SOCIAL COGNITION AND PHYSICAL ILLNESS

During the health-conscious 1980s, reports by the National Academy of Sciences and other agencies informed us that half of all deaths are linked with behavior—with consuming cigarettes, alcohol, drugs, and harmful foods; with reactions to stress; with lack of exercise and not following a doctor's orders. Efforts to study and change these behavioral contributions to illness helped create a new interdisciplinary field called behavioral medicine.

Health Psychology

Psychology's contribution to this interdisciplinary science is its new subfield health psychology. The American Psychological Association's division of health psychology, formed in 1979, mushroomed to 2900 members in its first 10 years, and includes many of the estimated 3000 psychologists now working in U.S. medical schools. Among health psychology's questions (and some tentative answers), are the following:

·        Do characteristic emotions, and ways of responding to stressful events, predict susceptibility to heart disease, stroke, cancer, and other ailments?

·        Heart disease has been linked with a competitive, impatient, and the aspect that matters—anger-prone personality. Under stress, reactive, anger-prone "Type A" people secrete more of the stress hormones believed to accelerate the buildup of plaque on the walls of the heart's arteries.

·        Sustained stress suppresses the disease-fighting immune system, leaving us more vulnerable to infections and malignancy. Experiments reveal that the immune system's activity can also be influenced by conditioning.

How can we control or reduce stress?

Health psychologists are exploring the benefits of aerobic exercise (an effective antidote to mild depression and anxiety), relaxation training (to help control such tension-related ailments as headaches and high blood pressure), and supportive close relationships (which can help buffer the impact of stress).

·        How do people decide whether they are ill, and 'what can be done to ensure that they seek medical help and follow a treatment regimen?

We decide we are sick when symptoms fit one of our existing "schemas" for disease. Does the small cyst match our idea of a malignant lump? Is the stomachache bad enough to be appendicitis? Is the pain in the chest area merely—as many heart attack victims suppose—a muscle spasm. Patients are more willing to follow treatment instructions when they have a warm relationship with their doctor, when they help plan their treatment, and when options are framed attractively, People are more likely to elect an operation when given "a 40 percent chance of surviving" than when given "a 60 percent chance of not surviving".

·        What Lifestyle changes would prevent illness and promote health, and how might such changes be encouraged?       

Psychologists are exploring the social influences that motivate adolescents to start smoking and have pioneered effective smoking prevention techniques. New explorations of internal and external influences on body weight explain why the obese have difficulty losing weight permanently and also how they can best modify eating and exercise.

Optimism and Health:        Understanding the links between attitudes and disease requires more than dramatic true stories such as this, however. Even if hopelessness coincides with cancer, does cancer breed hopelessness, or does hopelessness also hinder resistance to cancer? To resolve this chicken-and-egg riddle, researchers have (1) experimentally created hopelessness by subjecting organisms to uncontrollable stresses and (2) correlated the hopeless explanatory style with future illnesses.

Stress and Illness:                 The dearest indication of the effects of hopelessness comes from experiments that subject animals to mild but uncontrollable electric shocks, loud noises, or crowding. Such experiences do not cause diseases, such as cancer, but they lower the body's resistance. Rats injected with live cancer cells more often develop and die of tumors if they also receive inescapable-shocks than if they receive escapable shocks or no shocks, Moreover, compared to juvenile rats given controllable shocks, those given uncontrollable shocks are twice as likely in adulthood to develop tumors if given cancer cells and another round of shocks. Animals that have learned helplessness react more passively, and blood tests reveal a weakened immune response.

Pessimistic Explanatory Style and Illness:           If uncontrollable stress affects health by generating a passive, hopeless resignation, then will people who exhibit such attitudes be more vulnerable to illness?  Several studies have confirmed that a pessimistic style of explaining bad events (saying, "It's my responsibility, it’s going to last, and it's going to undermine everything") makes illness more likely. Christopher Peterson and Martin Seligman studied the press quotes of 94 members of baseball's Hall of Fame and gauged how often they offered pessimistic (stable, global, internal) explanations for bad events, such as losing big games. Those who routinely did so tended to die at somewhat younger ages. Optimists—who offered stable, global, and internal explanations for good events—usually outlived the pessimists.

Peterson, Seligman, and George Valliant offer other findings: Harvard graduates who expressed the least pessimism when interviewed in 1946 were healthiest when restudied in 1980. Virginia Tech introductory psychology students who offered stable and global explanations for bad events suffered more colds, sore throats, and flush a year later. Michael Scheier and Charles Carver similarly report that optimists (who agree, for example, that "I usually expect the best") are less often bothered by various illnesses and recover faster from coronary bypass surgery.