Module Seven: Psychosocial Correlates of Specific Chronic Illnesses

Module Seven: Psychosocial Correlates of Specific Chronic Illnesses

During this module, we will extend the concepts that were introduced during Module Six and apply them to a number of specific chronic illnesses. The illnesses that we will focus upon include Coronary Heart Disease (CHD), Hypertension, Stroke, HIV/AIDS, Cancer, Type 2 Diabetes, and Type 1 Diabetes. These illnesses are some of the most prevalent in our society, as well as the most widely studied by health psychologists and other researchers.
Psychosocial factors play a major role in the development of various chronic illnesses. This is particularly true in relation to illnesses involving the cardiovascular system. For example, heart attacks in vulnerable populations are most likely to occur (or be “triggered”) at times when we are feeling particularly stressed from acute demands of daily life. Also, while some might think of heart disease as a purely physical disorder, it has been well established that negative social and emotional experiences are contributing causes. These findings are particularly important in light of the fact that coronary heart disease (CHD) is the number one killer in the United States. As you will see as we proceed in this module, a variety of psychosocial factors are implicated as contributing to the development of cardiovascular problems, including depression, anxiety, certain personality traits, social isolation, and both acute and chronic stress. These links remain apparent even when potentially confounding factors like high cholesterol, smoking, physical inactivity, and overeating have been experimentally controlled. Emotions are so prominent in CHD that researchers have even gone so far as to identify coronary prone behavior – a set of behavioral and attitudinal attributes that tend to place people at particularly elevated risk for heart problems. Coronary prone behavior—also referred to as Type A behavior—is demonstrated by people who are not only ambitious and competitive, but (most importantly) impatient and angry. Hostility appears to be one of the more perilous characteristics as far as heart health, especially when it is of the type characterized by suspiciousness, resentment, frequent anger, antagonism, and distrust for others (cynical hostility). As will be demonstrated during this module, health psychology and other fields are establishing that negative emotions are not only unpleasant, but dangerous to our physical health.
As we have learned in past modules, health psychologists are also very interested in the psychosocial consequences that develop subsequent to the diagnosis of chronic or terminal disease. As it turns out, not all diseases are created equally in relation to their typical impact on psychosocial functioning. For example, HIV/AIDS is considered to be a particularly devastating disease, not only because of the brutal physical symptoms, but also because of the stigma that is commonly attached to this disorder. HIV infection is often associated with sexual and drug-using behaviors that are considered by many to be unacceptable. Because of this, people with HIV/AIDS must sometimes face prejudice from others who view them as more responsible for their illness and perhaps less worthy of high-quality care than those with other chronic conditions (Valdiserri, 2002). The stigma can also disruptive to the
Module Seven: Psychosocial Correlates of Specific Chronic Illnesses
2 PSY 225 Module Seven
HIV/AIDS patients’ established social relationships, as prejudice and fear associated with the illness may cause some in their circle to avoid them. These problems only serve to compound the more typical emotional difficulties often experienced by chronically and terminally ill individuals (e.g., depression and anxiety; see Chapter 11).
The psychosocial correlates of chronic, advancing, and terminal illness is an area of research that is both fruitful and important. As will be evident in the readings for this module, CHD and HIV/AIDS are only two of many illnesses where psychosocial factors play a major role in how (or whether) the illness progresses. Identification of the complicating psychological and social factors associated with specific health conditions is critical if we are to develop effective preventative programs and treatment regimens that will serve to maximize the quality of life for at-risk or diagnosed populations. As specialists in the mind-body connection, health psychologists will likely continue to play a critical role in these efforts.
PSY

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