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Health Psychology : a Textbook

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  • 1: An introduction to health psychology Acknowledgements xxvii

    • CHAPTER OVERVIEW

    • THE BACKGROUND TO HEALTH PSYCHOLOGY

    • WHAT IS THE BIOMEDICAL MODEL?

    • THE TWENTIETH CENTURY

      • Psychosomatic medicine

      • Behavioural health

      • Behavioural medicine

      • Health psychology



    • WHAT ARE THE AIMS OF HEALTH PSYCHOLOGY?

    • WHAT IS THE FUTURE OF HEALTH PSYCHOLOGY?

      • The clinical health psychologist

      • A professional health psychologist



    • WHAT ARE THE AIMS OF THIS BOOK?

      • A note on theory and health psychology

      • A note on methodology and health psychology



    • THE CONTENTS OF THIS BOOK

    • THE STRUCTURE OF THIS BOOK

    • QUESTIONS

    • FOR DISCUSSION

    • FURTHER READING



  • 2: Health beliefs

    • CHAPTER OVERVIEW

    • WHAT ARE HEALTH BEHAVIOURS?

    • WHY STUDY HEALTH BEHAVIOURS?

      • McKeown’s thesis



    • LAY THEORIES ABOUT HEALTH

    • PREDICTING HEALTH BEHAVIOURS

      • Attribution theory

      • Health locus of control

      • Unrealistic optimism

      • The stages of change model

      • Integrating these different health beliefs: developing models



    • COGNITION MODELS

      • The health belief model

      • The protection motivation theory

        • BEHAVIOUR FOCUS ON RESEARCH 2.1: TESTING A THEORY – PREDICTING SEXUAL





    • SOCIAL COGNITION MODELS

      • The theories of reasoned action and planned behaviour

      • The health action process approach



    • PROBLEMS WITH THE MODELS

      • Conceptual problems

      • Methodological problems

      • Predictive problems

        • new cognitions Predicting intentions: the need to incorporate



      • Predicting behaviour: exploring the intention–behaviour gap

      • Developing theory based interventions

      • Putting theory into practice

      • Existing theory based interventions



    • TO CONCLUDE

    • QUESTIONS

    • FOR DISCUSSION

    • ASSUMPTIONS IN HEALTH PSYCHOLOGY

    • FURTHER READING



  • 3: Illness cognitions

    • CHAPTER OVERVIEW

    • WHAT DOES IT MEAN TO BE HEALTHY?

    • WHAT DOES IT MEAN TO BE ILL?

    • WHAT ARE ILLNESS COGNITIONS?

      • Evidence for these dimensions of illness cognitions

      • Measuring illness cognitions



    • LEVENTHAL’S SELF-REGULATORY MODEL OF ILLNESS COGNITIONS

      • Stage 1: Interpretation

      • Stage 2: Coping

      • Stage 3: Appraisal



    • WHY IS THE MODEL CALLED SELF-REGULATORY?

      • AND COPING FOCUS ON RESEARCH 3.1: TESTING A THEORY – ILLNESS REPRESENTATIONS

      • Problems with assessment



    • STAGE 1: INTERPRETATION

      • Symptom perception

      • Social messages



    • STAGE 2: COPING

      • Coping with a diagnosis

      • Coping with the crisis of illness

      • adaptation Adjustment to physical illness and the theory of cognitive



    • The role of illusions

    • Implications for the outcome of the coping process



  • THE POSITIVE INTERPRETATION OF ILLNESS

  • USING THE SELF-REGULATORY MODEL TO PREDICT OUTCOMES

    • Predicting adherence to treatment

    • Predicting recovery from stroke

    • Predicting recovery from MI



  • TO CONCLUDE

  • QUESTIONS

  • FOR DISCUSSION

  • ASSUMPTIONS IN HEALTH PSYCHOLOGY

  • FURTHER READING

  • professionals’ health beliefs 4: Doctor–patient communication and the role of health

  • CHAPTER OVERVIEW

  • WHAT IS COMPLIANCE?

  • PREDICTING WHETHER PATIENTS ARE COMPLIANT: THE WORK OF LEY

    • Patient satisfaction

    • Patient understanding



  • FOCUS ON RESEARCH 4.1: TESTING A THEORY – PATIENT SATISFACTION

    • Patient’s recall



  • HOW CAN COMPLIANCE BE IMPROVED?

