1.1 Psychological view of health and disease 1.1 Psychological view of health ① physical, intellectual and emotional harmony; ② adapt to the environment, interpersonal relationships can be humble to each other; ③ have a sense of well-being; ④ in professional work, can give full play to their abilities, and live an efficient life. Maslow and Mittelman have proposed ten criteria: ① Adequate sense of self-security; ② Adequate understanding of oneself and proper evaluation of one’s abilities; ③ Realistic life ideals; ④ Not detached from the surrounding reality; ⑤ Able to maintain the integrity and harmony of personality; ⑥ Good at learning from experience; ⑦ Able to maintain good interpersonal relationships; ⑧ Able to moderately vent (8) can vent emotions and control emotions; (9) can give limited play to individuality while conforming to the requirements of the group; (10) can appropriately meet the basic needs of individuals without violating social norms. 1.2 Psychologically Oriented View of Illness The psychologically oriented view of illness focuses on the psychological aspects of illness and considers human illness to be not only physical but also psychological (mental illness). For more than one hundred years, psychiatrists and clinical psychologists have made fine observations and descriptions of the psychological symptoms of patients with mental illness, including consciousness, perception, thinking, emotion, behavior, intelligence and other aspects, and many specialized terms and nomenclature have been coined and applied. These psychological symptoms are the main basis for diagnosing mental disorders. 1.3 Psychologically Oriented View of Subhealth The psychologically oriented view of subhealth considers subhealth to be an intermediate state between mental health and mental illness. It can also be called psychological subhealth. Specifically, psychologically oriented subhealth refers to the psychological and behavioral effects of stress or post-stress effects that occur when and after people are under stress. This effect can make people’s psychology and behavior deviate slightly from the normal track, but not to the extent of psychological (mental) illness. The severity of this effect varies due to the different intensity of stress and the different psychological qualities of individuals. 2, the causes of the formation of sub-health 2.1 stress factors Modern life is fast-paced, knowledge is updated quickly, and competition is fierce. While society provides people with more opportunities for development and space for choice, it also brings more risks and pressure. People hope to keep pace with the times, win in the competition and become successful, they have to study hard, perfect themselves desperately, improve their ability and quality; even if a person does his best and dare not slacken, he cannot guarantee that he will be successful because others are equally hardworking and diligent, even more so than himself. Such real or imagined dangerous scenarios can cause stress, and continuous stress can have adverse effects on a person’s physical and mental health, as many clinical experiences and laboratory experiments have shown; the organism under certain stress has to produce a series of physical and mental reactions. 2.2 Personality factors Psychology has a wide range of in-depth research on personality, different scholars have different theoretical elaboration, but all try to reveal the activity law of personality. For example, psychologist Eysenck (Eysenck) uses four dimensions to represent personality characteristics, they are inward and outward, mental quality, neuroticism, and degree of concealment. From the dimension of introversion and extroversion people can be classified as introverted or extroverted. People with extroverted characteristics are lively, like to interact with people, have a wide range of interests and adaptability, and therefore tend to increase the efficiency of his behavior under pressure. Like to take risks and excitement, sometimes even like to find some risky accidents. Introverts are quiet, introspective, and have good insight into others and themselves. They don’t like to go to extremes, often make decisions after careful consideration, and do things in an organized manner. Extroverts are likely to be more responsive and effective when it comes to unexpected events. In contrast, introverts are likely to be more solid and careful in their daily lives. There is also a study that divides personalities into Type A and Type B. Type A personalities are those who pursue a fast pace, have a sense of time urgency, like power and domination, enjoy challenges and attacks, are result-oriented, desire success, and are not willing to be beneath others. This kind of person is also rushing to see the park and then running to the front, and constantly urging their swimming partners to hurry up. Such a personality may have an advantage in competition, but cannot enjoy relaxation and leisure. Type B personality is not very competitive, likes to live a slow-paced life, is less concerned with possession and domination, and has less aggression and hostility. However, he has a strong ability to deal with stress and enjoys leisure and ease. Some researchers observed the physical and mental health level of these two types of people and found that Type A personalities are more likely to suffer from coronary heart disease and cardiovascular disease. 