aptitudes, health behavior, and intensity of mental health
problems etc. The tests used include behavioral assessment and observation encompassing the
rating scales; intellectual assessments, e.g., IQ tests; neuropsychological tests e.g., Halstead
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Reitan tests; personality scales (objective and projective tests); diagnostic interviews (structured
and semi-structured); psychophysiological and bio-behavioral monitoring e.g. biofeedback;
mental status examination; forensic assessments; psycho-educational measurements and
vocational tests.
Professional psychologists are the only mental and physical health professionals who have the
legal right to use, administer, and interpret the psychological assessments.
Treatment
A major activity engaged in by psychologists in delivering health care is intervention or
treatment, providing a wide variety of clinical interventions for individuals, groups, couples, and
families with physical and mental health problems. These interventions are directed at
preventing, treating, and correcting emotional conflicts, personality disturbances,
psychopathology, and the skill deficits underlying human distress and dysfunction. They provide
a variety of psychological interventions such as cognitive behavior therapy; behavioral
modification; family and couple therapy; biofeedback; rehabilitation; group psychotherapy;
psychoanalysis; client-centered therapy; pain management; neuropsychological rehabilitation;
interpersonal psychotherapy etc.
Research has indicated that less than 25% of physical complaints presented to physicians have
known or demonstrative organic or biological signs and that a substantial number of physical or
medical symptoms presented by patients are unexplained medically (functional symptoms) that
respond well to the psychological intervention.23 Therefore, psychological interventions are
effective and cost-effective for the improvement of physical and mental health and the quality of
life.
Consultations
Many psychologists provide psychological consultation for health care professionals,
businesspersons, schools, organizations, communities etc. For example, a psychologist may help
a physician to better manage noncompliance with unpleasant medical procedure. A businessman
may consult a psychologist to help reduce conflicts among workers or provide stress
management. Psychologists’ consultation might include assessment, teaching, research, and
therapy.
Administrative Privileges
As experts in human behavior, psychologists are considered as efficient and competent
administrators. Because the understanding of human behavior in social contexts is considered the
backbone of management, therefore psychologists find themselves in administrative positions in
hospitals and other residential treatment settings. Clinicians from psychology serve as
chairpersons of departments, units, or divisions in hospitals e.g. neuropsychology, mental health,
rehabilitation, and occupational health. They could be directors of graduate training programs in
mental health, student counseling-psychological centers, hospital outpatient departments, and
directors of hospitals. Moreover, they participate in assigned committees and are active members
of their departments. In administration, psychologists manage budgets, lead multidisciplinary
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professional and support staff; they develop policies and procedures for planning and personnel
issues etc. Finally, they participate and contribute to all quality management activities of
hospitals and other care settings.
Teaching and Training
A considerable portion of the time of many psychologists who work in medical settings is spent
in academic activities (teaching and training). They teach all courses of psychology, human
behavior and behavioral sciences included in the curricula of undergraduate and postgraduate
medical, dental, nursing and other allied health professionals as well as psychology students,
interns and residents, and train health professionals.
Research and Supervision
With their training and qualifications, clinical and health psychologists are research-oriented.
Examples of their research activities include;
(a) The development and standardization of clinical tools for diagnostic assessment tests and
examination of their reliability and validity;
(b) Adapting and testing the efficacy of both psychological and biological interventions to
promote health and overcome disorders;
(c) Studies to reveal the cultural and cross-cultural aspects of psychological abnormalities;
(d) Ascertaining the impact of both positive and negative human behavior on the physical health;
and
(e) Supervising projects, thesis and dissertations of candidates whose researches have
psychological components.
