Representations of depression and schizophrenia in the community: The role of illness and risk perceptions on help-seeking intentions.

Objective: Illness perceptions (IPs) are important in understanding human reactions to illnesses, including mental health disorders. They influence risk perceptions and several variables relevant to the adjustment to a disorder, treatment seeking, and health outcomes. This study sought to compare IP, risk perception, and help-seeking intention for depression and schizophrenia in a community sample and to assess the mediating role of risk perception in the relationship between IP and help-seeking intention. Materials and methods: A total of 380 adults participated in this study and filled out self-report measures of IPs, risk perceptions, and help-seeking intention. The previous diagnosis of depression was used to control the comparisons between the two disorders. A structural equation model (SEM) was used to test the mediation relationship. Results: Perceived consequences, expected timeline, lack of personal control, and symptom identity were higher for schizophrenia, while lack of treatment control and concern were higher for depression. An interaction occurred with a previous diagnosis of depression for several dimensions of IP. Concerning the SEM, a valid model was obtained for depression, explaining 15.5% of help-seeking intentions, but not for schizophrenia. Conclusion: The results show that the general population represents depression and schizophrenia differently. These representations are influenced by having experienced depression, and that illness and risk perceptions contribute to explaining the intention to seek help. Considering these illness representations makes it possible to understand the general population's emotional and cognitive reactions to mental health disorders.

Corrigendum: Representations of depression and schizophrenia in the community: The role of illness and risk perceptions on help-seeking intentions.

[This corrects the article DOI: 10.3389/fpsyg.2022.1011195.].

Definition and Characteristics of Behavioral Medicine, and Main Tasks and Goals of the International Society of Behavioral Medicine-an International Delphi Study.

BACKGROUND: In the past decades, behavioral medicine has attained global recognition. Due to its global reach, a critical need has emerged to consider whether the original definition of behavioral medicine is still valid, comprehensive, and inclusive, and to reconsider the main tasks and goals of the International Society of Behavioral Medicine (ISBM), as the umbrella organization in the field. The purpose of the present study was to (i) update the definition and scope of behavioral medicine and its defining characteristics; and (ii) develop a proposal on ISBM's main tasks and goals. METHOD: Our study used the Delphi method. A core group prepared a discussion paper. An international Delphi panel rated questions and provided comments. The panel intended to reach an a priori defined level of consensus (i.e., 70%). RESULTS: The international panel reached consensus on an updated definition and scope of behavioral medicine as a field of research and practice that builds on collaboration among multiple disciplines. These disciplines are concerned with development and application of behavioral and biomedical evidence across the disease continuum in clinical and public health domains. Consensus was reached on a proposal for ISBM's main tasks and goals focused on supporting communication and collaboration across disciplines and participating organizations; stimulating research, education, and practice; and supporting individuals and organizations in the field. CONCLUSION: The consensus on definition and scope of behavioral medicine and ISBM's tasks and goals provides a foundational step toward achieving these goals.

Psychometric Properties of the Brazilian Version of the Revised Illness Perception Questionnaire for Healthy Women (IPQ-RH) / Propriedades Psicométricas da Versão Brasileira do Questionário de Percepção da Doença Revisado para Mulheres Saudáveis (IPQ-RH) / Propriedades Psicométricas de la Versión Brasileña del Cuestionario de Percepción de la Enfermedad Revisado para Mujeres Sanas (IPQ-RH)

Abstract The Common Sense Model refers to the association between disease perception and health behaviors. This study aimed to analyze the psychometric properties of the Revised Illness Perception Questionnaire for Healthy People - (IPQ-RH) in healthy women about breast cancer. A total of 321 women participated, with a mean age of 55.72 years old (SD = 10.75), users of Basic Health Units. Confirmatory factor analyzes (CFAs) were carried out and the McDonald's Omega and Cronbach's alpha coefficients were calculated. The results of the CFAs confirmed the structure of seven factors for the IPQ-RH (CFI = .92; TLI = .91; RMSEA = .03; SRMR = .06) and of two factors for the subscale of causes of the disease (CFI = .97; TLI = .97; RMSEA = .00; SRMR = .05). The instrument's reliability was, in general, satisfactory. The IPQ-RH has appropriate psychometric properties to investigate the illness perception in healthy women.