    • The role of information

    • Recommendations for improving compliance



  • THE WIDER ROLE OF INFORMATION IN ILLNESS

    • Information and recovery from surgery

    • Using information to improve recovery



  • THE ROLE OF KNOWLEDGE IN DOCTOR–PATIENT COMMUNICATION

    • Problems with the traditional approach to doctor–patient communication

    • The adherence model of communication



  • THE PROBLEM OF DOCTOR VARIABILITY

    • Explaining variability – clinical decision making as problem solving

    • Explaining variability – the role of health professionals’ health beliefs

    • Communicating beliefs to patients

      • patient Explaining variability – an interaction between health professional and



    • Patient centredness

    • Agreement between health professional and patient



  • TO CONCLUDE

  • QUESTIONS

  • FOR DISCUSSION

    • ASSUMPTIONS IN HEALTH PSYCHOLOGY

    • FURTHER READING



  • 5: Smoking and alcohol use

    • CHAPTER OVERVIEW

    • WHO SMOKES?

    • WHO DRINKS?

    • HEALTH IMPLICATIONS OF SMOKING AND ALCOHOL USE

      • Is smoking bad for health?

      • Is alcohol consumption bad for health?



    • WHAT IS AN ADDICTION?

      • APPROACH HISTORICAL CHANGES IN ATTITUDE AND THEORETICAL

      • The seventeenth century and the moral model of addictions

      • The nineteenth century and the 1st disease concept

      • The twentieth century and the 2nd disease concept

      • The 1970s and onwards – social learning theory



    • WHAT IS THE 2ND DISEASE CONCEPT?

      • A pre-existing physical abnormality

      • A pre-existing psychological abnormality

      • Acquired dependency



    • PROBLEMS WITH A DISEASE MODEL OF ADDICTION

    • WHAT IS THE SOCIAL LEARNING PERSPECTIVE?

      • The processes involved in learning an addictive behaviour

      • Integrating a disease and social learning perspective



    • THE STAGES OF SUBSTANCE USE

    • STAGES 1 AND 2: INITIATING AND MAINTAINING AN ADDICTIVE BEHAVIOUR

      • Smoking initiation and maintenance

      • Alcohol initiation and maintenance

      • Psychological predictors of alcohol limitation and maintenance



    • STAGE 3: THE CESSATION OF AN ADDICTIVE BEHAVIOUR

      • The process of cessation



    • FOCUS ON RESEARCH 5.1: TESTING A THEORY – STAGES OF SMOKING CESSATION

    • INTERVENTIONS TO PROMOTE CESSATION

      • Clinical interventions: promoting individual change

      • Public health interventions: promoting cessation in populations

        • SMOKING BAN FOCUS ON RESEARCH 5.2: PUTTING THEORY INTO PRACTICE – WORKSITE



      • Methodological problems evaluating clinical and public health interventions



    • STAGE 4: RELAPSE IN SMOKING AND DRINKING

      • Baseline state

      • Pre-lapse state

      • No lapse or lapse?

      • The abstinence violation effect



    • A CROSS-ADDICTIVE BEHAVIOUR PERSPECTIVE

      • Smoking and eating behaviour



    • TO CONCLUDE

    • QUESTIONS

    • FOR DISCUSSION

    • ASSUMPTIONS IN HEALTH PSYCHOLOGY

    • FURTHER READING



  • 6: Eating behaviour

    • CHAPTER OVERVIEW

    • WHAT IS A HEALTHY DIET?

    • HOW DOES DIET AFFECT HEALTH?

      • Diet and illness onset

      • Diet and treating illness



    • WHO EATS A HEALTHY DIET?

    • DEVELOPMENTAL MODELS OF EATING BEHAVIOUR

      • Exposure

      • Social learning

      • Associative learning

      • Problems with a developmental model



    • COGNITIVE MODELS OF EATING BEHAVIOUR

      • Using the TRA and TPB

      • Adding extra variables

      • Problems with a cognitive model of eating behaviour



    • A WEIGHT CONCERN MODEL OF EATING BEHAVIOUR

      • The meaning of food and weight

      • What is body dissatisfaction?



    • THE CAUSES OF BODY DISSATISFACTION

    • SOCIAL FACTORS

      • The role of the media

      • Ethnicity

      • Social class

      • The family



    • PSYCHOLOGICAL FACTORS

      • Beliefs



    • DIETING

      • Dieting and undereating

      • Dieting and overeating

      • The causes of overeating



    • FOCUS ON RESEARCH 6.1: TESTING A THEORY – OVEREATING AS A REBELLION

      • Dieting and weight loss

      • The role of dieting in mood and cognitive changes

      • Problems with a weight concern model of eating behaviour



    • TO CONCLUDE

    • QUESTIONS

    • FOR DISCUSSION

    • FURTHER READING



  • 7: Exercise

    • CHAPTER OVERVIEW

    • DEVELOPING THE CONTEMPORARY CONCERN WITH EXERCISE BEHAVIOUR

    • WHAT IS EXERCISE?

