PSYCHOLOGY AND HEALTH: CONTRIBUTIONS OF PSYCHOLOGY TO THE IMPROVEMENT OF HEALTH AND HEALTH CARE

Psychology as both a science and a profession has been closely identified with other disciplines in the broad field of health since the turn of the century. Recent advances in health care have reinforced the growing belief that the promotion of health and the prevention and treatment of illness can be greatly enhanced by incorporating the scientific findings and modern technology of psychology into everyday practices. Outlining the contributions of psychology to health care throughout the world is the primary purpose of this report. In this brief survey, only some of the most timely and relevant issues can be mentioned, together with examples of current work in the field. The reader interested in pursuing these psychological contributions more thoroughly is encouraged to review pertinent references from the citations at the end of this report. After an introductory overview, special attention is given to each of the major areas within the broad field of health care where psychological applications have been particularly useful.     

Book Reviews

The Psychological Record -     

The interaction of stressful life events and chronic strains on community mental health

One of the possible adaptive costs of coping with stress is diminished capacity to respond to subsequent adaptive demands. This paper examined the complex interplay between major life events and one source of chronic strain. Residents of the greater Los Angeles metropolitan area exposed to higher levels of smog, who had also experienced a recent stressful life event, exhibited poorer mental health than those exposed to pollution who had not experienced a recent stressful life event. There were, however, no direct effects of smog levels on mental health. These patterns of results were replicated in both a cross-sectional and a longitudinal study. The interplay of psychosocial vulnerability and environmental conditions is discussed.     

The principle of charity and the problem of irrationality (translation and the problem of irrationality)

Common formulations of the principle of charity in translation seem to undermine attributions of irrationality in social scientific accounts that are otherwise unexceptionable. This I call the problem of irrationality. Here I resolve the problem of irrationality by developing two complementary views of the principle of charity. First, I develop the view (ill-developed in the literature at present) that the principle of charity is preparatory, being needed in the construction of provisional first-approximation translation manuals. These serve as the basis for explanatory accounts and associated refinements in the translation manual. In developing such explanatory accounts, the principle of charity is no longer constraining. Thus, the principle of charity applies only in the early stages of constructing translation manuals, and there is no problem of irrationality in the later stages of constructing translation manuals. Second, I reduce the principle of charity, where it does apply, to a special case of what I call the principle of explicability: so translate as to attribute explicable beliefs and practices to the speakers of the source-language. I show that the appropriate formulation of the principle of charity counsels just what the principle of explicability requires in the early stages of social scientific investigation.I am grateful to Robert Barrett, Roger Gibson, and Paul Roth for their generous assistance.     

Intuition in insight and noninsight problem solving

People’s metacognitions, both before and during problem solving, may be of importance in motivating and guiding problem-solving behavior. These metacognitions could also be diagnostic for distinguishing among different classes of problems, each perhaps controlled by different cognitive processes. In the present experiments, intuitions on classic insight problems were compared with those on noninsight and algebra problems. The findings were as follows: (1) subjective feeling of knowing predicted performance on algebra problems but not on insight problems; (2) subjects’ expectations of performance greatly exceeded their actual performance, especially on insight problems; (3) normative predictions provided a better estimate of individual performance than did subjects’ own predictions, especially on the insight problems; and, most importantly, (4) the patterns-of-warmth ratings, which reflect subjects’ feelings of approaching solution, differed for insight and noninsight problems. Algebra problems and noninsight problems showed a more incremental pattern over the course of solving than did insight problems. In general, then, the data indicated that noninsight problems were open to accurate predictions of performance, whereas insight problems were opaque to such predictions. Also, the phenomenology of insight-problem solution was characterized by a sudden, unforeseen flash of illumination. We propose that the difference in phenomenology accompanying insight and noninsight problem solving, as empirically demonstrated here, be used to define insight.     

The relationship of affiliative arousal to dopamine release

Higher levels of affiliation motivation after exposure to affiliative films are significantly related to higher dopamine concentrations in saliva in one study of 61 college students of both sexes, and in plasma in another study of 47 adults of both sexes. Individuals high in dispositionaln Affiliation, if they also reported high life stress, showed high gains in dopamine concentration in plasma after exposure to an affiliative film significantly more often than other individuals. Since aroused affiliation motivation was not associated with higher concentrations of norepinephrine, epinephrine, or cortisol in either study, it appears likely that dopamine is especially associated with arousal of affiliation motivation, just as norepinephrine has been found to be associated with arousal of power motivation. Thus, different motives may be subserved by different hormones, making it unlikely that all motives lead to the same state of physiological arousal.This research was carried out when all the authors were connected with the Department of Psychology and Social Relations at Harvard University. We acknowledge with thanks the support of the John D. and Catherine T. MacArthur Foundation through a grant to the senior author.     

Modification of Type A behavior through aerobic exercise

This psychophysiological evaluation of an aerobic exercise program examined specifically whether aerobic training modified Pattern A for those individuals at behavioral risk for developing coronary heart disease, i.e., young Type A individuals. At pretest and posttest of this secondary prevention study, Type A and Type B subjects were assessed in three conditions: aerobic exercise program, nonaerobic activity (Aikido, a martial art) control, and notreatment control. After 10 weeks, Type A but not Type B subjects exhibited lower Pattern A behavior in the aerobic program than in control conditions. Average workout pulse rates and differentially reliable increases in aerobic capacity indicated that aerobic training was indeed aerobic, whereas aikido activity was not. Even though selected nonaerobic factors, such as locus of control and group participation, did not mediate the Pattern A decrease for Type A's when comparing aikido and aerobic conditions, changes in aerobic capacity may have been the mediator. Generalizability of the results and implications for theoretical development and clinical intervention are discussed.