Biological vs. Social Contributions to Health

Introduction

Health psychology is considered as a special subject where biological, behavioural, sociological and psychological factors affect the health of an individual. Sometimes medical psychology or behavioural medicine are synonymous with the subject. Health and illness can get influenced by several factors. Hereditary illness or contagious disease are common but many behavioural and/or psychological factors influences physical health and various kinds of medical conditions. Ogden stated that certain questions can be addressed to analyse health psychology in biomedical model, they are like, what are the causes of illness? Who get responsible for this? How this can be treated? Who will intervene during the treatment? What would be the probable relation of health with illness and mind with body? What is the role of psychology in health as well as wellness? (Ogden, 2012) By taking this questions’ probable answer in account proper health psychological interventions could be taken which will lead to promote the health as well as to prevent and to treat the illness in a proper manner. It also focused on facts that how people will react and cope up with the illness. (Sarafino, et al, 2014) This health psychology field is relatively emerging one and its proper development will make the life expectancy much better. Here in this essay, me as a staff, associated with the health psychological intervening nurses would like to discuss about the difference between biological and social contributions that regulates physical and behavioural nature of a person during different stages of their life. Moreover, it is also essential to discuss the theories of health believe and their contribution towards disorders related to behaviour. In this context various forms of strategies used to dragonize and set the plan for treatment. Therefore, this plans should also be discussed with respect to psychological framework in professional practice, highlighting the importance of healthcare dissertation help in developing effective interventions.

The impact of biological and social factors on health and behaviour of individuals at different life stages

The whole life span of human being can be divided into six stages and different life stages have different biological characteristics, they can affect behavioural, cognitive, intellectual as well as emotional characteristic of a human. These changes can be discussed as follows:

Infancy (0- 2 yrs.): during this time babies have least control on muscle coordination, therefore they cannot move or turn around.

Early childhood (3-8 yrs.): by this time the motor neuron skills develop to control different bodily behaviour and they start doing minimal body movement of locomotion. In later stage they walk, jump and grow habits of writing and reading. During this time they learn basic social skills by playing and interacting with elders. This is the time when they grow friendship and try to explore the environment.

Adolescence (9-18 yrs.): during this time males and females undergo physical changes related to growth. Puberty takes place during this time, for male penis and testes enlargement happens, whereas for female uterus get enlarged and the vagina lengthens. Due to hormonal change in men formation of sperm begins as well as a secondary characteristics like, body hairs start growing up. For female breast develop with formation of eggs in ovary and also menstrual cycle starts. During this time a lot of behavioural and social changes occurs, they try to be more independent and so get socialize outside the family. More friendship and relationship comes into life which sometimes leads to risky behaviour like alcoholism and drug addiction.

Early adulthood (19-45 yrs.): this is the peak time of gaining physical strength, height and instructiveness, after this they may grow some weakness and physical capabilities slowly get down. For women this is the general time of their pregnancy and lactation and this time also they undergo menopause. This is the time of maturity and during early adulthood the friendship network becomes very much important and people come in intimate relationship, this the tie for career, marriage, parenthood and major social development, after this time they become experienced and may limit the social activity by getting involve in family, commitments.

Middle adulthood (46-65 yrs.): during this time after gradual ending of menstruation the hormonal pattern of women changes lot and they grow problems like, anxiety, mood swing and depression. For both men and women during this time midlife crisis may grow leading to sever behavioural problems like alcoholism, erratic sexual behaviour and emotional problems.

Older adulthood (65 yrs onwards): during this time the physical strength get lower and chronic diseases may affect the livelihood. This is the dusky time when a person slowly get involved into social skills, develop friendship, look for pastime, travel to enrich view points and spirituality.

