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Illness perceptions and coping in physical health conditions: A meta-analysis
Open accessAbstract
Objective There is a considerable body of research linking elements of Leventhal's Common Sense Model (CSM) to emotional well-being/distress outcomes among people with physical illness. The present study aims to consolidate this literature and examine the evidence for the role of coping strategies within this literature.Methods A systematic review was conducted where the outcomes of interest were: depression, anxiety and quality of life. A total of 1050 articles were identified and 31 articles were considered eligible to be included in the review.Results Across a range of illnesses, perceptions of consequences of the illness and emotional representations were consistently the illness perceptions with the strongest relationship with the outcomes. Coping variables tend to be stronger predictors of outcomes than the illness perception variables. The evidence for the mediating effect of coping was inconsistent.Conclusions Illness perceptions and coping have an important role to play in the explanation of distress outcomes across a range of physical health conditions. However, some clarity about the theoretical position of coping in relation to illness perceptions, and further longitudinal work is needed if we are to apply this information to the design of interventions for the improvement of psychological health among people with physical health conditions.
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“The differential relationship between illness perceptions outcomes is similar to other studies that find that illness perceptions are better at explaining psychological dimensions than behavioral dimensions (Dempster et al., 2015; Aujla et al., 2016).”
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Apers, S., Rassart, J., Luyckx, K., Oris, L., Goossens, E., Budts, W., Moons, P., & for the I-DETACH Investigators (2016) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.3402/qhw.v11.29346 · Cited by 29
Zarotti, N., Coates, E. J., McGeachan, A. J., Williams, I. A., Beever, D., Hackney, G., Norman, P. E., Stavroulakis, T., White, D. A., White, S., et al. (2019) · British Journal of Health Psychology · doi:10.1111/bjhp.12388 · Cited by 28
Kurt, G., Acar, İ. H., İlkkurşun, Z., Yurtbakan, T., Acar, B., Uygun, E., & Acartürk, C. (2021) · International Journal of Intercultural Relations · doi:10.1016/j.ijintrel.2021.02.001 · Cited by 27
Wang, J., Yang, Z., Zheng, Y., Peng, Y., Wang, Q., Xia, H., Wang, Y., Ding, J., Zhu, P., Shang, L., et al. (2021) · Health and Quality of Life Outcomes · doi:10.1186/s12955-021-01770-4 · Cited by 27
“Health interventions based on understanding and modifying perceptions of illness proved useful in facilitating patient’s HRQoL [51, 52].”
BackgroundFang, X., Albarqouni, L., Rothe, A. V. E., Hoschar, S., Ronel, J., & Ladwig, K. (2016) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2016.10.008 · Cited by 27
“The examination of potential differences between the impact of denial on delay in the time window of <3 hours and 3-24 hours (and additionally in the delay time of >24hours) revealed that patients within the most favorable <3 hours time window had experienced substantially higher symptom burden and symptom severity wh…”
BackgroundCerea, S., Ghisi, M., Pitteri, M., Guandalini, M., Strober, L. B., Scozzari, S., Crescenzo, F., & Calabrese, M. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10235607 · Cited by 24
Freda, M. F., Savarese, L., Dolce, P., & Picione, R. D. L. (2019) · Frontiers in Psychology · doi:10.3389/fpsyg.2019.02609 · Cited by 25
Roberts, D., Calman, L. A., Large, P., Appleton, L., Grande, G., Lloyd‐Williams, M., & Walshe, C. (2017) · Psycho-Oncology · doi:10.1002/pon.4497 · Cited by 24
Bailey, C., Agrawal, N., Cope, S. R., Proctor, B. J., Mildon, B., Butler, M., Holt, K., Edwards, M. J., Poole, N. A., & Nicholson, T. R. (2024) · BMJ Neurology Open · doi:10.1136/bmjno-2024-000633 · Cited by 30
Potter, C., Kelly, L., Hunter, C., Fitzpatrick, R. M., & Peters, M. (2017) · Sociology of Health & Illness · doi:10.1111/1467-9566.12624 · Cited by 26
“Much of this research has focused on the categorisation of various ‘coping strategies’ (Dunkelschetter et al. 1992, Dempster et al. 2015, Moskowitz et al. 2015, Silver et al. 2002), or alternatively on coping as a distinct process (Pennebaker et al. 1990) that overlaps with the concept of…”
BackgroundKelada, L., Wakefield, C. E., Muppavaram, N., Lingappa, L., & Chittem, M. (2020) · Psychology and Health · doi:10.1080/08870446.2020.1859113 · Cited by 23
“Illness perceptions have typically been discussed in terms of the patient’s perceptions of their own condition (Dempster et al., 2015).”
