Illness perceptions in mental health: Issues and potential applications

Abstract

Understanding patients’ perceptions of their condition has proved a useful way of predicting behaviour in patients suffering from physical illness or injury. Now more investigators are examining how illness perceptions can be applied to the mental health area by considering how patient views of their mental health problem relate to psychological and treatment outcomes. We believe this work has potential to lead to improved understanding of behaviour in patients with psychological disorders and may offer new applications and approaches to improve patients’ adjustment to their illness. The work on illness perceptions is based on a self-regulation theory developed by Howard Leventhal. The theory proposes that individuals form common-sense beliefs concerning their illness in order to understand and cope with health threats (Leventhal et al., 1997; Leventhal, Nerenz, & Steele, 1984). Individuals are seen as actively trying to understand their symptoms and illness and it is the nature of this understanding process that drives the patient’s coping and emotional responses to the health threat. The process is a dynamic one where information about the illness or changes in symptoms may cause a re-evaluation of an individual’s perceptions of their illness and a consequent shift in a patient’s coping patterns, help seeking or emotional response. Research has established that patients’ ideas about their illness coalesce around five main components. These components usually form a logically consistent pattern of beliefs about the illness. These components have been well established in physical illness but it is likely there may be some differences in patients with mental disorders. The first of these components are the personal beliefs patients have about what caused their condition. Causal beliefs are often prominent following the diagnosis of an illness as the individual seeks to understand why they have developed the condition and they are often drawn from shared cultural understandings about a particular illness. Research has shown that psychosocial factors are often identified by the public as the likely cause of depression whereas organic disorders such as a genetic problem or a brain disorder are seen as the most likely causes of schizophrenia (Jorm et al., 1997a; Schomerus, Matchinger, & Angermeyer, 2006). Causal