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Chapter 16

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PSYC 3110
Kieran O' Doherty

Chapter 16  Cognitive Approaches o Illness Perceptions Howard Leventhal and his colleagues were the ones to develop the most current and in depth model of cognitive  model of illness.  This was derived from their work on impact of fear communication.  They found that, irrespective of fear, the message conveyed was effective if it produced a plan of action. This ultimately led them to infer that the key factor was the way the threat was presented or understood.  They developed the dual processing model to accommodate the representation of fear and of the threat (this model has been inspirational and has gone through some changes and elaborations by Leventhal). o Dual Processing Model  Basically the model suggests that when we are faced with a threat, the person forms a cognitive and emotional representation to that particular threat. They cope with the threat depending upon the character of the threat representation. The consequences of these coping strategies will then be appraised and the representations and coping strategies are  revised accordingly. o The Leventhal Group  The dual processing model led to the Leventhal group exploring how lay people represented specific threats such as illness.  They conducted open ended interviews with a sample of patients suffering from various diseases.  From the information that they were able to gather, they proposed a self-regulation model of illness that suggested that lay people's thoughts on illness could be organized along four dimensions.  Since the information was derived from individuals that had acute illness, Lau and Hartman (1983) proposed that a fifth dimension be created in order to cover those that are not already ill.  The five dimensions that were created are often coined as the Common Sense Model (CSM) of illness.  Identity -signs, symptoms and the illness label.  Consequence - the perceived physical, social and economic consequences of the disease and the felt emotional consequences.  Causes - the perceived causes of the disease.  Time line - the perceived time frame for the development and duration of the illness threat.  Cure/Contro l - the extent to which illness is responsive to treatment. o Illness Perception Questionnaire (IPQ) by Weinman, Petrie, Moss-Morris and Horne (1996)  Meant to measure the original five dimensions as stated above.  This actual measure has been used extensively on a wide range of populations with varying degrees of success.  In was found that popular illness beliefs are largely formed by information that is gathered before illness sets in. o Illness Perception Questionnaire Revised (IPQ-R)  Introduced a measure of illness coherence and of emotional representations of illness.  It also divided the cure/control dimension into personal control and treatment control. This enabled researchers to distinguish between perceived control of the illness and perceived control of the treatment.  It has been generally agreed upon that this tool is to be used lightly according to the situation as opposed to assuming that it has universal validity.  Causes of Disease o The perceived cause of an illness is the central component of Leventhal's lay illness representations. o The attribution theoryis used to explain how lay people explain the onset of disease.  With this theory, people attempt to provide a causal explanation for events in their world particularly if those events are unexpected or have particular personal relevance. o Swartzman and Lees (1996)  They considered the character of the causal explanations of various physical symptoms. Initial classification suggested 14 different categories, but multidimensional scaling analysis of the scores suggested three dimensions that they be labeled;  Non-physical-physical Stable-unstable  iii. Controllable-uncontrollable
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