Abstract research has greatly inform Social cognition r an research on attitudes has decades, Social Cognito westigations inte | to change health behaviors. In | | Sesnerabie impact. Cognitive appa ely aden cognitions such as " health are affe avoidance frameworks, res nd disclosure and social support fav Current social cogniton research in health F processes to neural and physiolog tnd behaviors affect long-term mental Key Words: health psychology, cognitive appr Introduction Health has proved co be a fru which to explore the ramifications of soci health domain has moved through | phase The earliest health-related work in social cognitic scamined the relation of beliefs co health behavior fan interface that continues to be productive inca ¢ present, Work on message framing and on cogni | In the late 1970 and carly 1980s, researchers anderstanding of cognitive processes, such as causal attribution or beliefs in psychological control, anc applied them in the heath domain, the idea bein thatthe specific content of such beliefs might pre the course of illness itself. This perspective gave w {6 a focus on affectively laden social cognitions in the health domain. ‘Thus, for example, rescarchers 876 | J health psy Gyof factors, t0 pathogens, : and ealy ie welevant ‘Meexpe- themselves made fiom include; 4s willbe seen, heh hele ene, twa eabc tcl anaapelll ae construal of events as stressful ee ing - : mse Camlcyte Ptertnremrwoperenigeey finer toellndtlosetiein Sethe oral the acon sem fom te ee ‘ines dal umcae Forea SS olented by Pacheco tick te hat eee perpen capone a opin, «sens of mute, dae will vor ia a ieee. ment t Subjective Horas ae oti «pec te Pee Reeier dete on biclogial Crcomes think that person 1k that person should de (normative belief) and the motivation to compl » comply with those norms old such as physiological functioning, an tive beliefs. Believing rs think one prognostic for diagnosable health condition: had ean Lestone conclude that health is simply a xercise and being moriated to comply with thot nmenly Spwlchisseidl copnicion is applied, the health normative beliefs would further induce a person t0 ity has also been immensely valuable for un Lapse iron avioral com “A underlying basic thecretical teh | Sa ts m th “aq researchers who have fo welt aoa Dy hots have identified the under eb esas’ beliefs influence Pica elon meee a such as well-being, but also all may be Webiaveaeell butions of such field ' eit health and related and medicine are integrated ken, 199 well-being tiveand emotion research that ch wv M ently. ®* spawned on, Gibbons i eee ; ' ky beh: sain il pl Social Cognition, Health Attitudes : nplacene 5 and Health Behavior Change Hale Isher et al., 200 i Socialipsychological research, ancl in particu Tistorically ef using social cognition research on atvivucles © ape ave emphasi mse 8 eli iempenis!for designing persuasive comme Recently, research fro a ine en ee ‘ fl nce has found that some successful health behavior the one TGtions designed toichange poot health habie. © : ee a Serine inderiving ube cary work was that It OM ange occurs ourside of awareness: AN PSS en” Hr teec ite eo health ick and case thet lev’ sharon within social cognition research tat Y Se ci ev perwoetconerolled and automate proces CO concern, ‘ativate them to change th Eiecrenamaae ipronchs vo chaneine Tells Ae Cacioppo, 1984). People can rely on wail ae igen ms, ts tmodel (Rosenstock: 1966); the Prot nact throughout social & ‘ . ccicony ak Nadieprohaendmedls OE Peis model ger: 1979) 27! * (Fiske & Taylor, 2008) a i ‘behavior (Ajeen, 2002): planned TAYLORichough _vencss as well (McCaul eal 2002)- intentions to use of the variance in behavior, d by self-reported attics intentions. In other words, processes accessible to consciovsness noncthe- predicted the health behavior of pattern means is not yet fully known. ‘possibility is that activity in mPFC and signals behavioral intentions at an implicit el thar is not consciously accessible (Falk et al, 2010). Alternatively, activity in mP=C may reflect "self referential processes and be related to behavior "change primarily because participants have linked 4a persuasive communication 10 the self (cf, Liberzon, Welsh, & Strecher, 2009). Persuasion ‘efforts thar successfllly modify a person's sense of self “appear to be most successful in modifying behavior and helping people form specific behavioral incen- tions (Rise, Sheeran, & Hukkelberg, 2010). Social cognition research on attitudes and persua- sion was, thus, one of the first sources of influence | anhealth psychology, and it is also cne of the most "enduring. As the origin of the very earliest models for understanding health behaviors. ‘tus for interventions to bring about health bchavior ge, it continues to provide insights for both ding and changing health behaviors. id as the impe- Message Framing and Cognitive Biases “Much theory and research in social cognition to understanding biases in human message framing. ‘This lsson has bee health psychology, where it has been fully to address health behaviors ‘can