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Illness Representations and Coping with Health Threats

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... One of the reasons that current medication adherence interventions are ineffective for Black adults is that their unique beliefs about diabetes have not yet been addressed (Shenolikar et al., 2006). In Leventhal's extended self-regulatory model, beliefs that an individual has about their disease strongly contribute to self-management behaviours (Leventhal & Steele, 1984). Black adults' perceptions of diabetes are linked with sociocultural factors such as self-identity, religious beliefs, and family influences (Shiyanbola, Ward, & Brown, 2018a). ...
... Black adult perceptions of diabetes were assessed using our culturally adapted IPQ-R, a validated measure capturing nine domains of illness representations. According to Leventhal's self-regulatory model, individuals represent their perceptions of illness along five dimensions: identity, consequence, cause, timeline, cure, and control (Leventhal & Steele, 1984). Our prior work further differentiated consequences into external and internal consequences (indicating two distinct influences of personal and significant others) (Shiyanbola et al., 2022). ...
... Last, findings from this study may be limited to participants' demographics, such as age and geographic region. Illness perceptions are highly dependent on individual past experiences, which may be determined by cultural backgrounds, significant events in the past, or neighbourhood influences (Leventhal & Steele, 1984). Future studies could integrate additional beliefs to expand the understanding of the overwhelming feelings of having diabetes and replicate the findings with a larger and more varied sample. ...
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Objectives This study explores the structure of beliefs about type 2 diabetes among Black adults and informs potential targets to reframe negative beliefs and enhance diabetes self‐management. Research Design and Methods We applied network analysis to investigate the interrelated structure and clusters of beliefs about diabetes and identify specific items that could serve as behavioural targets. We obtained self‐reported survey data from 170 Black adults with type 2 diabetes. Regularised partial correlation networks and a Gaussian graphical model were used to explore and visualise the interrelationship among 21 items of a culturally adapted Illness Perception Questionnaire‐Revised. Results Overwhelming negative emotions representing the current and long‐term effects of diabetes were central to the illness perceptions network among Black adults, with feeling depressed having the highest node strength of centrality indices in the network. Four beliefs had a bridging effect with the central cluster: diabetes taking away the ability to enjoy food, diabetes keeping me away from the job I want, being poor contributed to my having diabetes, and I receive encouragement from friends and family. Conclusions In addition to highlighting the overwhelming feeling of diabetes, the illness perception network further differentiated the role of racial identity and social determinants of health as discrete, though both are related sociocultural influence constructs. To enhance self‐management for Black adults with type 2 diabetes, this network informs promising intervention targets focused on culturally tailored education related to emotional regulation, internalised stigma and healthy food adaptation, and leveraging support to address social determinants of health.
... According to the Common-Sense Model of Illness Representations (CSM: also known as the Self-Regulation Model), illness perceptions comprise multiple dimensions. Individuals actively form seven cognitive representations of the illness when they encounter a health threat (e.g., symptoms and diagnosis), in order to understand and cope with the threat (Leventhal et al. (1980); Leventhal et al. (1984)). These dimensions are: (1) identityhow the illness and its symptoms are identified and labeled; (2) causethe perceived reasons why an illness develops; (3) timelinethe ideas about how long it will last; (4) consequencesthe emotional and functional effects on life; (5) control/cure, the extent to which a patient believes how controllable an illness is by the treatment and by themselves; (6) emotional representationsemotional responses towards the illness; and (7) coherencehow much individuals believe they understand their illness (Leventhal et al. (1980); Leventhal et al. (1984); Moss-Morris et al., 2002). ...
... Individuals actively form seven cognitive representations of the illness when they encounter a health threat (e.g., symptoms and diagnosis), in order to understand and cope with the threat (Leventhal et al. (1980); Leventhal et al. (1984)). These dimensions are: (1) identityhow the illness and its symptoms are identified and labeled; (2) causethe perceived reasons why an illness develops; (3) timelinethe ideas about how long it will last; (4) consequencesthe emotional and functional effects on life; (5) control/cure, the extent to which a patient believes how controllable an illness is by the treatment and by themselves; (6) emotional representationsemotional responses towards the illness; and (7) coherencehow much individuals believe they understand their illness (Leventhal et al. (1980); Leventhal et al. (1984); Moss-Morris et al., 2002). ...
... This exploratory study investigated parents' perceptions of their adolescents' ADHD and compared these perceptions with those of their diagnosed offspring, using the Common Sense Model (Leventhal et al. (1984)) as a theoretical framework. The correlates of perceptions of ADHD that diverge between parents and the offspring were also examined. ...