Medical psychology is a branch of psychology which studies the psychology of the patient, the
role of psychic factors in the origin and development of the disease, the psychology of
relationships between doctor, staff and patient, as well as the use of a psychological approach in
medical practice. Medical psychology has two lines of development – general medical
psychology and applied medical psychology. General medical psychology studies psychological
peculiarities of the patient; the criteria of normal, temporarily altered and morbid psychics; the
correlations between an individual and a disease; psychology of a doctor in his relations with the
hospital staff; psychology of relationships between the doctor, his patient and relatives; teaching
on a doctor's duty and ethics; teaching on iatrogenic caused by the carelessness of a doctor's
words; peculiarities of ageing and its influence on the disease. Applied medical psychology
studies psychology of patients suffering from nervous-psychic disorders; psychology of
psychiatric patients and patients with dependencies; psychology of patients with nervous
diseases; psychology of patients prior to and after an operation; psychology of patients with
cardio-vascular, gastric infectious, veneric, pulmonary, gynecological diseases; psychohygiene
and psychoprophylactics in cases of pregnancy and child-birth; psychology of endocrinological
and oncological patients psychology of patients with physical abnormalities and sensory defects
(e.g. blindness, deafness); psychology of the disabled.
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The basic points of contact of these sciences are the psychological peculiarities in doctor's
conduct, correction of mentality while treating the patient and psychotherapeutic influence.
Medical psychology is connected with all medical specialties (therapy, surgery, obstetrics,
gynecology, pediatrics, hygiene and others). It has some specific methods and thus it plays an
important role in doctor's training in any specialty. Mental phenomena are determined by the
factors of environment (mentality is a form of reflection of the objective reality). However, any
outer influence produces one or another psychological effect under inner conditions such as the
mood of the individual, his aims, needs and life experience. Due to activity the mentality fulfils
the function of orientation of the person in a variety of surrounding events and phenomena (it is
manifested in selectivity of the subject regarding outer influence) and the function of regulating
behavior (stimulation to the activity which meets needs and interests of the individual). In a
definite situation the person's behavior depends on his interpretation and treatment of the
situation. On the other hand, the character of treatment of the given situation, extent of
knowledge about the situation will depend on interaction of the person with this situation. For the
scientific cognition of different mental phenomena an their functional mechanisms medical
psychology uses such methods:
1. Method of observation.
2. Method of clinical interview.
3. Experiment.
4. Psycho-diagnostic examination.
One of the most typical ways of examination is observation of an object (a person, a group of
people) pending the phenomena interested by an examiner will show themselves to be recorded
and described. By means of this method the mental processes, states and properties of sick and
healthy are studied. Mentality is studied under natural living conditions, and this study differs
from an experiment because a doctor or a psychologist is a passive observer that has to wait for
those phenomena he is interested in. The advantage of this method is that during the observation
the natural course of mental phenomena is not broken. The disadvantage of the observation is
that it does not allow determining the cause of a certain mental phenomenon precisely, because it
is not possible to take into account all interrelations of a mental phenomenon in the process of
observation. Observation is carried out under usual living conditions: in families, at work, game,
during studies, in a hospital ward. Independent activity, observation, reaction peculiarities of a
patient, his relationship with other people are taken into consideration. Observation should be
purposeful, following some certain tasks. In medical practice it allows to estimate the patient's
sleep, appetite, mood, psychic activity, ect.
PSYCHOSOMATIC DISORDERS IN GENERAL CLINICAL PRACTICE
Objectives: to learn how to consider psychosomatic relations in diagnosis, treatment and
prevention of somatic diseases. Contents: The ideas about close relation between the body and
the soul, somatic health and mental state have always been the leading issue of medicine.
Hipocrates considered that it was necessary to treat the patient, not the illness, i.e. a holistic
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approach to diagnosis and treatment was necessary. When studying the relation between somatic
and mental states it is reasonable to distinguish the following types:
1. Psychological factors as a cause of somatic disease (proper psychosomatic diseases).
2. Mental disorders which manifest with somatic symptoms and signs (somatization disorders).
3. Mental consequences of somatic diseases (including psychic reactions to the fact of somatic
disease).
4. Incidentally simultaneous mental disorders and somatic diseases.
5. Somatic complications of mental disorders.
At present there is a system of somato psychic and psychosomatic relations which are necessary
to distinguish and consider during the treatment. The latter three types of psychosomatic
reactions are featured in other chapters of the book. Among the changes in the somatic health
caused by emotional impact, we can distinguish non-pathological psychosomatic reactions,
psychosomatic diseases, influence of the emotional state on the development and course of
somatization disorders.