be framed in terms of gains nple, a reminder to use sunscreen fits of sunscreen to appear- -can emphasize the costs of not JON AND HEALTH ‘on how they are framed in terms of a person's own peychological orientation. People who have a Bas {promo bby messages th int (Sunsereen will protect your skin"), whereas people who have a BIS (preven tion) that mph influenced by messages that stress the risks of not performing 2 health not only from social cognition research but also from health psychology. Taylor (1983) theory of cogniti develop “positive illusions, Messages are differentially effective depending wn of approach) orientation that empha- Pres maximizing opportunities are more influcneed hat are phrased in terms of benefits 1 of avoidance orients minimizing risks are more ce es es your risk of skin cancer”) (Mann, Sherman, & Updegraff, 2005) Knowledge concerning errors and biases and a ei? their effects on psychological functic as come a0 posi - Negat adaptation, in which she a that following a major health threat, people ma ® that is, illusions that protect them psychologically from the threats they face and enable them to cope and make pr ‘ngiehout by the ev toward restoring good psychological fun: "pote pial ing, The vey a that these ‘waco To center on the making of meaning, mast Sdfenkuncement From dese obseratons, Tot | and Brown (1988) developed a more general model hie Othe of social cognition suggesting that unrealistic opt: gg tive mism, an exaggerated sense of personal control « and self-enhancement not only characterize pee —_ responses to intensely threatening events u also may commonly be found in normal, everydsy thought. They argued that rather than being ma Se. heals ated with the criteria indicative of ment seat including a positive sense of self, the ability mak progress toward goals, th y to deal effectively te with threats, the capacity for developing and malt taining positive social relationships, and othet teria associated with mental health. Subsequent! Taylor and colleagues found that these postive | adaptive, these mild, positive distortion2 butte lings su nitions that has fed back» SSRI ponte theory and research, into health, Psychology ‘The idea thac Retin 0 Stress ition is vn standing stress was a ye © | _prrchology research. For cxample and collegues (Lazaras 8 Folkman, inn J Beltinies 1978) who inialy forma se Togical research on stress and copine PE” how critical cognitive appraisals 2c, eA ing stress and musteing the resmoner gor” ing it (Lazarus, 1968; Lazarus & Folkman trent These researchers maintained th a encounter a potentially stressful event hey if a process of primary appraisal whereby she ces iS evaluated to be positive, neurs al to under. carly insight in health Be ontcquences. Negative or porn ee events are Further appraised for their possible harm threat, or challenge. Harm is the assessment of the damage that has already been donc assessment of possible future damage that may be brought about by the event. Challenge perceptions Fepresent the potential to overcome or even profi from an event (cf. Tomaka, Blascovich, Kelsey, & Leitten, 1993). Thus, stressful events are not intrin: sically harmful or threatening, but rather are influ- enced by the cognitive appraisals that are made | ‘The importance of primary appraisal in the expe Fience of stress was well illustrated in an early clas Lazarus, Mordkoff, Threat is the sie study of stress (Speisman, & Davison, 1964). College students viewed 2 BFiesome film depicting unpleasant cribal iniva tion rites that included genital mutilation. a Viewing the film, they were exposed 10 one perimental conditions. Pe err . Anthropological account of the meaning Another bu heard a lecture thac deem! a pain the initiaces were experiencin& a af their excitement over artiving a ae ane up heard a description thar empl noe frrausma that the initiates were “ stened co an of the rites: jhasized ‘ot omy to 4 aca but alne 4 Petpet on prety Simul," Poop responac tac ations AS primary: mie *Pomial ae Perception of one’s copin ow: substantial stress is experienced, whereas when coping abilities and reso be minimal. puress are high; eres may BELIEFS ABOUT ILLNESS Many of the early applications of social cogni- tion research to health involved relating specific social cognitions to problems faced by people with chronic conditions or illnesses: Chronic illness isan important topic in health psychology for a number of reasons. At any given time, 50% of the popula- tion has a chronic condition that involves medical Taylor, 2012 nge from relatively mild ones such as a partial management These conditions may hearing loss to severe and life-threatening disorders, such as cancer, coronary artery disease, and diabetes. These are conditions with which people may live for decades, yet medical facilites are much better designed for dealing with acute disorders thar ean be cured than they are for dealing with chronic ill nesses that can only be managed. Thus, people who have chronic conditions must engage in a great deal ys in which they ‘of