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Differences in the perceptions of illness between patients and caregivers are associated with negative health-related outcomes. However, little is known about the correlates of divergent perceptions of ADHD among diagnosed adolescents and their parents. This study applied the Common-Sense Model of Illness Representations (CSM) to examine how parent perceptions of ADHD, including divergent parent-adolescent perceptions, relate to coping, quality of life (QoL), and treatment adherence, among adolescents with ADHD. Participants were 63 adolescents diagnosed with ADHD (10–18 years, 79.3% male, mean age = 14.28, SD = 2.07) and their parents (78.8% mothers), recruited from clinics and support services. Self-report measures were completed by adolescents and parents in isolation from one another. Results from a series of hierarchical regressions indicated that adolescents held less pessimistic views of the disorder and believed it was less biologically based than did parents. Divergent parent-adolescent perceptions regarding timeline and causes were significantly related to adolescent coping and QoL. Adolescents’ expectation of a shorter duration of ADHD was associated with reduced active coping. Their stronger attribution to insufficient efforts was associated with lower QoL. Although adolescents with a stronger belief in psychosocial causes exhibited poorer active coping and QoL, they exhibited greater active coping when their parents endorsed this belief. Taken together, these findings identify beneficial and detrimental beliefs about ADHD for both diagnosed adolescents and their parents. The results underscore the potential importance of beliefs about psychosocial causes to coping and well-being, as well as the importance of divergent parent-adolescent perceptions.
... A partir de esta idea nuclear de la autorregulación, se han construido distintos modelos teóricos para la psicología de la salud. Uno de los más extendidos es el Modelo del Sentido Común de la Enfermedad de Howard Leventhal et al. (26,27) . Estos autores proponen que en el proceso autorregulatorio se activan esquemas cognitivos para dar sentido a lo que el paciente experimenta con la enfermedad (28) . ...
... Estos autores proponen que en el proceso autorregulatorio se activan esquemas cognitivos para dar sentido a lo que el paciente experimenta con la enfermedad (28) . Los esquemas cognitivos se nutren de diversas fuentes (esquemas aprendidos, información de medios de comunicación, aprendizajes vicarios, entre otros) y configuran una representación de la enfermedad (en adelante RE) que Leventhal llamó de sentido común (26,28) . En el estado de emergencia e incertidumbre experimentado en el peridiagnóstico, la comprensión del paciente sobre la naturaleza del cáncer, su pronóstico y consecuencias se construye a partir de esquemas cognitivos previamente adquiridos. ...
... Se hallaron diferencias con significación estadística y tamaño del efecto grande para las mediciones pre-post intervención de las dos escalas que conforman la valoración de la RE del paciente. Las puntuaciones elevadas en las escalas RCE y REE reflejan una comprensión del cáncer como enfermedad predominantemente asociada a la muerte y el sufrimiento (51,52) , lo que Leventhal identificó como comprensión de sentido común (26,28) . Estos datos aportan evidencia sobre la aplicabilidad y adecuación del MIPP para favorecer la modificación de la RE de sentido común, adoptando una RE más ajustada a la propia enfermedad (ver Figura 2). ...
Article
Introducción: El diagnóstico oncológico impacta en distintos aspectos de la vida del paciente. Su adaptación al cáncer debería ser evaluada en función del momento del curso oncológico, siendo la activación emocional (AE) y la representación de la enfermedad (RE)sus dos componentes medulares. Se diseñó una intervención psicooncológica centrada en la adaptación a la enfermedad para el peridiagnóstico, etapa del curso con características y demandas específicas. El objetivo del trabajo es presentar resultados derivados de la aplicación de un Modelo de Intervención Psicooncológica en el Peridiagnóstico (MIPP) en pacientes adultos. Método: Se realizó un estudio experimental aleatorizado de 50 pacientes recientemente diagnosticados (en la semana posterior a primera consulta con oncólogo), asistidos por el servicio de oncología del Hospital Ramón Santamarina (Tandil, Argentina). Se evaluó AE con DASS 21, REcon BIPQ-R y ajuste al cáncer con miniMAC, en el primer y último día de aplicación del protocolo. Resultados: Se obtuvieron diferencias estadísticas significativas positivas y tamaño del efecto grande en la comparación intergrupos (intervención/control) en las medidas pre/post para las variables AE y RE. En el análisis intragrupo (intervención) se mantuvo la significación estadística, con tamaño del efecto medio y grande. Conclusión: La implementación del MIPP resultó efectiva y relevante clínicamente para mejorar la adaptación a la enfermedad en la primera fase del curso oncológico en pacientes adultos.
