Handbook of Health Psychology

By Andrew Baum; Tracey A. Revenson et al. | Go to book overview

Illness Cognition, Self-Regulation, and Practice

An important next step for the self-regulation model is to demonstrate its utility for the development and empirical testing of educational and therapeutic interventions. These interventions should be based on the concepts defining illness representations and should incorporate ideas as to how representations shape coping procedures. The presentations should make use of concrete (i.e., perceptual) as well as abstract material in order to fully engage participants' underlying schemata of illness and procedural strategies and tactics. The material must be skillfully designed to appeal to these cognitive structures and to meld them with the ecological and biological realities of potential or actual health threats. The participant in self-management has to learn how to determine whether specific, somatic symptoms and declines in feelings of vigor or pleasure define the presence of illness, and they must learn when to seek professional assistance in clarifying their perceived cause and meaning. Kovatchev, Cox, Gonder-Frederick and Schlundt (1998) offered a path to interventions in their analysis of the transitions involved in diabetic's use of symptoms to achieve control over blood sugar levels. When in treatment, patients must learn how to share information and develop realistic expectations about the consequences of disease and specific treatments, and they must learn how to be sensitive to the meaning of “side effects” and the time lines for effective outcomes. Professional or self-care procedures for the management of disease threats may change subjective experience and lead to increasing differentiation of the representation of a disease, (as with the separation of the symptoms from the underlying disease by patients with rheumatoid arthritis), and the differentiation of the positive and negative effects of treatment. A critical question is whether the model can be used to help patients shape these changes to enhance their ability to minimize the destructive impact of disease on their physical, emotional, and social well being; that is, can people be helped to live with chronic disease rather than be overwhelmed by it? If the self-regulation model adds to our understanding of the processes involved in avoiding and adapting to health threats and assists us in facilitating effective adaptations, it will vindicate the effort and time spent in its development.


Preparation of this chapter was supported by grants AG 03501 and AG12072.


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