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Implicit models of illness

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Abstract

This study was designed to be an initial investigation of implicit models of illness, that is, the dimensional structure that organizes an individual's common-sense illness schema. Nurses, college students, and diabetics rated the qualities of two different diseases, one that was personally salient (i.e., flu or diabetes) and one with which they were familiar but did not have direct experience (i.e., cancer), on a 38-item Implicit Models of Illness Questionnaire (IMIQ). An exploratory factor analysis revealed a four-dimensional structure of illnesses composed of (a) Seriousness, (b) Personal Responsibility, (c) Controllability, and (d) Changeability. The stability of this fourdimensional model was established using confirmatory factor analysis to test the fit of this structure to the IMIQ data of another sample of subjects drawn from the same populations. The structure of this implicit model proved stable for judgments of different diseases and across groups of subjects, even though they differed in their physical-health status and occupational roles. The dimensions identified in the present study were compared to those described in other papers. Our dimensions seemed to be both personally and psychologically meaningful. The implications of this preliminary “generic” implicit illness model for future work in the field of health cognition are discussed.

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References

  • Allen, M. J., and Yen, W. M. (1979).Introduction to Measurement Theory, Brooks/Cole, Monterey, Calif.

    Google Scholar 

  • Antonovsky, A. (1972). The image of four diseases held by the urban Jewish population of Israel.J. Chron. Dis. 25: 375–384.

    PubMed  Google Scholar 

  • Bentler, P. M., and Bonett, D. G. (1980). Significance tests and goodness of fit in the analysis of covariance structures.Psychol. Bull. 88: 588–606.

    Article  Google Scholar 

  • Ben-Sira, Z. (1977). The structure and dynamics of the image of diseases.J. Chron. Dis. 30: 831–842.

    PubMed  Google Scholar 

  • Brickman, P., Rabinowitz, C., Krauta, J., Coates, D., Cohn, E., and Kidder, L. (1982). Models of helping and coping.Am. Psychol. 37: 368–384.

    Google Scholar 

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

    Google Scholar 

  • D'Andrade, R. G., Quinn, N. R., Nerlove, S. B., and Romney, A. K. (1972). Categories of disease in American and Mexican-Spanish. In Romney, A. K., Shepard, R. N., and Nerlove, S. B. (eds.),Multidimensional Scaling: Theory and Applications in the Behavioral Sciences, Vol. 2, Seminar Press, New York, pp. 132–158.

    Google Scholar 

  • Desroches, H. F., Kaiman, B. D., and Ballard, H. T. (1967). Factors influencing reporting of physical symptoms by the aged patient.Geriatrics 22: 169–175.

    PubMed  Google Scholar 

  • Fabrega, H. (1977). Group differences of the structure of illness.Culture Med. Psychiat. 1: 379–384.

    Google Scholar 

  • Folkman, S. (1984). Personal control and stress and coping processes: A theoretical analysis.J. Personal. Soc. Psychol. 46: 839–852.

    Google Scholar 

  • Janis, I., and Rodin, J. (1979). Attribution, control, and decision making: Social psychology and health care. In Stone, G. C., Cohen, F., and Adler, N. E. (eds.),Health Psychology, Jossey-Bass, San Francisco.

    Google Scholar 

  • Jenkins, C. D. (1966). The semantic differential for health.Public Health Rep. 81: 549–558.

    PubMed  Google Scholar 

  • Jenkins, C. D., and Zyzanski, S. J. (1968). Dimensions of belief and feeling concerning three diseases, poliomyelitis, cancer, and mental illness.Behav. Sci. 13: 372–381.

    PubMed  Google Scholar 

  • Jones, R. A., and Wiese, H. J. (1982). Provider and consumer differences in perceived relationships among symptoms. Paper presented at the Annual Meeting of the American Psychological Association, Washington, D.C., Aug.

  • Jones, R. A., Wiese, H. J., Moore, R. W., and Haley, J. V. (1981). On the perceived meaning of symptoms.Med. Care 19: 7100–717.

    Google Scholar 

  • Joreskog, K. G. (1978). Structural analysis of covariance and correlation matrices.Psychometrika 43: 443–477.

    Google Scholar 

  • Joreskog, K. G., and Sorbom, D. (1981).LISREL V: Analysis of Linear Structural Relationships by Maximum Likelihood and Least Squares Methods, International Educational Services, Chicago.

    Google Scholar 

  • Kaiser, H. F. (1974). An index of factorial simplicity.Psychometrika 39: 31–36.

    Google Scholar 

  • Kleinman, A. (1980).Patients and Healers in the Context of Culture, University of California Press, Berkeley.

    Google Scholar 

  • Lau, R. R., and Hartman, K. A. (1983). Common sense representations of common illnesses.Health Psychol. 2: 167–186.

    Google Scholar 

  • Lazarus, R. S., and Launier, R. (1978). Stress-related transaction between person and environment. In Pervin, L. A., and Lewis, M. (eds.),Perspectives in Interactional Psychology, Plenum Press, New York, pp. 116–158.

    Google Scholar 

  • Lefcourt, H. M. (1976).Locus of Control: Current Trends in Theory and Research, Erlbaum, Hillsdale, N.J.

    Google Scholar 

  • Leventhal, H., and Nerenz, D. R. (1982). Representations on threat and the control of stress. In Meichenbaum, D., and Jaremko, M. (eds.),Stress management and Prevention: A Cognitive-Behavioral Approach, Plenum Press, New York, pp. 5–38.

    Google Scholar 

  • Leventhal, H., Meyer, D., and Nerenz, D. (1980). The commonsense representation of illness danger. In Rachman, S. (ed.),Contributions to Medical Psychology, Vol. 2, Pergamon Press, Oxford, pp. 3–26.

