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Top of FormThe patient presents with community-acquired pneumonia and other comorbidities, including COPD, hypertension, hyperlipidemia, and diabetes. According to Regunath & Oba (2022), when a patient has comorbidities, the care provider should offer a fluoroquinolone or a combination of oral beta-lactam and macrolide. The patients current treatment includes ceftriaxone (Third-generation cephalosporin) and azithromycin (macrolide). The patients main needs include continued therapy to ensure sustained improvement and recovery. While the current combination is effective, the lack of food tolerance may significantly impact the patient. With the patient having a penicillin allergy when changing the medication, the care provider must ensure that the alternative is penicillin based or cross-reactive.
While the patient is having nausea and vomiting, they are common side effects of taking both ceftriaxone and azithromycin. Since pneumonia has a high risk of drug resistance, I would keep the patient on the same medication. However, I would aim to reduce the dosage the patient is taking. The FDA recommends that IV azithromycin is followed by oral route azithromycin. I would move the patient to a 500 mg dose administered as 250 mg twice daily. If the patient’s symptoms do not improve, the patients treatment should be changed to levofloxacin 750mg, taken once daily. According to Izadi et al. (2018), levofloxacin is well tolerated compared to a combination of ceftriaxone and azithromycin and remains as effective as the combination. I would educate the patient on the side effects of the medication and how to take the medication properly. Since they are suffering from side effects, I would also educate them on the side effects they should observe and seek medical advice when they develop. Simple and clear language is essential for the patient to ensure they understand and reduce confusion. I would educate the patient using the teach-back method as it allows one to also assess the patients understanding of the content.

Michaela E

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According to the case study, the patient has been diagnosed with pneumonia and has comorbidities of COPD, HTN, hyperlipidemia, and diabetes. He has been administered a cephalosporin and macrolide for treatment of the pneumonia. The patient is experiencing nausea and vomiting and unable to tolerate his diet. The patient is already at high risk for respiratory issues and complications due to his history of COPD. The patient should be closely monitored for any respiratory decline due to his history. The patients nutrition is also a concern due to his diagnosis of diabetes. With infection and decreased nutrition, the patients glucose levels can be difficult to manage.
The treatment regimen that the patient is taking is ceftriaxone 1 g IV daily and azithromycin 500mg IV daily. These medication choices are best for treating complicated pneumonia with a penicillin allergy. However, the azithromycin should have been a one-time dose of 500mg then decreased to 250mg daily. Phillips et al. explain, that patients with pneumonia should be treated with a loading dosage and then taper the medication to a maintenance dose for treatment (2019). I would also recommend treating the patient with an antiemetic to decrease nausea and vomiting to allow for nutritional intake. Rosenthal and Burchum provide evidence that cephalosporin and macrolide therapies both have side effects of nausea and vomiting (2021). When the patient is switched to a lower dosage of azithromycin, this side effect could resolve but antiemetics should be used for treatment if not. Sitompul et al. explain that patients who are treated for complicated pneumonia should receive lower dosage and longer course of therapy to achieve full treatment of the infection (2022). The medications should still be given every 24 hours but extended for 7 to 14 days to treat the patients pneumonia.
While the patient is in the hospital, education about pneumonia and history of COPD should be provided. The patient should be educated on the increase risk of pneumonia due to his medical history and the complications of treating pneumonia with respiratory disorders. According to Restrepo et al., patients should be educated on extended treatment with by mouth antibiotics after intravenous antibiotics to provide continued treatment after discharging from the hospital (2018). The patient should be educated on taking all by mouth antibiotics and monitoring for recurrence of any issues after going home from the hospital. Education should also be given on the risk of reoccurrence of the infection and importance of monitoring glucose for any changes while the patient still has infection. The patient should also follow-up with his primary care provider within 1 week of the hospital stay to be reevaluated for signs or symptoms of pneumonia.
When treating a patient who has complicated pneumonia due to medical history, it can be difficult to provide the correct regimen without specific side effects. Treatment should be followed carefully and the patient should closely be monitored for any concerns. If the patient does have side effects from treatment, then intervention should take place to assist with these side effects. Once the patient is getting planned for discharged, thorough education should be provided to the patient/family on follow-up appointments and extended regimens to continue fighting the infection.
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Shelley E. Taylor




