Hellenic Journal of Psychology   Psychological Society of Northern Greece VOLUME 2, ISSUE 2 INFORMATION HELLENIC JOURNAL OF PSYCHOLOGY ÉSSN 1790-1391 Edited three times a year by the Psychological Society of Northern Greece (PSNG) Volume 2, Issue 2, 2005 Legally responsible: Anastasia Efklides, President of the Psychological Society of Northern Greece School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece. Tel: ++30-2310-997374. Fax: ++30-2310-997384. E-mail: efklides@psy.auth.gr Editors Editor-in-Chief:  Anastasia Efklides Aristotle University of Thessaloniki, Greece Associate Editors: Maria Dikaiou Angeliki Leondari Georgios D. Sideridis Aristotle University of Thessaloniki, Greece University of Thessaly, Greece University of Crete, Greece Assistant Editors: Irini Dermitzaki Mary H. Kosmidis Robert Mellon Plousia Misailidi Pagona Roussi University of Thessaly, Greece Aristotle University of Thessaloniki, Greece University of Crete, Greece University of Ioannina, Greece Aristotle University of Thessaloniki, Greece Guest Editor of Issue 2 Pagona Roussi Aristotle University of Thessaloniki, Greece Editorial Board Anastasia Efklides Diomedes Markoulis Markku Niemivirta Jose M. Prieto Yannis Theodorakis Maria Tzouriadou Marja Vauras Marcel Veenman Aristotle University of Thessaloniki, Greece Aristotle University of Thessaloniki, Greece University of Helsinki, Finland Complutense University, Madrid, Spain University of Thessaly, Volos, Greece Aristotle University of Thessaloniki, Greece University of Turku, Finland University of Leiden, The Netherlands Publisher: ELLINIKA GRAMMATA: Emm. Benaki 59, 106 81 Athens, Greece Ôel: ++30-210-3891800 - Fax: ++30-210-3836658 Bookstore: Zood. Pigis 21 & Tzavela 1, 106 81 Athens, Greece © Copyright 2004: Psychological Society of Northern Greece (PSNG) All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means (electronic, mechanical, photocopying, recording, or otherwise) for commercial purposes without the written permission of the copyright own-ers. Manuscripts submitted to the journal in no case are returned back Volume 2, Issue 2, 2005     HELLENIC JOURNAL OF PSYCHOLOGY Founded 2004 CURRENT ISSUES IN HEALTH PSYCHOLOGY Guest Editor: Pagona Roussi               ELLINIKA GRAMMATA   CONTENTS Prologue           Pagona Roussi ..........................................................................................................VII Health psychology: A critical review of the field          Tanya Anagnostopoulou.............. .................................................................................93 Interventions to promote treatment adherence in patients with chronic  physical illnesses: A review          Sophia D. Macrodimitris..............................................................................................114 Genetic testing for breast and ovarian cancer: A review of  psychological and behavioral outcomes          Pagona Roussi & Suzanne M. Miller................................................................................135 Psychosocial factors and adjustment to breast cancer: A structural  equation model          Eyfrosyni Spanea, Fotios Anagnostopoulos,  Anastasia Kalantzi-Azizi, & Demosthenes Skarlos ......................................................................159 Rethinking health psychology’s approach to the study of pain and  disease         Michele L. Crossley ....................................................................................................183 Hellenic Journal of Psychology, Vol. 2 (2005), pp. VII-IX PREFACE  This special issue of the Hellenic Journal of Psychology is dedicated to the rapidly evolving field of health psychology. Health psychology has been defined 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 and the identification of the etiologic and diagnostic correlates of health, illness and related dysfunction…” (Matarazzo, 1980). Health psychology as a field has grown tremendously in the past 20 years, as researchers have realized that the separation between the “psychological” and “physical/ somatic” is artificial and have acknowledged the impact of behavior on health status. Other factors that have contributed to the explosive growth of health psychology include recent findings in the fields of genetic research and psychoneuroimmunology, as well as the changing nature of the problems we now face, including an aging population and the in-creasing prevalence of chronic illnesses.        The emerging field of genetic research has allowed clinicians to identify at risk individuals, who face difficult life decisions and a new urgency for behavioral change. The developing field of psychoneuroimmunology is an exciting new area, as it has highlighted the impact of psychological factors, such as stress, on the immune system. An aging population and the prevalence of chronic illnesses have created new challenges for health psychologists, such as the need for the development of programs for health promotion and for an understanding of the psychosocial issues that arise in response to chronic illness. Recent research efforts also have focused on other important problems of our times, such as the prevention of AIDS and the contribution of psychosocial factors in the development of coronary disease.        