The proposed studies use multi-dimensional scaling and open-ended interviews to uncover the content and underlying dimensions of elderly people's illness cognition: i.e. the cues they use to identify specific illnesses, and their ideas about the cause, time line and consequences of illness. The procedures will also tap how they respond emotionally to illness and how they cope with it. Scales will be developed to measure these factors in clinical populations so we can compare elderly and middle-aged respondents and patients to one another and to patients with four different chronic diseases (hypertension, COPD, arthritis and cancer - in remission). We will study how illness cognition affects emotion and coping, how all three affect selection of symptoms for reporting at clinic visits, how the three affect confusions between different illnesses and how they influence compliance with treatment for problems presented by the patients in comparison to unreported problems uncovered by the practitoner. We will assess whether patients misidentify the nature and cause of illness because their expectations regarding symptom presentations are appropriate to the natural history of disorders in the middle rather than the later years of life. The final goals are to see whether illness representations and coping are related to feelings of age and to the development of dependency and to unnecessary physical and psychosocial disability. Seeing illness as progressing uncontrollably with age may provoke loss of hope and depressive feelings and lead to apathy and withdrawal from social relationships. These hypotheses will be tested in the four clinical populations of elderly patients. Finally, an intervention study is proposed comparing a participatory interaction with a standard, treatment control. The participatory interaction is designed to enhance the patient's perception that he/she is an active agent in the identification and treatment of illness problems and to increase his/her feeling of competence, reduce his/her sense of psychological age, and generalize improved coping skills to every-day problems so as to reduce physical and psychosocial disability.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG003501-08
Application #
3114761
Study Section
Behavioral Medicine Study Section (BEM)
Project Start
1982-09-01
Project End
1990-08-31
Budget Start
1989-03-01
Budget End
1990-08-31
Support Year
8
Fiscal Year
1989
Total Cost
Indirect Cost
Name
Rutgers University
Department
Type
Organized Research Units
DUNS #
038633251
City
New Brunswick
State
NJ
Country
United States
Zip Code
08901
Mora, Pablo A; Orsak, Gabriela; DiBonaventura, Marco D et al. (2013) Why do comparative assessments predict health? The role of self-assessed health in the formation of comparative health judgments. Health Psychol 32:1175-8
Mora, Pablo A; Beamon, Teerah; Preuitt, LeAnn et al. (2012) Heterogeneity in depression symptoms and health status among older adults. J Aging Health 24:879-96
Mora, Pablo A; DiBonaventura, Marco D; Idler, Ellen et al. (2008) Psychological factors influencing self-assessments of health: toward an understanding of the mechanisms underlying how people rate their own health. Ann Behav Med 36:292-303
Idler, Ellen; Leventhal, Howard; McLaughlin, Julie et al. (2004) In sickness but not in health: self-ratings, identity, and mortality. J Health Soc Behav 45:336-56
Benyamini, Yael; Leventhal, Howard; Leventhal, E A Elaine A (2004) Self-rated oral health as an independent predictor of self-rated general health, self-esteem and life satisfaction. Soc Sci Med 59:1109-16
Benyamini, Yael; Leventhal, Elaine A; Leventhal, Howard (2003) Elderly people's ratings of the importance of health-related factors to their self-assessments of health. Soc Sci Med 56:1661-7
Benyamini, Yael; McClain, Colleen S; Leventhal, Elaine A et al. (2003) Living with the worry of cancer: health perceptions and behaviors of elderly people with self, vicarious, or no history of cancer. Psychooncology 12:161-72
Brissette, Ian; Leventhal, Howard; Leventhal, Elaine A (2003) Observer ratings of health and sickness: can other people tell us anything about our health that we don't already know? Health Psychol 22:471-8
Mora, Pablo A; Robitaille, Chantal; Leventhal, Howard et al. (2002) Trait negative affect relates to prior-week symptoms, but not to reports of illness episodes, illness symptoms, and care seeking among older persons. Psychosom Med 64:436-49
Duke, Jennifer; Leventhal, Howard; Brownlee, Susan et al. (2002) Giving up and replacing activities in response to illness. J Gerontol B Psychol Sci Soc Sci 57:P367-76

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