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5 - Becoming ill

Published online by Cambridge University Press:  05 June 2012

Antonia C. Lyons
Massey University, Auckland
Kerry Chamberlain
Massey University, Auckland
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[M]ost people, doctors and scientists included, find it inherently easier to believe in the reality of apparently simple physical causes of disease (such as cholesterol, salt, bacteria or viruses) than to accept that mere thoughts or emotions can affect our health

(Martin, 1997, p. 11)

We must now turn our attention toward describing the biological and cultural mechanisms through which psychological processes contribute to disease onset and progression.

(Revenson, 1990, p. 86)

Learning objectives

This chapter reviews factors that influence people becoming ill. We examine research investigating whether psychological factors, such as stress and personality, play any role in disease causation. The chapter also provides a review of social and environmental factors that influence becoming ill, such as social support, gender and SES. Some physiological pathways through which psychosocial factors could influence physical health are described. Finally, we present examples of research which attempt to integrate this somewhat disjointed field through meta-level theorising. By the end of this chapter you should be able to:

  • identify key psychological factors which influence people becoming ill;

  • explain how sociocultural factors, such as gender, ethnicity and SES, need to be accounted for in any account of illness causation;

  • provide an outline of how environments affect disease causation;

  • discuss the implications of traditional health psychology research on psychological factors and disease processes;

  • highlight the necessity for effective and integrative ‘biopsychosocial’ theorising in disease etiology.

Does stress influence health? Are people who repress their emotions more likely to develop cancer? Is there a disease-prone personality?

Health Psychology
A Critical Introduction
, pp. 140 - 180
Publisher: Cambridge University Press
Print publication year: 2006

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Bartlett, D. (1998). Stress: perspectives and processes. Buckingham, UK: Open University Press. In ch. 2 of this book, Bartlett provides an insightful discussion of contemporary stress theories, and describes the dominant approach to stress and coping developed by Lazarus and colleagues over the last thirty years. He also highlights both theoretical and methodological problems with stress conceptualisations.Google Scholar
Martin, P. (1997). The sickening mind: brain, behaviour, immunity and disease. London: Flamingo. This book provides an engaging and well-informed account of how psychosocial factors might be related to disease. The author is a respected behavioural biologist and health psychologist, and he provides interesting examples of psychosomatic phenomena using well-known literature classics.Google Scholar
Special section on reactivity. Psychosomatic Medicine, 65 (1) (2003): This issue of the journal contains a special section on cardiovascular reactivity. It includes five articles which are both a reflection on where the research has got us to date, and what is required in the future. This section provides a very good account of reactivity research and its problems.
Smith, T. W., & Ruiz, J. M. (2002). Psychosocial influences on the development and course of coronary heart disease: current status and implications for research and practice. Journal of Consulting and Clinical Psychology, 70, 548–68. In this paper Smith and Ruiz provide a concise and accessible review of some of the physiological mechanisms linking psychosocial factors and CHD. The paper covers cardiovascular psychophysiology, particularly ‘cardiovascular reactivity’. It also reviews research linking psychosocial factors to disease, as well as findings from intervention studies.CrossRefGoogle ScholarPubMed
Taylor, S. E., Repetti, R. L. & Seeman, T. (1997). Health psychology: what is an unhealthy environment and how does it get under the skin?Annual Review of Psychology, 48, 411–47. This paper provides a good overview of how environments and psychosocial factors work together to affect health. It explicitly includes race and SES as contextual factors, and also considers health outcomes across the lifespan.CrossRefGoogle ScholarPubMed

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