    • WHO EXERCISES?

    • WHY EXERCISE?

      • The physical benefits of exercise

      • The psychological benefits of exercise



    • FOCUS ON RESEARCH 7.1: TESTING A THEORY – EXERCISE AND MOOD

    • WHAT FACTORS PREDICT EXERCISE?

      • Social/political predictors of exercise



    • FOCUS ON RESEARCH 7.2: TESTING A THEORY – PREDICTING EXERCISE

    • EXERCISE RELAPSE

    • TO CONCLUDE

    • QUESTIONS

    • FOR DISCUSSION

    • ASSUMPTIONS IN HEALTH PSYCHOLOGY

    • FURTHER READING



  • 8: Sex

    • CHAPTER OVERVIEW

    • DEVELOPING THE CONTEMPORARY RESEARCH PERSPECTIVES ON SEX

      • Sex as biological, for reproduction

      • Sex as biological, for pleasure

      • Sex as a risk to health

      • Sex as interaction

      • Sex as a risk and pregnancy avoidance

      • What is contraceptive use?

      • Who uses contraception?

      • Developmental models

      • Decision-making models

        • contraception use Integrating developmental and decision-making approaches to





    • SEX AS A RISK IN THE CONTEXT OF STDs/HIV AND AIDS

      • Do people use condoms?

      • Predicting condom use

      • Social cognition models

      • Perceptions of susceptibility – are you at risk?

      • Sex as an interaction between individuals

        • USE FOCUS ON RESEARCH 8.1: TESTING A THEORY – THE SITUATION AND CONDOM



      • THE BROADER SOCIAL CONTEXT

        • Sex education

        • Power relations between men and women

        • Social norms of the gay community

        • Discourses about sex, HIV and illness



      • TO CONCLUDE

      • QUESTIONS

      • FOR DISCUSSION

      • ASSUMPTIONS IN HEALTH PSYCHOLOGY

      • FURTHER READING



    • 9: Screening

      • CHAPTER OVERVIEW

      • WHAT IS SCREENING?

      • THE HISTORY OF THE SCREENING ETHOS

        • Early screening programmes

        • Recent screening programmes



      • SCREENING AS A USEFUL TOOL

      • GUIDELINES FOR SCREENING

      • PSYCHOLOGICAL PREDICTORS OF THE UPTAKE OF SCREENING

        • Patient factors

        • Health professional factors



      • FOCUS ON RESEARCH 9.1: TESTING A THEORY – PREDICTING SCREENING

        • Organizational factors



      • SCREENING AS PROBLEMATIC

        • Is screening ethical?

        • Is screening cost-effective?

          • individual The effects of screening on the psychological state of the



        • The debates

        • Why has this backlash happened?



      • TO CONCLUDE

      • QUESTIONS

      • FOR DISCUSSION

      • ASSUMPTIONS IN HEALTH PSYCHOLOGY

      • FURTHER READING





  • 10: Stress

    • CHAPTER OVERVIEW

    • WHAT IS STRESS?

    • THE DEVELOPMENT OF STRESS MODELS

      • Cannon’s fight or flight model



    • Selye’s general adaptation syndrome

    • Life events theory

    • A ROLE FOR PSYCHOLOGICAL FACTORS IN STRESS

      • The transactional model of stress

      • Does appraisal influence the stress response?

      • What events are appraised as stressful?

      • Self-control and stress



    • STRESS AND CHANGES IN PHYSIOLOGY

      • Stress reactivity



    • MEASURING STRESS

      • Laboratory setting

      • Naturalistic setting

      • Physiological measures

      • Self-report measures



    • FOCUS ON RESEARCH 10.1: PUTTING THEORY INTO PRACTICE

      • Laboratory versus naturalistic measures

      • Physiological versus self-report measures

        • OF STRESS THE INTERACTION BETWEEN PSYCHOLOGICAL AND PHYSIOLOGICAL ASPECTS





    • TO CONCLUDE

    • QUESTIONS

    • FOR DISCUSSION

    • ASSUMPTIONS IN HEALTH PSYCHOLOGY

    • FURTHER READING



  • 11: Stress and illness

    • CHAPTER OVERVIEW

    • DOES STRESS CAUSE ILLNESS?

