The impact of discrepancies in illness perceptions, between parent and child, in childhood unusual experiences.

Student thesis: Doctoral ThesisDoctor of Philosophy


An individuals’ beliefs about health and illness can have a profound impact on clinical care. In trying to understand variations in illness-related behaviours, research has focused primarily on social cognition models. The Self-Regulation Model (SRM) provides a theoretical framework to help understand how an individuals’ conceptualisation of their illness influences coping behaviour and a range of health outcomes. The model proposes that when individuals are faced with a health threat, they develop a set of organised beliefs (illness perceptions) about the illness in terms of five core constructs (identity, timeline, cause, cure/control, and consequences). The principle aim of establishing the applicability of the SRM is to be able to predict how illness perceptions will impact on coping and, with tailored intervention, be adapted for better clinical outcomes. Reviews and meta-analyses across a range of physical illnesses, have demonstrated significant correlations between the SRM dimensions and outcomes. The applicability of this model in a mental health setting has also started to be explored and a systematic review of the adult literature demonstrated that the model was supported in a mental health population. Childhood is a critical period for cognitive and emotional development and a vulnerable period for the onset of mental health difficulties. Understanding illness perceptions in this population is vital considering the evidence of their importance in physical health and growing evidence within the mental health setting for adults. This is the first systematic review to investigate illness perceptions of children and young people (CYP) with mental health conditions in relation to the SRM. This review sought to synthesise a) illness perceptions endorsed by this population, b) the interrelations between illness representation dimensions and c) the relationship between illness perceptions and outcomes.
A comprehensive search of Web of Science, PsycINFO and Medline was undertaken. Studies
were assessed for eligibility and the quality of the study rated using established measures. Information pertaining to illness perceptions of CYP with mental health difficulties was extracted and synthesised.
Of 1484 titles, abstracts and full-texts assessed, eight studies met the inclusion criteria, six
were cross-sectional and two were qualitative. The findings indicate that the illness perception dimensions, outlined within the SRM, are largely endorsed by CYP experiencing a range of mental health problems. The studies also provided evidence of associations between illness perceptions and clinical outcomes. In addition, perceptions of stigma were discussed in consideration of further illness representation dimensions, appropriate to this population, which may need to be incorporated to improve applicability of the SRM.
This review is the first to summarise the illness perceptions of CYP with a mental health condition. The findings provide evidence that the SRM was applicable to CYP with mental health conditions and is associated with clinical outcomes in this population. However, due to the methodological issues raised and the small number of studies reviewed, it was not possible to draw firm conclusions. Adaptations to the model may be beneficial within this setting, but further research is needed. Further qualitative research is needed to ensure all illness perceptions reported by this population are addressed by the model. Quantitative research, with improved methodologically quality in terms of sample size and selection, and conceptualisation and measurement of both outcomes and IPs, is needed, to rigorously test the use of the illness perception questionnaire (IPQ) and the application of the SRM.
Date of Award2018
Original languageEnglish
Awarding Institution
  • King's College London
SupervisorSuzanne Jolley (Supervisor) & Juliana Onwumere (Supervisor)

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