Conceptual Frameworks for Viewing Health and Illness [chapter]

1998 Life-span Perspectives on Health and Illness  
Author Index 295 Subject Index 311 vii Preface UNTIL RECENTLY, psychology and medicine have existed to a great extent as parallel universes. However, with the emergence of the behavioral medicine and health psychology fields, the recent research on the critical connection between mind and body, the emphasis on holistic medicine and health promotion, and the recognition of the importance of psychosocial aspects of illnesses, there have been unprecedented interdisciplinary efforts by two
more » ... rts by two disciplines to collaborate on the treatment of disease and maintenance of health. As a consequence, psychology has progressed from playing an ancillary role in medicine to one that is more integrated into the comprehensive treatment of illness, particularly chronic illness, and the promotion of health and wellness. The goal of this book is to expand this integration of psychology with medicine by placing these disciplines into a life-span developmental context. The life-span approach presents a broad conceptual perspective for viewing human development. When medicine is viewed in this framework, the development of biological, psychological, and social systems can provide a new way of contextualizing health and illness. This developmental context provides information that has significant implication for medical and psychological treatments and outcomes. With a lifespan developmental perspective as the guide, this book examines the changing influence of biological, psychological, and social factors on health and illness during infancy, childhood, adolescence, and adulthood. The first section of the book (chapters 1-4) introduces the life-span model. Chapter 1 traces the historical relation between psychology and medicine. In addition, models for examining the connections among biological, psychological, and environmental factors and health are described, with particular attention given viii Preface to conceptualizations that emphasize the reciprocal relation of these domains. More specifically, this chapter reviews historical (mind-body), medical, psychological, environmental, biopsychoenvironmental, stress-coping, and risk-resiliency conceptualizations of health. The chapter proposes a more comprehensive framework, the life-span developmental systems model, which incorporates components from the models described, as well as risk-resiliency and stress-coping conceptualizations, into one dynamic framework. Chapter 2 examines how biological functioning unfolds across the life span and the reasons different age groups are predisposed to developing certain types of health problems. Development in major biological subsystems (e.g., neurological, immunological, and cardiovascular) as aging occurs are reviewed, along with their relations to changing patterns of health. Chapter 3 discusses individual differences in health from infancy to old age, describing specific models for conceptualizing the variety of ways that genetic and environmental factors can influence health and illness during different parts of the life span. Behavioral genetic research focusing on specific health problems across major developmental periods is reviewed and discussed. In chapter 4, significant health problems that occur across the life span and can be linked to poverty are described. For different age groups, critical health problems are identified and their social roots are examined. The chapter concludes with a discussion of intervention programs and social policy issues. The next four chapters examine environmental, psychological, and biological perspectives on health and illness during specific periods of life from conception to adolescence. Chapter 5 describes environmental influences on the developing fetus. Stages of human embryological and fetal development are described, morbidity data related to prenatal development are presented, and the concept of the uterus as an environment is introduced. The process through which diverse teratogens influence the fetus during different stages of development is articulated along with the effects of specific teratogens (e.g., alcohol, smoke, AIDS, syphilis, and rubella). Educational and medical prevention and intervention programs are discussed along with relevant social policy issues. Chapter 6 explores how hospital and home environments affect growth and development in preterm and full-term infants, with special consideration given to the effect of the caretaking process on infant health. The potential benefits of maternal involvement, tactile interaction, and touch interventions for infants, along with related research, are described in the context of premature birth, sudden infant death syndrome, and failure to thrive syndrome. In chapter 7, health and illness during early and later childhood are investigated, emphasizing how environmental factors, such as parenting style, and psychological characteristics, such as temperament, are related to specific health problems, including accidental injuries, obesity, juvenile diabetes, and enuresis. A final section provides suggestions for future research and outlines the importance of a multivariate approach to understanding the Preface ix processes involved in childhood health. Chapter 8 examines how the unique cognitive, emotional, and behavioral characteristics of adolescents place them at risk for specific health problems. It emphasizes that adolescents are basically biologically healthy but might become vulnerable because of social, lifestyle, and psychological factors as well as risky behavior. Chapter 9 examines the diverse impact of childhood illnesses, particularly those that are more chronic in nature, on the adjustment of affected children. Conceptual models for understanding child adaptation to illness are described, giving special attention to the influences of illness-related parameters, child characteristics, and socioenvironmental factors. The need for research that examines factors that moderate and mediate the influence of chronic illness on child adjustment is discussed at length. The next four chapters examine health issues during the adult years. Chapter 10 explores the biological, socioenvironmental, and psychological changes that occur during adulthood and how these changes influence health and illness. A conceptual framework for studying health during this period is examined. Chapter 11 examines psychosocial attributes that promote stress resistance and resiliency in later life and identifies factors that are important elements in intervention and prevention programs for older people. Chapter 12 examines the health effects of caregiving on the care receiver and caregiver. The influence of care receiver and caregiver characteristics and social support are explored along with implications for the development of intervention programs. The last chapter (chapter 13) in this section explores death and dying in our society The causes of death across the life span are reviewed in a gender and race/ethnicity framework. Changing attitudes toward death as aging occurs are described. Attention is also given to how individuals cope with death and how family and society cope with its dying members and the dying process. Finally, the aftermath of death, specifically grieving and bereavement, is examined in a life-span framework. Using the life-span developmental conceptual framework described in chapter 1, chapter 14 integrates the materials from the other chapters as well as presents a process-oriented model of health influences and health outcomes. The model describes individual, social, and environmental factors that affect coping processes that, in turn, affect health outcomes. FROM AN historical perspective, patterns of health and illness have undergone extensive change. In contrast to earlier centuries, people are, on average, living much longer and are afflicted by quite different types of illnesses. Whereas in earlier times people were likely to die of infectious diseases (e.g., smallpox, diphtheria, yellow fever, and influenza), today deaths are more commonly due to non-infectious and sometimes chronic degenerative illnesses, particularly heart disease, cancer, and stroke. The types and causes of "modern" illnesses have also been expanded with the advent of new viruses, toxic substances, and problematic life-styles. Because people are staying alive longer, they are giving considerable attention to disease prevention and health maintenance. Accompanying this emphasis has come the realization that psychological and socioenvironmental factors play vital roles in the creation and treatment of medical problems. This chapter examines historical and current concepts of the causes of health and illness. The terms health and illness have been referred to as concepts on opposite ends of a continuum (Antonovsky, 1979; , with health indicating a positive state of physical well-being that varies in degree from illness. Illness, at the other end of the spectrum, is characterized by signs, symptoms, and disabilities varying in severity. Whether health and illness are in fact quantitatively different, as this continuum suggests, or qualitatively different, can be debated. An alternative concept emphasizes that although biological, psychological, and environmental factors play a role in both health and illness, the specific types and pattern of factors that increase or maintain healthy states are different from those that produce illness. Moreover, the impact that these various determinants have on health and illness changes in profound ways across the life span as people grow older. A unique contribution of this book lies in its emphasis on a life-span perspective. 6
doi:10.4324/9781410601063-6 fatcat:shndng5zxrdrfb6cle3ddg3bka