self-management, and so the ir disorders can influe cof well-being, and ultimately, the construe th ce their health behaviors, se course of illness. JELIEFS ABOUT CAUSES : People with both acute and chronic disorders where their illnesses ofien develop theories about _ “Tsorders came from (Cosanaos Lurgendort Bradley, Rose, 8 Anderson, 2005). For example, ravion | 879disorders: Do they blame themselves, person, the envirorment, a quirk of fate, oF “some other factor? $elFblame for chronic conditions is common. "People frequently perceive themselves as. hav ing brought on theie disorders through their own actions. In some cases, these perceptions are (0 @ degree correct. Poor health habits, such as smoking, and a poor diet or lack of exercise, can contribute to heart disea ceases, sel-blame is ill placed, as when a disease is brought on pri (oF exposure t0 an infectious or eoxic agent. Wha stroke, and cancer. Bur in many genetically based defect are the consequences of self-blame? Despite sub: stantial efforts to arrive ara definitive answer to hi question, none has been found. Using correlational researchers have found that self-blame can lead co guilt, self-recrimination, ot depression (Bennett ‘Compas, Beckjord, & Glinder, 2005). For example Frazier, Mortensen, and Steward (2005) found that selEblame for a physical aseaule prompted copi through social withdrawal, which in curn predicted hieightened psychological distress. Bur perceiving the cause of one’s disorder as self-generated can also. represent an effort to assume control over the di order. Such feelings can be adaptive in comin terms with the disorder, It may be that self-blame bu not oth- ets (Schulz & Decker, 1985; Taylor, Lichtman, & Wood, 1984), Research uniformly suggests, however, that is adaptive under some circumstan blaming another person for oncs disorder is adaptive (cg, Allleck, Tennen, Pieiffer, & Fifield 1987; Taylor et al., 1984). For example, som Patients believe that their disorder was brought on by stress caused by olleagues at work, The direction of causality in the observational studies is, however, unclear. Blame of thers may be tied to unresolved hostility, which can itself interfere with adjustment to the discas and potentially exacerbate its ours On the whole, though, crusal attributions for ‘one’s disorder have not been found to have sub. stantial explanatory value in understanding. either Psychological adjustment to adisorder or its course Indeed the focus on causal atwibutions may simply be misplaced. Although for many disorders, people do come up with causal explanations (98% in one study; Taylor et al, 1984), ulimately people move 6n, and other types of cognitions may become more important. 880 COGNITION AND HeaLrn ions that h Research on causal attributions that has foeigey ‘on underlying dimensions of attribution, rather thy their specific content, has produced more robug, ial antibucone and coping with ill, Roget adaptive coping efforts: stable and uncontrollable illness attsibutions were associated with maladjug, ment through avoidane coping. BELIEFS ABOUT CONTROL comes (Fiske 8 Taylor, 1991). Iris closely related wf-efficacy, which is the more nar ption Bandura, 1977). Both types of beliefs help Sclusl2, Miller, Lupien, & D 007). In bot experimental studies thar manipula control and studies that exami ological control has been fo be ep cents with asthma w ' h of control have better immun. ses relat their disease (Chen, Fisher, Ba &S 003). A high sense of cor been lower risk for mortality as wel (S. Tinta Luben, Khawy & Day, 20¢ Control appears to be esp oa Aderly people, who a " (Wrosch er al, 2007). For exa we mental study with institutionalized eldetly pa pants, Langer and eign the part articipants toa control-enhancing inte other half were assigned to condi a comparisd Those in the control-enhan subsequent! enhancing group subseq Participated in more sense of well-being 18 months later hey were judged to be in be health (Rodin & Lauren, 197, population,Perecved relation of ment, ps © typical sfal events nple, ado high sense related t0 & Strunk, linked « yrtant for ren, and poe n exper y part 4 half int make re panes So powerful are ‘rol beliefs chat hy interventions to the eects of payto Y are now used BEAL eon. Promote SXtensivel to help people cope note 80d health pe im dares sich ag beth difcle meg htbt and ‘ ical : Bastroende Proce tions (Johnson 8 Levenghe 1 eos (eventhal, Leventral 70s hilar 1989), and the edict P . conditions (see Ludwie 1988, for a rev modest steps th Sh Easterling ‘of many othe me k-Rosenthal few). When people axed + chronic Med breathir ath fully with it (Taylor, 2019; porte idee Ng OF rethinkin Beas Pav also examined whether peop who believe they can control theicdiserd irdisorders are better offthan those who donorsce their d They may believe, as ¢ personal control. Indeed, peop cop 2 number ence of a disease throu good health habits or even shocr fore of lh te may believe that by complying with teatments and us control over their illnesses (Helgeson through self-administation ofa treatment