BackgroundResultInfluentialZhu, L., Wang, J., Liu, S., Xie, H., Hu, Y., Yao, J., Ranchor, A. V., Schroevers, M. J., & Fleer, J. (2020) · Mindfulness · doi:10.1007/s12671-020-01455-x · Cited by 22
Jabbarian, L. J., Korfage, I. J., Červ, B., van Delden, J. J. M., Deliens, L., Miccinesi, G., Payne, S., Thit Johnsen, A., Verkissen, M. N., Wilcock, A., et al. (2020) · Psycho-Oncology · doi:10.1002/pon.5259 · Cited by 21
Cross-country variations in the caregiver role: evidence from the ENTWINE-iCohort study
Zarzycki, M., Vilchinsky, N., Bei, E., Ferraris, G., Seddon, D., & Morrison, V. (2024) · BMC Public Health · doi:10.1186/s12889-024-18302-6 · Cited by 21
Which factors impact on quality of life for adults with blepharospasm and hemifacial spasm?
Lawes-Wickwar, S., McBain, H. B., Hirani, S. P., Hurt, C. S., Dunlop, N., Solly, D., Crampton, B., Newman, S. P., & Ezra, D. G. (2020) · Orbit · doi:10.1080/01676830.2020.1733028 · Cited by 21
“34 The treatment beliefs of patients with BEB and HFS were also examined in this study and demonstrated that both groups of patients value their botulinum toxin treatment, are satisfied with the decisions made about using this treatment, believe their injections cure their condition, and generally…”
Martín-Higarza, Y., Fontanil, Y., Méndez, M. D., & Ezama, E. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17228507 · Cited by 17
“While the role of coping styles seems proven [37], the results obtained in the”
ResultIllness Perception of Patients with Functional Gastrointestinal Disorders
Xiong, N., Wei, J., Ke, M., Hong, X., Li, T., Zhu, L.-M., Sha, Y., Jiang, J., & Fischer, F. H. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00122 · Cited by 22
“Besides, illness perceptions were found to have an even stronger relationship with outcomes than indicators of the severity of illnesses across a range of organic diseases (44).”
BackgroundVarallo, G., Franceschini, C., Rapelli, G., Zenesini, C., Baldini, V., Baccari, F., Antelmi, E., Pizza, F., Vignatelli, L., Biscarini, F., et al. (2024) · Scientific Reports · doi:10.1038/s41598-024-62698-5 · Cited by 20
“Coping strategies are crucial to the management of chronic health conditions in promoting quality of life 17–19 and have been extensively studied in several chronic health conditions 18 .”
BackgroundIllness perception and resilience in patients with cancer: a cross-sectional study
Shabanloei, R., Ghasempour, M., Zamanesazi, R., Purabdollah, M., & Asghari-Jafarabadi, M. (2025) · BMC Psychology · doi:10.1186/s40359-025-02572-9 · Cited by 20
A qualitative study on coping strategies of young women living with breast cancer in Ghana
Iddrisu, M., Aziato, L., & Dedey, F. (2019) · International Journal of Africa Nursing Sciences · doi:10.1016/j.ijans.2019.100173 · Cited by 20
Fisher, P. L., Reilly, J., & Noble, A. (2018) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2018.07.008 · Cited by 19
Application of the common sense model in inflammatory bowel disease: A systematic review
Hayes, B., Moller, S., Wilding, H., Burgell, R., Apputhurai, P., & Knowles, S. R. (2020) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2020.110283 · Cited by 19
Shiloh, S., Peleg, S., & Nudelman, G. (2021) · Psychology and Health · doi:10.1080/08870446.2021.1925670 · Cited by 19
“This theory has been used extensively and successfully in numerous studies of healthy and patient groups around the world (Dempster et al., 2015a; Hagger et al., 2017).”
