Institute for the Study of
Healthcare Organizations & Transactions


Note:  During the Fall, 1999, Dr. Lucy Canter Kihlstrom and Dr. John Kihlstrom taught a class that focused on adherence to medical regimens from a social science perspective.  The syllabus and reading list are reproduced below.  To view the PowerPoint presentations that were constructed for this class, go to  This will take you to the Welcome Page for the course, where you may sign in using the username, guest, and the password, psy290pk.  Then, click on "Course Content by Week" to view the PowerPoint presentation for any individual topic.

In the future, this page will contain papers and articles that address issues of adherence.


University of California, Berkeley
Department of Psychology

Psychology 290P

Co-Sponsored by the Institute for Personality and Social Research

Fall Semester, 1999


Monday, 4:00-6:00 PM
5101 Tolman Hall

Instructors | Course Description
Requirements | Required Readings | Recommended Readings
Internet Resources | Syllabus


Lucy Canter Kihlstrom
Institute for Personality & Social Research
4201 Tolman Hall
John F. Kihlstrom
Department of Psychology
3333 Tolman Hall

Course Description

The focus of this seminar will be on health and illness behavior, normal and abnormal, viewed from both individual (micro) and social (macro) levels of analysis. At the individual level, topics will include common-sense representations of sickness and health; symptom perception and reporting; medication compliance; and utilization of health-care services. At the macro level of analysis, topics will include the dynamic nature of the health-care system, organizational effects on patient and provider behavior, and mental health issues in primary care (somatization, hypochondriasis, anxiety, and depression). This seminar will also explore the interactions between the micro and macro levels, including provider-patient communication; adherence to guidelines and plans for treatment and prevention, and inter-professional relations affecting provider and patient behavior.

Special topic for Fall 1999: Medical Compliance: acceptance of, and adherence to, disease-focused and lifestyle regimens.


This seminar may be repeated for credit.

Students registered for credit and letter grade will be required to lead a one-hour session of the seminar. Grades will be based on this seminar participation, and a term paper (approximately 25 pp.) corresponding to the oral presentation.

Required Readings

Seminar readings will be available on reserve in the Education/Psychology Library, in Tolman Hall.

Recommended Readings

The following texts provide general overviews of the topic of this seminar:

Conrad, P. (Ed.). (1997). The sociology of health and illness: Critical perspectives. 5th ed. New York: St. Martin's.

Gochman, D.S. (Ed.). (1997). Handbook of health behavior research. Vol. 1: Personal and Social Determinants. Vol. 2: Provider Determinants. Vol. 3: Demography, Development, and Diversity. Vol. 4: Relevance for Professionals and Issues for the Future. New York: Plenum.

Taylor, S.E. (1999). Health psychology. 4th ed. New York: McGraw-Hill.

Internet Resources

National Institutes of Health, Office of Behavioral and Social Science Research

Health Care Compliance Association

Literature, Arts, & Medicine Database

ORION: Outcomes Research Information On Line

NIH Health Information Index

National Library of Medicine LOCATORplus

PDR.NET (Physicians' Desk Reference)

Center for the Advancement of Health

Health and Behavior Alliance



August 23

Kasl, S.V., & Cobb, S. (1966). Health behavior, illness behavior, and sick role behavior: I. Health and illness behavior. Archives of Environmental Health, 12, 246-266.

Haynes, R.B. (1979). Introduction. In R.B. Haynes, D.W. Taylor, & D.L. Sackett (Eds.), Compliance in health care (pp. 1-7). Baltimore, Md.: Johns Hopkins University Press.

Sackett, D.L., & Snow, J.C. (1979). The magnitude of compliance and noncompliance. In R.B. Haynes, D.W. Taylor, & D.L. Sackett (Eds.), Compliance in health care (pp. 11-22). Baltimore, Md.: Johns Hopkins University Press.

Gochman, D. (1997). Adherence to and acceptance of regimens: General perspectives. In D. Gochman (Ed.), Handbook of health behavior research (Vol. 2, pp. 105-107). New York: Plenum.