Resumo O Modelo do Senso Comum aponta para a associação entre a percepção da doença e comportamentos em saúde. Este estudo teve por objetivo examinar as propriedades psicométricas do Questionário de Percepção da Doença para Pessoas Saudáveis - Revisado (IPQ-RH) em mulheres saudáveis sobre o câncer de mama. Participaram 321 mulheres, com idade média de 55,72 anos (DP = 10,75), usuárias de Unidades Básicas de Saúde. Foram realizadas análises fatoriais confirmatórias (AFCs) e calculados os coeficientes Ômega de McDonald e alpha de Cronbach. Os resultados das AFCs confirmaram a estrutura de sete fatores para o IPQ-RH (CFI = .92; TLI = .91; RMSEA = .03; SRMR = .06) e de dois fatores para a subescala de causas da doença (CFI = .97; TLI = .97; RMSEA = .00; SRMR = .05). A fidedignidade do instrumento foi, em geral, satisfatória. O IPQ-RH apresenta propriedades psicométricas adequadas para investigar a percepção da doença em mulheres saudáveis.

Resumen El modelo del Senso Comum refiere que existe una asociación entre percepción dela enfermedad y conductas em salud. El objetivo de la investigación fue examinar las propiedades psicométricas del Cuestionário de Percepción de la Enfermedad para personas sanas - Revisado (IPQ-RH) en mujeres sanas con respecto al cáncer de mama. Participaron 321 mujeres, con edad media de 55,72 años (DP = 10,75), usuarias de la atención primaria en salud. Fueron realizadas análisis factoriales confirmatórias (AFCs) y calculados los coeficientes Omega de McDonald y alpha de Cronbach. Los resultados de las AFCs confirmaron la estructura de siete factores para el IPQ-RH (CFI = 0.92; TLI = 0.91; RMSEA = 0.03; SRMR = 0.06) y de dos factores para la subescala de las causas de la enfermedad (CFI = 0.97; TLI = 0.97; RMSEA = 0.00; SRMR = 0.05). La fiabilidad del cuestionario fue, en general, satisfactoria. El IPQ-RH presenta propiedades psicométricas adecuadas para investigar la percepción de la enfermedad en mujeres sanas.

Impact of economic crisis on the social representation of mental health: Analysis of a decade of newspaper coverage.

BACKGROUND: Mass media plays a fundamental role in how communities understand mental health and its treatment. However, the effect of major events such as economic crises on the depiction of mental health is still unclear. AIMS: This study aimed at analyzing representations of mental health and its treatment and the impact of the 2008 economic crisis. METHODS: In total, 1,000 articles were randomly selected from two newspapers from a period before and after the economic crisis. These articles were analyzed with a closed coding system that classified the news as good or bad news according to the presence of themes associated with positive or stigmatizing representations. RESULTS: The results show a positive representation of mental health and a negative representation of treatment. Furthermore, the economic crisis had a negative impact on the representation of mental health, but not on treatment. CONCLUSION: These findings suggest that the representation of mental health is multifaceted and may be affected differently in its dimensions. There is a need for stigma-reducing interventions that both account for this complexity and are sensitive to context and period.

Discerning the impact of personal and situational variables in risk perception of coronary heart disease.

Research into how people perceive risk has highlighted the interaction between the available information and personal variables and their impact on judgement. This study sought to identify demographic and health variables that influenced risk and the influence of individual risk assessment, dispositional optimism and negative affect on judgement. A total of 476 participants were asked to make risks judgements of 24 vignettes depicting hypothetical risk scenarios. The findings showed that while people are able to correctly recognise, in others, relevant risk factors for coronary heart disease, risk perception is likely to imply a personal consideration of the same risk factors in themselves.

Randomized controlled trial of an intervention to change cardiac misconceptions in myocardial infarction patients.

There is converging evidence that changing beliefs about an illness leads to positive recovery outcomes. However, cardiac misconceptions interventions have been investigated mainly in Angina or Coronary Heart Disease patients, and less in patients following Myocardial Infarction (MI). In these patients, cardiac misconceptions may play a role in the adjustment or lifestyle changes. This article reports a randomized controlled trial of an intervention designed to reduce the strength of misconceptions in patients after a first MI. The primary outcome was the degree of change in misconceptions and the secondary outcomes were: exercise, smoking status, return to work and mood (anxiety and depression). Patients in the intervention condition (n = 60) were compared with a control group (n = 67) receiving usual care. Both groups were evaluated at baseline and 4, 8 and 12 months after hospital discharge. There was a significant time-by-group interaction for the total score of cardiac misconceptions. Patients in the intervention group significantly decreased their total score of cardiac misconceptions at 4 months compared with the control group and this difference was sustained over time. Patients in the intervention group were also more likely to exercise at the follow-up period after MI than the control group. This intervention was effective in reducing the strength of cardiac misconceptions in MI patients and had a positive impact on health behaviour outcomes. These results support the importance of misconceptions in health behaviours and the utility of belief change interventions in promoting health in patients with Myocardial Infarction.

