Temporal-Experiential Model of Progressive Illness and Unified Self (TEMPUS): Rethinking Psychopathology in Chronic Disease Through Narrative Identity and Self-Coherence / Modelo temporal-experiencial de la enfermedad progresiva y el yo unificado (TEMPUS): un nuevo enfoque de la psicopatología en las enfermedades crónicas a través de la identidad narrativa y la coherencia del yo

Progressive chronic diseases such as heart failure, COPD, chronic kidney disease, and Parkinson’s disease are associated with a substantial psychiatric burden that remains only partly explained by existing psychopathological models. Several limitations may contribute to this gap. Current models often blur the distinction between objective disease severity and subjective experience, give limited attention to how illness reshapes the temporal structure of the self, and rarely offer a clinically useful distinction between depression and demoralization. We introduce TEMPUS (Temporal-Experiential Model of Progressive Illness and Unified Self), a theoretical framework in which psychological vulnerability emerges from disruptions in temporal self-coherence. This construct refers to the capacity to maintain a continuous narrative linking past experience, present functioning, and anticipated future. The model describes interacting components and feedback processes that may help explain why patients with comparable disease severity follow different psychological trajectories. Beyond description, TEMPUS is intended to generate testable hypotheses and inform intervention. It also proposes a clearer distinction between depression and demoralization, with potential implications for clinical decision-making.