Trostle, J.A. (1997). The history and meaning of patient compliance as ideology. In D. Gochman (Ed.), Handbook of health behavior research (Vol. 2, pp. 109-124). New York: Plenum.

August 30
Representations of Health, Illness, and Disease

Schober, R., & Lacourix, J.M. (1991). Lay illness models in the Enlightenment and the 20th century: Some historical lessons. In J.A. Skelton & R.T. Croyle (Eds.), Mental representation in health and illness (pp. 10-31). New York: Springer-Verlag.

Leventhal, H., & Diefenbach, M. (1991). The active side of illness cognition. In J.A. Skelton & R.T. Coryle (Eds.), Mental representation in health and illness (pp. 247-272). New York: Springer-Verlag.

Leventhal, H., Benyamini, Y., Brownlee, S., Diefenbach, M., Leventhal, E.A., Patrick-Miller, L., & Robitaille, C. (1997). Illness representations: Theoretical foundations. In K.J. Petrie & J.A. Weinman (Eds.), Perceptions of health and illness (pp. 19-45). Amsterdam: Harwood Academic Publishers.

Lau, R.R. (1997). Cognitive representations of health and illness. In D. Gochman (Ed.), Handbook of health behavior research (Vol. 1, pp. 51-70). New York: Plenum.

Conrad, P., & Schneider, J.W. (1992). From badness to sickness: Changing designations of deviance and social control. In Deviance and medicalization: From badness to sickness (Exp. Ed., pp. 17-37). Philadelphia, Pa.: Temple University Press.

Aronowitz, R.A. (1998). Introduction. In Making sense of illness: Science, society, and disease (pp. 1-18). Cambridge, U.K.: Cambridge University Press.

September 6
No Class (Labor Day)

September 13
The Biomedical Model
Clinical Problem: Epilepsy

Shagass, C. (1975) The medical model in psychiatry. Comprehensive Psychiatry, 16, 405-413.

Engel, B.T. (1977). The need for a new medical model: A challenge for biomedicine. Science, 196, 129-136.

Engel, B.T. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137, 535-544.

Di Iorio, C. (1997). Epilepsy self-management. In D.S. Gochman (Ed.), Handbook of health behavior research. Vol. II. Provider Determinants (pp. 213-230). New York: Plenum.

Epilepsy Foundation of America

September 20
Operant Behavior and Social Learning
Clinical Problem: Diabetes

Dunbar, J., Marshall, G., & Hovell, M. (1979). Behavioral strategies for improving compliance. In R.B. Haynes (Ed.), Compliance in health care (pp. 174-190). Baltimore, Md.: Johns Hopkins University Press.

Bandura, A. (1991). Self-efficacy mechanism in physiological activation and health-promotion behavior. In J. Madden (Ed.), Neurobiology of learning, emotion, and affect (pp. 229-269). New York: Raven.

Glasgow, R.E. (1991). Compliance to diabetes regimens: Conceptualization, complexity, and determinants. In J.A. Cramer & B. Spilker (Eds.), Patient compliance in medical practice and clinical trials (pp. 209-224). New York: Raven.

Fisher, E.B., Arfken, CL, Heins, J.M., Houston, C.A., Jeffe, D.B., & Sykes, R.K. (1997). Acceptance of diabetes regimens in adults. In D.S. Gochman (Ed.), Handbook of health behavior research. Vol. II. Provider Determinants (pp. 189-212). New York: Plenum.

American Diabetes Association

September 27
No Class

October 4
Health Belief and Decision Models
Clinical Problem: Renal Dialysis

Rosenstock, I.M. (1974). Historical origins of the health belief model. Health Education Monographs, 2, 328-335.

Becker, M.H. (1974). The health belief model and sick role behavior. Health Education Monographs, 2, 409-419.

Jaccard, J. (1975). A theoretical analysis of selected factors important to health education strategies. Health Education Monographs, 3, 152-167.

Godin, G., & Kok, G. (1996). Theory of planned behavior: A review of its application to health related behaviors. American Journal of Health Promotion, 11, 87-96.

