Post-Traumatic Growth

Post-Traumatic Growth 

Experiences of life disruption, threat, distress, or adversity can lead to positively evaluated “growth” (Tedeschi and Calhoun, 1995). It has been observed for centuries that benefit finding and posttraumatic growth (PTG) can follow the occurrence of traumatic events including accidents, warfare, death of a loved one, and cancer diagnosis and treatment (Stanton, 2010).

Benefit finding and growth represent a fundamental restorative principle of homeostasis that is continually active towards the achievement of stability, equilibrium and well-being. Adaptation to any life-threatening illness, such as cancer, is facilitated by homeostasis systems that include the drive to find meaning, exert mastery or control over the experience, and bolster self-esteem. Growth and benefit-finding are frequently reported by cancer survivors as they gain awareness of their illness, its treatment and prognosis.

Measurement of PTG

The theoretical model of PTG proposed by Tedeschi and Calhoun suggests growth occurs in different ways.  Developing new relationships, finding new appreciation for life, new meanings in life, discovering personal strength, experiencing spiritual change, and realizing new opportunities are all possibilities. The experiences of benefit finding and growth are undeniable. The methods and measurements used for their study, however, raise more questions than answers.

Among cancer populations, reported prevalence rates of perceived PTG range from 53 to 90% and vary according to the type of cancer, time since diagnosis, heterogeneity and ethnicity of the sample, choice of measurement, and many personal factors (Coroiu et al., 2016). Posttraumatic growth is measured using scales such as “The Posttraumatic Growth Inventory” (PTGI), a 21-item measure of positive change following a traumatic or stressful event (Tedeschi and Calhoun, 1996). Respondents rate the degree to which positive change had occurred in their life “as a result of having cancer.” A total PTGI score and five subscale scores (New Possibilities, Relating to Others, Personal Strength, Spiritual Change, and Appreciation of Life) are calculated.

What the Critics Say

Critics have been less than enthusiastic about measuring PGI in this manner. James Coyne and Howard Tennen (2010) argue that: “Every PTG scale asks participants to rate how much they have changed on each scale item as the result of the crisis they faced. Thus, a respondent must: (a) evaluate her/his current standing on the dimension described in the item, e.g., a sense of closeness to others; (b) recall her/his previous standing on the same dimension; (c) compare the current and previous standings; (d) assess the degree of change; and (e) determine how much of that change can be attributed to the stressful encounter. Psychological science, which purportedly guides positive psychology, tells us that people cannot accurately generate or manipulate the information required to faithfully report trauma- or stress-related growth (or to report benefits) that results from threatening encounters…The psychological literature demonstrates consistently that people are unable to recollect personal change accurately” (Coyne and Tennen, 2010, p. 23).

The five steps a-e certainly are a tall order, and it seems highly doubtful that anybody could achieve them with any accuracy. It seems naïve to analyse numbers that research participants place on scales from the PTGI as though they are valid indices of ‘post-traumatic growth’ when no attempt is made to validate these measures.  In spite of these criticisms, many studies have been conducted using the PTGI scale.

Quack Science 

Quite rightly, Coyne and Tennen (2010) have damned the flawed methods and measures concerning PTG: “We are at a loss to explain why positive psychology investigators continue to endorse the flawed conceptualization and measurement of personal growth following adversity. Despite Peterson’s …warning that the credibility of positive psychology’s claim to science demands close attention to the evidence, post-traumatic growth—a construct that has now generated hundreds of articles—continues to be studied with flawed methods and a disregard for the evidence generated by psychological science. It is this same pattern of disregard that has encouraged extravagant claims regarding the health benefits of positive psychological states among individuals living with cancer” (p. 24).

As long as psychologists use shoddy methods, invalid measures and draw quack conclusions, they will not be taken seriously by outsiders.

Based on a section of: David F Marks et al. (2018) Health Psychology. Theory, Research & Practice (5th ed.) SAGE Publications Ltd.

The PACE Trial: A Catalogue of Errors

What was the PACE Trial?