regimen In some cases, these control-rlated beliefs are tr Srl kernel of uth, For example, if patents aithfully follow a trearmene regimen, they may ver wel exercise real con he course of ther i ness. On the other hand, some belief, such as the belief thac one’ illness can be controlled thr Positive attitude, may or may not be correc Nonetheless, a belief in control and a sense o selF-efficacy with respect and its treat ment are generally adaptive (Thompson, Nanni & Levine, 1994). d improved adjustment among patients with a bro array of chronic conditions including cancer (Taylor etal., 1984), cheumatoid arthritis (Tennen, Affcck, Mendola, 1992), sickle ¢ 001). Urrows, Higy : disease (Edwards, ‘Telfair, Cecil, & Lene chronic obstructive pulmonary disease (Koble Fish, & Greene, 2002), AIDS (Taylor, Helgeson Reed, & Skokan, 1991), and many overs _ ally. or psychologically a by beliefs in doing poorly, adjustment is facilitated control (MeQuillen, Licht, & Licht, 4 f (McQuill 10 be helpful for Perceptions of control appear = managing both acute disorders and team’ mnt issues that may Well as the long-term manageme rd dis from chronic ot advancing illness (Se & Revenson, 1992). tn fae, a sex actually he lp aaa rien, Pt Prolong life: For eaampla cenanty fen sth ci dace pa sth wih cee plan, Ries, Prewite, & Rakin, 1994), : Prychotogical control health psychology: Much of ofthe esearch pet puting perceived contra to the py chological ogical and the Broup, whereas biological benef of the tanger dies have focused more on ntol. In both cases, the cl- generated feelings Positive relationshi nd adjustment pri evidence con Mlness Representations People hold cogniti nas of theiillneses th influence how they man on fillness ate acquired through he media, through personal exp ron amily and frends +, 19 ew). Mlness represent range fom b quite sketchy and inaccurate ro being exten understanding of the illness experience, and such, can influence proven havie nterprotations of symp 7 her Rabin, Leventhal, & Good M h ness: An acute illness, cx is shore in duration with 1 People vary in how they interpret the same dis order, For example, diabetes may be regard cyclical condition by one patient but as a chronic condition by another. One person with hypertensio may consider it to be an episodic disor its chronic nature another person may recogni Clearly the person who understands the chronic nature ofa serious condition is predisposed to show race self-management, including. fol mnerating appropri more appro lowing medication regimens ons about the futur are expectation ravion | SBE“engnitions that may have domain. This shift in “roughly with a broader change “cognition, specifically the move- ‘an emphasis on cold, nonmotiva- ‘of inference to more motivational ‘and: affective processes (Fiske & Taylor, 1991). ‘Health-related social cognition research has, thus, ‘especially focused on cognitions thar have an cmo- tional component, such as pessimistic and optimis, tic expectations regarding health conditions. One ofthe reasons for focusing on cognitions with amaffective component stems from the fact that such bells often engage physiological and neuroendo- ‘ine activity. Under conditions of threat or ses. least ewo important systems of the body are engaged, The first is the sympathetic nervous system, which includes indicators such as heart rate and blood pres- sure. The second is the hypothalamic pituitary adre- nal system, which engages stress hormones such as contisol. Together, these two systems mobilize the body to fend off threats or stress. Over the short term, these are highly protective responses. Over the long term, however, researchers believe that underlying, biological damage accumulates (McEwen, 1998). As these biological stress systems are repeatedly engaged iti tesponse to challenging or stressful circumstances, the systems may lose their elasticity and ability w fespond adaptively to changing circumstances. These systems may develop new higher set points with Adverse health consequences, or they may simply lose their resiliency. An example is high blood pressure In response to repeated engagement of the sympa thetic nervous system, blood pressure evel may cage 1p, with the resule that over time, a risk for disease such as hypertension and heart discase, increases, ‘These changes are typically associated with 0 Horthe extent that they occur in younger people who Ate coping with chronically sissful cvents, thew ‘hanges may be thought of as representing neler a pof biological systems, Adverse changes in fanetioning asa result of chronic exposure te may abo occur. The following sec- sefer t0 such cutcome variables as activity and elevated corti- ‘stress exposure, Eleva tion oF loss of COGNITION AND HeaLry ive Expectations ‘Certain people are dispositionally predisposed yy experience events as particularly stressful, which tur exacerbates tel parol dtr, hy hysieal symptoms, the likelihood of illnes, Fron whether the illness progress. This line ur research began with exploration of the psychologia, vegative affectivity (Watson 8 Clatk, 1984), pervasive negative mood marked by anxicty, depres sion, and hostility. People high in negative affectviy (or neuroticism) hold negative expectations abouy a variety of potential outcomes in their lives, and ‘Beperpieh Hatheiethacoenoct, a dlameisaes actoss a wide range of situations (Gunthert, Cohen & Armeli, 1999). People high in negative affecty are more likely to report and experience unpleasant physical symproms (Cohen, Doyle, Turner, Alper, & Skoner, 2003; Watson & Pennebaker, 198 Some of this tendency appears to be because the are inwardly focused and catastrophize c also related to poor health (e.g., Friedman & Booth-Kewley, 1987). In prospective corre studies, negative beliefs about the se future have been tied to a decline in helpe (CD4), an indicator of immune functioning, a the onset of AIDS in people with HIV (S Taylor, Kemeny, Reed, & Vissc Nega expectations have also been related to an ace ated course of disease (ronson ¢ 005: Ri Kemeny, Taylor, & Visscher, 1999; Reed, Kemeny Taylor, Wang, & Visscher, 1 Negative aff tivity is associated with clevated cortisol (a str hormone), and high levels of adrenocortical ity may provide a biopsychosocial pathway tha links negative expectations to at least some adver health outcomes (Polk, Cohen, Doyle, Skonet & Kirschbaum, 2005). Although these studies are cot relational in nature, they are typically prospect over time and demonstrate that the changes in neg ative beliefs precede, often substantially, changes it health markers. As such, the evidence implies that these beliefs may cause changes in disease statu Positive Beliefs Although research has focused somewhat disp portios ative beliefs that exacerbate conditions, many people ly on the n or result from medical CS S RREN SAR x 4a ‘ly fin ose i 90 dower ili soles ‘tba, 19 Ow nig ope aioe a hi oe tie wee t Sg %€ even ming roticism. Friedman & correlational elf and 1 clper T tioning (Segerstrom 6). Negativ 2005; Reo d, Kemem fi yative 4! a Skoneé one oe ive (oF personal growth health events in example, one suid 1990) found that m, reported at least so (Collins, me beneficial lives a8 a result of canc heart attack patients, 1m. Re thaehote third reporsed that their lives had inypren “t overall (Mohr et al, Be Pica: these: reporsed. che includ an inereased ability to appreciay things now rather than pac « tem: Maty people say that they a nn Beave sbquired more awareness of others andmore empathy and compassion i They report feeling stro nore sl s well. Benefit findi 8 reduced likelthoo event. Other stu tions to be associat cal health (€ « od of sustaining » repeat ceding es have alo found postive rear, wed with beter mental and phys Shen 8 Pressman, 2006: Presta te shen, 2005): A peace emationse style has been els (Pollet a 005), bee (Marsland, sistance till ht virus (Cohen, Alper, Treanor, & Tamer, 2006 tack, 2006 wing exposure to af ces appears to sl mn HI ' x . l I Pet I heir experi ame of these exper an ac ployin, managing these even " 7 pens to them, hold posit future, and have a pesii : hh oflicfvareadapive for mena and physic ee ecaplnaar eect 1988); bu they become special im i sermon fine faces a stressful challenge, si) . aa f other m ; : chronic illness or « skepeeey ota : investigation, Helgeon perigee fr asain he ' beliefs in men anc eae eae = prea for coronary artery diese an then one a tooopes hee Br ctiptaboar che fucam oot only co haber openers control, and optimism al \ intro the d predicted positive adjustme ravton | 8p‘recall of risk-telated information. espe- {information was self-relevane. Thus, ‘may actually increase rather than seceptivity to personally relevant negarive health information. Social Cognition and Coping ‘As the previous sections have suggested, many '6f the social cognitions that people develop in Fesponse to health disorders enable them to cope more effectively, an issue to which we turn more cecxplictly here Approach-Avoidance Nu ous frameworks for understanding cop ing have been advanced (for « review, see Skinner Bdge, Altman, & Sherwood, 2003), but one cen tral distinetion is approach versus avoidanc jing, Reflecting a core motivational construct (cg Davidson, Jackson, & Kalin, 2000) that is central {0 social cognition research, the approach~avoid heeicontinuuim maps easily onto broader theories Approach-orie of biobehavioral functioning te oping, sometimes called active, confrontative, 0 vigi taking direct action with respect to stressful event int coping, involves gathering problem solving, sccking socal support, and ing outlets for emotional expression. Avoidant coping involves withdrawing from, minimizing, or avoiding stcssful events Although neither style is necessarily more eff five for managing stressful events, inasmuch as cach has advantages and liabilities, on the whole avoidant oping fas proved to be generally unsuccessful. Th ftnpirical iterarure suggests that coping through avoidance can be useful in some specific situations, particularly those thavare short-term and uncontrol Table (Suls & Flercher, 1985); however, o Ft