Handbook of Clinical Health Psychology: Volume 1, Medical Disorders and Behavioral Applications

Canadian Psychology, Nov 2003 by Aboussafy, David

SUZANNE BENNETT JOHNSON, NATHAN W. PERRY, JR., and RONALD H. ROZENSKY (Volume Eds.) Handbook of Clinical Health Psychology: Volume 1, Medical Disorders and Behavioral Applications Washington DC: American Psychological Association, 2002, 654 pages. (ISBN 1-55798-909-5, US$69.95 Hardcover)

The goal of the three volume Handbook of Clinical Health Psychology, published by The American Psychological Association, is to describe in detail health psychology's contribution to scientific knowledge and improved health care delivery. The information to be covered makes this series of three handbooks the first comprehensive effort to characterize the field of health psychology. As noted in the series introduction, it does this by describing health psychology's scientific basis, delineating specific techniques and evaluation procedures, and by demonstrating applications of health psychology to the full range of medical diagnoses. This is extremely worthwhile, given how slowly physicians, the patient population, and third-party payers have been to recognize the positive impact that psychological interventions have on health care delivery. This handbook's publication is particularly timely, given the recent reduction of psychological services in many Canadian hospitals.

The first volume in this series is entitled: Medical Disorders and Behavioral Applications. Forthcoming titles in the series are: Volume 2: Disorders of Behavior and Health, and Volume 3: Models and Perspectives in Clinical Health Psychology. Volume 1 focuses on health psychology's contributions to the management of specific diseases and disorders. The volume is organized around the International Classification of Diseases, Ninth Revision (ICD-9, 1998), a coding system used in the U.S. and commonly used worldwide. This volume is comprised of 17 chapters exactly paralleling the 17 categories into which the ICD-9 organizes diseases and disorders.

In each of these chapters, chapter authors, typically health psychologists with experience in one or more of the chapter's disorder, first briefly describe the diseases and disorders that fall within their specific ICD-9 disease category (e.g., Chapter 8, Diseases of the Respiratory System). Next, the authors provide some epidemiological data relevant to these diseases and disorders and highlight health psychology's contributions to these conditions. Finally, chapter authors conclude by commenting on areas in which health psychology may yet have made minimal impact and suggest opportunities for new research and applications. The volume does a good job in providing a systematic overview of all the ICD-9 disease categories, with the disease and disorder descriptions included in each chapter being particularly comprehensive.

However, adopting the ICD-9 organizational approach, as this volume does, has some drawbacks. The first being the ICD-9's rather rigid mind-body dualism, that may be contrary to the biopsychosocial model which underlies the health psychology approach. For example, the ICD-9 classification system deems that physical diseases seen as being in some way "psychogenic" in origin are to be classified under Mental Disorders whereas if they are seen as "organic" in origin they may be classified under their specific disease category and never the twain shall meet. Under this system, headache symptoms can be classified in three different categories (Mental Disorder, a Disorder of the Nervous System, a Symptom Involving the Head). This ICD-9 structure also caused problems for chapter authors. For example, clinical neuropsychologists Breier and Fletcher who wrote Chapter 6, Diseases of the Nervous System and Sensory Organs, expressed dismay that disorders commonly seen as under the purview of neuropsychologist, such as vascular disease and traumatic brain injury, are not included in this ICD-9 category for their review. That being said, I appreciate how using the ICD-9 system may make the volume more accessible to those working in the health care system, particularly in the U.S.

Another quibble is that Volume 1 gives short shrift to prevention, focusing as it does on disease categories. This is particularly noticeable when tobaccorelated illnesses such as lung disease are discussed. Presumably, preventative health psychology interventions will be covered in detail in Volume 2 of the Handbook.

These concerns aside, Volume 1 of the Handbook of Clinical Health Psychology is an invaluable resource for clinicians and researchers, providing both a comprehensive overview of disorders and succinct summaries of health psychology work done in relation to them. It would also be a useful resource to pass along to physicians, policy-makers, and administrators in order to help demonstrate that health psychology interventions have an important place in health care across the full gamut of medical conditions.

Suzanne Bennett Johnson is Professor and Director of the Center for Pediatric Psychology and Family Studies at the University of Florida, Gainesville. She has published widely in the areas of pediatric psychology, medical regimen adherence, psychosocial aspects of Type 1 diabetes, and the psychological impact of genetic testing.