Author:

Keywords:

Mental health, Chronic illness, Congenital heart disease, type 1 diabetes, illness identity, Social Sciences, Psychology, Multidisciplinary, Psychology, 11 Medical and Health Sciences, 13 Education, 17 Psychology and Cognitive Sciences, Public Health, 42 Health sciences, 52 Psychology

Abstract:

Background. To understand why some patients adjust well to chronic illness, whereas others fail to do so, the present talk focuses on illness identity - or the degree to which chronic illness becomes integrated as part of one’s self. We developed a new questionnaire, the Illness Identity Resolution Scale (IIRS), that distinguishes among four illness identity resolutions (i.e., engulfment, rejection, acceptance, and enrichment). This questionnaire was validated in two chronic illnesses, and relationships between the four illness identity resolutions and psychological and illness-specific functioning were investigated. Methods. Study 1 sampled 276 adults with congenital heart disease (CHD; 22-78 years of age). Study 2 sampled 471 adolescents with type 1 diabetes (T1D; 14-25 years of age). In both studies, participants completed self-report questionnaires. Clinical data were obtained from medical records. Results. Factor analysis indicated that the four illness identity resolutions could be clearly differentiated in both studies. In Study 1 path analysis demonstrated that acceptance was related to adaptive illness perceptions, whereas enrichment, engulfment, and rejection were related to rather maladaptive illness perceptions. Enrichment was also positively related to perceived personal control. Engulfment and rejection were related to maladaptive psychological functioning, whereas acceptance and engulfment were related to adaptive psychological functioning. In Study 2, engulfment was related to maladaptive psychological functioning and more diabetes-related problems. Rejection was related to less treatment adherence. In contrast, acceptance was related to maladaptive psychological functioning, less diabetes-related problems, and better treatment adherence. Finally, enrichment was related to adaptive psychological functioning. Conclusions. The IIRS proved to be a valid questionnaire to assess illness identity in patients with CHD and T1D. Meaningful differential relationships with various outcome variables were obtained.