Illness perception, knowledge and self-care about cervical cancer / Percepção da doença, conhecimento e autocuidado sobre o câncer do colo do útero

Prevention plays a central role in early detection of cervical cancer. Common Sense Model proposes that the nature and organization of illness representations can guide actions related to health and how self-care is exercised. The aim of this study was to describe and compare illness perception, knowledge and self-care in women with and without cancer precursor lesions. Participants were 92 women (aged 18-59) from primary care unity divided into two groups: women with and without premalignant lesion. Measures for illness perception, knowledge and self-care were used. There was no statistically significant difference (t test e chi-square test) between groups in the variables analyzed. Despite the risk for cervical cancer, women with precursor lesions do not adjust their illness perceptions, knowledge and self-care to the situation. These data show the need to warn women against the cervical cancer risks, because their distorted perceptions and lack of knowledge about the disease may hamper the screening and control of cervical cancer.

A prevenção tem papel central na detecção precoce do câncer do colo do útero. O Modelo do Senso Comum propõe que a natureza e a organização das representações da doença podem orientar ações relacionadas à saúde e ao modo como o autocuidado é exercido. Este estudo buscou caracterizar e comparar a percepção da doença, o conhecimento e o autocuidado em mulheres com e sem lesões precursoras de câncer do colo do útero. Participaram 92 usuárias de uma Unidade Básica de Saúde (18-59 anos), dividas em dois grupos pareados por idade e escolaridade: com e sem lesões precursoras do colo do útero. Foram utilizados instrumentos de avaliação da percepção da doença, conhecimento sobre o câncer do colo do útero e autocuidado. Não houve diferenças estatisticamente significativas (teste t e qui-quadrado) entre os grupos quanto às variáveis investigadas. Apesar de estarem em risco para o câncer do colo do útero, as mulheres com lesões precursoras não ajustaram sua percepção da doença, conhecimento e autocuidado à situação. Esse dado alerta para a necessidade de sensibilizar as mulheres sobre o risco da doença, já que percepções errôneas e o desconhecimento sobre a doença podem dificultar o seu amplo rastreio e controle.

Cardiac misconceptions among healthy adults: implications for the promotion of health in the community.

This study sought to confirm the structure and to investigate the psychometric properties of an experimental Portuguese version of the York Cardiac Beliefs Questionnaire (YCBQ) in a general population sample. It also set out to identify the prevalent misconceptions in the community and to assess the differences according to socio-demographic characteristics. It involved a cross-sectional survey in which both test and validation samples were collected (n = 476), including participants aged between 18 and 40, recruited via e-mail and social networks. The Confirmatory Factor Analysis on both samples suggested a shorter, three factor version of the YCBQ. Also, misconceptions differed significantly according to sociodemographic variables. The validation of the YCBQ for samples in the community constitutes an important starting point to promote research on misconceptions held in the community by specific groups, as well as to provide key points for health promotion.

Cardiac misconceptions among healthy adults: implications for the promotion of health in the community / Crenças erróneas sobre as doenças cardíacas em adultos saudáveis: implicações para a promoção da saúde na comunidade

This study sought to confirm the structure and to investigate the psychometric properties of an experimental Portuguese version of the York Cardiac Beliefs Questionnaire (YCBQ) in a general population sample. It also set out to identify the prevalent misconceptions in the community and to assess the differences according to socio-demographic characteristics. It involved a cross-sectional survey in which both test and validation samples were collected (n = 476), including participants aged between 18 and 40, recruited via e-mail and social networks. The Confirmatory Factor Analysis on both samples suggested a shorter, three factor version of the YCBQ. Also, misconceptions differed significantly according to sociodemographic variables. The validation of the YCBQ for samples in the community constitutes an important starting point to promote research on misconceptions held in the community by specific groups, as well as to provide key points for health promotion.

Este estudo teve como objetivo confirmar a estrutura e investigar as propriedades psicométricas de uma versão experimental portuguesa do York Cardiac Beliefs Questionnaire numa amostra da população geral; identificar as crenças erróneas mais fortes na comunidade; e avaliar as diferenças de acordo com características sociodemográficas. Trata-se de um estudo transversal com uma amostra de teste e outra de validação, incluindo um total de 476 participantes, com idade entre 18 e 40 anos, recrutados via e-mail e nas redes sociais. A Análise Fatorial Confirmatória em ambas as amostras indicou uma versão reduzida do YCBQ de três factores. As crenças erróneas diferiram significativamente de acordo com as variáveis sociodemográficas. A validação do YCBQ para amostras da comunidade constitui um importante ponto de partida para promover a investigação sobre crenças erróneas em grupos específicos da comunidade, assim como fornecer indicadores relevantes para a promoção da saúde.

