Multimethod Approaches In Health Psychology

Bärbel Knäuper and Rupert Klein

Health psychology is a fairly new discipline, having emerged as a formally organized subdiscipline of psychology only in the late 1970s (Division 38, Health Psychology, of the American Psychological Association was founded in 1978). As a consequence, its boundaries are still somewhat fuzzy. Matarazzo, in 1980, defined health psychology as the aggregate of the specific educational, scientific, and professional contributions of the discipline of psychology to the promotion and maintenance of health, the prevention and treatment of illness, the identification of etiologic and diagnostic correlates of health, illness and related dysfunction, and the improvement of the health care system and health policy formation. (Matarazzo, 1980, p. 815)

A more pragmatic definition holds that it is the study of the role of psychological factors in the cause, progression, and consequences of health and illness (Ogden, 1996). The psychological factors include, in particular, the behavioral and lifestyle variables that affect a person's susceptibility to physical illness, the adaptation to illness, and the preventive behaviors that people engage in (see American Psychological Association, 1976). Health psychology can be distinguished from the related field of behavioral medicine, which, according to a definition by Schwartz and Weiss (1978), is concerned with psychological phenomena only if they contribute to physical disorders as an endpoint.

There are various scientific disciplines that health psychology research questions touch on, including medicine (particularly immunology, endocrinology, behavioral medicine, cardiology, oncology, occupational health, and psychiatry), epidemiology, public health, sociology, and education. Within psychology itself, relevant areas include behavioral neuroscience, physiological psychology, psychopharmacology, social psychology, personality psychology, developmental psychology, educational psychology, and clinical psychology. Each of these areas has excelled in the development of their own methods to target their specific research questions. Health psychology, which can be viewed as applying "the accumulated knowledge from the science and profession of generic psychology to the area of health" (Matarazzo, 1987, p. 41), uses all these methods to study its specific questions and beyond that has developed its own unique arsenal of methods and approaches.

Health psychology research benefits from using multiple methods because it studies the bases of health and illness from a variety of perspectives: biological, cognitive, emotional, social, organizational, and policy making. Obviously, the methodological approaches used within these subdomains differ widely, and their coordination, integration, and interpretation pose challenges to researchers. Common methods in health psychology include strategies discussed in detail in previous chapters. These are self-report methods such as those discussed in chapter 3 (e.g., paper-pencil or computerized questionnaires, tests, surveys, observational methods using verbal codes), but also nonreactive methods such as those discussed in chapter 9 (e.g., analyses of archives, diaries, or patients' records) and implicit methods such as those detailed in chapter 10 (e.g., reaction time measurement). Other typical methods include physiological (e.g., electrocardiography, electromyography, electroencephalography, and skin responses) and biochemical methods (e.g., Cortisol analyses). On the most molecular level, health psychology uses brain imaging and other currently evolving methods in behavioral neuroscience to study its research questions.

These research methods are often used in one-shot studies such as surveys, case studies, correlational studies, or experiments. Experiments can range from natural experiments to randomized controlled trials. However, designs with several points of assessment (e.g., panel surveys, longitudinal studies), or time-series designs in which data are collected from various times per minute to various times per week over extended periods of time (e.g., experience-sampling techniques) are also commonly used. To illustrate, each of the methods and research designs just listed have been used in the past to study psychosocial, behavioral, and lifestyle determinants of cardiovascular disease and cancer, the leading causes of death in industrialized countries.

The purpose of this chapter is to describe how previous researchers have used multiple-method strategies in health psychology to discuss some of the problems with the predominance of self-report measures and to outline strategies that can be used to overcome these problems.

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