Food studies

From Wikipedia, the free encyclopedia

 

Food studies is the critical examination of food and its contexts within science, art, history, society, and other fields. It is distinctive from other food-related areas of study such as nutrition, agriculture, gastronomy, and culinary arts in that it tends to look beyond the mere consumption, production, and aesthetic appreciation of food and tries to illuminate food as it relates to a vast number of academic fields. It is thus a field that involves and attracts philosophers, historians, scientists, literary scholars, sociologists, art historians, anthropologists, and others.

State of the field

This is an interdisciplinary and emerging field, and as such there is a substantial crossover between academic and popular work. Practitioners reference best-selling authors, such as the journalist Michael Pollan, as well as scholars, such as the historian Warren Belasco and the anthropologist Sidney Mintz. While this makes the discipline somewhat volatile, it also makes it interesting and engaging. The journalist Paul Levy has noted, for example, that "Food studies is a subject so much in its infancy that it would be foolish to try to define it or in any way circumscribe it, because the topic, discipline or method you rule out today might be tomorrow’s big thing."

Research questions

Qualitative questions that are wrestled with include: What impact does food have on the environment? What are the ethics of eating? How does food contribute to systems of oppression? How are foods symbolic markers of identity? At the same time practitioners may ask seemingly basic questions that are nonetheless fundamental to human existence. Who chooses what we eat and why? How are foods traditionally prepared—and where is the boundary between authentic culinary heritage and invented traditions? How is food integrated into classrooms? There are also questions of the spatialization of foodways and the relationship to place. This has led to the development of the concept of "foodscape" - introduced in the early 1990s - and the related practice of foodscape mapping. Discussion of these questions has increased as a result of public concern about issues which have arisen as a result of the emergence of a vast array of novel food technologies throughout the last century, ranging from chemical fertilizers to GMOs. Pursuers of food studies approach these questions by first understanding the scientific, economic, and philosophical issues surrounding them.

Institutions

One branch of this community has organized itself as The Association for the Study of Food and Society. This group hosts an annual conference (along with the Agriculture, Food, and Human Values Society); it publishes an interdisciplinary journal, Food, Culture, and Society; and it maintains an email listserv with over a thousand members for discussion of food-related topics. ASFS maintains a list of institutions granting food studies related degrees. 

A few schools have programs in the field, including Julia Child and Jacques Pepin founded Boston University's Gastronomy Masters program and New York University's program in Nutrition, Food Studies, and Public Health. The Department of Anthropology at Indiana University has recently started a food studies concentration within their program, leading to a PhD in Anthropology, while The New School is developing an undergraduate program in Food Studies. Prof. Fabio Parasecoli is the Coordinator of Food Studies at the New School in New York City. 

Indiana University began offering a PhD track in Food Anthropology in 2005, and an undergraduate minor in the anthropology of food in 2007, followed quickly by the IU Geography Department, which now also offers an MA and PhD in Food Systems. In 2016 the Collins Living-Learning center at IU started offering an undergraduate certificate in Food and Sustainability. At the same time the University has established the IU Food Institute, to house a growing interdisciplinary Food Studies research group, chaired by Profs. Peter Todd and Richard Wilk. 

Syracuse University offers a Bachelor of Science or minor in food studies at the undergraduate level and a Masters of Science or Certificate of Advance Study (CAS) at the graduate level. With a systems perspective grounded in political economy, food studies at Syracuse University is a full stand-alone program with dedicated faculty, a dynamic and devoted group of students, a physical home - including extensive teaching kitchens, community partners including farms, food businesses, government agencies, and not-for-profit organizations, complementary programs on campus, and a growing list of professional contacts nationwide.

Chatham University Master of Arts in Food Studies. The Masters of Arts in Food Studies emphasizes a holistic approach to food systems, from agriculture and food production to cuisines and consumption, providing intellectual and practical experience from field to table. Prof. Alice Julier is the Coordinator of Food Studies at Chatham University. The University of Oregon in Eugene, USA, has recently launched a graduate specialization in food studies, and is aiming for a 2014 launch of an undergraduate degree. 

University of the Pacific, San Francisco has the only Master of Arts in Food Studies program on the West Coast. It is multidisciplinary and the curriculum encompasses food history, food writing, food production, food scarcity and justice, and food industry management and business. In addition to graduate seminars, faculty leads field visits to area restaurants, farms and food processing facilities. Ken Albala, a food historian and director of program is the author or editor of 23 scholarly and popular books on food. He writes, “Our goal is to engage students in the dynamism that is the Bay Area food and farming scene, while making connections with leaders throughout the food system. This is a great opportunity for people with an interest in food and food-related issues to earn a master’s degree in something they feel passionate about." 

In Italy, the American University of Rome offers a US-accredited 15-month Master in Food Studies with a strong international dimension focused on the linkages between food and the environment and policies for sustainable production, consumption and diets.

The Technological University Dublin, Ireland (previously Dublin Institute of Technology), offers a Master of Arts in Gastronomy and Food Studies that focuses on three pillars: History, Society and Practice. The two-year part-time programme - first of its kind in Ireland - features masterclasses, workshops, guest speakers, field trips and meal experiences and includes such courses as Global Cultural History of Food, Politics of the Global Food System, Food Writing and Media, History of Irish Food, Reading Historic Cookbooks, Social Approaches to Wine and Beverage Culture, Food Tourism, and Consumer Culture and Branding.

In the United Kingdom, SOAS, University of London has offered a master’s programme in the Anthropology of Food since 2007. The course offers students the opportunity to study food on a variety of levels, ranging from the domestic to the international. The institution is also home to the SOAS Food Studies Centre, an interdisciplinary research centre focused on furthering the academic study of food. 

Queen Margaret University in Edinburgh, Scotland has launched a new master's degree in Gastronomy. This is a unique qualification and the first of its kind in Scotland, which allows students to engage with the broad range of issues connected with food, provenance, diet, health, and nutrition. The degree is not just about food, but also delves deeper to consider food culture within the contexts of anthropology, environment, sustainability, politics and communications. 

Food & History is a multilingual (French, English, German, Italian and Spanish) scientific journal that has been published since 2003 as the biannual scientific review of the European Institute for the History and Cultures of Food [fr] (IEHCA) based in Tours (linked to the Université François Rabelais). 

