Relationship Between Illness Representations, Psychosocial Adjustment, and Treatment Outcomes in Mental Disorders: A Mini Review.

Priscillia Averous,Lionel Dany,Elodie Charbonnier

doi:10.3389/fpsyg.2020.01167

Priscillia Averous, Lionel Dany + Show 1 more

Open Access

https://doi.org/10.3389/fpsyg.2020.01167

Copy DOI

Abstract

Understanding and improving the psychosocial adjustments (e.g., quality of life, depression) and treatment outcomes (e.g., adherence, beliefs about treatments) of people with mental disorders are major health issues. The self-regulation model (SRM) postulates that illness representations play a central role on adjustment and treatment of people with physical illnesses. Recently, the SRM has been used with people with mental disorders. However, the manifestations of somatic and psychiatric disorders can be very different. Therefore, the use of SRM in the field of mental health is very complex. This difficulty, as well as the growing interest for illness representations in the field of mental health, justifies the utility to conduct a review on this topic. The current review shows that illness representations are related to psychosocial adjustment and/or treatment outcomes for people with various mental disorders [e.g., psychotic disorders, mood disorder, posttraumatic stress disorder (PTSD), attention deficit hyperactivity disorder (ADHD)]. However, some limitations to the applicability of SRM to mental disorders have been highlighted. These limitations should be considered in future studies.

Highlights

Psychosocial adjustment of people with mental disorders is severely diminished, in particular, they live 10 years less than the general population (Walker et al, 2015), with a lower quality of life (Alonso et al, 2004; Fleury et al, 2013) and a higher level of disability (Alonso et al, 2004)
According to the self-regulation model (SRM; Leventhal et al, 1984), illness representations can be divided into six dimensions: timeline; consequences; cure/control, which can be divided into personal control, and treatment control; identity; emotional representations; and cause
Twelve studies have explored the relationship between psychosocial adjustment and illness representations in people with psychotic disorders (Lobban et al, 2004, 2005, 2006; Fialko et al, 2006; Watson et al, 2006; Stainsby et al, 2010; Cavelti et al, 2012a,b; Moriarty et al, 2012; Theodore et al, 2012; Gómez-de-Regil et al, 2014; Maguire et al, 2016)

Summary

Introduction

Psychosocial adjustment of people with mental disorders is severely diminished, in particular, they live 10 years less than the general population (Walker et al, 2015), with a lower quality of life (Alonso et al, 2004; Fleury et al, 2013) and a higher level of disability (Alonso et al, 2004). To manage these disorders, the emphasis is on medication and/or psychosocial interventions. According to the self-regulation model (SRM; Leventhal et al, 1984), illness representations can be divided into six dimensions: timeline (considering whether the illness is acute, chronic, or cyclical); consequences (assessing its impact on life, including physical, emotional, social, and economic outcomes); cure/control, which can be divided into personal control (beliefs about personal abilities to control the illness), and treatment control (beliefs about the treatment’s effectiveness in curing or managing the illness); identity (overall comprehensibility of the illness); emotional representations (emotional impact or emotional response to the illness); and cause (factors believed to be responsible for the illness or condition)

Methods

Results

Conclusion