Introduction
The power of the imagination is a great factor in medicine.
It may produce diseases in man and in animals, and it may cure them.
PARACELSUS,SIXTEENTH CENTURY1By no means should the above observation be equated with
a contemporary de“nition of health psychology, but in his
quote, the noted reformer and physician Paracelsus argues
that disease, neither in its etiology nor in its cure, can be
totally understood in terms limited to the realm of the
soma. This is the essence of the “eld of health psychology
that disease processes cannot be understood solely in terms of
biological and physiological parameters. Instead, a biopsy-
chosocialmodel better represents a more complete picture of
disease, illness, health, and wellness. Rather than underscor-
ing the primacy of somatic variables, such a model (see
Schwartz, 1982) contends that biological, psychological, and
social factors all constitute important and crucial indices of a
de“nition of disease with regard to issues of etiology, patho-
genesis, course, and treatment. Recent research suggests that
less than 25% of physical complaints presented to primary
care physicians have known or demonstrable organic or bio-
logical etiologies, greatly highlighting the need for a more
complete model (Nezu, Nezu, & Lombardo, 2001). Such a
view is consistent with a planned critical multiplismperspec-
tive (Shadish, 1986), which is a methodological approach
whereby attempts are made to minimize the biases inherent
in any univariate search for knowledge. During the past
two decades, efforts by a wide range of psychologists inter-
ested in disease and illness have provided varying types of
support for this biopsychosocial model using this multivari-
ate perspective.
Starting with simpler questions, such as what types of psy-
chological processes affect illness, the “eld of health psy-
chology has since expanded greatly in terms of its scope,
depth, and impact. For example, Taylor•s (1990) con“dent
prediction that succinct papers reviewing the current status of
health psychology would disappear due to the •diversity of
issues studied and the complexity and sophistication of the
models and designs used to explore themŽ (p. 47) appears to
have been con“rmed. Initially, the “eld was composed of
researchers and practitioners with common interests in issues
related to health and illness who were trained in more tradi-
tional (but varied) areas of psychology. The diversity of con-
ceptual approaches, models, and designs brought together by
these individuals have helped to establish a “eld that is
broad in scope, eclectic, multidisciplinary, dynamic, and al-
lowing for creative developments. Training programs in
health psychology have tapped this breadth and students now
have signi“cant exposure to neurology, endocrinology, im-
munology, public health, epidemiology, and other medical
subspecialties, in addition to a solid grounding in psychology
(Brannon & Feist, 1992).
Over the past two decades, health psychologists have be-
come more integrated into the general “eld of health research
and intervention, and have gained job opportunities in a
range of health-oriented settings (Belar & Deardorf, 1995).
Although psychology has been involved with health in some
capacity since early in the twentieth century, very few psy-
chologists worked in medical settings, and more as adjuncts
than as full members of multidisciplinary teams. Recent is-
sues of the APA Monitor,however, now advertise a wide
array of health-related positions for psychologists in settings
such as universities, medical schools, hospitals, health clin-
ics, health maintenance organizations, and private practices,
highlighting the growing demand for such services. The
focus of clinical health psychology on empirically supported,
brief, problem-centered, cognitive-behavioral interventions
and skills training has been compatible with the demands of
the managed care system, which must provide authorization
for treatment plans. Moreover, the large and continually
growing percentage of the gross national product that
Americans spend on health care, more than any other indus-
trialized country (over 13.5% in 1998; U.S. Health Care
Financing Administration, 1999), highlights the need to
contain costs through early detection and disease prevention.
Health psychology research focusing on the development and