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Disease/Illness
Disease – biological event with pathology – disease as a specific entity
Illness – subjective experience – devalued changes
Disease does not exist as a social phenomenon until we agree it does, who labels this: Dr? Patient? Science?
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Diseaseillness
Doctor’s viewPatient’s view
More objectiveMore subjective
GeneralizedIndividualized
AbstractConcrete
CategoricalNarrative
BiomedicalBio-psychosocial
Rational/ ExperimentalPhenomenological
Disease Vs. IllnessDisease Vs. Illness
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A medical model which is based on multilevel A medical model which is based on multilevel
interactions, from molecule to society.interactions, from molecule to society.
Multilevel assessment/ interventionMultilevel assessment/ intervention
The scope of psychosomatic medicine?The scope of psychosomatic medicine?
Person – centered not disease - orientedPerson – centered not disease - oriented
Psychosomatic Approach toPsychosomatic Approach to Disease & Illness Disease & Illness
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Thoughts & Images
Physiology (Central Chemistry)Emotions
Behaviour
Cognitive Model
Environment
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Triggersstress, distress, anxiety, illness, symptoms
Physical symptoms
Meaning/interpretationThreat, loss, inability to cope
Emotional responseAnxietyDepression
Behaviour: rest, checking, reassurance seeking,
medication, treatments
Cognitive Model of Somatisation
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Probability x (perceived cost) awfulness
Anxiety =Perceived ability to cope + chance of help (rescue)
Cognitive behavioural approachto understanding health anxiety
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Factors involved in the maintenance of health anxiety
Physiological & biologicalSymptoms
Bodily variationsMedical information
(Selective attention)(Arousal)
Beliefs about being ill
•Probability•Cost•Coping•RescueReassurance
seeking,Checking, safety behaviours
Mood changes• anxiety• depression
(Prevent disconfirmation) (Alters perception)
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Approach to patients: Approach to patients: disease or illness orienteddisease or illness oriented? ?
Ideas, BeliefsIdeas, Beliefs Cognitive styles Cognitive styles EmotionEmotion FunctionFunction ExpectationExpectation Concerns, questionsConcerns, questions
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What is sick roleWhat is sick role??
The protective role given an individual who is physically or mentally ill or injured; it may be assumed by the individual or it may be imposed as a part of social
custom.
A behavior pattern in which a person adopts the symptoms of a physical or mental disorder to be cared for, sympathized with, and protected from the demands and stresses of life.
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