Chapter 9: how can symptoms be experienced and interpreted? Flashcards
difference illness and disease
Illness is what someone feels, the complaints with which he goes to the doctor. Disease is what
is wrong with organs, cells or tissues.
The Pennebaker (1982) attention model
describes how competition for attention between different internal or external cues or stimuli leads to the same
physical signs or physiological change immediately being noticed in some contexts, but not in other context
The
cognitive-perceptual model of Cioffi (1991)
focuses more on the processes of interpretation of physical signs and
influences on attribution as symptoms, and on the role of selective attention. There appear to be biological,
psychological and contextual influences on the interpretation of symptoms. In general, a symptom receives attention
from the individual dependent of when it is painful or disruptive, new or persistent. People with a chronic illness
more often notice symptoms and also report them more often.
medical student
disease
Students who are going to study medicine or psychology initially think that they have everything because
they recognize symptoms in themselves.
monitors
pay attention to the source of their symptoms and immediately try to do something about it.
blunters
who ignore the source of stress as much as possible, for example by
avoiding information about the complaint.
The common-sense model
the
representations people have of diseases are formed by the media, by personal experience and by what friends
experience. This model is based on the parallel
processing of the components of the stimuli: a symptom causes pain (cognition) and the person reacts emotionally,
for example with anxiety. The model has a so-called feedback loop of coping and representations
A disease representation is created as soon as someone becomes aware of the symptoms. Five consistent themes in
disease representation have been identified over time:
- Identity: variables that indicate the presence or absence of a disease
- Consequences: the expected influence of the disease on the person concerned
- Cause: the assumed cause: someone may think that it is biological, psychological, emotional, genetic or
environmental - Timeframe: does anyone expect it to be short (acute) or long (chronic)?
- Controllability / curability: to what extent someone thinks something can be done about the disease?
The Illness Perception Questionnaire (IPQ and IPQ-R)
The IPQ is a well-validated questionnaire and there is a specific version for children. The revised version, the IPQ-R,
distinguishes between convictions about personal control over the outcome outcome disease and expected
treatment control. It also assesses a new dimension of emotional responses to illness such as anxiety, and examines
the extent to which a person feels they understand their condition.
illness behavior
The behavior of people who have recognized
symptoms but are not yet seeking medical help is called illness behavior. Illness behavior consists of rest, selfmedication, seeking sympathy and seeking (informal) information to determine health status. When they have done
that, they can decide to ignore the symptoms and hope that they will pass, seek other advice or go to a health
professional. Usually someone ultimately takes all these steps in the above order.
lay referral system
also called
for advice from family, friends, acquaintances and colleagues about health issues.
Safer et al. (1979) has devised a three-phase
model and indicates that an individual will seek help when the three phases have been completed with a positive
answer
Appraissal delay: having or not having symptoms
Illness delay: whether or not to seek medical assistance
Utilizsation delay: the time between determining that people need help and actually visiting a doctor