There is no common idea about the origin of psychosomatic diseases, their pathogenesis and
treatment.
Psychosomatic medicine began to develop quickly at the beginning of the 20th century. Millions
of cases of so-called "functional patients" were registered at that time. Their somatic complaints
were not confirmed by objective studies, treatment with traditional drugs was ineffective. At first
correction of the affective states and disorders in the interpersonal relations of the patients , that
is psychotherapy, mental consultations were necessary.
The representatives of psychoanalysis explain psychosomatic pathology emphasizing the prevail
of forcing out emotional experience (protective mental mechanism which manifests with
Sub conscious exclusion of the undesirable thought or emotion from the conscience) which later
manifests with somatic symptoms and signs in the patients with psychosomatic signs. But they
neglect the organic pathology, though in practice the physician should remember that the patients
may develop organic diseases, psychotherapy is not sufficient right from the beginning of the
disease, the treatment modern pharmaceuticals, sometimes surgery are necessary. Scientific
validation of psychosomatic relations can be found in I.P. Pavlov's theory of conditional reflexes.
P.K. Anokhin, a Russian neurophysiologist, worked out a biological theory of functional
systems. It is the concept about organization of the processes in the whole organism which
interacts with the environment. This theory regards the functions as achievement of an adaptation
state by the organism at its interactions with the environment.
According to this theory, any emotional reaction is viewed as a holistic functional system
which combines the brain cortex, subcortical structures and the respective regions of the body.
From the point of view of neurophysiology, emotional processes involve both central
(hypothalamus, limbic system, structures of activation and rewarding) and peripheral structures
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(catecholamines, adrenal hormones, and vegetative nervous system). Extreme in its force and
duration irritants change the functional state of the central and peripheral nervous system. With
this functional disturbances locus minor is resistentiae (sites of minor resistance) may develop.
There is a system of constant feedback which determines the possibility of therapeutic action on
the emotional factor. In response to psycho emotional stimuli various non-pathological
psychosomatic reactions (visceral, sensor) may develop. Psychosomatic reactions may appear
not only in response to psychic, emotional influences but also to direct action of the irritants
(e.g., a view of a lemon). Representations may influence the somatic health of the person. Psycho
emotional factors may cause the following physiological disturbances in various organs and
systems of the organism:
a) In the cardiovascular system — increased heartbeat, changes in the blood pressure, vascular
spasms
b) In the respiratory system — delay, increased or decreased respiratory rate;
c) In the digestive system — vomiting, diarrhea, constipation increased salivation, dryness in the
mouth;
d) In the sexual sphere — increased erection, weak erection, clitoris swelling, lubrication of the
sex organs, anorgasmia ;
e) In the muscles — involuntary reactions: muscular strain, tremor;
f) In the vegetative system — perspiration, hyperemia.
Psychosomatics (from Greek psyche — soul and soma — body) is a branch of medical
psychology dealing with the study of psychical factors and development of functional and
organic somatic disorders. Psychosomatic disorders are those the origin and course of which are
chiefly determined by psychological factors .The cause of psychosomatic diseases is affective
(emotional) overstrain (conflicts, rage, fear) when definite personality features are present.
Psychological factors play a role in other diseases: migraines, endocrine disorders, malignant
tumors. Nevertheless, it is important to distinguish true psychosomatic diseases, the development
of which is determined by psychic factors and prevention should be aimed at elimination and
correction of emotional overstrain (psychotherapy and psychopharmacology), and the diseases,
the development of which is also influenced by mental and behavioral factors because they
change nonspecific organism resistance but they are not the primary cause of their occurrence.
For example, it is known that influence of psycho emotional stress can decrease the immune
reactivity which increases the probability of diseases (including infectious). Psychogenic
component plays an active role in various organic disorders, e.g. hypertension , gastric and
duodenal ulcer, myocardial infarction, migraine, bronchial asthma, ulcerative colitis,
neurodermitis. These diseases are frequently termed "major" psychosomatic diseases,
emphasizing the severity of the disease and a leading role of the psychogenic factor in their
development. True psychosomatic disorders are characterized by the following:
1. Psychic stress plays a key role in the origin.
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2. After its manifestation the disease becomes chronic or relapsing.
