Current issues and new directions in Psychology and Health: ‘Plus ça change, plus c’est la même chose’

This issue of Psychology and Health marks the editorial handover from Paul Norman and his team of co-editors to ourselves and our team. The journal has continued to go from strength to strength over recent years, reaching a record impact factor of 1.80 for 2005 that confirms the journal as one of the top international health psychology publications. This achievement is not only a testament to the previous editor's vision and hard work, but is also due to the members of his editorial team, who have provided authors with careful, expert and sensitive consideration of their articles, and have provided readers with an assurance of the high quality of the research that has been published. Thanks are also due to the European Health Psychology Society and to Taylor and Francis for all the support and encouragement they have given the past and incoming editorial teams, and their work in promoting the journal. It is in the light of this past record of the ever-growing popularity of the journal that we chose the title for our editorial. The title reflects our wish to retain the existing spirit and excellence of the journal by building steadily on its past success, while also introducing some changes that we hope that authors and readers will welcome, and that will capitalise on and create new opportunities for the development and dissemination of health psychology research.

One exciting new opportunity that we are sure that authors and readers will welcome is the introduction of electronic submission to the journal. This will help our editorial team to ensure that manuscripts can be processed quickly and efficiently, giving authors rapid feedback and readers rapid access to new research. In addition, the handover has provided the opportunity for new people to become co-editors and members of the editorial board, providing a wide variety of perspectives on health psychology. A further change is that book reviews will no longer appear in this journal. In their place, we are introducing a series of invited editorials entitled ‘Current Issues and New Directions in …’. Each editorial will highlight and critically debate a different issue or trend in health psychology that is of current interest. This editorial, therefore, commences the series by considering some current trends in published research in Psychology and Health, and some issues these developments raise.

Health psychology has often tended to focus specifically on the individual, sometimes neglecting their social context. It is, therefore, refreshing to see that in recent issues of Psychology and Health, a number of authors have examined the impact of health problems on families, and the impact of families on how individuals cope with health problems. For example, Pinquart and Duberstein (2005) identified predictors of depressive symptoms in the spouses of lung cancer patients, De Ridder, Schreurs and Kuijer (2005) compared the effects of different types of support from spouses on the psychological wellbeing of patients with chronic disease, while Knussen, Tolson, Swan, Stott and Brogan (2005) investigated predictors of deteriorating relationships between family caregivers and their older relatives. A revealing qualitative analysis by Jarman, Walsh and De Lacey (2005) highlighted the importance HIV positive individuals attach to protecting those around them not only from physical harm but also from the emotional impact of the disease. In an innovative experimental study, Prestwich et al. (2005) demonstrated the value of forming collaborative implementation intentions with a partner – which led in their study to 100% performance of the target breast screening behaviour!

Another welcome feature of the articles mentioned above is that three of the four quantitative studies employed longitudinal designs, while the fourth used an experimental design. There is a growing appreciation of the need to try to establish causal relationships in health psychology research, using prospective or longitudinal designs if it is not feasible to experimentally manipulate the variables of interest. However, it is encouraging to note that several recent authors have succeeded in experimentally testing interventions. For example, Ziegelmann, Lippke and Schwarzer (2006) showed that assistance in completing action plans can help to maintain long-term physical activity, while Wolitzky, Fivush, Zimand, Hodges and Rothbaum (2005) used engaging head-mounted virtual reality environments to reduce the distress of children with cancer undergoing painful medical procedures. Brosschot and van der Doef (2006) provided an impressive demonstration that simply instructing students to postpone worrying until a short worry period each day could lead to reductions in their levels of a wide range of somatic complaints.

There are inevitably limited resources for carrying out large-scale field trials of interventions, and there is consequently a need for more small-scale experimental studies that can help to identify the active components of an intervention and establish the mechanisms by which they may affect outcomes. Provided that interventions are theory-based, this provides an important means of testing the relationships predicted by our theoretical models and the validity of the models themselves. Analysis of the mediators and moderators of treatment effects can also be helpful in this respect. For example, Cameron, Petrie, Ellis, Buick and Weinman (2005) showed that myocardial infarction patients low on trait negative affectivity benefited from a health education intervention, but patients high on negative affectivity did not.

These are existing strengths that we hope to encourage further in future submissions to Psychology and Health, but what of new directions? To date, there has been a paucity of studies in the journal in the area of psychoneuroimmunology. As we mentioned earlier, it is encouraging to see articles focussing on the ‘social’ component of the biopsychosocial model, but we should not neglect the ‘bio’ component.

We also need to address broadening the target readership for the journal. In many instances the take home messages of our research are directed not only towards health psychologists, but towards health care providers, and public health practitioners and policy makers. Whilst we do not want to diminish the psychological and theoretical rigour of articles in our journal, perhaps we need to be aware of the language we are using. For instance, few physicians would have any understanding of what is meant by implementation intentions, protection motivation, illness representations and common sense models. Does this mean we should not use psychological terminology? No – clearly these terms are needed to define our constructs precisely, but in a nice example of how we can address this issue, Sniehotta, Scholz and Schwarzer (2005) begin their abstract on a study on bridging the intention-behaviour gap as follows. ‘Although some people may develop an intention to change their behaviour, they might not take any action. This discrepancy has been labelled the “intention-behaviour gap” ’ (p. 143). Defining key constructs in this way in the abstract allows people searching the data bases for articles to have a clear understanding of the content of the article. Similar considerations can be applied to the titles of our articles.

We talked earlier about longitudinal, experimental and intervention studies. Another way of increasing the credibility of these studies within the medical professions is to frame them around existing funding and publication guidelines. For instance, the Medical Research Council (MRC) in the UK has published detailed guidelines for the development of complex interventions (Campbell et al., 2000), whilst the US based Society of Behavioural Medicine has published a multiphase strategy for optimising and evaluating interventions (MOST) (Collins, Murphy, Nair, & Strecher, 2005). The longitudinal and smaller experimental studies discussed above could fulfil the objectives of the ‘modelling’ (Phase I) stage recommended in the MRC guidelines, or the ‘screening’ and ‘refining’ phases of MOST.

Pilot and randomised controlled trials of both public health and clinical health psychology interventions can be represented within phases II and III of the MRC framework. Using the CONSORT guidelines (Moher, Schulz, & Altman, 2001) for publication to help design and then write-up these studies will ensure a high-quality publication that adheres to the medical guidelines for the publication of clinical trials. We also need to address translating applied behavioural research into practice. Glasgow, Klesges, Dzewaltowski, Bull and Estabrooks (2004) have provided the useful ‘RE-AIM’ framework for evaluating the extent to which a behavioural intervention Reaches all of the target population, is Effective and widely Adopted, and is consistently Implemented and Maintained in the long-term.

In summary, we look forward to an exciting era for the journal. We support the ongoing submission of high-quality articles that use a variety of methodologies to test and build on theoretical aspects of health psychology, including social cognition and self regulation models. We hope to broaden the scope of the journal by encouraging people to submit articles that focus on PNI, socio-cultural issues and critical health psychology. We would also like to broaden our readership and welcome studies that report on the psychological contributions to medical and clinical interventions, such as studies carried out to identify, select and refine the psychological elements of interventions, or to identify psychological mediators or moderators of intervention outcomes.

Lucy Yardley and Rona Moss-Morris

Editors-in-Chief