Even study abroad programs have created new, interdisciplinary food studies programs, among them Palazzo Rucellai in Florence and The Umbra Institute in Perugia. Gustolab International is another institution which offers research internships and courses in sustainable production and consumption, food and media, food waste, advertising, science and nutrition, new technologies, and the history of food in Italy, Japan and Vietnam. To be mentioned also is the Pollenzo-based (near Bra, Cuneo, Italy) University of Gastronomic Sciences, the Institut Européen d'Histoire et des Cultures de l'Alimentation (of Tours, France, mentioned above) and FOST: Social and Cultural Food Studies of the Vrije Universiteit Brussel (Belgium), providing education in bachelor, master or postgraduate studies. 

Numerous presses publish academic and popular books about the cultural significance of food, some of which are Columbia University Press, University Press of Mississippi, the University of Nebraska Press, University of California Press, the University of Illinois Press, the MIT Press, Bloomsbury Academic, Rowman & Littlefield, Berg, Earthscan, Routledge, Prospect, and Equinox Publishing.

Food insecurity and health outcomes

In America, almost 50 million people are considered food insecure. This is because they do not have the means to buy healthy food, therefore, lead an unhealthy lifestyle. At least 1.4 times more children who are food insecure are likely to have asthma, compared to food-secure children. And older Americans who are food-insecure will tend to have limitations in their daily activities. When a household is lacking the means (money) to buy proper food, their health ultimately suffers. Supplemental Nutrition Assistance Program (SNAP, formerly known as the Food Stamp Program) is put in place to help families in need to get the proper nutrition they need in order to live a healthy lifestyle. There are 3 points that make a household eligible for SNAP. One, is their gross monthly income must be 130% of the federal poverty level. The second point they have to meet is being below poverty. And the last thing is they have to have assets of less than $2,000 except that households with at least one senior and households that include at least one person with a disability can have more assets. Multiple studies have shown SNAP as being successful in reducing poverty.

The major part of this research was examining children’s food insecurity, the effect of this have greatly affected a child’s performance. Due to food insecurity also runs the risk of possibly birth defects “5 anemia, 6,7 lower nutrient intakes, 8 cognitive problems, 9 and aggression and anxiety.”  As opposed to children in food-secure households, “children in food-insecure households had 2.0-3.0 times higher odds of having anemia, 6, 7 2.0 times higher odds of being in fair or poor health, 8 and 1.4-2.6 times higher odds of having asthma, depending on the age of the child.” 

Non senior adult had less research done on them in regards with the impacts of food insecurity “however, some of the studies in this limited set have shown that food insecurity is associated with decreased nutrient intakes; 20-25 increased rates of mental health problems and depression,10,26-30 diabetes, 31, 32 hypertension, 33 and hyperlipidemia; 32 worse outcomes on health exams; 33 being in poor or fair health; 23 , 34 and poor sleep outcomes 35.” Mothers who are food insecurity tend to be twice as likely to report mental health issues as well as oral health problems.

Food and education

Food and school are two interconnected topics. Children spend a large part of their day in school, so the food that is served in and around school greatly influences eating habits. Fast food in particular has proven to affect school children's health. Fast food marketing targets children. In the United States, more than 13 million children and adolescents are obese. Obesity prevalence was 13.9% among 2- to 5-year-olds, 18.4% among 6- to 11-year-olds, and 20.6% among 12- to 19-year-olds. The close proximity of fast food restaurants to schools has been speculated be one of the reasons for such high childhood obesity. in California, students with fast food restaurants within a half mile from their schools are more likely to be overweight, and are less likely to eat healthier foods. Fast food restaurants are also concentrated around schools in Chicago, increasing the risk of poor food choices for school children there. Research has shown that at least 80% of schools in Chicago have at least one fast food restaurant 10 minutes away. The close proximity of fast food restaurants to schools exposes US children to unhealthy, cheap meals that they can easily get to and from school, increasing the chances of childhood obesity. 

The influence of food on school children can also be a positive thing. Schools are being used to advocate for obesity prevention, since nutrition has been proven to be linked to academic performance. The overweight students do not perform as well academically, and also deal with health related issues that take away from school time To combat this, schools are working to help their students. 83% of public and private schools provide breakfast and lunch programs that serve nutritious food up to federal standards, and these programs are proven to be beneficial for students' nutrition.

The prevalence of competitive foods in schools are still providing students with unhealthy foods. Competitive foods are the foods that are for sale to students besides the federal meals. Usually these foods are high in fat and sugar, and access to vending machines allows for students to have sugary drinks as well. A 2003 California High School Fast Food Survey found that about one-fourth of 173 districts served brand name fast food from Subway, Domino's, Pizza Hut, and Taco Bell. These foods are reached for more than the healthier options. 

Parents and the public have raised concerns about the health impacts of the competitive food in schools. Healthier food costs schools more to buy, so the concern of losing revenue influences the purchase of cheaper, less healthy options. Even so, schools in Maine, California, Minnesota, and Pennsylvania were able to replace sugary drinks with healthier options without losing revenue.

School nutrition programs have also helped fight poor eating habits of students with the support of parents and school administrators. Making it Happen! School Nutrition Success Stories is a program that provides healthier alternative foods to schools. Schools have been doing their part by changing food contracts, promoting better eating, and fundraising for better student health.

Food industry and economy

The food industry has a rapid rate of increasing sectors such as restaurants and fast food places that impact the economy in the long and short run. There are many people involved behind a successful business. In the food industry, the workers that are involved include servers, waiters, chefs, farmworkers and all restaurant workers. The issue is that some of these workers are paid minimum wage for all the effort they put in. The work individuals do involves picking fruits and vegetables that are served in the meal, they make the food, serve it to the consumers and wash dishes. These workers deal with working conditions, aspirations and labor practices. But these workers specifically have to deal with poor working conditions such as unsanitary kitchens which affect the food that is served to the consumers and can negatively impact their health. 

This allows the society to see from the perspective of how the workers and their relationship to the food can be demonstrated as multiple meanings for them because they live off of it. These people include immigrant restaurant owners and mobile food vendors. Ellen Kossek and Lisa Burke did a research on “Developing Occupational and Family Resilience in US Migrant Farm Workers” which explained how the migrant workers in the agriculture industry face tough circumstances in their work and home environment. The other conditions besides low work wages include difficult working conditions, health problems, not well suited housing, family issues and children's lives impacted negatively. These conditions are categorized as 'acculturative stress' but the goal is to maintain a healthy and better life which does not have a negative impact on family relations and job performance. One of the findings from the research was that the farm work mothers who had an infant in the Migrant Head Start Program, those ladies performed better in their household and at work. 