University of California, Los Angeles


Published by McGraw-Hill Education, 2 Penn Plaza, New York, NY 10121. Copyright 2018 by
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Library of Congress Cataloging-in-Publication Data
Names: Taylor, Shelley E., author.
Title: Health psychology / Shelley Taylor, University of California, Los Angeles.
Description: Tenth edition. | New York, NY : McGraw-Hill Education, [2018] |
Includes bibliographical references and indexes.
Identifiers: LCCN 2016044904| ISBN 9781259870477 | ISBN 1259870472
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For Nathaniel


SHELLEY E. TAYLOR is Distinguished Professor of Psychology at the
University of California, Los Angeles. She received her Ph.D. in social psychol-
ogy from Yale University. After a visiting professorship at Yale and assistant and
associate professorships at Harvard University, she joined the faculty of UCLA.
Her research interests concern the psychological and social factors that promote
or compromise mental and physical health across the life span. Professor Taylor
is the recipient of a number of awardsmost notably, the American Psychological
Associations Distinguished Scientific Contribution to Psychology Award, a
10-year Research Scientist Development Award from the National Institute of
Mental Health, and an Outstanding Scientific Contribution Award in Health Psy-
chology. She is the author of more than 350 publications in journals and books
and is the author of Social Cognition, Social Psychology, Positive Illusions, and
The Tending Instinct. She is a member of the National Academies of Science and
the National Academy of Medicine.




P A R T 1



C H A P T E R 1

What Is Health Psychology? 2

Definition of Health Psychology 3
Why Did Health Psychology Develop? 3

The Mind-Body Relationship: A Brief History 4
The Rise of the Biopsychosocial Method 5

Psychosomatic Medicine 5
Advantages of the Biopsychosocial Model 5
Clinical Implications of the Biopsychosocial

Model 6
The Biopsychosocial Model: The Case History of

Nightmare Deaths 6
The Need for Health Psychology 6

Changing Patterns of Illness 7
Advances in Technology and Research 8
Expanded Health Care Services 8
Increased Medical Acceptance 9

Health Psychology Research 9
The Role of Theory in Research 9
Experiments 10
Correlational Studies 10
Prospective and Retrospective Designs 10
The Role of Epidemiology in Health Psychology 11
Methodological Tools 11
Qualitative Research 12

What Is Health Psychology Training For? 12

C H A P T E R 2

The Systems of the Body 14

The Nervous System 15
Overview 15
The Brain 15
B O X 2.1 Costs of War to the Brain 17

The Role of Neurotransmitters 17
Disorders of the Nervous System 17

The Endocrine System 19
Overview 19
The Adrenal Glands 19
Disorders Involving the Endocrine System 19

The Cardiovascular System 20
Overview 20
The Heart 20
Disorders of the Cardiovascular System 21
Blood Pressure 22
The Blood 22

The Respiratory System 23
Overview 23
The Structure and Functions of the Respiratory

System 23
Disorders Associated with the Respiratory System 24
Dealing with Respiratory Disorders 25

viii Contents

Genetics and Health 29
Overview 29
Genetics and Susceptibility to Disorders 29

The Immune System 31
Overview 31
Infection 31
The Course of Infection 31
B O X 2.2 Portraits of Two Carriers 32

Immunity 32
Disorders Related to the Immune System 34

The Digestive System and the Metabolism of Food 25
Overview 25
The Functioning of the Digestive System 25
Disorders of the Digestive System 25

The Renal System 27
Overview 27
Disorders of the Renal System 27

The Reproductive System 28
Overview 28
The Ovaries and Testes 28
Fertilization and Gestation 28
Disorders of the Reproductive System 28

P A R T 2


C H A P T E R 3

Health Behaviors 38

An Introduction to Health Behaviors 39
Role of Behavioral Factors in Disease and

Disorder 39
Health Promotion: An Overview 39

Health Behaviors and Health Habits 39
Practicing and Changing Health Behaviors:

