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June 25, 2002
Journal Explores Links Between Illness, State of Mind
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The growing science of that interplay between psychology and biology known as behavioral medicine is the focus of a special issue of the Journal of Consulting and Clinical Psychology, a publication of the American Psychological Association.
"With steadily increasing sophistication, the evidence continues to mount that behavioral factors play a key role in the development and course of nearly all major diseases and disorders, as does the evidence that a wide variety of behavioral interventions produce useful changes in the risk, impact and course of disease," the editors wrote in an introduction to the issue.
The Philadelphia Inquirer reports that the special issue contains 27 articles on everything from AIDS and arthritis to smoking cessation, obesity, and the cost-effectiveness of treatment.
Some argue for a larger role for psychologists in the treatment of physical disease and for better reimbursement.
Philip Kendall, a Temple University psychology professor who edits the journal, told the Inquirer that the boundaries between the mind and the body are disappearing.
"Clinical psychology and health and behavioral medicine are areas where two one-time opposites are converging," he said. That is, the previous "it's-all-biological" view and the "it's-all-in-your-mind" ideology have found compatibility. Healthy behavior, he said, influences weight, breathing, organ function and recovery from illness. "Even the simple adherence to medical advice... requires consideration of psychological influences."
Thomas Wadden, a psychologist who directs the Weight and Eating Disorders Program at the University of Pennsylvania, said studying how behavior and health interact had gained importance as science had conquered many of the infectious diseases that used to send people to their graves. Now, it's more often our own temperament and behavior that make us sick and determine whether we get well.
The Inquirer notes some of the other behavioral connections explored in the report:
- Immune function. Psychosocial factors such as depression or stress affect immune function in infectious disease, cancer, wound healing, autoimmune disease and HIV, research increasingly shows. Negative emotions have been associated with inflammation, which has itself been linked to many conditions of aging.
- Heart disease. Evidence is mounting that anger, depression, anxiety, pessimism, social isolation, and job stress all increase the risk for heart disease. Preliminary evidence also points to "social dominance" evidenced by controlling behaviors such as a tendency to cut off and talk over an interviewer as a risk factor. It's not yet clear whether treating these problems affects the course of the disease.
- Chronic pain. Psychological factors affect quality of life, the ability to cope, and disability associated with pain. These factors include emotions, social background and the meaning of pain to the sufferer. Long-term pain affects all aspects of a person's functioning.
To read the Philadelphia Inquirer article, click here.