Doctorate in Clinical Psychology: Main Research Portfolio
: 1) What is known about the association between illness perceptions and mental health in children and young people with long-term health conditions: a scoping review; 2) Does a skills-based education programme for care coordinators change their attitudes towards and confidence in working with clients with emotionally unstable personality disorder?; 3) Illness perceptions, fear of cancer recurrence and mental health in teenage and young adult cancer survivors.

  • Mike Horwood

Student thesis: Doctoral ThesisDoctor of Clinical Psychology (DClinPsy)


Introduction : The CommonSense Model of illness selfregulation suggests that someone’s cognitive and emotional representations of their illness influence their health outcomes and coping strategies. This model is suggested to underpin illness specific cognitions (including both illness perceptions and a fear of cancer recurrence; FCR). There is evidence in adults of associations between FCR, illness perceptions and mental health in adult cancer survivors. However, despite this theoretical underpinning and evidence in other age groups, there is limited e mpirical research examining these constructs within the developmentally distinct population of teenage and young adult 9 (TYA) survivors of cancer. The current study aimed to bridge that gap to inform potentially modifiable treatment targets in this population. Method: A cross-sectional, correlational design was used to examine the associations between illness perceptions, FCR and mental health. A web-based survey was completed by a convenience sample of TYA cancer survivors, recruited over 14 months (November 2020 - January 2022) via several charities, support groups and social media. Results: The sample consisted of 90 TYA cancer survivors, aged 16-30 years. Overall, more negative illness perceptions were associated with more severe FCR and greater depressive and anxiety symptomatology (r > 0.4, p ≤ .01). Higher FCR was predictive of worse overall mental health. More negative overall illness perceptions predicted the relationship between FCR-Depression (β = .110, p = .036), mediating 24.1% of the variance (p ≤. 01). Contrastingly, overall illness perceptions did not predict or mediate the relationship between FCR-Anxiety. However, the specific illness perceptions regarding timeline (β = -.393, p = .023), personal control (β = .409, p = .040), and emotional representation (β = .798, p = .004), were predictive of the FCR-Anxiety relationship. Conclusions: In line with the Common-Sense Model, both illness perceptions and FCR were predictive of mental health outcomes. Identifying and therapeutically targeting negative illness perceptions in those young adults who have survived teenage cancer could therefore be a means of reducing anxiety and depressive symptomatology. Further work is needed using longitudinal and experimental methods to develop this understanding and inform future clinical interventions.
Date of Award10 Oct 2022
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorMaria Loades (Supervisor) & Cara Davis (Supervisor)

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