Eraker, S.A., Kirscht, J.P., & Becker, M.H. (1984). Understanding and improving patient compliance. Annals of Internal Medicine, 100, 258-268.

Fabrega, H. (1973). Toward a model of illness behavior. Medical Care, 11, 470-484.

Christensen, A.J., Benotsch, E.G., & Smith, T.W. (1997). Determinants of regimen adherence in renal dialysis. In Gochman, Handbook of health behavior research: Vol. 2: Provider Determinants, pp. 231-244.

RENALNET Kidney Information Clearinghouse

October 11
The Communication Approach
Clinical Problem: Asthma

Ley, P. (1982). Satisfaction, compliance, and communication. British Journal of Clinical Psychology, 21, 241-254.

Ley, P. (1989). Improving patients' understanding, recall, satisfaction, and compliance. In A. Broome (Ed.), Health psychology (pp. 74-102). London: Chapman & Hall.

DiMatteo, M.R. (1985). Physician-patient communication: promoting a positive health care setting. In J.C. Rosen & L.J. Solomon (Eds.), Prevention in health psychology (pp. 328-365). Hanover, N.H.: University Press of New England.

DiMatteo, M.R. (1997). Health behaviors and care decisions: An overview of professional-patient communication. In D.S. Gochman (Ed.), Handbook of health behavior research. Vol. II. Provider Determinants (pp. 5-22). New York: Plenum.

Spector, S.L., & Mawhinney, H. (1991). Aerosol inhaler monitoring of asthmatic medication. In J.A. Cramer & B. Spilker (Eds.), Patient compliance in medical practice and clinical trials (pp. 149-162). New York: Raven.

Bosley, C.M., Fosbury, J.A., & Cochrane, G.M. (1995). The psychological factors associated with poor compliance with treatment in asthma. European Respiratory Journal, 8, 899-904.

Creer, T.L., & Levstek, D. (1997). Adherence to asthma regimens. In D.S. Gochman (Ed.), Handbook of health behavior research: Vol. 2. Provider determinants (pp. 131-148). New York: Plenum.

Asthma Management Model System

October 18
Self-Regulative Systems
Clinical Problem: Cardiovascular Syndromes

Scheier, M.F., & Carver, C.S. (1988). A model of behavioral self-regulation: Translating intention into action. In L. Berkowitz (Ed.), Advances in experimental social psychology (vol. 21, pp. 303-346). San Diego, Ca.: Academic.

Carver, C.S., & Scheier, M. (1990). Principles of self-regulation: Action and emotion. In E.T. Higgins & R.M. Sorrentino (Eds.), Handbook of motivation and cognition: Foundations of social behavior (vol. 2, pp. 3-52). New York: Guilford.

Carver, C.S., Scheier, M.F., & Pozo, C. (1992). Conceptualizing the process of coping with health problems. In H.S. Friedman (Ed.), Hostility, coping, and health (pp. 167-182). Washington, D.C.: American Psychological Association.

Carver, C.S., & Scheier, M.F. (1999, in press). Themes and issues in the self-regulation of behavior [Precis of Carver, C.S., & Scheier, M.F. (1998). On the self-regulation of behavior. New York: Cambridge University Press]. In R.S. Wyer (Ed.), Advances in social cognition, Vol. 12, pp. 1-105. Mahwah, N.J.: Erlbaum.

Baumeister, R.F., & Heatherton, T.F. (1996). Self-regulation failure: An overview. Psychological Inquiry, 7, 1-15.

Leventhal, H., Zimmerman, R., & Gutmann, M. (1984). Compliance: A self-regulation perspective. In D. Gentry (Ed.), Handbook of behavioral medicine (pp. 369-434). New York: Pergamon.

Leventhal, H., & Cameron, L. (1987). Behavioral theories and the problem of compliance. Patient Education & Counseling, 10, 117-36.

Leventhal, H., Diefenbach, M., & Leventhal, E.A. (1992). Illness cognition: Using common sense to understand treatment adherence and affect cognition interactions. Cognitive Therapy & Research, 16, 143-163.

