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.     

Neuroticism,Somatic Complaints,and Disease: Is the Bark Worse than the Bite?

Perhaps because negative emotions are frequently expressed in physiological reactions, psychosomatic theories have often identified Neuroticism and its component traits (including anxiety, anger, and depression) as causal influences on the development of disease. These views are apparently supported by correlations between physical symptom reports and measures of Neuroticism in males. Data from 347 adult women in the Baltimore Longitudinal Study of Aging replicate this finding for total physical complaints and for most body systems. However, analyses of mortality in the literature and in the present article show no influence of Neuroticism, suggesting that symptom reporting may be biased by Neuroticism-related styles of perceiving and reporting physiological experiences. Researchers in this area are urged to employ objective measures of medical status, and to be alert to possible biases of self-selection and selective perception in interpreting associations between Neuroticism and disease.     

Study of neuromotor reaction times under the influence of thyrotropin-releasing hormone

Neuromotor reaction times (simple, choice, and decision) were measured when Thyrotropin-releasing hormone (TRH) was administered intravenously to nine healthy men in a double-blind study. Measurements were made of simple reaction time, choice reaction time, and decision time for each subject at various intervals over a 54-hr. period. Given the observed inherent interaction of the drug with the long time used (54 hr.), most analyses were conducted across separate time epochs. Injected subjects showed inhibition in the normal improvement of simple reaction time (which occurs with practice), and they reduced the time required to make a decision. Choice reaction time, however, remained unchanged across the drug-nondrug experimental conditions.     

Preliminary evidence for body-centered coding of tactile motor events

A number of experimental studies have consistently shown that on reaction time tasks with visual or auditory stimuli, the subjects code their responses in environmental rather than body-centered terms. The aim of the present study was to determine which of these two frames of reference subjects spontaneously adopt to code tactile motor events. Eight subjects were requested to respond with key-presses to mechanical stimulations delivered under the finger tips. Reaction time was analysed as a function of device- and body-centered S-R relationships. Subjects displayed a strong S-R compatibility effect that suggested their body-centered coding of tactile motor events.     

Handedness and dementia

Some researchers have speculated that left-hand dominance is more prevalent among patients suffering from dementia of the Alzheimer's type which began prior to age 65 yr. and that, in those patients, the disease runs a more rapid course. In the present study, seven left-handed dementia patients were matched with seven right-handed dementia patients on the basis of age and years of education and were compared with regard to neuropsychological compromise. While the left-handed group was somewhat more impaired than the right-handed subjects, the difference between the two groups was not statistically significant.     

Implications of memory and language dysfunction in the naming deficit of senile dementia

Young normals, elderly normals, and patients with either mild-to-moderate or severe senile dementia of the Alzheimer type (SDAT) were administered several tests of language function and remote memory. On all of the language tests examined, elderly normals exhibited a mild, nonsignificant performance decrement relative to the young normals. Advanced SDAT patients were markedly impaired on all of the tests. Early dementia patients were most impaired, relative to aged normals, on tests of object naming, category instance fluency, and remote memory. The deficit was smaller on the WAIS vocabulary subtest, on selecting the name of a visually presented object, and on recalling the function of an object. Early SDAT patients were least impaired in selecting the picture of an object after its name had been provided and in selecting objects that belong to a specified functional category. The results are consistent with the notion that the language dysfunction in early SDAT is due to a deficit in semantic memory function in which general, categorical information remains available whereas information about specific attributes becomes less accessible. The object naming test might be useful in the assessment of treatment effects upon SDAT because of its sensitivity and specificity to dementia, its high face validity, and its independence of recent memory.     

Psychosocial characteristics of preschool siblings of handicapped and nonhandicapped children

This project examined psychosocial characteristics of 24 preschool-aged siblings of handicapped children in relation to a control group of 22 siblings of nonhandicapped children. Subjects were matched on family size and income, sibling age, birth order, sex, age spacing, and marital status of their parents. Results indicated no statistically significant differences between groups of children on measures of perceived self-competence and acceptance, understanding of developmental disabilities, empathy, and child care responsibility. Significant group differences were found where brothers of handicapped children were rated by their mothers as being more depressed and aggressive than brothers of nonhandicapped control children. Sisters of handicapped children were rated by mothers as being more aggressive than sisters of nonhandicapped children. Sisters of handicapped children and brothers of nonhandicapped children had significantly fewer privileges and more restrictions on their home activities than other groups. Results are discussed in relation to previous research on older silbings of handicapped children and the general literature on family stress and childhood disability and disease. The importance of examining sibling functioning via multiple measures of child behavior is stressed.The authors are grateful to the children and families who participated in the project. The assistance of Dr. Ricardo Barrera, Christine DiBlasio, Lisa Kaye, Paola Bellabarba, Jeanne Logozzo, Donna Motley, Jennifer Harter, and Tina Meisell is also gratefully acknowleged. This project was funded by Grant Number G008300345 from the U.S. Department of Education.