MethodO’Connor, S. S., Hevey, D., & O’Keeffe, F. M. (2022) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-022-09851-2 · Cited by 19
“However, some degree of overlap may be expected and a person’s general level of distress over the last two weeks as measured by the HADS is likely to be influenced by their emotional response to their illness (Dempster et al., 2015).”
BackgroundXiong, N., Wei, J., Fritzsche, K., Leonhart, R., Hong, X., Li, T., Jiang, J., Zhu, L., Tian, G., Zhao, X., et al. (2017) · Annals of General Psychiatry · doi:10.1186/s12991-017-0158-y · Cited by 19
“Furthermore, how patients understand their symptoms or illness is essential, as it influences their coping behavior [24, 25] and consecutive health outcomes [26].”
BackgroundKudjawu, S., & Agyeman‐Yeboah, J. (2021) · Nursing Open · doi:10.1002/nop2.1029 · Cited by 19
McBride, E., Marlow, L. A. V., Chilcot, J., Moss-Morris, R. E., & Waller, J. (2021) · Annals of Behavioral Medicine · doi:10.1093/abm/kaab022 · Cited by 18
Figueiras, M. J., Neto, D. D., Marôco, J. P., & de Castro, E. K. (2022) · Health Risk & Society · doi:10.1080/13698575.2022.2031911 · Cited by 18
“Illness perceptions have been widely studied and have been shown to predict health-related outcomes and behaviours (Dempster et al., 2015; Kaptein et al., 2015; Mc Sharry et al., 2011).”
BackgroundIllness perceptions in long-COVID: A cross-sectional analysis in adults
Bierbauer, W., Lüscher, J., & Scholz, U. (2022) · Cogent Psychology · doi:10.1080/23311908.2022.2105007 · Cited by 18
“Current results also align with published literature showing that greater concern or worry (i.e., emotional representation) about diseases is related to worse psychological health outcomes (i.e., depressive symptoms, anxiety; e.g., Dempster et al., 2015).”
ResultResilience after severe critical illness: a prospective, multicentre, observational study (RESIREA)
Mathieu, A., Reignier, J., Gouge, A. L., Plantefeve, G., Mira, J.-P., Argaud, L., Asfar, P., Badie, J., Botoc, N.-V., Bui, H., et al. (2024) · Critical Care · doi:10.1186/s13054-024-04989-x · Cited by 16
“Illness perception seems readily amenable to change via simple interventions, which thus deserve to be investigated in survivors of critical illness [41].”
BackgroundZarotti, N., Deane, K., Ford, C., & Simpson, J. (2023) · Disability and Rehabilitation · doi:10.1080/09638288.2023.2181409 · Cited by 16
“Along with its sub-constructs, perceived control is thought to play a pivotal role in the successful adjustment not only to chronic illness in general [35], but also to neurodegenerative diseases specifically [36–39], including Parkinson’s [40].”
