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There are limits to which psychoeducational interventions can be simplified without loss of effectiveness in terms of relapse prevention in schizophrenia. Enhanced insight may be associated with increased suicidal ideation.

Objectives. Construct overlap among important variables in health psychology was studied. Competing theories related to the reporting of medically unexplained symptoms (somatization) and illness severity were examined. These objectives were studied in the setting of insulin-dependent diabetes mellitus (IDDM).Design. A correlational design was employed. Sufficient numbers of participants were sought in order to test theoriee of symptom reporting using structural equation modelling and other multivariate techniques.Methods. Two hundred and two people with IDDM attending a diabetes out-patient clinic acted as participants. Personality traits, alexithymia and illness-related coping factors were the key psychological constructs studied. Experience of medically unexplained symptoms (somatization) and diabetes severity were measured.Results. Neuroticism, alexithymia and negative emotion coping were all significantly related to somatization, and there was significant construct overlap. Competing models of symptom reports-transactional versus negative affectivity-were formulated and tested using structural equation modelling. However, the best fitting model was one that integrated features of both. Constructs showed considerable overlap, with evidence for a very general factor related to the reporting of negative affects and bodily disturbances. However, there is also evidence of unique variance in constructs, especially that of negative emotion coping.Conclusions. Important constructs used in health psychology show significant overlap, and this general source of variance warrants further study. Despite overlap, constructs contributed unique variance to health outcomes. Transactional and negative affectivity models of symptom reporting may be reconciled in an integrated model. Generalization of the models tested here to other illness samples and healthy individuals is recommended. Suggestions arc made for further research to refine constructs in health psychology and to limit their present profusion.The effect of psychological processes on health and illness behaviour are currently part of the growing area of health psychology. Various models, processes and *Request for reprints. p < .Ol).

It is widely recognized that psychological factors play a central role in the adjustment process and subsequent management of chronic pain. The role of anxiety, and specifically pain-related fear, has received particular attention. Paralleling developments in the anxiety disorders literature, psychological models of pain-related fear now highlight the importance of cognitive processes in its maintenance and treatment. However, theoretical and treatment advances in the anxiety disorders literature have not been widely applied to the pain field. In particular, certain cognitive processes, specifically safety-seeking behaviours and imagery, which appear to be involved in the maintenance of pain-related fear. This paper explores how these concepts may apply to pain-related fear and demonstrates how they may aid conceptualization and be used to guide a more cognitively orientated and efficacious treatment.who believes that their pain signals damage and who interprets the sensations they experience when they attempt a certain activity as harmful will become fearful of carrying out such activities. Understanding the difference between acute and chronic pain is central to its management and underpins the cognitive-behavioural approach as described in this paper.The role of pain-related fear † in the development and/or maintenance of long-term disability has received much attention in the literature. Fear of pain has been proposed to be more disabling than even the pain itself (Waddell et al. 1993). The object of fear can be wide-ranging, encompassing fears such as the pain itself, movement and (re)injury, long-term disability, loss of identity and social isolation (Morley & Eccleston, 2004). The pain-related-fear literature has developed from a purely behavioural approach (Fordyce et al. 1982; Lethem et al. 1983) to the incorporation and emphasis of cognitive factors. This reflects a similar shift from behavioural to cognitive-behavioural models of anxiety disorders in non-pain populations.Vlaeyen and colleagues' cognitive-behavioural model of pain-related fear (Vlaeyen et al. 1995a, b;Vlaeyen & Linton, 2000) pays attention to cognitive factors, such as pain catastrophizing and hypervigilance, in addition to behavioural factors. The model suggests that a vicious cycle becomes established as a result of negative appraisals about the pain and its consequences (specifically catastrophic thinking and misinterpretation), avoidance of the threat situation/object, hypervigilance to possible signals of threat, subsequent 'deconditioning' of the body as a result of reduced muscular activity, depression and long-term disability. To date, this model has provided the foundation for theory-driven cognitive-behavioural interventions of pain-related fear, with specific foci on education and graded exposure (e.g. Vlaeyen et al. 2002Vlaeyen et al. , 2004. Recent research developments, including a randomized controlled study (Woods & Asmundson, 2007) lend support to the hypotheses proposed in this model and suggest interventions based o...