APPLYING LEVENTHALS SELF-REGULATION MODEL TO ADAPTATION AND INTERVENTION IN RHEUMATIC DISEASE

Chronic illnesses are the leading cause of death, disability, and heal th care expenditure in the US and UK. Although advances in medical car e have improved survival, people are often left with major limitations in physical, emotional, social and occupational functioning. The pote ntial role of psychology to contribute to the prevention and managemen t of chronic illness is now being recognized (Smith and Nicassio, 1995 ). This paper discusses the application of Leventhal's self regulation model to rheumatic disease (Leventhal et al., 1980, 1984, 1992a,b). P sychological research in rheumatic disease has explored a number of is sues: (1) The role that psychological factors may play in the onset an d course of the disease; (2) the psychological consequences of the dis ease; (3) whether psychological variables may mediate between the dise ase and its outcome; (4) psychological interventions (Anderson et al., 1985; Young, 1992). This paper considers whether the self regulation model provides a useful framework for guiding research in this field. The nature of rheumatic diseases and the challenges they present are c onsidered first followed by a discussion about application of the self regulation model to rheumatic disease. Research that has investigated the role that self regulation processes may play in adaptation to rhe umatic disease is reviewed. Finally we discuss psychological intervent ions for rheumatic disease and consider whether an understanding of se lf regulation processes could improve the design and outcome of these interventions. (C) 1998 John Wiley & Sons, Ltd.