Chronic Illness and the Life Cycle:A Conceptual Framework |
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Authors: | JOHN S. ROLLAND M.D. |
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Affiliation: | Medical Director, Center for Illness in Families, New Haven CT;Assistant Clinical Professor, Department of Psychiatry, Yale University School of Medicine, New Haven CT. Send reprint requests to 165 Alden Avenue, New Haven CT 06515. |
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Abstract: | This article provides a conceptual framework for thinking about the system created at the interface of chronic illness with the family life cycle. First, a psychosocial typology and time phases of illness schema is described as a necessary, preliminary step to create a common language that bridges the worlds of illness, individual, and family development. This schema organizes similarities and differences between diseases in a manner useful to psychosocial-developmental rather than biomedical inquiry. Then, drawing on several major life-cycle theories in the literature, key concepts (periods of transition, life-structure building and maintaining, centripetality, and centrifugality) are used in a complementary fashion to link these three lines of development. Equipped with these psychosocial languages, consideration is given to transgenerational aspects of illness, loss, and crisis, and the interwoven threads of illness, family, and individual development. Clinical vignettes are provided to highlight this conceptual framework. |
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