CIE A Level Psychology Health Psychology Exam Questions

About CIE A Level Psychology Health Psychology

Health psychology is one of four specialist options at A Level on the Cambridge 9990 course. It has five topics: 3.1 The patient-practitioner relationship, 3.2 Adherence to medical advice, 3.3 Pain, 3.4 Stress and 3.5 Health promotion. It draws on biological, cognitive and learning approaches to explain how people use health services, manage illness and change their behaviour. The five key studies are Savage and Armstrong (1990), Yokley and Glenwick (1984), Brudvik et al. (2016), Bridge et al. (1988) and Shoshani and Steinmetz (2014). The option is assessed in Paper 3 and in Section A of Paper 4, where you must apply theory to scenarios and evaluate methods of measurement.

What you need to know

• 3.1 Patient-practitioner relationship Interpersonal skills (e.g. doctors' clothing, McKinstry and Wang, 1991; medical jargon), doctor-centred and patient-centred styles, and misuse of health services such as delay and Munchausen syndrome. Savage and Armstrong (1990) found patients were more satisfied with a directing style than a sharing style from a GP.
• 3.2 Adherence to medical advice Types and reasons for non-adherence, including rational non-adherence and the health belief model. Measures include interviews, pill counts and biological tests. Yokley and Glenwick (1984) found that prompts and especially money incentives increased immunisation rates for pre-school children.
• 3.3 Pain Types of pain (acute, chronic), phantom limb pain, specificity theory and gate control theory. Measures include the clinical interview, McGill Pain Questionnaire, visual analogue scales and the UAB pain behaviour scale. Brudvik et al. (2016) found that doctors underestimated children's pain compared with the children's own ratings in an emergency department.
• 3.4 Stress Sources of stress (GAS model, life events, work stress, Type A personality), measures (physiological, salivary cortisol, self-report scales) and management. Bridge et al. (1988) found relaxation and imagery training improved mood in women with breast cancer having radiotherapy.
• 3.5 Health promotion Fear arousal (Janis and Feshbach, 1953), providing information, interventions in schools and worksites, unrealistic optimism (Weinstein, 1980) and positive psychology. Shoshani and Steinmetz (2014) evaluated a school positive psychology programme that improved wellbeing and reduced distress in adolescents.
• Evaluation of health topics Compare objective and subjective measures (e.g. pill counts versus self-report), consider the ethics of interventions with patients and children, and assess usefulness and generalisability of field studies.

Common mistakes in Health Psychology

• Describing gate control theory as pain travelling directly from receptor to brain. That is specificity theory; gate control theory says a 'gate' in the spinal cord can open or close to change pain perception.
• Saying patient-centred styles are always preferred. Savage and Armstrong found patients were more satisfied with a directing style in their sample.
• Treating pill counts as perfectly valid. Patients can throw pills away, so counts may overestimate adherence.
• Mixing up rational non-adherence with forgetting. Rational non-adherence is a deliberate decision based on reasons such as side effects or cost.
• Describing the GAS model with the stages in the wrong order. It is alarm, resistance, then exhaustion.

Try three Health Psychology exam-style questions