Gruis, Michael (2005) Mental Life and Medical Illness: A Study of General Practice Patients. PhD thesis, Victoria University.

Abstract

Most research on the mental life of medical patients has focused on personality characteristics said to influence the experience and reporting of physical symptoms. This is despite minimal support for personality as causally related to physical illness. The popularity of daydreaming (and dreaming) is widespread in the self-help market. Yet research definitions of mental life have seldom included imaginal activities. The aim of this research was to establish a health (and mental life) profile of patients in general practice to the west of Melbourne. The principal focus was to determine if the health of patients could be predicted by mental life. Two studies were conducted. The first study investigated mental life in the form of daydreaming. Patients, approached prior to their consultation with a general practitioner, completed the Short Form Health Survey (SF-36), Severity of Physical Symptoms Checklist (SPSC), Daydream Frequency Scale (DFS), and Short Imaginal Processes Inventory (SIPI). The mental health of the sample was below the norm in the general population. The physical health of males, but not females, was also below the norm. Most patients reported less frequent daydreaming. They did, nevertheless, report more negative daydreams (than the norm). Patients unable to maintain sufficient mental control reported more negative daydreams, but not more (or fewer) positive daydreams. More negative daydreams predicted lower mental health. Patients reported fewer positive daydreams than the norm, and more positive daydreams did not improve their mental health. These findings were only partially consistent with the research literature. The second study sought to explore these findings further by determining if they were mediated by life orientation. Patients completed the Revised Life Orientation Scale (LOT-R), in addition to the SF-36 and SIPI. There were important sex differences in relationships between measures of mental life and mental health. For females, more pessimism was related to more negative daydreams and predicted lower mental health. For males, insufficient mental control predicted lower mental health. Consistent with the first study, positive daydreams (and optimism in the second study) was not related to male or female mental health. Results for females support recent research indicating that it is pessimism, and not optimism, that is the principal determinant of mental health. It is clear, however, that much more research on the correlates of male mental health, and how these differ from those of females, is warranted. The findings of the present research suggest that daydreaming is not a mundane activity: rather it is an important dimension of mental life requiring further consideration in mental health research.

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