| Course | HLTH 8745 Health Psychology |
|---|---|
| Week | Week 1 |
| Paper type | Discussion post |
| Length | About 510 words, 3 pages |
| Format | Discussion post, APA 7 citations |
| School | Walden University |
| Program | PhD in Public Health |
| Updated | October 2026 |
Free sample paper for HLTH 8745 Week 1
Week 1 Discussion: Evaluating Psychological Explanations of Illness
Why the Stress Account of Peptic Ulcer Lost Ground: A Route Never Shown Case by Case Against a Bacterium Named, Found in the Tissue and Removed to Stop Recurrence
For much of the twentieth century, peptic ulcers were explained as the stomach's answer to worry. Hard-driving executives were said to get them, and treatment combined acid reduction with rest and a bland diet. By the 1990s that account had largely given way to a bacterial one. I think the shift happened not because stress was disproved but because the bacterial account met a standard the stress account never did: it named an agent, found it in the diseased tissue and stopped the disease by removing it.
The bacterial account met all three steps. Marshall and Warren (1984) reported curved bacilli, later named Helicobacter pylori, in the stomachs of patients with gastritis and peptic ulceration, linking an agent to the tissue where the disease occurred. The decisive evidence came from treatment. In a randomized trial, Hentschel et al. (1993) gave patients with duodenal ulcers either antibiotics or placebo alongside acid suppression. Over 12 months, ulcers recurred in 8% of patients given antibiotics and 86% of those given placebo. Among patients whose infection was eradicated, only 1 of 46 had a recurrence.
The stress account rested mostly on associations: people under strain seemed to get ulcers more often. What it never showed, patient by patient, was the route from worry to a hole in the duodenal wall. Without a route, it could not predict who would get an ulcer or offer a treatment that removed the cause.
Yet the story is not simply bacteria winning over psychology. Most people infected with H. pylori never develop an ulcer, and some ulcers occur without it, often linked to anti-inflammatory drugs. Levenstein (2000) argued that a biopsychosocial view still fits the evidence: infection may be necessary in many cases but not sufficient, and stress could plausibly affect susceptibility through behaviors such as smoking and drug use or through physiological effects on acid and healing. That is a narrower claim than the old stress account, and it comes with routes that can be tested.
The lesson I take for this course is that psychological explanations of illness need to specify a route as concretely as a biological one would. "Stress causes ulcers" told doctors nothing they could act on; "stress increases smoking, which impairs healing of an infected mucosa" is a claim with steps that can each be checked.
The same standard applies to explanations we may find more appealing today. Claims that loneliness causes heart disease or that optimism protects against infection often rest on associations in large cohorts, much as the ulcer stress account once did. Some of them may be right. What would make them convincing is the same thing that made the bacterial account convincing: a named intermediate step, evidence that the step occurs in the people who become ill and, ideally, a test showing that changing the step changes the outcome.
Classmates: which psychological explanation in your own area still lacks a demonstrated route?
References
Hentschel, E., Brandstätter, G., Dragosics, B., Hirschl, A. M., Nemec, H., Schütze, K., Taufer, M., & Wurzer, H. (1993). Effect of ranitidine and amoxicillin plus metronidazole on the eradication of Helicobacter pylori and the recurrence of duodenal ulcer. New England Journal of Medicine, 328(5), 308-312. https://doi.org/10.1056/NEJM199302043280503
Levenstein, S. (2000). The very model of a modern etiology: A biopsychosocial view of peptic ulcer. Psychosomatic Medicine, 62(2), 176-185. https://doi.org/10.1097/00006842-200003000-00003
Marshall, B. J., & Warren, J. R. (1984). Unidentified curved bacilli in the stomach of patients with gastritis and peptic ulceration. The Lancet, 323(8390), 1311-1315. https://doi.org/10.1016/S0140-6736(84)91816-6
Reading the HLTH 8745 Week 1 instructions
The opening thread asks students to evaluate a psychological explanation of illness using a historical case. Faculty expect the post to state a standard for judging explanations and to apply it to the competing accounts, rather than simply retelling the history. The strongest posts explain why one account replaced another, focusing on the kind of evidence each could produce: associations, an identified agent, evidence in diseased tissue, or a trial showing that removing the cause changes the outcome. Faculty also value posts that avoid swinging from a psychological explanation to an equally unexamined biological one, and that state what role psychology might still play. Asking classmates to hold one claim from their own field to this standard gives the replies somewhere to go.
