Health Psychology

Glaser, Ronald; Thorn, Beverly E.; Tarr, Kathleen L.; Kiecolt-Glaser, Janice K.; D’Ambrosio, Steven M.

doi: 10.1037/0278-6133.4.5.403pmid: N/A

Theenhancement of tumor development following acute stress has been demonstrated insome animal studies. This study was designed to explore mechanisms that wouldaccount in part for the relationship between stress and tumor development at thelevel of DNA repair, using a rat model. Forty-four rats were given thecarcinogen dimethylnitrosamine in their drinking water, and half were randomlyassigned to a rotational stress condition. The levels of methyl-transfer ase, aDNA repair enzyme induced in response to carcinogen damage, were significantlylower in spleens from the stressed animals. These data suggest that stress mayimpair DNA repair.

Carmelli, Dorit; Chesney, Margaret A.; Ward, Marcia M.; Rosenman, Ray H.

doi: 10.1037/0278-6133.4.5.413pmid: N/A

Cardiovascular (CV) responses to laboratory stressors were measured in 12 pairs of identical and 21 pairs of fraternal adult male twins. For this study, blood pressure and heart rate were measured during a mental arithmetic task and the Cold Pressor Test. The analyses of cardiovascular responses to these stressors were designed to test for the presence of a genetic component in cardiovascular reactivity in an adult sample of twins aged 54–64 years. The results suggest that certain measures of cardiovascular reactivity to laboratory stressors may be heritable for both physical and psychological stressors. The possible role of this genetic component in the etiology and course of coronary heart disease is discussed.

Zonderman, Alan B.; Heft, Marc W.; Costa, Paul T.

doi: 10.1037/0278-6133.4.5.425pmid: N/A

Abnormal illness behavior (AIB) has been proposed as a construct measuring the inappropriate or maladaptive modes of responding to one’s state of health, and the Illness Behavior Questionnaire (IBQ; Pilowsky, 1975) was designed to measure this construct. Previous studies using small samples have failed to agree on the factor structure of this questionnaire. The present paper examines the factor structure of the Illness Behavior Questionnaire and critically evaluates the interpretation of its dimensions as well as the construct of AIB. A factor analysis of responses from 1,061 health care and nonhealth care seeking subjects yielded six interpretable factors which substantially replicated Pilowsky’s previous results. Six scales were calculated and correlated with several personality measures. The results indicated that the Illness Behavior Questionnaire is saturated with neuroticism, a dimension known to be related to excessive medical complaints. But excessive medical complaints cannot be equated with hypochondriasis or AIB in the absence of objective medical information. In the absence of evidence for the discriminant validity of the IBQ, its use as a diagnostic device is unwarranted. Treating elevated IBQ scores as indicators of abnormal illness behavior without corroborating medical information may be more misleading than accepting patients’ symptom reports at face value.

Dickson-Parnell, Barbara E.; Zeichner, Amos

doi: 10.1037/0278-6133.4.5.437pmid: N/A

The present study investigated the effects of a short-term exercise program on caloric intake. Thirty-three women were randomly assigned to either a high-intensity exercise group (80% maximum heart rate), low-intensity exercise group (55% maximum heart rate), or waiting list control group. Exercisers were required to ride ergometer bicycles three times per week for 7 weeks, expending 200 kilocalories of energy per exercise session. All participants recorded food intake during specified weeks before, during, and following the exercise program. Results showed no significant caloric intake differences among the three groups, but a trend toward reduction in food intake with increased exercise intensity was found. Interestingly, comparisons between caloric intake on exercise and nonexercise days revealed that both exercise groups consumed significantly less on exercise days. Additionally, the control group evidenced a larger caloric intake level than did the two exercise groups on exercise days. These results suggest that exercisers do not compensate for energy expenditure by increasing caloric intake and that choosing between low- and high-intensity exercise does not differentially alter caloric intake. Nevertheless, maximization of negative energy balance or weight loss may be best achieved by exercise programs of high frequency and intensity.

Flay, Brian R.

doi: 10.1037/0278-6133.4.5.449pmid: N/A

Twenty-seven school-basedstudies of psychosocial approaches to smoking prevention are reviewed. Two major approaches arerepresented: the “social influences” approach and the broader“life/social skills” approaches. The research studies are considered infour “generations”: the seminal work by Richard Evans and colleagues at theUniversity of Houston; seven “pilot” studies of improved programs atStanford, Minnesota, New York, and Washington, with one school or classroom per experimentalcondition; twelve improved “prototype” studies by these four groups andothers, with two or three units randomly assigned to conditions; and six studies in whichmaximizing internal validity was of prime concern. Reported results were fairly consistent,with each tested program seeming to reduce smoking onset by about 50%. However, none of thepilot or prototype studies considered alone provided easily interpreted results. The majorcontributions were improved programs and methods. The findings from the fourth generation ofstudies were more easily interpreted, though only two of them were interpreted with highconfidence. It seems that psychosocial approaches to smoking prevention, particularly thesocial influences approach-fourth generation tests of the broader life/social skills approacheshave yet to be reported—are effective, but at this time we know very little aboutwhy, for whom, or under what conditions. Suggestions are provided for improved futureresearch.

Boudewyns, Patrick A.; Nolan, William P.

doi: 10.1037/0278-6133.4.5.489pmid: N/A

This article describes the new Medicare payment system based on diagnosis-related groups (DRGs) and its impact on professional psychology. DRGs represent medically oriented notions about how many inpatient days a prudent physician needs to effectively treat a patient who suffers from a specified disease. However, for the most part, DRGs ignore the behavioral variables that moderate entry into the tertiary care system and the subsequent use of hospital resources. Under DRGs, the development and use of behavioral treatments for somatic disorders could be discouraged. For example, many newer behavioral medicine techniques may be more time-consuming and/or expensive than traditional treatment options (e.g., bed rest vs. biofeedback for low back pain) and thus not fall within the time period or “trim points” alloted for such disorder, regardless of comparative effectiveness. Also, under the new system, psychologists can no longer bill separately for their inpatient services. It is argued that the framers of health care policies should recognize and support health psychologists in light of the fact that many of their techniques can reduce the cost and consumption of health care through programs that: (a) reduce behavioral risk factors, (b) increase compliance with medical regimens, and (c) prepare patients psychologically for stressful medical procedures.