3. The first manifestations can be noted at any age, but chiefly in teen-agers.
Classical clinical pictures of seven diseases, namely essential hypertension, ulcer, bronchial
asthma, neuro dermitis , thyrotoxicosis, ulcerative colitis, rheumatoid arthritis, are
psychosomatic disorders.
Psychosomatic disorders are the consequence of stress caused by prolonged mental traumas,
inner conflicts between similar in the intensity but different in direction motives. Some types of
motivation conflicts are believed to be specific for definite diseases.
Thus, hypertension is associated with the conflict between strict social control of the behavior
and an unrealized need of power. The unrealized need causes aggression, which cannot be
manifested because of social restrictions. In contrast to neuroses based on intra psychic conflicts,
psychosomatic disorders are characterized by dual forcing out of an unacceptable motive and
neurotic anxiety and neurotic behavior.
As it is important to understand the essence of protective psychological mechanisms, therefore it
is necessary to characterize them. The protective mechanisms are divided into primitive, or
immature (splitting, projection, idealization, identification), and more mature (sublimation,
rationalization). But neither the number of variants of protection (several dozen have been
described) nor their taxonomy are generally accepted. One group combines the types of
protection which decrease the level of anxiety but do not change the character of inducements.
They are inhibition or forcing out from the conscience of unacceptable inducements or feelings;
denial of the source or feeling of anxiety; projection of transfer of the desires and feelings to the
other; identification — mimicking the other person with ascribing his qualities; inhibition —
blocking in the behavior and conscience all manifestations associated with the anxiety. The other
group unites the forms of protection in which the mechanisms reducing the anxiety and changing
the direction of the motives work: auto aggression — direction of the hostility to himself;
reversion — polar changes in the motives and feelings to opposite; regression — decrease, or
turning to earlier childish forms of reaction; sublimation — transformation of the unacceptable
forms of satisfaction of the needs to other forms, e.g. creative work in art or science.
What Is Somatic Symptom Disorder?
Somatic symptom disorder involves a person having a significant focus on physical symptoms,
such as pain, weakness or shortness of breath that results in major distress and/or problems
functioning. The individual has excessive thoughts, feelings and behaviors relating to the
physical symptoms. The physical symptoms may or may not be associated with a diagnosed
medical condition, but the person is experiencing symptoms and believes they are sick (that is,
not faking the illness).
A person is not diagnosed with somatic symptom disorder solely because a medical cause can’t
be identified for a physical symptom. The emphasis is on the extent to which the thoughts,
feelings and behaviors related to the illness are excessive or out of proportion.
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Diagnosis
Somatic symptom disorder diagnosis
One or more physical symptoms that are distressing or cause disruption in daily life
Excessive thoughts, feelings or behaviors related to the physical symptoms or health concerns
with at least one of the following:
Ongoing thoughts that are out of proportion with the seriousness of symptoms
Ongoing high level of anxiety about health or symptoms
Excessive time and energy spent on the symptoms or health concerns
At least one symptom is constantly present, although there may be different symptoms and
symptoms may come and go
People with somatic symptom disorder typically go to a primary care provider rather than
psychiatrist or other mental health professional. Sometimes it can be difficult for individuals with
somatic symptom disorder to understand that their concerns about their symptoms are excessive.
They may continue to be fearful and worried even when they are shown evidence that they do
not have a serious condition. Somatic symptom disorder usually begins by age 30.
Treatment
Treatment for somatic symptom disorder is intended to help control symptoms and help the
person function as normally as possible.
Treatment for somatic symptom disorder typically involves the person having regular visits with
a trusted health care provider. The provider can offer support and reassurance, monitor heath and
symptoms and avoid unnecessary tests and treatments. Psychotherapy (talk therapy) can help the
individual change their thinking and behavior, and learn ways to cope with pain or other
symptoms, deal with stress and improve functioning.