Rarely in the history of clinical medicine have doctors and patients been placed so bitterly at loggerheads. The dispute had been a long time coming. Thirty years ago, a few psychiatrists and psychologists offered a hypothesis based on a Psychological Theory in which ME/CFS is constructed as a psychosocial illness. According to their theory, ME/CFS patients have “dysfunctional beliefs” that their symptoms are caused by an organic disease. The ‘Dysfunctional Belief Theory’ (DBT) assumes that no underlying pathology is causing the symptoms; patients are being ‘hypervigilant to normal bodily sensations‘ (Wessely et al., 1989; Wessely et al., 1991).

The Psychological Theory assumes that the physical symptoms of ME/CFS are the result of ‘deconditioning’ or ‘dysregulation’ caused by sedentary behaviour, accompanied by disrupted sleep cycles and stress. Counteracting deconditioning involves normalising sleep cycles, reducing anxiety levels and increasing physical exertion. To put it bluntly, the DBT asserts that ME/CFS is ‘all in the mind’.  Small wonder that patient groups have been expressing anger and resentment in their droves.

Top-Down Research

‘Top-down research’ uses a hierarchy of personnel, duties and skill-sets. The person at the top sets the agenda and the underlings do the work. The structure is a bit like the social hierarchy of ancient Egypt. Unless carefully managed, this top-down approach risks creating a self-fulfilling prophecy from confirmation biases at multiple levels. At the top of the research pyramid sits the ‘Pharaoh’, Regius Professor Sir Simon Wessely KB, MA, BM BCh, MSc, MD, FRCP, FRCPsych, F Med Sci, FKC, Knight of the Realm, President of the Royal College of Medicine, and originator of the DBT.  The principal investigators (PIs) for the PACE Trial, Professors White, Chalder and Sharpe, are themselves advocates of the DBT.  The PIs all have or had connections both to the Department of Work and Pensions and to insurance companies. The objective of the PACE Trial was to demonstrate that two treatments based on the DBT, cognitive behavioural therapy (CBT) and graded exercise therapy (GET), help ME/CFS patients to recover. There was zero chance the PACE researchers would fail to obtain the results they wanted. 

Groupthink, Conflicts and Manipulation

The PACE Trial team were operating within a closed system or groupthink in which they ‘know’ their theory is correct. With every twist and turn, no matter what the actual data show, the investigators are able to confirm their theory. The process is well-known in Psychology. It is a self-indulgent processes of subjective validation and confirmation bias.  Groupthink occurs when a group makes faulty decisions because group pressures lead to a deterioration of “mental efficiency, reality testing, and moral judgment” (Janis, 1972). Given this context, we can see reasons to question the investigators’ impartiality with many potential conflicts of interest (Lubet, 2017). Furthermore, critical analysis suggests that the PACE investigators involved themselves in manipulating protocols midway through the trial, selecting confirming data and omitting disconfirming data, and publishing biased reports of findings which created a catalogue of errors.

‘Travesty of Science’

The PACE Trial has been termed a ‘travesty of science’ while sufferers of ME/CFS continue to be offered unhelpful or harmful treatments and are basically being told to ‘pull themselves together’. One commentator has asserted that the situation for ME patients in the UK is: The 3 Ts – Travesty of Science; Tragedy for Patients and Tantamount to Fraud” (Professor Malcolm Hooper, quoted by Williams, 2017). Serious errors in the design, the protocol and procedures of the PACE Trial are evident. The catalogue of errors is summarised below. The PACE Trial was loaded towards finding significant treatment effects.

A Catalogue of Errors

The claimed benefits of GET and CBT for patient recovery are entirely spurious. The explanation lies in a sequence of serious errors in the design, the changed protocol and procedures of the PACE Trial. The investigators neglected or bypassed accepted scientific procedures for a RCT, as follows:

