Illness cognition: Using common sense to understand treatment adherence and affect cognition interactions

Howard Leventhal, Michael Diefenbach, Elaine A. Leventhal

Research output: Contribution to journalArticlepeer-review

1060 Scopus citations


We summarize basic empirical themes from studies of adherence to medical regimens and propose a self-regulatory model for conceptualizing the adherence process. The model posits that self-regulation is a function of the representation of health threats and the targets for ongoing coping (symptom reduction, temporal expectancies for change) set by the representation, the procedures to regulate these targets, and the appraisal of coping outcomes. The underlying cognitive mechanism is assumed to function at both a concrete (symptom-based schemata) and abstract level (disease labels), and individuals often engage in biased testing while attempting to establish a coherent representation of a health threat. It also is postulated that cognitive and emotional processes form partially independent processing systems. The coherence of the system, or the common-sense integration of its parts, is seen as crucial for the maintenance of behavioral change. The coherence concept is emphasized in examples applying the model to panic and hypochondriacal disorders.

Original languageEnglish (US)
Pages (from-to)143-163
Number of pages21
JournalCognitive Therapy and Research
Issue number2
StatePublished - Apr 1992

All Science Journal Classification (ASJC) codes

  • Experimental and Cognitive Psychology
  • Clinical Psychology


  • common-sense models
  • illness cognition
  • self-regulation
  • system coherence


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