Psychosocial risk factors, natural immunity, and cancer progression: Implications for intervention

One of the more important and emerging fields in which psychologists collaborate with other disciplines is psychoimmunology. Centuries of clinical anecdote and decades of psychosomatic hypotheses have gained credibility in the eyes of the medical establishment—and many patients—by the systematic investigation of mechanisms potentially explaining how events intrapsychic and interpersonal could affect physical disease processes. The central nervous system is connected with the immune system by both neuronal and endocrinological pathways. The immune system has been found to mediate the organism’s response to aberrations of its own normal functions, as well as to invading organisms from without. AIDS, arthritis, asthma, lupus, and herpes are some of the illnesses in which research is demonstrating important relationships among psychosocial and immunological factors and disease course. In this article, we first discuss the immunological apparatus in order to provide a base for subsequent discussions of the effects of stress on immune function. Then we discuss malignant diseases and current evidence that disease course is related to both psychosocial stressors and immune function. We next discuss a model of these interactions, and finally we talk about interventions incorporating psychosocial factors aimed at influencing immune status and, thus, disease course.     

Alcoholism: A conflict of models

Adherents to the traditional model of alcoholism explain alcoholic behavior as a consequence of alcoholism. Alcoholism is identified as an unseen, unmeasured entity inherent in alcoholics. This concept parallels the thinking of Copernicus, Kepler, Galileo, and Newton, who believed in an unseen, unmeasurable creator behind the physical world. These traditional approaches contrast with the emergent model of alcoholism and twentieth-century scientific thought. Emergent scientific model adherents explain alcoholic behavior without resort to unseen factors. Since the traditional and emergent scientific models begin with different assumptions, model adherents experience communication difficulties. Future developments with determine which model will dominate the field of alcohol studies and treatment.     

The interaction of stimulus and reinforcer control in complex temporal discrimination.

Six pigeons were trained in a discrete-trials signal-detection procedure to discriminate between a fixed-duration stimulus (5 s or 20 s) and a set of variable durations ranging from 2.5 s to 57.5 s in steps of 5 s. For each fixed-duration stimulus, the ratio of reinforcer frequencies contingent upon reporting the fixed versus the variable stimulus was systematically manipulated. Detection performance was well controlled by both the stimulus value and the reinforcer ratio. Both the discriminability between the fixed duration and the set of variable durations, and the discriminability between the fixed duration and each of the variable durations, were independent of the reinforcer-frequency ratio when discriminability was measured as log d. The sensitivity of response bias to reinforcement-ratio changes was independent of the value of the fixed duration, but was not independent of the discriminability of the variable durations from the fixed durations. Under current models, discriminability measures in complex temporal discrimination may be independent of biasing manipulations, but bias measures are not independent of stimulus values.     

Choice between reliable and unreliable outcomes: mixed percentage-reinforcement in concurrent chains.

Pigeons' choices between alternatives that provided different percentages of reinforcement in mixed schedules were studied using the concurrent-chains procedure. In Experiment 1, the alternatives were terminal-link schedules that were equal in delay and magnitude of reinforcement, but that provided different percentages of reinforcement, with one schedule providing, reinforcement twice as reliably as the other. All pigeons preferred the more reliable schedule, and their level of preference was not systematically affected by variation in the absolute percentage values, or in the magnitude of reinforcement. In Experiment 2, preference for a schedule providing 100% reinforcement over one providing 33% reinforcement increased systematically with increases in the duration of the terminal links. In contrast, preference decreased systematically with increases in the duration of the initial links. Experiment 3 examined choice with equal percentages of reinforcement but unequal delays to reinforcement. Preference for the shorter delay to reinforcement was not systematically affected by variation in the absolute percentage of reinforcement. The overall pattern of results supported predictions based on an extension of the delay-reduction hypothesis to choice procedures involving mixed schedules of percentage reinforcement.     

Effects of delayed conditioned reinforcement in chain schedules.

The contingency between responding and stimulus change on a chain variable-interval 33-s, variable-interval 33-s, variable-interval 33-s schedule was weakened by interposing 3-s delays between either the first and second or the second and third links. No stimulus change signaled the delay interval and responses could occur during it, so the obtained delays were often shorter than the scheduled delay. When the delay occurred after the initial link, initial-link response rates decreased by an average of 77% with no systematic change in response rates in the second or third links. Response rates in the second link decreased an average of 59% when the delay followed that link, again with little effect on response rates in the first or third links. Because the effect of delaying stimulus change was comparable to the effect of delaying primary reinforcement in a simple variable-interval schedule, and the effect of the unsignaled delay was specific to the link in which the delay occurred, the results provide strong evidence for the concept of conditioned reinforcement.     

Spiritual issues in mental health care

Religious and spiritual issues in mental health are explored in the context of four conceptual models: the medical, the nursing, the humanistic, and the pastoral. This is done by looking at each model in terms of content, diagnostic focus, language and treatment goals, and primary qualities in the health provider.The models are illustrated by case studies gathered from a multidisciplinary setting. The discovery that each model can incorporate the religious and spiritual dimension in mental health care, but that each model does this in distinctive ways, is a key point.     

Automaticity and the capture of attention by a peripheral display change

The proposal that peripheral visual changes (cues) tend to summon attention automatically was tested by studying the effect of peripheral cueing on simple detection latency. Delay between cue onset and target onset, the contingent relationship between cue location and target location, and instructions to subjects were manipulated. Results showed that a peripheral display change could capture attention even when the target was far more likely to appear at an uncued location. When subjects were explicitly informed that targets were likely to appear away from the cued location they were able to suppress this effect, but were unable completely to reverse it by rapidly orienting attention towards the uncued side. Hence the process appears to be automatic in the sense that it occurs unless there are explicit instructions to the contrary. With explicit instructions the processing operation can be suppressed, but not completely reversed. This work was supported by the U.K. Admiralty Research Establishment (Research Agreement No. 53482).     

The type a behavior pattern and the need to prove oneself: A correlational study

This study set out to investigate the relationship between the Type A behavior pattern, the need for approval, and the need to prove oneself. One hundred and two subjects completed four questionnaires: two measuring A-type behavior, one social desirability, and one—especially devised for this study—the belief in the need to prove oneself consistently. Results showed that Type A’s have significantly lower needs for approval than Type B’s, yet appear to show considerably greater interest in comparing their achievements with others. It seems that Type A’s do not have any special need to prove their worth to others, but that they must constantly prove themselves to themselves. Limitations of this preliminary study are discussed.     

Perceived control and health

Perceived control (PC) is defined as thebelief that one can determine one’s own internal states and behavior, influence one’s environment, and/or bring about desired outcomes. Two important dimensions of PC are delineated: (1) whether the object of control is located in the past or the future and (2) whether the object of control is over outcome, behavior, or process. A variety of constructs and measures of PC (e.g., efficacy, attribution, and locus of control) are discussed in relation to these dimensions and selected studies are reviewed. The issues, controversies, and limits of the research on perceived control and health are addressed in terms of the antecedents and consequences of perceived control. Investigations should clearly conceptualize the object of perceived control, use measures that match the conceptualization, and when attempting to manipulate control, directly measure perceived control. The relation between PC and health outcomes is complex, and different aspects of PC may interact to affect health outcomes.