Formalization as a Field of Inquiry and Practice 455an area of study that grew rapidly. As described by Levenson
(1994), Ader himself was troubled by the fact that his initial
work might have received attention in part because of his rep-
utation as a very careful, conservative scientist. He wondered
what would have happened if an unknown investigator had
come to the same conclusions.
In 1977, a number of psychologists, physicians, and other
behavioral scientists attended the Yale Conference on Behav-
ioral Medicine to give support to the birth of a new interdis-
ciplinary field labeled behavioral medicine. Many of these
attendees believed that as then conceptualized, psychoso-
matic medicine did not clearly represent the thrust of current
research and practice. Joined by others the next year at a con-
ference at the National Academy of Sciences, they adopted
the following definition for the new field:
Behavioral medicine is the interdisciplinary field concerned with
the development and integration of behavioral and biomedical
science knowledge and techniques relevant to health and illness
and the application of this knowledge and these techniques to
prevention, diagnosis, treatment and rehabilitation. (Schwartz &
Weiss, 1978)By 1979, the explosion of research in health and behavior,
and its practical significance to medicine, was recognized by
the Institute of Medicine (IOM) of the National Academy
of Sciences. A committee was formed to review the field and
set a research agenda with psychiatrist David Hamburg as
chair and psychologist Judith Rodin as vice-chair; over half the
membership were psychologists. The subsequent report (IOM,
1982) documented that 50% of mortality from the 10 leading
causes of death could be traced to behavior. This effort, plus
support from U.S. surgeon general Joseph Califano (Healthy
People: The Surgeon General’s Report on Health Promotion
and Disease Prevention,1979), stimulated congressional in-
terest and led to increased funding for NIH for research on be-
havioral factors in disease prevention and health promotion.
The zeitgeist transcended national boundaries. European
health psychologists have made innovative and significant
contributions in a variety of areas, especially the relationships
among personality, stress, and disease; the role of social cog-
nition in health and illness behavior; and the development and
outcome evaluation of health promotion programs in various
contexts (school, work, and community). Other contri-
butions of European health psychologists have been in mea-
surement, both in developing new measures and in adapting
and validating many English-language psychological instru-
ments to various populations in each country. The cross-
validation of measures in many cultural contexts has been an
important opportunity for testing theory and related constructs
in the domain of health psychology, as well as measurement
theory. Finally, several Europe-wide studies, some of them
under the auspices of the World Health Organization (WHO),
have increased understanding of epidemiological patterns and
their relationship to psychosocial variables. Examples are those
projects related to cardiovascular disease (WHO-MONICA
project [WHO, 2000]) and health behaviors in school-aged
children (WHO-HBSC project [Currie, Hurrelmann, Set-
tertobulte, Smith, & Todd, 2000]).
Worldwide, over the past 25 years there has been a signifi-
cant focus on research and practice related to health behaviors
such as those involved in dietary management, exercise, ad-
herence to medical regimens, and seat belt usage. Although the
termbehavioral healthwas originally defined by Matarazzo
(1980) as a corollary to behavioral medicine in order to em-
phasize health promotion and prevention rather than illness it-
self, it was unfortunate that the term was not trademarked at
that time. In the last decade, this term has come to be used to
describe alcohol, substance abuse, and other more traditional
mental health services in the evolving health care system and
no longer conveys its distinctive meaning.
Other trends have been an increased emphasis on environ-
mental health psychology (e.g., examination of stress-related
health effects of environmental noise, Staples, 1996), occupa-
tional health psychology, and genetic testing. There has also
been increased emphasis on women’s health issues and issues
of diversity in health behavior research. In 1992, the National
Conference on Behavioral and Sociocultural Perspectives on
Ethnicity and Health was held, resulting in a special issue of
Health Psychologyedited by Norman B. Anderson, the con-
ference organizer (Anderson, 1995). There has also been
more focus on the application of health behavior research
findings to public policy, of which Patrick DeLeon has been a
leader within U.S. psychology.
In conclusion, despite harsh criticism, the psychosomatic
movement within which psychology and psychologists have
played significant roles has survived and evolved to include
more social and cultural correlates of illness. The terminology
related to the field has also evolved such that terms such as
behavioral medicine, behavioral health, health psychology,
andhealth behavior researchare more prominent. From its
initial focus on personality and disease, the movement has
given rise to work on the relationship between illness and be-
reavement, helplessness, life changes, occupational stress, so-
cial support, health beliefs, ethnicity, environmental stressors,
and others. Moreover, it has stimulated new multidisciplinary
areas of inquiry, such as psychoneuroimmunology and psy-
choneuroendocrinology. It has also been home for a wide
range of theoretical viewpoints, including psychodynamic,
psychophysiological, and cognitive-behavioral theories. It