Stage 1: Interpretation
An individual may be confronted with the problem of a potential illness through two
channels: symptom perception (I have a pain in my chest), or social messages (the doctor
has diagnosed this pain as angina).
Once the individual has received information about the possibility of illness through
these channels, according to theories of problem solving, the individual is then moti-
vated to return to a state of ‘problem-free’ normality. This involves assigning meaning to
the problem. According to Leventhal, the problem can be given meaning by accessing
the individual’s illness cognitions. Therefore, the symptoms and social messages will
contribute towards the development of illness cognitions, which will be constructed
according to the following dimensions: identity, cause, consequences, time line, cure/
control. These cognitive representations of the ‘problem’ will give the problem meaning
and will enable the individual to develop and consider suitable coping strategies.
However, a cognitive representation is not the only consequence of symptom percep-
tion and social messages. The identification of the problem of illness will also result in
changes in emotional state. For example, perceiving the symptom of pain and receiving
the social message that this pain may be related to coronary heart disease may result in
anxiety. Therefore, any coping strategies have to relate to both the illness cognitions and
the emotional state of the individual.Stage 2: Coping
The next stage in the self-regulatory model is the development and identification of
suitable coping strategies. Coping can take many forms, which will be discussed in detail
later in this chapter and in Chapter 11. However, two broad categories of coping have
been defined that incorporate the multitude of other coping strategies: approach coping
(e.g. taking pills, going to the doctor, resting, talking to friends about emotions) and
avoidance coping (e.g. denial, wishful thinking). When faced with the problem of illness,
the individual will therefore develop coping strategies in an attempt to return to a state of
healthy normality.Stage 3: Appraisal
The third stage of the self-regulatory model is appraisal. This involves individuals evalu-
ating the effectiveness of the coping strategy and determining whether to continue with
this strategy or whether to opt for an alternative one.WHY IS THE MODEL CALLED SELF-REGULATORY?
This process is regarded as self-regulatory because the three components of the model
(interpretation, coping, appraisal) interrelate in order to maintain the status quo (i.e.
they regulate the self). Therefore, if the individual’s normal state (health) is disrupted (by
illness), the model proposes that the individual is motivated to return the balance back
to normality. This self-regulation involves the three processes interrelating in an ongoing54 HEALTH PSYCHOLOGY