Psychosocial and Behavioral Aspects of Chronic Illness and Medical Rehabilitation
Core concepts
Understand chronic illness as a trajectory involving adjustment, identity change, uncertainty, and grief, and know models such as the common-sense/self-regulation model (illness representations: identity, cause, timeline, consequences, controllability) and stage/trajectory frameworks. Know constructs like health locus of control, illness intrusiveness, stigma, coping (problem- vs. emotion-focused, meaning-making), social support types (instrumental, emotional, informational), and adherence determinants. In rehabilitation, grasp goal-setting (SMART), self-management support, and the biopsychosocial framing of disability (ICF model: impairment, activity limitation, participation restriction). Recognize caregiver burden and the difference between coping styles that help versus those (e.g., avoidance, catastrophizing) that predict worse outcomes.
Traps
Questions often test whether you pathologize normal adjustment-grief and distress after diagnosis are not automatically a disorder. Watch for conflating impairment (body function) with participation restriction (life roles). Another trap: assuming more social support is always better; support can be unhelpful or controlling. Also beware equating adherence with compliance and blaming patients for nonadherence without assessing barriers (cost, regimen complexity, side effects, beliefs).
Worked example
A patient newly diagnosed with diabetes says "my body has betrayed me and nothing I do matters." This reflects illness representations (low controllability, negative consequences) and predicts poor self-management; target beliefs, not just education. Rule of thumb: assess the representation before designing the intervention.
Study tip
Translate vignette language into the underlying construct (representation, coping style, support type) to find the best answer.