Antidepressant or anti-anxiety medications can be useful if the person is also experiencing
depression or anxiety.
Related Disorders
Illness anxiety disorder involves a person preoccupied with having an illness or getting an illness
– constantly worrying about their health. They may frequently check themselves for signs of
illness and take extreme precautions to avoid health risks. This condition was previously referred
to as “hypochondriasis.” Unlike somatic symptom disorder, a person with illness anxiety
disorder generally doesn’t experience symptoms.
Conversion disorder is a condition in which symptoms affect a person’s perception, sensation or
movement with no evidence of a physical cause. A person may have numbness, blindness or
trouble walking. The symptoms tend to come on suddenly and may last for a while or may go
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away quickly. People with conversion disorder also frequently experience depression or anxiety
disorders.
Factitious disorder involves people producing or faking physical or mental illness when they are
not really sick, or intentionally making a minor illness worse. A person with factitious disorder
may also create an illness or injury in another person, for example faking the symptoms of a
child in their care. The person may or may not seem to benefit (such as getting out of school or
work) from the situation they create.
Understanding Educational Psychology
Today’s educational system is highly complex. There is no single learning approach that works
for everyone.
That’s why psychologists working in the field of education are focused on identifying and
studying learning methods to better understand how people absorb and retain new information.
Educational psychologists apply theories of human development to understand individual
learning and inform the instructional process. While interaction with teachers and students in
school settings is an important part of their work, it isn’t the only facet of the job. Learning is a
lifelong endeavor. People don’t only learn at school, they learn at work, in social situations and
even doing simple tasks like household chores or running errands. Psychologists working in this
subfield examine how people learn in a variety of settings to identify approaches and strategies
to make learning more effective.
Educational Psychology Applied
Psychologists working in education study the social, emotional and cognitive processes involved
in learning and apply their findings to improve the learning process. Some specialize in the
educational development of a specific group of people such as children, adolescents or adults,
while others focus on specific learning challenges such as attention deficit hyperactivity disorder
(ADHD) or dyslexia.
No matter the population they are studying, these professionals are interested in teaching
methods, the instructional process and different learning outcomes.
How much the time of day when new information is does introduced influence whether a person
retains that information? What does culture have to do with how we process new ideas? How
does age affect our ability to develop new skills, like language? How is in-person learning
different from remote learning using technology? How does the choice of a media platform make
a difference in learning?
These are all questions that educational psychologists are asking — and answering — in settings
as diverse as government research centers, schools, community organizations and learning
centers.
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Medical Definition of DSM

DSM: Abbreviation for the "Diagnostic and Statistical Manual of Mental
Disorders," a comprehensive classification of officially recognized psychiatric
disorders, published by the American Psychiatric Association , for use by mental
health professionals to ensure uniformity of diagnosis.
DSM describes symptoms and does not discuss the causes of the disorders.
DSM-IV designates the 4th edition. Issued in 1993, DSM-IV is the edition (as of
2001).
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)
is the 2013 update to the Diagnostic and Statistical Manual of Mental Disorders,
the taxonomic and diagnostic tool published by the American Psychiatric
Association (APA). In the United States, the DSM serves as the principal
authority for psychiatric diagnoses. Treatment recommendations, as well as
payment by health care providers, are often determined by DSM classifications,
so the appearance of a new version has significant practical importance.
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What is Psychosomatic Medicine?
Psychosomatic medicine (PM) is a newly licensed subspecialty in the field of psychiatry; it is also known
as consultation-liaison (C-L) psychiatry. C-L psychiatry provides knowledge, practice, and instruction in
the relation between mental and physical illness. This field is associated with services like diagnosis,
therapeutics and research of illnesses in this area. Hence it connects psychiatry and other medical
specialties, so that physicians and psychiatrists can discuss how to best manage patients with
psychosomatic illness.

History of Psychosomatic Medicine

The ancient Greeks and the French were well aware of psychosomatic disorders. Hippocrates was the
first physician to affirm that mental factors have an impact on health and disease. The French
philosopher Rene Descartes refreshed the psychological ethics of Hippocrates through his “body-mind
dualism” theory, which promoted many scientific studies in relation to the body and mind.

