Objectives. The self-regulatory model proposes that an individual"s cognitive representations of illness threat (illness representations) influence the selection and performance of strategies to cope with that illness (Leventhal, Meyer & Nerenz, 1980). Also implicit in the model is the proposal that such coping strategies influence illness outcomes. These relationships represent a mediational model (Baron & Kenny, 1986). The aim of the present study was to test the hypothesis that coping strategies partially mediate the relationship between illness representations and illness outcome in women with rheumatoid arthritis.Design and Methods. The study was an observational cross-sectional design. Self-report measures of illness representations, coping strategies, and illness outcome were collected from 125 women with rheumatoid arthritis attending rheumatology outpatient clinics. Clinical measures of disease activity and severity were obtained from hospital records.Results. Avoidant and resigned coping was found to partially mediate the relationship between symptom identity and the illness outcome measures of disability and psychiatric morbidity. As in other studies, strong relationships were found between illness representations and illness outcome.Conclusions. The finding that avoidant and resigned coping partially mediated the relationships between the illness representation dimension of symptom identity and two of the illness outcome measures (disability and psychiatric morbidity) provided some support for the hypothesis.However, the hypothesis was not fully supported, as coping did not partially mediate the relationship between any of the other illness representations and illness outcomes. (1977). Such social-cognition models have been used to help identify the complex processes involved in mediating between disease, pain, disability & adjustment.However this research has been inconclusive, as none of the individual factors studied have consistently predicted health and illness behaviours (Turk, Rudy & Salovey, 1986). Marteau (1993) suggests that this may either be due to inadequacies in the research, or may indicate that the above theories do not contain the cognitions that predict health behaviour and outcomes. In the last decade much attention has been directed towards Leventhal"s self-regulatory model (Leventhal et al. 1980) in the hope that this will provide a more complete model of health behaviour.An advantage of utilising the self-regulatory model with individuals who are diagnosed with a chronic illness is the potential to explore sophisticated responses to an illness from a number of domains. The self-regulatory model proposes that an individual"s cognitive representations of illness threat (illness representations) influence the selection and performance of strategies to cope with that illness, which in turn influence outcome appraisals (Leventhal et al., 1980). Also implicit in the model is the proposal that such coping strategies influence illness outcomes (Leventhal et al., 1980). The mode...

The paper focuses on the psychological consequences of disaster work. The issue of identifying staff who may be more vulnerable to psychological distress is discussed as is the need for services to plan psychological screening and support for staff who will be exposed to the trauma of dealing with the aftermath of disasters. It is concluded that active steps need to be taken to incorporate psychological aspects into disaster planning. Specifically, attention should be paid to staff selection, training, use of resources, supervision, debriefing, counselling and feedback.

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This paper describes the integration of structural family therapy and systemic consultation into an in‐patient paediatric unit. Two case examples illustrate the approach used. It is concluded that six stages are involved in the successful integration of a systemic approach: planning and convening an initial staff meeting, developing a structural hypothesis, enlisting hierarchical support in the ward system, holding the family meeting, reconvening the professional team and disengaging the family and ward system.

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