Error Category of error Description of error
1Ethical issue: Applying for ethical approval and funding for a long-term trial when the PIs knew already knew CBT effects on ME/CFS were short-lived. On 3rd November 2000, Sharpe confirmed: “There is a tendency for the difference between those receiving CBT and those receiving the comparison treatment to diminish with time due to a tendency to relapse in the former” (www.cfs.inform/dk). Wessely stated in 2001 that CBT is “not remotely curative” and that: “These interventions are not the answer to CFS” (Editorial: JAMA 19th September 2001:286:11) (Williams, 2016).
2Ethical issue: Failure to declare conflicts of interest to Joint Trial Steering Committee.Undeclared conflicts of interest by the three PIs in the Minutes of the Joint Trial Steering Committee and Data Monitoring Committee held on 27th September 2004.
3Ethical issue: Failure to obtain fully informed consent after non-disclosure of conflicts of interest.Failing to declare their vested financial interests to PACE participants, in particular, that they worked for the PHI industry, advising claims handlers that no payments should be made until applicants had undergone CBT and GET.
4Use of their own discredited “Oxford” criteria for entry to the trial.Patients with ME would have been screened out of the PACE Trial even though ME/CFS has been classified by the WHO as a neurological disease since 1969 (ICD-10 G93.3).
5Inadequate outcome measures.Using only subjective outcome measures.The original protocol included the collection of actigraphy data as an objective outcome measure. However, after the Trial started, the decision was taken that no post-intervention actigraphy data should be obtained.
6Changing the primary outcomes of the trial after receiving the raw data. Altering outcome measures mid-trial in a manner which gave improved outcomes.
7Changing entry criteria midway through the trial. Altering the inclusion criteria for trial entry after the main outcome measures were lowered so that some participants (13%) met recovery criteria at the trial entry point.
8The statistical analysis plan was published two years after selective results had been published. The Re-definition of “recovery” was not specified in the statistical analysis plan.
9Inadequate control Sending participants newsletters promoting one treatment arm over another, thus contaminating the trial.
10Inadequate controlLack of comparable placebo/control groups with inexperienced occupational therapists providing a control treatment and experienced therapists provided CBT.
11Inadequate controlRepeatedly informing participants in the GET and CBT groups that the therapies could help them get better.
12Inadequate control Giving patients in the CBT and GET arms having more sessions than in the control group.
13Inadequate controlAllowing therapists from different arms to communicate with each other about how patients were doing.

14

Lack of transparency

Blocking release of the raw data for five years preventing independent analysis by external experts.

Cover-Up

Blocking release of the raw data for five years and preventing independent analysis by external experts was tantamount to a cover-up of the true findings. An editorial by Keith Geraghty (2016) was entitled ‘PACE-Gate’. ME/CFS patient associations were rightly suspicious of the recovery claims concerning the GET arm of the trial because of their own experiences of intense fatigue after ordinary levels of activity which were inconsistent with the recovery claims of the PACE Trial reports. For many sufferers, even moderate exercise results in long ‘wipe-outs’ in which they are almost immobilized by muscle weakness and joint pain. In the US, post-exertional relapse has been recognized as the defining criterion of the illness by the Centers for Disease Control, the National Institutes of Health and the Institute of Medicine. For the PACE investigators, however, the announced recovery results validated their conviction that psychotherapy and exercise provided the key to reversing ME/CFS.

Alem Matthees Obtains Data Release

When Alem Matthees, a ME/CFS patient, sought the original data under the Freedom of Information Act and a British Freedom of Information tribunal ordered the PACE team to disclose their raw data, some of the data were re-analysed according to the original protocols. The legal costs of the tribunal at which QMUL were forced to release the data, against their strenuous objections, was over £245,000. The re-analysis of the PACE Trial data revealed that the so-called “recovery” under CBT and GET all but disappeared (Carolyn Wilshire, Tom Kindlon, Alem Matthees and Simon McGrath, 2016). The recovery rate for CBT fell to seven percent and the rate for GET fell to four percent, which were statistically indistinguishable from the three percent rate for the untreated controls. Graded exercise and CBT are still being routinely prescribed for ME/CFS in the UK despite patient reports that the treatments can cause intolerable pain and relapse. The analysis of the PACE Trial by independent critics has revealed a catalogue of errors and provides an object lesson in how not to conduct a scientific trial. The trial can be useful to instructors in research design and methodology for that purpose.

Following the re-analyses of the PACE Trial, the DBT is dead in the water. There is an urgent need for new theoretical approaches and scientifically-based treatments for ME/CFS patients. Meanwhile, there is repair work to be done to rebuild patient trust in the medical profession after this misplaced attempt to apply the Psychological Theory to the unexplained syndrome of ME/CFS. The envelope theory of Jason et al. (2009) proposes that people with ME/CFS need to balance their perceived and expended energy levels and provides one way forward, pending further research.

