| Many researchers have investigated the complex and often ambiguous association between psychological variables and physical health. However, many prior studies of psychological predictors of health assess neither actual physical health nor actual illness behaviors (e.g., care seeking). Instead, they often assess research participants' subjective beliefs about their health (Watson & Pennebaker, 1989). Further, most of these studies assess psychological variables using self-report scales taken at face value. This may be problematic, because self-report measures of psychological health/distress may unwittingly assess defensive denial, not actual psychological well-being (Shedler, Mayman & Manis, 1993). This dissertation presents two studies, one cross-sectional and one prospective, which investigate the relations between a variety of psychological predictors and health service utilization in a college student sample. Psychological predictors include measures of stress, psychological defense, and alexithymia. Results indicate that a subjects who defensively deny psychological distress (e.g., subjects characterized by "illusory mental health") have significantly more medical visits due to verified medical illness (as determined by independent health professionals) than genuinely psychologically healthy subjects; (b) subjective clinical judgments of psychological health/distress, based on the Early Memory Test, predict health service utilization due to verified physical illness, whereas self-report mental health scales do not; and (c) stress, operationalized as number of negative life events, is significantly related to self-reported health service utilization, but not to health service utilization due to verified medical illness. Implications of these findings are discussed. |
