5 Mental and Physical Health
- Syllabus
- 2025
- Section
- 5
- Level
- —
Health psychology addresses physical health and wellness as they relate to behavior and mental processes. It asks how what people do, think, and feel is associated with health—and how health experiences are associated with behavior and mental life.
| Domain | Health-psychology focus |
|---|---|
| Physical health | Bodily health conditions and functioning |
| Wellness | Overall state of functioning and well-being |
| Behavior | Actions relevant to health and responses to health conditions |
| Mental processes | Thoughts, emotions, perceptions, and other internal processes related to health |
A health psychologist might examine a relationship among a health-related action, a person's thoughts or emotions, and a physical or wellness outcome. The psychological task is to identify the measured relationship and evidence, not to assume that any association proves one-way causation.
Health psychology is not limited to diagnosing physical disease, and it does not treat health as purely mental. Its scope is the connection among physical health, wellness, behavior, and mental processes.
Stress can heighten susceptibility to disorders and disease. It is linked with physiological issues including hypertension, headaches, and immune suppression. A link means stress contributes to risk; it does not mean every stressed person develops the same condition or that stress is the only cause.
| Stressor category | Distinguishing feature |
|---|---|
| Eustress | Experienced as motivating |
| Distress | Experienced as debilitating |
| Trauma | An intensely stressful experience |
| Daily hassle | A smaller recurring stressor whose effects can accumulate |
| Adverse childhood experience (ACE) | Childhood source of stress that can affect a person across the lifespan |
The same demand may be interpreted as motivating by one person and debilitating by another. Duration also matters: a single daily hassle may be limited, but repeated hassles can build up over time and contribute to sustained stress.
Eustress is still stress; the term identifies a motivating appraisal rather than the absence of physiological activation. An ACE is a source of later risk, not a guarantee of a particular lifelong outcome.
| GAS phase | What happens |
|---|---|
| Alarm reaction | The stressor is encountered and a fight-flight-freeze response begins |
| Resistance | The person confronts or adapts to the continuing stress while resources remain engaged |
| Exhaustion | The stress subsides or resources are spent; susceptibility to illness is greatest |
General adaptation syndrome describes a process, so phase order matters. Alarm is the initial response, resistance is sustained confrontation, and exhaustion reflects the endpoint of prolonged resource use or the period after the stress subsides.
Tend-and-befriend theory proposes another stress reaction: tending to one's own needs or the needs of others and seeking connection. The CED reports that this pattern seems to occur mostly in women; this is a research tendency, not a rule that excludes men or requires every woman to respond this way.
Fight-flight-freeze and tend-and-befriend describe reaction patterns; problem-focused and emotion-focused coping describe strategies for managing stress. Do not treat reaction and coping as the same stage.
| Coping form | Primary target | CED-supported example |
|---|---|---|
| Problem-focused | The stress-producing problem | Work through possible solutions until one is found |
| Emotion-focused | The emotional reaction to stress | Deep breathing, meditation, or medication aimed at reducing the stressful emotional response |
To classify a coping response, ask what the person is trying to change. Creating and carrying out a solution targets the problem. Regulating distress targets the emotional response even if the stressor itself remains.
The two forms are not mutually exclusive. A person can use deep breathing to manage emotion and then work through a practical solution. Each action is classified by its immediate target.
Emotion-focused coping is not automatically avoidance, and problem-focused coping is not simply thinking about a problem. The defining difference is regulation of emotion versus action toward solving the stressor.
Positive psychology seeks to identify factors associated with healthy and constructive functioning. Its targets include well-being, resilience, positive emotions, and psychological health.
| Target | Research focus |
|---|---|
| Well-being | How positively a person experiences and evaluates life |
| Resilience | Positive adaptation or recovery when facing difficulty |
| Positive emotions | Pleasant emotional experiences and their relationships with behavior and thought |
| Psychological health | Healthy mental functioning, not only the absence of symptoms |
A study that asks which experiences or practices relate to resilience or subjective well-being uses a positive-psychology approach. The approach still requires systematic evidence; calling an experience 'positive' does not establish that it causes the same benefit for everyone.
