Understanding the illness representations of young people with anxiety and depression: A qualitative study

Abstract

Background. Many young people with anxiety or depression drop out of treatment early, and/or leave treatment without showing measurably improved symptom levels. To enhance treatment engagement and effectiveness, it is critical to better understand how young people's perceptions of the symptoms, causes, consequences, treatability, and course of their anxiety and depression influence engagement.Aim. This study aimed to provide a qualitative account of illness perceptions among youth with anxiety and depression by applying the Common Sense Model of Self-Regulation (CSM), which was developed in physical health contexts.Methods. Semi-structured interviews were conducted with 26 young people (aged 16-24, 73% female) with a history of anxiety and/or depression. Interviews were analysed using a combination of theory-and data-driven analysis techniques, consisting primarily of deductive thematic analysis.This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

What treatment outcomes matter most? A Q-study of outcome priority profiles among youth with lived experience of depression

“…Profile A expressed a desire to overcome depressive symptoms once and for all, while Profile B conveyed a cyclical understanding of depression and prioritised the acquisition of coping skills. The importance of learning to cope has been a common theme in previous qualitative studies with youth [17-19, 22, 54, 55], including a recent study of youth's cognitive illness representations that identified a similar linkage between perceptions of depression as a cyclical long-term condition and a focus on self-management [56]. Youth in Profile C were disproportionately affected by neurodevelopmental and learning difficulties and struggled with ongoing emotional distress.…”

“…They also appear to vary with regards to young people's beliefs about the timelines of their depression (e.g., acute, chronic, cyclical), their perceived locus of control over symptoms, and the perceived effectiveness of treatment in durably alleviating symptoms. These factors have previously been described to shape an individual's cognitive representation of a health condition, as well as their approach to managing it, including in relation to youth depression [56,59,60].…”

“…Goal setting research shows that youth aspirations are shaped by age, gender, family characteristics, and ethnicity; the socio-political environment; as well as cultural and gender norms [61,62]. Additional research is needed to explore how outcome priorities evolve over time, and to what extent they are influenced by current symptom levels, cognitive representations of depression e.g., [56], and sociocultural factors.…”

How I see is how I feel. Identification of illness perception schema and its association with adaptation outcomes in multiple sclerosis – a 5-year prospective study

“…Worrying about the future starts, along with a subjective assessment of the limitations caused by the illness. Anxious illness perception may be characterized by cognitive errors such as tunnel thinking, which may involve focusing on selective aspects of the illness consistent with subjective perception of the latter [ 79 ]. This may also imply the potential role of metacognitive beliefs about emotional state, which may significantly alter the way of perceiving and experiencing the illness, as suggested in a group of patients with diabetes [ 80 ].…”

A Pluralistic Perspective on Research in Psychotherapy: Harnessing Passion, Difference and Dialogue to Promote Justice and Relevance

“…Other studies have analysed qualitative evidence around how clients, their family members and therapists decide whether therapy has had an effect on depression and has found that these stakeholders make use of a much wider set of outcome criteria than those deployed in research studies (Catchpole, 2020;Chevance et al, 2020;De Smet et al, 2020;Krause et al, 2020a,b). Research into the experience of depression in everyday life has found that lay people possess complex and highly differentiated discourses and frameworks for making sense of recovery from depression (Hänninen and Valkonen, 2019;Llewellyn-Beardsley et al, 2019;Bear et al, 2021), including a range of possible pathways to change (Valkonen et al, 2011). Finally, studies in non-Western cultures observe important differences between the ways that depression is understood in these settings, and the measures used by therapy researchers (Haroz et al, 2017;Vink et al, 2020).…”