Advertisement

Springer Nature is making Coronavirus research free. View research | View latest news | Sign up for updates

Illness cognition and behavior: An experimental approach

  • 268 Accesses

  • 58 Citations

Abstract

The study of illness cognition and behavior has relied primarily on nonexperimental research designs. In this paper we review the results of a program of experimental investigations of psychological reactions to health threats. Most of the studies employ a new experimental paradigm developed to study illness cognition and behavior in the laboratory. The paradigm has been used in several experiments to examine the cognitive and motivational processes underlying reactions to medical test results. A converging series of studies has shown that denial, manifested in a variety of ways, is a common initial reaction to threatening information. In addition, the studies demonstrate that the perceived prevalence of a health disorder is an important determinant of its perceived seriousness. The insights gained from these studies illustrate the complementary roles of basic experimental research and more naturalistic observational research in the formulation of comprehensive theories of health and illness behavior.

This is a preview of subscription content, log in to check access.

References

  1. Aronson, E., Brewer, M., and Carlsmith, J. M. (1985). Experimentation in social psychology. In Lindzey, G., and Aronson, E. (eds.),The Handbook of Social Psychology, 3rd ed., Vol. I, Random House, New York, pp. 441–486.

  2. Barondess, J. A. (1979). Disease and illness-A crucial distinction.Am. J. Med. 66: 375–376.

  3. Barsky, A. J., and Klerman, G. L. (1983). Overview: Hypochondriasis, bodily complaints and somatic styles.Am. J. Psychiat. 140: 273–283.

  4. Baumann, L. J., Cameron, L. D., Zimmerman, R. S., and Leventhal, H. (1989). Illness representations and matching labels with symptoms.Health Psychol. 8: 449–469.

  5. Bloom, J. R., and Monterossa, S. (1981). Hypertension labeling and well-being.Am. J. Public Health 71: 1228–1232.

  6. Bulman, R. J., and Wortman, C. B. (1977). Attributions of blame and coping in the “real world”: Severe accident victims react to their lot.J. Personal. Soc. Psychol. 35: 351–363.

  7. Carlsmith, J. M., Ellsworth, P. C., and Aronson, E. (1976).Methods of Research in Social Psychology, Addison-Wesley, Reading, MA.

  8. Carlson, C. R., and Masters, J. C. (1986). Inoculation by emotion: Effects of positive emotional states on children's reactions to social comparison.Dev. Psychol. 22: 760–765.

  9. Chrisman, N. J., and Kleinman, A. (1983). Popular health care, social networks, and cultural meanings: The orientation of medical anthropology. In Mechanic, D. (ed.),Handbook of Health, Health Care, and the Health Professions, Free Press, New York, pp. 569–590.

  10. Cohen, F., and Lazarus, R. S. (1979). Coping with the stresses of illness. In Stone, G. C., Cohen, F., and Adler, N. E. (eds.),Health Psychology-A Handbook, Jossey-Bass, San Francisco, pp. 217–254.

  11. Cohen, S., and Syme, L. (eds.) (1985).Social Support and Health, Academic Press, New York.

  12. Croog, S. H., Shapiro, D. S., and Levine, S. (1971). Denial among heart patientsPsychosom. Med. 33: 385–397.

  13. Croyle, R. T. (1990). Biased appraisal of high blood pressure.Prev. Med. (in press).

  14. Croyle, R. T., and Sande, G. N. (1988). Denial and confirmatory search: Paradoxical consequences of medical diagnosis.J. Appl. Soc. Psychol. 18: 473–490.

  15. Croyle, R. T., and Uretsky, M. B. (1987). Effects of mood on self-appraisal of health status.Health Psychol. 6: 239–253.

  16. Ditto, P. H., and Jemmott, J. B. (1989). From rarity to evaluative extremity: Effects of prevalence information on the evaluation of positive and negative characteristics.J. Personal. Soc. Psychol. 51: 16–26.

  17. Ditto, P. H., Jemmott, J. B., and Darley, J. M. (1988). Appraising the threat of illness: A mental representational approach.Health Psychol. 7: 183–200.

  18. Festinger, L. (1954). A theory of social comparison processes.Hum. Relat. 7: 117–140.

  19. Feuerstein, M., Labbé, E. E., and Kuczmierczyk, A. R. (1986).Health Psychology: A Psychobiological Perspective, Plenum, New York.

