Biobehavioral Factors in Health & Disease

Older adult couple jogging on a nature path

Biobehavioral factors in health and disease refer to the interactions between biological processes and behavioral factors that influence an individual's health and susceptibility to disease. These factors recognize that health outcomes are not solely determined by biology such as genetics or pathophysiological processes, but also by psychological factors and health behaviors.

Some examples of biobehavioral and psychological factors include:

  • Lifestyle choices: Behaviors such as diet, physical activity, smoking, alcohol consumption, and substance abuse significantly impact an individual's health. Poor lifestyle choices can increase the risk of chronic diseases like obesity, cardiovascular disease, and certain types of cancer.
  • Stress and psychosocial factors: Psychological stress and social factors can have profound effects on health. Chronic stress can contribute to the development of various conditions, including cardiovascular disease, depression, and weakened immune function.
  • Health beliefs and attitudes: Individual beliefs, perceptions, and attitudes towards health and healthcare can influence health outcomes. Positive health beliefs, engagement in preventive behaviors, and adherence to treatment regimens can contribute to better health outcomes.
  • Social support: The presence of social networks and support systems can positively impact health. Strong social connections are associated with improved mental well-being and physical health outcomes, as they provide emotional support, resources, and encouragement for healthy behaviors.
  • Health behaviors and self-care: Individuals' engagement in health-promoting behaviors, such as regular exercise, proper nutrition, adequate sleep, taking medications as prescribed, and preventive healthcare, plays a significant role in maintaining overall health and preventing disease.
  • Cognitive and emotional factors: Cognitive abilities, such as decision-making and problem-solving skills, as well as emotional factors, such as optimism and resilience, can influence health outcomes. Positive cognitive and emotional states are associated with better-coping mechanisms and improved overall well-being.
  • Health disparities: Biobehavioral factors can contribute to health disparities among different population groups. Socioeconomic status, education level, access to healthcare, and discrimination can influence health behaviors, healthcare utilization, and health outcomes.

Understanding and addressing biobehavioral factors in health and disease requires a holistic approach that considers the interplay between biological, behavioral, psychological, and social determinants of health. By recognizing and addressing these factors, healthcare professionals can develop more effective strategies for promoting health, preventing disease, and improving overall well-being.

Duke University established one of the first behavioral medicine programs in the United States, beginning in the 1970s, based in the Department of Psychiatry and Behavioral Sciences. The program, which grew to national prominence and has maintained a reputation of preeminence for several decades, draws experts from psychology, medicine, nutrition, aging, mHealth innovations, and public health. 

Changes in lifestyle behaviors and health habits can improve quality of life, mitigate disease progression and reduce symptom burden across a broad range of health conditions, including cardiovascular diseases, depression, anxiety, cancer, chronic pain, insomnia, pulmonary disease, solid organ transplantation, and age-related cognitive impairment.

Our faculty working in this field develop and implement innovative behavioral interventions combining novel clinical research approaches, technological innovations, and empirically validated psychological treatments to promote adaptive coping skills, stress management, and healthy lifestyles designed to prevent or reduce the burden of chronic illnesses.​​​​

Representative Studies & Clinical Trials

  • Improving Lung Transplant Outcomes with Coping Skills and Physical Activity 
  • Sleep Quality and Mechanisms of Cardiovascular Risk in Adults with Hypertension
  • The Role of Stress in Blood Pressure Regulation
  • Effect of Reducing Posttraumatic Stress Disorder Symptoms on Cardiovascular Risk 
  • Insomnia Treatment to Reduce Cardiovascular Risk in Posttraumatic Stress Disorder
  • Genes, Environmental Stressors, and the Biobehavioral Pathways to CVD
  • The Role of Personality in Health and Disease in Middle and Later Life
  • Anger Management Training for Fire Fighters
  • Coping Skills Training in Patients with Heart Failure
  • Promoting Effective Self-Management of Chronic Pain with mHealth Neurofeedback
  • Neurocognition, Lifestyle Modification, and Treatment Resistant Hypertension
  • Exercise and Pharmacotherapy for Anxiety in Cardiac Patients
  • Exercise Training and Depression in Older Adults
  • Stress and Myocardial Ischemia: Mechanisms and Treatment
  • Biobehavioral Mechanisms of Blood Pressure Regulation
  • Exercise, Depression and Cardiac Risk  
  • Menopausal Effects on Cardiovascular Stress Responses
  • Heart Disease in Women: Estrogen Effects on Hemodynamics
  • Stress & Heart Failure: Prognosis and Mechanisms
  • Biobehavioral Mechanisms of Nighttime Blood Pressure Dipping
  • Behavioral Treatment of High Blood Pressure


Click on a faculty member’s name to view their profile, including their grants and publications.