Treating Illness Distress in Chronic Illness: Integrating Mental Health Approaches With Illness Self-Management

Hudson, Joanna L.; Moss-Morris, Rona

doi:10.1027/1016-9040/a000352

Cited by 27Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and AssessmentsCancer survivorship and care

Treating Illness Distress in Chronic Illness: Integrating Mental Health Approaches With Illness Self-Management

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Hudson, Joanna L., Moss-Morris, Rona·2019·European Psychologist

DOI 10.1027/1016-9040/a000352

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Abstract

Abstract. Cognitive-behavioral therapy (CBT) is an evidence-based treatment for depression and anxiety recommended for those with and without physical long-term conditions (LTCs). However, the cognitive-behavioral mechanisms targeted in CBT protocols are based on empirical cognitive-behavioral models of depression and anxiety. In these models, emotions are conceptualized as primary mental health disorders rather than a reaction to the challenges of living with a LTC commonly referred to as illness distress. This raises important clinical questions with theoretical implications. These include: Is the experience of illness distress conceptually distinct from primary mental health diagnoses of anxiety and mood disorder? Are there unique cognitive-behavioral mechanisms related to illness self-management, which should be incorporated into CBT for illness distress? How can illness self-management interventions be embedded within existing CBT protocols for depression and anxiety? To address these questions, we distinguish between primary mental health disorders and illness distress conceptually and explore the impact of this on tailored treatment planning and engagement. Second, we review how health psychology theoretical models can help to inform modifications of existing cognitive-behavioral treatments for anxiety and depression to better support the needs of individuals experiencing illness distress. Third, we provide examples of how to embed processes important for illness self-management including, illness cognitions and adherence, alongside existing CBT techniques. The mechanisms and intervention techniques discussed may help to inform the development of integrated CBT treatments for illness distress for future hypothesis testing in comparative effectiveness trials.

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Jones, A. S. K., Seaton, N., Brown, A., Jenkinson, E., Carroll, S., Dietz, K. C., Hudson, J. L., Wroe, A. L., & Moss-Morris, R. E. (2025) · Psychological Medicine · doi:10.1017/s003329172500090x · Cited by 6 · see citing works
“Third, relating adjustment to diagnostic levels of anxiety and depression may unnecessarily pathologize the negative emotionsresulting fromobject-ively challenging illness-related stressors (Hudson & Moss-Morris, 2019).”
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Development and validation of the Brief Assessment of Distress about Pain
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Keikhosrokiani, P., Isomursu, M., Korhonen, O., & Sean, T. T. (2024) · Communications in computer and information science · doi:10.1007/978-3-031-59080-1_24 · Cited by 3 · see citing works
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Self-citation
The plight of prestige: The subjective experiences of women managing chronic physical illnesses and their emotional well-being in the context of the prestige hierarchy
Hook, C., Palfreyman, Z., Gibson, B., & Svirydzenka, N. (2025) · Journal of Health Psychology · doi:10.1177/13591053251329675 · Cited by 1 · see citing works
“Such challenges, including the burden of symptoms or stigma can reduce emotional well-being (EWB) (Hudson and Moss-Morris, 2019).”
Stress and Coping in Teens with Chronic Physical Health Conditions: A Cross-Sectional Study
Ersig, A. L., Hawn, R., Nolan, N., & Brown, R. (2025) · Children · doi:10.3390/children12070858 · Cited by 1 · see citing works
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Type 1 diabetes and mental health difficulties: development of an evidence-based care pathway identification tool
Jell, G., Wroe, A. L., Saadiya, A., Causier, C., Palmer, E., Dosanjh, L., & McKechnie, V. (2025) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x25100159
“It is understood that the distress experienced in a primary mental health disorder such as anxiety or depression differs significantly from the distress experienced as part of a long-term health condition (Carroll et al ., 2022; Hudson and Moss-Morris, 2019).”
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“While diabetes-related distress is frequently discussed in health and psychology research [8, 26], the psychological, emotional, and motivational aspects of self-care remain relatively underexplored from a design perspective in HCI.”
Associations between older adults’ attitudes to ageing, mental health, and quality of life: a systematic review
Overman, M. J., Hopkins, L., & Evans, K. (2026) · European Journal of Ageing · doi:10.1007/s10433-026-00932-x
“Mental health in older adults with particular health conditions or living in residential care can be affected by distinct illness-related psychological processes (Vilhjalmsson 1998; Hudson and Moss-Morris 2019) and environmental or institutional factors (Choi et al. 2008; Chao and Chen 2019).”

Authors: Hudson, J. L., & Moss-Morris, R.
Affiliations: King's College London (GB)
ORCID: Hudson, Joanna L.
Moss-Morris, Rona
Venue: European Psychologist
Publisher: Hogrefe Publishing Group
Published: 2019-01
Volume: 24
Issue: 1
Pages: 26-37
ISSN: 1016-9040 (ISSN-L)
1878-531X
DOI: 10.1027/1016-9040/a000352
OpenAlex: W2914141747
Cited by: 27
References: 67
Citations by year: 2026: 2 · 2025: 5 · 2024: 3 · 2023: 1 · 2022: 6 · 2021: 3 · 2020: 4 · 2019: 3
FWCI: 4.72
Type: journal article
Language: en
Open access: green
kclpure.kcl.ac.uk
Licence: other-oa
Locations: European Psychologist (publishedVersion)
Research Portal (King's College London) (submittedVersion, other-oa)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords: chronic disease, cognitive behavioral therapy, depression, anxiety, illness self-management, illness cognitions, medication adherence, treatment engagement

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Treating Illness Distress in Chronic Illness: Integrating Mental Health Approaches With Illness Self-Management

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