BackgroundThong, M. S. Y., Mols, F., Kaptein, A. A., Boll, D., Vos, C., Pijnenborg, J. M. A., van de Poll-Franse, L. V., & Ezendam, N. P. M. (2018) · Supportive Care in Cancer · doi:10.1007/s00520-018-4451-3 · Cited by 17
Kwon, M., & Kang, J. (2018) · Health Psychology Open · doi:10.1177/2055102918817228 · Cited by 17
Lau, J. T. F., Dang, L., Cheung, R. Y.-H., Zhang, M. X., Chen, J. H., & Wu, A. M. S. (2020) · Journal of Behavioral Addictions · doi:10.1556/2006.2020.00043 · Cited by 17
Hill, E. M., & Frost, A. (2020) · Chronic Illness · doi:10.1177/1742395320983875 · Cited by 17
“For the regressions, a hierarchical model was applied; illness perceptions were entered in the first block, followed by coping strategies in the second block—an analytical approach used in previous research on the CSM.12”
BackgroundMethodInfluentialMuñoz-Moreno, J. A., Cysique, L. A., & Rourke, S. B. (2021) · Current topics in behavioral neurosciences · doi:10.1007/7854_2021_233 · Cited by 16
Robertson, E. G., Kelada, L., Ilin, R., Palmer, E. E., Bye, A., Jaffé, A., Kennedy, S., Ooi, C. Y., Drew, D., & Wakefield, C. E. (2024) · Journal of Child Health Care · doi:10.1177/13674935241238485 · Cited by 16
“Research has highlighted the impact of illness perceptions on coping in parents who have a child with a neurological condition, and the relationship between illness perceptions and psychological wellbeing across a range of illnesses (Dempster et al., 2015).”
Mehrabizadeh, M., Zaremohzzabieh, Z., Zarean, M., Ahrari, S., & Ahmadi, A.-R. (2024) · BMC Women's Health · doi:10.1186/s12905-024-03383-7 · Cited by 17
“This is consistent with conclusions from a recent meta-analysis, which found that strategies such as avoidance and emotional venting mediate the relationship between illness perceptions and adjustment in illness [56].”
ResultMemory complaints in epilepsy: An examination of the role of mood and illness perceptions
Tinson, D., Crockford, C., Gharooni, S., Russell, H., Zoeller, S., Leavy, Y., Lloyd, R., & Duncan, S. (2018) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2017.11.028 · Cited by 15
The Impact of Illness Perceptions and Coping Strategies on Use of Supportive Care for Cancer
Stephenson, P., Yuen, E. Y. N., Skaczkowski, G., Spelten, E. R., Orbell, S., & Wilson, C. J. (2021) · Cancers · doi:10.3390/cancers13102501 · Cited by 16
“Reflecting past research [39,40], evidence in the present study that coping mediates the illness perception–behavioural outcome relationship was uneven.”
ResultAkin‐Odanye, E. O., Ogo, C. N., Sulaiman, F. A., Suleiman, L., Ogunsanya, M. E., & Odedina, F. T. (2021) · African Journal of Urology · doi:10.1186/s12301-021-00173-7 · Cited by 16
Barberis, N., Cannavò, M., Cuzzocrea, F., Saladino, V., & Verrastro, V. (2023) · Psychology Health & Medicine · doi:10.1080/13548506.2023.2175878 · Cited by 16
“In this regard, the current study endorses results stemming from psychosomatic research emphasizing the significant correlation between illness perceptions and psychological distress found in medical populations (Broadbent et al., 2015; Dempster et al., 2015).”
ResultThe Common Sense Model of Self-Regulation: Meta-Analysis and Test of a Process ModelPreprint
Hagger, M. S., Koch, S., Chatzisarantis, N. L. D., & Orbell, S. (2017) · doi:10.31234/osf.io/wx54h · Cited by 20
Mavroeides, G., & Koutra, K. (2021) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2021.100099 · Cited by 16
Xin, M., Chan, V. W. Y., Kong, A. P. S., Lau, J. T. F., Cameron, L. D., Mak, W. W. S., & Mo, P. K. H. (2022) · Patient Education and Counseling · doi:10.1016/j.pec.2022.107581 · Cited by 16
Ames, S. C., Lange, L. J., Ames, G. E., Heckman, M. G., White, L. J., Roy, V., & Foran, J. M. (2024) · Cancer Medicine · doi:10.1002/cam4.6906 · Cited by 14
“12,13 To our knowledge, illness perception in HSCT has been investigated in only one prior study.”