awoidance coping is not helpful. Acccmpcin ights and feelings surrounding. per predicts elevated distress across a (Taylor & Stanton, 2007). work on ironic processes suggests Kei Wegner, Schneider, Carter, & White, 1987). @voidance isnot always succesful, with reminders ‘Of stressful events breaking through ino conscious “Avoidance-oriented coping also predicts lower 10 medical regimens, greater viral load in SOCIAL COGNITION AND HEALTH (vanes, Warburton, & Margolin, 20 m ae eymproms among caregivers (Billing, Disa ere 8c Moskowiet, 2000), oie we surgery (Stephens, Duley, & promised Feovery of fune 20043 se Taylot & Stanton, Avoidant behavior under stex mised recovery ft Zautea, 2002), and co tion (Stephens et al 2007, for a review). has been tied to heightened newroendoctine activity re well (esp Roelofs, Elzinga, & Rottevecl, 2005 Rosenberger. Jokl, 2004): scientists and hea Jncened neuroend Tckovics, pel, D'Emtremont, & his is important because many medi ch. psychol that exposure to heig rime activity has cumulative adverse contribute t ich disorders as heart disease, hypertension, and * tumor development in animal models. For exam fg gies ‘i pein > ple, Vegas, Fano, Brain, Alonso, and Azpiroz (204 si rund thar mice who dealt with aggressive encou te * with other mice through absence of attack ion srdinate behavior, and little explorati a likely to develop: metastases in respon os implantation that mi sei talog for avoidance se Although mi hi air shuchateiprens seein 0 of sme variab nina what less consist proach va Kn lly, approach copi i (eg. Billings 000 The self has b a ognition rese and 1 the findings have applicabi P e Theories of the self, in athe ory (Steele, 1988) and coy dapratio aylor, 1983), posit that affirmation or enhai ment of the self ean buffer an individual agains ce ef of sen These hypotheses have b widely tested both experimentally through i Sherman, Sage, and McDowell (2003) fou relative to their p heir peers, people who enhanced th personal qualities had lower basal cortisol levels and lower cardiovascular responses to a laboratory SteeDisclosure and Writing ble research IBBESt thar self Mention for help 4 test of NBS ako su fay be an effective ine “firmatig INE People complete a self-affry Personally important v, tol task (writing 8 before participating (Counting backward benefits oF clarify Pe of coping is called ne) oF to, a eoinplew gn ional approach Hie involves f rs Focusing in a laboratory strese so ae Conjunction with a streeane (Stanton, Danof Burg PY 138 as rapidly apogee, SION, Big 19 and delivering p ) ing 2 alee ah posible gam 4). Emotional approach OF exam, Broke who had affirmed their rns Mience), cl aay am © pe at (2006) Sly lower contol spon, Md signi. ing ype 2? felon condo, eneoL with control particip ear me 2? PHI Ea. ck, sub, the relationship between i ieeestcem moderated Camecnt of Bang oo Saco Ki as Shological stress responses, such an Ps Writing about of ohewige tu high dispositional se aaa a8 maya i ; ne oh Hestem and optim who yea a8 ma : ae it Petsona, values repored Process of work ‘ stress. Thus, reflects e least helping people to poten. Sana 8 Pewonal vals chvougn h 7 a sila Kelp to keep neuroendocnne = abut Sie F some Hellas paychological responses on nee aS ther Lg an, & J X correla Similarly affirmation of personal values can anne, “tH Ay allow one to gain in it rsonal values can attenu, sis = ateperceptions of threat (Sherman 8 Cohan : ho ei some Heduce euminative thought attr tule oe, S'PPO" te gener Smeets Yan Knippenberg, & Dijksierhuis, 1999), “pana 1986) had 46 undergrad ; logical hd reduce defensive responses to threatening inten acter aa eae ences Mation (Sherman, Nelson, & Stecle. 2000). tiga nepneie ; The selFaffirmation perspective has alo been hela ’ change health behaviors (Sherman 2000). General 3 fi son Wher: people have affirmed important selfrelated ing int ude immediate paychol values, they are receptive to health informa- cal distress but long-term improvements ta hesth Hon! that might otherwise be threatening. ‘This and in some cases wel ws PFinciple thas been used tc influence receptivity 10 2002). For example. Peanchake Ho GOmmunications about vulnerability o breast can- _ O'Heeron (1987) found that when people val et isk for HIV, and risks to oral health (Sherman, about traumatic events, their skin conuctanes Updegeaff, & Mann, 2008) hosp aieatiRLe leas i Social Cognition, Social Interaction, ey iri sear * . and Health Thus fa, the social cognition rescarch discussed has focused heavily on how individuals oe nis individualistic ( “ hin 2004), breast-cancer patients (Stanton et al, 2002) y coved health among AIDS patients rie, Fontanill, Thomas, Booth, & Pennebaker health-related circumstances Fianail mphasis is consistent with much carly researc Social cognition and has persisted even as aay social cognition has become a more central of the field. However, social cognitions become A TavLon | asthma and rheumatoid arthritis patients, as: well as those with other conditions (Norman, Lumly Duley, & Diamond, 2004)Construal of Social