Ultimately, patients, doctors and psychologists are waiting for an organic account of ME/CFS competent to explain the symptoms and to open the door to effective treatments. Patients have a right to nothing less.

An extract from: David F Marks et al. (2018) Health Psychology. Theory, Research & Practice (5th ed.) SAGE Publications Ltd.

Psychology – Science or Delusion?

‘Mass Delusion’

Psychology is full of theories, not ‘General Theories’, but ‘Mini-Theories’ or ‘Models’.  Most Mini-Theories/Models are wrong.  Unfortunately these incorrect theories and models often persist in everyday practice. This happens because Psychologists are reluctant to give up their theories. These incorrect theories then act like ‘mass delusions’, which can have consequences for others, especially students and patients.

Academic Psychology suffers from ‘delusions of grandeur’. It is as if an entire academic discipline is manifesting a chronic disorder – a kind of  ‘Scientific Psychosis’.   Psychologists claim that Psychology is a Science but there is no objective evidence to support it.  In fact, the evidence suggests the exact opposite.

Aping Science

The ability to ape proper science is not in doubt. Laboratories, experiments and grants, thousands of journals, books, institutes and universities all espouse Psychology as a Science.  Many psychologists even wear white lab coats and poke around in animals’ brains. The ability to mimic genuine scientists like Physicists or Biologists, however, does not make Psychology a science. It actually makes a mockery of science.

There are many reasons why this is the case. I mention here two:

1) Psychology does not meet even the most essential criterion for an authentic science – quantitative  measurement along ratio scales.

2) Unlike all the true natural sciences, Psychology lacks a general theory. A general theory is held by the majority of scientists working in the field.

The shared belief of the vast majority of psychologists that they are scientists, when all of the evidence suggests that this can’t be true,  is a form of professional ‘mass hysteria’.  Psychologists share a belief system of scientific delusion, thought disorder and conceptual confusion. They then impose their beliefs, not only on one another, but on their students and their patients.

Students and Patients

Many students and patients are having none of it.  They refuse to be suckered in by the claim.  But they have to be courageous enough to come out of the closet and say it. If they dare to say it in an essay or exam, then they’d better be prepared for a grade C, D, E or F.

Researchers have found that  “medical students think their psychology lectures are “soft and fluffy”students think psychology is less important than the other natural scienceschildren rate psychological questions as easier than chemistry or biology questions; and expert testimony supporting an insanity defence is seen as less convincing when delivered by a psychologist than a psychiatrist.”

On a few rare occasions, established psychologists have expressed their doubts about the scientific credentials of Psychology. For example, Jan Smedslund wrote about: “Why Psychology Cannot be an Empirical Science.” There is increasing evidence that many patients are skeptical about Psychology also.

woman-outnumbered-by-male-scientists

Folie Imposée

Folie à deux (“madness of two”) occurs when delusional beliefs are transmitted from one individual to another.  When one dominant person imposes their delusional beliefs on another, it is folie imposée. In this case, the second person probably would never have become deluded if left to themselves. The second person is expected ultimately to reject the delusion of the first person, due to disproof of the delusional assumptions, and protest. This protest, however, will fall upon deaf ears.

The situation I describe is far from hypothetical.  It exists day in, day out, for millions of patients. One particular patient group are those labeled with ‘Medically Unexplained Symptoms’ (MUS).  Within this group is a particular group of patients with Myalgic Encephalomyelitis (“ME”) and/or Chronic Fatigue Syndrome (“CFS”).

Delusional thinking certainly can hurt and embarrass the individuals having the delusion (Psychologists and Psychiatrists). It can also be imposed upon others, for example, people in their care (Patients). To the help-seeking Patient, the Psychologist (or Psychiatrist) is an expert who follows the rules of Science. The Science informs the aetiology, diagnosis, and treatment of the Patient.

Treating Patients with ME/CFS

I consider here how many psychologists in the UK treat people labeled with ME/CFS. This treatment comes with the full backing of NICE (currently under review).

