many kinds of psychologists—social, industrial,
physiological, and others. Health psychology has
been specifically defined as
the aggregate of the specific educational,
scientific, and professional contributions of
the discipline of psychology to the pro-
motion and maintenance of health, the
prevention and treatment of illness, and the
identification of etiologic and diagnostic
correlates of health, illness and related
dysfunction. (Matarazzo, 1980, p. 815)
This definition was later amended to include
psychologists’roles as formulators of health care
policy and contributors to the health care system
(see, e.g., DeLeon, Frank, & Wedding, 1995). A
recent definition of health psychology that incor-
porates these new roles has been offered by
Brannon and Feist (2010), who state that health
psychology “includes psychology’s contributions
to the enhancement of health, the prevention and
treatment of disease, the identification of health risk
factors, the improvement of the health care system,
and the shaping of public opinion with regard to
health”(p. 13).
HistoryTwo major perspectives have influenced our views of
health and illness (Rice, 1998). First is thebiomedical
tradition, which developed over time as people sought
to gain knowledge throughexperience and observa-
tion. Early attempts were rather crude (e.g., the dis-
covery of the benefits of acupuncture, Hippocrates’
humoral theory of disease and treatment), but later
biomedical scientists focused on anatomy,“germ the-
ory,”and ultimately genetics in their attempt to
define and understand illness and disease. This West-
ern tendency to focus solely on biological factors and
to adopt a reductionistic approach is not without its
limitations, however. For example, critics argue that
we still do not know what causes disease; rather, we
have simply discovered another malfunction at a
smaller level of analysis (e.g., at the molecular genetic
level). Biomedical research may be so enamored with
somatic correlates (e.g., abnormal physical processes
and biochemical imbalances) that psychosocial vari-
ables are often ignored. Finally, this tradition rein-
forces the mind–body dualism perspective, which is
both outdated and limited in its utility. This is not to
say that the biomedical tradition has been unimpor-
tant or irrelevant to medicine, science, and psychol-
ogy.Rather,astrictbiomedicalviewpointisattimes
too narrow because it cannot adequately account for
widely encountered forms of illness and disease.
A second major influence on our views of health
andillnessisthepsychosocial perspective(Rice, 1998).
For centuries, medical literature has recognized that
psychological and social processes may either cause or
influence illness and disease. By the 1940s, this broad
generalization had coalesced into the field ofpsychoso-
matic medicine. Psychosomatic medicine is based on
the assumption that certain illnesses and disease states
are caused by psychological factors. Researchers (e.g.,
Alexander, 1950) identified several“psychosomatic”
diseases, including peptic ulcers, essential hyperten-
sion, and bronchial asthma. All illnesses were divided
into those caused by“organic”or physical factors and
those caused by psychological factors. Some who
adopted this perspective believed that each psychoso-
matic illness had a different, specific underlying
unconscious conflict predisposing the person to that
disorder. For example, repressed hostility was
believed to result in rheumatoid arthritis. Although
initially appealing, these ideas (and psychosomatic
medicine in general) began to flounder as it became
apparent that such specific psychogenic factors were
not very predictive; most empirical studies did not
support the theories. In fact, psychosocial factors are
involved in all diseases, but these factors may not
necessarily have a primary causal role.
Psychosomatic medicine was largely the prov-
ince of psychiatrists and physicians. However, behav-
ioral psychologists began to extend the range of their
therapy methods to the so-called medical disorders.
Problems such as obesity and smoking came under
the scrutiny of psychologists as well. Then came a
rapid increase in the use of biofeedback (discussed
later in this chapter) to help patients control or mod-
ify certain physiological responses.HEALTH PSYCHOLOGY ANDBEHAVIORAL MEDICINE 487