Positive psychology does not deny stress, trauma, or psychological disorders. It changes the research question toward factors that may support positive functioning.
| Positive-psychology idea | CED relationship |
|---|---|
| Expressing gratitude | Increases subjective well-being |
| Exercising signature strengths or virtues | People report greater happiness and subjective well-being |
| Posttraumatic growth | Positive growth may occur after trauma or stress |
A classification of character strengths groups virtues into six categories: wisdom, courage, humanity, justice, temperance, and transcendence. A signature strength is a strength especially characteristic of the individual; applying it is the experience linked with the reported outcome, not merely knowing the category name.
Posttraumatic growth means a positive change may emerge after trauma or stress. The word 'may' is essential: growth is a possible outcome, can coexist with distress, and should not be assumed from the fact that trauma occurred.
Subjective well-being is the person's experienced or reported well-being; it is not identical to an externally measured life condition. Positive experiences are associated with beneficial outcomes but do not make negative emotion or difficulty disappear.
| Identification factor | Question it raises |
|---|---|
| Dysfunction | Does the pattern interfere with important areas of functioning? |
| Perceived distress | Does the person experience significant suffering or difficulty? |
| Deviation from social norms | Is the pattern outside expectations in the relevant social and cultural context? |
These factors are considered together and in context. Deviation alone is not enough: cultural and societal norms influence judgment, and racism, sexism, ageism, stigma, or other discrimination can distort who is labeled and how a diagnosis is received.
| Classification system | Developer | Role |
|---|---|---|
| DSM | American Psychiatric Association | Classifies mental disorders |
| ICD | World Health Organization | Classifies mental disorders |
Classification can support communication, evidence-based decisions, and access to appropriate help, but it can also contribute to stigma or biased treatment. Diagnosis therefore requires specialized training and evidence-based tools. DSM and ICD are updated as research and practice advance.
Unusual behavior is not automatically disordered, and a checklist used without specialized training is not a valid diagnosis. Classification describes a clinically evaluated pattern, not the whole person.
| Perspective | Primary causal focus |
|---|---|
| Behavioral | Maladaptive learned associations among stimuli and responses |
| Psychodynamic | Unconscious thoughts and experiences, often developing in childhood |
| Humanistic | Limited social support and inability to fulfill one's potential |
| Cognitive | Maladaptive thoughts, beliefs, attitudes, or emotions |
| Evolutionary | Behaviors or mental processes that reduce likelihood of survival |
| Sociocultural | Maladaptive social and cultural relationships or dynamics |
| Biological | Physiological or genetic issues |
To identify a perspective, locate the proposed cause—not the symptom being described. A learned association indicates a behavioral explanation; maladaptive belief patterns indicate a cognitive explanation; a physiological or genetic mechanism indicates a biological explanation.
An eclectic approach deliberately uses more than one psychological perspective when diagnosing or treating a client. It can combine complementary explanations rather than assuming that one perspective accounts for every contributing factor.
A perspective is a framework for explaining possible causes; it is not itself a disorder or a diagnostic test. Multiple perspectives can propose different mechanisms for the same observed pattern.
| Model | Factors combined | Core claim |
|---|---|---|
| Biopsychosocial | Biological, psychological, and sociocultural | Any psychological problem may involve a combination across these domains |
| Diathesis-stress | Genetic vulnerability (diathesis) and stressful life experience | Disorder develops through the combination of vulnerability and stress |
A biopsychosocial explanation might examine a physiological predisposition, maladaptive beliefs, and a stressful social environment together. The model organizes kinds of contributors; it does not require that all three contribute equally in every case.
In a diathesis-stress explanation, a genetic vulnerability may not produce a disorder on its own, and a stressful experience may not affect every person in the same way. Risk changes through their combination.
The models are not interchangeable. Biopsychosocial is a broad multi-domain framework; diathesis-stress is a specific vulnerability-by-stress mechanism. Neither model says that one factor alone guarantees a disorder.
Neurodevelopmental disorders begin during the developmental period. Their symptoms are evaluated in relation to behavior expected for the person's age or maturity range, so the same behavior cannot be interpreted without developmental context.
| AP scope element | CED boundary |
|---|---|
| Selected disorders | Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) |
| Symptom frame | Whether behavior is appropriate for age or maturity range |
| Possible causes | Environmental, physiological, or genetic |
A valid description connects the observed pattern to developmental timing and functioning rather than treating one isolated behavior as sufficient. Possible causes identify domains to investigate; they do not prove that one factor produced a disorder.