An Overview 40
Barriers to Modifying Poor Health Behaviors 41
Intervening with Children and Adolescents 42
Intervening with At-Risk People 43
Health Promotion and Older Adults 44
Ethnic and Gender Differences in Health Risks

and Habits 45
Changing Health Habits 45

Attitude Change and Health Behavior 45
The Health Belief Model 47
The Theory of Planned Behavior 47
Criticisms of Attitude Theories 49
Self Regulation and Health Behavior 49
Self Determination Theory 49
Implementation Intentions 49
Health Behavior Change and the Brain 50

Cognitive-Behavioral Approaches to Health
Behavior Change 50

Cognitive-Behavior Therapy (CBT) 50
Self-Monitoring 50
Stimulus Control 51
The Self-Control of Behavior 51

B O X 3.1 Classical Conditioning 52
B O X 3.2 Operant Conditioning 53
B O X 3.3 Modeling 54

Social Skills and Relaxation Training 54
Motivational Interviewing 54
Relapse Prevention 55
Evaluation of CBT 56

The Transtheoretical Model of Behavior Change 56
Stages of Change 56
Using the Stage Model of Change 57

Changing Health Behaviors Through Social
Engineering 58
Venues for Health-Habit Modification 59

The Practitioners Office 59
The Family 59
Self-Help Groups 60
Schools 60
Workplace Interventions 60
Community-Based Interventions 60
The Mass Media 61
Cellular Phones and Landlines 61
The Internet 61

C H A P T E R 4

Health-Promoting Behaviors 64

Exercise 65
Benefits of Exercise 65
Determinants of Regular Exercise 66
Exercise Interventions 67

Contents ix

Evaluation of Cognitive-Behavioral Weight-Loss
Techniques 90

Taking a Public Health Approach 90
Eating Disorders 91

Anorexia Nervosa 91
B O X 5.3 The Barbie Beauty Battle 92

Bulimia 93
Binge Eating Disorder 94

Alcoholism and Problem Drinking 94
The Scope of the Problem 94
What Is Substance Dependence? 95
Alcoholism and Problem Drinking 95
Origins of Alcoholism and Problem Drinking 95
Treatment of Alcohol Abuse 96
Treatment Programs 97
B O X 5.4 After the Fall of the Berlin Wall 97
B O X 5.5 A Profile of Alcoholics Anonymous 98
B O X 5.6 The Drinking College Student 99

Evaluation of Alcohol Treatment Programs 100
Preventive Approaches to Alcohol Abuse 100
Drinking and Driving 101
Is Modest Alcohol Consumption a Health

Behavior? 101
Smoking 101

Synergistic Effects of Smoking 102
A Brief History of the Smoking Problem 102
Why Do People Smoke? 103
Nicotine Addiction and Smoking 105
Interventions to Reduce Smoking 106
Smoking Prevention Programs 109
B O X 5.7 The Perils of Secondhand Smoke 110

Accident Prevention 68
Home and Workplace Accidents 68
Motorcycle and Automobile Accidents 69

Vaccinations and Screening 69
Vaccinations 70
Screenings 70
Colorectal Cancer Screening 71

Sun Safety Practices 71
Developing a Healthy Diet 72

Changing Diet 73
Resistance to Modifying Diet 73

Sleep 75
What Is Sleep? 75
Sleep and Health 75

Rest, Renewal, Savoring 76

C H A P T E R 5

Health-Compromising Behaviors 79

Characteristics of Health-Compromising Behaviors 80
Obesity 81

What Is Obesity? 81
Obesity in Childhood 83
B O X 5.1 The Biological Regulation of Eating 85

SES, Culture, and Obesity 85
Obesity and Dieting as Risk Factors for Obesity 86
Stress and Eating 87
Interventions 87
B O X 5.2 Dont Diet 88

Cognitive Behavioral Therapy (CBT) 88

P A R T 3


C H A P T E R 6

Stress 114

What Is Stress? 115
What Is a Stressor? 115
Appraisal of Stressors 115

Origins of the Study of Stress 115
Fight or Flight 115
Selyes General Adaptation Syndrome 115
Tend-and-Befriend 117
How Does Stress Contribute to Illness? 117

