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.     

Generalised anxiety: A controlled treatment study

The effects of anxiety management training were evaluated by allocating 66 generally anxious clients to either a wait list condition, non-directive counselling, or a combination of relaxation and brief cognitive therapy. Anxiety management was significantly more effective than the wait list condition on a number of relevant measures at post-treatment, but there were relatively few differencs between anxiety management and non-directive counselling, either at post-treatment or at 6 months follow-up. Those differences which were found could plausibly be explained in terms of the demand characteristics of training in relaxation or cognitive therapy. It was concluded that anxiety management is clearly better than a non-treatment control condition, but that its superiority to plausible alternatives which lack the specific components thought to be responsible for improvement has yet to be demonstrated.     

The varieties of fear

Conclusion I shall conclude with a methodological moral. I have tried to show that there are several fundamentally different kinds of fear. One is a pure propositional attitude, one is partially a bodily state, and one is a relation between a person and a nonpropositional object. Other emotions come in similar varieties, such as hope and happiness, but with significant differences. The state of happiness, for example, does not entail any particular bodily state or feeling. So one lesson is this: it is hard to generalize about the emotions. Further detailed, analytical studies of particular emotions are needed before a general theory of the emotions can be fruitfully attempted.     

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.     

Locus of control,choice, and satisfaction with an assigned task

P. E. Spector's (1982, Psychological Bulletin, 91, 482–497) hypothesis that under conditions of freedom of choice persons characterized by an internal locus of control will experience greater satisfaction with an undesirable task than persons characterized by an external locus of control is considered in light of distinctions between perceived control and perceived choice. Perceived choice is proposed as an intervening variable implicit in Spector's argument. This reasoning was tested with 46 male and female college student participants in a 2 (Choice) × 2 (Locus of Control) factorial design experiment. An interaction of Choice × Locus of Control on task satisfaction was obtained such that internals tended to be more satisfied when given a choice while externals experienced greater satisfaction when not given a choice. The implications of this result for Spector' hypothesis and for the manner in which undesirable work is assigned are discussed.     

Constrained classification: The use of a priori information in cluster analysis

In many classification problems, one often possesses external and/or internal information concerning the objects or units to be analyzed which makes it appropriate to impose constraints on the set of allowable classifications and their characteristics. CONCLUS, or CONstrained CLUStering, is a new methodology devised to perform constrained classification in either an overlapping or nonoverlapping (hierarchical or nonhierarchial) manner. This paper initially reviews the related classification literature. A discussion of the use of constraints in clustering problems is then presented. The CONCLUS model and algorithm are described in detail, as well as their flexibility for use in various applications. Monte Carlo results are presented for two synthetic data sets with appropriate discussion of the resulting implications. An illustration of CONCLUS is presented with respect to a sales territory design problem where the objects classified are various Forbes-500 companies. Finally, the discussion section highlights the main contribution of the paper and offers some areas for future research.We wish to thank C. Mallows and J. D. Carroll for some helpful technical discussion and L. Clark and D. Art for their valuable computer assistance. We also wish to thank H. Pollak, R. Gnanadesikan, and J. Kettenring for their thorough reviews of a previous draft of this paper. Finally, we acknowledge helpful comments of the editor and two anonymous reviewers.     

Affection deprivation is more aversive than excessive affection: A test of affection exchange theory

Affection exchange theory predicts that both excessive affection and affection deprivation are associated with poorer health, compared with receiving the level of affectionate communication that one desires. A similar yet-untested prediction is that affection deprivation is more aversive than excessive affection. This preregistered study tested both hypotheses on a battery of mental and physical health outcomes, including depression, loneliness, stress, physical pain, frequency of nightmares, and sleep quality, using a Census-matched sample of U.S. American adults (N = 827). As hypothesized, receiving the right amount of affection was associated with more health-supportive scores on all outcomes than either excessive or deficient affection. Similarly, excessive affection was associated with lower depression, loneliness, stress, and pain, and higher sleep quality, than affection deprivation.     

Stereopsis with opposite contrast contours

The effects of incidental stimuli, defined as visual stimuli not under verbal control, upon a selection task were observed as a function of feedback contingency. Ss judged letter pairs to be valid or invalid completions of preceding letter parts. During the presentation of the letter parts, the response pair or an alternative pair of letters was intermittently presented at a threshold value individually determined for each S. One group of Ss received a light feedback of performance contingent upon responding to the incidental stimuli; whereas a second group received a random noncontingent feedback. The results indicated: (a) both groups responded to the incidental stimuli; (b) feedback contingency had no effect on frequency of responding to the incidental stimuli; (c) frequency of responding to the incidental stimuli remained constant over 32 trials.