Upon biological aging there is always a change happen in the physiological, physical, cognitive, intellectual, emotional and many other features of human being. In general they cope up with the changes and with this change they are social sphere also changes. In spite of these changes some basic behavioural traits may stay constant but obviously the biological and social impact has ability to restructure the overall behaviour of a person. Say for example retirement may have impact on behavioural traits. Some people adjust with it very well, however, many examples are found where retirement makes huge social impact on behavioural transition. Coe et al, have discussed the impact of retirement on behaviour in the context of European countries. They have discussed the change in behavioural trait upon retirement (Coe, et al, 2011). Loretto et al. have argued there is an effect of retirement on behavioural changes but it is also variable with respect to the context of gender (Loretto, et al, 2013). With aging health factors also changes, a person feels change in vision, hearing and other sensory organs with aging. Say for example eyes may have difficulty in focusing object upon aging, difficulties in hearing is also observed. As a person grows older it is important that he/she cope up with these changes, otherwise they need to struggle with accepting these health problems. Ability of walking and other motile behaviour changes with age and with limitation in physical activity the behavioural trait of a person also changes a lot. Howcroft et al. have discussed the effect of driving patterns in older adults upon change in eyesight (Howcroft, et al, 2019). On the other hand Tun, et al. have discussed the impact of the change in auditory behaviour in older adults, they have argued there is a change in cognitive behaviour at different stage of life span, with a change in auditory processing ability, using a case study model (Tun, et al, 2012). Apart from the ailments due to old age, there are several changes that human psychology faces throughout the lifetime. One factor is adolescence, at this stage due to change in physical and physiological factors, human behaviour changes a lot. Mercken et al. have discussed the impact of smoking behaviour in adolescence of male and female and its impact on their friendship network (Mercken, et al, 2010). Somerville et al. have corelated the bahavioural change in adolescence with neurological factors in there review (Somerville, et al, 2010). Casiy et al. have argued that there is a change in risk taking behaviour during adolescence and due to change in neurobiological factors adolescent human try to do experimentation with alcohols and drugs (Casiy, et al, 2010). Upon aging intellectual fictionality changes a lot due to a change in self-awareness, personality traits from childhood to adolescence (Dometriou, et al, 2013).

Upon aging a huge change happens with health pattern of human being, as human being grow older they become more prone towards chronic health problems. Someone who was healthy during his/her whole span of life may have problem in accepting these changes. Tiihonen et al. have argued that with aging the microbiota of intestine changes a lot, there is an increase in enterobacteria with a decrease in anaerobes and bifidobacterial growth. Therefore, the nutrition pattern and propensity towards disease changes a lot (Tiihonen, et al, 2010). During childhood many of the viral infection receptors are not expressed in the cell membrane, which will gradually expressed during the maturity phase of a child (Solana, et al, 2012). Brunner et al. explained that as the development of thymus gland become effective with the growing age thus the expression of the T cells will be more with the age, so immunological responses for viral infection will be more for older children than the younger one (Brunner, et al, 2011). Barber et al. stated that the propensity towards parasitic infection, such as malaria get enhanced with age (Barber, et al, 2017).

Other social factors like family and relationship have complex but definite effect on health and well being of person. Relationship problem can trigger negative emotion, stress, confusion can lead to problems like difficulty in eating or sleeping behaviour and at the same time increase the risk of drug and alcohol abuse due to escaping tendencies (Umberson, et al, 2010). Work place relationship are also important in this context, Dehue et al. have discussed the effect of workplace mis-behaviours on health problems (Dehue, et al, 2012).

Theoretical perspectives in health psychology explain human behaviors

Health and behavioural wellbeing are summed up effect of different cognitive issues. The cognitive models explains behaviour in terms of rational processing of information and intrinsic cognition factors irrespective of social context. Health behaviours are defined as the intrinsic behaviour of a person towards combating diseases. The man feature of this behaviour are behaviour to prevent disease, for example eating healthy diet; illness behaviour like going to the doctor for remedy; sick role behaviour like taking prescribed medicine and rest. In contrary there are health impairing habits also termed as ‘behavioural pathogens’, like smoking, alcoholism, junk food consumption. To combat this protective behaviours are also there called bahavioural immunogens. In this context three theoretical models have been discussed.

Health Belief Model

To predict, develop, this health related behaviours health belief model was developed in the year 1950s by US public health service. This model predicts about health immunogens and its response to patient’s with acute and chronic illness. The core ideas of health belief can be conceptualize as a perception of individual like,

Someone’s belief on susceptibility towards illness. (like, ‘I am prone to lung cancer’) This is also called perceived susceptibility.

Belief towards the severity of the particular disease. (like, ‘lung cancer is incurable’) This is also called perceived severity.

Health motivation towards treatment or cure. (like, ‘I must stop smoking’)

Perception about carrying out the health behaviour. (like, ‘if I stop smoking, I will feel irritated) This is basically a barrier towards the health behaviour and termed as perceived barriers.

Benefits involved in health behaviour. (like, ‘my expenditure after smoking will be zero’) This is termed as perceived benefits.

These above stated points are together promote the action. The weightage of barrier and benefits dictates the format of actions.

Reason behind the actions may be intrinsic (like, shortness of breath) or extrinsic (like, information from external sources about lung cancer).

