‘It was all intertwined’: Illness representations and self-management in patients with cancer and anxiety/depression

Objective: Cancer and anxiety/depression frequently co-occur, leading to poorer outcomes for these illnesses. However, the majority of existing research investigates how participants view single illnesses alone. This study aimed to explore the content of individuals’ multimorbid representations and how these relate to their coping behaviours and self-management strategies for cancer and anxiety/depression.

Design: A semi-structured qualitative research design with theoretical thematic analysis.

Main Outcome Measures: Multimorbid illness representations, coping behaviours, and self-management strategies.

Results: In interviews with 21 participants multimorbid representations varied, three participants viewed cancer and anxiety/depression as unrelated, five participants were uncertain about the relationship between cancer and anxiety/depression, and the majority of participants perceived cancer and anxiety/depression as related. This third group of participants often described relationships as causal, with representations having both positive and negative influences on coping behaviours and self-management strategies. Representations were shown to change over the course of the cancer experience, with fear of cancer recurrence and the influence of participants’ most challenging illness also discussed.

Conclusions: People hold multimorbid illness representations that can influence self-management. An awareness of these representations by researchers, health professionals, and patients is important for the creation of future interventions that aim to improve and maintain patient wellbeing.     

The recollective qualities of adolescents’ and adults’ narratives about a long-ago tornado

The recollective qualities of autobiographical memory are thought to develop over the course of the first two decades of life. We used a 9-year follow-up test of recall of a devastating tornado and of non-tornado-related events from before and after the storm, to compare the recollective qualities of adolescents’ (n?=?20, ages 11 years, 11 months to 20 years, 8 months) and adults’ (n?=?14) autobiographical memories. At the time of the tornado, half of the adolescents had been younger than age 6. Nine years after the event, all participants provided evidence that they recall the event of the tornado. Adults also had high levels of recall of the non-tornado-related events. Adolescents recalled proportionally fewer non-tornado-related events; adolescents younger than 6 at the time of the events recalled the fewest non-tornado-related events. Relative to adolescents, adults produced longer narratives. With narrative length controlled, there were few differences in the recollective qualities of adolescents’ and adults’ narrative reports, especially in the case of the tornado; the recollective qualities were stronger among adolescents older at the time of the events. Overall, participants in both age groups provided evidence of the qualities of recollection that are characteristic of autobiographical memory.