Relationships and Support How people construe their socal rela and whether or not they regard them as supy thar protects against the ravages of stress. S port is defined as informati a network of communica (Wills, 1991). th fll: Inde, che eect sie of socal support in pred tive studies of morbidity and! mortal 3 other well-established risk factors for chronic ill and morality (House, Landis, & Um 088 Early in the study of soci focused heavily on the number of people i cused. heavil 5c hanges dur pseu port and not ie tions people hold about ther | More I me evi at person, ie may u ‘ have bec provided by + provi by the recipient, may be m ive than sup Bolger, Zuckerman, & Kesler, 200 support from another h : May provide the benefits of sup upport without und. mining important self-rclan Met perecption of socal support wheshe tSactually present or actually utilined «nt teducing, with conco: se In fact, beliefs ab — 886 995). Th docs (Thuis, 19! Ho vcary their soctal SUPPOTE nee nition meena teap dhe beni of soca Ings such as th a ne the neural nd colleagues (Eisen Lieberman, 200 snd : a h ne di ; i 1 de I: t 1, t Teale, adthsuyhen I : ip! d eeetheexpe- the dAC The amygdala is especially tal cues signaling danger Bookheimer, & Ma Srony asa threardetector responding o conflict in incor in ing information (Carteret l., 2000) and vo soca Sad ess (Eisenberger et al, 2003) es Once activated, these neural threat detectors st ¢ moni netetpaiakenscc nce cipans corteraimedaramplifing or atenuating che tne People signal and enabling a person to prepare to respond uuppor: to the threat. For example, links to the hypothala dACC mus are likely to have downstream effects on both clusion sympathetic and hypothalamic pituitary adrenal siting Fesponses to threat, both of which are activated in dAcC response to stressor. ie A neural region that appears critical for regula ie ing the magnitude of these biological and neural responses to stress is the ventrolateral prefrontal ‘cortex (vIPFC; Hariri et al., 2000; Ochsner et al. 2004). Specifically, activation of the right vIPFC can directly down-regulate activation of the amygdala and the dACG, so it can be thought of, at leas in part, asa self-regulatory structure that modulates the reactivity of brain regions t The neural bases of threat detection and regu lation are important to studying health because they provide clues to how coping processes regi! late psychological and biological health-related ‘outcomes. For example, zeople with strong coping, resources may show lower amygdala and/or dACC ‘reactivity to threatening stimuli. Alternatively, they may show stronger vIPFC responses (0 threat- “ening, stimuli. A third possibility is thac strong t respond to stress. F novelty (e.g., Hariei, iotta, 2000). The dACC serves "optimism, personal anda postive sense of self, benef affect arog ‘sponses. Two hypotheses. were examined: frst, that poychosocial resources are tied to detteaed sensitive to trea and second, that coping led tesourees are associated with enhanced pecfomel inhibition of th hreat responses during threat reg: lation. Using fMRI, this study found thatthe health-rcaed cognitions “were amined greater right vIPEC associated with activity and less amygdala activ- ity during a chreat regulation task. These cognitions were also related to lower cortisol responses t0 labo Kory stressors. Mediational analyses suggested that the relation of these co nitions 10 lower cortisol reactivity was mediated by lower amygdala activity during threar regulation. Thus, this study suggests that health-related cognitions may be associated with lower biological stress responses (cortisol) by means of enhanced inhibition of threat responses during threat regulation and not by diminished per Interventions Social cognition research has generated a variety of interventions that have helped people to: man- age stressful events more successfully, predicting better well-being and better health. The clearest ‘examples of these intervention. benefits have per: haps been the writing interventions already referred o. For example, one intervention (Mann, 2001) assigned HIV-seropositive women to write about positive events that would happen in the future ‘or to complete a control writing task. Among pa ticipants who were initially low in optimism, the writing intervention led to increased optimism, self-reported increases in adherence to medications, and less distress from medication side effects. These findings suggest thac a furure-oriented. positive if intervention may be a useful technique for decreasing distress and increasing adherence, expe= cially for initially pessimistic people. TAYLOR2002; Taylor, 2012). As es for the development of hhealth habits, as by target- itions for modification. ent interventions draw signifi- cial cognition for their efficacy. In these 3s (Taylor, 2012), participants are fist tify and verbalize the stressors in their selfmonitoring phase that follows, GS monitor their behavior in response t0 fdentify emotional and cognitive responses Participants are then taught how