These four belief are used to predict the likelihood of behaviour will happen. This model has been construct to originate health motivation and to measure the readiness of individual to response towards the illness.

Perceived susceptibility is a persons assessment towards the risk of him/her to develop a particular illness. These believes born out from the day to day practice of an individual and in-turn believes make the person cautious about the disease by developing positive health behaviour. On the other hand the person take it lightly and believe they have low susceptibility generally do not grow healthy behaviour. Therefore the perceived susceptibility has dual effect on the intrinsic well being of a person. The approach of this theory allow the health professionals to asses individual’s biased perception about certain type of disease. Smokers, as an example, have higher perceived susceptibility towards lung cancer. In fact as a result of perceived susceptibility, lung cancer has been found be more stigmatic than other variants of cancer (Marlow, et al, 2015). Smerecnik et al. have corelated this perception with genetic trends and have found that there is no solid evidence of beneficial effect for the genetic testing rather the motivational effect of testing make a positive outcome(Smerecnik, et al, 2012). On the other hand for diabetic patient the perceived risk of unhealthy diet has a huge impact, generally a care free person with no control over his/her food habits consume fat rich food and grow high risk of disease. Piri has discussed diet adherence as one of the main corner stone of self-management of diabetic patient (Piri, 2010). Perceived severity is a negative process of thinking about a disease of an individual. This type of thinking can born out of the anticipated trouble and risk factor of a particular disease. This type of thinking process trigger stress related problems in many cases. Safa et al have discussed the stress related problem can make situation worse in case of patients with asthma and chronic obstructive pulmonary diseases. They have correlated the suicidal tendency of the patients with such disease and concluded about the necessities of psychological interventions (Safa, et al, 2014).

Social cognitive theory: This theory deals with social context of health behaviour that is interaction of social factors like, environment with a person and its effect on behaviour. This theory deals with acquired behaviour of a person under social constraints with respect to his/her past experiences. Past experiences can increase or decrease expectations and can shape a persons trait to engage or reject a behaviour. The goal of this theory is to explain how a person control or reinforce a behaviour and how he or she can maintain it over time. The content of this theory are :

Reciprocal determinism is the central concept of this theory, it deals with interaction of a person either dynamic or reciprocal, the environment and the outcome of behaviour.

Capability of behaviour of a person is important and individual perform a particular behaviour from his/her skills and knowledge. From the consequence of behaviour they can see what is the effect on environment.

Learning from observation is a key trait where people witness and perceive a particular behaviour conducted by other. If the observation is correct then probably the behaviour is also successful.

Reinforcement of the behaviour is possible when the particular behaviour exerts a positive outcome in the environment. If not it will be negative in nature.

Expectation is the anticipated consequence of a particular behaviour and it may vary from one person to another.

A persons self-efficacy allows successful performance of a particular behaviour. Confident approach of a person streamlines the behavioural outcomes.

In this context it is worth to mention that interventions using this theory can bring forth several extrinsic factor related to a particular disease. Dennis et al. have discussed about obesity prevention and social cognitive theory with respect to a case study model of college students (Dennis, et al,2012). On the other hand Hagger-Johnson et al. have illustrated the usefulness of social cognition for the prevention of HIV and use of condom among gay and bisexual men (Hagger-Jonson, et al, 2010).

Theory of planned behaviour: This theory assess the intention of an individual to get engage in a particular behaviour at a particular time and place. The main reason behind coining this term is to explain the behaviour on which a person can control. This intentions are strongly influenced by the fact whether the expected outcome will be coming or there will be a risk. A wide range of behavioural trait are encompassed under this theory, like smoking, drinking, breast feeding, utilization of health service and use of a condom. It comprises of six constructs such as:

Attitude of a person

Intention to perform the behaviour

Subjective factors

Social factors

Perceived outcome

Perceived control over behaviour

As a whole this interrelated factors give rise to behavioural output through channelize intention. Alcoholism is a problem encompassing the tenure of adolescence, early adulthood, midlife as well as old age. Restriction of drinking behaviour in necessary to stop the harmful consequences of alcoholism and this can be achieved by planned behaviour. Cooke et al. have done a systematic review on the predictability of theory of planned behaviour on alcoholism. They found the importance of the model in increasing self-efficacy of reducing the drinking behaviour. (Cooke, et al, 2016) However, there is considerable importance of change in methodology for both genders, which is not discussed by this particular model (Zimmermann and Sieverding, 2010).