  20. Gruman, J. C., and Sloan, R. P. (1983). Disease as justice: Perceptions of the victims of physical illness.Basic Appl. Soc. Psychol. 4: 39–46.

  21. Haan, N. (1977).Coping and Defending: Processes of Self-Environment Organization, Academic Press, New York.

  22. Hampton, M. L., Anderson, J., Lavizzo, B. S., and Bergman, A. B. (1974). Sickle cell “nondisease”: A potentially serious public health problem.Am. J. Dis. Child. 128: 58–61.

  23. Hopp, H. P., and Croyle, R. T. (1989). Reactions to risk factor labeling: The role of affect. Presented at the Annual Meeting of the Midwestern Psychological Association, Chicago, May.

  24. Jamison, R. N., Lewis, S., and Burish, T. G. (1986). Psychological impact of cancer on adolescents: Self-image, locus of control, perception of illness and knowledge of cancer.J. Chron. Dis. 39: 609–617.

  25. Janis, I. L. (1958).Psychological Stress, Wiley, New York.

  26. Janis, I. L. (1984). Improving adherence to medical recommendations: Prescriptive hypotheses derived from recent research in social psychology. In Baum, A.,et al. (eds.),Handbook of Psychology and Health, Vol. IV, Erlbaum, Hillsdale, NJ, pp. 113–148.

  27. Jemmott, J. B., Ditto, P. H., and Croyle, R. T. (1986). Judging health status: Effects of perceived prevalence and personal relevance.J. Person. Soc. Psychol. 50: 899–905.

  28. Jemmott, J. B., Croyle, R. T., and Ditto, P. H. (1988). Commonsense epidemiology: Self-based judgments from laypersons and physicians.Health Psychol. 7: 55–73.

  29. Johnson, E., and Tversky, A. (1983). Affect, generalization, and the perception of risk.J. Person. Soc. Psychol. 36: 236–246.

  30. Kalish, J., Hilton, J. L., and Ditto, P. H. (1988). The effects of patients' expectations and physicians' communication styles on doctor-patient interactions. Unpublished manuscript, University of Michigan, Ann Arbor.

  31. Kasl, S. V., and Cobb, S. (1966). Health behavior, illness behavior and sick role behavior.Arch. Environ. Health 12: 246–266.

  32. Katon, W. (1984). Depression: Relationship to somatization and chronic medical illness.J. Clin. Psychiat. 45(3; Sect. 2): 4–11.

  33. Kroeber, T. C. (1963). The coping functions of the ego mechanism. In White, R. W. (ed.),The Study of Lives, Prentice-Hall, Englewood Cliffs, NJ.

  34. Lazarus, R. S. (1983). The costs and benefits of denial. In Breznitz, S. (ed.),The Denial of Stress, International Universities Press, New York, pp. 1–30.

  35. Lazarus, R. S., and Folkman, S. (1984).Stress, Appraisal, and Coping, Springer, New York.

  36. Lehman, D. R., Wortman, C. B., and Williams, A. F. (1987). Long-term effects of losing a spouse or child in a motor vehicle crash.J. Person. Soc. Psychol. 52: 218–231.

  37. Leventhal, H. (1970). Findings and theory in the study of fear communications. In Berkowitz, L. (ed.),Adv. Exp. Soc. Psychol. Vol. 3, Academic Press, New York, pp. 120–186.

  38. Leventhal, H. (1986). Symptom reporting: A focus on process. In McHugh, S., and Vallis, T. M. (eds.),Illness Behavior: A Multidisciplinary Model. Plenum, New York, pp. 219–237.

  39. Leventhal, H., Leventhal, E., and Schaefer, P. (1987). Seeking health care: The wisdom of vigilant coping. Presented in Illness Appraisal: Social and Cognitive Processes (Chaired by Croyle, R. T.). Symposium at the meeting of the Midwestern Psychological Association, Chicago, May 1987.

  40. Leventhal, H., Meyer, D., and Nerenz, D. (1980). The commonsense representation of illness danger. In Rachman, S. (ed.),Medical Psychology, 2, Pergamon, New York.

  41. Ley, P. (1979). Memory for medical information.Br. J. Soc. Clin. Psychol. 18: 245–255.

  42. Lipowski, Z. J. (1970). Physical illness, the individual and the coping process. International.J. Psychiat. Med. 1: 91: 102.