There can be programs developed as a solution to the problem with the goal of improving social networks for the migrant farmworkers and better education systems for the children. The benefits of creating these programs will help in improving work, childcare and housing conditions for farmworkers and their families. The issue is that they have to move constantly based on the season because there are limited opportunities. Another study was done by Saru Jayaraman and Sean Basinski who focused on this issue. In "Feeding America: Immigrants in the Restaurant Industry and Throughout the Food System Take Action for Change," they provide data which looks at the working conditions and poverty rates that affect the workers. There were efforts made by Restaurant Opportunities Centers United to better wages, benefits and opportunities to advance. These studies allow us to see the workers experiences and the conditions they deal with. Our goal should be to get involved and make a healthy and sustainable industry.

Food choice

From Wikipedia, the free encyclopedia

 

Research into food choice investigates how people select the food they eat. An interdisciplinary topic, food choice comprises psychological and sociological aspects (including food politics and phenomena such as vegetarianism or religious dietary laws), economic issues (for instance, how food prices or marketing campaigns influence choice) and sensory aspects (such as the study of the organoleptic qualities of food).

Factors that guide food choice include taste preference, sensory attributes, cost, availability, convenience, cognitive restraint, and cultural familiarity. In addition, environmental cues and increased portion sizes play a role in the choice and amount of foods consumed.

Food choice is the subject of research in nutrition, food science, psychology, anthropology, sociology, and other branches of the natural and social sciences. It is of practical interest to the food industry and especially its marketing endeavors. Social scientists have developed different conceptual frameworks of food choice behavior. Theoretical models of behavior incorporate both individual and environmental factors affecting the formation or modification of behaviors. Social cognitive theory examines the interaction of environmental, personal, and behavioral factors.

Taste preference

Researchers have found that consumers cite taste as the primary determinant of food choice. Genetic differences in the ability to perceive bitter taste are believed to play a role in the willingness to eat bitter-tasting vegetables and in the preferences for sweet taste and fat content of foods. Approximately 25 percent of the US population are supertasters and 50 percent are tasters. Epidemiological studies suggest that nontasters are more likely to eat a wider variety of foods and to have a higher body mass index (BMI), a measure of weight in kilograms divided by height in meters squared.

Environmental influences

Many environmental cues influence food choice and intake, although consumers may not be aware of their effects. Examples of environmental influences include portion size, serving aids, food variety, and ambient characteristics (discussed below).

Portion size

Portion sizes in the United States have increased markedly in the past several decades. For example, from 1977 to 1996, portion sizes increased by 60 percent for salty snacks and 52 percent for soft drinks. Importantly, larger product portion sizes and larger servings in restaurants and kitchens consistently increase food intake. Larger portion sizes may even cause people to eat more of foods that are ostensibly distasteful; in one study individuals ate significantly more stale, two-week-old popcorn when it was served in a large versus a medium-sized container.

Serving aids

Over 70 percent of one's total intake is consumed using serving aids such as plates, bowls, glasses, or utensils. Consequently, serving aids can act as visual cues or cognitive shortcuts that inform us of when to stop serving, eating, or drinking.

In one study, teenagers poured and consumed 74 percent more juice into short, wide glasses compared to tall, narrow glasses of the same volume. Similarly, veteran bartenders tend to pour 26 percent more liquor into short, wide glasses versus tall, narrow glasses. This may be explained in part by Piaget's vertical-horizontal illusion, in which people tend to focus on and overestimate an object's vertical dimension at the expense of its horizontal dimension, even when the two dimensions are identical in length.

In addition, larger bowls and spoons can also cause people to serve and consume a greater volume of food, although this effect may not also extend to larger plates. It has been suggested that people serve more food into larger dishes due to the Delboeuf illusion, a phenomenon in which two identical circles are perceived to be different in size depending upon the sizes of larger circles surrounding them.

Plate color has also been shown to influence perception and liking; in one study individuals perceived a dessert to be significantly more likable, sweet, and intense when it was served on a white versus a black plate.

Food variety

'The Food Guide Pyramid.

 

As a given food is increasingly consumed, the hedonic pleasantness of the food's taste, smell, appearance, and texture declines, an effect commonly referred to as sensory-specific satiety. Consequently, increasing the variety of foods available can increase overall food intake. This effect has been observed across both genders and across multiple age groups, although there is some evidence that it may be most pronounced in adolescence and diminished among older adults.

Even the perceived variety of food can increase consumption; individuals consumed more M&M candies when they came in ten versus seven colors, despite identical taste. Furthermore, simply making a food assortment appear more disorganized versus organized can increase intake.

It has been suggested that this variety effect may be evolutionarily adaptive, as complete nutrition cannot be found in a single food, and increased dietary variety increases the likelihood of meeting nutritional requirements for various vitamins and minerals.

Ambient characteristics

Salience

Increased food salience in one's environment (including both food visibility and proximity) has been shown to increase consumption. Regarding visibility, food is consumed at a faster rate or at a greater volume when it is presented in clear versus opaque containers. Having large stockpiles of food products at home can increase their rate of consumption initially; however, after about a week's time the consumption rate may drop back down to the level of non-stockpiled foods, perhaps due to sensory-specific satiety. Salient foods may increase intake by serving as a continuous consumption reminder and increasing the number of food-related cognitive choices an individual must make. Additionally, some studies have found that obese individuals may be more susceptible to the influence of food salience and external cues than individuals with a normal-weight BMI.

Distractions

Distractions can increase food intake by initiating patterns of consumption, obscuring ability to accurately monitor consumption, and extending meal duration. For example, greater television viewing has been associated with increased meal frequency and caloric intake. A study in Australian children found that those who watched two or more hours of television per day were more likely to consume savory snacks and less likely to consume fruit compared to those who watched less television. Other distractors such as reading, movie watching, and listening to the radio have also been associated with increased consumption.

Temperature

Energy expenditure increases when ambient temperature is above or below the thermal neutral zone (the range of ambient temperature in which energy expenditure is not required for homeothermy). It has been suggested that energy intake also increases during conditions of extreme or prolonged cold temperatures. Relatedly, researchers have posited that reduced variability of ambient temperature indoors could be a mechanism driving obesity, as the percentage of US homes with air conditioning increased from 23 to 47 percent in recent decades. In addition, several human  and animal studies have shown that temperatures above the thermoneutral zone significantly reduce food intake. However, overall there are few studies indicating altered energy intake in response to extreme ambient temperatures and the evidence is primarily anecdotal.

Lighting

There is a dearth of research investigating relationships between lighting and intake; however, extant literature suggests that harsh or glaring lighting promotes eating faster, whereas soft or warm lighting increases food intake by increasing comfort level, lowering inhibition, and extending meal duration.