The CED names ADHD and ASD here but does not supply full diagnostic criteria. Age-inappropriate behavior may be relevant evidence, but diagnosis requires a broader trained assessment.
| Area | CED description | Symptom type |
|---|---|---|
| Delusion | False belief, such as persecution or grandeur | Positive |
| Hallucination | False perception involving one or more senses | Positive |
| Disorganized thinking or speech | May include word salad, a nonsensical string of words | Positive |
| Disorganized motor behavior | May include catatonic excitement or stupor | Positive or negative manifestation |
| Negative symptom | Lack of a typical behavior, such as flat affect or movement | Negative |
Schizophrenia can be acute or chronic. Positive symptoms add or markedly distort experience or behavior; negative symptoms involve a reduction or absence of typical functioning. Catatonia can appear as excitement or as stupor, so its manifestation determines the classification.
Possible causes suggest genetic or biological links, including prenatal virus exposure and neurotransmitter imbalance described by the dopamine hypothesis. These are risk explanations, not single-case proof.
Hallucinations are perceptions; delusions are beliefs. Schizophrenia is not the same as dissociative identity disorder, and the presence of one unusual experience alone does not establish a diagnosis.
Depressive disorders involve a sad, empty, or irritable mood together with physical and cognitive changes that affect the person's ability to function. The functional effect separates a clinically relevant pattern from an ordinary temporary mood alone.
| AP scope | Included content |
|---|---|
| Selected disorders | Major depressive disorder and persistent depressive disorder |
| Possible-cause domains | Biological, genetic, social, cultural, behavioral, or cognitive |
Relevant evidence can include mood plus changes in areas such as thought, sleep, appetite, pleasure, or other functioning when supported by the scenario. A causal explanation must name the supported domain rather than assume every depressive pattern has the same origin.
Sadness by itself is not equivalent to a depressive disorder. The CED names the two selected disorders but does not provide subtype duration thresholds here, so those thresholds should not be invented.
Bipolar disorders are characterized by periods of mania and periods of depression. Bipolar cycling means these mood periods alternate, and each period can last a different amount of time.
| AP scope element | Included content |
|---|---|
| Selected disorders | Bipolar I disorder and Bipolar II disorder |
| Defining pattern | Alternating periods of mania and depression |
| Possible-cause domains | Biological, genetic, social, cultural, behavioral, or cognitive |
The key evidence is a pattern across time, not simply intense emotion at one moment. Possible causes may come from several domains, so a biological risk finding and a social stressor can both be relevant without either being a universal cause.
Bipolar cycling is not ordinary rapid mood change in everyday situations. The CED names Bipolar I and II but does not specify their distinguishing episode thresholds here, so the card does not add them.
| Disorder | Distinguishing focus |
|---|---|
| Specific phobia | A particular object or situation, such as heights or spiders |
| Agoraphobia | Situations such as transport, open or enclosed spaces, crowds or lines, or being outside home alone |
| Panic disorder | Unanticipated, overwhelming panic attacks involving biological, cognitive, and emotional fear |
| Social anxiety disorder | Intense fear of being judged or watched by others |
| Generalized anxiety disorder | Prolonged nonspecific anxiety or fear |
The CED includes culture-bound manifestations. Ataque de nervios is associated mainly with people of Caribbean or Iberian descent. Taijin kyofusho, associated mainly with Japanese people, involves fear that others judge one's body as undesirable, offensive, or unpleasing.
Possible causes include learned associations, maladaptive thinking or emotional responses, and biological or genetic sources. The supported cause must be inferred from evidence in the scenario, not from the disorder label alone.
Agoraphobia is not simply fear of open spaces, and social anxiety is not merely shyness. Social anxiety is distinct from, though it may include, agoraphobia.
| Construct | CED meaning | Role in the cycle |
|---|---|---|
| Obsession | Intrusive thought | Produces a concern or distress that the person experiences |
| Compulsion | Intrusive, often repetitive behavior intended to address an obsession | Acts as the attempted response to the obsession |
The selected disorders in AP scope are obsessive-compulsive disorder and hoarding disorder. Possible causes may involve learned associations, maladaptive thinking or emotional responses, and biological or genetic sources.
A repetitive action counts as a compulsion in this framework when it is intended to address an obsession, such as reducing anxiety linked to the intrusive thought. Repetition alone does not reveal the function of the behavior.