Psychological treatment for patients labeled with ME/CFS is based on a Psychological Theory of the illness. This theory is highly contested and has caused major controversies that has divided Patients from Psychologists and Psychiatrists.

The main Psychological Theory of ME/CFS asserts that ‘maladaptive’ cognitions and behaviours perpetuate the fatigue and impairment of individuals with ME/CFS (Wessely, David, Butler and Chalder, 1989). These authors represent the two main professions concerned with psychological illness, Psychology and Psychiatry.  They state: “It is essential to agree jointly on an acceptable model, because people need to understand their illness. The cognitive – behavioural model …can explain the continuation of symptoms in many patients.” This is where the imposition of the therapist’s model snaps in. “The process is therefore a transfer of responsibility from the doctor, in terms of his duty to diagnose, to the patient, confirming his or her duty to participate in the process of rehabilitation in collaboration with the doctor, physiotherapist, family and others.” (p. 26).

Although the Psychological Theory is contested by many scientists, patients and patient organisations who assume that their symptoms have an organic basis, i.e. a Physical Theory.

Vercoulen et al. (1998) developed a model of ME/CFS based on the Psychological Theory. However, Song and Jason (2005) suggested that the Psychological Theory was inaccurate for individuals with ME/CFS. In spite of the evidence against it, the Psychological Theory continues as the basis for cognitive behavioural and graded exercise therapies (GET) offered to individuals with ME/CFS. One reason for the continued use of an unsupported Psychological Theory is the PACE Trial, a lesson in how not to do proper science. Like most research, this trial was organised by a team and, in this case, the majority of principle investigators were Psychiatrists. This trial has been described as “one of the biggest medical scandals of the 21st century.”

New Approach Needed

In spite of the lack of empirical support, the Psychological Theory of ME/CFS lives on. ME/CFS patients are subjected to CBT and GET.  Patients and patient organisations protest about the treatments and are opposed to the Psychological Theory.  Perhaps Psychologists need to turn the Psychological Theory of unhelpful beliefs upon themselves.  If  ME/CFS has a physical (e.g. immunological) cause, then once the cause has been established, patients will have the chance of an effective treatment and decent care and  support.

The problems that exist for Psychologists’ treatment of patients with MUS and ME/CFS exist more generally across the discipline. A totally new approach is necessary.  Instead of tinkering with the problems at a cosmetic level by papering over the cracks, there is a need for root-and-branch change of a radical kind. The measurement problem must be addressed and there is a need for a general theory.   A new General Theory of Behaviour takes a step in that direction.

Psychology in Crisis – Sail On

 

‘Psychology in Crisis’ by Brian M Hughes has much in its favour. Like a knife through soft butter, it cuts through the huge swathes of BS that permeate Academic Psychology.  Brian Hughes addresses many different crises in Academic Psychology:

the Replication Crisis

the Paradigmatic Crisis (aka as the Theory Crisis or Fragmentation)

the Measurement Crisis 

the Statistical Crisis

the Sampling Crisis

the Exaggeration Crisis

None of these crises is new. The problem is the different crises are all getting bigger and more insoluble over time.

In his delightful book,  Psychology in Crisis, Hughes explains that there is little momentum to change because the discipline has taken over a century to build the mould. “The fact that the majority of those who teach psychology see no problem with the status quo, and so say nothing about it, does not indicate that their discipline is healthy. If anything, it implies the presence of groupthink. One might even consider it an instance of a mass delusion.” (p. 148, my italics).

A ‘mass delusion’! Strong words, but fully justified. The biggest delusion of all is the claim that Academic Psychology is a Science. There is no justification for this claim if Hughes’ allegations are true. Which they are.

As an academic discipline, Psychology continues to grow. The American Psychological Association reports that in 2012 – 2013, 1.84 million bachelor’s degrees were awarded to students. Of those, 6.2 percent of the degrees (or 114,080) went to psychology majors. The psychology major is the fourth most popular college major after business, health-related majors, and social science and history. In the 2013 academic year, 6,496 psychology doctorates were awarded in the U.S., a 32 percent increase from 2004.