How the HLTH 8745 Week 1 example is put together
The post opens by describing the stress account of ulcers and states the three-step standard the bacterial account met. A paragraph cites Marshall and Warren on bacilli in the stomachs of patients with gastritis and ulcers and Hentschel and colleagues' randomized trial with its recurrence figures. A paragraph explains that the stress account rested on associations without a demonstrated route. A paragraph cites Levenstein's biopsychosocial view, noting that infection is common while ulcers are not and that stress could act through behaviors and healing. The author then draws a lesson for the course, applies the standard to current claims about loneliness and optimism, and ends with a question asking classmates which explanation in their area still lacks a route.
Where the marks sit in the HLTH 8745 Week 1 rubric
Faculty grade this post on the clarity of the standard and the accuracy of its application. Retelling the discovery of H. pylori earns modest credit. Credit rises when the post explains why the evidence for one account was stronger, using the specific features of each kind of evidence. Reporting trial results accurately is checked. Faculty value a balanced conclusion that preserves a role for psychological factors where the evidence supports it, rather than declaring psychology irrelevant. Applying the standard to a current claim shows the lesson has been generalized. Sources should be primary or authoritative reviews. The engagement share goes to an ending that hands peers the standard to try on their own topics.
HLTH 8745 Week 1 help from the desk
Posts on the ulcer case often tell the story of a surprising discovery and conclude that stress was a myth. That misses the methodological lesson. To write a stronger post, state what an explanation of illness needs to show, such as a named intermediate step, evidence that the step occurs in affected people and a test showing that changing it changes the outcome. Apply that standard to both accounts. Report the key trial results accurately. Explain what role stress might still play and how that role could be tested. Then apply the standard to a psychological claim you meet today. A discussion post on the case your thread assigns can be drafted to this structure.
Get a HLTH 8745 Week 1 example written to your instructions
Send the thread prompt, its rubric and any claim to be tested. Back comes a post that uses settled medical history to state what a link between mind and body has to show, cites Engel for his argument, and ends on an answerable question. No real patient appears. It takes 24 to 48 hours, with the first free.
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HLTH 8745 Week 1 questions, answered
Why use peptic ulcers in a health psychology discussion?
Because the answer is known, which is rare. Most mind-body claims are still open, so a debate about them tests opinion as much as method. The ulcer history lets your post show a method working on a case where the outcome is settled, and then carry that method to a claim that is not. Some sections prefer a current example; the four conditions travel either way.
Does the biopsychosocial model count as evidence for a mind-body link?
No. Engel's model is an argument about what a complete explanation should include, and it is well suited to widening a question. It does not specify which psychological factor affects which physical outcome, or through what route. Your post can cite it to justify looking at psychological and social levels, and then needs separate evidence for any particular link it proposes.
Is the post saying stress has nothing to do with ulcers?
It avoids saying that. The sample states that most ulcers are now attributed to infection or to anti-inflammatory drugs, and that stress continues to be studied as a possible contributor. Overcorrecting into a flat denial would make the same error in reverse: a confident claim about a mind-body link, this time negative, without the evidence to carry it.
Where can I find a free HLTH 8745 Week 1 sample paper?
Here, in full: the Week 1 post uses the history of peptic ulcer to argue that explanations of illness need a demonstrated route, with three references.
What evidence persuaded doctors that bacteria cause most ulcers?
An agent was found in the diseased tissue, and removing it changed the outcome. In one randomized trial, ulcers recurred within a year in 8% of patients given antibiotics and 86% of those given placebo, and in only 1 of 46 whose infection was eradicated.