... Additionally, according to Leventhal's self-regulation model (Leventhal et al., 1980(Leventhal et al., , 1984 self-regulation mechanisms are crucial for adapting to threats by activating coping strategies aligned with an effective use of available resources. Understanding people's behaviors during the pandemic and its potential effects on mental health indicators and well-being is essential for future directions. ...
... A particularly insight from this study is the significant role that compassionate social connections (e.g., helping others or video calls), and personal activities (e.g., reading and physical exercise) played in buffering stress and enhancing wellbeing during the pandemic. Within the theoretical proposed by the Leventhal's self-regulation model (Leventhal et al., 1980(Leventhal et al., , 1984, understanding people's behaviors could be helpful to invest in health psychology strategies aiming at enhancing healthy habits (adaptive coping mechanisms) in Table 3 Mean (M), standard deviation (SD), and t-tests results of rumination, compassion and mindfulness based on the degree of utility of activities to deal with the lockdown (N = 238) ...
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Introduction The COVID-19 pandemic and lockdown experience required finding new resources and lifestyle changes. Understanding people’s behaviors during the pandemic and its potential effects on mental health indicators and well-being is essential for future directions. This study aimed to compare mental health symptoms during Portugal’s first lockdown with normative data, analyze the perceived utility of activities during this period, and explore how these perceptions related to individuals’ mental health indicators and emotion regulation processes (e.g., mindfulness and compassion). Methods A sample comprising 238 (186 women and 52 men) participants completed an online survey during the first lockdown of the COVID-19 pandemic in April (M1) and June (M2) 2020. The survey addressed the perceived utility of various activities to deal with the lockdown (e.g., exercise). It also included self-report measures of psychopathological symptoms and emotion regulation processes. Results No differences were found between depression and anxiety scores (at M1 and M2) and Portuguese normative pre-pandemic data. During the lockdown, perceived stress was higher than normative data. Reading, being outdoors, talking with friends, video calls, and helping others were scored as very useful. Mean comparisons of emotion regulation processes and psychopathological symptoms based on the utility of activities to deal with the lockdown were reported. Discussion Activities related to meaningful connections with others and personal activities may be encouraged as protective activities buffering the potentially harmful effect of isolation and external and uncontrollable threats. These findings highlighted the importance of promoting personal health behaviors and emphasize real social connections (e.g., social activities prescriptions).
... In general, there are five dimensions of the cognitive representations of IP: (1) beliefs about causes of the illness, i.e., ideas about its origin; (2) beliefs about consequences or the impact of the illness on life domains; (3) beliefs about the timeline, i.e., ideas about the duration of the illness; (4) beliefs about control of the illness or ideas about treatment and recovery; (5) and finally beliefs about identity or ideas of symptoms of the illness. On the other hand, emotional representations of IP comprise negative affects, such as fear or anger 9,10 . ...
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Illness perceptions (IP), as measured by the Brief Illness Perception Questionnaire (BIPQ), and adverse childhood experiences (ACE) have been shown to affect the physical and psychological well-being in different patient populations. However, little is known about IP and ACE in patients with an implantable cardioverter-defibrillator (ICD). Our objectives were to investigate the dimensional structure and to evaluate correlates of the BIPQ in ICD patients. 423 patients with an ICD were prospectively recruited. We conducted a principal component analysis to determine the dimensional structure of the BIPQ. Associations between ACE, other sociodemographic and clinical variables, and IP were analysed using a multivariable linear regression. We identified a two-factor structure (I = Consequences, II = Control) of the BIPQ. Among others, a higher number of ICD shocks in the past (0.21, 95% CI = 0.01–0.41, p = 0.036), low physical activity (-2.16, 95% CI = -4.37 to -0.37, p = 0.045), more frequent ACE (0.56, 95% CI = 0.08–1.22, p = 0.030), ICD shock-related concerns (0.75, 95% CI 0.62–0.89, p < 0.001), and primary ICD indication (-2.29, 95% CI -4.47 to -0.11, p = 0.039) were significantly associated with more threatening IP. The identification of those variables might lead to more precise interventions targeting maladaptive IP in this vulnerable patient population.
... The interview guide was designed with a phenomenological approach, with focus on experiences and perceptions rather than exploring theories participants had [17]. Some questions were loosely based on models of symptom perception for adults, such as the Common-Sense Model by Leventhal [21]. However, the interview guide was designed to allow space for new ideas. ...