Diefenbach, M.A., & Leventhal,H. (1996). The common-sense model of illness representations: Theoretical and practical considerations. Journal of Social Distress & the Homeless, 5, 11-38.

Leventhal, H., Lambert, J.F., Diefenbach, M., & Leventhal, E.A. (1997). From compliance to social self-regulation: Models of the compliance process. In B. Blackwell (Ed.), Treatment compliance and the therapeutic alliance (pp. 17-33). Amsterdam: Harwood Academic Publishers.

Leventhal, E.A., Leventhal, H, Robitaille, C., & Brownlee, S. (1999). Psychosocial factors in medication adherence: A model of the modeler. In D.C. Park, & R.W. Morrell (Eds.), Processing of medical information in aging patients: Cognitive and human factors perspectives (pp. 145-165). Yahweh, NJ: Album.

Meyer, D., Leventhal, H., & Gutmann, M. (1985). Common-sense models of illness: The example of hypertension. Health Psychology, 4, 115-135.

Dunbar-Jacob, J., Dwyer, K., & Dunning, E.J. (1991). Compliance with antihypertensive regimen: A review of the research in the 1980s. Behavioral Medicine, 13, 31-39.

Clark, N.M. (1997). Self-regulation and heart disease. In D.S. Gochman (Ed.), Handbook of health behavior research, Vol. 2: Provider determinants, pp. 149-168). New York: Plenum.

Kaplan, R.M., Eakin, E.G., Ries, A.L., Toshima, M., & Atkins, C.J. (1998). Co-Management of chronic obstructive pulmonary disease. In S.A. Shumaker, E.B. Schron, J.K. Ockene, & W.L. McBee (Eds.), Handbook of health behavior change, 2nd ed. (pp. 411-434). New York: Springer.

Heart Information Network

October 25
Adherence Issues in Primary Care

Robinson, P., Bush, T., Von Korff, M., Katon, W., Lin, E., Simon, G.E., & Walker, E. (1995). Primary care physician use of cognitive behavioral techniques with depressed patients. Journal of Family Practice, 40, 352-357.

Katon, W., Von Korff, M., Lin, E., Walker, E., Simon, G.E., Bush, T., Robinson, P., & Russo, J. (1995). Collaborative management to achieve treatment guidelines: Impact on depression in primary care. JAMA, 273, 1026-1031.

Katon, W., Robinson, P., Von Korff, M., Lin, E., Bush, T., Ludman, E., Simon, G., & Walker, E. (1996). A multifaceted intervention to improve treatment of depression in primary care. Archives of General Psychiatry, 53, 924-932.

Kravitz, R.L. (1996). Patients' expectations for medical care: An expanded formulation based on review of the literature. Medical Care Research & Review, 53, 3-27.

Kravitz, R.L., Callahan, E.J., Paterniti, D., Antonius, D., Dunham, M., & Lewis, C.E. (1996). Prevalence and sources of patients' unmet expectations for care. Annals of Internal Medicine, 125, 730-737.

Kravitz, R.L., Callahan, E.J., Azari, R., Antonius, D., & Lewis, C.E. (1997). Assessing patients' expectations in ambulatory medical practice: Does the measurement approach make a difference? Journal of General Internal Medicine, 12, 67-72.

Kravitz, R.L., & Callahan, E.J. (1998). Patients' perceptions of omitted examinations and tests: A qualitative analysis. Unpublished ms., Center for Health Services Research in Primary Care, University of California, Davis School of Medicine.

Primary Care Clinical Practice Guidelines

November 1
Medication Adherence

Conrad, P. (1997). The meaning of medications: Another look at compliance. In P. Conrad (Ed.), Sociology of Health and Illness (pp. 147-158). New York: St. Martin's Press.

Horne, R. (1997). Representations of medication and treatment: Advances in theory and measurement. In K.J. Petrie & J.A. Weinman (Eds.), Perceptions of health and illness (pp. 155-188). Amsterdam: Harwood.