Initially, physicians of C-L psychiatry were not aware of the psychosomatic features of medically ill
patients. In the USA, C-L psychiatry started to evolve and underwent a series of developmental changes
in the 20th century. In 2003, C-L psychiatry was given the comprehensive name psychosomatic
medicine.

Objectives of Psychosomatic Medicine

The psychosomatic medicine service (PMS) provides a complete approach to the emotional,
cognitive, and behavioral needs of a patient through its dual function—as a consultant and as a
part of a primary care crew. Both the functions of C-L psychiatry pursue the following
objectives:
Medical intelligence: C-L psychiatrists need to possess extensive knowledge about physical,
social, and neurological disorders and their relation to abnormal illness. They should be capable
of implementing this intelligence in patient care. Practitioners in this field should also be aware
of the therapies used for psychosomatic patients.
Patient care: Specialists in this field improve the quality of psychiatric care for both in- and
outpatients. A warm atmosphere, appropriate consultations, and evidence-based patient care
promotes the physical and mental health of the patient.
Evaluation of mental factors: This enables complete assessment of the psychological and social
factors responsible for an individual’s mental illness through observation under psychiatric
consultants. The symptoms of mental disorders are diagnosed and effectively treated by
psychiatric therapies.
Individual therapy plans: In addition to being a skilled diagnostician, the C-L psychiatrist is
required to develop effective treatment plans for individual patients, which are effective in the
prevention, treatment, and recovery of physical disease.
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Collaborative care: The consultant promotes education on mental health and psychosocial skills
for patients, their families, and medical physicians, which results in effective exchange of
information. This cooperative care enables them to take care of the root cause of the patient’s
disease.
Training: Specialists provide training to junior consultants and to the nonpsychiatric healthcare
provider to help them identify aberrant reactions in patients caused by treatment, plus the
psychological care required in such reactions.
Functions of Psychosomatic medicine
1. Clinical function:
In relation to the clinical function of psychosomatic medicine, there are two categories of
psychiatrists:
Consultation psychiatrists: They are usually seen in outpatient departments and in chronic care
facilities where they can impart advice to requesting physicians involved in treatment of patients.
Referral psychiatrist: They assist the medical physician by providing comprehensive psychiatric
care to patients who are hospitalized.
2. Educational function:
Specialists in psychosomatic medicine provide education to non psychiatric physicians, medical
students, and nursing staff about the psychological needs of patients based on their behavior
immediate management of psychiatric conditions use of psychotropic drugs and recognizing
drug reactions in patients
3. Research function:
The field of psychosomatic medicine offers opportunity for research in the interface between
medicine and psychiatry. Most research studies in this field over the last century has been
conducted by consulting liaison psychiatrists, who are responsible for the rise of subspecialties
like psycho-oncology, psycho-immunology, and psycho-obstetrics.
4. Administrative function:
This function is generally authorized either by the government or the respective institution. It
usually involves an assessment of the violent actions of patients while they are under forcible
restraint, and non voluntary treatment. For example, the psychiatrist in this department will
assess the patient’s tendency to refuse medical procedures.
Other Services of Psychosomatic Medicine
Other ways in which PM contributes to medical care include:
The specialist in psychosomatic medicine delivers emergency services to attempted suicide
patients and help with managing their serious behavioral disturbances.
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PM specialists participate in consultation services for patients with psychosomatic illness who
undergo surgery.
The consultant will provide optimal care for patients with complicated medical illnesses such as
AIDS, cancer, or patients being advised for transplants. This service of C-L psychiatry calls for
close connection with primary physicians.
Some psychiatrists collaborate with the specialized care team for early detection and prevention
of symptoms in patients.
The above practices of psychosomatic medicine are limited in the field of teaching and in
specialty hospitals because of the shortage of PM psychiatrists.
What Is Forensic Psychology?
When we think of a forensic psychologist, we may think of the character that Jodi Foster played
in Hannibal, where she treats psychiatrist turned serial killer, Hannibal Lecter. Forensic
psychology has become popular due to the exciting way that this career is portrayed in television
and movies.