One of simplest measures of Academic Psychology’s growth is publications numbers. The figures are plotted below for each quarter century since 1900. I got these numbers from Google Scholar.  Bearing in mind that the current quarter century still has 6 years to run, the increases are huge. The dotted line is an estimate for 2000-24 based on current trends. The line goes way off the chart.

Number of Publications about Psychology

Screen Shot 2018-09-21 at 16.54.11

As the Psychology enterprise continues to grow, it becomes ever more difficult to turn it around. To use a nautical analogy, the radius of the Turning Circle widens. The momentum to ‘Sail On’ becomes ever greater.

Landscape photography, nature and well-being

Landscape photography is beneficial to self-development, self-discovery and eudaimonic wellbeing. To the photographer, that is, and hopefully to others as well. In particular, landscape photography and post-photography processing can connect the photographer with nature. Research on well-being has explored two general perspectives: a hedonic approach, in which happiness and well-being are about pleasure attainment and pain avoidance, and a eudaimonic approach, in which meaning, self-realization and the degree to which a person is fully functioning are important. This post explores the links between landscape photography, nature connectedness and well-being

The beneficial role of nature connectedness in well-being has been suggested in recent publications:

The relationship between nature relatedness and anxiety, Martyn, Patricia, Brymer, Eric., Journal of Health Psychology, 2016, 21: 1436-1445.

Are nature lovers happy? On various indicators of well-being and connectedness with nature. Cervinka, Renate, Roderer, Kathrin, Hefler, Elisabeth. Journal of Health Psychology, 2012, 17: 379-388.

Flourishing in nature: A review of the benefits of connecting with nature and its application as a wellbeing intervention. Capaldi, C. A., Passmore, H.-A., Nisbet, E. K., Zelenski, J. M., & Dopko, R. L.  International Journal of Wellbeing, 2015, 5(4), 1-16.

Natural environments have a stress-reducing or restorative influence, a form of homeostasis, while urban environments have the opposite effect.  Roger S Ulrich et al. (1991) showed 120 participants a stressful movie, and then videotapes of different natural and urban settings. Stress recovery measures were obtained from self-ratings of affective states and a battery of physiological measures: heart period, muscle tension, skin conductance and pulse transit time, a non-invasive measure that correlates with systolic blood pressure.

Recovery was “faster and more complete when people experienced natural rather than urban environments. The pattern of findings indicated that responses to nature had a salient parasympathetic nervous system component; however, there was no evidence of pronounced parasympathetic involvement with urban settings.”  Findings were consistent in showing the restorative influence of nature to produce a shift towards a positively-toned feelings and sustained attention.

Liz Brewster and Andrew Cox study the connection between involvement in digital communities and well-being by examining ‘digital daily practice’. Digital daily practices involves doing one thing – exercise, photography or writing – every day and sharing it online. They explored the digital daily practice, photo-a-day, to understand the ‘affordances’ it offers for well-being. They found that: “Photo-a-day is not a simple and uncomplicated practice; rather it is the complex affordances and variance within the practice that relate it to well-being. We conclude that this practice has multifaceted benefits for improving well-being.”

C Yuill and colleagues highlight that “human social agents are embedded in particular landscapes and it is in landscapes that environmental changes are experienced, which can have implications for wellbeing.”  They study  how environmental change impacts on health and well-being. They analysed the connections between landscape, environment and wellbeing in Xuan Thuy National Park in north Vietnam (see photograph below). This area is in a precarious coastal region where extreme weather events can impact on the wellbeing of both humans and other living things. They state: “Landscapes can be protective of wellbeing or can be affected by rises in temperature, changes in sea level or extreme weather events which exert serious negative implications for wellbeing.”

Screen Shot 2018-09-16 at 11.23.21 Reproduced from Yuill et al. 2018.

The harmony between humans and the environment is under significant threat.  The natural level of homeostasis is being disrupted. This disruption is causing increases in anxiety, depression and chronic stress. These processes in turn have a domino effect on many physical indicators of well-being including overweight and obesity. The current threats to homeostasis between human well-being and the physical landscape cannot be underestimated. The landscape photographer plays a key role in documenting landscape change.  Photographs are a significant tool in rebalancing disequilibrium between human beings and the natural environment. The ultimate goal of all living beings is the preservation of homeostasis. Environmental activists use photography in their struggle for conservation.

