Cognitive representations of breast cancer. Emotional distress and preventive health behaviour: A theoretical perspective

Individuals at high risk for developing breast and/or ovarian cancer are fa ced with difficult decisions regarding genetic testing, cancer prevention a nd/or intensive surveillance. Large interindividual differences exist in th e uptake of these health-related services. This paper is aimed at understan ding and predicting how people emotionally and behaviourally react to infor mation concerning genetic predisposition to breast/ovarian cancer. For this purpose, the self-regulation model of illness representations is elaborate d. This model suggests that health-related behaviour is influenced by a per son's cognitive and emotional representation of the health threat. These re presentations generate coping behaviour aimed at resolving the objective he alth problems problem-focussed coping) and at reducing the emotional distre ss induced by the health threat (emotion-focussed coping). Based on theoret ical considerations and empirical studies, four interrelated attributes of the cognitive illness representation of hereditary breast/ovarian cancer ar e described: causal beliefs concerning the disease, perceived severity, per ceived susceptibility to the disease and perceived controllability. The pap er also addresses the complex interactions between these cognitive attribut es. emotional distress and preventive health behaviour. Copyright (C) 2000 John Wiley & Sons, Ltd.