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Representations, Procedures, and Affect
in Illness Self-Regulation:
A Perceptual-Cognitive Model
Howard Leventhal
Rutgers University
Elaine A. Leventhal
Robert Wood Johnson School of Medicine
Linda Cameron
University of Auckland
The explosion of research in health psychology over the past 40 years has been accompanied by the proliferation of a variety of theoretical models to help find a better understanding of the reciprocal relations between health and behavior. One set of models that has been used for the analysis of behaviors to promote health and treat and adapt to disease (e.g., utility theories and social learning models) has focused on five types of variables: The cognitive processes involved in the perceptions of vulnerability to disease (Becker, 1974; Hochbaum, 1958; Janz & Becker, 1984; Rogers, 1983; Rosenstock, 1966); the availability of actions to manage threat and/or emotional reactions to it (Lazarus & Launier, 1978); intentions to act based on the perceptions of the barriers and benefits of particular actions for threat avoidance (Fishbein & Ajzen, 1974; Janz & Becker, 1984; Rosenstock, 1966); the views held by valued others respecting specific healthy and risky behaviors (Fishbein & Ajzen, 1974); and perceptions of self-competence or self-efficacy to perform these actions (Ajzen, 1988; Bandura, 1977; Clark & Zimmerman, 1990). To a substantial degree, these constructs are the inventions of the investigators (see Krasnegor, Epstein, Bennett-Johnson, & Yaffe, 1993; Leventhal & Cameron, 1987; Leventhal, Zimmerman, & Gutmann, 1984). This contrasts with a second set of models with names such as “self-regulation and adaptation” (Kanfer, 1977), “illness cognition” (Croyle & Barger, 1993), “mental representation in health and illness” (Skelton & Croyle, 1991), and “common- sense representation of illness danger” (Leventhal, Meyer, & Nerenz, 1980). These models, the focus of this chapter, make extensive use of constructs generated by their subjects (i.e., they incorporate the subjects' phenomenology into their scientific vocabulary). The approach reflects a long-standing tradition in social and personality psychology (e.g., Kelly, 1955; Lewin, 1935), and in studies of “folk illness” by medical anthropologists (e.g., Chrisman, 1977; Kleinman, 1980; Pachter, 1993; Simons, 1993). The variation in their names reflects differential emphasis on various features of self-regulation in acting to prevent, treat, cure, or adjust to acute or chronic illnesses. All of the models are driven by three fundamental themes: perceptionsRepresentations, Procedures, and Affect
in Illness Self-Regulation:
A Perceptual-Cognitive Model
Howard Leventhal
Rutgers University
Elaine A. Leventhal
Robert Wood Johnson School of Medicine
Linda Cameron
University of Auckland
| 1. | Individuals are conceptualized as active problem solv trying to make sense of potential or existent changes in |
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