IMG_1374

Stopping the Obesity ‘Epidemic’

Purpose of Post

Here I introduce a powerful new explanation of the obesity ‘epidemic’. I reveal some surprising but brutal truths about the condition. For example, obesity is unavoidable for the majority of people in contemporary living conditions. Without radical change, the ‘epidemic’ will get much, much worse.

Obesity an ‘Epidemic’?

Notice I put the word ‘epidemic’ in single quote marks. This is because the word can only really be applied to infectious diseases. Obesity is not a disease. It’s not infectious. Obesity is a bodily condition of being overweight. It is defined loosely as having a body mass index (BMI) above 30.  This places people at increased risk for a variety of chronic conditions.  Unpleasant things like diabetes Type 2, cardiovascular diseases, cancer and obstructive sleep apnea. [As a scientific measure the BMI is a bit of a joke, by the way, but we’ll leave that for another post.]

The Problem

Two billion people alive today are overweight or living with obesity. There is no sign that the obesity epidemic is slowing down or that medical science has an understanding of the problem. A universal feature of living beings called ‘homeostasis’ is linked to obesity. Its disruption, dyshomeostasis, is a contributory cause of overweight and obesity.

The Solution

Obesity is an unavoidable human response to contemporary conditions of living. ‘Blaming and shaming’ individual sufferers is oppressive and is a part of the problem, not part of the solution. Blame and shame makes matters far, far worse. Only by reversing this form of prejudice, and the chronically stressful living conditions of hundreds of millions of people, is there any hope that we can stop the ‘epidemic’.

Take-home Message

This book is not for the faint-hearted. It cuts through the ‘shock-horror’ narrative of obesity with brutal truths about the serious and intransigent nature of obesity. Once the causes are fully understood, the obesity epidemic can be stopped. And about time too! This book is a step towards that goal.

Grab a Free Copy Now

The book is available as a kindle edition , as a free e-book here , or at iBooks ,or it can be read freely here, or here.  So there’s really no excuse for not getting hold of a copy!

“Worth considering as a core text”

Reviews of “Research Methods for Clinical and Health Psychologyedited by David F Marks and Lucy Yardley

‘The book gives a detailed treatment of a range of important methods. It will strike a chord with applied psychologists in particular – but will also be of interest to healthcare professionals generally

If you are teaching postgraduate research methods courses, including those aimed at a mixture of psychologists and other health professionals, this book is worth considering as a core text.’

– John Hegarty, THES

‘Most texts on research methods focus either on qualitative approaches or on quantitative approaches. A unique feature of this book is that the editors and authors are experts on both qualitative and quantitative methods, and that these two approaches to research in clinical and health psychology are given equal weight. The philosophy that guides this book is that different methods have different advantages and are used for different purposes, but that the understanding of substantive research issues such as medication adherence can benefit from the use of multiple methods. The methods are described in sufficient detail that readers can learn how to apply them without needing to consult other sources’

-Stephen Sutton, University of Cambridge

“A classic in the field”

Warm thanks to the following seven endorsers of  Health Psychology (4th & 5th Editions) quoted below:

Fourth Edition:

“This book has become a classic in the field – sophisticated,  accessible and interesting.   It is of great use to students, teachers and practitioners of Health Psychology world wide.”

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Leslie Swartz, Distinguished Professor of Psychology, Stellenbosch University, South Africa.

“This is a remarkable book. It is exceptionally complete, thoughtful, and deep.  It avoids the superficial accounting of many texts and does not shy away from controversy. It is fully rooted in today’s science of health psychology.”

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Stevan E. Hobfoll, Ph.D. Professor of Behavioral Sciences, Medicine, and Preventive Medicine, Rush University Medical Center, Illinois, USA.

 

“A very nice introductory text that takes a biopsychosocial approach to health and illness, and recognizes the importance of culture, health literacy, and issues such as racism and health inequities/disparities that continue to impact disadvantaged communities.”

Cheryl Holt

Cheryl L. Holt, University of Maryland, USA.