co chart sir stress responses, to examine the antecedent conditions under which they experience stress. For “example, one person may feel substantial stress is “response to a deadline at work, athough another Tndividual might regard the same circumstances as "challenging. Identifying negative sdf-talk and mod- "fying these cognitions isan imporant phase of the “stress management process as well. That is, people ‘can undermine their ability to man “by mentally rehearsing failure or dwelling on che ospect of being overwhelmed, ints experience a sense of control their stressors, the antecedents, ond to them, they are able gradually to intro- ¢ coping techniques for managing stress, ‘These luce reappraising stressful events as less so, iden- he personal and social resources they stressful events, and reassuring themselves sons of worth with skillsand talents to manage stfess more successfully. 1s then set explicit goals for man- angage in positive self-talk, and use ge their stress f- tion involves remind- cific steps that are required to nd positive self-talk involves hhas been tial co expan ‘example, one recommendations. Even the most castal exposure to patient-practti ‘ever, suggests that and the poten. ot rach interventions is substantial. For of the biggest problems in patient care eae pkably low levels of adherence 10 treatment ioner communication issues, how- Das principles of social cognition vaddress this problem. Consider the fh ereatment recommendations are tupensed In caditional medical practice, a paint soe ie anxious about his or her health and is no Jou distracted as/a result is expected to attend to tind vemember a physician’ outline of the deals of tare. "The person may then be sent home, sometimes could help to context in whicl th a prescription that says no more than “Take as directed.” An ex: patient-practitioner com suggestions such as “writ “test the patient for recall” qualify as breakthroughs nination of the literature on nications indicates that down the regimen” and in this problem area (Taylor, 2012). Ie scems likely that insights from such social cognition research as busyness (Gilbert, Pelham, & Krull, 1988), mem- and the impact of emotion on ory, dual processing, cognitive processing could be fruitfully employed to design practitioner communications with patients and the construction of aids to recall for patients Many health messages are likely to be processed peripherally, in highly busy conditions. What constitutes an effective mess may be informed by ights from these literatures. By contrast, if health care provider has a patient’s undivided atten tion, the message may be processed centrally. To date, these literatures have not been exploited for their health potential ‘This is but one example of @ potential expanding role for social cognition-based interventions in health psychology. Assecond likely direction for future expansion of social cognition perspecti to change health habi ‘oncerns interventions As behaviorally related con nd unsafe sex are increasingly shown to be vital links in growing health care costs worldwide, developig Persuasive communications, educational program’: and other interventions to. alter these conditions before they lead to i ithol i i Imporangs {2 Pathology wil assume increasingthroughs likely sloyed t patie patients What d nformed In addition t6 an health-related interve Chiet among, these ways th to mental neural, connect belefs, emotio and physical health outco neuroendocrine Research has begun to illuminate th much remains to be learned. Conclusion expanding role in designing ations; social cognition pee lated issues arc likely to expand will be research on the path ns, and behaviors mes through and immune pathways ise Tinks, but Aspinvall, Ls Gy 8 Mac Avante S. Ks, Warburton, L.A, fe Margolin, A (2601), Mow Social cognition perspectives have Benat KK Compa & Glin J enhanced the understanding of how people man ee owe pals Sars age their health, ‘The benefits go in both direction Health psychology as a field has been heavily infla- tiling, DW, Foun al enced by social cognition perspective i 0 dpe daring cae oussections attest, andas health psychology resea jf pate od aie a has inconporated new techniques that identify neu- Std vila pa eS. ral underpinnings of health-related phenomena, par and adj o hese insights and methods have moved in ; ae cognition as well. What the health dona : > oS. 8 Fa outcomes and the potential ps oi Vac : Mosk 09) sb their effects on biology and ultimate ; By understanding the reural, neuroendocri : immune pathways by which uh : Ich psych, ach 1 : functioning, health j “ ways by which social 1 ‘ology mi biological perspective Author Note ror E " Preparation of this manuscr fi f National Instituce of Agi og nl by a grant from the fens ad (AG030309 103 ny Hy Ph ; ron che rol ard predictab LB, & Si Seceeioni Appraisals of con & Si ' cacy Rt ro sel Liber, Le a Ape Sl yon 32.505 83 sin Fer and peeved behwn) NGI AM urna of Experiment a 2003). Us sole, MJT ahsid 4 Da & Sa hen, S Ales a A geningtomorinte HIV eesingaon5 RB.