The Physiology of Stress 118
Effects of Long-Term Stress 119
Individual Differences in Stress Reactivity 120
Physiological Recovery 121
Allostatic Load 121
B O X 6.1 Can Stress Affect Pregnancy? 122

What Makes Events Stressful? 122
Dimensions of Stressful Events 122
Must Stress Be Perceived as Such to Be Stressful? 123
Can People Adapt to Stress? 124

x Contents

Psychosocial Resources 140
B O X 7.2 Religion, Coping, and Well-Being 142

Resilience 142
Coping Style 143
Problem-Focused and Emotion-Focused Coping 144
B O X 7.3 The Brief COPE 145

Coping and External Resources 146
B O X 7.4 Coping with HIV 146

Coping Outcomes 147
Coping Interventions 147

Mindfulness Meditation and Acceptance/Commitment
Therapy 147

Expressive Writing 148
Self-Affirmation 149
Relaxation Training 149
Coping Skills Training 149

Social Support 151
What Is Social Support? 151
Effects of Social Support on Illness 152
B O X 7.5 Is Social Companionship an Important

Part of Your Life? 153
Biopsychosocial Pathways 153
Moderation of Stress by Social Support 154
What Kinds of Support Are Most Effective? 155
B O X 7.6 Can Bad Relationships Affect Your

Health? 156
Enhancing Social Support 157

P A R T 4

How Has Stress Been Studied? 124
Studying Stress in the Laboratory 124
Must a Stressor Be Ongoing to Be Stressful? 124
Inducing Disease 125
Stressful Life Events 125
B O X 6.2 Post-Traumatic Stress Disorder 126

Daily Stress 127
Sources of Chronic Stress 128

Effects of Early Stressful Life Experiences 128
B O X 6.3 Can an Exciting Sports Event Kill You?

Cardiovascular Events During World Cup
Soccer 128

B O X 6.4 A Measure of Perceived Stress 129
B O X 6.5 The Measurement of Daily Strain 130

Chronic Stressful Conditions 130
Stress in the Workplace 131
B O X 6.6 Can Prejudice Harm Your Health? 132

Some Solutions to Workplace Stressors 134
Combining Work and Family Roles 134

C H A P T E R 7

Coping, Resilience, and Social Support 137

Coping with Stress and Resilience 138
Personality and Coping 138
B O X 7.1 The Measurement of Optimism:

The LOT-R 140


C H A P T E R 8

Using Health Services 160

Recognition and Interpretation of Symptoms 161
Recognition of Symptoms 161
Interpretation of Symptoms 162
Cognitive Representations of Illness 162
B O X 8.1 Can Expectations Influence Sensations?

The Case of Premenstrual Symptoms 163
Lay Referral Network 164
The Internet 164

Who Uses Health Services? 164
Age 164
Gender 164

Social Class and Culture 165
Social Psychological Factors 165

Misusing Health Services 165
Using Health Services for Emotional

Disturbances 165
Delay Behavior 166
B O X 8.2 The June Bug Disease: A Case of

Hysterical Contagion 167

C H A P T E R 9

Patients, Providers, and Treatments 170

Health Care Services 171
Patient Consumerism 171

Contents xi

Who Uses CAM? 192
Complementary and Alternative Medicine: An

Overall Evaluation 192
The Placebo Effect 193

History of the Placebo 193
What Is a Placebo? 193
Provider Behavior and Placebo Effects 194
B O X 9.6 Cancer and the Placebo Effect 194

Patient Characteristics and Placebo Effects 194
Patient-Provider Communication and Placebo

Effects 195
Situational Determinants of Placebo Effects 195
Social Norms and Placebo Effects 195
The Placebo as a Methodological Tool 196

C H A P T E R 1 0

The Management of Pain and
Discomfort 199

The Elusive Nature of Pain 201
B O X 10.1 A Cross-Cultural Perspective on Pain:

