ABSTRACT

The current chapter updates and reorganizes our earlier handbook contribution, “Representations, Procedures and Affect in Illness Self Regulation” (H. Leventhal, Leventhal, and Cameron, 2001). The changes are a product of our insights into what the common-sense model (CSM) is now telling us and was telling us throughout its history. The CSM has undergone a number of changes in name refl ecting the evidence and insights into the mechanisms underlying response to health information. The earliest version, the parallel processing model (H. Leventhal, 1970), emerged from studies of fear communications. The data from these studies showed that cognitive information and affective information were processed as separate, interacting meanings and feelings that affected immediate and delayed response to warnings of threatening health events. The fear studies and the descriptive and experimental studies of preparation for and response to stressful interventions-for example, such medical interventions as endoscopy (Johnson & Leventhal, 1974), such natural but stressful processes as childbirth (E. A. Leventhal, Leventhal, Shacham, & Easterline, 1989), and laboratory tests examining responses to the cold pressor (Ahles, Blanchard, & Leventhal, 1983; H. Leventhal, Brown, Shacham, & Engquist, 1979)—indicated that procedures and action plans, the nondeclarative knowledge involved in self-regulation, were separate from the cognitive representations and emotional reactions to stressful events. These data led us to change the model’s name from “parallel processing model” to “self-regulation model” to emphasize the focus on the performance components (perceptions and action plans) of the system. Finally, as we and many other investigators identifi ed the cognitive contents and processes that guided how patients managed chronic conditions in their home environments, we recognized that a patient’s cognitive representations of a condition and its treatment provided the frameworks guiding everyday management. The cognitive emphasis led to a mix of renaming, including “model of illness cognition” (Croyle & Barger, 1993), “mental representations in health and illness” (Skelton & Croyle, 1991), and “common-sense representation of illness danger” (H. Leventhal, Meyer, & Nerenz, 1980). In sum, the name changes refl ect the

evolution of the CSM as a framework for understanding how people adapt to health threats in settings ranging from hospitals to clinics and the home.