Transtheoretical model: This model considers the process of decision making by a model of change in intention. This theory pre considers about the fact that change in behaviours of a person is not very quick and decisive. Rather it happens in a cyclic process. The processes are of six steps : Pre contemplation - this is the initial stage where a person do not understand the importance of their problematic behaviour and they underestimate the positivity of behavioural change; Contemplation – they intend to start healthy behaviour after recognizing the problematic side of ill behaviour; Preparation – now they are ready to make action and take small steps towards change with a pragmatic visionary; Action – this is the stage where they are under change and are moving towards healthy end; Maintenance – they sustain the good behaviour and try to prevent going backward to earlier state; Termination – now they are able to change the behavioural flaws, unwilling to return the previous ill state and under control of maintenance stage.

For patients suffering from obesity need change to habit of eating healthy diet. This model is appropriate for change in food habit in a step by step manner. Mastellos et al. have discussed the importance of dietary and exercise modification to reduce obesity using transtheoretical model (Mastellos, et al, 2014). However Tuah et al. argued that there is a very low evidence of usefulness of this model using a case study scenario(Tuah, et al, 2011).

Attribution theory: This theory deals with the interpretation of a layman about a particular behaviour. It checks the information and the way such information led to a particular simplified judgment. The nature of attribution is twofold: Dispositional attribution- This attribution deals with the very basic characteristics of person in terms of behavioural reasoning. The attribution is put forward to the behavioural traits like personality, believes and motives; Situational attribution – in this case the attribution is given to the situation or a particular event which is not under control of personal characteristic.

This theory is useful to understand the attribution of a cancer patient on their treatment. Ferrucci et al. have discussed the role of casual attribution in cancer treatment using an assessment model of a few key questions they concluded about the casual attributions adopted by many individuals is “ why me?” (Ferrucci, et al, 2011)

Though these above stated theories have been used for correlation of social, intellectual and cognitive factors with behavioural outcome, they have several pitfalls. Health belief theory can not fully account the acceptance of behaviour by a person, it cannot even decide whether the action can be recommended. It also fails to engulf social factors, environmental and economic factor. On the other hand social cognitive theory which includes social factors failed to evaluate or predict what will happen if the personal change fail to achieve the optimum behavioral outcome. The theory of planned behaviour which focuses on the intentions failed to account the availability of opportunity and resources. Moreover it do not consider the dynamism of innate psychological alignment.

Explore the various forms of assessment used to diagnose and plan treatment for different health issues

Assessment of the client is an important issue a clinician encounter in day to day life. It includes preliminary observation, skills, abilities, cognitive and emotional condition of the patient. Doctor patient relationship is a corner stone of assessment, a good relation makes the data collection, diagnosis and healing much easier. Different intervention process are utilized by different types of clinicians and the variation may change the mode of treatment. The methods of assessment are many fold, observation of the disease should be scientific and should be valid at the same time. In this regard a clinical interview can be effective if not then further physical examination, behavioural assessment and intelligence test are required. In this regard adherence is important for a clinician for the wellbeing of the patient. It has been found adherence has positive effect on cognition and emotion, Kardas et al.have discussed about the factors influence the adherence (Kardas, et al, 2013). General practitioners (GP) who encompass broad spectrum of health service has a pivotal role in managing long and short term chronic illness. Regular checkup of simple biochemical parameters and physical fitness has been found to have high impact on the early diagnosis of cardiovascular disease. Here the interventions are made by verbal discussions about the problem and checking the psychological intricacies of the patient.

In this regard it is worth to mention the role of different kind of professional in assessing and treating diseases. In the short space of this essay two types of disease will be considered critically.

Heart disease can get trigger from different physical, psychological reasons, therefore the interventions by general practitioners (GP), psychiatrist, health psychologist and social workers treat the disease from different view point and components. GPs do the diagnosis and SOS treatment. European society for cardiology has defined few important guidelines for the general practitioners (Vahanian, et al, 2012). On the other hand psychologist supports the underlying psychological stress behind the suffering. Casal-Godley et al. have discuss the role of psychiatrist at palliative care related to heart disease (Casal-Godley, et al, 2014). Health psychologist on the other hand provide referral and try to understand how the change can be provided through emotional and behavioural development for complete recovery. In heart disease the stress and anxiety. Zhu et al. have demonstrated the role of exercise behaviour in recovery of patients suffering from coronary heart disease. They use transtheoretical model and found a positive outcome (Zhu, et al, 2014). On the other hand McEachan et al. have reported the importance of planned behaviour in heart disease treatment (McEachan, et al, 2011). Social workers are also important in this perspective, Schnall has discussed the importance of social care giving for controlling hypertension. Community care is important in this regards and this is a part of translational care model as described by Williams et al (Williams, et al, 2010).

