The Role of Cultural, Social, and Psychological Factors in Disease and Illness

Abstract

Abstract Understanding the effects of social, psychological, and cultural processes on the body raises age‐old questions that remain perplexing puzzles still today. Research by biomedical, social, and behavioral scientists on the role played by these factors in causing disease and people's subjective experience of it promises to advance understanding of issues about the connections between mind and body. This essay summarizes findings from relevant areas of research, identifies the most promising lines of inquiry to date, poses questions that remain to be investigated going forward, and concludes with speculation about possible applications of existing and prospective new knowledge in health‐related and other arenas of social practice. Among the various avenues of research relevant to this topic, three in particular stand out. They are (i) studies of the connections between stress and sickness, (ii) studies of persons' subjective experiences of physical symptoms, and (iii) studies of expectancy effects. Studies of stress document the physical effects of long‐term exposure to adverse social, psychological, and environmental conditions, the role these play in causing disease, their effects on people's experiences of sickness, and on their ability to recover. Studies of symptom perception focus on people's subjective experiences of being ill, investigating ways in which aspects of culture, social environment, traits of personality, and psychological states affect our awareness of bodily symptoms, and how we interpret and experience them subjectively. Studies of expectancy effects, commonly referred to as the placebo or the healing response , aim to learn if beliefs alone can have physiologically measurable effects on bodily symptoms and on our perceptions of them, on how we feel and on how we respond to the treatments we are given. Taken together, these areas of research support the conclusion that understanding sickness requires simultaneous knowledge of two factors: the biological conditions diagnosed on the basis of physical signs (disease) and an individual's subjective experiences of the physical symptoms that a disease manifests (illness).