      • How does stress cause illness?

      • The chronic process

      • The acute process



    • STRESS AND CHANGES IN BEHAVIOUR

      • Smoking

      • Alcohol

      • Eating

      • Exercise

      • Accidents

      • Illness as a stressor



    • STRESS AND CHANGES IN PHYSIOLOGY

      • Stress and illness onset and progression

      • Interaction between the behavioural and physiological pathways



    • INDIVIDUAL VARIABILITY IN THE STRESS–ILLNESS LINK

      • Stress reactivity

      • Stress recovery

      • Allostatic load

      • Stress resistance



    • PSYCHONEUROIMMUNOLOGY (PNI)

      • The immune system

      • Conditioning the immune system

      • Measuring immune changes

      • Psychological state and immunity

      • Mood

      • Beliefs

      • Emotional expression

      • Stress



    • THE IMPACT OF CHRONIC STRESS

      • Job stress

      • Relationship stress



    • WHICH FACTORS MODERATE THE STRESS–ILLNESS LINK?

    • COPING

      • What is coping?

      • Ways of coping

      • Measuring coping



    • SOCIAL SUPPORT

      • What is social support?

      • Does social support affect health?

      • How does social support influence health?



    • FOCUS ON RESEARCH 11.1: TESTING A THEORY: SOCIAL SUPPORT AND HEALTH

    • PERSONALITY

      • Who is hostile?

      • How does hostility link to stress?

      • How does hostility link to illness?



    • CONTROL

      • What is control?

      • Does control affect the stress response?

      • Does control affect health?

      • How does control mediate the stress–illness link?

      • The possible benefits of low control



    • CONTROL AND SOCIAL SUPPORT IN STRESS AND ILLNESS

    • TO CONCLUDE

    • QUESTIONS

    • FOR DISCUSSION

    • ASSUMPTIONS IN HEALTH PSYCHOLOGY

    • FURTHER READING



  • 12: Pain

    • CHAPTER OVERVIEW

    • WHAT IS PAIN?

    • EARLY PAIN THEORIES – PAIN AS A SENSATION



  • INCLUDING PSYCHOLOGY IN THEORIES OF PAIN

  • THE GATE CONTROL THEORY OF PAIN

    • Input to the gate

    • Output from the gate

    • How does the GCT differ from earlier models of pain?

    • What opens the gate

    • What closes the gate

    • Problems with the GCT



  • THE ROLE OF PSYCHOSOCIAL FACTORS IN PAIN PERCEPTION

  • SUBJECTIVE-AFFECTIVE-COGNITIVE PROCESSES

    • The role of learning

    • The role of affect

    • The role of cognition

    • Behavioural processes

    • The interaction between these different processes



  • THE ROLE OF PSYCHOLOGY IN PAIN TREATMENT

    • Cognitive behavioural therapy

      • CHRONIC PAIN FOCUS ON RESEARCH 12.1: PUTTING THEORY INTO PRACTICE – TREATING



    • Placebos and pain reduction

      • ACCEPTANCE? THE OUTCOME OF PAIN TREATMENT AND MANAGEMENT – A ROLE FOR PAIN





  • MEASURING PAIN

    • Self-reports

    • Observational assessment

    • Physiological measures



  • TO CONCLUDE

  • QUESTIONS

  • FOR DISCUSSION

  • ASSUMPTIONS IN HEALTH PSYCHOLOGY

  • FURTHER READING

  • and health 13: Placebos and the interrelationship between beliefs, behaviour

  • CHAPTER OVERVIEW

  • WHAT IS A PLACEBO?

  • A HISTORY OF INERT TREATMENTS

    • Modern-day placebos

    • Placebos – to be taken out of an understanding of health?



  • HOW DO PLACEBOS WORK?

    • Non-interactive theories

    • Interactive theories

    • Physiological theories



  • THE CENTRAL ROLE OF PATIENT EXPECTATIONS

    • PLACEBO FOCUS ON RESEARCH 13.1: TESTING A THEORY – ‘DOING AS YOU’RE TOLD’ AS A



  • COGNITIVE DISSONANCE THEORY

    • The effect of investment

    • Justification and changes in symptoms

    • Evidence for the role of justification

    • An example of Totman’s theory

    • Support for cognitive dissonance theory

    • Problems with cognitive dissonance theory



  • THE ROLE OF PLACEBO EFFECTS IN HEALTH PSYCHOLOGY

    • Health beliefs

    • Illness cognitions

    • Health professionals’ health beliefs

    • Health-related behaviours

    • Stress

    • Pain

    • Implications for dualism



  • TO CONCLUDE

  • QUESTIONS

  • FOR DISCUSSION

  • ASSUMPTIONS IN HEALTH PSYCHOLOGY

  • FURTHER READING

  • illness (1) 14: HIV and cancer: psychology throughout the course of

  • CHAPTER OVERVIEW

  • HIV AND AIDS

    • The history of HIV

    • What is HIV?