Diabetes on the other hand a fatal disease and need immediate intervention from the general practitioner, they provide important medicinal and alternative cares. Thepwongsa et al. have discussed the role of motivational intervention by GP in diabetes (Thepwongsa, et al, 2017). Along with GP, there is a big role of health psychologist in the intervention. For diabetic care role of controlled food habit is very important in this regard, role of planned behaviour has been analyzed by White et al. (White, et al, 2010). Physical activity, food habit and self-efficacy are important for diabetic care and should be considered under the intervention of health psychologist using transtheoretical model (Guicciardi, et al, 2014). Many kind of sociological intervention has been utilized to control the atrocities related to diabetes through psychological interventions within the integral framework model (Delamater, et al, 2014).

The assessment framework in England has been classified as two categories (i) the common assessment framework: is the process of identifying the needs of children and young adults and take the required measures, (ii) the single share assessment: is used in Scotland and older people of England, Wales and Northern Ireland using procedural and questioning model. Procedural model is a direct process of exploring needs of adult where as questioning model includes question format for assessing the needs.

Role of health psychology practice to improve individual’s health

Health psychologist are people with special training of dealing with psychological and emotional facets of illness of a person, they also provide supportive treatment for the illness. Promotion of healthy lifestyle encourage people like, wight loss and quit smoking strategies help patients with diabetes, arthritis, cardiovascular disorders and asthma. To promote the skills of improving health the health advisors frequently communicate with their patients and supply the needful things. To establish these service in a sustainable framework with needful development provisions several bodies have been constructed with government interventions. British Psychological Society is one of the most important charitable institution in UK and constantly supply guidelines and standards for psychological intervention of patients. The main goal of this institution is to provide protection to the public in a mindful way. They set standards and ethics for practice and education. They also promote new implementation in the particular field to maintain professional excellence with constant surveillance over the service. They have made certain codes and ethical guidelines in this contest. The practice of decision making has been emphasized specially with multiple relationship with the stakeholders, personal relationship with the patient, surveillance over unclear practice, confidentiality and utmost importance over competence. The ethical principle states the importance of RESPECT: working by valuing the dignity of the individual. COMPETANCE: high standard of competence with functional knowledge, skill, experience and education is solicitated. RESPONSIBILITY towards the patient to the profession, to the science of psychology, keeping in mind the no harm policy. INTEGRITY: honesty, accuracy, fairness and policy to promote scientific and professional intervention. (National collaborating center for mental health, 2011)

The core skill required to follow the BPS guidelines for successful clinical practice . In this regards BPS has mentioned and described this skills in a cyclic way, to develop continuously. Following are the core skill: Assessment – of the problems and ailment by successful use of academic as well as applied psychologist, psychometric test can be done with a proper combination of systematic observation by maintaining a dynamic attitude; Formulation – of the basic needs and problems of a client by integrating the knowledge gain from assessment. Number of models can be discussed for making successful sum up; Intervention – or implementation of amicable solutions is done by involving psychological models, hypothesis to solve the problem; Evaluation – of the results whether effective or ineffective, should be done to confirm the success of next steps; Communication - skills are integral in this regard and should be effective with methodical reporting; Audit and Research – is the overall process of developing to achieve professional satisfaction. Other than this point role of HEALTH and CARE PROFESSIONS COUNCIL (HCPC) is important for reflective practice and shall be discussed later. In spite of methodical formulation of psychological interventions the guidelines have problems regarding the involvement of multidisciplinary team. All members of the team may not have equal ability of analyzing data, moreover sharing of data in an integrated system may have several problematic sides (Alter, et al, 2018).

HEALTH and CARE PROFESSIONS COUNCIL (HCPC) is another body for regulating the standards and ethical values, they are also involved in provide registration. Registered person should meet a few criteria like ability to promote and protect, good communication skill, working within limit, delegate duty, respect, manage the risk, report regularly on safety, be honest and keep records. (HCPC, 2012)

The other notable institutes are also present like, Division of Health Psychology (DPH) for making development by change.

The role of British Psychological Society has been found to have positive impact on counselling psychology in detail. This has improves the relationship between the client and therapist to make a basis of effective treatment (Woolfe, 2016). By circulating knowledge they have provided scientific basis of psychological therapies for schizophrenia and psychosis. In this regard Gore et al. have defined the importance of positive behavioural support in a case study scenario. They have also discussed importance of BPS upon formulation of standards (Gore, et al, 2013).