Music

Compared to fast-tempo music, low-tempo music in a restaurant setting has been associated with longer meal duration and greater consumption of both food and drink, including alcoholic beverages. Similarly, when individuals hear preferred versus non-preferred music they tend to stay at dining establishments longer and spend more money on food and drink.

Expert advice

In 2010, for the first time, the Dietary Guidelines for Americans (DGA) highlighted the role of the food environment in American food choices and recommended changes in the food environment to support individual behavior modification. The influence of environmental cues and other subtle factors have increased interest in using the principles of behavioral economics to change food behaviors.

Social influences

Presence and behavior of others

There is a substantial amount of research indicating that the presence of others influences food intake (discussed below). In reviewing this literature, Herman, Roth, and Polivy have outlined three distinct effects: 

1. Social facilitation – When eating in groups, people tend to eat more than they do when alone.

In daily diary studies, individuals have been found to eat from 30  to 40-50 percent more while in the presence of others versus eating alone. In fact, some research has indicated that the rate of intake is best described as a linear function of the number of people present, such that meals eaten with one, four, or seven other people were 33, 69, and 96 percent larger than meals eaten alone, respectively. In addition to these observational findings, there is also experimental evidence for social facilitation effects.

Meal duration may be an important factor in social facilitation effects; observational research has identified positive correlations between group size and meal duration, and further investigation has confirmed meal duration as a mediator of group size-intake relationships.

2. Modeling – When eating in the presence of others who consistently eat either a lot or a little, individuals tend to mirror this behavior by also eating either a lot or a little.

Early studies of modeling effects investigated food intake alone versus in the presence of others who either ate either a very small amount (1 cracker) or a larger amount (20-40 crackers). Findings were consistent, with individuals consuming more when paired with a high-consumption companion than a low-consumption companion, whereas eating alone was associated with an intermediate amount of intake. Research manipulating eating social norms within real-life actual friendships has also demonstrated modeling effects, as individuals ate less in the company of friends who had been instructed to restrict their intake versus those who had not been given these instructions. Furthermore, these modeling effects have been reported across a range of diverse demographics, affecting both normal-weight and overweight individuals, as well as both dieters and non-dieters. Finally, regardless of whether individuals are very hungry or very full, modeling effects remain very strong, suggesting that modeling may trump signals of hunger or satiety sent from the gut.

3. Impression management – When people eat in the presence of others who they perceive to be observing or evaluating them, they tend to eat less than they would otherwise eat alone.

Leary and Kowalski define impression management in general as the process by which individuals attempt to control the impressions others form of them. Previous research has shown that certain types of eating companions make people more or less eager to convey a good impression, and individuals often attempt to achieve this goal by eating less. For example, people who are eating in the presence of unfamiliar others during a job interview or first date tend to eat less.

In a series of studies by Mori, Chaiken and Pliner, individuals were given an opportunity to snack while getting acquainted with a stranger. In the first study, both males and females tended to eat less while in the presence of an opposite-sex eating companion, and for females this effect was most pronounced when the companion was most desirable. It also seems that women may consume less in order to exude a feminine identity; in a second study, women who were made to believe that a male companion viewed them as masculine ate less than women who believed they were perceived as feminine.

The weight of eating companions may also influence the volume of food consumed. Obese individuals have been found to eat significantly more in the presence of other obese individuals compared to normal-weight others, while normal-weight individuals' eating appears unaffected by the weight of eating companions.

4. Awareness Although the presence and behavior of others can have a strong impact on eating behavior, many individuals are not aware of these effects, and instead tend to attribute their eating behavior primarily to other factors such as hunger and taste. Relatedly, people tend to perceive factors like cost and health effects as significantly more influential than social norms in determining their own fruit and vegetable consumption.

Weight bias

Individuals who are overweight or obese may suffer from stigmatization or discrimination related to their weight, also called weightism or weight bias. There is emerging evidence that experiences with weight stigma may be a type of stereotype threat which leads to behavior consistent with the stereotype; for example, overweight and obese individuals ate more food after exposure to a weight stigmatizing condition. Additionally, in a study of over 2,400 overweight and obese women, 79 percent of women reported coping with weight stigma on multiple occasions by eating more food.

Cognitive dietary restraint

Cognitive dietary restraint refers to the condition where one is constantly monitoring and attempting to restrict food intake in order to achieve or maintain a desired body weight. Strategies used by restrained eaters include choosing reduced-calorie and reduced-fat foods, in addition to restricting overall caloric intake. Individuals are classified as restrained eaters based on responses to validated questionnaires such as the Three Factor Eating Questionnaire and the restraint subscale of the Dutch Eating Behavior Questionnaire. Recent research suggests that the combination of restraint and disinhibition more accurately predict food choice than dietary restraint alone. Disinhibition is another factor measured by the Three Factor Eating Questionnaire. A positive score reflects a tendency towards overeating. Individuals scoring high on the disinhibition subscale eat in response to negative emotion, overeat when others are eating, and when in the presence of tasty or comfort foods.

Gender differences

When it comes to selecting food, women are more likely than men to choose and consume foods based on health concerns or food contents. One possible explanation for this observed difference is women may be more concerned with body weight issues when choosing certain types of foods. There may be an inverse relationship, as adolescent girls are noted to have lower intakes of vitamins and minerals and ingest fewer fruits/vegetables and dairy foods than adolescent boys.

Age differences

Across the lifespan, different eating habits can be observed based on socio-economic status, workforce conditions, financial security, and taste preference amongst other factors. A significant portion of middle-aged and older adults responded to choosing foods due to concerns with body-weight and heart disease, whereas adolescents select food without consideration of the impact on their health. Convenience, appeal of food (taste and appearance), and hunger and food cravings were found to be the greatest determinants of an adolescent’s food choice. Food choice can change from an early to mature age as a result of a more sophisticated taste palate, income, and concerns about health and wellness.

Socio-economic status

Income and level of education influence food choice via the availability of the resources to purchase a higher quality food and awareness of nutritious alternatives. Diet may vary depending on the availability of income to purchase more healthier, nutrient-rich foods. For a low-income family, pricing plays a larger role than taste and quality in whether the food will be purchased. This may partly explain the lower life expectancy of lower-income groups. Similarly, higher levels of education equate to higher expectations from functional foods and avoidance of food additives. Compared to conventional foods, organic foods have a higher cost and people may have limited access if generating a low income. The variety of foods carried in neighborhood stores may also influence diet ("food deserts").