An obsession is not ordinary enthusiasm, and a compulsion is not merely a preferred routine. The CED names hoarding disorder but does not provide separate criteria here, so none are inferred.
Dissociative disorders involve disruptions or separations in normally integrated experience. The CED domains include consciousness, memory, identity, emotion, perception, body representation, motor control, and behavior.
| AP scope element | Included content |
|---|---|
| Selected disorders | Dissociative amnesia, with or without fugue, and dissociative identity disorder |
| Possible causes | Experience of trauma or stress |
To recognize this category, identify which aspect of experience is disconnected—for example memory or identity—rather than looking for a hallucination or delusion. Trauma or stress is a possible causal context, not proof from symptoms alone.
Dissociation is not the same as schizophrenia. The CED names amnesia with and without fugue but does not give a separate fugue criterion here, so the card does not invent one.
Trauma and stressor-related disorders begin with exposure to a traumatic or stressful event followed by psychological distress. The selected disorder in AP scope is posttraumatic stress disorder (PTSD).
CED-listed possible symptoms are hypervigilance, severe anxiety, flashbacks to traumatic or stressful experiences, insomnia, emotional detachment, and hostility. A scenario may show more than one because the category includes cognitive, emotional, behavioral, and arousal-related effects.
The diagnostic learning link is temporal and contextual: a trauma or stressor is experienced, and continuing psychological distress follows. Possible causes therefore involve the experience of trauma or stress.
Experiencing stress or one short-lived reaction does not by itself establish PTSD. The CED supplies a category pattern, while diagnosis requires trained assessment of the complete presentation.
Feeding and eating disorders involve altered consumption or absorption of food that impairs physical health or psychological functioning. The impairment is part of the category definition; a food preference alone is not enough.
| AP scope element | Included content |
|---|---|
| Selected disorders | Anorexia nervosa and bulimia nervosa |
| Possible-cause domains | Biological, genetic, social, cultural, behavioral, or cognitive |
A description should identify the altered food-related pattern and its effect on health or psychological functioning. A cause explanation should name the supported domain and avoid assuming that culture, biology, or cognition acts alone in every case.
The CED names anorexia nervosa and bulimia nervosa but does not give their differential diagnostic criteria in this Objective. Do not infer a diagnosis from body size, one meal, or appearance.
Personality disorders involve an enduring pattern of internal experience and behavior that deviates from the person's culture, is pervasive and inflexible, begins in adolescence or early adulthood, remains stable over time, and causes personal distress or impairment.
| Cluster | CED description | Selected disorders |
|---|---|---|
| A | Odd or eccentric | Paranoid, schizoid, schizotypal |
| B | Dramatic, emotional, or erratic | Antisocial, histrionic, narcissistic, borderline |
| C | Anxious or fearful | Avoidant, dependent, obsessive-compulsive personality |
Possible causes may involve biological, genetic, social, cultural, behavioral, or cognitive sources. The classification focuses on a stable pattern across contexts and time, not on one isolated trait or reaction.
A personality trait is not automatically a personality disorder; the pattern must be enduring, pervasive, inflexible, culturally deviant, and linked with distress or impairment. Obsessive-compulsive personality disorder is listed in Cluster C and is not the same label as obsessive-compulsive disorder.
Meta-analytic studies combine findings across many psychotherapy studies. Many researchers using this approach conclude that psychotherapies are generally effective. This supports a broad trend, not a claim that every therapy works equally well for every client or disorder.
| Treatment element | Role |
|---|---|
| Meta-analytic evidence | Estimates overall patterns across studies |
| Evidence-based intervention | Uses research evidence to help build a treatment plan |
| Cultural humility | Keeps the therapist attentive to the client's cultural context and limits of the therapist's assumptions |
| Therapeutic alliance | Establishes a collaborative working relationship needed to deliver therapy successfully |
A sound treatment plan therefore needs more than a technique name: it connects an evidence-supported intervention with the client's needs and context, while the therapeutic alliance supports successful delivery.
General effectiveness does not prove that one approach is best in every case. An evidence-based technique and a strong alliance serve complementary rather than interchangeable functions.
As psychotropic medication therapy became more widely used and effective, hospitals and asylums deinstitutionalized large numbers of people in the late twentieth century. Treatment increasingly moved away from long-term centralized institutions toward decentralized settings.
| Trend | Meaning |
|---|---|
| Deinstitutionalization | Large-scale movement of people out of hospitals and asylums |
| Decentralized treatment | Care delivered outside one large long-term institution |
| Combined treatment | Medication used together with psychological therapy |
The modern preference described by the CED is often a combination of medication and psychological therapies. Each component targets different aspects of a disorder, so combination does not mean they are the same intervention.