Integration of health psychology

Integration of health psychology has several positive impact on wellbeing and healthcare. In this regard BPS has taken a very positive role. Scott et al. have discussed it’s importance over early diagnosis and treatment pathways (Scott, et al, 2013). Integration of health psychology is necessary to overcome the psychological, social and behavioural problems associated with a particular disease. Importance of health psychology has been discussed by Danner et al. for the women suffering from eating disorder they found the patients have decision making problems which may be a reason behind the disorder. In this regard motivational boosts may have pragmatic role by enhancing the quality of food habit. Another important implication of health psychological intervention is treatment of addictiveness. The involvement of occupational health psychology is an important process in this regard (Quick, et al, 2011). Best et al, have discussed the role of positive psychological intervention by social identity model (Best, et al, 2015).

The promotion of health psychology is important to make constant upliftment in healthcare. The role of Derbyshire Community Health Service is important in this regard (Holt, 2016). They recruit high quality professionals with ability to multitasking and high team working spirit. Recently they have achieved a good task outcome with high patient satisfaction. They provide proper assessment based advices following a few key points like,

Adjustment with the physical problems.

Improvement of life quality.

Training with key skills to recover properly.

Use of best quality physical treatment.

Treatment of psychological problems whose reason is rooted in health problems.

By following these strategies recently they have achieved a significant height of professionalism. (Henry, 2016)

Conclusion

So far the importance of psychological health has been discussed in the context of theoretical and practical frameworks. The basic theoretical background emphasize on factors related to intrinsic, social and interpersonal traits. These theories though incomplete in nature can have good complementarity and commensalism in practical scenario. The framework exist in current scenario have significant role in shaping the integration of psychological wellbeing in clinical practice. Moreover, new research with developmental strategies are also implemented to mobilize professional services.

References

Alter, G. and Gonzalez, R., 2018. Responsible practices for data sharing. American Psychologist, 73(2), p.146.

Barber, B.E., Grigg, M.J., William, T., Piera, K.A., Boyle, M.J., Yeo, T.W. and Anstey, N.M., 2017. Effects of aging on parasite biomass, inflammation, endothelial activation, microvascular dysfunction and disease severity in Plasmodium knowlesi and Plasmodium falciparum malaria. The Journal of Infectious Diseases, 215(12), pp.1908-1917.

Best, D., Beckwith, M., Haslam, C., Alexander Haslam, S., Jetten, J., Mawson, E. and Lubman, D.I., 2016. Overcoming alcohol and other drug addiction as a process of social identity transition: The social identity model of recovery (SIMOR). Addiction Research & Theory, 24(2), pp.111-123.

Brunner, S., Herndler-Brandstetter, D., Weinberger, B. and Grubeck-Loebenstein, B., 2011. Persistent viral infections and immune aging. Ageing research reviews, 10(3), pp.362-369.

Casey, B.J. and Jones, R.M., 2010. Neurobiology of the adolescent brain and behavior: implications for substance use disorders. Journal of the American Academy of Child & Adolescent Psychiatry, 49(12), pp.1189-1201.

Coe, N.B. and Zamarro, G., 2011. Retirement effects on health in Europe. Journal of health economics, 30(1), pp.77-86.

Cooke, R., Dahdah, M., Norman, P. and French, D.P., 2016. How well does the theory of planned behaviour predict alcohol consumption? A systematic review and meta-analysis. Health psychology review, 10(2), pp.148-167.

Danner, U.N., Ouwehand, C., van Haastert, N.L., Hornsveld, H. and de Ridder, D.T., 2012. Decision‐making impairments in women with binge eating disorder in comparison with obese and normal weight women. European Eating Disorders Review, 20(1), pp.e56-e62.

Dehue, F., Bolman, C., Völlink, T. and Pouwelse, M., 2012. Coping with bullying at work and health related problems. International Journal of Stress Management, 19(3), p.175.

Delamater, A.M., de Wit, M., McDarby, V., Malik, J. and Acerini, C.L., 2014. Psychological care of children and adolescents with type 1 diabetes. Pediatric diabetes, 15(S20), pp.232-244.

Demetriou, A. and Kazi, S., 2013. Unity and modularity in the mind and self: Studies on the relationships between self-awareness, personality, and intellectual development from childhood to adolescence. Routledge.