The Childbirth Experience 202
Measuring Pain 202
The Physiology of Pain 204
B O X 10.2 Headache Drawings Reflect Distress and

Disability 204
B O X 10.3 Phantom Limb Pain: A Case History 206
Neurochemical Bases of Pain and Its Inhibition 206

Clinical Issues in Pain Management 207
Acute and Chronic Pain 207
Pain and Personality 209

Pain Control Techniques 209
Pharmacological Control of Pain 210
Surgical Control of Pain 210
Sensory Control of Pain 211
Biofeedback 211
Relaxation Techniques 211
Distraction 212
Coping Skills Training 213
Cognitive Behavioral Therapy 214

Pain Management Programs 214
Initial Evaluation 215
Individualized Treatment 215
Components of Programs 215
Involvement of Family 215
Relapse Prevention 215
Evaluation of Programs 215

Structure of the Health Care Delivery System 171
Patient Experiences with Managed Care 172

The Nature of Patient-Provider Communication 173
Setting 173
Provider Behaviors That Contribute to Faulty

Communication 174
B O X 9.1 What Did You Say?: Language Barriers

to Effective Communication 175
Patients Contributions to Faulty Communication 175
Interactive Aspects of the Communication

Problem 176
Results of Poor Patient-Provider Communication 177

Nonadherence to Treatment Regimens 177
Good Communication 177
B O X 9.2 What Are Some Ways to Improve

Adherence to Treatment? 178
Improving Patient-Provider Communication and
Increasing Adherence to Treatment 178

Teaching Providers How to Communicate 178
B O X 9.3 What Can Providers Do to Improve

Adherence? 179
The Patient in the Hospital Setting 180

Structure of the Hospital 181
The Impact of Hospitalization on the Patient 182
B O X 9.4 Burnout Among Health Care

Professionals 183
Interventions to Increase Information in Hospital
Settings 184
The Hospitalized Child 184

B O X 9.5 Social Support and Distress from
Surgery 185

Preparing Children for Medical Interventions 185
Complementary and Alternative Medicine 186

Philosophical Origins of CAM 186
CAM Treatments 188

Dietary Supplements and Diets 188
Prayer 188
Acupuncture 189
Yoga 189
Hypnosis 190
Meditation 190
Guided Imagery 190
Chiropractic Medicine 191
Osteopathy 191
Massage 191

xii Contents

C H A P T E R 1 2

Psychological Issues in Advancing and
Terminal Illness 239

Death Across the Life Span 240
Death in Infancy and Childhood 240
Death in Adolescence and Young Adulthood 243
Death in Middle Age 244
Death in Old Age 244
B O X 12.1 Why Do Women Live Longer Than

Men? 245
Psychological Issues in Advancing Illness 246

Continued Treatment and Advancing Illness 246
B O X 12.2 A Letter to My Physician 247
Psychological and Social Issues Related to

Dying 247
B O X 12.3 Ready to Die: The Question of Assisted

Suicide 248
The Issue of Nontraditional Treatment 249

Are There Stages in Adjustment to Dying? 249
Kbler-Rosss Five-Stage Theory 249
Evaluation of Kbler-Rosss Theory 250

Psychological Issues and the Terminally Ill 251
Medical Staff and the Terminally Ill Patient 251
Counseling with the Terminally Ill 253
The Management of Terminal Illness in Children 253

Alternatives to Hospital Care for the Terminally Ill 253
Hospice Care 253
Home Care 254

Problems of Survivors 254
B O X 12.4 Cultural Attitudes Toward Death 255
The Survivor 255
Death Education 257

C H A P T E R 1 3

Heart Disease, Hypertension, Stroke,
and Type II Diabetes 259

Coronary Heart Disease 260
What Is CHD? 260
Risk Factors for CHD 260
Stress and CHD 261
Women and CHD 263
Personality, Cardiovascular Reactivity, and CHD 264

C H A P T E R 1 1

Management of Chronic Health
Disorders 218

Quality of Life 220
What Is Quality of Life? 220
Why Study Quality of Life? 220

Emotional Responses to Chronic Health Disorders 221
Denial 221
Anxiety 222
Depression 222

