Lay concepts of health and illness from a developmental perspective

The concepts of children, adolescents and their mothers with regard to diff erent aspects of health and illness in general and five specific diseases w ere explored in this study. An exploration with fully standardised question s and open answers was subjected to a content analysis. A reliable rating s ystem was developed to score the sophistication of the answers. The study i ncluded 99 Ss of the age groups 5, 8, 12 and 16 years, as well as 48 mother s of the children. Many children and adolescents were able to define health positively (well-being) and not merely as the absence of illness. The defi nition of illness in general was frequently composed of somatic symptoms an d disorders, feeling poorly and things one would like to accomplish but can 't. The causality explanations of illness in general were dominated by cont agion. The concepts of the older children and the mothers were richer, more elaborated, less concrete and less action-oriented than those of the young er children. However, abstract formulations and complex aspects of illness were very rarely expressed. In addition, concepts regarding the characteris tics (definition, symptoms, causality, treatment and prevention) of five di seases (cold, measles, heart infarction, cancer and AIDS) were measured. Th e pattern of results was strongly influenced by age. By and large, the deve lopment of most disease concepts was linear with significant differences be tween age groups. Conversely, within a given age group, significant differe nces were found in the cognitive level of disease characteristics, either w ith respect to the same disease or between different diseases ("horizontal shifts").