Dennis, E.A., Potter, K.L., Estabrooks, P.A. and Davy, B.M., 2012. Weight gain prevention for college freshmen: comparing two social cognitive theory-based interventions with and without explicit self-regulation training. Journal of obesity, 2012.

Ferrucci, L.M., Cartmel, B., Turkman, Y.E., Murphy, M.E., Smith, T., Stein, K.D. and McCorkle, R., 2011. Causal attribution among cancer survivors of the 10 most common cancers. Journal of psychosocial oncology, 29(2), pp.121-140.

Gore, N.J., McGill, P., Toogood, S., Allen, D., Hughes, J.C., Baker, P., Hastings, R.P., Noone, S.J. and Denne, L.D., 2013. Definition and scope for positive behavioural support. International Journal of Positive Behavioural Support, 3(2), pp.14-23.

Guicciardi, M., Lecis, R., Anziani, C., Corgiolu, L., Porru, A., Pusceddu, M. and Spanu, F., 2014. Type 2 diabetes mellitus, physical activity, exercise self-efficacy, and body satisfaction. An application of the transtheoretical model in older adults. Health Psychology and Behavioral Medicine: An Open Access Journal, 2(1), pp.748-758.

Ham, C., Smith, J. and Eastmure, E., 2011. Commissioning integrated care in a liberated NHS. London: Nuffield Trust.

Hagger-Johnson, G. and Shickle, D., 2010. Conscientiousness, perceived control over HIV and condom use in gay/bisexual men. Psychology & Sexuality, 1(1), pp.62-74.

Health and Care Professions Council, 2012. Standards of conduct, performance and ethics. HCPC.

Henry, P.M., 2016. Evaluating Derbyshire community health services trust spiritual and pastoral care provision 2015-16.

Holt, R., 2016. Evaluation of the'Live Life Better Service', a community-based weight management service, for morbidly obese patients.

Howcroft, J., Knoefel, F., Wallace, B., Goubran, R., Porter, M.M. and Marshall, S., 2019. Impact of health differences and longitudinal changes on deceleration driving patterns in older adult drivers. Transportation research part F: traffic psychology and behaviour, 60, pp.137-146.

Integrated primary care for patients with mental and physical multimorbidity: cluster randomised controlled trial of collaborative care for patients with depression comorbid with diabetes or cardiovascular disease. bmj, 350.

Kardas, P., Lewek, P. and Matyjaszczyk, M., 2013. Determinants of patient adherence: a review of systematic reviews. Frontiers in pharmacology, 4, p.91.

Kasl-Godley, J.E., King, D.A. and Quill, T.E., 2014. Opportunities for psychologists in palliative care: Working with patients and families across the disease continuum. American Psychologist, 69(4), p.364.

Kinderman, P., McKenna, P. and Laws, K.R., 2015. Are psychological therapies effective in treating schizophrenia and psychosis?. Progress in Neurology and Psychiatry, 19(1), pp.17-20.

Knowles, L., Anokhina, A. and Serpell, L., 2013. Motivational interventions in the eating disorders: what is the evidence?. International Journal of Eating Disorders, 46(2), pp.97-107.

Loretto, W. and Vickerstaff, S., 2013. The domestic and gendered context for retirement. Human relations, 66(1), pp.65-86.

Marlow, L.A., Waller, J. and Wardle, J., 2015. Does lung cancer attract greater stigma than other cancer types?. Lung Cancer, 88(1), pp.104-107.

Mastellos, N., Gunn, L.H., Felix, L.M., Car, J. and Majeed, A., 2014. Transtheoretical model stages of change for dietary and physical exercise modification in weight loss management for overweight and obese adults. Cochrane Database of Systematic Reviews, (2).

McEachan, R.R.C., Conner, M., Taylor, N.J. and Lawton, R.J., 2011. Prospective prediction of health-related behaviours with the theory of planned behaviour: A meta-analysis. Health Psychology Review, 5(2), pp.97-144.

Mercken, L., Snijders, T.A., Steglich, C., Vertiainen, E. and De Vries, H., 2010. Smoking‐based selection and influence in gender‐segregated friendship networks: a social network analysis of adolescent smoking. Addiction, 105(7), pp.1280-1289.

National Collaborating Centre for Mental Health (Great Britain), National Institute for Health, Clinical Excellence (Great Britain), British Psychological Society and Royal College of Psychiatrists, 2011. Common mental health disorders: identification and pathways to care (Vol. 123). RCPsych Publications.

Ogden, J., 2012. Health Psychology: A Textbook: A textbook. McGraw-Hill Education (UK).

