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Silvana Grandi - One of the best experts on this subject based on the ideXlab platform.
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Illness Behavior.
Advances in psychosomatic medicine, 2011Co-Authors: Laura Sirri, Silvana GrandiAbstract:The term Illness Behavior was introduced by Mechanic and Volkart to describe the individuals' different ways to respond to their own health status. Pilowsky's concept of abnormal Illness Behavior encompasses several clinical conditions characterized by a maladaptive mode of experiencing, perceiving, evaluating and responding to one's own health status. The concept of somatization was criticized because it implies the presence of psychological distress or an underlying psychiatric disturbance when an organic cause for somatic symptoms is not found. Thus, more atheoretical terms , such as functional somatic symptoms and medically unexplained symptoms, were introduced. Both Kellner's Symptom Questionnaire and Derogatis' Symptom Checklist-90 include a scale for somatic symptoms, and other questionnaires were specifically designed to measure their frequency and severity. Kellner's Illness Attitude Scales appear to be the gold standard for the measurement of the hypochondriacal spectrum, which includes several clinical conditions, such as nosophobia, thanatophobia and health anxiety. The assessment of Illness denial should consider that a certain degree of denial may sometimes prevent patients from overwhelming psychological distress resulting from life-threatening or stigmatized diseases. Denial may concern both physical and psychiatric symptoms. Specific instruments are available for both types of denial. The cognitive and emotional representations developed by subjects when they have to cope with an Illness or a perceived health threat are subsumed under the concept of Illness perception and may be assessed by the Brief Illness Perception Questionnaire.
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A cluster analysis-derived classification of psychological distress and Illness Behavior in the medically ill
Psychological medicine, 2011Co-Authors: Giovanni A. Fava, Silvana Grandi, Luigi Grassi, Jenny Guidi, Piero Porcelli, Chiara Rafanelli, Antonello Bellomo, Lara Mangelli, Paolo Pasquini, Angelo PicardiAbstract:Background The classification of psychological distress and Illness Behavior in the setting of medical disease is still controversial. Current psychiatric nosology does not seem to cover the spectrum of disturbances. The aim of this investigation was to assess whether the joint use of DSM-IV categories and the Diagnostic Criteria for Psychosomatic Research (DCPR), that provide identification of syndromes related to somatization, abnormal Illness Behavior, irritable mood, type A Behavior, demoralization and alexithymia, could yield subtyping of psychosocial variables in the medically ill. Method A cross-sectional assessment using both DSM-IV and the DCPR was conducted in eight medical centers in the Italian Health System. Data were submitted to cluster analysis. Participants were consecutive medical out-patients and in-patients for whom a psychiatric consultation was requested. A total of 1700 subjects met eligibility criteria and 1560 agreed to participate. Results Three clusters were identified: non-specific psychological distress, irritability and affective disturbances with somatization. Conclusions Two-step cluster analysis revealed clusters that were found to occur across clinical settings. The findings indicate the need of expanding clinical assessment in the medically ill to include the various manifestations of somatization, Illness Behavior and subclinical distress encompassed by the DCPR.
Susan D. Horn - One of the best experts on this subject based on the ideXlab platform.
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Modeling and reinforcement of the sick role during childhood predicts adult Illness Behavior.
Psychosomatic medicine, 1994Co-Authors: William E. Whitehead, Michael D. Crowell, Barbara R. Heller, J. C. Robinson, Marvin M. Schuster, Susan D. HornAbstract:Previous studies suggest that the ways in which parents respond to children's health complaints (reinforcement) and the ways in which they cope with their own Illnesses (modeling) influence the frequency of symptoms, disability days, and health care visits made by these children when they grow up. However, previous studies have not controlled for the mediating influence of stress, neuroticism, and physical examination findings. This study investigated the influence of childhood social learning on adult Illness Behavior in 383 women aged 20 to 40 years. Illness Behavior was measured prospectively for 12 months by the frequency of symptoms, disability days, and physician visits for menstrual, bowel, and cold (upper respiratory) symptoms. Childhood reinforcement and modeling was measured retrospectively by validated questionnaires. Other independent variables were stress, neuroticism, and selected demographic variables. Multiple regression analysis was used to assess the relative contribution of each independent variable to each category of Illness Behavior. The principal findings were as follows. First, childhood reinforcement of menstrual Illness Behavior significantly predicted adult menstrual symptoms and disability days, and childhood reinforcement of cold Illness Behavior significantly predicted adult cold symptoms and disability days. These effects were independent of stress and neuroticism. Second, childhood reinforcement scales were useful to predict which functional disorders (dysmenorrhea or irritable bowel syndrome) these subjects had even after we controlled for stress and neuroticism.
Shunzo Koizumi - One of the best experts on this subject based on the ideXlab platform.
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Abnormal Illness Behavior of patients with functional somatic symptoms: relation to psychiatric disorders.
