Handbook of Clinical Health Psychology

1. On the Nature of Clinical Health Psychology.- 1. Some Historical and Philosophical Reflections.- 1.1. Historical Notes.- 1.2. Bridging the Mind-Body Dichotomy.- 2. Problems of Boundary and Definition.- 2.1. Psychosomatic Medicine.- 2.2. Medical Psychology.- 2.3. Rehabilitation Psychology.- 2.4. Health Care Psychology.- 2.5. Behavioral Medicine.- 2.6. Behavioral Health.- 2.7. Health Psychology.- 2.8. Clinical Health Psychology.- 3. The Domain of Clinical Health Psychology.- 3.1. Personality: The Styles of Coping.- 3.2. Psychogenic Attitudes: Objective and Subjective Stressors.- 4. Clinical Settings and Functions of Health Psychologists.- 4.1. The Clinical Settings of Health Psychology.- 4.2. The Clinical Functions of the Health Psychologist.- 5. Training Clinical Health Psychologists.- 5.1. Need for Formal Training.- 5.2. Problems in Program Development.- 5.3. General Training Goals.- 5.4. University of Miami Clinical Health Track.- 6. References.- I. The Knowledge Domain of Clinical Health Psychology.- 2. Psychobiological Factors in Bodily Disease.- 1. The Development of Psychosomatic Concepts.- 1.1. Behavioral Factors in Disease.- 1.2. Social Factors in Disease.- 2. The Current Status of Psychosomatic Concepts.- 3. The Predisposition to Disease.- 4. The Onset and Initiation of Disease.- 5. Initiating Mechanisms of Disease.- 6. Social and Psychological Effects of Illness.- 7. Factors That Sustain Disease.- 8. Conclusion.- 9. References.- 3. Psychological Processes Induced by Illness, Injury, and Loss.- 1. Experiences during Intrusive and Denial States.- 1.1. Perception and Attention.- 1.2. Ideas and Feelings Related to the Event.- 1.3. Conceptual Attributes of Intrusive and Denial States.- 1.4. Emotional Attributes.- 1.5. Somatic Attributes.- 1.6. Action Patterns.- 2. Contents of Concern.- 2.1. Fear of Repetition.- 2.2. Shame over Helplessness or Emptiness.- 2.3. Rage at “the Source”.- 2.4. Guilt Feeling or Shame over Aggressive Impulses.- 2.5. Fear of Aggressivity.- 2.6. Survivor Guilt.- 2.7. Fear of Identification or Merger with Victims.- 2.8. Sadness in Relation to Loss.- 2.9. Recapitulation.- 3. Coping.- 4. Treatment.- 4.1. Goals of Treatment for Stress Response Syndromes.- 4.2. The Pattern of Psychological Treatment.- 4.3. Summary.- 5. References.- 4. The Risks and Course of Coronary Artery Disease: A Biopsychosocial Perspective.- 1. Premorbid Phase: Who Is At Risk?.- 1.1. Mind over Body.- 1.2. Risk Related to Biochemistry, Personal Habits, and Family History.- 1.3. The Risk of the Coronary-Prone Behavior Pattern.- 2. Biological Mediators of Coronary Artery Disease.- 3. Psychosocial Risk Factors of Coronary Artery Disease.- 4. Psychopathology as a Risk Factor.- 5. Hospital-Phase Risk Factors.- 5.1. Coronary Care Unit: Risks the Technology Fails to Treat.- 5.2. The Risk of Getting Better: Transfer from the Coronary Care Unit.- 5.3. The Risk of Delirium.- 5.4. Disturbances of Sleep in the Coronary Care Unit.- 6. Posthospital Phase.- 6.1. Length of Hospitalization: Is More Better?.- 6.2. Psychological Risks during Convalescence.- 7. Conclusion.- 8. References.- 5. Some Issues in Research on Stressful Life Events.- 1. Evidence about the Relationship of Life Stress to Illness.- 2. Definition of Populations of Life Events.- 3. Measurement of the Magnitudes of Life Events.- 4. Research Design.- 5. Mediation of the Impact of Stressful Life Events.- 6. Conclusion.- 7. References.- 6. Stress, Coping and Illness: A Transactional Perspective.- 1. Stress as an Environmental Event.- 2. Stress as a Response.- 3. A Transactional Conception of Stress.- 3.1. Appraisal.- 3.2. Coping.- 4. Coping and Health.- 5. Coping Skills Treatment.- 6. Transactional Conceptions of Causality.- 7. Stress in Its Social Context.- 7.1. Social Support.- 7.2. The Family.- 7.3. Family Interventions.- 8. Concluding Remarks.- 9. References.- 7. Coping with Acute Health Crises.