Psychological testing

From Wikipedia, the free encyclopedia

 

Psychological testing
Medical diagnostics
ICD-10-PCS	GZ1
ICD-9-CM	94.02
MeSH	D011581

Psychological testing is the administration of psychological tests, which are designed to be "an objective and standardized measure of a sample of behavior". The term sample of behavior refers to an individual's performance on tasks that have usually been prescribed beforehand. The samples of behavior that make up a paper-and-pencil test, the most common type of test, are a series of items. Performance on these items produce a test score. A score on a well-constructed test is believed to reflect a psychological construct such as achievement in a school subject, cognitive ability, aptitude, emotional functioning, personality, etc. Differences in test scores are thought to reflect individual differences in the construct the test is supposed to measure. The science behind psychological testing is psychometrics.

Psychological tests

A psychological test is an instrument designed to measure unobserved constructs, also known as latent variables. Psychological tests are typically, but not necessarily, a series of tasks or problems that the respondent has to solve. Psychological tests can strongly resemble questionnaires, which are also designed to measure unobserved constructs, but differ in that psychological tests ask for a respondent's maximum performance whereas a questionnaire asks for the respondent's typical performance. A useful psychological test must be both valid (i.e., there is evidence to support the specified interpretation of the test results) and reliable (i.e., internally consistent or give consistent results over time, across raters, etc.). 

It is important that people who are equal on the measured construct also have an equal probability of answering the test items accurately. For example, an item on a mathematics test could be "In a soccer match two players get a red card; how many players are left in the end?"; however, this item also requires knowledge of soccer to be answered correctly, not just mathematical ability. Group membership can also influence the chance of correctly answering items (differential item functioning). Often tests are constructed for a specific population, and this should be taken into account when administering tests. If a test is invariant to some group difference (e.g. gender) in one population (e.g. England) it does not automatically mean that it is also invariant in another population (e.g. Japan). 

Psychological assessment is similar to psychological testing but usually involves a more comprehensive assessment of the individual. Psychological assessment is a process that involves checking the integration of information from multiple sources, such as tests of normal and abnormal personality, tests of ability or intelligence, tests of interests or attitudes, as well as information from personal interviews. Collateral information is also collected about personal, occupational, or medical history, such as from records or from interviews with parents, spouses, teachers, or previous therapists or physicians. A psychological test is one of the sources of data used within the process of assessment; usually more than one test is used. Many psychologists do some level of assessment when providing services to clients or patients, and may use for example, simple checklists to osis for treatment settings; to assess a particular area of functioning or disability often for school settings; to help select type of treatment or to assess treatment outcomes; to help courts decide issues such as child custody or competency to stand trial; or to help assess job applicants or employees and provide career development counseling or training.

History

A Song Dynasty painting of candidates participating in the imperial examination, a rudimentary form of psychological testing.

 

Physiognomy was used to assess personality traits based on an individual's outer appearance.

 

The first large-scale tests may have been examinations that were part of the imperial examination system in China. The test, an early form of psychological testing, assessed candidates based on their proficiency in topics such as civil law and fiscal policies. Other early tests of intelligence were made for entertainment rather than analysis. Modern mental testing began in France in the 19th century. It contributed to separating mental retardation from mental illness and reducing the neglect, torture, and ridicule heaped on both groups.

Englishman Francis Galton coined the terms psychometrics and eugenics, and developed a method for measuring intelligence based on nonverbal sensory-motor tests. It was initially popular, but was abandoned after the discovery that it had no relationship to outcomes such as college grades. French psychologist Alfred Binet, together with psychologists Victor Henri and Théodore Simon, after about 15 years of development, published the Binet-Simon test in 1905, which focused on verbal abilities. It was intended to identify mental retardation in school children.

The origins of personality testing date back to the 18th and 19th centuries, when personality was assessed through phrenology, the measurement of the human skull, and physiognomy, which assessed personality based on a person's outer appearances. These early pseudoscientific techniques were eventually replaced with more empirical methods in the 20th century. One of the earliest modern personality tests was the Woolworth Personality Data Sheet, a self-report inventory developed for World War I and used for the psychiatric screening of new draftees.

Principles

Proper psychological testing is conducted after vigorous research and development in contrast to quick web-based or magazine questionnaires that say "Find out your Personality Color," or "What's your Inner Age?" Proper psychological testing consists of the following:

• Standardization - All procedures and steps must be conducted with consistency and under the same environment to achieve the same testing performance from those being tested.
• Objectivity - Scoring such that subjective judgments and biases are minimized, with results for each test taker obtained in the same way.
• Test Norms - The average test score within a large group of people where the performance of one individual can be compared to the results of others by establishing a point of comparison or frame of reference.
• Reliability - Obtaining the same result after multiple testing.
• Validity - The type of test being administered must measure what it is intended to measure.

Interpreting scores

Psychological tests, like many measurements of human characteristics, can be interpreted in a norm-referenced or criterion-referenced manner. Norms are statistical representations of a population. A norm-referenced score interpretation compares an individual's results on the test with the statistical representation of the population. In practice, rather than testing a population, a representative sample or group is tested. This provides a group norm or set of norms. One representation of norms is the Bell curve (also called "normal curve"). Norms are available for standardized psychological tests, allowing for an understanding of how an individual's scores compare with the group norms. Norm referenced scores are typically reported on the standard score (z) scale or a rescaling of it. 

A criterion-referenced interpretation of a test score compares an individual's performance to some criterion other than performance of other individuals. For example, the generic school test typically provides a score in reference to a subject domain; a student might score 80% on a geography test. Criterion-referenced score interpretations are generally more applicable to achievement tests rather than psychological tests. 

Often, test scores can be interpreted in both ways; answering 80% of the questions correctly on a geography test could place a student at the 84th percentile (that is, the student performed better than 83% of the class and worse than 16% of the classmates), or a standard score of 1.0 or even 2.0.

Types

There are several broad categories of psychological tests:

IQ/achievement tests

IQ tests purport to be measures of intelligence, while achievement tests are measures of the use and level of development of use of the ability. IQ (or cognitive) tests and achievement tests are common norm-referenced tests. In these types of tests, a series of tasks is presented to the person being evaluated, and the person's responses are graded according to carefully prescribed guidelines. After the test is completed, the results can be compiled and compared to the responses of a norm group, usually composed of people at the same age or grade level as the person being evaluated. IQ tests which contain a series of tasks typically divide the tasks into verbal (relying on the use of language) and performance, or non-verbal (relying on eye–hand types of tasks, or use of symbols or objects). Examples of verbal IQ test tasks are vocabulary and information (answering general knowledge questions). Non-verbal examples are timed completion of puzzles (object assembly) and identifying images which fit a pattern (matrix reasoning). 