General hospital psychiatry, 2001Co-Authors: Yingqiu Guo, Toshihide Kuroki, Shunzo KoizumiAbstract:Functional somatic symptoms are highly associated with hypochondriasis, anxiety, and depressive disorders. Despite the absence of an organic disorder, underlying psychological distress of patients with functional somatic symptoms may result in abnormal Illness Behavior such as inadequate treatment seeking or overuse of medical services. Using the Illness Behavior Questionnaire (IBQ), we examined the Illness Behavior of Japanese patients visiting a general medicine clinic whose physical symptoms were considered functional. We used the General Health Questionnaire-30 to classify patients with functional somatic symptoms as those with and without psychological distress. Patients with distress (n=35) reported more physical complaints and higher IBQ scores than did patients without distress (n=22). The IBQ profile of patients with psychological distress was identical to that of patients diagnosed with either hypochondriasis or major depression. The Illness Behavior of patients without psychological distress was indistinguishable from that of patients whose physical symptoms were attributed to organic disease. These results further support the hypothesis that functional somatic symptoms may be associated with hypochondriasis and major depression, the pathology of which may contribute to the development of abnormal Illness Behavior.
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Abnormal Illness Behavior and psychiatric disorders: a study in an outpatient clinic in Japan.
Psychiatry and clinical neurosciences, 2000Co-Authors: Yingqiu Guo, Toshihide Kuroki, Seiji Yamashiro, Takeshi Sato, Masashi Takeichi, Shunzo KoizumiAbstract:Abnormal Illness Behavior, such as hypochondriacal attitude and inappropriate treatment-seeking, has been associated with various psychiatric disorders in which patients tend to abuse medical services and seek inappropriate treatment in general practice clinics rather than psychiatric clinics. However, the relationship between Illness Behavior and psychiatric disorders in Japan is yet to be elucidated. We examined the abnormal Illness Behavior of 243 patients who visited the outpatient department of psychiatry at Saga Medical School Hospital, Saga, Japan, using a Japanese version of the Illness Behavior Questionnaire (IBQ). Multivariate analysis indicated significant association between some of the IBQ scale scores and age, sex and employment status. Patients with anxiety disorder scored higher on five of the seven IBQ scales compared with patients with another major disorder (mood disorder, schizophrenia or somatoform disorder). When compared with the IBQ scale scores reported in Australian patients in a psychiatric hospital, most of the IBQ scale scores differed significantly in our patients; a higher score among Japanese patients on the general hypochondriasis scale was most prominent. A similar trend in IBQ scale scores was also noted among Japanese patients visiting the hospital's general medicine clinic in comparison with Australian patients visiting a general practice clinic. Japanese patients with anxiety disorder may display the most salient abnormal Illness Behaviors among patients with psychiatric disorders. Sociocultural background may contribute to the characteristic abnormal Illness Behaviors of Japanese patients.
William E. Whitehead - One of the best experts on this subject based on the ideXlab platform.
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Intergenerational transmission of gastrointestinal Illness Behavior.
The American journal of gastroenterology, 2000Co-Authors: Rona L. Levy, William E. Whitehead, Michael Von Korff, Andrew D. FeldAbstract:Abstract OBJECTIVE: Previous research, based on retrospective reporting, suggests that parental reinforcement and modeling may be important mechanisms in the development of gastrointestinal Illness Behavior in children and adults. The aim of this study was to determine the relationship between the Illness Behavior of parents, in the form of health care use for irritable bowel symptoms, and the Illness Behavior of their children, without relying on retrospective recall. METHODS: A comparison of two matched groups was made. Groups included 631 children of parents who were diagnosed with irritable bowel syndrome during 1 calendar yr and 646 children of parents matched by parental age, gender, and number of children in the family who did not receive an IBS diagnosis during the same 1 yr. Health care use and costs over a 3-yr calendar period for all children and their parents collected from the health care database of a large health maintenance organization were evaluated. RESULTS: Case children had significantly more ambulatory care visits for all causes (mean 12.26 vs 9.81, p = 0.0001) and more ambulatory visits for gastrointestinal symptoms (0.35 vs 0.18, p = 0.0001). Outpatient health care costs over the 3-yr period were also significantly higher for case than control children ($1979 vs $1546, p = 0.0001). Controlling for the total number of ambulatory visits of the parents, excluding gastrointestinal visits, did not alter the findings. Gender of the IBS parent was not related to children’s gastrointestinal visits. CONCLUSION: This study extends previous research by showing that specific types of Illness Behavior may be learned through modeling.
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Modeling and reinforcement of the sick role during childhood predicts adult Illness Behavior.