The historical trend does not show that medication alone addresses every psychological or social need. It explains a change in treatment setting and practice, not a universal outcome for every person.
| APA principle | Treatment duty |
|---|---|
| Nonmaleficence | Avoid causing harm |
| Fidelity | Maintain trust and professional responsibility |
| Integrity | Act honestly and accurately |
| Respect for people's rights and dignity | Protect autonomy, privacy, and human worth |
The principles work together. A therapist considering an intervention must weigh possible harm, preserve a trustworthy professional relationship, describe the treatment honestly, and respect the client's rights and dignity.
A helpful intention does not remove ethical duties. Clinical and therapeutic situations require psychologists to follow the principles throughout assessment, planning, delivery, and communication.
| Approach | CED techniques | Intended change |
|---|---|---|
| Psychodynamic | Free association, dream interpretation | Uncover unconscious material |
| Cognitive | Cognitive restructuring, fear hierarchies; examine the cognitive triad of negative thoughts about self, world, and future | Change maladaptive thinking |
| Applied behavior analysis | Exposure or systematic desensitization, aversion therapy, token economies | Apply conditioning principles to behavior |
| Biofeedback | Condition regulation of body systems such as sympathetic and parasympathetic activity | Improve control of bodily responses linked with anxiety or depression |
| Cognitive-behavioral | Dialectical behavior therapy, rational-emotive behavior therapy | Combine cognitive and behavioral techniques |
| Humanistic/person-centered | Active listening, unconditional positive regard | Provide a client-centered relationship |
Identify a technique by its mechanism. Changing a maladaptive interpretation is cognitive; changing learned behavior through conditioning is behavioral; using both is cognitive-behavioral. Active listening and unconditional positive regard indicate a person-centered approach.
A fear hierarchy is listed with cognitive therapies in this CED, while systematic desensitization is an exposure method using behavioral principles. Similar topics do not make their mechanisms identical.
| Format | Participants in the therapeutic session | Distinct interaction source |
|---|---|---|
| Individual therapy | One client works with a therapist | Therapist–client interaction |
| Group therapy | Multiple clients participate with a therapist or therapists | Therapist interaction plus interaction among group members |
The difference is the treatment format, not necessarily the theoretical perspective. A cognitive, behavioral, or other technique can be delivered in a format whose participants and interactions differ.
The CED Objective asks for the distinction but supplies no claim that one format is always more effective. Do not infer superiority, confidentiality practices, or outcomes not provided by evidence.
| Claim about hypnosis | Research status in the CED |
|---|---|
| Treating pain | Has shown effectiveness |
| Treating anxiety | Has shown effectiveness |
| Retrieving accurate memories | Not supported |
| Regressing a person in age | Not supported |
An evidence-based use must match the supported outcome. Data showing reduced chronic pain after hypnosis can support a treatment claim about pain; it cannot be repurposed as evidence that hypnosis recovers accurate memories.
A vivid or confident recollection produced under hypnosis is not evidence of accuracy. Effectiveness for pain or anxiety does not validate unrelated claims about memory or age regression.
| Medication class or example | Biological principle |
|---|---|
| Antidepressants | Interact with specific central nervous system neurotransmitters |
| Antianxiety drugs | Interact with specific central nervous system neurotransmitters |
| Lithium | Addresses a possible biochemical cause through biological action |
| Antipsychotic medication | Interacts with neurotransmitter systems to treat psychotic symptoms |
Psychoactive medications can cause side effects. Tardive dyskinesia is a movement disorder related to dopamine regulation in the nervous system and is an important risk associated with some medication use.
| Surgical or invasive intervention | CED scope |
|---|---|
| Psychosurgery | May involve lesioning |
| TMS | Transcranial magnetic stimulation |
| Electroconvulsive therapy | Listed biological intervention |
| Lobotomy | Historical psychosurgery, popular in the mid-twentieth century and rarely, if ever, performed today |
Biological interventions are not interchangeable: medications act through biochemical systems, while procedures intervene differently. The CED describes categories and risks, not instructions for choosing or administering treatment.