Common sense representations of common illnesses.

Evidence is provided that common sense representations of common illnesses involve five components: (1) a label; (2) consequences; (3) a time line; (4) a cause; and (5) a cure. The last two components, attributions for getting sick and for getting better, can be conceptualized along the familiar dimensions of stability, locus, and controllability. The content of schemas for one's most recent illness are shown to have small but significant effects on changes in health locus of control beliefs but not on preventive health behaviors. It is suggested that if people consistently employ the same schemas for every disease they experience, then cumulatively schematic processing could have very large effects on health beliefs and health behaviors. It is further suggested that if the same illness schemas are employed when major diseases are encountered, then schemas based on the experience of minor illnesses could have dramatic and much more immediate effects on morbidity and mortality. The germ model of disease suggests that people get sick when an external, organic agent (a germ) somehow invades the body. When people are sick, they experience unpleasant symptoms, which motivates them to visit a physician. The physician cures the disease by killing the germs, often with the purposive introduction of another external organic agent, a drug or medicine. However, health researchers have long known that this simple germ model of disease is not a very satisfactory representation of the disease experience for many of us. People's subjective experience with any given disease varies a great deal more than is suggested by the simple determinacy of the germ model. For example, people differ in how frequently they complain about different symptoms (Desroches, Kaiman, Suchman, 1965; Zborowski, 1952; Zola, 1966) and in their propensity to