published_or_final_version / abstract / toc / Clinical Psychology / Master / Master of Social Sciences

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Self-regulation theory was used to examine how people cope with the diagnosis and management of chronic neurological illness. Three studies are reported, all of which examined the three main elements of self-regulation theory as outlined by Leventhal et al (1984), people's representations of their condition, the actions they took to manage and their evaluation of those efforts, and the outcome as assessed by their feelings about themselves, their emotional wellbeing and severity of disability. A longitudinal study examined 20 people at three stages, before coming into hospital for tests and investigations for multiple sclerosis, 6 weeks and 6 months later. This study provided some support for representations as being important in guiding coping. However, both representations and people's own evaluations of their coping efforts were more predictive of outcome. The second, cross-sectional study compared people being investigated for three differing chronic diseases; the previous 20 people being investigated for multiple sclerosis, 11 and 22 people being investigated for motor neurone disease and liver disease respectively. Results showed that how people represented their condition, and not the diagnosis, was related to outcome. The third study was pseudo-longitudinal and examined people at different times since the diagnosis of multiple sclerosis. People at six months (n=20 from first study), 2 years (n=19), and over 7 years (n=25) from diagnosis were included. This study again highlighted the relationship between representations and outcome; perceiving more symptoms and adverse consequences being associated with poorer outcomes of all types. Coping was also associated with outcome, in particular, more social supports and greater satisfaction with that support being associated with higher Self Esteem, better emotional wellbeing and less severe disability. It is concluded that self-regulation theory is a useful framework within which to understand how people cope with chronic neurological illness, in chronic illnesses with no cure or effective palliative treatments people's representation of their condition and evaluation of their coping efforts predicted outcome. The low level of psychological distress found in all studies suggests that while no particular coping actions are associated with better outcomes, it may be that taking some kind of action, rather than taking no action, in a situation where there is nothing the medical profession can do is sufficiently motivating to minimise depression.

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