- 1. Crisis Theory as a General Perspective.- 2. A Conceptual Framework.- 2.1. Sociodemographic and Personal Factors.- 2.2. Illness-Related Factors.- 2.3. Physical and Social-Environmental Factors.- 2.4. Mediating Factors: Appraisal and Activation.- 2.5. Major Adaptive Tasks.- 2.6. Major Types of Coping Skills.- 3. The Crisis of Illness: Coping with Cancer.- 4. The Crisis of Treatment: Unusual Hospital Environments.- 5. The Therapeutic Role of Staff.- 6. References.- 8. Adaptation to Chronic Illness and Disability.- 1. A Paradox.- 1.1. Resolution.- 1.2. Adaptation to What?.- 2. Implications.- 2.1. An Example.- 3. Fundamental Differences in Viewpoints.- 3.1. Introduction.- 3.2. Research Implications.- 4. Scope and Limitations.- 5. Differences in Problem Definition.- 5.1. Possible Resolutions.- 6. Perceptions of Locus of Problems.- 6.1. Possible Resolution.- 7. Attitudes toward Subjectivity.- 7.1. Possible Resolution.- 8. Values.- 8.1. Possible Resolution.- 9. Temporal Perspective.- 9.1. Possible Resolution.- 10. Units of Measurement and Conceptualization.- 10.1. Possible Resolution.- 11. Decision Making.- 11.1. Possible Resolution.- 12. General Reconciliation of the Two Viewpoints.- 13. A Final Question.- 14. References.- II. The Clinical Settings of Health Psychology.- 9. The Psychologist as Health Care Clinician.- 1. Historical Review.- 1.1. Ideological Issues.- 1.2. Traditional and More Recent Hospital Roles for Psychologists..- 2. Contemporary Pressures.- 2.1. Problems in the Health Care System.- 2.2. Credentialing and Intraprofessional Strains.- 2.3. Legal Conflict with Psychiatry.- 3. Pragmatics of Practice.- 4. The Future Yield.- 5. Implications for Training.- 6. References.- 10. Pediatric Psychology: Health Care Psychology for Children.- 1. Introduction.- 1.1. Rationale of Pediatric Psychology.- 1.2. Characteristics of Pediatric Psychology.- 1.3. Overview of Chapter.- 2. Definitions and Conceptualizations of Pediatric Psychology.- 2.1. Underlying Philosophy.- 2.2. Definitional Characteristics.- 2.3. Psychological Aspects.- 2.4. Conceptualizations of Roles and Functions.- 3. Development of Pediatric Psychology.- 3.1. Historical Milestones.- 3.2. Society of Pediatric Psychology.- 3.3. Training.- 3.4. Accumulation of Knowledge through Research.- 4. The Clinical Practice of Pediatric Psychology.- 4.1 Types of Intervention.- 4.2. Examples of Pediatric Psychological Functioning.- 4.3. Models of Consultation.- 4.4. Characteristics of Practice Procedures.- 5. A Survey of Research: Selected Topics.- 5.1. Range of Research Activity.- 5.2. Chronic Conditions.- 5.3. Acute Conditions.- 5.4. Developmental Disorders.- 5.5. Terminal Illness and Death.- 6. Research: The Future of Pediatric Psychology.- 6.1. Compliance to Medical Regimens.- 6.2. Psychogenic Pain.- 6.3. Prevention.- 6.4. Protocols and Standardized Procedures.- 6.5. Additional Areas of Research.- 7. Concluding Comments.- 8. References.- 11. The Psychologist as Geriatric Clinician.- 1. Developmental Features of Later Life.- 1.1. Health Changes.- 1.2. Psychological Changes.- 1.3. Social Changes.- 1.4. Personality Changes.- 2. Testing and Assessment.- 2.1. Goals in Clinical Assessment with Older Adults.- 2.2. Instrumenting Assessment.- 2.3. Psychological Assessment.- 3. Therapy and Clinical Practice.- 3.1. Efficacy.- 3.2. Technique.- 4. Research.- 4.1. Designs in Aging Research.- 4.2. Issue Areas in Aging Research.- 5. Concluding Statement.- 6. References.- 12. Collaborative Efforts in Liaison Psychiatry.- 1. The Precepts of Liaison Psychiatry.- 2. The Practice of Primary, Secondary, and Tertiary Prevention.- 3. The Fostering of Diagnostic Accuracy.- 4. Clarification of the Status of the Caretaker.- 4.1. Evaluating the Doctor.- 4.2. Evaluating the Family.- 5. The Provision of Ongoing Education to the Nonpsychiatric Staff to Promote Autonomy.- 5.1. The Pre-Ombudsman Meeting.- 5.2. The Ombudsman Rounds.- 6. The Development of Core Biopsychosocial Knowledge.