Is there a Science of the Processes Underlying Health and Illness Behaviors? A Comment on Maes and Karoly

Maes and Karoly (2005) provide thorough overview of many of the current theoretical models and much of the empirical data describing application of self-regulation concepts to chronic illness management. They make clear that much of theory and data focuses on remote and proximal goals involved in the self-regulation process. The review makes clear, however, that few models and studies conceptualise and examine how individuals create goals and evaluate progress. Knowledge of these processes is essential for the development of effective interventions. We argue that understanding these processes is essential for understanding the interplay of concrete experience and conceptual processes. Concepts in this area are central for understanding how top-down and bottom-up processes integrate in generating self-regulatory behaviors to affect somatic experience. We discuss theoretical frameworks that can generate research paths that will lead to effective interventions.     

Federal Funds to Train Clinical Psychologists for Work with Underserved Populations: The Bureau of Health Professions Graduate Psychology Education Grants Program

This paper describes the Bureau of Health Professions (BHPr) Graduate Psychology Education program (GPE), which supports projects that train health service psychologists for work with underserved populations. BHPr history and funding criteria are discussed, as are those of BHPr's parent organization, the Health Resources Service Administration. BHPr objectives and methods for support of clinical psychology training parallel those that BHPr has used to support training in other heath professions. The paper also describes three psychology internship training programs in academic medical settings that competed successfully for BHPr GPE funding in 2002. The three training projects differ significantly in training rotation sites, target populations with which trainees work, and the other health care professions that partner with psychology in interdisciplinary training—but they are similar in that each project provides an example of a program that effectively satisfied BHPr criteria for expanding psychology's scope of practice with underserved populations.     

Implicit associations between smoking and social consequences among smokers in cessation treatment

Explicit expectations of the negative and positive social consequences of smoking are likely to have substantial influence on decisions regarding smoking. However, among smokers trying to quit, success in smoking cessation may be related not only to the content of expectancies about smoking's social effects but also to the ease with which these cognitive contents come to mind when confronted with smoking stimuli. To examine this possibility, we used the implicit association test (IAT) [Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. K. (1998). Measuring individual differences in implicit cognition: The implicit association test. Journal of Personality and Social Psychology, 74, 1464-1480] to assess implicit cognitive associations between smoking and negative vs. positive social consequences among 67 heavy social drinkers seeking smoking cessation treatment in a randomized clinical trial. Results showed that the relative strength of implicit, negative, social associations with smoking at baseline predicted higher odds of smoking abstinence during treatment over and above the effects of relevant explicit measures. The only variable that significantly correlated with IAT scores was the density of smokers in participants' social environment; those with more smoking in their social environment showed weaker negative social associations with smoking. Results suggest implicit cognition regarding the social consequences of smoking may be a relevant predictor of smoking cessation outcome.     

Illness representations and matching labels with symptoms

Three studies are reported that show that health-relevant information (e.g., blood pressure [BP] or symptoms) initiates an active cognitive search process that results in the construction of an illness representation. Study 1 showed that informing subjects that their BP was elevated affected two attributes of illness representation: identity (label and symptoms), and time line or expected chronology of the health threat. Subjects given a high-BP reading reported symptoms commonly associated with high BP, especially if they attributed the high-BP reading to stress. Study 2 showed that the active search process uses causal information (a third attribute of representations) to give meaning to symptoms. Specifically, subjects used environmental cues to interpret whether familiar, unfamiliar, and ambiguous symptoms were due to illness or to stress. In Study 3 we showed that the constructive process, initiated by a high-BP reading, is directed by prior beliefs about the time line for developing high BP and by the presence of external cues about the stressfulness of the subject's daily life. Subjects who believed BP was labile and that they were under high daily stress or who believed BP was stable and that they were under low daily stress reported more symptoms. The significance of these findings for understanding how people process diagnostic labels and symptom information involved in the construction of illness representations is discussed.     

Evidence for all-or-none preperceptual processing in perceptual set

“Set” is known to improve the accuracy of report of the stimulus attributes for which Ss are set to respond. The set may produce this effect by acting on either preperceptual or postperceptual processes, or both. To elucidate the manner by which set produces its effect, this paper explores the consequences of two assumptions concerning set (1) On any given trial, a S is either “set” or “not set”: (2) if “set” by the stimulus information. S’s perception of the stimulus actually improves, whereas, if “not set” by the stimulus reformation, the S’s report correctness is improved by an independent interaction of stimulus and set information on a response process. Evidence is provided for both these assumptions. In addition. It is argued that only set given before stimulation can affect a perceptual process.