Cognitive theory and illness behavior in disability syndromes

There are many controversial disability syndromes, representing medicolegal and social dilemmas for a variety of medical disciplines. While illness be havior and sick role phenomena are often invoked to explain many of these s yndromes, the extent to which such phenomena are under volitional control h as not been thoroughly explored. The volitional control of illness behavior has important treatment implications, and may explain why cognitive therap y can be effective in these patients. Further understanding of the relevanc e of cognitive theory to illness behavior, the sick role, secondary gain, a nd disability may render even more effective cognitive therapy approaches. This review explores the consciousness states, the role of each state in in formation processing (in this case processing illness information), the aut omaticity and hence volitional state oi each level of information processin g, and the likelihood that illness behavior in disability syndromes is voli tional. The cognitive model of these syndromes considers the interaction of automaticity, volition, and illness behavior and likely has numerous clini cal, social, and legal applications. (C) 2001 Harcourt Publishers Ltd.