IQ tests (e.g., WAIS-IV, WISC-V, Cattell Culture Fair III, Woodcock-Johnson Tests of Cognitive Abilities-IV, Stanford-Binet Intelligence Scales V) and academic achievement tests (e.g. WIAT, WRAT, Woodcock-Johnson Tests of Achievement-III) are designed to be administered to either an individual (by a trained evaluator) or to a group of people (paper and pencil tests). The individually administered tests tend to be more comprehensive, more reliable, more valid and generally to have better psychometric characteristics than group-administered tests. However, individually administered tests are more expensive to administer because of the need for a trained administrator (psychologist, school psychologist, or psychometrician).

Public safety employment tests

Vocations within the public safety field (i.e., fire service, law enforcement, corrections, emergency medical services) often require Industrial and Organizational Psychology tests for initial employment and advancement throughout the ranks. The National Firefighter Selection Inventory - NFSI, the National Criminal Justice Officer Selection Inventory - NCJOSI, and the Integrity Inventory are prominent examples of these tests.

Attitude tests

Attitude test assess an individual's feelings about an event, person, or object. Attitude scales are used in marketing to determine individual (and group) preferences for brands, or items. Typically attitude tests use either a Thurstone scale, or Likert Scale to measure specific items.

Neuropsychological tests

These tests consist of specifically designed tasks used to measure a psychological function known to be linked to a particular brain structure or pathway. Neuropsychological tests can be used in a clinical context to assess impairment after an injury or illness known to affect neurocognitive functioning. When used in research, these tests can be used to contrast neuropsychological abilities across experimental groups. 

Infant and Preschool Assessment

Due to the fact that infants and preschool aged children have limited capacities of communication, psychologists are unable to use traditional tests to assess them. Therefore, many tests have been designed just for children ages birth to around six years of age. These tests usually vary with age respectively from assessments of reflexes and developmental milestones, to sensory and motor skills, language skills, and simple cognitive skills.

Common tests for this age group are split into categories: Infant Ability, Preschool Intelligence, and School Readiness. Common infant ability tests include: Gesell Developmental Schedules (GDS) which measures the developmental progress of infants, Neonatal Behavioral Assessment Scale (NBAS) which tests newborn behavior, reflexes, and responses, Ordinal Scales of Psychological Development (OSPD) which assesses infant intellectual abilities, and Bayley-III which tests mental ability and motor skills.

Common preschool intelligence tests include: McCarthy Scales of Children’s Abilities (MSCA) which is similar to an infant IQ test, Differential Ability Scales (DAS) which can be used to test for learning disability, Wechsler Preschool and Primary Scale of Intelligence-III (WPPSI-III) and Stanford-Binet Intelligence Scales for Early Childhood which could be seen as infant versions of IQ tests, and Fagan Test of Infant Intelligence (FTII) which tests recognition memory.

Finally, some common school readiness tests are: Developmental Indicators for the Assessment of Learning-III (DIAL-III) which assesses motor, cognitive, and language skills, Denver II which tests motor, social, and language skills, and Home Observation for Measurement of Environment (HOME) which is a measure of the extent to which a child’s home environment facilitates school readiness.

Infant and preschool assessments, since they do not predict later childhood nor adult abilities, are mainly useful for testing if a child is experiencing developmental delay or disabilities. They are also useful for testing individual intelligence and ability, and, as aforementioned, there are some specifically designed to test school readiness and determine which children may struggle more in school.

Personality tests

Psychological measures of personality are often described as either objective tests or projective tests. The terms "objective test" and "projective test" have recently come under criticism in the Journal of Personality Assessment. The more descriptive "rating scale or self-report measures" and "free response measures" are suggested, rather than the terms "objective tests" and "projective tests," respectively.

Objective tests (Rating scale or self-report measure)

Objective tests have a restricted response format, such as allowing for true or false answers or rating using an ordinal scale. Prominent examples of objective personality tests include the Minnesota Multiphasic Personality Inventory, Millon Clinical Multiaxial Inventory-IV, Child Behavior Checklist, Symptom Checklist 90 and the Beck Depression Inventory. Objective personality tests can be designed for use in business for potential employees, such as the NEO-PI, the 16PF, and the OPQ (Occupational Personality Questionnaire), all of which are based on the Big Five taxonomy. The Big Five, or Five Factor Model of normal personality, has gained acceptance since the early 1990s when some influential meta-analyses (e.g., Barrick & Mount 1991) found consistent relationships between the Big Five personality factors and important criterion variables. 

Another personality test based upon the Five Factor Model is the Five Factor Personality Inventory – Children (FFPI-C.).

Projective tests (Free response measures)

Projective tests allow for a freer type of response. An example of this would be the Rorschach test, in which a person states what each of ten ink blots might be.

Projective testing became a growth industry in the first half of the 1900s, with doubts about the theoretical assumptions behind projective testing arising in the second half of the 1900s. Some projective tests are used less often today because they are more time consuming to administer and because the reliability and validity are controversial.

As improved sampling and statistical methods developed, much controversy regarding the utility and validity of projective testing has occurred. The use of clinical judgement rather than norms and statistics to evaluate people's characteristics has raised criticism that projectives are deficient and unreliable (results are too dissimilar each time a test is given to the same person). However, as more objective scoring and interpretive systems supported by more rigorous scientific research have emerged, many practitioners continue to rely on projective testing. Projective tests may be useful in creating inferences to follow up with other methods. The most widely used scoring system for the Rorschach is the Exner system of scoring. Another common projective test is the Thematic Apperception Test (TAT), which is often scored with Westen's Social Cognition and Object Relations Scales and Phebe Cramer's Defense Mechanisms Manual. Both "rating scale" and "free response" measures are used in contemporary clinical practice, with a trend toward the former.

Other projective tests include the House-Tree-Person test, the Animal Metaphor Test.

Sexological tests

The number of tests specifically meant for the field of sexology is quite limited. The field of sexology provides different psychological evaluation devices in order to examine the various aspects of the discomfort, problem or dysfunction, regardless of whether they are individual or relational ones.