Piri, A.R., 2010. Effects of education based on health belief model on dietary adherence in diabetic patients. Journal of Diabetes and Metabolic Disorders, 9, p.15.

Quick, J.C.E. and Tetrick, L.E., 2011. Handbook of occupational health psychology. American Psychological Association.

Safa, M., Boroujerdi, F.G., Talischi, F. and Masjedi, M.R., 2014. Relationship of coping styles with suicidal behavior in hospitalized asthma and chronic obstructive pulmonary disease patients: substance abusers versus non-substance abusers. Tanaffos, 13(3), p.23.

Sarafino, E.P. and Smith, T.W., 2014. Health psychology: Biopsychosocial interactions. John Wiley & Sons.

Schnall, E., 2016. Social support: A role for social work in the treatment and prevention of hypertension. Einstein Journal of Biology and Medicine, 21(2), pp.50-56.

Scott, A.J. and Hanley, T., 2012. On becoming a pluralistic therapist: A case study of a student’s reflexive journal. Counselling Psychology Review, 27(4), p.29.

Scott, S.E., Walter, F.M., Webster, A., Sutton, S. and Emery, J., 2013. The model of pathways to treatment: conceptualization and integration with existing theory. British journal of health psychology, 18(1), pp.45-65.

Smerecnik, C., Grispen, J.E. and Quaak, M., 2012. Effectiveness of testing for genetic susceptibility to smoking-related diseases on smoking cessation outcomes: a systematic review and meta-analysis. Tobacco control, 21(3), pp.347-354.

Solana, R., Tarazona, R., Gayoso, I., Lesur, O., Dupuis, G. and Fulop, T., 2012, October. Innate immunosenescence: effect of aging on cells and receptors of the innate immune system in humans. In Seminars in immunology (Vol. 24, No. 5, pp. 331-341). Academic Press.

Somerville, L.H., Jones, R.M. and Casey, B.J., 2010. A time of change: behavioral and neural correlates of adolescent sensitivity to appetitive and aversive environmental cues. Brain and cognition, 72(1), pp.124-133.

Thepwongsa, I., Muthukumar, R. and Kessomboon, P., 2017. Motivational interviewing by general practitioners for Type 2 diabetes patients: a systematic review. Family practice, 34(4), pp.376-383

Tiihonen, K., Ouwehand, A.C. and Rautonen, N., 2010. Human intestinal microbiota and healthy ageing. Ageing research reviews, 9(2), pp.107-116.

Tuah, N.A., Amiel, C., Qureshi, S., Car, J., Kaur, B. and Majeed, A., 2011. Transtheoretical model for dietary and physical exercise modification in weight loss management for overweight and obese adults. Cochrane Database of Systematic Reviews, (10).

Tun, P.A., Williams, V.A., Small, B.J. and Hafter, E.R., 2012. The effects of aging on auditory processing and cognition. American Journal of Audiology.

Umberson, D. and Karas Montez, J., 2010. Social relationships and health: A flashpoint for health policy. Journal of health and social behavior, 51(1_suppl), pp.S54-S66.

Vahanian, A., Alfieri, O., Andreotti, F., Antunes, M.J., Barón-Esquivias, G., Baumgartner, H., Borger, M.A., Carrel, T.P., De Bonis, M. and Evangelista, A., 2012. Guidelines on the management of valvular heart disease (version 2012) The Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). European heart journal, 33(19), pp.2451-2496.

White, K.M., Terry, D.J., Troup, C., Rempel, L.A. and Norman, P., 2010. Predicting the consumption of foods low in saturated fats among people diagnosed with Type 2 diabetes and cardiovascular disease. The role of planning in the theory of planned behaviour. Appetite, 55(2), pp.348-354.

Williams, G., Akroyd, K. and Burke, L., 2010. Evaluation of the transitional care model in chronic heart failure. British Journal of Nursing, 19(22), pp.1402-1407.

Woolfe, R., 2016. Mapping the world of helping: The place of counselling psychology. The handbook of counselling psychology, pp.5-19.

Zhu, L.X., Ho, S.C., Sit, J.W.H. and He, H.G., 2014. The effects of a transtheoretical model-based exercise stage-matched intervention on exercise behavior in patients with coronary heart disease: a randomized controlled trial. Patient Education and Counseling, 95(3), pp.384-392.

Zimmermann, F. and Sieverding, M., 2010. Young adults' social drinking as explained by an augmented theory of planned behaviour: The roles of prototypes, willingness, and gender. British journal of health psychology, 15(3), pp.561-581.