An analysis of the impact of irrational beliefs and illness representation in predicting distress in cancer and type II diabetes patients.

ABSTRACT The role played by psychological, social and cultural factors in health and illness related behaviors is no longer breaking news. Individual differences such as illness representation and irrational beliefs have been shown to contribute to variability in distress when confronted with stressful events or certain illnesses. However, the relationship among these characteristics is not well established. Moreover, there is considerable lack of research concerning the impact of specific irrational beliefs in mediating the relationship between general irrational beliefs and distress. The purpose of this study was to investigate the interrelations among illness representation, general and specific irrational beliefs and distress levels in type two diabetes and breast cancer patients. The illness representation of 56 patients (30 breast cancer patients and 26 diabetes patients) was evaluated with semi-structured interviews; subsequently, they completed the Beck Depression Inventory, State Trait Anxiety Inventory X1 and X2, Profile of Mood States, Attitudes and Beliefs Scale II and an adapted version of the ABS II for illness. Results revealed that specific illness-related irrational beliefs mediate the relationship between general irrational beliefs and emotional distress (p KEYWORDS: illness representation, general and specific irrational beliefs, distress, diabetes and cancer patients. INTRODUCTION In attempting to understand the variation of individual responses to illness and health, research has focused on different theoretical approaches trying to explain the relationship between various biological, social and psychological aspects of health, illness and health care. In recent years, social cognition models and cognitive behavioral approaches to illness and health have dominated most of the research and practice in this field. In concordance with mainstream literature, several theoretical assumptions guiding our research are briefly presented. Cognitive-behavioral approach to illness and health According to one of the main principles of cognitive behavioral therapy (CBT), all human beings must be analyzed at for distinct levels: cognitive, behavioral, biological and subjective. The cognitive level refers to information content and processing which gives the quality of our subjective level. The behavioral level generally refers to operant behaviors, which are mainly learned motor behaviors under voluntary control. The biological level indicates all modifications taking place in our body at anatomical and physiological level; the modifications of the autonomic nervous system are responsible for the intensity of our subjective state. The subjective level refers to the emotional states generally indicated by various verbal labels. The interactions among these levels explain and produce mental, physical, and psychosomatic disorders on one side and normal functioning of the human being on the other side (David, 2000). For example, the interaction among the environment, internal stimuli and our cognitive structures or information processing can determine a negative subjective state. The role of cognitions in predisposing, causing, and maintaining emotional disturbance has lead to the development of various treatment theories and practices designed to alter cognitions hypothesized to be pathogenic (Olioff, Bryson, & Wadden, 1989). Over the last decades, several hundred papers have been published focusing on cognitive models of psychopathology; Rational Emotive Behavior Therapy (REBT), the first form of CBT, has particularly paid attention to the way people's descriptions and interpretations of life events lead to the way they feel (the subjective level) and act (the behavioral level). REBT is based on Albert Ellis' ABCDE model of emotional distress (Ellis, 1962); according to this model, people experience various activating events (A) about which they have adaptive (rational/functional) or maladaptive (irrational/dysfunctional) beliefs (B). …