Personal Issues in Chronic Health Disorders 223
B O X 11.1 A Future of Fear 223
The Physical Self 223
The Achieving Self 224
The Social Self 224
The Private Self 224

Coping with Chronic Health Disorders 224
Coping Strategies and Chronic Health Disorders 224
Patients Beliefs About Chronic Health Disorders 225
B O X 11.2 Chronic Fatigue Syndrome and Other

Functional Disorders 226
Comanagement of Chronic Health Disorders 227

Physical Rehabilitation 227
B O X 11.3 Epilepsy and the Need for a Job

Redesign 228
Vocational Issues in Chronic Health Disorders 228
Social Interaction Problems in Chronic Health

Disorders 228
B O X 11.4 Who Works with People with Chronic

Health Disorders? 229
Gender and the Impact of Chronic Health

Disorders 232
Positive Changes in Response to Chronic Health

Disorders 232
When a Child Has A Chronic Health Disorder 232

Psychological Interventions and Chronic Health
Disorders 234

Pharmacological Interventions 234
Individual Therapy 234
Relaxation, Stress Management, and Exercise 235
Social Support Interventions 236
B O X 11.5 Help on the Internet 236
Support Groups 237

P A R T 5


Contents xiii

Negative Affect and Immune Functioning 287
Stress, Immune Functioning, and Interpersonal

Relationships 288
Coping and Immune Functioning 288
Interventions to Improve Immune Functioning 289

HIV Infection and AIDS 290
A Brief History of HIV Infection and AIDS 290
HIV Infection and AIDS in the United States 291
The Psychosocial Impact of HIV Infection 292
Interventions to Reduce the Spread of HIV

Infection 293
Coping with HIV+ Status and AIDS 296
Psychosocial Factors That Affect the Course of HIV

Infection 297
Cancer 298

Why Is Cancer Hard to Study? 299
Who Gets Cancer? A Complex Profile 299
Psychosocial Factors and Cancer 299
Psychosocial Factors and the Course of Cancer 301
Adjusting to Cancer 301
Psychosocial Issues and Cancer 302
Post-traumatic Growth 302
Interventions 303
Therapies with Cancer Patients 304

Arthritis 304
Rheumatoid Arthritis 305
Osteoarthritis 306

Type I Diabetes 306
Special Problems of Adolescent Diabetics 307

B O X 13.1 Hostility and Cardiovascular Disease 265
Depression and CHD 266
Other Psychosocial Risk Factors and CHD 267
Management of Heart Disease 267
B O X 13.2 Picturing the Heart 269
Prevention of Heart Disease 271

Hypertension 272
How Is Hypertension Measured? 272
What Causes Hypertension? 272
Treatment of Hypertension 274
The Hidden Disease 275

Stroke 275
Risk Factors for Stroke 276
Consequences of Stroke 277
Rehabilitative Interventions 277

Type II Diabetes 278
Health Implications of Diabetes 280
Psychosocial Factors in the Development of

Diabetes 280
The Management of Diabetes 281
B O X 13.3 Stress Management and the Control of

Diabetes 281

C H A P T E R 1 4

Psychoneuroimmunology and
Immune-Related Disorders 284

Psychoneuroimmunology 285
The Immune System 285
Assessing Immune Functioning 285
Stress and Immune Functioning 285
B O X 14.1 Autoimmune Disorders 287

P A R T 6


C H A P T E R 1 5

Health Psychology: Challenges
for the Future 312

Health Promotion 314
A Focus on Those at Risk 314
Prevention 314
A Focus on Older Adults 314
Refocusing Health Promotion Efforts 315
Promoting Resilience 315
Health Promotion and Medical Practice 316
Health Disparities 316

Stress and Its Management 318
Where Is Stress Research Headed? 318

Health Services 319
Building Better Consumers 319

Management of Serious Illness 320
Quality-of-Life Assessment 320
The Aging of the Population 320

Trends in Health and Health Psychology 321
The Research of the Future 321
The Changing Nature of Medical Practice 321

xiv Contents





Systematic Documentation of Cost Effectiveness
and Treatment Effectiveness 322

International Health 324
Becoming a Health Psychologist 325

Undergraduate Experience 325
Graduate Experience 325
Postgraduate Work 326
Employment 326