    Google Scholar 

  • Linz, D., Penrod, S., Siverhus, S., and Leventhal, H. (1982). The cognitive organization of disease and illness among lay persons. Paper presented at the Annual Meeting of the American Psychological Association, Washington, D.C., Aug.

  • Long, J. S. (1983).Confirmatory Factor Analysis, Sage, Beverly Hills, Calif.

    Google Scholar 

  • McIver, J. P., and Carmines, E. G. (1981).Unidimensional Scaling, Sage, Beverly Hills, Calif.

    Google Scholar 

  • Mechanic, D. (1962). The concept of illness behavior.J. Chron. Dis. 15: 189–194.

    PubMed  Google Scholar 

  • Meyer, D. (1981).The Effects of Patients' Representations of High Blood Pressure on Behavior in Treatment, Unpublished doctoral dissertation, University of Wisconsin-Madison.

  • Nerenz, D. (1979).Control of Emotional Distress in Cancer Chemotherapy, Unpublished doctoral dissertation, University of Wisconsin-Madison.

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

    Google Scholar 

  • Richmond, J. B. (1979).Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention, DHEW PHS Publ. No. 79-55071, U.S. Government Printing Office, Washington, D.C.

    Google Scholar 

  • Rodin, J., Rennert, K., and Solomon, S. K. (1980). Intrinsic motivation for control: Fact or fiction? In Baum, A., and Singer, J. E. (eds.),Advances in Environmental Psychology, Vol. 2, Erlbaum, Hillsdale, N.J., pp. 131–148.

    Google Scholar 

  • Rodin, J., Salovey, P., Ellias, M., and Krause, N. (1984). Effects of attribution of responsibility for causing and solving one's problems on judgments of people with health or personal problems. (submitted for publication).

  • Rosenstock, I. M., and Kirscht, J. P. (1979). Why people seek health care. In Stone, G. C., Cohen, F., and Adler, N. (eds.),Health Psychology Jossey-Bass, San Francisco, pp. 161–188.

    Google Scholar 

  • Rotter, J. (1954).Social Learning and Clinical Psychology, Prentice-Hall, Englewood Cliffs, N.J.

    Google Scholar 

  • Rudy, T. E., Salovey, P., and Turk, D. C. (1986). The effects of health salience on the structure and consistency of health-protective attitudes and behaviors (submitted for publication).

  • Salovey, P., Turk, D. C., Rudy, T. E., Kerns, R. D., and Holzman, A. D. (1983). Perceptions of health and illness among cardiac patients. Paper presented at the fourth Annual Meeting of the Society of Behavioral Medicine, Baltimore, Mar.

  • Schorr, D., and Rodin, J. (1984). Motivation to control one's environment in individuals with obsessive-compulsive, depressive, and normal personality traits.J. Personal. Soc. Psychol. 46: 1148–1161.

    Google Scholar 

  • Snygg, D., and Combs, A. W. (1959).Individual Behavior, revised ed., Harper, New York.

    Google Scholar 

  • Steele, D. J., and Leventhal, H. (1982). Illness cognition and the provider-patient encounter in the treatment of hypertension. Paper presented at the Annual Meeting of the American Psychological Association, Washington, D.C., Aug.

  • Taylor, S. E. (1982). Social cognition and health.Personal. Soc. Psychol. Bull. 8: 549–562.

    Google Scholar 

  • Taylor, S. E., Lichtman, R. R., and Wood, J. V. (1984). Attributions, beliefs, and adjustement to breast cancer.J. Personal. Soc. Psychol. 46: 489–502.

    Google Scholar 

  • Turk, D. C. (1979). Factors contributing to the adjustment with chronic illness. In Sarason, I. G., and Spielberger, C. D. (eds.),Stress and Anxiety, Vol. 6, Hemisphere, Washington, D.C., pp. 291–313.

    Google Scholar 

  • Turk, D. C., Kerns, R. D., and Rudy, T. E. (1984a). Identifying the links between chronic illness and depression. Paper presented at the annual convention of the American Psychological Association, Toronto, Canada, Aug.

  • Turk, D. C., Rudy, T. E., and Salovey, P. (1984b). Health protection: Attitudes and behaviors of LPNs, teachers, and college students.Health Psychol. 3: 189–210.

    PubMed  Google Scholar 

  • Wallston, K. A., and Wallston, B. S. (1982). Who is responsible for your health—The construct of health locus of control. In Sanders, G. S., and Suls, J. (eds.),Social Psychology of Health and Illness, Erlbaum, Hillsdale, N.J., pp. 50–85.

    Google Scholar 

  • White, K. L., Williams, F., and Greenberg, B. G. (1961) The ecology of medical care.N. Eng. J. Med. 265: 885.

    Google Scholar 

  • Zborowski, M. (1969).People in Pain, Jossey-Bass, San Francisco.

    Google Scholar 

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

    PubMed  Google Scholar 

  • Zola, I. K. (1972). Studying the decision to see a doctor: Review, critique, corrective.Adv. Psychosom. Med. 8: 216–236.

    PubMed  Google Scholar 

  • Zola, I. K. (1973). Pathways to the doctor: From person to patient.Soc. Sci. Med. 7: 677.

    PubMed  Google Scholar 

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Support for this project was provided in part by a contract from Boehringer Mannheim Diagnostics, Inc.

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Turk, D.C., Rudy, T.E. & Salovey, P. Implicit models of illness. J Behav Med 9, 453–474 (1986). https://doi.org/10.1007/BF00845133

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