BackgroundA meta‐analysis of coping strategies and psychological distress in rheumatoid arthritis
Hinch, R., & Sirois, F. M. (2024) · British Journal of Health Psychology · doi:10.1111/bjhp.12726 · Cited by 17
Rzeszutek, M., Pięta, M., & Huzar, M. (2019) · Brain and Behavior · doi:10.1002/brb3.1488 · Cited by 16
Sirri, L., Pierangeli, G., Cevoli, S., Cortelli, P., Grandi, S., & Tossani, E. (2018) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2018.05.011 · Cited by 14
Karademas, E. C., Barouxi, E., & Mavroeides, G. (2018) · Psychology and Health · doi:10.1080/08870446.2018.1525490 · Cited by 14
Chen, L., Huang, Z., Jiang, C., Wu, C., He, S., Zeng, F., Huang, S., & Zhang, F. (2025) · BMC Public Health · doi:10.1186/s12889-024-21260-8 · Cited by 13
Geller, S., Levy, S., & Avitsur, R. (2025) · Health Psychology Open · doi:10.1177/20551029251327441 · Cited by 16
“…al., 2020), gastroparesis (Woodhouse et al., 2018), asthma (Achstetter et al., 2019), osteoarthritis (Knowles et al., 2016), cancer (Dempster et al., 2012; Lee et al., 2023), heart conditions (McCabe and Barnason, 2012), and brain injuries (Snell et al., 2013), among others (Dempster et al., 2015).”
Chan, V. W. Y., Kong, A. P. S., Lau, J. T. F., Mak, W. W. S., Cameron, L. D., & Mo, P. K. H. (2020) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000883 · Cited by 14
Psychological processes in adapting to dementia: Illness representations among the IDEAL cohort.
Clare, L., Gamble, L. D., Martyr, A., Quinn, C., Litherland, R., Morris, R. G., Jones, I. R., & Matthews, F. E. (2021) · Psychology and Aging · doi:10.1037/pag0000650 · Cited by 13
“Several meta-analytic reviews provide evidence that individual elements of the IR are associated with outcomes, albeit with small-to-moderate effect sizes, across a range of physical health conditions (Dempster et al., 2015; Hagger et al., 2017; Hagger & Orbell, 2003) and in specific conditions such as stroke (Pai et…”
BackgroundPsychosocial impact of being diagnosed with mild cognitive impairment: patient and carer perspective
Munawar, N., Kennedy, L., Usman, M., Burgui, D., Bruce, I., Robinson, D. J., & Greene, E. (2023) · BJPsych Open · doi:10.1192/bjo.2023.499 · Cited by 14
Schmid‐Mohler, G., Caress, A., Spirig, R., & Yorke, J. (2019) · Journal of Advanced Nursing · doi:10.1111/jan.13968 · Cited by 13
Sadeghi, M., Alavi, M., Mohammadi, M., Roohafza, H., Mahmoodi, A., Visentin, D. C., López, V., & Cleary, M. L. (2019) · Nursing and Health Sciences · doi:10.1111/nhs.12635 · Cited by 14
Metadata
- Authors
- Dempster, M., Howell, D., & McCorry, N. K.
- Affiliations
- Queen's University Belfast (GB)
- University of Toronto (CA)
- Marie Curie Hospice (GB)
- Corresponding author
- Dempster, Martin
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2015-12
- Volume
- 79
- Issue
- 6
- Pages
- 506-513
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W2188189394
- Cited by
- 275
- References
- 56
- Citations by year
- 2026: 19 · 2025: 33 · 2024: 37 · 2023: 31 · 2022: 26 · 2021: 39 · 2020: 22 · 2019: 21 · 2018: 24 · 2017: 16 · 2016: 7
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- green
- pure.qub.ac.uk
- Licence
- cc-by-nc-nd
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (Queen's University Belfast) (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health, psychology, and well-being
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- illness perception, coping strategies, physical illness, depression, anxiety, quality of life, emotional distress, emotion representation
- MeSH terms
- Adaptation, Psychological, Anxiety, Depression, Emotions, Health Status, Humans, Judgment, Quality of Life, Stress, Psychological
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