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Background Preschoolers experience physical symptoms, like abdominal pain or minor injuries, almost every day. These experiences may shape how they deal with health issues later in life. To gain insight into these early life experiences, information from multiple perspectives is useful. This qualitative study aimed to explore important themes in preschoolers’ experience of physical symptoms, using adult professionals from various backgrounds as informants. Methods 20 semi-structured interviews were performed with professionals from different fields in healthcare and education, to learn about their ideas and observations on preschoolers’ experiences with physical symptoms. The interviews were verbatim transcribed and coded in Atlas.ti by two independent coders, after which thematic content analysis was applied to define themes. Results Three themes emerged from the interviews: unawareness, seeking attention, and parental influence. Unawareness refers to the professionals’ idea that preschoolers have limited cognitions about causes and consequences of physical symptoms. Seeking attention was described as important for preschoolers with symptoms, both as comfort and in a social context. Professionals described diminished attention-seeking behavior in preschoolers with more severe symptoms. Parental influence was seen as highly relevant in preschoolers’ experiences with physical symptoms, with both supportive and disruptive aspects. Healthcare professionals differed from educational professionals in their observations and ideas, especially about underlying mechanisms influencing symptoms. Conclusions Professionals report attention-seeking and parental influence as important factors in preschoolers with physical symptoms, and they report limited cognitions about causality. Professionals in healthcare and education show different perceptions, suggesting the importance of incorporating both views into research.
... [7][8][9] These include worry, a sense of perceived urgency, lack of knowledge, fear of consequences and views of family and friends. [10][11][12] The Common-Sense Model developed by Leventhal and colleagues [13][14][15] unfolds this mechanism, suggesting that individuals confronted with illness create dynamic organised patterns of lay perceptions about STRENGTHS AND LIMITATIONS OF THIS STUDY ⇒ Data collection was carried out in real time when presenting to the emergency department with acute somatic illness, minimising the risk of recall bias. ⇒ The study included a large sample size of 944 patients. ...
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Objectives The study aimed to investigate the correlation between illness perceptions and self-reported degree-of-worry (DOW) in patients presenting to the emergency department with acute somatic illness. Design A cross-sectional survey study collected data from a survey on DOW, the Brief-illness Perception Questionnaire (B-IPQ) and demographics. Setting An emergency department at a university hospital in the Capital Region of Denmark. Participants 944 patients (≥18 years) presenting to the emergency department with acute somatic illness. Data collection was conducted during day and evening shifts on weekdays from 13 January to 19 December 2020. Methods Correlations between B-IPQ scores and DOW, including (1) the total B-IPQ score, (2) emotional representations (emotion and illness concern combined) and (3) the single items, respectively. Secondary analysis : linear relationships between the single B-IPQ items and DOW. Analyses included the variables sex, age, reason for contact, self-reported comorbidity, employment, highest educational attainment, cohabitation status and region of origin. Results The study found moderate correlations between the total illness perceptions score and DOW of 0.47 (95% CI 0.42 to 0.52) and emotional representations and DOW of 0.57 (95% CI 0.52 to 0.61). Linear regression showed the largest and most significant changes in DOW with an increasing score of the B-IPQ items for consequence, illness concern and emotion. Conclusion Illness perceptions overall and perceptions of consequences of symptoms, illness concern and emotional representations are correlated with patients’ DOW, with increasing DOW related to more negative illness perceptions. This finding contributes to insight into how illness perceptions are related to illness worry when presenting to the emergency department. Incorporating the novel DOW scale may aid triage and clinical encounters in the emergency department. Study registration ClinicalTrails.gov reference: NCT04226040 .
Chapter
This chapter introduces crisis decision theory (CDT, Sweeny, Psychol Bull 134(1):61–76, 2008), as one of the few fitting psychology theories addressing crisis with applicability to sports. The focus of CDT lies in the responses to crises and in factors determining the response. It is based on the transactional model of stress (Lazarus and Folkman, Stress, appraisal, and coping, Springer Publishing Company, 1984) and the self-regulation model of illness (Leventhal et al., Illness representations and coping with health threats, Routledge, 1984), combined with research on decision-making. Originally, CDT addressed responses to different forms of crises with a specific focus on responses to illness diagnoses. The focus of this chapter is to apply the theory to sports. In the applied part of this chapter, a common example of a response to such a crisis is elaborated, the hiring and firing of coaches. A few teams of the English Premier League are examined more carefully. In many cases, the coach seems to be held responsible for poor team performance and is therefore let go. While firing the coach is often chosen as a response to poor performance, it may not always be the most efficacious and certainly not the only option. The present chapter aims to convey, in line with CDT, more response options need to be considered to deal with poor performance.
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