2.3 Self-perception Self-perception should be understood as the subjectivization of objective stimuli, both the stimuli have to be subjectively evaluated by the individual before they have an effect on the human psyche. However, people will not reflect the object like a child, each person has their own value system, cognitive system, emotional activity tendencies, so they will make an amplified or reduced evaluation of the stimulus, and then make a behavioral response. If a person is extremely concerned about his health, he will react to the slightest discomfort of physical signs, think he may be sick, and then go to the hospital for examination. This has the advantage of early detection and early treatment of disease. The disadvantage is high alertness, consumption of unnecessary energy, and poor internal experience; an extreme example of this concern is hypochondria. Conversely, some people do not take their bodies seriously, are dull of sensation, and are oblivious to some discomfort. The advantage is that they feel good about themselves; the disadvantage is that they can ignore meaningful information and even miss the best time to treat their illness. A similar phenomenon exists for reactions to people and things, with sensory hypersensitivity on one side and sensory dullness on the other. People who are sensory-allergic can feel the slightest change in a person or object, and many artists have very acute senses, yet they are able to express these feelings in art form and find a healthy outlet for their intense inner feelings and experiences. However, many people are not so fortunate. They are anxious, tense, and worried about others’ opinions of them, and they are overly concerned about the outcome of things and are incapable of controlling it, so they experience extreme pain inside. In severe cases, they interpret neutral, irrelevant stimuli as harmful to them, which is the meaning of the idiom of “catching the wind and catching the shadow”. People with dull senses may not feel subtle changes, which helps them feel balanced and often feel good about themselves, but it is difficult to understand the meaning beyond the words and the meaning beyond the strings, and they are less introspective and lose a lot of information that is meaningful to them in reality. This shows that people have a tendency to amplify or minimize their responses to stimuli and to influence their self-perceptions to some extent. It is difficult to say which tendency is good, a person can better recognize their own tendency, understand the characteristics of this tendency, and try to overcome the weaknesses of this tendency, he can maintain their good self-perception. People in a state of stress, suffering setbacks or psychological conflict, will intentionally or unintentionally use some methods to make certain changes in their relationship with reality, so that it becomes easy to accept and does not cause too much psychological tension and pain, in order to maintain a quiet mood, psychological balance, in psychology called psychological defense mechanism (also known as defense mechanism). Common psychological defense mechanisms are: rationalization, repression, projection, transference, sublimation, etc. By denying the value of the event itself in exchange for psychological balance, and conversely for their own things, they are considered to be good and valuable, and if they do not get grapes and currently only have lemons, then they determine that lemons are sweet. The appropriate application of defense mechanisms can make a person in a strong psychological stimulation, so that the mood is tranquil and helpful in maintaining a good sense of self. If the defense mechanism is used excessively, always by distorting the facts, denying objectivity and other means to maintain the psychological balance, it will easily cause psychological degeneration and immaturity, which is not conducive to psychological development and personality maturity. 3. Psychological clinical manifestations of subhealth 3.1 Depression 3.2 Anxiety 3.3 Obsessive-compulsive 3.4 Fear 3.5 Paranoia 3.6 Hostility 3.7 Suspicion 3.8 Loneliness 3.9 Inferiority complex 3.10 Light-heartedness 3.11 Jealousy 3.12 Sense of helplessness 3.13 Sense of discrimination and rejection 3.14 Mental fatigue 4. Psychological assessment of subhealth The psychological assessment of subhealth should include the general assessment of psychological status, personality traits, intelligence, memory and social adaptation, etc. The assessment methods can also be divided into self-assessment, assessment by others (family members and acquaintances) and assessment by professionals. This book only introduces several subhealth assessment methods, which do not fully explain the subhealth status of an individual, but are based on other methods, such as knowing one’s physical health status before assessing one’s psychological status, for example, blood pressure measurement and blood lipid test, because we know that one’s psychological status is closely related to one’s physical status and social adaptation. However, generally speaking, if a person’s psychological assessment is somewhat “over the top”, the likelihood of psychological subhealth is higher. This scale has 80 items with a wide range of psychiatric symptoms, ranging from feelings, emotions, thinking, consciousness, behavior, life habits, interpersonal relationships, eating and sleeping, etc. Each item is rated on a 5-point scale, and the term “affect” is used here. This includes pain and distress caused by feelings, as well as the impairment of psychosocial functioning caused by feelings. The specific definitions of “mild”, “moderate” and “severe” should be experienced by the evaluators themselves, and there is no need to make rigid rules. 