Horne, R. (1993). One to be taken as directed: Reflections on non-adherence (non-compliance). Journal of Social & Administrative Pharmacy, 10, 150-156.

Donovan, J.L., & Blake D.R. (1992). Patient non-compliance: Deviance or reasoned decision-making? Social Science & Medicine, 34, 507-513.

Eisen, S.A. (1991). Developing more clinically meaningful definitions of medication compliance. In J.A. Cramer & B. Spilker (Eds.), Patient compliance in medical practice and clinical trials (pp. 225-231). New York: Raven.

Weinman, J. (1990). Providing written information for patients: Psychological considerations. Journal of the Royal Society of Medicine, 83, 303-305.

Ried, L.D., & Christensen, D.B. (1988). A psychosocial perspective in the explanation of patients' drug-taking behavior. Social Science & Medicine, 27, 277-285.

Haynes, R.B., Wang, E., & Gomes, M.daM. (1987). A critical review of interventions to improve compliance with prescribed medications. Patient Education & Counseling, 10, 155-166.

US Food and Drug Administration Center for Drug Evaluation & Research: Drug Information

November 8
Adherence Issues in Mental Health

Chen, A. (1991). Noncompliance in community psychiatry: A review of clinical interventions. Hospital & Community Psychiatry, 42, 282-287.

Schneider, L.S. (1993). Efficacy of treatment for geropsychiatric patients with severe mental illness. Psychopharmacology Bulletin, 29, 501-524.

Draine, J., & Solomon, P. (1994). Explaining attitudes toward medication compliance among a seriously mentally ill population. Journal of Nervous & Mental Disease, 182, 50-54.

Kupfer, D.J. (1995). Introduction: Compliance strategies to optimize antidepressant treatment outcomes. Journal of Clinical Psychiatry, 56, 3.

Fawcett, J. (1995). Compliance: Definitions and key issues. Journal of Clinical Psychiatry, 56, 4-10.

Frank E., Kupfer, D.J., & Siegel, L.R. (1995). Alliance not compliance: A philosophy of outpatient care. Journal of Clinical Psychiatry, 56, 11-17.

Paykel, E.S. (1995). Psychotherapy, medication combinations, and compliance. Journal of Clinical Psychiatry, 56, 24-30.

Edelman, R.E., & Chambless, D.L. (1995). Adherence during sessions and homework in cognitive-behavioral group treatment of social phobia. Behaviour Research & Therapy, 33, 573-577.

Mammen, O., Shear, K., Greeno, C., & Wheeler, S. (1997). Anger attacks and treatment nonadherence in a perinatal psychiatry clinic. Psychopharmacology Bulletin, 33, 105-108.

Salmon, P.G., Santorelli, S.F., & Kabat-Zinn, J. (1998). Intervention elements promoting adherence to mindfulness-based stress reduction programs in the clinical behavioral medicine setting. In S.A. Shumaker & E.B. Schron (Eds.), Handbook of health behavior change, 2nd ed. (pp. 239-266). New York: Springer.

Swartz, M.S., Swanson, J.W., Hiday, V.A., Borum, R., Wagner, R., & Burns, B.J. (1998). Taking the wrong drugs: The role of substance abuse and medication noncompliance in violence among severely mentally ill individuals. Social Psychiatry & Psychiatric Epidemiology, 33(Suppl. 1), S75-S0).

National Health Information (1998). Battling the blues: DM programs fight depression. In 1998 Disease Management Directory and Guidebook (pp. 182-188). Marietta, Ga.: National Health Information.

National Health Information (1998). Zero in on depression as a major source of savings. In 1998 Disease Management Directory and Guidebook (pp. 189-195). Marietta, Ga.: National Health Information.

National Institute of Mental Health

Internet Mental Health

November 15
Adherence by the Elderly

Spiers, M..V., & Kutzik, D.M. (1995). Self-reported memory of medication use by the elderly. American Journal of Health-Systems Pharmacy, 52, 985-990.

Saltzman, C. (1995). Medication compliance in the elderly. Journal of Clinical Psychiatry, 56, 18-23.