  43. Markus, H. M., and Zajonc, R. B. (1985). The cognitive perspective in social psychology. In Lindzey, G., and Aronson, E. (eds.),The Handbook of Social Psychology, Vol. 1, Erlbaum, Hillsdale, NJ.

  44. Marteau, T. M., and Johnson, M. (1986). Determinants of beliefs about illness: A study of parents of children with diabetes, asthma, epilepsy, and no chronic illness.J. Psychosom. Res. 30: 673–683.

  45. Mechanic, D. (1972). Social psychologic factors affecting the presentation of bodily complaints.N. Engl. J. Med. 286: 1132–1139.

  46. Pennebaker, J. (1982).The Psychology of Physical Symptoms, Springer-Verlag, New York.

  47. Pilowsky, I. (1967). Dimensions of hypochondriasis.Br. J. Psychiat. 113: 89–93.

  48. Pilowsky, I. (1969). Abnormal illness behavior.Br. J. Med. Psychol. 42: 347–351.

  49. Raphael, K. (1987). Recall bias: A proposal for assessment and control.Int. J. Epidemiol. 123: 670–676.

  50. Rook, K. S. (1984). The negative side of social interaction: Impact on psychological well-being.J. Person. Soc. Psychol. 46: 1097–1108.

  51. Ross, L., Lepper, M., and Hubbard, M. (1975). Perseverance in self perception and social perception: Biased attributional processes in the debriefing paradigm.J. Person. Soc. Psychol. 32: 880–892.

  52. Sanders, G. S. (1982). Social comparison and perceptions of health and illness. In Sanders, G. S., and Suls, J. (eds.),Social Psychology of Health and Illness, Erlbaum, Hillsdale, NJ, pp. 129–157.

  53. Sarason, I. G., and Sarason, B. R. (1985).Social Support: Theory, Research, and Applications, Martinus Nijhoff, Boston.

  54. Sarason, I. G., and Sarason, B. R. (1986). Experimentally provided social support.J. Person. Soc. Psychol. 50: 1222–1225.

  55. Skelton, J. A., and Croyle, R. T. (eds.) (1990).The Mental Representation of Health and Illness, Springer-Verlag, New York (in press).

  56. Snyder, M. (1984). When belief creates reality. In Berkowitz, L. (ed.),Adv. Exp. Soc. Psychol. Vol. 18, Academic Press, New York.

  57. Suls, J. (1982). Social support, interpersonal relations, and health: Benefits and liabilities. In Sanders, G. S., and Suls, J. (eds.),Social Psychology of Health and Illness, Erlbaum, Hillsdale, NJ., pp. 255–278.

  58. Suls, J., and Fletcher, B. (1985). The relative efficacy of avoidant and nonavoidant coping strategies: A meta-analysis.Health Psychol. 4: 249–288.

  59. Taylor, S. E. (1986).Health Psychology, Random House, New York.

  60. Taylor, S. E., Lichtman, R. R., and Wood, J. V. (1984). Attributions, beliefs about control, and adjustment to breast cancer.J. Person. Soc. Psychol. 46: 489–502.

  61. Turnquist, D. C., Harvey, J. H., and Anderson, B. L. (1988). Attributions and adjustment to life-threatening illness.Br. J. Clin. Psychol. 27: 55–65.

  62. Watson, M., Greer, S., Blake, S., and Shrapnell, K. (1984). Reactions to the diagnosis of breast cancer: Relationship between denial, delay and rates of psychological morbidity.Cancer 53: 2008–2012.

  63. Weinstein, N. D. (1982). Unrealistic optimism about susceptibility to health problems.J. Behav. Med. 5: 441–460.

  64. Weinstein, N. D. (1987). Unrealistic optimism about susceptibility to health problems: Conclusions from a community-wide sample.J. Behav. Med. 10: 481–500.

  65. Wills, T. A. (1987). Downward comparison as a coping mechanism. In Snyder, C. R., and Ford, C. E. (eds.),Coping with Negative Life Events, Plenum, New York, pp. 243–268.

  66. Zola, I. K. (1966). Culture and symptoms-an analysis of patients' presenting complaints.Am. Sociol. Rev. 31: 615–630.

Download references

Author information

Correspondence to Robert T. Croyle.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Croyle, R.T., Ditto, P.H. Illness cognition and behavior: An experimental approach. J Behav Med 13, 31–52 (1990). https://doi.org/10.1007/BF00844898

Download citation

Key words

  • illness cognition
  • illness behavior
  • coping
  • health beliefs
  • methodology