 

“Like other textbooks, this book provides a comprehensive introduction to the field of health psychology. Unlike other books however, this one takes a holistic-systems approach to health, and uses the novel concept of the Health Onion to do so: The myriad determinants of health are presented as different layers – biological, familial, behavioral, neighborhood, social and cultural – that must be scientifically-examined and peeled away to understand health. Consequently, the book contains many valuable chapters that other textbooks lack, including chapters on macro-level influences (Chapter 2), social justice and social inequality (Chapter 3), and cultural factors (Chapter 4). Moreover, the examples provided to illustrate each layer of the influences on health are global ones, and include health and its psychology in Europe, the USA, Asia, Africa, and elsewhere. This unique approach helps students understand that the health of individuals is a part and product of the family, social-network, neighborhood, and society in which they are embedded. Hence, this revised edition provides an excellent overview of health and of the science of health psychology in their local and larger contexts.”

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Hope Landrine, Professor of Public Health and of Psychology, Brody School of Medicine, East Carolina University, USA.

 

Just as the Journal of Health Psychology is not like any other journal in the field, this new edition of David Marks’ “Health Psychology” textbook is different from all the other textbooks in the field. It will broaden your perspectives as it educates your mind.

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Kenneth A. Wallston, Professor of Psychology, Emeritus, School of Nursing, Vanderbilt Institute for Global Health, USA.

 

Fifth Edition:

An essential text for both graduate and undergraduate health psychology courses, the authors elegantly and comprehensively explore health psychology in the 21st century.  The fifth edition further advances a critical perspective on health while introducing readers to emerging issues such as long-term conditions and end-of-life care.

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Christopher Godfrey, Professor of Psychology, Pace University, USA. 2018-01-01

Marks and colleagues’ capacity to provide a global perspective, while including elements of social justice, with a consideration of the social and political determinants of health, makes this text an invaluable companion when introducing undergraduates to the field of health psychology.

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Nancy L. Worsham, Professor of Psychology, Gonzaga University, USA.  2018-01-01

 

 

 

“Absolute joy to read”

Click below for a Preview of the Editor’s Introduction and Chapter 1: Matarazzo, J. D. (1982). Behavioral health’s challenge to academic, scientific, and professional psychology. American Psychologist37(1), 1.

`This book was an absolute joy to read and offers a comprehensive review of health psychology…. This book should become a classic – necessary reading for students in all branches of health. Nursing students will find it invaluable, but other students – and their teachers – will also find it very useful. SAGE have added a valuable and important text to their already impressive list, and Marks can be complimented on his scholarly organisation of complex topics into an accessible and readable whole. No library should be without it and serious students should invest in a copy of their own’

Health Matters


‘The Health Psychology Reader provides a concise guide to Health Psychology. It is set out in 5 key sections and explores key theories and research in the area. This is a great, stimulating text to health psychology students at all levels.’

Miss Gemma Wilson

School of Social Sciences and Law, University of Teesside
April 22, 2012

‘This book is clear, informative and easy to read. A good text for students on an M.Sc. Health Psychology module.’

Ms Lynda Hyland

School of Health and Social Sciences, Middlesex University Dubai
March 6, 2012
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‘A great compilation of key readings for psychology students and researchers.’

Dr Benjamin Gardner

Health Behaviour Research Centre, University College London
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“Brilliant new book”

Reviewed by Ewan McDougall:
“When I first read David Marks brilliant new book Obesity, there was a story on Radio New Zealand that two thirds of Auckland adults were now over weight or obese and the statistic for children was not much better. You don’t have to be an epidemiological genius to see that this will become a major problem for us and for other Western countries which are in the throes of an obesity epidemic.
David Marks presents a fresh, clear-eyed analysis of the complex causes of this epidemic: social, economic and psychological. He discusses the role of neoliberal capitalism in the promotion of poor, calorie rich food and animal products. The psychologist’s discussion of a person’s ‘circle of discontent’ which undermines homeostasis and then ‘feeds’ the spiral of unhealthy eating is fascinating and rings true. And he provides a refreshing solution including the adoption of veganism. The book is lucid and courageous and is the best analysis of a harrowing problem in the world, and a call to action, which I have read.

 

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