Emotion, Cognition, Health, and Development in Children and Adolescents (PLE: Emotion)

Elizabeth J. Susman, Lynne V. Feagans, William J. Ray

• Publisher: Psychology Press
• Year: 2014
• ISBN:
  9781317579076
• Edition: 1
• Topic: Psychology
• Subtopic: Developmental Psychology
• Index: Psychology

Originally published in 1992, this title came out of a conference on emotion and cognition as antecedents and consequences of health and disease processes in children and adolescents. The theoretical rationale for the conference was based on the assumption that the development of emotion, cognition, health and illness are processes that influence each other through the lifespan and that these reciprocal interactions begin in infancy. The chapters discuss developmental theories, research and implications for interventions as they relate to promoting health, preventing disease, and treating illness in children and adolescents.

1

Here’s Looking at You, Kid! New Ways of Viewing the Development of Health Cognition¹

David S. Gochman

University of Louisville

This chapter provides a picture of what we currently know about health cognitions in young populations. In this chapter, the term cognition denotes “those personal thought processes that serve as frames of reference for organizing and evaluating experiences. Beliefs, expectations, perceptions, values, motives, and attitudes all provide the person with ways of filtering, interpreting, understanding, and predicting events” (Gochman, 1988b, p. 21). Health cognitions, then, refer broadly to those beliefs, expectations, perceptions, values, motives, and attitudes that serve as personal frames of reference for organizing and evaluating health, regardless of whether those cognitions have demonstrable empirical linkages with health status and regardless of whether they are “objectively valid.”

The chapter then identifies some critical areas for future research and concludes with a discussion of how we ought to think about and how we ought to conduct this research. The chapter is thus a background and introduction to the overall themes of the book namely, emotion, cognition, health, and development in children and adolescents.

WHAT DO WE KNOW ABOUT HEALTH COGNITIONS IN YOUNG POPULATIONS?

We know a little–but very little–about some areas of youngsters’ health cognitions. For example, in addition to some knowledge about locus of control and the development of autonomy related to health (see Iannotti and Bush, chapter 4), we have some data-based knowledge about youngsters’ beliefs about the causes of illness, about body parts, about their definitions and conceptions of health and illness, about their perceptions of vulnerability, and about their health-related motivation.

Causes of Illness

From Nagy’s (1951, 1953) explorations of beliefs about germs and contagion, we have learned ways in which beliefs about causes of illness changed with age: Children younger than 5 seem incapable of grasping the real origins of illness, whereas those 6 and older appear to be able to apply the concepts of infection, and their precision in doing so increases developmentally.

Body Parts

From the observations gleaned by Geliert (1962, 1978) through her standardized questionnaire, we have learned that egocentrism and concreteness tend to be more characteristic of the way in which younger children–in contrast to older ones–view their bodies and that older children tend to demonstrate greater degrees of articulation of parts of the various body systems and increased conceptions of their permanence.

Definitions and Conceptions of Health and Illness

From Rashkis’s (1965) observations based on play-period interviews with elementary school children, we have learned that older youngsters more than younger ones equate being well with positive, pleasant states. Younger respondents are apparently unable to integrate their health-related feelings and experiences into a clear, conscious conception of health as a positive state.

From Natapoffs data (1982) we have learned that youngsters equate being healthy with (in order of preference) feeling good, with the ability to do the things they want to do, and with not being sick. They are least likely to equate being healthy with being happy or with having a strong body. They equate not being healthy with being sick and with not being able to do things. We have also learned, as might be expected, that older children demonstrate greater analytic processes, greater levels of abstraction in their thinking, and greater ability to see part-whole relationships than do younger ones. Thus, older children and adolescents are able to think beyond their current sensory inputs to consider hypotheses about health and illness and to project linkages between health and the future; younger children remain bound by the specifics of health cues that are immediate to the senses and think primarily about health in the present. Simeonsson, Buckley, and Monson (1979) reported similar findings in their study of conceptions of health and illness in hospitalized youngsters. From Campbell’s work (1975a, 1975b), we have learned that youngsters and their mothers show strong consensus about the relative importance of specific signs and symptoms as indicators of illness (e.g., fever, vomiting).

Perceived Vulnerability to Health Problems

From data derived from the health-belief model (e.g., Gochman, 1986), we learn that perceptions of being vulnerable to health problems are relatively stable between ages 8 and 14 or 15; that perceived vulnerability can be thought of as a consistent personality characteristic; that youngsters on the average see themselves as neither especially vulnerable or invulnerable to health problems; and that perceived vulnerability is negatively related to self-concept or self-esteem (Gochman & Saucier, 1982), is related more to self-concept than to prior traumatic experiences (Gochman, 1977), and is directly related to anxiety (Gochman & Saucier, 1982). This last finding suggests that perceived vulnerability is not a “pure” cognition but one that has an affective or emotional component, making it especially relevant to both the emotional and cognition focal points of this volume.

Health Motivation

We have learned that health is not an especially salient motive, preference, value, or priority for youngsters (Gochman, 1986) and that it declines appreciably in relation to appearance or cosmetic concerns between ages 8 and 15 (Gochman, 1986). Of course, this conclusion may be overly simplistic; the observed lack of potency in relation to appearance may disappear when comparisons are made with other motives.

