Understanding Psychology (10th Ed)

R E T H I N K
1.
Is there a danger of “blaming the victim” when we argue 
that the course of cancer can be improved if a person with 
the disease holds positive attitudes or beliefs, particularly 
when we consider people with cancer who are not recov-
ering? Explain your answer.
2. From the perspective of a health-care provider: What type of 
advice would you give to your patients about the connec-
tions between personality and disease? For example, 
would you encourage Type A people to become “less Type 
A” in order to decrease their risk of heart disease?
 Answers to Evaluate Questions 
1.
B, A; 
2.
false; T
ype A
behavior is related to a higher incidence of 
coronary heart disease but does not necessarily cause it dir
ectly; 
3.
immune; 4.
tr
ue
 Module 
44 
Psychological Aspects of Illness and Well-Being 
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Key Concepts 
How do our interactions with 
physicians aff ect our health 
and compliance with medical 
treatment?
How does a sense of well-
being develop?
M O D U L E 4 5 
Promoting Health and Wellness
When Stuart Grinspoon fi rst noticed the small lump in his arm, he assumed it was just 
a bruise from the touch football game he had played the previous week. But as he 
thought about it more, he considered more serious possibilities and decided that he’d 
better get it checked out at the university health service. But the visit was less than 
satisfactory. A shy person, Stuart felt embarrassed talking about his medical condition. 
Even worse, after answering a string of questions, he couldn’t even understand the phy-
sician’s diagnosis and was too embarrassed to ask for clarifi cation. 
Many of us share Stuart Grinspoon’s attitudes toward health care. We approach 
physicians the same way we approach auto mechanics. When something goes wrong 
with the car, we want the mechanic to fi gure out the problem and then fi x it. In the 
same way, when something isn’t working right with our bodies, we want a diagno-
sis of the problem and then a (we hope, quick) repair. 
Yet such an approach ignores the fact that—unlike auto repair—good health care 
requires taking psychological factors into account. Health psychologists have sought 
to determine the factors involved in the promotion of good health and, more broadly, 
a sense of well-being and happiness. Let’s take a closer look at two areas they have 
tackled: producing compliance with health-related advice and identifying the deter-
minants of well-being and happiness.
Following Medical Advice
We’re not very good at taking medical advice. Consider these fi gures: 
• As many as 85% of patients do not fully comply with a physician’s 
recommendations.
• Between 14–21% of patients don’t ever fi ll their drug prescriptions.
• Some 10% of adolescent pregnancies result from noncompliance with birth 
control practices.
• Sixty percent of all patients cannot identify their own medicines.
• From 30–50% of all patients ignore instructions or make errors in taking 
medication (Christensen & Johnson, 2002; Health Pages, 2003; Colland et al., 
2004).
Noncompliance with medical advice can take many forms. For example, patients 
may fail to show up for scheduled appointments, not follow diets or not give up 
smoking, or discontinue medication during treatment. In some cases, they fail to take 
prescribed medicine at all. 
Patients also may practice creative nonadherence in which they adjust a treatment 
prescribed by a physician by relying on their own medical judgment and experience. 
In many cases patients’ lack of medical knowledge may be harmful (Taylor, 1995; 
Hamani et al., 2007). 
Noncompliance is sometimes a result of psychological reactance. Reactance is a 
negative emotional and cognitive reaction that results from the restriction of one’s 
freedom. People who experience reactance feel hostility and anger. Because of such