    • The progression from HIV to AIDS

    • The prevalence of HIV and AIDS



  • THE ROLE OF PSYCHOLOGY IN THE STUDY OF HIV

    • Psychology and susceptibility to the HIV virus

    • Psychology and progression from HIV to AIDS

    • Psychology and longevity

      • FUNCTIONING FOCUS ON RESEARCH 14.1: TESTING A THEORY – PSYCHOLOGY AND IMMUNE





  • CANCER

    • What is cancer?

    • The prevalence of cancer

    • The role of psychology in cancer

    • The psychosocial factors in the initiation and promotion of cancer

    • Psychological consequences of cancer

    • Psychology and the alleviation of symptoms

    • Psychological factors in longevity

      • CANCER SYMPTOMS FOCUS ON RESEARCH 14.2: PUTTING THEORY INTO PRACTICE – TREATING





  • TO CONCLUDE

  • QUESTIONS

  • FOR DISCUSSION

  • ASSUMPTIONS IN HEALTH PSYCHOLOGY

  • FURTHER READING

  • the course of illness (2) 15: Obesity and coronary heart disease: psychology throughout

  • CHAPTER OVERVIEW

  • OBESITY

    • The role of psychological factors in obesity



  • WHAT IS OBESITY?

  • HOW COMMON IS OBESITY?

  • WHAT ARE THE PROBLEMS WITH OBESITY?

    • Physical problems

    • Psychological problems



  • WHAT CAUSES OBESITY?

    • Physiological theories

    • Behavioural theories

    • What does all this research mean?



  • OBESITY TREATMENT

    • Traditional treatment approaches

    • Multidimensional behavioural programmes

    • The role of dieting in treating obesity



  • SHOULD OBESITY BE TREATED AT ALL?

    • The benefits of treatment

    • The treatment alternatives

    • Drug treatments of obesity

    • Surgical treatments of obesity



  • CONCLUSION

  • CORONARY HEART DISEASE (CHD)

    • What is CHD?

    • The prevalence of CHD

    • Risk factors for CHD

    • The role of psychology in CHD

    • Beliefs about CHD

    • The psychological impact of CHD



  • FOCUS ON RESEARCH 15.1: TESTING A THEORY: THE CONSEQUENCES OF DISEASE

    • Predicting and changing behavioural risk factors for CHD

    • Psychology and rehabilitation of patients with CHD

      • Conclusion



    • TO CONCLUDE

    • QUESTIONS

    • FOR DISCUSSION

    • ASSUMPTIONS IN HEALTH PSYCHOLOGY

    • FURTHER READING

    • of life 16 Measuring health status: from mortality rates to quality

    • CHAPTER OVERVIEW

    • MORTALITY RATES

    • MORBIDITY RATES

    • MEASURES OF FUNCTIONING

    • SUBJECTIVE HEALTH STATUS

    • WHAT IS QUALITY OF LIFE?

      • Creating a conceptual framework

      • How should it be measured?

        • REPLACEMENT SURGERY FOCUS ON RESEARCH 16.1: PUTTING THEORY INTO PRACTICE – EVALUATING HIP





    • A SHIFT IN PERSPECTIVE

      • Value

      • Subjectivity of the subject

      • Subjectivity of the researcher

      • Definition of health



    • USING QUALITY OF LIFE IN RESEARCH

      • Quality of life as an outcome measure

      • Quality of life as a predictor of longevity



    • TO CONCLUDE

    • QUESTIONS

    • FOR DISCUSSION

    • ASSUMPTIONS IN HEALTH PSYCHOLOGY

    • FURTHER READING



  • 17 The assumptions of health psychology

    • CHAPTER OVERVIEW

    • THE ASSUMPTIONS OF HEALTH PSYCHOLOGY

      • The mind–body split

      • Dividing up the soup

      • The problem of progression

      • The problem of methodology

      • The problem of measurement

      • Integrating the individual with their social context

      • Data are collected in order to develop theories; these theories are not data





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