Direct observation tests

Although most psychological tests are "rating scale" or "free response" measures, psychological assessment may also involve the observation of people as they complete activities. This type of assessment is usually conducted with families in a laboratory, home or with children in a classroom. The purpose may be clinical, such as to establish a pre-intervention baseline of a child's hyperactive or aggressive classroom behaviors or to observe the nature of a parent-child interaction in order to understand a relational disorder. Direct observation procedures are also used in research, for example to study the relationship between intrapsychic variables and specific target behaviors, or to explore sequences of behavioral interaction. 

The Parent-Child Interaction Assessment-II (PCIA) is an example of a direct observation procedure that is used with school-age children and parents. The parents and children are video recorded playing at a make-believe zoo. The Parent-Child Early Relational Assessment is used to study parents and young children and involves a feeding and a puzzle task. The MacArthur Story Stem Battery (MSSB) is used to elicit narratives from children. The Dyadic Parent-Child Interaction Coding System-II tracks the extent to which children follow the commands of parents and vice versa and is well suited to the study of children with Oppositional Defiant Disorders and their parents.

Interest tests

Psychological tests to assess a person’s interests and preferences. These tests are used primarily for career counseling. Interest tests include items about daily activities from among which applicants select their preferences. The rationale is that if a person exhibits the same pattern of interests and preferences as people who are successful in a given occupation, then the chances are high that the person taking the test will find satisfaction in that occupation. A widely used interest test is the Strong Interest Inventory, which is used in career assessment, career counseling, and educational guidance.

Aptitude tests

Psychological tests measure specific abilities, such as clerical, perceptual, numerical, or spatial aptitude. Sometimes these tests must be specially designed for a particular job, but there are also tests available that measure general clerical and mechanical aptitudes, or even general learning ability. An example of an occupational aptitude test is the Minnesota Clerical Test, which measures the perceptual speed and accuracy required to perform various clerical duties. Other widely used aptitude tests include Careerscope, the Differential Aptitude Tests (DAT), which assess verbal reasoning, numerical ability, abstract Reasoning, clerical speed and accuracy, mechanical reasoning, space relations, spelling and language usage. Another widely used test of aptitudes is the Wonderlic Test. These aptitudes are believed to be related to specific occupations and are used for career guidance as well as selection and recruitment.

Biographical Information Blank

The Biographical Information Blanks or BIB is a paper-and-pencil form that includes items that ask about detailed personal and work history. It is used to aid in the hiring of employees by matching the backgrounds of individuals to requirements of the job.

Test security

Many psychological tests are generally not available to the public, but rather, have restrictions both from publishers of the tests and from psychology licensing boards that prevent the disclosure of the tests themselves and information about the interpretation of the results. Test publishers consider both copyright and matters of professional ethics to be involved in protecting the secrecy of their tests, and they sell tests only to people who have proved their educational and professional qualifications to the test maker's satisfaction. Purchasers are legally bound from giving test answers or the tests themselves out to the public unless permitted under the test maker's standard conditions for administration of the tests.

The International Test Commission (ITC), an international association of national psychological societies and test publishers, publishes the International Guidelines for Test Use, which prescribes to "protect the integrity" of the tests by not publicly describing test techniques and by not "coaching individuals" so that they "might unfairly influence their test performance."

Hypochondriasis

From Wikipedia, the free encyclopedia

Hypochondriasis
Other names	Hypochondria, health anxiety (HA), illness anxiety disorder, somatic symptom disorder
Specialty	Psychiatry, psychology
Treatment	Cognitive behavioral therapy
Medication	SSRI, antidepressants
Frequency	~5%

Hypochondriasis or hypochondria is a condition in which a person is excessively and unduly worried about having a serious illness. An old concept, its meaning has repeatedly changed due to redefinitions in its source metaphors. It has been claimed that this debilitating condition results from an inaccurate perception of the condition of body or mind despite the absence of an actual medical diagnosis. An individual with hypochondriasis is known as a hypochondriac. Hypochondriacs become unduly alarmed about any physical or psychological symptoms they detect, no matter how minor the symptom may be, and are convinced that they or others have, or are about to be diagnosed with, a serious illness.

Often, hypochondria persists even after a physician has evaluated a person and reassured them that their concerns about symptoms do not have an underlying medical basis or, if there is a medical illness, their concerns are far in excess of what is appropriate for the level of disease. Many hypochondriacs focus on a particular symptom as the catalyst of their worrying, such as gastro-intestinal problems, palpitations, or muscle fatigue. To qualify for the diagnosis of hypochondria the symptoms must have been experienced for at least 6 months.

The DSM-IV-TR defines this disorder, "Hypochondriasis", as a somatoform disorder and one study has shown it to affect about 3% of the visitors to primary care settings. The 2013 DSM-5 replaced the diagnosis of hypochondriasis with the diagnoses of "somatic symptom disorder" and "illness anxiety disorder".

Hypochondria is often characterized by fears that minor bodily or mental symptoms may indicate a serious illness, constant self-examination and self-diagnosis, and a preoccupation with one's body. Many individuals with hypochondriasis express doubt and disbelief in the doctors' diagnosis, and report that doctors’ reassurance about an absence of a serious medical condition is unconvincing, or short-lasting. Additionally, many hypochondriacs experience elevated blood pressure, stress, and anxiety in the presence of doctors or while occupying a medical facility, a condition known as "white coat syndrome". Many hypochondriacs require constant reassurance, either from doctors, family, or friends, and the disorder can become a debilitating challenge for the individual with hypochondriasis, as well as their family and friends.^[8] Some hypochondriacal individuals completely avoid any reminder of illness, whereas others frequently visit medical facilities, sometimes obsessively. Some sufferers may never speak about it.

Signs and symptoms

Hypochondriasis is categorized as a somatic amplification disorder—a disorder of "perception and cognition"—that involves a hyper-vigilance of situation of the body or mind and a tendency to react to the initial perceptions in a negative manner that is further debilitating. Hypochondriasis manifests in many ways. Some people have numerous intrusive thoughts and physical sensations that push them to check with family, friends, and physicians. For example, a person who has a minor cough may think that they have tuberculosis. Or sounds produced by organs in the body, such as those made by the intestines, might be seen as a sign of a very serious illness to patients dealing with hypochondriasis.

Other people are so afraid of any reminder of illness that they will avoid medical professionals for a seemingly minor problem, sometimes to the point of becoming neglectful of their health when a serious condition may exist and go undiagnosed. Yet others live in despair and depression, certain that they have a life-threatening disease and no physician can help them. Some consider the disease as a punishment for past misdeeds.