1. Forensic psychology can be defined as a specialization within the field of psychology that
represents the synthesis between psychology and law. Forensic psychologists may work in a
variety of settings, including a school doing threat assessments, the prison doing assessments, or
in the courtroom serving as an expert witness. If the situation has legal elements and requires
psychological analysis, evolution, assessment, or treatment, a forensic psychologist will be the
one for the job.
Forensic psychology has a rich and interesting history, beginning in the late 19th century.
2. Forensic psychology is the study of clinical psychology in legal situations. This refers to the
study of the relationship between human psychology and the criminal justice system. This is a
broad definition of the term, allocating room for research and academic study of psychology and
law; the narrow definition refers to the professional psychological assessment of an individual
who is currently participating in a legal process. This can be an assessment to understand a
person’s state of mind during a crime, their ability to stand trial, witness credibility, and more.
Forensic Psychology Education Requirements
Working as a psychologist usually requires a Ph.D. in Psychology or a Psy.D. degree, but there
are some job opportunities in school and industrial organizations that may become available after
a student has earned a master’s degree. However, specializing in forensic psychology doesn’t
necessarily require a doctorate. A student’s future employment goals will usually dictate the type
of degree required for work.
For future forensic psychologists, the educational journey begins with a bachelor’s degree in
psychology from an accredited university or college. Some students may choose to major in
psychology with a concentration in forensic psychology, but other students may find it more
advantageous to earn a degree in a related area like criminal psychology. Some students choose
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to adopt a minor in criminology or criminal justice while earning a Bachelor of Science in
Psychology or a Bachelor of Science in Forensic Psychology.
Duties and Responsibilities
Depending on whether a forensic psychologist works in the academic or applied field, their
duties and responsibilities will differ. Academic psychologists in this field focus on research
methods to create more accurate psychological assessments, learn how psychology and crime
relate to one another and are responsible for reforming psychological aide within the criminal
justice system. Forensic psychologists who work in the field are responsible for the
psychological assessment of their subjects and in some cases, when they work in the correctional
system, they may be the primary psychologist for inmates. Because this is a clinical profession,
all forensic psychologists are required to have a Ph.D. in Psychology prior to entering the field;
certification and licensing are also necessary.
Employment Opportunities
Forensic psychologists can work in a variety of workplaces. Academics in the field often work in
labs, colleges, or research centers that focus on this area; they can also find placement in
government agencies who support their work. Forensic psychologists in the fieldwork for law
firms, courts, the government, in mental health facilities, halfway homes, parole programs,
hospitals, state correctional systems, and rehabilitation facilities. In some cases, forensic
psychologists can work as consultants, building their own brand and working on contracts that
they receive from law enforcement, the government, and private law firms. It is always a
possibility that these psychologists can go to work in the intelligence community as instructors,
training agents to spot criminal behavior through psychological analysis.
Forensic medicine:
The branch of medicine dealing with the application of medical knowledge to establish facts in
civil or criminal legal cases, such as an investigation into the cause and time of a suspicious
death. Also known as forensic pathology.
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Since the mid-twentieth century, psychiatry has undergone revolutionary changes in how
psychiatrists diagnose patients, how they treat them, and how they evaluate whether a treatment
works. These changes have brought with them major advances, especially in the neurosciences.
But this history also suggests that psychiatry has lost something as it has narrowed its focus
mainly to the brain and psychotropic drugs. Though psychiatrists are now trained to expertly
manipulate a patient's drug regimen, they have become increasingly less able to situate a patient's
suffering within a psychological and social context, and the doctor-patient interaction is often
reduced to a querying and reporting of diagnostically sanctioned symptoms. Psychiatry, long
charged with caring for those suffering from largely chronic conditions, has become focused on
the diagnosis and cure of disease. This focus may someday bear therapeutic fruit, but until true
cures are actually forthcoming it is important that the role of care not be lost. Like many of the
shifts that psychiatry has undergone, these concerns are not unique to psychiatry, but are part of
larger changes within medicine and the culture in which it is situated.
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