Psychosomatic medicine, 1994Co-Authors: William E. Whitehead, Michael D. Crowell, Barbara R. Heller, J. C. Robinson, Marvin M. Schuster, Susan D. HornAbstract:Previous studies suggest that the ways in which parents respond to children's health complaints (reinforcement) and the ways in which they cope with their own Illnesses (modeling) influence the frequency of symptoms, disability days, and health care visits made by these children when they grow up. However, previous studies have not controlled for the mediating influence of stress, neuroticism, and physical examination findings. This study investigated the influence of childhood social learning on adult Illness Behavior in 383 women aged 20 to 40 years. Illness Behavior was measured prospectively for 12 months by the frequency of symptoms, disability days, and physician visits for menstrual, bowel, and cold (upper respiratory) symptoms. Childhood reinforcement and modeling was measured retrospectively by validated questionnaires. Other independent variables were stress, neuroticism, and selected demographic variables. Multiple regression analysis was used to assess the relative contribution of each independent variable to each category of Illness Behavior. The principal findings were as follows. First, childhood reinforcement of menstrual Illness Behavior significantly predicted adult menstrual symptoms and disability days, and childhood reinforcement of cold Illness Behavior significantly predicted adult cold symptoms and disability days. These effects were independent of stress and neuroticism. Second, childhood reinforcement scales were useful to predict which functional disorders (dysmenorrhea or irritable bowel syndrome) these subjects had even after we controlled for stress and neuroticism.
Joris Yzermans - One of the best experts on this subject based on the ideXlab platform.
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noise sensitivity symptoms health status Illness Behavior and co occurring environmental sensitivities
Environmental Research, 2016Co-Authors: Christos Baliatsas, Irene Van Kamp, Wim Swart, Mariette Hooiveld, Joris YzermansAbstract:Epidemiological evidence on the symptomatic profile, health status and Illness Behavior of people with subjective sensitivity to noise is still scarce. Also, it is unknown to what extent noise sensitivity co-occurs with other environmental sensitivities such as multi-chemical sensitivity and sensitivity to electromagnetic fields (EMF). A cross-sectional study performed in the Netherlands, combining self-administered questionnaires and electronic medical records of non-specific symptoms (NSS) registered by general practitioners (GP) allowed us to explore this further. The study sample consisted of 5806 participants, drawn from 21 general practices. Among participants, 722 (12.5%) responded "absolutely agree" to the statement "I am sensitive to noise", comprising the high noise-sensitive (HNS) group. Compared to the rest of the sample, people in the HNS group reported significantly higher scores on number and duration of self-reported NSS, increased psychological distress, decreased sleep quality and general health, more negative symptom perceptions and higher prevalence of healthcare contacts, GP-registered NSS and prescriptions for antidepressants and benzodiazepines. These results remained robust after adjustment for demographic, residential and lifestyle characteristics, objectively measured nocturnal noise exposure from road-traffic and GP-registered morbidity. Co-occurrence rates with other environmental sensitivities varied between 9% and 50%. Individuals with self-declared sensitivity to noise are characterized by high prevalence of multiple NSS, poorer health status and increased Illness Behavior independently of noise exposure levels. Findings support the notion that different types of environmental sensitivities partly overlap.
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comparing non specific physical symptoms in environmentally sensitive patients prevalence duration functional status and Illness Behavior
Journal of Psychosomatic Research, 2014Co-Authors: Christos Baliatsas, Irene Van Kamp, Mariette Hooiveld, Joris Yzermans, Erik LebretAbstract:article i nfo Objective:Littleisknown about thepotential clinical relevance ofnon-specific physicalsymptoms (NSPS)report- ed by patients with self-reported environmental sensitivities. This study aimed to assess NSPS in people with general environmental sensitivity (GES) and idiopathic environmental intolerance attributed to electromagnetic fields (IEI-EMF) and to determine differences in functional status and Illness Behavior. Methods: An epidemiological study was conducted in the Netherlands, combining self-administered question- naires with the electronic medical records of the respondents as registered by general practitioners. Analyses in- cluded n = 5789 registered adult (≥18 years) patients, comprising 5073 non-sensitive (NS) individuals, 514 in the GES group and 202 in the IEI-EMF group. Results: Participants with GES were about twice as likely to consult alternative therapy compared to non- sensitive individuals; those with IEI-EMF were more than three times as likely. Moreover, there was a higher prevalence of symptoms and medication prescriptions and longer symptom duration among people with sensi- tivities. Increasing number and duration of self-reported NSPS were associated with functional impairment, ill- ness Behavior, negative symptom perceptions and prevalence of GP-registered NSPS in the examined groups. Conclusion: Even after adjustment for medical and psychiatric morbidity, environmentally sensitive individuals experience poorer health, increased Illness Behavior and more severe NSPS. The number and duration of self- reported NSPS are important components of symptom severity and are associated with characteristics similar to those of NSPS in primary care. The substantial overlap between the sensitive groups strengthens the notion that different types of sensitivities might be part of one, broader environmental Illness.