When I wrote the first edition of Health Psychology over 30 years ago, the task
was much simpler than it is now. Health psychology was a new field and was
relatively small. In recent decades, the field has grown steadily, and great research
advances have been made. Chief among these developments has been the use and
refinement of the biopsychosocial model: the study of health issues from the stand-
point of biological, psychological, and social factors acting together. Increasingly,
research has attempted to identify the biological pathways by which psychosocial
factors such as stress may adversely affect health and potentially protective factors
such as social support may buffer the impact of stress. My goal in the tenth edition
of this text is to convey this increasing sophistication of the field in a manner that
makes it accessible, comprehensible, and exciting to undergraduates.
Like any science, health psychology is cumulative, building on past research
advances to develop new ones. Accordingly, I have tried to present not only the
fundamental contributions to the field but also the current research on these
issues. Because health psychology is developing and changing so rapidly, it is
essential that a text be up to date. Therefore, I have not only reviewed the recent
research in health psychology but also obtained information about research proj-
ects that will not be available in the research literature for several years. In so
doing, I am presenting a text that is both current and pointed toward the future.
A second goal is to portray health psychology appropriately as being inti-
mately involved with the problems of our times. The aging of the population and
the shift in numbers toward the later years has created unprecedented health needs
to which health psychology must respond. Such efforts include the need for health
promotion with this aging cohort and an understanding of the psychosocial issues
that arise in response to aging and its associated chronic disorders. Because AIDS
is a leading cause of death worldwide, the need for health measures such as con-
dom use is readily apparent if we are to halt the spread of this disease. Obesity
is now one of the worlds leading health problems, nowhere more so than in the
United States. Reversing this dire trend that threatens to shorten life expectancy
worldwide is an important current goal of health psychology. Increasingly, health
psychology is an international undertaking, with researchers from around the
world providing insights into the problems that affect both developing and devel-
oped countries. The tenth edition includes current research that reflects the inter-
national focus of both health problems and the health research community.
Health habits lie at the origin of our most prevalent disorders, and this fact
underscores more than ever the importance of modifying problematic health behav-
iors such as smoking and alcohol consumption. Increasingly, research documents
the importance of a healthy diet, regular exercise, and weight control among other
positive health habits for maintaining good health. The at-risk role has taken on
more importance in prevention, as breakthroughs in genetic research have made
it possible to identify genetic risks for diseases long before disease is evident.
How people cope with being at risk and what interventions are appropriate for
them represent important tasks for health psychology research to address.
Health psychology is both an applied field and a basic research field. Accord-
ingly, in highlighting the accomplishments of the field, I present both the scientific