- 7. Promotion of Structural Changes in the Medical Setting.- 8. Commentary.- 9. References.- 13. The Psychologist as Social Systems Consultant.- 1. Introduction.- 1.1. Definition of a System.- 1.2. General Systems Theory.- 1.3. Social Systems Involved in Health Care.- 2. Basic Issues in Social System Theory.- 2.1. Introduction.- 2.2. Social Ties.- 2.3. Social Roles.- 2.4. Cross-Level Linkage among Systems.- 2.5. Mutual Contingency.- 2.6. Summary of Key Concepts.- 2.7. Patient Assessment.- 3. Applications of the Systems Approach to Health Care.- 3.1. Social Ties and Health.- 3.2. Doctor and Patient Roles.- 3.3. Interface between Social and Physiological Processes.- 3.4. Doctor-Patient Communication.- 4. Discussion.- 5. References.- 14. Behavioral Cardiology with Emphasis on the Family Heart Study: Fertile Ground for Psychological and Biomedical Research.- 1. Introduction.- 1.1. Behavioral Cardiology.- 2. The Evolution of Behavioral Cardiology at the University of Oregon School of Medicine.- 2.1. The Family Heart Study: Recruitment and Baseline.- 2.2. The Family Heart Study: Intervention Phase.- 2.3. The Family Heart Study: Control Groups.- 3. Recruitment Studies.- 3.1. Joiners versus Nonjoiners.- 3.2. Health Survey Results.- 3.3. Recruitment Phase: Summary of Results.- 4. Health Attitudes and Biomedical Status.- 4.1. Health Attitudes and Plasma Cholesterol Level.- 4.2. Health Attitudes and Obesity.- 4.3. Internal Locus of Control and Biomedical Status.- 4.4. Health Attitudes of Smokers and Nonsmokers.- 4.5. Health Attitudes and Leisure Activity.- 4.6. Health Attitudes: Implications of Our Findings.- 5. Cigarette Smoking.- 5.1. Smokers’ Use of Coffee, Alcohol, and Other Drugs.- 5.2. Psychological Characteristics and Smoking Status.- 5.3. Biomedical Characteristics and Smoking Status.- 5.4. Leisure Exercise and Smoking Status.- 5.5. Cigarette Smoking: Implications of Our Findings.- 6. Conclusion.- 7. References.- III. The Clinical Functions of the Health Psychologist.- 15. Psychological Assessment in Medical Settings.- 1. Psychological Analysis in Medical Settings.- 2. Assessment Trends in Medical Settings.- 2.1. General Criteria for Test Evaluation.- 2.2. Criteria for Assessing Tests Used with Medical Populations.- 3. Symptom Checklists.- 3.1. Cornell Medical Index (CMI).- 3.2. Symptom Check List—90 (SCL-90).- 4. Single-Trait Instruments.- 4.1. Internal-External Scale (I-E Scale).- 4.2. Beck Depression Inventory.- 4.3. State-Trait Anxiety Inventory (STAT).- 5. Life-Style Inventories.- 5.1. Jenkins Activity Survey QAS).- 5.2. Life Experiences Survey (LES).- 6. Personality Inventories.- 6.1. 16 Personality Factor Inventory (16 PF).- 6.2. Minnesota Multiphasic Personality Inventory (MMPI).- 6.3. Millon Behavioral Health Inventory (MBHI).- 7. Discussion.- 8. References.- 16. Assessing the Impact of Life Changes.- 1. Assessing Life Changes.- 1.1. Schedule of Recent Events.- 1.2. The Life Experiences Survey.- 1.3. The Diversity of Approaches to Assessing Stressful Life Events.- 2. Life Change and the Onset of Illness.- 3. Moderators of Stressful Life Events.- 3.1. Sensation Seeking.- 3.2. Locus of Control.- 3.3. Social Support.- 4. Methodological Issues in Assessing Stressful Life Events.- 4.1. Types of Events.- 4.2. Magnitude of Events.- 4.3. Timing of Events.- 4.4. Meaning of Events.- 4.5. Causality versus Correlation.- 4.6. Moderator Variables.- 5. Cognitive Appraisal and the Experience of Stress.- 6. References.- 17. Behavioral Indicators of Client Progress after Spinal Cord Injury: An Ecological-Contextual Approach.- 1. Background.- 2. Observational Developments.- 3. Reduction and Selection.- 4. Clinical Personnel as Estimators.- 5. Self-Observation and Report of Behavior.- 6. Prediction of Outcomes.- 7. Concluding Comments.- 18. Issues in Patient Compliance.- 1. Medical Compliance.- 2. Social Compliance.- 2.1. Social Exchange.- 2.2. Social Power.- 2.3. Social Influence.