4.1.2 There are two main statistical indicators, i.e., total score and factor score. ① Total score: the sum of 80 items grouped individually, which reflects the severity of the disease. Total mean score: the total score of 80, indicating which score degree the subject’s self-perception is located between 1~5 levels from the overall situation. Number of positive items: the number of items with a single score ≥ 1.6, indicating the number of items on which the subject presents “feelings”. The number of negative items: the number of items with a single score = 1, indicating the number of items in which the subject “does not feel”. Mean score of positive feelings: (total score – number of negative items)/number of positive items, indicating the average score of the test subject in the “feeling” items. This reflects the range of severity of the items in which the participant does not feel good about himself/herself. ② Factor score: There are 9 factors, i.e. all 80 items are divided into 9 categories, each factor reflects a certain aspect of the subject’s situation, so the factor score can be used to understand the distribution of the subject’s feelings, and can be used for Frofile analysis. 4.1.3 The scale is suitable for the assessment of mental health of adults. According to the research experience of domestic scholars, this scale has good self-assessment effect and can quickly understand people’s mental health. Those with a total score of more than 115~139 are considered subhealthy, and those with 30~37 positive items or any factor score between 1.6-1.9 can be considered subhealthy and need further examination. 4.2 Self-Rating Anxiety Scale (SAS) The Self-Rating Anxiety Scale (SAS) was developed by Zung in 1971. It is a self-rating scale containing 20 items divided into four levels to assess the severity of anxiety and its change in treatment. According to the Chinese normative results, the total crude score of the anxiety self-assessment scale is capped at 40, with a standard score of 50. The total crude score for the subnormal state was 30-90, and the standard score was between 38-48. Application evaluation: Foreign studies have concluded that the SAS can more accurately reflect the subjective feelings of people with anxiety tendencies. Anxiety, on the other hand, is a more common mood disorder in counseling clinics. In recent years, the SAS has been used as a self-assessment tool to understand anxiety status in counseling clinics. 4.3 Self-Rating Depression Scale (SDS) The Self-Rating Depression Scale (SDS) was published by W.K Zung in 1965 to assess the severity of depressive states and their changes in treatment. According to the Chinese normative results, the upper limit of the total crude score of the Self-Rating Depression Scale is 41, and the standard score is 53. The total crude score of the SDS was 31-40, and the standard score was between 39-52. Application evaluation: SDS is a self-assessment scale of knowledge process, which is easy to operate and easy to grasp, and can effectively reflect the symptoms related to depressive state and its severity and changes, especially suitable for general hospitals to detect depressed patients. 4.4 Self-Rating Scale of Sub-Health Status (SRSHS) This scale was developed by the authors, consisting of 30 questions, divided into three factors: physical, psychological, and social functioning. The test subjects were asked to evaluate each item according to their personal feelings in the past month, and they were classified into 5 levels: “none”, “very mild”, “moderate”, “severe” and “serious”. There were 10 questions asking about physical discomfort; 15 questions about psychological problems, including depression, distress, fatigue, loss of help, low self-esteem, despair, fear, anger, and irritability; and 5 questions about impaired social functioning. The higher the score, the worse the health condition. The selected subjects had no physical diseases and no mental disorders, which were consistent with the distribution of the population and the definition of the concept of subhealth revealed by the subhealth study. The scale had good reliability and validity. When subjects were enrolled, they were excluded from suffering from somatic diseases and mental disorders, so they were considered to be in a healthy or subhealthy state. We arranged the corresponding entries from somatic, psychological, and social aspects, and rated them according to five levels, with indicators consisting of total and factor scores, and we defined the more complete state as 30-39 points; the subhealthy state as 40-69 points; and the disease state as 70 points or more. The compilation process refers to a large number of research materials, plus our clinical experience, and strives to reflect the situation of people in sub-health, but also strives to be simple and easy to use.