6 Health and well-being

Health and well-being is the context in which psychology is applied to illness and to living well. It studies mental health disorders such as depression, health problems such as obesity and addiction, and the ways both can be prevented and treated.

The context treats mind and body as one system. Chronic stress raises blood pressure and suppresses the immune system; physical illness affects mood; and behaviours such as eating, drinking and smoking are shaped by thoughts, feelings and social influences. Mental health and physical health can be assessed fairly objectively, through diagnosis and medical measures, while well-being is people’s own sense that their life is going well. Being free of a disorder is not the same as having high well-being, and both matter.

Well-being is usually measured by asking people to rate how satisfied they are with their life and how often they feel positive and negative emotions.

A mental health disorder is a pattern of thoughts, emotions and behaviour that causes significant distress or impairment and meets agreed criteria, usually those of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) or the World Health Organization’s ICD-11. A health problem is a condition that harms physical health and is strongly influenced by behaviour, such as obesity, drug misuse or social media addiction.

Questions the topic tries to answer

• Why do some people develop a mental health disorder such as depression while others in similar situations do not?

• How much do genes, brain chemistry, ways of thinking, life events and social conditions each contribute, and how do they interact?

• Why do recorded rates of disorders and health problems differ between countries, cultures and groups, and change over time?

• How do stress, social influence and the environment shape health behaviours such as eating, smoking and drug use?

• How effective are biological and psychological treatments, and how should effectiveness be measured?

• What works in preventing health problems, and why do people find healthy behaviour change so hard?

The subtopics

The topic has three groups of subtopics. Major depressive disorder is the main disorder across the topic, with post-traumatic stress disorder, panic disorder, other anxiety disorders and schizophrenia used for comparison; obesity and addiction, especially tobacco addiction, are the main health problems.

The disorders named in the topic

How the subtopics connect

The first four subtopics explain mental health disorders from the biological, cognitive and sociocultural approaches. They are best read together, because each explains a different part of the same process: a genetic or cognitive vulnerability, triggered by an environmental stressor, expressed in culturally shaped ways. The diathesis-stress model is the framework that joins them. The treatment subtopics follow from them: antidepressants were developed from biological explanations, and cognitive behavioural therapy from cognitive models.

The health-problem subtopics explain why behaviours such as overeating and smoking spread and persist, through social learning, stress and changes in the environment. Their findings are applied in prevention, which is why the last subtopic asks what works and why change is hard. Stress links the two halves: stressful life events trigger depression, and chronic stress also affects the immune system and health behaviours.

Links to the concepts and the rest of the course

The context uses terms from all three approaches: chemical messengers, genetic inheritance, neurotransmission and the diathesis-stress model from the biological approach; cognitive models and schema theory from the cognitive approach; and cultural dimensions, the emic and etic approaches, acculturation and social learning theory from the sociocultural approach. Research methodology matters throughout, since much of the evidence comes from twin studies, cohort studies, randomised controlled trials and cross-cultural surveys. The class practical linked to this context is the interview, which suits research on people’s experience of health and illness.

How SL and HL differ

SL and HL students study the same health and well-being content and sit the same Papers 1 and 2. HL students go further through the HL extensions: culture (for example, how culture shapes help-seeking and the adaptation of therapies), motivation (for example, motivation to change health behaviour) and technology (for example, internet-delivered therapy and the effects of social media on mental health). HL students apply this to unseen sources, often set in the health context, in Paper 3.

Assessment

• Paper 1 Section B: a short scenario may be set in health and well-being and ask how an approach term, such as the diathesis-stress model, schema theory or social learning theory, applies to it.

• Paper 1 Section C: one of the two essay questions may be set in this context, combining an area of study, such as biological explanations or environmental factors, with a concept such as causality or perspective.

• Paper 2 Section A: when the interview is the class practical examined, the questions concern the interview used in that practical, which is linked to this context.

• Paper 2 Section B: the unseen study may come from health and well-being research, such as a trial of a treatment or a survey of health behaviour.

• Paper 3 (HL): sources may explore the role of culture, motivation or technology in health and well-being, for example technology and the mental health of students.