Campus Units

Psychology

Document Type

Article

Publication Version

Published Version

Publication Date

10-2-2019

Journal or Book Title

Health Psychology Review

Volume

13

Issue

4

First Page

427

Last Page

446

DOI

10.1080/17437199.2018.1521730

Abstract

Consistent with the common-sense model of self-regulation, illness representations are considered the key to improving health outcomes for medically unexplained symptoms and illnesses (MUS). Which illness representations are related to outcomes and how they are related is not well understood. In response, we conducted a meta-analysis of the relationship between illness representations, self-management/coping, and health outcomes (perceived disease state, psychological distress, and quality of life) for patients with MUS. We reviewed 23 studies and found that threat-related illness representations and emotional representations were related to worse health outcomes and more negative coping (moderate to large effect). Generally, increases in negative coping mediated (with a moderate to large effect) the relationship of threat/emotional illness representations and health outcomes. Protective illness representations were related to better health outcomes, less use of negative coping and greater use of positive coping (small to moderate effect). The relationship of protective illness representations to better health outcomes was mediated by decreases in negative coping (moderate to large effect) and increases in positive coping (moderate effect). Perceiving a psychological cause to the MUS was related to more negative health outcomes (moderate to large effect) and more negative emotional coping (small effect). The relationship of perceiving a psychological cause and more negative health outcomes was mediated by increases in negative emotional coping. Improving our understanding of how illness representations impact health outcomes can inform efforts to improve treatments for MUS. Our results suggest behavioural treatments should focus on reducing threat-related illness representations and negative coping.

Comments

This article is published as McAndrew, Lisa M., Marcus Crede, Kieran Maestro, Sarah Slotkin, Justin Kimber, and L. Alison Phillips. "Using the common-sense model to understand health outcomes for medically unexplained symptoms: a meta-analysis." Health Psychology Review 13, no. 4 (2019): 427-446. DOI: 10.1080/17437199.2018.1521730.

Rights

Works produced by employees of the U.S. Government as part of their official duties are not copyrighted within the U.S. The content of this document is not copyrighted.

Language

en

File Format

application/pdf

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