J.A. Skelton

Professor J.A. Skelton

Most of my scholarship concerns applying social psychology to health issues. It flows from the recognition that our pre-existing knowledge and beliefs influence the way we react to our own bodily feelings and to other people’s health problems. When I began research in this field, I was concerned with demonstrating that what we “know” and believe can make us misinterpret physical sensations. For example, if I don’t know that some kinds of heart attacks are signalled by shooting pains in the left arm, I may fail to call 911 and thereby precipitate my own demise (if I’m the one having the pains) or the death of someone who tells me about their sinister pain. Or, if I believe that (say) fluorescent lights can cause body temperature to fluctuate, I may misinterpret normal sensations as “proof” of my belief (by the way, fluorescent lighting has no known effect on body temperature). We refer to such knowledge and beliefs as mental representations of illness.

Mental representations can affect our reactions to others who are sick. For example, if I believe disease X can be prevented by taking appropriate precautions, I may devalue individuals with disease X, as often happens when people catch STDs. Thinking that disease Y is caused by “stress” can make us doubt the suffering of people with disease Y or recommend ineffective treatments, as was done for years with peptic ulcers. The articles How Do Observers Understand Work-related Injuries? and How Negative Are Attitudes toward Persons with AIDS? describe some of my research on how people react to the sick.

Recently, I’ve extended this representational metaphor to the case of how people communicate about health problems. When we ask people, “Does that hurt?,” or “How often do you have headaches?”, their answers depend not just on what they feel but also on what they think is the purpose of the question and what they remember. Each of these, in turn, can depend on social context. When a drill sergeant asks a boot camp trainee, “Does that hurt?” the question has very different meaning than when it comes from the medic at the infirmary. The way we ask people about their health makes them think about the kind of answer we want and perhaps introduces distortion into the communication process. My most recent research has addressed such subtleties such as the temporal framing of health questions and the kinds of response alternatives people have their disposal. The symptom accessibility article is an example.