Michela and Contento’s innovative study (1986) of health orientations, taste orientations, and multiple-motive orientations, which integrated Piagetian developmental concepts with value-expectancy theory, is one of the few rigorous inves tigations in this area. Their findings reveal complex linkages between patterns of motivation within individual youngsters, levels of cognitive development, and youngsters’ food decisions and eating behaviors.

AN AGENDA FOR FUTURE RESEARCH

From these beginnings, available evidence is congruent with both Piagetian and Lewinian models of conceptual growth and development. No single theoretical model has an advantage in accounting for or making predictions about aspects of the development of health related cognitions. Despite these important starts, consensus exists that much more needs to be learned (Bruhn & Parcel, 1982). What we currently know reflects a lack of systematic efforts at developing this knowledge. In terms of a sociology of knowledge (e.g., Hayes-Bautista, 1978), what we currently know as professionals is lacking in depth, coherence, and organization. Literature reviews (e.g., Burbach & Peterson, 1986; Gochman, 1985, 1988a, 1988c, 1988d; Kalnins & Love, 1982) affirm that there have been few systematic replications, little effort directed at broadening samples, and little done to move beyond specific cultural frameworks.

It is implicit from this overview of what is currently known that even in the areas where some knowledge exists, there is an urgent need to expand this knowledge systematically. A future research agenda for young persons’ health cognitions should assign high priority to the following five areas: the origins and development of health cognitions, the role of the family as a determinant of these cognitions, health-germane motivation, cognitions related to coping, and searches for meaning.

Origins and Development of Health Cognitions

A gap exists in our knowledge about the roots or sources of health cognitions, as it does in our knowledge of health behavior in general. Much research has been undertaken to shape and modify selected health cognitions and other health behaviors, but few investigations have attempted systematically to explore their origins.

Coupled with the need for greater knowledge and understanding about the origins of health cognitions is the need for greater knowledge and understanding about how such cognitions develop. Although perceived vulnerability appears to be one of the most systematically examined health cognitions in younger populations, its origins in family, peer, media, and experiential factors remain unstudied. The dearth of well-conducted, rigorous research in this area has been noted repeatedly (e.g., Bruhn & Parcel, 1982; Gochman, 1985, 1988a, 1988c, 1988d; Kalnins & Love, 1982).

Questions arise about the importance of a range of factors such as the family, friends, peer groups, social relationships, and societal and cultural values and institutions in the origins and development of such cognitions.

Basic research into the origins of health cognitions and how they develop is thus a major challenge for the future and leads directly to the second area identified for future research-the family.

The Family and Health Cognitions

Although the family is presumed to be a major determinant of health cognitions, and although Campbell (1978), for example, has shown how some maternal values serve as determinants of youngsters’ conceptions of sick role, reviews of the literature (e.g., Baranowski & Nader, 1985; Gochman, 1985, 1988c) attest to the virtual nonexistence of knowledge about relationships between family characteristics and children’s health cognitions. Baranowski and Nader described this relationship as “almost ignored” (1985, p. 53), Sallis and Nader (1988) noted the paucity of documentation of mechanisms of family influence, and Drotar et al. (1989) continued to point to the need to expand knowledge in this area. Moreover, Dielman, Leech, Becker, Rosenstock, and Horvath (1982), noting that studies relating parental and youngsters’ health beliefs have been “relatively rare,” were unable in their own investigation to demonstrate any relationships. They asserted, “Child health beliefs are scarcely influenced by parental characteristics” (p. 63).

Possibly, the failure to discover the roots of children’s health behavior in family characteristics reflects an unfortunate combination of inadequate conceptualizations of the family together with a small number of studies conducted in this area. Research has seldom looked at the family as an entity or unit, that is, as a social group or social system. More often than not, research has considered family solely in terms of some personal or demographic characteristic of one or both parents or in terms of its size.

Future research into youngsters’ health cognitions should examine the family in terms of its characteristics as an integral social unit, that is, its role structure, norms, values, and patterns of communication. Pratt (1976) has developed one of the few extant conceptual models available that considers the family in this way, and studies based on her model, or similarly coherent ones, are sorely needed.

Health-Germane Motivation

Few studies have been conducted on health, the desire for health, or the wish to possess good health as motives. This is a research arena in which cognitions have affective or emotional components and thus is especially important to the theme of this volume. Moreover, it is increasingly important to differentiate between health as a motive and health-germane motives, those motives that can effectively be drawn on to generate health actions. Thus, a more basic question for future research is: What are the motives that generate health actions in young populations? The desires of young people to be physically or socially active, to be academically successful, to be athletically proficient, or to engage responsibly in family and peer roles may be more critical to health actions than the value of health itself.

Moreover, future research in youngsters’ health cognitions needs to address issues such as those raised by Burt (1984) of whether youngsters perceive health as juxtaposed with pleasure, indicating that actions considered to be healthy are often thought to be unappealing, distasteful, and otherwise noxious; and those raised by Bruhn (1988) about the conflict between personal r...

Table of contents

• Cover Page
• Half Title Page
• Title Page
• Copyright Page
• Contents
• Historical and Theoretical Perspectives on Behavioral Health in Children and Adolescents: An Introduction
• 1 Here's Looking at You, Kid! New Ways of Viewing the Development of Health Cognition
• Part I Developmental Trajectories in Behavioral Health
• Part II Developmental Processes and Disease
• Part III New Perspectives on Health and Development
• Author Index
• Subject Index