Dobbs, R.J., Dobbs, S.M., & Dickins, J. (1997). Monitoring compliance: The sine qua non of assessing therapeutics in the elderly. In J.A. Cramer & B. Spilker (Eds.), Patient compliance in medical practice and clinical trials (pp. 139-148). New York: Raven.

Park, D.C., & Jones, T.R. (1997). Medication adherence and aging. In A.D. Fisk & W.A. Rogers (Ed.), Handbook of human factors and the older adult (pp. 257-287). San Diego: Academic.

McElnay, J.C., McCallion, C.R. (1998). Adherence and the elderly. In L.B. Myers & K. Midance (Eds.), Adherence to treatment in medical conditions (pp. 223-253). Amsterdam: Harwood Academic Publishers.

Murdaugh, C.L. (1998). Problems with adherence in the elderly. In S.A. Shumaker, E.B. Schron, J.K. Ockene, & W.L. McBee (Eds.), Handbook of health behavior change, 2nd ed. (pp. 357-376). New York: Springer.

Monane, M., Matthias, D.M., Nagle, B.A., & Kelly, M.A. (1998). Improving prescribing patterns for the elderly through an online drug utilization review intervention: A system linking the physician, pharmacist, and computer. JAMA, 280, 1249-1252.

Morrell, R.W., & Shifren, K. (1999). Issues in the measurement of medication adherence. In D.C. Park & R.W. Morrell (Eds.), Processing of medical information in aging patients: Cognitive and human factors perspectives (pp. 185-198). Mahwah, N.J.: Erlbaum.

ADL Digest (Aging, Disability, & Long-Term Care)

November 22
Prospective Memory and Medical Compliance

Morris, P.E. (1992). Prospective memory: Remembering to do things. In M.M. Gruneberg & P.E. Morris (Eds.), Aspects of memory, Vol. 1: The practical aspects, 2nd ed. (pp. 196-222). London: Routledge.

Einstein, G.O., & McDaniel, M.A. (1996). Remembering to do things: Remembering a forgotten topic. In D. Herrmann, C. McEvoy, C. Hertzog, P. Hertel, & M.K. Johnson (Eds.), Basic and applied memory research: Vol. 2, Practical applications (pp. 79-94). Mahwah, N.J.: Erlbaum.

Park, D.C., & Mayhorn, C.B. (1996). Remembering to take medications: The importance of nonmemory variables. In D. Herrmann, C. McEvoy, C. Hertzog, P. Hertel, & M.K. Johnson (Eds.), Basic and applied memory research: Vol. 2, Practical applications (pp. 95-110). Mahwah, N.J.: Erlbaum.

Ellis, J. (1998). Prospective memory and medicine-taking. In L.B. Myers & K. Midence (Eds.), Adherence to treatment in medical conditions (pp. 113-131). Amsterdam: Harwood.

Knight, R.G. (1998). Prospective memory in aging and neurodegenerative disease. In A.I. Troester (Ed.), Memory in neurodegenerative disease: Biological, cognitive, and clinical perspectives (pp. 172-183). New York: Cambridge University Press.

November 29

Karoly, P. (1993). Enlarging the scope of the compliance construct: Toward developmental and motivational relevance. In N.A. Krasnegor, L. Epstein, S.B. Johnson, & S.J. Yaffe (Eds.), Developmental aspects of health compliance behavior (pp. 11-27). Hillsdale, N.J.: Erlbaum.

Couch, J.B. (1997). Disease management: An overview. In J.B. Couch (Ed.), The physician's guide to disease management (pp. 1-27). Gaithersburg, Md.: Aspen Publications.

Zitter, M. (1997). A new paradigm in health care delivery: Disease management. In W.E. Todd & D. Nash (Eds.), Disease management: A systems approach to improving patient outcomes (pp. 1-25). Chicago, Il.: American Hospital Publishing.

Copyright 2000 Institute for the Study of Healthcare Organizations & Transactions

Last modified:  04.08.2010 02:58 PM