TY - JOUR
T1 - An Evidence-Based Theory of Psychological Adjustment to Long-Term Physical Health Conditions
T2 - Applications in Clinical Practice
AU - Carroll, Susan
AU - Moon, Zoe
AU - Hudson, Joanna
AU - Hulme, Katrin
AU - Moss-Morris, Rona
N1 - Funding Information:
Source of Funding and Conflicts of Interest: This work was funded by the Mind & Body Programme, King’s Health Partners. Rona Moss-Morris is part funded by the Department of Health via the National Institute for Health Research (NIHR) Specialist Biomedical Research Centre for Mental Health award to the South London and Maudsley NHS Foundation Trust (SLaM) and the Institute of Psychiatry at King's College London. Unrelated to this specific work, RMM is a beneficiary of a license agreement between King's College London and Mahana Therapeutics for a digital CBT programme for irritable bowel syndrome. RMM receives consultancy fees as a scientific advisor to Mahana therapeutics and ad hoc payments for CBT training workshops. There are no conflicts of interest to declare.
Publisher Copyright:
© Lippincott Williams & Wilkins.
PY - 2022/6/30
Y1 - 2022/6/30
N2 - OBJECTIVE: Around 30% of people with long-term physical health conditions (LTCs) experience comorbid anxiety and depression. For many, comorbid distress is linked to difficulties adjusting to the challenges of the LTC. The aims of this article are to present a transdiagnostic theoretical model of adjustment to LTCs (TMA-LTC), demonstrate the application of this model in clinical practice, and highlight the distinguishing features of treating LTC-related distress compared with treating primary anxiety and/or depression. METHODS: A systematic review (k = 21) was conducted to collate preexisting evidence-based models of adjustment across LTCs. Models of adjustment for a range of LTCs were extracted and synthesized into a new preliminary TMA-LTC. Two expert consensus meetings were held, where experts rated the relevance and importance of all concepts within the models. RESULTS: The TMA-LTC proposes that acute critical events or ongoing illness stressors can disrupt emotional equilibrium, and that whether a person returns to equilibrium and achieves good psychological adjustment depends on a number of cognitive and behavioral factors, as well as their interpersonal, intrapersonal, environmental, and illness-specific contexts. A case study is presented to demonstrate the clinical application of this model in treating illness-related distress, highlighting how it overcomes roadblocks that may be encountered when working primarily within traditional mental health paradigms. CONCLUSIONS: As an empirically and clinically informed model, TMA-LTC provides a useful guide for assessment, formulation, and treatment in the context of psychological adjustment to LTCs. Future studies are needed to test treatments that have been developed based on TMA-LTC.
AB - OBJECTIVE: Around 30% of people with long-term physical health conditions (LTCs) experience comorbid anxiety and depression. For many, comorbid distress is linked to difficulties adjusting to the challenges of the LTC. The aims of this article are to present a transdiagnostic theoretical model of adjustment to LTCs (TMA-LTC), demonstrate the application of this model in clinical practice, and highlight the distinguishing features of treating LTC-related distress compared with treating primary anxiety and/or depression. METHODS: A systematic review (k = 21) was conducted to collate preexisting evidence-based models of adjustment across LTCs. Models of adjustment for a range of LTCs were extracted and synthesized into a new preliminary TMA-LTC. Two expert consensus meetings were held, where experts rated the relevance and importance of all concepts within the models. RESULTS: The TMA-LTC proposes that acute critical events or ongoing illness stressors can disrupt emotional equilibrium, and that whether a person returns to equilibrium and achieves good psychological adjustment depends on a number of cognitive and behavioral factors, as well as their interpersonal, intrapersonal, environmental, and illness-specific contexts. A case study is presented to demonstrate the clinical application of this model in treating illness-related distress, highlighting how it overcomes roadblocks that may be encountered when working primarily within traditional mental health paradigms. CONCLUSIONS: As an empirically and clinically informed model, TMA-LTC provides a useful guide for assessment, formulation, and treatment in the context of psychological adjustment to LTCs. Future studies are needed to test treatments that have been developed based on TMA-LTC.
KW - psychological adjustment
KW - long-term conditions
KW - Transdiagnostic
UR - http://www.scopus.com/inward/record.url?scp=85131270353&partnerID=8YFLogxK
U2 - 10.1097/PSY.0000000000001076
DO - 10.1097/PSY.0000000000001076
M3 - Article
C2 - 35412516
AN - SCOPUS:85131270353
SN - 0033-3174
VL - 84
SP - 547
EP - 559
JO - Psychosomatic medicine
JF - Psychosomatic medicine
IS - 5
ER -