- 2.4. Forced Compliance.- 2.5. Attribution Processes.- 3. Behavioral Compliance.- 3.1. Self-Reinforcement.- 3.2. Self-Monitoring.- 3.3. Behavioral Contracting.- 3.4. Self-Instructional Training.- 4. Other Compliance-Improvement Strategies.- 5. Some Paradoxes.- 6. References.- 19. Psychomaintenance of Chronic Physical Illness: Clinical Assessment of Personal Styles Affecting Medical Management.- 1. Psychomaintenance of Physical Illness.- 2. Two Assumptions Relating to Assessment.- 3. Examples of Psychomaintenance.- 4. The Context of Psychomaintenance.- 5. Psychomaintenance and Its Assessment in Asthma.- 5.1. Characteristics of Asthma and Its Treatment.- 5.2. The Battery of Asthma Illness Behavior (BAIB).- 5.3. The Empirical Basis of the BAIB: Nine Personal Styles.- 6. Examples of Assessment and Treatment.- 6.1. Patient A: A Low Panic-Fear Personality, Symptom Disregarder..- 6.2. Patient B: A High Panic-Fear Personality, Vigilant Patient.- 6.3. Patient C: A Moderate Panic-Fear Personality, Vigilant Patient.- 6.4. Patient D: A Moderate Panic-Fear Personality, Typical Patient.- 6.5. Summary of the Psychomaintenance Assessment Approach and Its Implications for Treatment.- 7. Relevance and Generality of Psychomaintenance.- 8. References.- 20. Behavioral Health Care in the Management of Chronic Pain.- 1. Some Behavioral Concepts in Pain Treatment.- 1.1. Pain as Behavior.- 1.2. Respondent versus Operant Pain Behavior.- 1.3. Acute versus Chronic Pain.- 1.4. Behavioral Health Care Goals.- 1.5. Review of Behavioral Strategies in Pain Treatment.- 2. Behavioral Health Care Techniques.- 2.1. Evaluation Procedures.- 2.2. Treatment Strategies.- 2.3. Use of Adjunct Pain Treatment.- 2.4. Contraindications for Behavioral Health Care.- 3. Conclusion.- 4. References.- 21. Cognitive Behavior Therapy in Health Psychology.- 1. Theoretical Issues in Cognitive Behavioral Therapy.- 2. A Theoretical Model of Behavior Change.- 2.1. Description of the Model.- 2.2. Assessment.- 2.3. A Critical Appraisal of the Model.- 3. Issues in Cognitive Behavioral Assessment.- 4. Cognitive Behavioral Therapy for Type-A CHD Patients.- 5. Cognitive Behavioral Approach to Pain Treatment.- 6. Program Blending Cognitive Behavioral Aspects of Chronic Pain Treatment.- 6.1. Theoretical Assumptions.- 6.2. Program Overview.- 6.3. Assessment.- 6.4. Physical Therapy.- 6.5. Occupational/Recreational Therapy.- 6.6. Rehabilitation Specialist.- 6.7. Physical Medicine.- 6.8. Psychology Program.- 6.9. Research.- 7. Conclusion.- 8. References.- 22. Hypnosuggestive Procedures in the Treatment of Clinical Pain: Implications for Theories of Hypnosis and Suggestive Therapy.- 1. Hypnosuggestive Procedures in Surgery.- 2. Postsurgical Effects of Hypnosuggestive Procedures.- 3. Hypnosuggestive Procedures in the Treatment of Back Pain.- 4. Hypnosuggestive Procedures in the Treatment of Tension Headaches and Migraines.- 5. Hypnosuggestive Procedures for Cancer Pain.- 6. Hypnosuggestive Procedures with Burn Patients.- 7. Hypnosuggestive Procedures for Dental Pain.- 8. Hypnosuggestive Procedures for Childbirth Pain.- 9. Effects of Hypnosuggestion on Experimental Pain.- 10. “Good” Hypnotic Subjects and the Relief of Pain.- 11. Recommendations for More Effective Hypnosuggestive Procedures.- 11.1. Useful Preliminary Procedures.- 11.2. Useful Verbal Suggestions.- 11.3. Useful Nonverbal Suggestions.- 12. Overview: Hypnosuggestive Approaches to Pain.- 13. References.- 23. Patient-Centric Technologies: A Clinical-Cultural Perspective.- 1. The Domains of Patient Power.- 1.1. Experiential Expertise.- 1.2. Integrative Expertise.- 1.3. Initiator Expertise.- 1.4. Informative Expertise.- 1.5. Implementive Expertise.- 2. Patient-Centric Technologies—Unilateral and Shared.- 2.1. Unilateral Technologies.- 2.2. Shared Technologies.- 2.3. Emergent Inventory of Patient Tools and Skills.- 3. Health Care Delivery as a Bidirectional Process.- 4. References.- Author Index.