Handbook of Health Psychology

By Andrew Baum; Tracey A. Revenson et al. | Go to book overview

(as both women and women who partner/have sex with other women), and in some cases a triple minority status (lesbian/bisexual women from racial and ethnic minority groups). DiPlacido underscored the multiple levels of stressors and their effects on well-being among minority women who live in a social context of sexism, racism, heterosexism, and homophobia. Moreover, these multiple levels of stressors remain very much in focus as this researcher examines the social and personality influences that buffer the negative effects of minority stress on health outcomes. Many of these sexual minority women do indeed lead healthy, productive lives; but these lives go on within a negative sociocultural climate of hate and stigmatization.

Although these largely quantitative research efforts have produced important findings, the point here is to encourage the use of qualitative data collection and analysis strategies as researchers move closer to local contexts in personality and health research. Feminist and critical approaches in psychology have led psychologists finally to recognize what sociologists, anthropologists, and our other fellow social scientists have known for years; that is, there is much to be gained through the application of phenomenological and qualitative approaches and a close look at the contexts in which stressors are experienced. Their relevance is especially clear as investigators seek to resolve the ideological and value dilemmas noted earlier. For example, Burton, Obeidallah, and Allison (1996) summarized descriptive data from several ethnographic accounts based in the inner-city communities in which African American teens live. They made clear why and how researchers need radically to rethink the assumptions made about what are and are not normative adolescent stresses and adaptative and nonadaptive outcomes for adolescents. For many of the research participants, there really are no childhoods or adolescences as they have come to be known in certain segments of society. Notions like the innocence of childhood and the moratorium of adolescence make little sense in lives in which &year-old girls are staying home from school to be the primary care takers of infant siblings, 12, year-old girls are dating the same men that their mothers are dating, and 13-year-old boys who have experienced extraordinary violence do not worry about what they will do when they get older because getting older does not strike them as much of a possibility. The message from these data is not that there are no grounds for evaluating positive outcomes. But rather, the advice is that the researcher needs to entertain the possiblity of a diversity of outcomes and use the insights of members of the local context in the construction of the lists of outcomes that can be called desirable. For example, spiritual development and involvement in religious activities- for which African American adolescents are rarely given credit and which the research literature typically portrays as a simple coping strategy (if it considers it at all)-is seen by community participants in the Burton work as the most important outcome or indicator of positive adjustment to stressors among teens.

Sabat and Harré (1992, 1994; Sabat, 1994) also demonstrated the effectiveness of phenomenological and qualitative approaches in health research, and the dangers of relying strictly on researchers' and formal and informal caregivers definition of healthy functioning. Using records of conversations with persons living with Alzheimer's disease, both in treatment centers and at their homes, interviews with caregivers, and interviews conducted by social workers with Alzheimer's sufferers together with their caregiver, they used discourse analysis to reveal much about the experience of living with Alzheimer's and the construction of that experience. For example, their interviews revealed a higher level of cognitive functioning, one that includes a subjective experience of self, than has ever been recorded through standardized psychometric measures. In addition, they demonstrated how it is that professional and family caregivers shape the social self that the person with Alzheimer's presents to the world. That self is often minimized by those others in ways that lower self-esteem and contribute to the general loss of personhood often seen with Alzheimer's disease. The Sabat and Harré work demonstrated that a subjectively experienced sense of self, a key component of personality, is both present in those living with Alzheimer's and highly valued by those persons.


Twenty years ago, when the research literature said that not everyone falls ill in the wake of stressors and that a person's personality actually serves to promote and enhance health, it said something new. Now, such a remark is old hat. A lengthy list of personality constructs have been proposed and shown to be related to health variables. At this time, a good deal is known about how personality has its effect through mechanisms such as the appraisal of stressors and the use of particular coping strategies. The endeavor has reached a point at which researchers are no longer primarily debating whether personality is related to health, but rather, which personality construct is the most powerful one and how little one needs to know about personality to make health predictions. Hopefully, this chapter serves to celebrate what has been learned but also warns against the enterprise becoming too smug and too narrow. Serious concerns remain about how personality is related to health and what is to be made of the relation. New researchers are encouraged to continue the struggle after understanding and, in so doing, to take good advantage of what the broader fields of psychology, including its critical elements, have to say.


Work on this chapter was facilitated by a National Research Award in Health Psychology from NIMH 11532 to Joanne DiPlacido.


Abramson, L. Y., Dykman, B. M., & Needles, D. J. (1991). Attributional style and theory: Let no one tear them asunder. Psychological Inquiry, 2, 11–13.


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