Finally, research continues in areas in which much progress has already taken place, such as developing a better understanding of coping with illness and efficacious interventions to help people cope with serious illness. Most of the research in health psychology has been guided by the biopsychosocial model, that is, the study of health issues from the standpoint of biological, psychological and social factors acting together (Taylor, 1999). However, in recent years, this model has been criticized by the emerging field of critical health psychology, because, it is argued, it cannot adequately capture the experience of the individual dealing with illness and pain within their specific social and cultural context. In addition, the critique centers around the contention that ‘mainstream’ health psychology does not actually apply the biopsychosocial model in practice, as social, psychological and biological factors are often studied in isolation, in a fragmentary manner.        The papers included in this special issue deliberately cover not only diverse areas of research, but also diverse viewpoints of health psychology. Three articles are based on the biopsychosocial model, including a paper on coping with breast cancer among Greek women, and two review papers, one on issues related to genetic testing for breast and ovarian cancer and the other on interventions for treatment adherence. In contrast, two articles discuss health psychology from a critical point of view.       The first paper, by Tanya Anagnostopoulou, presents a review of the field of health psychology from the perspective of critical health psychology. Ôhe paper provides a brief overview of the field and its development, the basic assumptions of the biopsychosocial model and a brief description of the sociopolitical factors which facilitated the development of health psychology. Then, it presents the emerging field of critical health psychology and a critical review of prevention and patient care policies employed by mainstream health psychology. In the end, the author discusses her views about the future directions of health psychology, in general, and in Greece, in particular.       In the second paper, Sophia Macrodimitris reviews psychological interventions for the promotion of treatment adherence in adult patients with chronic physical illnesses, such as hypertension, HIV, and cancer treatments. She highlights difficulties in this area of research and discusses implications, such as the importance of improved scientific rigor for studies incorporating treatment adherence interventions and the need for more research on treatment adherence for more severe illnesses.       Patzia Roussi and Suzanne Miller review psychological issues related to genetic testing for women at increased risk for breast and ovarian cancer (BOC). Specifically, they present the psychological outcomes of receiving and communicating a genetic test result and the impact of genetic testing on risk reduction and screening behaviors. The cognitive-affective health information processing model is used to integrate the research findings. At the end, they discuss the limitations of the existing research and delineate recommendations for future research.        Efrosyni Spanea, Fotios Anagnostopoulos, Ánastasia Kalantzi-Azizi, and Demosthenis Skarlos present a study conducted among Greek women dealing with breast cancer. Guided by models that take into account multiple variables and how they all interact when faced with a serious illness, they conclude that in Greek women, personality and medical variables are related to situation-specific coping strategies. However, only one coping strategy, anxious preoccupation, is positively related to psychological adjustment.        In the last paper, Michelle Crossley sets out the rationale for a more critical approach within health psychology to the study of pain and disease. She characterises ‘mainstream’ health psychology's approach to such subject matter as deficient because of its reliance on the increasingly popular ‘biopsychosocial’ model of health care and practice and proposes that this approach comes at the cost of failing to appreciate the experiential nature of peoples’ experiences of pain and disease. She concludes that such an approach may be unethical, potentially perpetuating the objectification and depersonalisation experienced by so many people in health care.       I would like to thank Professor Efklides, editor of the Hellenic Journal of Psychology, for inviting me to prepare this special issue on Health Psychology. I also would like to express my appreciation to the authors for contributing to this special issue. Finally, I am grateful to the anonymous reviewers for offering their time generously to review the articles presented in this issue.  Thessaloniki, March 2005 Guest Editor Pagona Roussi Associate Professor REFERENCES Matarazzo, J. D. (1980). Behavioral health and behavioral medicine: Frontiers for a new health psychology. American Psychologist, 35, 807-817. Taylor, S. E. (1999). Health psychology (4th ed.). New York: McGraw Hill.