Hypochondriasis is often accompanied by other psychological disorders. Bipolar disorder, clinical depression, obsessive-compulsive disorder (OCD), phobias, and somatization disorder are the most common accompanying conditions in people with hypochondriasis, as well as a generalized anxiety disorder diagnosis at some point in their life.

Many people with hypochondriasis experience a cycle of intrusive thoughts followed by compulsive checking, which is very similar to the symptoms of obsessive-compulsive disorder. However, while people with hypochondriasis are afraid of having an illness, patients with OCD worry about getting an illness or of transmitting an illness to others. Although some people might have both, these are distinct conditions.

Patients with hypochondriasis often are not aware that depression and anxiety produce their own physical symptoms, and mistake these symptoms for manifestations of another mental or physical disorder or disease. For example, people with depression often experience changes in appetite and weight fluctuation, fatigue, decreased interest in sex and motivation in life overall. Intense anxiety is associated with rapid heartbeat, palpitations, sweating, muscle tension, stomach discomfort, dizziness, and numbness or tingling in certain parts of the body (hands, forehead, etc.).

If a person is ill with a medical disease such as diabetes or arthritis, there will often be psychological consequences, such as depression. Some even report being suicidal. In the same way, someone with psychological issues such as depression or anxiety will sometimes experience physical manifestations of these affective fluctuations, often in the form of medically unexplained symptoms. Common symptoms include headaches; abdominal, back, joint, rectal, or urinary pain; nausea; fever and/or night sweats; itching; diarrhea; dizziness; or balance problems. Many people with hypochondriasis accompanied by medically unexplained symptoms feel they are not understood by their physicians, and are frustrated by their doctors’ repeated failure to provide symptom relief.

Diagnosis

The ICD-10 defines hypochondriasis as follows:

A. Either one of the following:

• A persistent belief, of at least six months' duration, of the presence of a minimum of two serious physical diseases (of which at least one must be specifically named by the patient).
• A persistent preoccupation with a presumed deformity or disfigurement (body dysmorphic disorder).

B. Preoccupation with the belief and the symptoms causes persistent distress or interference with personal functioning in daily living, and leads the patient to seek medical treatment or investigations (or equivalent help from local healers).

C. Persistent refusal to accept medical advice that there is no adequate physical cause for the symptoms or physical abnormality, except for short periods of up to a few weeks at a time immediately after or during medical investigations.

D. Most commonly used exclusion criteria: not occurring only during any of the schizophrenia and related disorders (F20–F29, particularly F22) or any of the mood disorders (F30–F39).

The DSM-IV defines hypochondriasis according to the following criteria:

A. Preoccupation with fears of having, or the idea that one has, a serious disease based on the person's misinterpretation of bodily symptoms.
B. The preoccupation persists despite appropriate medical evaluation and reassurance.
C. The belief in Criterion A is not of delusional intensity (as in Delusional Disorder, Somatic Type) and is not restricted to a circumscribed concern about appearance (as in Body Dysmorphic Disorder).
D. The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
E. The duration of the disturbance is at least 6 months.
F. The preoccupation is not better accounted for by Generalized Anxiety Disorder, Obsessive-Compulsive Disorder, Panic Disorder, a Major Depressive Episode, Separation Anxiety, or another Somatoform Disorder.

The newly published DSM-5 replaces the diagnosis of hypochondriasis with "illness anxiety disorder".

Cause

Hypochondria is currently considered a psychosomatic disorder, as in a mental illness with physical symptoms. Cyberchondria is a colloquial term for hypochondria in individuals who have researched medical conditions on the Internet. The media and the Internet often contribute to hypochondria, as articles, TV shows and advertisements regarding serious illnesses such as cancer and multiple sclerosis often portray these diseases as being random, obscure and somewhat inevitable. Inaccurate portrayal of risk and the identification of non-specific symptoms as signs of serious illness contribute to exacerbating the hypochondriac’s fear that they actually have that illness.

Major disease outbreaks or predicted pandemics can also contribute to hypochondria. Statistics regarding certain illnesses, such as cancer, will give hypochondriacs the illusion that they are more likely to develop the disease.

Overly protective caregivers and an excessive focus on minor health concerns have been implicated as a potential cause of hypochondriasis development.

It is common for serious illnesses or deaths of family members or friends to trigger hypochondria in certain individuals. Similarly, when approaching the age of a parent's premature death from disease, many otherwise healthy, happy individuals fall prey to hypochondria. These individuals believe they are suffering from the same disease that caused their parent's death, sometimes causing panic attacks with corresponding symptoms.

Family studies of hypochondriasis do not show a genetic transmission of the disorder. Among relatives of people suffering from hypochondriasis only somatization disorder and generalized anxiety disorder were more common than in average families. Other studies have shown that the first degree relatives of patients with OCD have a higher than expected frequency of a somatoform disorder (either hypochondriasis or body dysmorphic disorder).

Treatment

Most research indicates that cognitive behavioral therapy (CBT) is an effective treatment for hypochondriasis. Much of this research is limited by methodological issues. A small amount of evidence suggests that selective serotonin reuptake inhibitors can also reduce symptoms, but further research is needed. In some cases, hypochondriasis responds well to antipsychotics, particularly the newer atypical antipsychotic medications.

Etymology

Among the regions of the abdomen, the hypochondrium is the uppermost part. The word derives from the Greek term ὑποχόνδριος hypokhondrios, meaning "of the soft parts between the ribs and navel" from ὑπό hypo ("under") and χόνδρος khondros, or cartilage (of the sternum). Hypochondria in Late Latin meant "the abdomen".

The term hypochondriasis for a state of disease without real cause reflected the ancient belief that the viscera of the hypochondria were the seat of melancholy and sources of the vapor that caused morbid feelings. Until the early 18th century, the term referred to a "physical disease caused by imbalances in the region that was below your rib cage" (i.e., of the stomach or digestive system). For example, Robert Burton's The Anatomy of Melancholy (1621) blamed it "for everything from 'too much spittle' to 'rumbling in the guts'".

Immanuel Kant discussed hypochondria in his 1798 book, Anthropology like this:

The disease of the hypochondriac consists in this: that certain bodily sensations do not so much indicate a really existing disease in the body as rather merely excite apprehensions of its existence: and human nature is so constituted – a trait which the animal lacks – that it is able to strengthen or make permanent local impressions simply by paying attention to them, whereas an abstraction – whether produced on purpose or by other diverting occupations – lessen these impressions, or even effaces them altogether.

• Anthropology by Immanuel Kant, 1798 Journal of Speculative Philosophy Vol. XVI edited by William Torrey Harris p. 395-396