Illness perceptions or recurrence risk perceptions: what comes first? A longitudinal examination among cardiac patients

Abstract

Background. Previous research suggested that illness perceptions provide the basis for illness risk perceptions through an inductive reasoning process. The present study assessed the causal direction of relationships between illness and recurrence risk perceptions among cardiac patients. Methods. A longitudinal study was conducted among 116 patients undergoing coronary angioplasty. Self-report questionnaires measured perceived recurrence risk and illness perceptions one day and one month after catheterization. Findings. Cross-lagged Panel Model Analyses revealed that higher perceptions of timeline, consequences, cause (attributing the disease to aging), and emotional representations of illness at hospitalization led to higher risk perceptions one month later. Perceived personal control was the only illness perception with bi-directional causal effects: higher perceived personal control at hospitalization led to higher risk perceptions one month later; and higher risk perceptions at hospitalization led to lower personal control one month later. Conclusions. The findings suggest that the associations between risk and illness perceptions can only partly be explained by inductive reasoning. Affective and defensive processes are suggested as complementary explanations for the observed associations between risk and illness perceptions.