Health Psychology Assumptions
Health Psychology Assumptions
Health Psychology Assumptions
HEALTH PSYCHOLOGY
By
Prof. Dr. Talat Sohail
THE ASSUMPTIONS OF HEALTH PSYCHOLOGY
Several assumptions central to health
psychology have been highlighted. These
include the following.
The mind–body split
Dividing up the soup
The problem of progression
The problem of methodology
The problem of measurement
Integrating the individual with their social context
Data are collected in order to develop theories; these theories are not data
Theories concerning different areas of health psychology are distinct from each
other
Studying a discipline
A critical health psychology
THE MIND–BODY SPLIT
Health psychology sets out to provide an integrated model of
the individual by establishing a holistic approach to health.
Therefore it challenges the traditional medical model of the
mind–body split and provides theories and research to
support the notion of a mind and body that are one.
For example, it suggests that beliefs influence behavior, which
in turn influences health; that stress can cause illness and
that pain is a perception rather than a sensation. In addition,
it argues that illness cognitions relate to recovery from
illness and coping relates to longevity. However, does this
approach really represent an integrated individual? Although
all these perspectives and the research that has been
carried out in their support indicate that the mind and the
body interact, they are still defined as separate. The mind
reflects the individuals’ psychological states (i.e. their
beliefs, cognitions, perceptions), which influence but are
separate to their bodies (i.e. the illness, the body, the body’s
systems).
DIVIDING UP THE SOUP
Health psychology describes variables such as beliefs (risk
perception, outcome expectancies, costs and benefits,
intentions, implementation intentions), emotions (fear,
depression, anxiety) and behaviors (smoking, drinking,
eating, screening) as separate and discrete. It then
develops models and theories to examine how these
variables interrelate.
For example, it asks, ‘What beliefs predict smoking?’, ‘What
emotions relate to screening?’ Therefore it separates out
‘the soup’ into discrete entities and then tries to put them
back together. However, perhaps these different beliefs,
emotions and behaviours were not separate until
psychology came along. Is there really a difference between
all the different beliefs? Is the thought ‘I am depressed’ a
cognition or an emotion? When I am sitting quietly thinking,
am I behaving? Health psychology assumes differences and
then looks for association. However, perhaps without the
original separation there would be nothing to associate!
THE PROBLEM OF PROGRESSION
This book has illustrated how theories, such as those relating to
addictions, stress and screening, have changed over time. In
addition, it presents new developments in the areas of social
cognition models and PNI.
For example, early models of stress focused on a simple stimulus–
response approach. Nowadays we focus on appraisal.
Furthermore, nineteenth century models of addiction believed
that it was the fault of the drug. In the early twenty-first century,
we see addiction as being a product of learning. Health
psychology assumes that these shifts in theory represent
improvement in our knowledge about the world. We know more
than we did a hundred years ago and our theories are more
accurate. However, perhaps such changes indicate different, not
better, ways of viewing the world. Perhaps these theories tell us
more about how we see the world now compared with then,
rather than simply that we have got better at seeing the world.
THE PROBLEM OF METHODOLOGY
In health psychology we carry out research to collect data
about the world. We then analyse these data to find out
how the world is, and we assume that our methodologies
are separate to the data we are collecting.
In line with this, if we ask someone about their
implementation intentions it is assumed that they have
such intentions before we ask them.
Further, if we ask someone about their anxieties we assume
that they have an emotion called anxiety, regardless of
whether or not they are talking to us or answering our
questionnaire. However, how do we know that our
methods are separate from the data we collect? How do
we know that these objects of research (beliefs, emotions
and behaviours) exist prior to when we study them?
Perhaps by studying the world we are not objectively
examining what is really going on but are actually
changing and possibly even creating it.
THE PROBLEM OF MEASUREMENT
In line with the problem of methodology is the problem
of measurement. Throughout the different areas of
health psychology, researchers develop research
tools to assess quality of life, pain, stress, beliefs and
behaviours. These tools are then used by the
researchers to examine how the subjects in the
research feel/think/behave.
However, this process involves an enormous leap of
faith – that our measurement tool actually measures
something out there. How do we know this? Perhaps
what the tool measures is simply what the tool
measures. A depression scale may not assess
‘depression’ but only the score on the scale.
Likewise, a quality-of-life scale may not assess quality
of life but simply how someone completes the
questionnaire.
INTEGRATING THE INDIVIDUAL WITH THEIR SOCIAL
CONTEXT
Psychology is traditionally the study of the individual.
Sociology is traditionally the study of the social
context. Recently, however, health psychologists have
made moves to integrate this individual with their
social world. To do this they turn to social
epidemiology (i.e. explore class, gender and
ethnicity), social psychology (i.e. turn to subjective
norms) or social constructionism (i.e. turn to
qualitative methods). Therefore health psychologists
access either the individuals’ location within their
social world via their demographic factors or ask the
individuals for their beliefs about the social world.
DATA ARE COLLECTED IN ORDER TO DEVELOP THEORIES;
THESE THEORIES ARE NOT DATA