The relationship between illness perceptions and cardiac misconceptions after Myocardial Infarction.

Research about cardiac misconceptions has focused on identifying the most common erroneous beliefs and understanding their impact on patients' outcomes. However, less is known about the underlying structure of cardiac misconceptions and how they relate to other belief dimensions. The aims of the present study were: (a) to characterize illness perceptions and cardiac misconceptions in a sample of Myocardial Infarction (MI) patients; (b) to analyse the structure of an experimental Portuguese version of the York Cardiac Beliefs Questionnaire (YCBQ); and (c) to examine whether illness perceptions are likely to influence cardiac misconceptions. This cross-sectional study included 127 first-MI patients from both sexes, aged up to 70 years old. Confirmatory factor analysis and structural equation modelling were performed with AMOS. The main results showed that a two-dimension (stress avoidance and exercise avoidance) version of the YCBQ offered the best fit to the data. A significant impact of psychological attributions was observed on cardiac misconceptions, as well as a moderate impact of emotional response explaining 26% of the variance. Although exploratory, this study gives a significant contribution to research in this field, as clarification on the different concepts and the way they relate is needed. Our findings suggest that further investigation into the concepts of cardiac knowledge and cardiac misconceptions may have an important role in understanding health behaviours in the context of heart disease.

Lay views about medicines: the influence of the illness label for the use of generic versus brand.

The aim of this cross-sectional study was to investigate how different types of prescriptions using different illness labels may influence lay views about the use of generic or brand medicines. The participants were 882 Portuguese (both sexes) recruited from the general population, who completed a self-administered questionnaire. A vignette methodology was used in which different prescriptions (generic versus brand) were given for the same label (flu, hypertension, asthma and angina pectoris). The dependent variables were for each illness label: (a) the level of agreement with the prescription, (b) beliefs about the efficacy of a medicine and (c) beliefs about the relief of symptoms. There were main effects of the label and the type of prescription upon beliefs about the use of medicines. There were interactions between illness label and type of medicines. Labels which were perceived as more serious were associated with a lower belief in generic medicines. These results raise important questions concerning the need to consider illness perceptions of lay people (including perceived severity) and its relationship with perceptions of treatment for different conditions. Furthermore, these results may have implications for health-related behaviour in general, and in particular for communication between lay people and health professionals, prescribing behaviour, health costs and adherence to treatment.

People's views on the level of agreement of generic medicines for different illnesses.

OBJECTIVES: The present study aims to investigate (1) what is the influence of illness labels (flu, asthma and angina pectoris) upon the level of agreement with the prescription of generic medicines, and (2) the influence of socio-demographic factors on lay beliefs about generic medicines, in general, and for different illness labels. METHOD: This was a cross-sectional design in which the participants were Portuguese, men and women, aged over 18 years old, and recruited from the general population (non-patients). The participants completed an anonymous self-administered questionnaire which included measures of lay beliefs about generic medicines in general (GMS), level of agreement with the prescription of a generic medicines for different illnesses, and socio-demographic factors. MAIN OUTCOME MEASURE: Level of agreement with the use of generic medicines for flu, asthma and angina pectoris. Results Participants seemed to have well-defined beliefs about generics concerning their efficacy and similarity with brand medicines. Beliefs about the efficacy of generic medicines were significantly different according to the three age groups (18-25 years, mean = 3.84 (0.56); 26-37 years, mean = 3.80 (0.61); >38 years, mean = 3.72 (0.66); F = 4.4; P = 0.01), and level of education attained (9 years, mean = 3.60 (0.69); 12 years, mean = 3.78 (0.57); graduate, mean = 3.93 (0.54); F = 32.2; P = 0.000). Although participants have a moderate level of agreement with the prescription of generic medicines for the three different illnesses, their agreement significantly decreased when the illness was perceived as more serious. The lay beliefs about generics seemed to moderate the level of agreement with the prescription of a generic medicine. CONCLUSIONS: Lay beliefs about generic medicines may influence the level of agreement with the prescription of a generic medicine in a general population sample. These results raise important questions concerning the need to consider illness perceptions of lay people and their relationship with perceptions of treatment for different conditions.