xvi Preface

progress and its important applications. Chief among these are efforts by clinical
psychologists to intervene with people to treat biopsychosocial disorders, such as
post-traumatic stress disorder; to help people manage health habits that have
become life threatening, such as eating disorders; and to develop clinical interven-
tions that help people better manage their chronic illnesses.
Finding the right methods and venues for modifying health continues to be a
critical issue. The chapters on health promotion put particular emphasis on the
most promising methods for changing health behaviors. The chapters on chronic
diseases highlight how knowledge of the psychosocial causes and consequences
of these disorders may be used to intervene with people at riskfirst, to reduce
the likelihood that such disorders will develop, and second, to deal effectively
with the psychosocial issues that arise following diagnosis.
The success of any text depends ultimately on its ability to communicate the
content clearly to student readers and spark interest in the field. In this tenth
edition, I strive to make the material interesting and relevant to the lives of student
readers. Many chapters highlight news stories related to health. In addition, the
presentation of material has been tied to the needs and interests of young adults.
For example, the topic of stress management is tied directly to how students might
manage the stresses associated with college life. The topic of problem drinking
includes sections on college students alcohol consumption and its modification.
Health habits relevant to this age grouptanning, exercise, and condom use,
among othersare highlighted for their relevance to the student population. By
providing students with anecdotes, case histories, and specific research examples
that are relevant to their own lives, they learn how important this body of knowl-
edge is to their lives as young adults.
Health psychology is a science, and consequently, it is important to commu-
nicate not only the research itself but also some understanding of how studies
were designed and why they were designed that way. The explanations of par-
ticular research methods and the theories that have guided research appear
throughout the book. Important studies are described in depth so that students
have a sense of the methods researchers use to make decisions about how to gather
the best data on a problem or how to intervene most effectively.
Throughout the book, I have made an effort to balance general coverage of
psychological concepts with coverage of specific health issues. One method of
doing so is by presenting groups of chapters, with the initial chapter offering
general concepts and subsequent chapters applying those concepts to specific
health issues. Thus, Chapter 3 discusses general strategies of health promotion,
and Chapters 4 and 5 discuss those issues with specific reference to particular
health habits such as exercise, smoking, accident prevention, and weight control.
Chapters 11 and 12 discuss broad issues that arise in the context of managing
chronic health disorders and terminal illness. In Chapters 13 and 14, these issues
are addressed concretely, with reference to specific disorders such as heart disease,
cancer, and AIDS.
Rather than adopt a particular theoretical emphasis throughout the book,
Ihave attempted to maintain a flexible orientation. Because health psychology is
taught within all areas of psychology (for example, clinical, social, cognitive,
physiological, learning, and developmental), material from each of these areas is
included in the text so that it can be accommodated to the orientation of each
instructor. Consequently, not all material in the book is relevant for all courses.
Successive chapters of the book build on each other but do not depend on each

Preface xvii

other. Chapter 2, for example, can be used as assigned reading, or it can act as a
resource for students wishing to clarify their understanding of biological concepts
or learn more about a particular biological system or illness. Thus, each instruc-
tor can accommodate the use of the text to his or her needs, giving some chapters
more attention than others and omitting some chapters altogether, without under-
mining the integrity of the presentation.


Coverage of qualitative methods, such as how interviews and personal narra-
tives can enrich our understanding of health experiences (Chapter 1)

Discussion of Alzheimers disease, its toll, and its increasing importance as
a disease of an aging population (Chapter 2)

New section on the self-regulation of health behaviors, including the impact
of self affirmation on health behavior change (Chapter 3)

Coverage of perceived barriers to health behavior change, one of the most
important reasons why people do not practice better health habits (Chapter 3)

Coverage of the post childbirth period as a teachable moment (Chapter 3)
Discussion of the health risks of being sedentary and sitting for long periods

of time (Chapters 4, 13)
Expanded coverage of vaccinations and ways to overcome resistance to getting

children vaccinated for major diseases (Chapter 4)
Coverage of new research on sleep and health (Chapter 4)
Enhanced coverage of eating disorders, including binge eating disorder

(Chapter 5)
Coverage of the newest research on the obesity epidemic (Chapter 5)
New research on stress in childhood and adolescence (Chapter 6)
Expanded converge on the effects of prejudice and discrimination on health

(Chapter 6)
Expanded coverage of how mindfulness meditation can aid coping with stress

(Chapter 7)
Coverage of dyadic coping, namely how partners can shape each others bio-

logical and psychological responses to stress (Chapter 7)
Discussion of how people are using probiotics to enhance the microbiome of

the gut and its potential effects on health (Chapter 9)
Coverage of the epidemic of opioid and heroin abuse and their effects on

health and on suicide (Chapters 10, 12)
Change in orientation from disease and illness to health and chronic health

disorders (Chapters 3, 11)
Discussion of the startling increase in the death rate of middle-aged adults

and the reasons why (Chapter 12)
Intervening in childhood and adolescence to forestall chronic health disorders

in middle age (Chapter 13)
Discussion of psychosocial factors in the development of Type II Diabetes

(Chapter 12)
Coverage of post-traumatic growth (Chapter 14)
Use of technology and the Internet to improve health and to assess and inter-

vene in the course of chronic health disorders (Chapters 1, 3, 13, 15)
Impact of changes in healthcare coverage in the United States (Chapter 15)
The chan


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