Health Psychology : a Textbook

involving chronic and acute stress. Both these pathways involve changes in behaviour

and changes in physiology. The behavioural pathway involves changes in health

behaviours such as smoking, alcohol consumption, eating and exercise, whereas the

physiological pathway involves changes in sympathetic activation or hypothalamic

pituitary adrenocorticoid activation. This chapter has also explored research in the

area of PNI which provides some insights into how psychological factors such as

emotional expression, mood, belief and stress might directly influence health. However,

there is much variability in the link between stress and illness and this chapter has

also examined coping, social support, personality and control as possible moderators

of this association.

ASSUMPTIONS IN HEALTH PSYCHOLOGY

The stress research highlights some of the assumptions in health psychology.

1 The problem of mind–body split. Although much of the stress research examines

how the mind may influence the body (e.g. appraisal relates to the release of stress

hormones, social support relates to resulting stress-related illnesses), how this process

occurs is unclear. In addition, although these relationships suggest an interaction

between the mind and the body, they still define them as separate entities which

influence each other, not as the same entity.

2 The problem of progress. It is often assumed that the most recent theories are

better than earlier theories. Therefore, models including appraisal, social support, etc.,

are better than those describing stress as a knee-jerk reaction to a stressor. Perhaps

these different theories are not necessarily better than each other, but are simply

different ways of describing the stress process.

3 The problem of methodology. It is assumed that methodology is neutral and

separate to the data collected. For example, factors such as hardiness, self-efficacy

and control exist before they are measured. Perhaps, however, methodology is not

so neutral, and that asking subjects questions relating to these factors actually

encourages them to see themselves/the world in terms of hardiness, self-efficacy and

control.

? QUESTIONS

1. Stress causes illness. Critically analyse the evidence to support this statement.


2. Describe the mechanisms behind the stress illness association.


3. How might the behavioural and physiological pathways interact?


4. Discuss the possible factors that moderate the stress–illness link.


5. Describe a study designed to assess the potential effect of perceived control on
   the development of illness.

FOR DISCUSSION

Consider the ways you cope with stress and discuss the extent to which these are

either beneficial or detrimental to your health.

282 HEALTH PSYCHOLOGY